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SÍNTESE, FOTORREATIVIDADE E INTERAÇÃO COM DNA DE UM NOVO COMPLEXO DE RUTÊNIO PROTÓTIPO PARA O DESENVOLVIMENTO DE AGENTES FOTOQUIMIOTERAPÊUTICOS SÍNTESE
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Pereira, Walysson Gomes

; Martins, Patrícia Helenita Rocha

; Martins Filho, Paulo Eduardo Cavalcanti

; Paulo, Tércio Freitas

; Diógenes, Izaura Cirino Nogueira

; Sousa, Eduardo Henrique Silva

; Lopes, Luiz Gonzaga de França

Química Nova

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2024, Volume 47 Nº 6 elocation e-20240008

Resumo: Pt | Texto: Pt | PDF: Pt

A new ruthenium polypyridine complex, cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6)2 (WP1), where 1-meimN and pyCHO are the ligands 1-methylimidazole and 4-pyridinecarboxaldehyde, respectively, was prepared as a prototype for use in phototherapeutic process. This compound was characterized by electronic absorption in UV-Visible, FTIR, 1H and 13C NMR, cyclic voltammetry, besides DFT that supported its molecular structure. The compound WP1 was photoreactive, where blue or green light promoted the release of 4-pyCHO ligand. Additionally, this compound was able to interact with DNA, mainly through electrostatic interactions showing photoinduced nuclease activity. There is also photoproduction of superoxide ions using blue or green light suggesting a route for DNA damage. These promising results opened new opportunities for the potential use of this system and analogues as phototherapeutic agents, which is an ongoing study in our lab. complex cisRubpy21meimN4pyCHOPF62 cisRubpymeimNpyCHOPF cis Ru bpy 2 1 meimN 4 PF6 PF cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6) WP1, WP , (WP1) 1meimN 1methylimidazole methylimidazole 4pyridinecarboxaldehyde, 4pyridinecarboxaldehyde pyridinecarboxaldehyde pyridinecarboxaldehyde, 4-pyridinecarboxaldehyde respectively process UVVisible, UVVisible UV Visible, Visible UV-Visible FTIR H C NMR voltammetry structure photoreactive 4pyCHO ligand Additionally activity damage agents lab cisRubpy pyCHOPF cisRubpy21meimN4pyCHOPF6 cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6 (WP1 cisRubpy21meimN4pyCHOPF cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF (WP

https://doi.org/10.21577/0100-4042.20240008

Growth performance, reproductive status, and chromosomal instability in triploid Nile tilapias performance status
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Menezes, Williane Ferreira

; Alvarenga, Érika Ramos

; Nóbrega, Rafael Henrique

; França, Luiz Renato

; Luz, Marcelo Rezende

; Manduca, Ludson Guimarães

; Costa, Franklin Fernando Batista da

; Bezerra, Vinícius Monteiro

; Fernandes, Arthur Francisco de Araújo

; Turra, Eduardo Maldonado

Animal Reproduction

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2024, Volume 21 Nº 2 elocation e20230147

Resumo: En | Texto: En | PDF: En

Abstract Reproductive control is one of the biggest challenges in tilapia production and triploidy was developed as an alternative to sterilization. In general, polyploids present chromosomal instability but for triploid Nile tilapia it has yet to be reported. This study evaluated the chromosomal instability from juveniles to adulthood, growth performance and gonadal status of tilapia hatched from eggs submitted or not to heat shock for triploid induction. Nile tilapia oocytes were fertilized (1,476 oocytes), half of the eggs were subjected to a four-minute shock in 41 °C water four minutes after fertilization and the other half were not (Control group). The eggs were incubated (at 27°C) and 160 larvae from the treated group hatched and survived after yolk sac absorption. The determination of ploidy was performed by flow cytometry at 85th (juveniles) and 301st (adults) days of age post yolk sac absorption. At the time of the first cytometry analysis there were 73 surviving juveniles from the treated group, and only 14 were confirmed triploid. However, at the analysis of adult ploidy, one out of 8 surviving adult tilapias from the 14 confirmed triploid juveniles remained triploid. Gonadal histology showed that the non-remaining triploids continued to produce gametes. The growth performance of triploid tilapia was initially superior to that of diploid tilapia during the juvenile phase, but similar in adults. Once the chromosome sets are lost and the tilapias become diploid again, at least in tissues with a high proliferation rate, such as the hematopoietic tissue that was analyzed (and possibly in gonads), all possible advantages of triploids are probably lost. Thus, our results suggest that, due to genomic instabilities, the triploid generation of tilapia has low efficiency. sterilization general reported adulthood induction 1,476 1476 1 476 (1,47 oocytes, , oocytes) fourminute minute 4 C Control group. . group) 27°C 27C 27 16 absorption th (juveniles st adults (adults 7 However nonremaining non remaining gametes phase again rate gonads, gonads gonads) Thus instabilities efficiency 1,47 147 47 (1,4 2 1,4 (1, 1, (1 (

https://doi.org/10.1590/1984-3143-ar2023-0147

We are Living on the Edge: Managing Extreme-Severity Claims Using Extreme Value Theory Edge ExtremeSeverity Severity
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Carvalho, João Vinícius França

; Oliveira, Luiz Henrique Alves

BBR. Brazilian Business Review

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2024, Volume 21 Nº 3 elocation e20221245

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

Abstract Claims with high severity and low probability constitute a high risk for the insurance market. One tool to deal with this kind of event is the Extreme Value Theory (EVT). The main goal of this article is to apply the EVT to Actuarial Science using a different estimator for parameters, allowing the calculation of pure reinsurance premiums and the choice for the retention limit for insurance companies. The execution was split into two parts: (i) comparing the estimators through simulations, and; (ii) using data from 5 SUSEP lines of business with different natures, intending to estimate some extreme value statistics. In simulation studies, the Pickands estimator was very promising, but the limited amount of data resulted in a great variance when applied to real cases. Lastly, we concluded that the EVT is a powerful tool for insurance, capturing the behavior of extreme clams amount better than traditional models. market EVT. . (EVT) parameters companies parts i (i simulations ii (ii natures statistics studies promising cases Lastly models (EVT

Resumo Ocorrências de altíssimo valor monetário e baixíssima probabilidade constituem grandes riscos no mercado segurador. Uma ferramenta para análise de eventos dessa natureza é a Teoria de Valores Extremos (TVE). O objetivo deste trabalho é aproximar a TVE das Ciências Atuariais, utilizando diferentes estimadores de parâmetros, possibilitando o cálculo de prêmios de resseguro e a escolha do limite de retenção ideal para seguradoras. A execução foi em duas etapas: (i) comparando os estimadores em simulações, e; (ii) usando microdados reais oriundos de 5 ramos SUSEP de naturezas distintas, com o intuito de estimar estatísticas de valores extremos. Em geral, o estimador de Momentos foi o mais consistente de todos. O estimador de Pickands nas simulações apresentou resultados promissores, mas a quantidade restrita de dados e sua grande variância o tornam inconstante na aplicação aos dados reais. Finalmente, observou-se que a TVE é um poderoso ferramental para a área de seguros, melhor capturando o comportamento de sinistros extremos do que métodos tradicionais. segurador TVE. . (TVE) Atuariais parâmetros seguradoras etapas i (i ii (ii distintas geral todos promissores Finalmente observouse observou se seguros tradicionais (TVE

https://doi.org/10.15728/bbr.2022.1245.en

Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves

; Guimarães, Camila

; Rêgo, Jozelia

; Machado, Ketty Lysie Libardi Lira

; Miyamoto, Samira Tatiyama

; Burian, Ana Paula Neves

; Dias, Laiza Hombre

; Pretti, Flavia Zon

; Batista, Danielle Cristina Filgueira Alves

; Mill, José Geraldo

; Oliveira, Yasmin Gurtler Pinheiro de

; Gadelha, Carolina Strauss Estevez

; Gouveia, Maria da Penha Gomes

; Moulin, Anna Carolina Simões

; Souza, Bárbara Oliveira

; Aguiar, Laura Gonçalves Rodrigues

; Vieira, Gabriel Smith Sobral

; Grillo, Luiza Lorenzoni

; Lima, Marina Deorce de

; Pasti, Laís Pizzol

; Surlo, Heitor Filipe

; Faé, Filipe

; Moulaz, Isac Ribeiro

; Macabú, Mariana de Oliveira

; Ribeiro, Priscila Dias Cardoso

; Magalhães, Vanessa de Oliveira

; Aguiar, Mariana Freitas de

; Biegelmeyer, Erika

; Peixoto;, Flávia Maria Matos Melo Campos

; Kayser, Cristiane

; Souza, Alexandre Wagner Silva de

; Castro, Charlles Heldan de Moura

; Ribeiro, Sandra Lúcia Euzébio

; Telles, Camila Maria Paiva França

; Bühring, Juliana

; Lima, Raquel Lima de

; Santos, Sérgio Henrique Oliveira Dos

; Dias, Samuel Elias Basualto

; Melo, Natália Seixas de

; Sanches, Rosely Holanda da Silva

; Boechat, Antonio Luiz

; Sartori, Natália Sarzi

; Hax, Vanessa

; Dória, Lucas Denardi

; Rezende, Rodrigo Poubel Vieira de

; Baptista, Katia Lino

; Fortes, Natália Rodrigues Querido

; Melo, Ana Karla Guedes de

; Melo, Tâmara Santos

; Vieira, Rejane Maria Rodrigues de Abreu

; Vieira, Adah Sophia Rodrigues

; Kakehasi, Adriana Maria

; Tavares, Anna Carolina Faria Moreira Gomes

; Landa, Aline Teixeira de

; Costa, Pollyana Vitoria Thomaz da

; Azevedo, Valderilio Feijó

; Martins-Filho, Olindo Assis

; Peruhype-Magalhães, Vanessa

; Pinheiro, Marcelo de Medeiros

; Monticielo, Odirlei André

; Reis-neto, Edgard Torres Dos

; Ferreira, Gilda Aparecida

; Souza, Viviane Angelina de

; Teixeira-Carvalho, Andréa

; Xavier, Ricardo Machado

; Sato, Emilia Inoue

; Valim, Valeria

; Pileggi, Gecilmara Salviato

; Silva, Nilzio Antonio da

Advances in Rheumatology

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2024, Volume 64 elocation 58

Resumo: En | Texto: En | PDF: En

Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26

https://doi.org/10.1186/s42358-024-00397-5

Perceptions of childhood immunization in São Paulo: quantitative-qualitative cross-sectional study Paulo quantitativequalitative quantitative qualitative crosssectional cross sectional
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Costa, Lucas de Brito

; França, Carolina Nunes

; Nali, Luiz Henrique da Silva

; Colombo-Souza, Patrícia

; Novo, Neil Ferreira

; Juliano, Yára

Sao Paulo Medical Journal

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2024, Volume 142 Nº 6 elocation e2023447

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Vaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum. OBJECTIVES: This study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization. DESIGN AND SETTING: A cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023. METHODS: This study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0–12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias. RESULTS: Marked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%). CONCLUSIONS: This study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations. BACKGROUND COVID19. COVID19 COVID 19 . (COVID-19) Brazil convenience Program vaccines antivaccine anti momentum OBJECTIVES COVID-1 immunization SETTING crosssectional cross sectional Paulo 2023 METHODS 0–12 012 0 12 (0–1 years locations 5 15 bias RESULTS sex race income education religion 52%, 52 52% , (52%) occurred 58%. 58 58% (58%) CONCLUSIONS decisions policies immunizations COVID1 1 (COVID-19 COVID- 202 0–1 01 (0– (52% (58% (COVID-1 20 0– (0 (52 (58 (COVID- 2 ( (5 (COVID

https://doi.org/10.1590/1516-3180.2023.0447.r1.05062024

Executive functions, mental health, and quality of life in healthy older adults functions health
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Verga, Cássia Elisa Rossetto

; Santos, Gabriela dos

; Ordonez, Tiago Nascimento

; Moreira, Ana Paula Bagli

; Costa, Laydiane Alves

; Moraes, Luiz Carlos de

; Lessa, Patrícia

; Cardoso, Neide Pereira

; França, Gustavo Domingos

; Ferri Neto, Ambrósio

; Gutierrez, Beatriz Aparecida Ozello

; Silva, Henrique Salmazo da

; Brucki, Sonia Maria Dozzi

; Silva, Thais Bento Lima da

Dementia & Neuropsychologia

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2024, Volume 18 elocation e20240156

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

RESUMO O envelhecimento populacional traz consigo inúmeros desafios, especialmente no que diz respeito à saúde cognitiva. Nesse contexto, fatores socioeconômicos como a educação têm recebido atenção especial em razão do seu papel na saúde cerebral. Objetivo: Este estudo teve como objetivo descrever o desempenho das funções executivas, variáveis de saúde mental e qualidade de vida entre idosos saudáveis em relação ao seu nível de educação. Métodos: Foi realizado um estudo descritivo e transversal com participantes de 60 anos ou mais. O protocolo de avaliação incluiu o Exame Cognitivo de Addenbrooke e Teste de Fluência Verbal (FAS), Testes de Trilhas A e B, Escala de Controle, Autonomia, Autorrealização e Prazer (CASP-19), bem como a Escala de Depressão, Ansiedade e Estresse. Resultados: Foram encontradas diferenças significativas no desempenho das funções executivas entre idosos com níveis mais elevados de educação. No entanto, variáveis de saúde mental e qualidade de vida estavam relacionadas apenas à idade dos participantes. Conclusão: O estudo mostrou que a saúde mental e a qualidade de vida não são influenciadas pelo nível de educação dos participantes, mas sim fortemente correlacionadas com a idade. desafios cognitiva contexto cerebral Objetivo Métodos 6 FAS, FAS , (FAS) B Controle Autonomia CASP19, CASP19 CASP 19 (CASP-19) Depressão Estresse Resultados entanto Conclusão (FAS CASP1 1 (CASP-19 (CASP-1 (CASP- (CASP

ABSTRACT Population aging brings about numerous challenges, particularly concerning cognitive health. In this context, socioeconomic factors such as education have received special attention due to their role in brain health. Objective: The aim of this study was to describe the performance of executive functions, mental health variables, and quality of life among healthy older adults in relation to their level of education. Methods: A descriptive, cross-sectional study was conducted with participants aged 60 or older. The assessment protocol included Addenbrooke’s cognitive examination and FAS, trail-making tests A and B, Control, Autonomy, Self-Realization, and Pleasure Scale (CASP-19), as well as the depression, anxiety, and stress scale. Results: Significant differences were found in the performance of executive functions among older adults with higher levels of education. However, mental health and quality of life variables were only related to participants’ age. Conclusion: The study showed that mental health and quality of life are not influenced by participants’ level of education but are instead strongly correlated with age. challenges context Objective Methods descriptive crosssectional cross sectional 6 Addenbrookes Addenbrooke s FAS trailmaking trail making B Control Autonomy SelfRealization, SelfRealization Self Realization, Realization Self-Realization CASP19, CASP19 CASP 19 , (CASP-19) depression anxiety scale Results However age Conclusion CASP1 1 (CASP-19 (CASP-1 (CASP- (CASP

https://doi.org/10.1590/1980-5764-dn-2024-0156

Guidelines for the use and interpretation of Alzheimer’s disease biomarkers in clinical practice in Brazil: recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology Alzheimers Alzheimer s Brazil
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Studart Neto, Adalberto

; Barbosa, Breno José Alencar Pires

; Coutinho, Artur Martins

; Souza, Leonardo Cruz de

; Schilling, Lucas Porcello

; Silva, Mari Nilva Maia da

; Castilhos, Raphael Machado

; Bertolucci, Paulo Henrique Ferreira

; Borelli, Wyllians Vendramini

; Gomes, Hélio Rodrigues

; Fernandes, Gustavo Bruniera Peres

; Barbosa, Maira Tonidandel

; Balthazar, Marcio Luiz Figueredo

; Frota, Norberto Anízio Ferreira

; Forlenza, Orestes Vicente

; Smid, Jerusa

; Brucki, Sonia Maria Dozzi

; Caramelli, Paulo

; Nitrini, Ricardo

; Engelhardt, Eliasz

; Resende, Elisa de Paula França

Dementia & Neuropsychologia

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2024, Volume 18 elocation e2024C001

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

RESUMO Nos últimos anos, a precisão diagnóstica da doença de Alzheimer tem sido aprimorada pelo desenvolvimento de diferentes tipos de biomarcadores que indicam a presença dos processos neuropatológicos. Além de melhorar a seleção de pacientes para ensaios clínicos, os biomarcadores podem avaliar os efeitos de novos tratamentos nos processos patológicos. No entanto, há preocupação com o uso indiscriminado e mal fundamentado de biomarcadores, especialmente em indivíduos assintomáticos ou com declínio cognitivo subjetivo. As dificuldades na interpretação desses testes, os altos custos e o acesso desigual tornam esse cenário ainda mais desafiador no cuidado assistencial. Neste artigo, são apresentadas as recomendações do Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia quanto ao uso racional e interpretação de biomarcadores da doença de Alzheimer na prática clínica. O diagnóstico clínico da síndrome cognitivo-comportamental é recomendado como o passo inicial para orientar a solicitação de biomarcadores. anos neuropatológicos clínicos patológicos entanto subjetivo testes assistencial artigo clínica cognitivocomportamental comportamental

ABSTRACT In recent years, the diagnostic accuracy of Alzheimer’s disease has been enhanced by the development of different types of biomarkers that indicate the presence of neuropathological processes. In addition to improving patient selection for clinical trials, biomarkers can assess the effects of new treatments on pathological processes. However, there is concern about the indiscriminate and poorly supported use of biomarkers, especially in asymptomatic individuals or those with subjective cognitive decline. Difficulties interpreting these tests, high costs, and unequal access make this scenario even more challenging in healthcare. This article presents the recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology (Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia) regarding the rational use and interpretation of Alzheimer’s disease biomarkers in clinical practice. The clinical diagnosis of cognitive-behavioral syndrome is recommended as the initial step to guide the request for biomarkers. years Alzheimers Alzheimer s processes trials However decline tests costs healthcare Departamento practice cognitivebehavioral behavioral

https://doi.org/10.1590/1980-5764-dn-2024-c001

Use of anti-amyloid therapies for Alzheimer’s disease in Brazil: a position paper from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology antiamyloid anti amyloid Alzheimers Alzheimer s Brazil
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Barbosa, Breno José Alencar Pires

; Resende, Elisa de Paula França

; Castilhos, Raphael Machado

; Borelli, Wyllians Vendramini

; Frota, Norberto Anízio Ferreira

; Balthazar, Marcio Luiz Figueredo

; Amato Filho, Augusto Celso Scarparo

; Smid, Jerusa

; Barbosa, Maira Tonidandel

; Coutinho, Artur Martins

; Souza, Leonardo Cruz de

; Schilling, Lucas Porcello

; Silva, Mari Nilva Maia da

; Fernandes, Gustavo Bruniera Peres

; Bertolucci, Paulo Henrique Ferreira

; Nitrini, Ricardo

; Engelhardt, Eliasz

; Forlenza, Orestes Vicente

; Caramelli, Paulo

; Brucki, Sonia Maria Dozzi

; Studart Neto, Adalberto

Dementia & Neuropsychologia

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2024, Volume 18 elocation e2024C002

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

RESUMO Novas terapias para a doença de Alzheimer, particularmente os anticorpos monoclonais antiamiloides como o lecanemab e o donanemab, demonstraram benefícios clínicos modestos, mas também riscos significativos. O presente artigo destaca os desafios do acesso ao diagnóstico, da relação custo-eficácia, da segurança e da necessidade de maior representação de populações diversas em ensaios clínicos. As recomendações incluem seleção cuidadosa dos pacientes, análise de risco-benefício e a importância da patologia amiloide comprovada para o tratamento. Trabalhos futuros envolvem mais pesquisas sobre terapias antiamiloides no Brasil e o desenvolvimento de tratamentos mais eficazes para a doença de Alzheimer. Alzheimer donanemab modestos significativos diagnóstico custoeficácia, custoeficácia custo eficácia, eficácia custo-eficácia pacientes riscobenefício risco benefício tratamento

ABSTRACT Novel therapies for Alzheimer’s disease, particularly anti-amyloid drugs like lecanemab and donanemab, have shown modest clinical benefits but also significant risks. The present paper highlights the challenges of access to diagnosis, cost-effectiveness, safety, and the need for more representation of diverse populations in clinical trials. Recommendations include careful patient selection, risk-benefit analysis, and the importance of proven amyloid pathology for treatment. Future work involves further research on anti-amyloid therapies in Brazil and the development of more effective treatments for Alzheimer’s disease. Alzheimers Alzheimer s disease antiamyloid anti donanemab risks diagnosis costeffectiveness, costeffectiveness cost effectiveness, effectiveness cost-effectiveness safety trials selection riskbenefit risk benefit analysis treatment

https://doi.org/10.1590/1980-5764-dn-2024-c002

Evaluation of in-vitro susceptibility of ß-lactam-resistant Gram-negative bacilli to ceftazidime-avibactam and ceftolozane-tazobactam from clinical samples of a general hospital in southern Brazil invitro vitro ßlactamresistant ß lactam resistant Gramnegative Gram negative ceftazidimeavibactam ceftazidime avibactam ceftolozanetazobactam ceftolozane tazobactam
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Carvalho, Thaisa Noceti

; Kobs, Vanessa Cristine

; Hille, Daniela

; Deglmann, Roseneide Campos

; Melo, Luiz Henrique

; França, Paulo Henrique Condeixa de

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0277-2022

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance. Methods: Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The β-lactamase-encoding genes were investigated using polymerase chain reaction. Results: High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common. Conclusions: C/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively). Background carbapenemase extendedspectrum extended spectrum βlactamase β lactamase ESBLproducing ESBL producing gramnegative gram negative (GNB patients invitro vitro βlactamresistant lactam resistant ceftazidimeavibactam ceftazidime avibactam CA C A (C/A ceftolozanetazobactam ceftolozane tazobactam C/T, CT , T (C/T) Methods Overall 10 analyzed method MIC50/90 MIC5090 MIC MIC50 90 (MIC50/90 Etest Etest® βlactamaseencoding encoding reaction Results 100% 100 (100 973 97 3 97.3 838 83 8 83.8 BRCAST respectively carbapenemresistant carbapenem P 92.3% 923 92 (92.3 872 87 2 87.2% respectively. . Carbapenemaseproducing Carbapenemase 80% 80 (80% 93.4%. 934 93.4% 93 4 (93.4%) K metalloβlactamaseproducing metallo 44.9% 449 9 (44.9% CTXM CTX M common Conclusions phenotypes metalloβlactamases. metalloβlactamases lactamases. lactamases metallo-β-lactamases C/Tresistant CTresistant 62.5% 625 62 5 (62.5 774 77 77.4% (C/T 1 MIC50/9 MIC509 MIC5 (MIC50/9 (10 97. 83. 92.3 (92. 87.2 (80 93.4 (93.4% 44.9 (44.9 Tresistant 62.5 6 (62. 7 77.4 MIC50/ (MIC50/ (1 92. (92 87. (8 93. (93.4 44. (44. 62. (62 77. (MIC50 ( (9 (93. (44 (6 (MIC5 (93 (4 (MIC

https://doi.org/10.1590/0037-8682-0277-2022

10.

Diálogos interinstitucionais na judicialização da saúde como estratégia de sustentabilidade do SUS
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Calixto, Fabiana

; Almeida, Ana Paula

; França, Luiz Henrique

Saúde em Debate

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Dez 2022, Volume 46 Nº 135 Páginas 1015 - 1029

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

RESUMO Este estudo teve por objetivo explorar as estratégias dialógicas adotadas na condução dos processos de saúde ajuizados pela Defensoria Pública no município de Barreiras-BA, de modo a demonstrar que o caráter complexo e policêntrico da judicialização exige uma atuação articulada entre os atores envolvidos, voltada à garantia de sustentabilidade do Sistema Único de Saúde. Adotou-se, para tanto, metodologia descritiva e retrospectiva, com foco em base documental. Os dados foram obtidos a partir de uma relação de processos elaborada pela Defensoria Pública atuante no município, seguida da consulta da íntegra dos autos no site do Tribunal de Justiça da Bahia. Foram analisados 94 processos, ajuizados entre janeiro de 2019 a dezembro de 2021. A análise das práticas dialógicas teve como referencial a Teoria da Ação Comunicativa de Habermas. Concluiu-se que a Defensoria possui protagonismo na etapa pré-processual, buscando, em um agir comunicativo, a resolução extrajudicial dos conflitos. Por outro lado, a postura dos órgãos destinatários demonstrou falha na gestão pública da saúde, que age de forma estratégica e não tem a resolução extrajudicial como prioridade. Restou evidente, ademais, a necessidade de fortalecimento do Núcleo de Apoio Técnico do Poder Judiciário (NAT-Jus), ainda pouco consolidado no Judiciário baiano.

ABSTRACT This study aims to explore the dialogic strategies adopted in the conduct of health processes filed by the Public Defender’s Office in Barreiras-BA, in order to demonstrate that the complex and polycentric character of judicialization requires an articulated action between the actors involved, aimed at guaranteeing the sustainability of the Unified Health System. A descriptive and retrospective methodology was adopted, focusing on a documental basis. The data were obtained from a list of cases prepared by the Public Defender’s Office operating in the municipality, followed by consultation of the entirety of the records on the website of the Court of Justice of Bahia. 94 cases were analyzed, filed between January 2019 and December 2021. The analysis of dialogic practices was based on Habermas’ Theory of Communicative Action. It was concluded that the Defender’s Office has a leading role in the pre-procedural stage, seeking, in a communicative action, the extrajudicial resolution of conflicts. On the other hand, the attitude of Organs recipient bodies showed a failure in public health management, which acts strategically and does not have extrajudicial resolution as a priority. Furthermore, the need to strengthen the NAT-Jus remained evident, which is still poorly consolidated in the Bahian Judiciary.

https://doi.org/10.1590/0103-1104202213505

11.

Diálogos interinstitucionais na judicialização da saúde como estratégia de sustentabilidade do SUS
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Calixto, Fabiana

; Almeida, Ana Paula

; França, Luiz Henrique

Saúde em Debate

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Dez 2022, Volume 46 Nº 135 Páginas 1015 - 1029

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

https://doi.org/10.1590/0103-1104202213505

12.

Declínio cognitivo subjetivo, comprometimento cognitivo leve e demência - diagnóstico sindrômico: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia
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Smid, Jerusa

; Studart-Neto, Adalberto

; César-Freitas, Karolina Gouveia

; Dourado, Marcia Cristina Nascimento

; Kochhann, Renata

; Barbosa, Breno José Alencar Pires

; Schilling, Lucas Porcello

; Balthazar, Márcio Luiz Figueiredo

; Frota, Norberto Anízio Ferreira

; Souza, Leonardo Cruz de

; Caramelli, Paulo

; Bertolucci, Paulo Henrique Ferreira

; Chaves, Márcia Lorena Fagundes

; Brucki, Sonia Maria Dozzi

; Nitrini, Ricardo

; Resende, Elisa de Paula França

; Vale, Francisco Assis Carvalho

Dementia & Neuropsychologia

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Set 2022, Volume 16 Nº 3 Páginas 1 - 24

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

RESUMO Este consenso realizado pela Academia Brasileira de Neurologia (ABN) abordará de maneira prática como avaliar pacientes com queixas cognitivas e como realizar o diagnóstico clínico e etiológico das três síndromes clínicas associadas aos estágios de declínio cognitivo: declínio cognitivo subjetivo (DCS), comprometimento cognitivo leve (CCL) e demência. O diagnóstico de DCS é discutido pela primeira vez em consenso da ABN e as atualizações para o diagnóstico de CCL e demência são abordadas, bem como a recomendação para o uso de testes cognitivos apropriados, investigação etiológica pertinente e cuidados aos pacientes com declínio cognitivo nos diferentes níveis de atenção do Sistema Único de Saúde. Foi realizada pesquisa dos principais instrumentos de avaliação utilizados em nosso meio e na América Latina.

ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.

https://doi.org/10.1590/1980-5764-dn-2022-s101pt

13.

National Brazilian survey on the outcomes of hepatitis c retreatment in patients non-responders to direct antiviral agents
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Ferraz, Maria Lúcia Gomes

; Piccoli, Leonora de Zorzi

; Rezende, Rosamar

; Borba, Luiz Augusto

; Pissaia Junior, Alcindo

; Cheinquer, Hugo

; Silva, Giovanni Faria

; Ferreira, Paulo Roberto Abrão

; Villela-Nogueira, Cristiane Alves

; Mazo, Daniel Ferraz

; Souza, Fernanda Fernandes

; Codes, Liana

; Ivantes, Claudia Alexandra Pontes

; Gomide, Geisa Perez Medina

; Pereira, Gustavo Henrique Santos

; Pessôa, Mário Guimarães

; França, Alex Vianey Callado

; Pinto, Arlene dos Santos

; Teixeira, Rosângela

; Bittencourt, Paulo Lisboa

Brazilian Journal of Infectious Diseases

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2022, Volume 26 Nº 4 elocation 102388

Resumo: En | Texto: En | PDF: En

ABSTRACT Background and aims: Treatment of hepatitis C with direct antiviral agents (DAA) is associated with almost 95% of sustained virological response. However, some patients need retreatment. In Brazil, it should be done according to the Ministry of Health guidelines, frequently updated to include newly available drugs. This study aimed to conduct a national survey about the characteristics and outcomes of retreatment of hepatitis C in previously non-responders to DAAs. Patients and methods: Institutions from all over the country were invited to participate in a national registry for retreatment, including information about clinical and epidemiological characteristics of the patients, type and outcomes of retreatment regimens. Only patients previously treated with interferon-free regimens were included. Results: As previous treatments the distribution was: SOF/DCV (56%), SOF/SIM (22%), 3D (11%), SOF/LED (6%) and SOF/RBV (5%). For retreatment the most frequently used drugs were SOF/GP (46%), SOF/DCV (23%) and SOF/VEL (11%). From 159 patients retreated, 132/159 (83%) had complete information in the registry and among them only seven patients were non-responders (SVR of 94.6%). All retreatments were well tolerated, without any serious adverse events or interruptions. Conclusion: The retreatment of patients previously non-responders to DAAs was associated with high rate of SVR in this sample of Brazilian patients. This finding allows us to conclude that the retreatment options available in the public health system in Brazil are effective and safe and are an important component of the strategy of elimination of hepatitis C in our country.

https://doi.org/10.1016/j.bjid.2022.102388

14.

Low frequency of SARS-CoV2 infection in daycare centers during the reopening of school activities in the Southeast’s poor area of Brazil
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Soares, Graciela dos Santos

; Morais, Lucas Vinicius

; Silva, Kevin Cézar Nascimento

; Ferreira, Elaine Moura

; Shio, Marina Tiemi

; Romano, Camila Malta

; Conde, Carla Regiani

; Sabino, Ester Cerdeira

; França, Carolina Nunes

; Nali, Luiz Henrique

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e46

Resumo: En | Texto: En | PDF: En

ABSTRACT SARS-Cov2 has already infected over 482 million people and caused more than 6.1 million deaths. The beginning of the pandemic has led the health authorities of several countries to adopt non-pharmacological preventive measures such as daycare closures. The reopening took place when the country had the highest rates of infection and mortality (mainly due to the gamma variant (P.1) outbreak) and the beginning of the vaccination program. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycare after educational activities resumed. The study was conducted in seven childcare facilities. Swab samples from the nasopharynx were collected from children and staff members. The viral RNA was obtained through PureLink RNA extraction kit purification and SARS-CoV2 presence was detected using the All plex SARS-CoV2 kit. The study population included 201 participants, including daycare workers and children. The average age of the workers and children is 40 and 3 years old, respectively. Among the children, 47.5% are female and among the workers, 91.4%. One (0.5%) test came out positive for the presence of SARS-CoV-2, which was from a sample of an asymptomatic childcare worker, and no secondary infections were detected. Considering that the return to daycare activities occurred during a period with a high number of deaths and a lack of vaccines throughout the country, the small number of cases indicates the effectiveness of the several preventive measures used by daycare centers in preventing SARS-CoV2 transmission.

https://doi.org/10.1590/s1678-9946202264046

15.

ABO blood group system and occurrence of ischemic stroke
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LOTZ, Rafaella Chiodini

; WELTER, Carolina da Silveira

; RAMOS, Silvia Aparecida

; FERREIRA, Leslie Ecker

; CABRAL, Norberto Luiz

; FRANÇA, Paulo Henrique Condeixa de

Arquivos de Neuro-Psiquiatria

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Dez 2021, Volume 79 Nº 12 Páginas 1070 - 1075

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

RESUMO Antecedentes: O acidente vascular cerebral isquêmico (AVCI) é uma doença multifatorial que apresenta altas taxas de morbimortalidade no Brasil. Vários estudos provaram que existe uma ligação entre o sistema ABO de grupos sanguíneos e a ocorrência de eventos trombóticos. No entanto, sua associação com AVCI não está bem estabelecida. Objetivo: Por essa razão, o objetivo deste trabalho foi investigar a relação entre os grupos sanguíneos ABO e a ocorrência de AVCI em uma coorte brasileira de doenças cerebrovasculares. Métodos: Ao longo de 12 meses foram incluídos 529 indivíduos, dos quais 275 apresentaram um episódio de AVCI e 254 compuseram o grupo controle. Amostras de sangue foram coletadas para sorotipagem direta e reversa. Os grupos controle e AVCI foram comparados em relação aos fatores de risco tradicionais e à distribuição dos grupos sanguíneos ABO. Resultados: O grupo AVCI apresentou maior prevalência de hipertensão arterial sistêmica (HAS), diabetes mellitus, tabagismo, história familiar, cardiopatia e estilo de vida sedentário em comparação ao grupo controle. O tipo sanguíneo AB prevaleceu entre os pacientes (5,1 vs. 1,6%; p<0,05) e apresentou mais casos de HAS em comparação ao tipo O (92,9 vs. 67,3%; p<0,05). Conclusões: Nossos resultados sugerem que a ocorrência de AVCI é mais frequente entre os pacientes do tipo sanguíneo AB.

ABSTRACT Background: Ischemic stroke (IS) is a multifactorial disease that presents high rates of morbimortality in Brazil. Several studies proved that there is a link between the ABO blood group system and the occurrence of thrombotic events. Nonetheless, its association with IS is not well established. Objective: For that reason, the purpose hereof was to investigate the relation between the ABO blood groups and the occurrence of IS in a Brazilian cohort of cerebrovascular diseases. Methods: Five hundred and twenty-nine subjects were included over 12 months, from which 275 presented an IS episode and 254 composed the control group. Blood samples were drawn for direct and reverse serotyping. The control and IS groups were compared regarding the traditional risk factors and the distribution of the ABO blood groups. Results: The IS group presented a higher prevalence of systemic arterial hypertension (SAH), diabetes mellitus, smoking habits, family history, cardiopathy, and sedentary lifestyle in comparison with the control group. The AB blood type prevailed among the patients (5.1 vs. 1.6%; p<0.05) and this group had more SAH cases in comparison with the O type group (92.9 vs. 67.3%; p<0.05). Conclusions: Our results suggest that the occurrence of IS is more frequent among patients of the AB blood type.

https://doi.org/10.1590/0004-282x-anp-2020-0219 2 downloads

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