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Abstract Background Heart rate (HR) has shown prognostic value in patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm. However, the method of measurement is debated in the literature. Objectives To compare HR on Holter with 3 resting electrocardiograms (ECG1, ECG2, and ECG3) in patients with HFrEF and sinus rhythm. Methods This was a cross-sectional study with 135 patients with heart failure with ejection fraction ≤ 40% and sinus rhythm. HR was assessed by ECG and Holter. Analyses included intraclass correlation coefficient (ICC), robust regression, root mean squared error, Bland-Altman, and area under the receiver operating characteristic (ROC) curve. A significance level of 0.05 and Bonferroni-Holm adjustment were adopted to minimize type I errors. Results The median [interquartile range] age and ejection fraction were 65 years [16] and 30% [11], respectively. The ICC of the 3 ECGs was 0.922 (95% confidence interval: 0.892; 0.942). The robust regression coefficients for ECG1 and ECG3 were 0.20 (95% confidence interval: 0.12; 0.29) and 0.21 (95% confidence interval: 0.06; 0.36). The robust R2 was 0.711 (95% confidence interval: 0.628; 0.76). In the Bland-Altman agreement analysis, the limits of agreement were −17.0 (95% confidence interval: −19.0; −15.0) and 32.0 (95% confidence interval: 30.0; 34.0). The area under the ROC curve was 0.896 (95% confidence interval: 0.865; 0.923). Conclusion The HR on ECG showed high agreement with the HR on Holter, validating its clinical use in patients with HFrEF and sinus rhythm. However, agreement was suboptimal in one third of patients with HR below 70 bpm on ECG; thus, 24-hour Holter monitoring should be considered in this context. (HR (HFrEF rhythm However literature ECG1, (ECG1 ECG2 crosssectional cross sectional 13 40 ICC, , (ICC) error BlandAltman, BlandAltman Bland Altman, Altman (ROC 005 0 05 0.0 BonferroniHolm Bonferroni Holm errors interquartile range 6 16 [16 30 11, 11 [11] respectively 0922 922 0.92 95% 95 (95 interval 0.892 0892 892 0.942. 0942 0.942 . 942 0.942) 020 20 0.2 0.12 012 12 0.29 029 29 021 21 0.06 006 06 0.36. 036 0.36 36 0.36) R 0711 711 0.71 0.628 0628 628 0.76. 076 0.76 76 0.76) analysis 170 17 −17. −19.0 190 19 −15.0 150 15 320 32 32. 30.0 300 34.0. 340 34.0 34 34.0) 0896 896 0.89 0.865 0865 865 0.923. 0923 0.923 923 0.923) 7 thus 24hour hour 24 context (ECG 1 4 (ICC 00 0. [1 [11 092 92 0.9 9 (9 089 89 094 0.94 94 02 2 0.1 01 03 0.3 071 71 0.7 0.62 062 62 07 −17 −19. −15. 30. 34. 0.8 0.86 086 86 [ 09 ( 08 8 0.6 −1 −19 −15 −

Resumo Fundamento A frequência cardíaca (FC) na insuficiência cardíaca com fração de ejeção reduzida (ICFEr) e ritmo sinusal apresenta valor prognóstico. Entretanto, o método de mensuração é debatido na literatura. Objetivos Comparar em pacientes com ICFEr e ritmo sinusal a FC no Holter com três eletrocardiogramas de repouso: ECG1, ECG2 e ECG3. Metodologia Estudo transversal com 135 pacientes portadores de insuficiência cardíaca com fração de ejeção ≤ 40% e ritmo sinusal. A FC foi avaliada por ECG e Holter. Análises incluíram o coeficiente de correlação intraclasse (CCI), regressão robusta, raiz do erro quadrático médio, Bland-Altman e a área sobre a curva ROC. Adotou-se nível de significância de 0,05 e o ajuste de Bonferroni-Holm para minimizar erros tipo I. Resultados As medianas [intervalo interquartil] de idade e fração de ejeção foram de 65 anos [16] e 30% [11], respectivamente. O CCI dos 3 ECG foi de 0,922 (intervalo de confiança de 95%: 0,892; 0,942). Os coeficientes de regressão robusta para ECG1 e ECG3 foram 0,20 (intervalo de confiança de 95%: 0,12; 0,29) e 0,21 (intervalo de confiança de 95%: 0,06; 0,36). O R2 robusto foi de 0,711 (intervalo de confiança de 95%: 0,628; 0,76). Na análise de concordância de Bland-Altman, os limites de concordância foram de −17,0 (intervalo de confiança de 95%: −19,0; −15,0) e 32,0 (intervalo de confiança de 95%: 30,0; 34,0). A área sob a curva ROC foi de 0,896 (intervalo de confiança de 95%: 0,865; 0,923). Conclusão A FC do ECG mostrou alta concordância com a FC do Holter, validando seu uso clínico em pacientes com ICFEr e ritmo sinusal. Contudo, a concordância foi subótima em um terço dos pacientes com FC inferior a 70 bpm pelo ECG, devendo ser considerada a realização de Holter neste contexto. (FC (ICFEr prognóstico Entretanto literatura repouso 13 40 CCI, , (CCI) médio BlandAltman Bland Altman Adotouse Adotou se 005 0 05 0,0 BonferroniHolm Bonferroni Holm I intervalo interquartil 6 16 [16 30 11, 11 [11] respectivamente 0922 922 0,92 95% 95 0,892 0892 892 0,942. 0942 0,942 . 942 0,942) 020 20 0,2 0,12 012 12 0,29 029 29 021 21 0,06 006 06 0,36. 036 0,36 36 0,36) R 0711 711 0,71 0,628 0628 628 0,76. 076 0,76 76 0,76) BlandAltman, Altman, 170 17 −17, −19,0 190 19 −15,0 150 15 320 32 32, 30,0 300 34,0. 340 34,0 34 34,0) 0896 896 0,89 0,865 0865 865 0,923. 0923 0,923 923 0,923) Contudo 7 contexto 1 4 (CCI 00 0, [1 [11 092 92 0,9 9 089 89 094 0,94 94 02 2 0,1 01 03 0,3 071 71 0,7 0,62 062 62 07 −17 −19, −15, 30, 34, 0,8 0,86 086 86 [ 09 08 8 0,6 −1 −19 −15 −

https://doi.org/10.36660/abc.20230771

Maternal deaths as a challenge for obstetric care in times of COVID-19 in Brazil COVID19 COVID 19 COVID-1 COVID1 1 COVID-
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Guimarães, Raphael Mendonça

; Moreira, Marcelo Rasga

Revista Brasileira de Saúde Materno Infantil

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2024, Volume 24 elocation e20230078

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

Abstract Objectives: to describe the effects of the Covid-19 pandemic on maternal mortality in Brazil in 2021. Methods: it is an exploratory study with description of the excess maternal mortality in Brazil for 2021, considering different scenarios: (i) 2015-2019 linear trend; (ii) 2020 observed number of deaths; (iii) 2015-2019 linear trend corrected for general mortality excess; (iv) 2020 observed number of deaths corrected for general mortality excess. Results: compared to the trend of the previous five years, the year 2021 showed an excess mortality of 39% (n=3030). The maternal mortality ratio for 2021 drastically exceeded the SDG target for this indicator, reaching approximately 110 maternal deaths per 100,000 live births. In any scenario described, there will be excess maternal mortality in 2021 higher than general mortality and higher than level presented in 2020. Analysis stratified by region demonstrates subnational heterogeneity. Conclusion: Covid-19 pandemic had a considerable impact on maternal health, not only by leading to increased deaths but also by increasing social health inequality. The year 2021 was the most critical period of the pandemic regarding the magnitude of mortality. Barriers to accessing and using essential health services are challenging to achieving health-related Sustainable Development Goals. Objectives Covid19 Covid 19 Covid-1 Methods scenarios i (i 20152019 2015 2019 2015-201 ii (ii 202 iii (iii iv (iv Results years 39 n=3030. n3030 n n=3030 . 3030 (n=3030) indicator 11 100000 100 000 100,00 births described heterogeneity Conclusion inequality healthrelated related Goals Covid1 1 Covid- 2015201 201 2015-20 20 3 n303 n=303 303 (n=3030 10000 10 00 100,0 201520 2015-2 2 n30 n=30 30 (n=303 1000 0 100, 20152 2015- n3 n=3 (n=30 n= (n=3 (n= (n

Resumo Objetivos: analisar os efeitos da pandemia da Covid-19 na mortalidade materna no Brasil em 2021. Métodos: realizou-se estudo exploratório com descrição do excesso de mortalidade materna no Brasil para 2021, considerando diferentes cenários: (i) tendência linear 2015-2019; (ii) número de óbitos observados em 2020; (iii) tendência linear 2015-2019 corrigida para excesso de mortalidade geral; (iv) número de óbitos observados em 2020 corrigido pelo excesso de mortalidade geral. Resultados: em comparação com a tendência dos cinco anos anteriores, o ano de 2021 apresentou excesso de mortalidade de 39% (n=3030). A razãode mortalidade materna para 2021 ultrapassou a meta dos ODS para este indicador, atingindo um nível superior a 110 mortes maternas por cem mil nascidos vivos. Em qualquer cenário, houve excesso de mortalidade materna em 2021 superior à mortalidade geral em 2020. A análise estratificada por região demonstra heterogeneidade subnacional. Conclusão: a pandemia da Covid-19 teve impacto considerável na saúde materna, não só por levar ao aumento de mortes, mas também por aumentar a iniquidade em saúde. O ano de 2021 foi o período mais crítico da pandemia em termos de mortalidade. Barreiras ao acesso e uso de serviços de saúde são um desafio para alcançar os Objetivos de Desenvolvimento Sustentável relacionados à saúde. Covid19 Covid 19 Covid-1 Métodos realizouse realizou se cenários i (i 20152019 2015 2019 ii (ii iii (iii 2015-201 iv (iv 202 Resultados anteriores 39 n=3030. n3030 n n=3030 . 3030 (n=3030) indicador 11 vivos cenário subnacional Conclusão Covid1 1 Covid- 2015201 201 2015-20 20 3 n303 n=303 303 (n=3030 201520 2015-2 2 n30 n=30 30 (n=303 20152 2015- n3 n=3 (n=30 n= (n=3 (n= (n

https://doi.org/10.1590/1806-9304202400000078-en

Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan Prospective randomized pressurelimiting pressure limiting communityacquired community acquired STAMINA trial)
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Maia, Israel Silva

; Medrado Jr, Fernando Azevedo

; Tramujas, Lucas

; Tomazini, Bruno Martins

; Oliveira, Júlia Souza

; Sady, Erica Regina Ribeiro

; Barbante, Letícia Galvão

; Nicola, Marina Lazzari

; Gurgel, Rodrigo Magalhães

; Damiani, Lucas Petri

; Negrelli, Karina Leal

; Miranda, Tamiris Abait

; Santucci, Eliana

; Valeis, Nanci

; Laranjeira, Ligia Nasi

; Westphal, Glauco Adrieno

; Fernandes, Ruthy Perotto

; Zandonai, Cássio Luis

; Pincelli, Mariangela Pimentel

; Figueiredo, Rodrigo Cruvinel

; Bustamante, Cíntia Loss Sartori

; Norbin, Luiz Fernando

; Boschi, Emerson

; Lessa, Rafael

; Romano, Marcelo Pereira

; Miura, Mieko Cláudia

; Alencar Filho, Meton Soares de

; Dantas, Vicente Cés de Souza

; Barreto, Priscilla Alves

; Hernandes, Mauro Esteves

; Grion, Cintia Magalhães Carvalho

; Laranjeira, Alexandre Sanches

; Mezzaroba, Ana Luiza

; Bahl, Marina

; Starke, Ana Carolina

; Biondi, Rodrigo Santos

; Dal-Pizzol, Felipe

; Caser, Eliana Bernadete

; Thompson, Marlus Muri

; Padial, Andrea Allegrini

; Veiga, Viviane Cordeiro

; Leite, Rodrigo Thot

; Araújo, Gustavo

; Guimarães, Mário

; Martins, Priscilla de Aquino

; Lacerda, Fábio Holanda

; Hoffmann Filho, Conrado Roberto

; Melro, Livia

; Pacheco, Eduardo

; Ospina-Táscon, Gustavo Adolfo

; Ferreira, Juliana Carvalho

; Freires, Fabricio Jocundo Calado

; Machado, Flávia Ribeiro

; Cavalcanti, Alexandre Biasi

; Zampieri, Fernando Godinho

Critical Care Science

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2024, Volume 36 elocation e20240210en

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

ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5

https://doi.org/10.62675/2965-2774.20240210-en

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

Hepatic endotheliitis in Golden Syrian hamsters (Mesocricetus auratus) experimentally infected with SARS-CoV-2 Mesocricetus auratus SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- SARS-CoV
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Souza, Alex Junior Souza de

; Souza Filho, Antônio Francisco de

; Zimpel, Cristina Kraemer

; Ayupe, Marina Caçador

; Araújo, Marcelo Valdemir de

; Machado, Rafael Rahal Guaragna

; Salles, Erika

; Salgado, Caio Loureiro

; Tavares, Mariana Silva

; Silva-Pereira, Taiana Tainá

; Souza, Paula Carolina de

; Durigon, Edison Luiz

; Heinemann, Marcos Bryan

; Brandão, Paulo Eduardo

; Fonseca, Denise Morais da

; Guimarães, Ana Marcia de Sá

; Sá, Lilian Rose Marques de

Revista do Instituto de Medicina Tropical de São Paulo

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2024, Volume 66 elocation e44

Resumo: En | Texto: En | PDF: En

ABSTRACT Hepatic injuries in COVID-19 are not yet fully understood and indirect pathways (without viral replication in the liver) have been associated with the activation of vascular mechanisms of liver injury in humans infected with SARS-CoV-2. Golden Syrian hamsters are an effective model for experimental reproduction of moderate and self-limiting lung disease during SARS-CoV-2 infection. As observed in humans, this experimental model reproduces lesions of bronchointerstitial pneumonia and pulmonary vascular lesions, including endotheliitis (attachment of lymphoid cells to the luminal surface of endothelium). Extrapulmonary vascular lesions are well documented in COVID-19, but such extrapulmonary vascular lesions have not yet been described in the Golden Syrian hamster model of SARS-CoV-2 infection. The study aimed to evaluate microscopic liver lesions in Golden Syrian hamsters experimentally infected with SARS-CoV-2. In total, 38 conventional Golden Syrian hamsters, divided into infected group (n=24) and mock-infected group (n=14), were euthanized at 2-, 3-, 4-, 5-, 7-, 14-, and 15-days post infection with SARS-CoV-2. Liver fragments were evaluated by histopathology and immunohistochemical detection of SARS-CoV-2 Spike S2 antigens. The frequencies of portal vein endotheliitis, lobular activity, hepatocellular degeneration, and lobular vascular changes were higher among SARS-CoV-2-infected animals. Spike S2 antigen was not detected in liver. The main results indicate that SARS-CoV-2 infection exacerbated vascular and inflammatory lesions in the liver of hamsters with pre-existing hepatitis of unknown origin. A potential application of this animal model in studies of the pathogenesis and evolution of liver lesions associated with SARS-CoV-2 infection still needs further evaluation. COVID19 COVID 19 COVID-1 without SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. 2 selflimiting self limiting SARS-CoV- attachment endothelium. endothelium . endothelium) COVID19, 19, total 3 n=24 n24 n 24 (n=24 mockinfected mock n=14, n14 n=14 , 14 (n=14) 2, 2- 3, 3- 4, 4 4- 5, 5 5- 7, 7 7- 14, 14- 15days days 15 S antigens activity degeneration SARSCoV2infected SARSCoVinfected animals preexisting pre existing origin evaluation COVID1 1 COVID- SARS-CoV n=2 n2 (n=2 n1 n=1 (n=14 n= (n= (n=1 (n

https://doi.org/10.1590/s1678-9946202466044

Association of antimicrobial use and incidence of hospital-acquired pneumonia in critically ill trauma patients with pulmonary contusion: an observational study hospitalacquired hospital acquired contusion
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Bassi, Estevão

; Merighi, Camila Trevizani

; Tomizuka, Carlos Issamu

; Guimarães, Thais

; Novo, Fernando da Costa Ferreira

; Damous, Sergio Henrique Bastos

; Utiyama, Edivaldo Massazo

; Malbouisson, Luiz Marcelo Sá

Brazilian Journal of Anesthesiology

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2024, Volume 74 Nº 3 elocation 744454

Resumo: En | Texto: En | PDF: En

Abstract Background: Pneumonia occurs in about 20% of trauma patients with pulmonary contusions. This study aims to evaluate the association between empirical antibiotic therapy and nosocomial pneumonia in this population. Methods: Retrospective cohort of adult patients admitted to a trauma-surgical ICU. The Antibiotic Therapy Group (ATG) was defined by intravenous antibiotic use for more than 48 h starting on hospital admission, while the Conservative Group (CG) was determined by antibiotic use no longer than 48 h. Primary outcome was microbiologically documented nosocomial pneumonia within 14 days after hospital admission. Logistic regression was used to estimate the association between group allocation and primary outcome. Exploratory analyses evaluating the association between resistant strains in pneumonia and antibiotic use were performed. Results: The study included 177 patients with chest trauma and pulmonary contusion on CTscan. ATG were more severely ill than CG, as shown by higher Injury Severity Score, SAPS3, SOFA score, higher rates, and longer duration of mechanical ventilation. In the multivariate analysis, ATG was associated with a lower incidence of primary outcome (OR = 0.25, 95% CI 0.09-0.64; p < 0.01). Similar results were found in the sensitivity analysis with another set of variables. However, each day of antibiotic use was associated with an increased risk of pneumonia by resistant bacteria (OR = 1.18 per day, 95% CI 1.05-1.36; p < 0.01). Conclusions: Empiric antibiotic therapy was independently associated with lower incidence of nosocomial pneumonia in critically ill patients with pulmonary contusion. However, each day of antibiotic use was associated with increased resistant strains in infected patients. Background 20 contusions population Methods traumasurgical surgical ICU (ATG 4 admission CG (CG 1 performed Results 17 CTscan Score SAPS3 SAPS score rates ventilation OR 025 0 25 0.25 95 0.090.64 009064 0.09 0.64 09 64 0.09-0.64 0.01. 001 0.01 . 01 0.01) variables However 118 18 1.1 1.051.36 105136 1.05 1.36 05 36 1.05-1.36 Conclusions 2 02 0.2 9 090 0.090.6 00906 009 0.0 064 0.6 6 0.09-0.6 00 11 1. 051 1.051.3 10513 105 1.0 136 1.3 3 1.05-1.3 0. 0.090. 0090 06 0.09-0. 1.051. 1051 10 13 1.05-1. 0.090 0.09-0 1.051 1.05-1 0.09- 1.05-

https://doi.org/10.1016/j.bjane.2023.07.011

Impact of withholding early antibiotic therapy in nonseptic surgical patients with suspected nosocomial infection: a retrospective cohort analysis infection
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Bassi, Estevão

; Tomazini, Bruno Martins

; Carneiro, Bárbara Vieira

; Siqueira, Amanda Rodrigues de Oliveira

; Siqueira, Sara Rodrigues de Oliveira

; Guimarães, Thais

; Novo, Fernando da Costa Ferreira

; Utiyama, Edivaldo Massazo

; Pelosi, Paolo

; Malbouisson, Luiz Marcelo Sá

Brazilian Journal of Anesthesiology

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2024, Volume 74 Nº 3 elocation 744431

Resumo: En | Texto: En | PDF: En

Abstract Background: Systemic inflammatory responses mimicking infectious complications are often present in surgical patients. Methods: The objective was to assess the association between withholding early antimicrobial therapy while investigating alternative diagnoses and worse outcomes in nonseptic patients with suspected nosocomial infection in a retrospective cohort of critically ill surgical patients. The initiation of antibiotic therapy within 24 h of the suspicion of infection was defined as the Early Empirical Antibiotic strategy (EEA) group and the initiation after 24 h of suspicion or not prescribed was defined as the Conservative Antibiotic strategy (CA) group. Primary outcome was composite: death, sepsis, or septic shock within 14 days. Main exclusion criteria were sepsis or an evident source of infection at inclusion. Results: Three hundred and forty patients were eligible for inclusion (74% trauma patients). Age, sex, reason for hospital admission, SAPS3 score, SOFA score, and use of vasopressors or mechanical ventilation were not different between the groups. Within 14 days of inclusion, 100% (130/130) of EEA patients received antibiotics compared to 57% (120/210) of CA patients. After adjusting for confounding variables, there was no association between primary outcome and the groups. In a post hoc subgroup analysis including only patients with a posteriori confirmed infection (by microbiological cultures), delay in initiation of adequate antimicrobial therapy was independently associated with the primary outcome (Odds Ratio = 1.19 per day of delay; 95% CI 1.05–1.37). Conclusions: Withholding early empiric antibiotic therapy was not associated with progression of organ dysfunction within 14 days in nonseptic surgical patients with suspected nosocomial infection without an obvious source. Background Methods 2 (EEA (CA composite death 1 Results 74% 74 (74 . patients) Age sex admission SAPS score groups 100 130/130 130130 130 (130/130 57 120/210 120210 120 210 (120/210 variables by cultures, cultures , cultures) Odds 119 19 1.1 95 1.05–1.37. 105137 1.05–1.37 05 37 1.05–1.37) Conclusions 7 (7 10 130/13 13013 13 (130/13 5 120/21 12021 12 21 (120/21 11 1. 9 10513 1.05–1.3 0 3 ( 130/1 1301 (130/1 120/2 1202 (120/2 1051 1.05–1. 130/ (130/ 120/ (120/ 105 1.05–1 (130 (120 1.05– (13 (12 1.05 (1 1.0

https://doi.org/10.1016/j.bjane.2023.03.003

Genetic diversity in half-sibling progenies of kale: A multivariate approach halfsibling half sibling kale
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Brito, Orlando Gonçalves

; Silva, Natália Oliveira

; Andrade Júnior, Valter Carvalho de

; Guimarães, Amanda Gonçalves

; Costa, Márcia Regina da

; Azevedo, Alcinei Mistico

; Santos, Marcelo Augusto Vieira

; Silva, Eduardo Alves da

Ciência e Agrotecnologia

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2024, Volume 48 elocation e008524

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

ABSTRACT Kale is one of the most widely cultivated leafy vegetables in Brazil, but its breeding genetic is still limited. Therefore, it is crucial to develop research that explores the genetic diversity of the available germplasms, aiming to establish promising crosses in the studied populations. The present study aimed to evaluate the genetic divergence between half-sibling progenies of kale, obtained through recurrent selection, using multivariate methods to select the most promising progenies for forming a recombinant population. The plants obtained from the seeds of 25 pre-selected half-sibling progenies and three commercial cultivars were evaluated as treatment groups. These seeds were produced in 2018 by subjecting the clones of the progenies to recombination, followed by the selection of appropriate seeds from plants with superior agronomic performance. In the present study, plants in each plot were evaluated for twelve quantitative and fifteen qualitative traits. Genetic divergence was studied based on canonical variables to obtain quantitative data. The UPGMA method was applied to the quantitative, qualitative, and combined data, and Mahalanobis genetic distance was adopted. The first three canonical variables explained 73.75% of the total cumulative variation compared to the commercial cultivars and 55.29% when considering the half-sibling progenies exclusively. The half-sibling progenies P1, P2, P3, P4, P5, P9, P11, P15, P16, P18, P20, P22, P23, P24, and P25 were the most divergent and should, therefore, be prioritized when composing the recombinant population for the third cycle of recurrent selection because, in addition to genetic variation, these progenies also present characteristics of interest to the kale genetic breeding program. The commercial cultivars exhibited the most divergent genotypes and should, therefore, be included in the next recombination cycle. Brazil limited Therefore germplasms populations halfsibling half sibling 2 preselected pre selected groups 201 performance traits data adopted 7375 73 75 73.75 5529 55 29 55.29 exclusively P1 P P2 P3 P4 P5 P9 P11 P15 P16 P18 P20 P22 P23 P24 should therefore because program 20 737 7 73.7 552 5 55.2 73. 55.

RESUMO A couve-de-folhas é uma das hortaliças folhosas mais cultivadas no Brasil, porém seu melhoramento ainda é limitado. Portanto, é crucial desenvolver pesquisas que explorem a diversidade genética dos germoplasmas disponíveis, visando estabelecer cruzamentos promissores nas populações estudadas. O objetivo deste estudo foi avaliar a divergência genética entre progênies de meios-irmãos de couve-de-folhas obtidas por seleção recorrente e selecionar as progênies mais promissoras para compor uma população recombinante utilizando métodos multivariados. Como tratamentos, foram avaliadas plantas obtidas a partir de sementes de 25 progênies de meio-irmãos pré-selecionadas e três cultivares comerciais. Para produzir essas sementes, clones das progênies foram submetidos a recombinação em 2018, com subsequente seleção de sementes de plantas com desempenho agronômico superior. Foram avaliadas doze características quantitativas e quinze qualitativas em cada parcela, totalizando vinte e sete características avaliadas. O estudo da divergência genética foi realizado através de variáveis canônicas para os dados quantitativos. O método UPGMA foi aplicado a dados quantitativos, qualitativos e combinados, utilizando-se a distância genética de Mahalanobis. As três primeiras variáveis canônicas explicaram 73,75% da variação total acumuladas quando comparadas às cultivares comerciais, e 55,29% quando considerado exclusivamente as progênies meios-irmãos. As progênies de meios-irmãos P1, P2, P3, P4, P5, P9, P11, P15, P16, P18, P20, P22, P23, P24 e P25 foram as mais divergentes e devem ser priorizadas na composição da população recombinante para o terceiro ciclo de seleção recorrente, pois além de variação genética, também apresentam características de interesse ao programa de melhoramento genético da couve. As cultivares comerciais apresentaram-se como os genótipos mais divergentes e deverão ser incluídas no próximo ciclo de recombinação. couvedefolhas couve folhas Brasil limitado Portanto disponíveis estudadas meiosirmãos meios irmãos multivariados tratamentos 2 meioirmãos meio préselecionadas pré selecionadas 2018 superior parcela quantitativos combinados utilizandose se Mahalanobis 7375 73 75 73,75 5529 55 29 55,29 meiosirmãos. irmãos. P1 P P2 P3 P4 P5 P9 P11 P15 P16 P18 P20 P22 P23 apresentaramse apresentaram 201 737 7 73,7 552 5 55,2 20 73, 55,

https://doi.org/10.1590/1413-7054202448008524

Cultivation of yellow melon subjected to different irrigation levels and application of arbolina® biostimulant arbolina
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Vieira, Nicolly Q. B.

; Simões, Welson L.

; Silva, José A. B. da

; Salviano, Alessandra M.

; Silva, Jucicléia S. da

; Braga, Marcos B.

; Guimarães, Miguel J. M.

; Martins, Marcelo da S.

Revista Caatinga

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2024, Volume 37 elocation e12452

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

RESUMO Objetivou-se avaliar as características fisiológicas e bioquímicas durante a floração, e a produtividades de frutos totais e comerciais de melão amarelo submetidas à a diferentes lâminas de irrigação e aplicação do bioestimulante Arbolina. O delineamento experimental foi em blocos casualizados, em arranjo fatorial 2×2×5 de parcelas sub-subdivididas, com quatro repetições. As parcelas consistiram de 2 formas de aplicação de bioestimulante (fertirrigação e pulverização), as subparcelas consistiram de 2 lâminas de irrigação (40% e 100% da evapotranspiração da cultura - ETc) e as subsubparcelas consistiram de 5 doses do bioestimulante Arbolina® (0; 0,1; 0,2; 0,4; e 0,8 L ha-1). As mudas foram transplantadas para o solo com espaçamento de 2,0 × 0,3 m, com irrigação por gotejamento. As adubações de plantio e cobertura foram realizadas via fertirrigação. As variáveis analisadas foram: produtividade total e comercial, taxa fotossintética, condutância estomática, concentração interna de CO2, transpiração e temperatura foliar, teores de clorofilas a e b, eficiência do uso de água e conteúdo relativo de água. As variáveis bioquímicas avaliadas foram: teores foliares de carboidratos, amido, e proteínas solúveis totais. A aplicação do bioestimulante por pulverização teve melhor efeito no processo de produção de plantas de melão amarelo, promovendo melhor eficiência metabólica nas células formadoras de órgãos, incluindo o processo de formação morfológica e constituição bioquímica dos frutos. Recomenda-se a utilização do bioestimulante nas doses de 0,446 e 0,443 L ha-1 combinadas com a utilização de 100% da ETc para atingir a maior produtividade total e comercial. Objetivouse Objetivou se floração Arbolina casualizados 225 2×2× subsubdivididas, subsubdivididas sub subdivididas, subdivididas sub-subdivididas repetições fertirrigação pulverização, , pulverização) 40% 40 (40 100 0 (0 0,1 01 1 0,2 02 0,4 04 4 08 8 0, ha1. ha1 ha . ha-1) 20 2, 03 3 m gotejamento comercial fotossintética estomática CO2 CO foliar b carboidratos amido órgãos Recomendase Recomenda 0446 446 0,44 0443 443 ha- 22 2×2 (4 10 ( 044 44 2×

ABSTRACT The objective was to evaluate the physiological and biochemical characteristics during flowering, and the total and marketable fruit yield of yellow melon subjected to different irrigation depths and application of the biostimulant Arbolina®. The experimental design was randomized blocks, in a 2×2×5 factorial arrangement of split-split plots, with four replicates. Plots consisted of 2 forms of biostimulant application (fertigation and spraying), subplots consisted of 2 irrigation depths (40% and 100% of crop evapotranspiration - ETc) and sub-subplots consisted of 5 doses of the biostimulant Arbolina® (0; 0.1; 0.2; 0.4; and 0.8 L ha-1). Melon seedlings were transplanted into the soil at a spacing of 2.0 × 0.3 m, with drip irrigation. Basal and topdressing fertilization was performed via fertigation. The variables evaluated were: for total yield and marketable yield, photosynthetic rate, stomatal conductance, internal CO2 concentration, transpiration and leaf temperature, chlorophyll a and b contents, water use efficiency and relative water content. The biostimulant application by spraying had a better effect on the production process of yellow melon plants, promoting better metabolic efficiency in organ-forming cells, including the process of morphological formation and biochemical constitution of the fruits. It is recommended to use of the biostimulant doses of 0.446 and 0.443 L ha-1 combined with the use of 100% of ETc to achieve the highest total and marketable productivity. flowering Arbolina blocks 225 2×2× splitsplit split plots replicates fertigation spraying, , spraying) 40% 40 (40 100 subsubplots sub 0 (0 0.1 01 1 0.2 02 0.4 04 4 08 8 0. ha1. ha1 ha . ha-1) 20 2. 03 3 m rate conductance CO concentration temperature contents content plants organforming organ forming cells fruits 0446 446 0.44 0443 443 ha- productivity 22 2×2 (4 10 ( 044 44 2×

https://doi.org/10.1590/1983-21252024v3712452rc

10.

Case Reports: Presumable tuberculous mastitis-like Reports mastitislike mastitis like
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Tavares, Michel de Araujo

; Santos, Marcelo Cordeiro dos

; Monteiro, Vinicius da Silva

; Baia-da-Silva, Djane

; Lacerda, Marcus Vinícius Guimarães de

; Vieira, René Aloisio da Costa

Revista da Sociedade Brasileira de Medicina Tropical

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2024, Volume 57 elocation e00806-2024

Resumo: En | Texto: En | PDF: En

ABSTRACT Tuberculous mastitis (TM) is a rare cause of breast disease. The test sensitivity for TM is low and sometimes characterized by idiopathic granulomatous mastitis. Both have different treatments; however, many patients are treated with presumptive TM (P-TM). We present fifteen women with confirmed TM or P-TM. We found 4% (5/124) of TM and 8% (10/124) of P-TM, grouped according to their diagnosis, with no differences between them, except for follow-up and treatment time. P-TM is an entity that must be considered based on clinical and radiological suspicion and is associated with presumptive pathological data. (TM disease treatments however PTM. PTM P . (P-TM) TM. 4 5/124 5124 5 124 (5/124 8 10/124 10124 10 (10/124 PTM, TM, diagnosis them followup follow up time data (P-TM 5/12 512 12 (5/12 10/12 1012 1 (10/12 5/1 51 (5/1 10/1 101 (10/1 5/ (5/ 10/ (10/ (5 (10 ( (1

https://doi.org/10.1590/0037-8682-0344-2023

11.

Impact of Photobiomodulation during Root Canal Treatment on Oral Health-Related Quality of Life: A Randomized Clinical Trial HealthRelated Health Related Life
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Moraes, Vania Gomes

; Nascimento, Wayne Martins

; Tavares, Marcelo Levin Cidade D’Amato

; Guimarães, Ludmila da Silva

; Silva, Erlange Andrade Borges

; Hespanhol, Fernanda Garcias

; Antunes, Livia Azeredo Alves

; Antunes, Leonardo dos Santos

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2024, Volume 24 elocation e230064

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To evaluate the impact of endodontic treatment with photobiomodulation on oral health-related quality of life (HRQoL). Material and Methods: Seventy participants with single-rooted teeth and a diagnosis of asymptomatic apical periodontitis were selected and randomized into two groups: control group (CG, n = 35), root canal treatment without additional treatment, and experimental group (EG, n = 35), root canal treatment associated with antimicrobial photodynamic therapy and low-level laser therapy. OHRQoL was assessed using the Oral Health Impact Profile Questionnaire (OHIP-14) at baseline and 7 and 30 days after treatment. Data were subjected to Wilcoxon, Mann-Whitney tests, and linear regression using the generalized estimating equation model, using the Statistical Package for Social Science software with a significance level of 5%. Results: No statistically significant differences were found between groups regarding sociodemographic and clinical characteristics (p>0.05). There was also no difference in the OHRQoL between the CG and EG (p>0.05). However, there was a statistical difference in OHIP-14 scores between baseline and the 7- and 30-day follow-up intervals in both groups for all domains (p<0.05). Conclusion: Root canal treatment, with or without photobiomodulation, significantly improved the OHRQoL of participants after 7 and 30 days of treatment. Objective healthrelated health related HRQoL. HRQoL . (HRQoL) Methods singlerooted single rooted CG, (CG 35, 35 , 35) EG, (EG lowlevel low OHIP14 OHIP 14 (OHIP-14 3 Wilcoxon MannWhitney Mann Whitney tests model 5 5% Results p>0.05. p005 p p>0.05 0 05 (p>0.05) However OHIP-1 30day day followup follow up p<0.05. p<0.05 (p<0.05) Conclusion (HRQoL OHIP1 1 (OHIP-1 p00 p>0.0 (p>0.05 OHIP- p<0.0 (p<0.05 (OHIP- p0 p>0. (p>0.0 p<0. (p<0.0 (OHIP p>0 (p>0. p<0 (p<0. p> (p>0 p< (p<0 (p> (p< (p

https://doi.org/10.1590/pboci.2024.085

12.

Precipitation of amorphous iron and aluminum during the weathering of rock dust in soil columns
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Silva, Rafael Cipriano da

; Guimarães, Clécia Cristina Barbosa

; Azevedo, Antonio Carlos de

; Alves, Marcelo Rodrigo

; Demattê, José Alexandre Melo

Scientia Agricola

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2024, Volume 81 elocation e20230219

Resumo: En | Texto: En | PDF: En

ABSTRACT The application of rock dust (RD) in agricultural soils has shown the capacity to improve soil conditions for plant growth. However, the successful use of RD requires understanding its effects on weathering in soil surfaces and its possible products. In this study, we present the results of an exploratory test in which a RD had its weathering intensified in a soil column by temperature (45 °C) and intense leaching (1,339.2 mm in 24 weeks), in the absence of plants. There was a significant increase in amorphous phases of iron (Fe) and particularly of aluminum (Al) to the amount of 0.13 g kg –1 for Fe and 0.16 g kg –1 for Al in the 0-0.05 m layer of the column and 0.22 g kg –1 for Al in the 0.05-0.10 m layer. These values account for 6 % of the total Fe, and 27 % of the total Al added as RD in the column. Spectral features in the visible-near infrared-short wave infrared (VIS-NIR-SWIR) and mid-infrared (MIR) range, as well as X-ray diffraction (XRD) scans, were inconclusive because of the small signal-noise ratio of the newly precipitated phases. Selective chemical methods targeted to specific soil pools (precipitated, adsorbed, and leached) were more sensitive to capture the new amorphous phases resulting from the RD dissolution. This study contributes to understanding the effects of RD on the availability of ions and the possibility of amorphous oxides precipitating in the soil. In addition, it helps identify other effects associated with using RD, such as changes in the pH, cation exchange capacity (CEC), and nutrient availability. (RD growth However products 45 (4 °C C 1,339.2 13392 1 339 2 (1,339. weeks, weeks , weeks) plants (Fe (Al 013 0 13 0.1 – 016 16 00.05 0005 0.05 05 0-0.0 022 22 0.2 0.050.10 005010 0.10 10 0.05-0.1 visiblenear visible near infraredshort short VISNIRSWIR VIS NIR SWIR (VIS-NIR-SWIR midinfrared mid MIR (MIR range Xray X ray XRD (XRD scans signalnoise signal noise precipitated, (precipitated adsorbed leached dissolution addition pH CEC, CEC (CEC) 4 ( 1,339. 1339 33 (1,339 01 0. 00 00.0 000 005 0.0 0-0. 02 050 0.050.1 00501 010 0.05-0. (CEC 1,339 133 3 (1,33 00. 0-0 0.050. 0050 0.05-0 1,33 (1,3 0- 0.050 0.05- 1,3 (1, 1, (1

https://doi.org/10.1590/1678-992x-2023-0219

13.

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

14.

Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023 202 20 2
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Almeida, André Luiz Cerqueira

; Melo, Marcelo Dantas Tavares de

; Bihan, David Costa de Souza Le

; Vieira, Marcelo Luiz Campos

; Pena, José Luiz Barros

; Del Castillo, José Maria

; Abensur, Henry

; Hortegal, Renato de Aguiar

; Otto, Maria Estefania Bosco

; Piveta, Rafael Bonafim

; Dantas, Maria Rosa

; Assef, Jorge Eduardo

; Beck, Adenalva Lima de Souza

; Santo, Thais Harada Campos Espirito

; Silva, Tonnison de Oliveira

; Salemi, Vera Maria Cury

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; Barberato, Silvio Henrique

; Rodrigues, Ana Clara

; Rabschkowisky, Arnaldo

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; Barretto, Rodrigo Bellio de Mattos

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; Leal, Gabriela Nunes

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; Cruz, Cecilia Beatriz Bittencourt Viana

; Guimarães Filho, Fabio Villaça

; Assunção, Bruna Morhy Borges Leal

; Fernandes, Rafael Modesto

; Saraiva, Roberto Magalhães

; Tsutsui, Jeane Mike

; Soares, Fábio Luis de Jesus

; Falcão, Sandra Nívea dos Reis Saraiva

; Hotta, Viviane Tiemi

; Armstrong, Anderson da Costa

; Hygidio, Daniel de Andrade

; Miglioranza, Marcelo Haertel

; Camarozano, Ana Cristina

; Lopes, Marly Maria Uellendahl

; Cerci, Rodrigo Julio

; Siqueira, Maria Eduarda Menezes de

; Torreão, Jorge Andion

; Rochitte, Carlos Eduardo

; Felix, Alex

Arquivos Brasileiros de Cardiologia

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Dez 2023, Volume 120 Nº 12 elocation e20230646

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

https://doi.org/10.36660/abc.20230646

15.

The challenges of the pandemic and the vaccination against covid-19 in pediatric patients with kidney disease covid19 covid 19 covid-1 covid1 1 covid-
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Soeiro, Emília Maria Dantas

; Penido, Maria Goretti Moreira Guimarães

; Palma, Lilian Monteiro Pereira

; Bresolin, Nilzete Liberato

; Lima, Eduardo Jorge da Fonseca

; Koch, Vera Hermina Kalika

; Tavares, Marcelo de Sousa

; Sylvestre, Lucimary

; Bernardes, Rejane de Paula

; Garcia, Clotilde Druck

; Andrade, Maria Cristina de

; Kaufman, Arnauld

; Chow, Charles Yea Zen

; Martins, Suelen Bianca Stopa

; Camargo, Suzana Friedlander Del Nero

Brazilian Journal of Nephrology

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Jun 2023, Volume 45 Nº 2 Páginas 244 - 251

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

ABSTRACT The covid-19 vaccine confers direct protection and reduces transmission rates of the virus and new variants. Vaccines from Pfizer/BioNTech and CoronaVac have been cleared for children in Brazil. They are safe, effective, and immunogenic. There are no known complications associated with the use of steroids or vaccines in pediatric patients with covid-19 and nephrotic syndrome. With or without immunosuppression, these patients are not at increased risk of severe covid-19, and steroids are safe for them. A milder form of covid-19 occurs in patients with chronic kidney disease without the need for hospitalization. The vaccine response may be reduced and/or the duration of antibodies after vaccination may be shorter than in the general population. However, considering risk of exposure, vaccination against covid-19 is recommended. It is believed that patients with hemolytic-uremic syndrome are at higher risk of severe covid-19. Vaccination is recommended, although specific data on the safety and efficacy of the covid-19 vaccine are limited. There is agreement that the benefits of induced immunity outweigh the risks of immunization. Vaccination against covid-19 is recommended for children and adolescents needing kidney transplantation or who have undergone transplantation. These patients present decreased immune response after vaccination, but immunization is recommended because the benefits outweigh the risks of vaccination. Current recommendations in Brazil stipulate the use of the messenger RNA vaccine. This paper aims to provide pediatric nephrologists with the latest knowledge about vaccination against covid-19 for children with kidney disease. covid19 covid 19 covid-1 variants PfizerBioNTech Pfizer BioNTech effective immunogenic immunosuppression covid19, 19, them hospitalization andor population However exposure hemolyticuremic hemolytic uremic covid19. 19. limited covid1 1 covid-

Resumo A vacina covid-19 confere proteção direta, reduz as taxas de transmissão do vírus e de novas variantes. No Brasil, estão liberadas para a população pediátrica as vacinas Pfizer/BioNTech e a CoronaVac, ambas seguras, eficazes e imunogênicas. Pacientes pediátricos com síndrome nefrótica e covid-19 têm curso clínico regular sem complicações relacionadas ao uso de esteroides ou vacinas. Esses pacientes, com ou sem imunossupressão, não apresentam maior risco de covid-19 grave e o tratamento com esteroides é seguro. Os pacientes com doença renal crônica têm covid-19 mais leve, sem necessidade de hospitalização. A resposta vacinal pode ser reduzida e/ou a duração dos anticorpos pós-vacinação pode ser menor do que na população geral. Entretanto, a vacina covid-19 está recomendada, considerando o risco de exposição. Acredita-se que pacientes com síndrome hemolítico-urêmica teriam maior risco de covid-19 grave. A vacina é recomendada, embora dados específicos sobre segurança e eficácia da vacina covid-19 sejam limitados. Há concordância que os benefícios da imunidade induzida superam quaisquer riscos da imunização. A vacina covid-19 é recomendada para crianças e adolescentes candidatos ao transplante renal ou já transplantados. Esses pacientes têm resposta imunológica reduzida após a vacina, entretanto ela é recomendada porque os benefícios superam qualquer risco dessa vacinação. A recomendação atual no Brasil é a vacina de tecnologia RNA mensageiro. O objetivo deste documento é levar aos nefrologistas pediátricos os conhecimentos mais recentes sobre a vacinação contra contra-19 em crianças com doenças renais. covid19 covid 19 covid-1 direta variantes PfizerBioNTech Pfizer BioNTech CoronaVac seguras imunogênicas imunossupressão seguro leve hospitalização eou pósvacinação pós geral Entretanto exposição Acreditase Acredita se hemolíticourêmica hemolítico urêmica limitados imunização transplantados mensageiro contra19 contra-1 renais covid1 1 covid- contra1 contra-

https://doi.org/10.1590/2175-8239-jbn-2022-0081en

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