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RESUMO: A contaminação de superfícies por micro-organismos patogênicos e deteriorantes é uma preocupação constante na indústria de alimentos. Dessa forma, o objetivo deste trabalho foi avaliar a atividade antimicrobiana de nanopartículas de prata (AgNPs) produzidas utilizando óleo essencial de Lippia origanoides Kunth e extrato etanólico da Hymenaea martiana Hayne, frente a bactérias de importância na contaminação em áreas de processamento do leite. Para isso, as AgNPs foram sintetizadas e sua atividade antimicrobiana foi avaliada através das concentrações inibitória e bactericida mínimas, tempo de morte, interferência sobre o biofilme, e por fim, a sua aplicação sobre superfícies de diferentes materiais. As AgNPs apresentaram atividade bacteriostática e/ou bactericida frente à Staphylococcus aureus (ATCC 25923), Staphylococcus aureus (ATCC 33591), Escherichia coli (ATCC 25922), Salmonella enterica subsp. enterica serovar Choleraesuis (ATCC 10708), Listeria monocytogenes, Escherichia coli, Salmonella spp. e Pseudomonas aeruginosa, e interferiram na formação do biofilme mais do que sobre o biofilme consolidado. O tempo de uma hora foi o suficiente para reduzir as populações bacterianas, enquanto o Minimum Duration for Killing MDK 99% foi atingido próximo a 30 minutos. As AgNPs foram eficientes contra bactérias aderidas ao inox e ao polietileno. Assim, tendo em vista a crescente resistência microbiana e o desenvolvimento de novos produtos baseados nos conceitos da química verde, essas nanopartículas de prata apresentam-se como uma nova possibilidade de uso nos processos de higienização da indústria de alimentos. RESUMO microorganismos micro organismos alimentos forma (AgNPs Hayne leite isso mínimas morte fim materiais eou ou ATCC 25923, 25923 , 25923) 33591, 33591 33591) 25922, 25922 25922) subsp 10708, 10708 10708) monocytogenes spp aeruginosa consolidado bacterianas 99 3 minutos polietileno Assim verde apresentamse apresentam se 2592 3359 1070 9 259 335 107 25 33 10 2 1

ABSTRACT: Surface contamination by pathogenic and deteriorating microorganisms is a constant concern in the food industry. Therefore, in this study we evaluated the antimicrobial activity of silver nanoparticles (AgNPs), produced using the essential oil of Lippia origanoides Kunth and ethanolic extract of Hymenaea martiana Hayne, against bacteria used in milk processing. For this, AgNPs were synthesized and their antimicrobial activity was evaluated for minimum inhibitory and bactericidal concentrations, time-kill, interference on the biofilm, and application on the surfaces of different materials. AgNPs showed bacteriostatic and bactericidal activity against Staphylococcus aureus (ATCC 25923), Staphylococcus aureus (ATCC 33591), Escherichia coli (ATCC 25922), Salmonella enterica subsp. enterica serovar Choleraesuis (ATCC 10708), Listeria monocytogenes, Escherichia coli, Salmonella spp.,andPseudomonas aeruginosa,and interfered with biofilm formation more than with consolidated biofilms. A 1hour period was sufficient to reduce the bacterial cells, whereas a Minimum Duration for Killing (MDK) of 99% was reached after approximately 30 min. AgNPs were effective against bacteria attached to stainless steel and polyethylene, but ineffective on tile surfaces. Thus, owing to the growing microbial resistance and the need to develop new products based on the concepts of green chemistry, these AgNPs are presented as a new possibility for cleaning processes in the food industry. ABSTRACT industry Therefore AgNPs, , (AgNPs) Hayne processing concentrations timekill, timekill time kill, kill time-kill materials ATCC 25923, 25923 25923) 33591, 33591 33591) 25922, 25922 25922) subsp 10708, 10708 10708) monocytogenes sppandPseudomonas spp andPseudomonas aeruginosaand aeruginosa biofilms hour cells MDK (MDK 99 3 min polyethylene Thus chemistry (AgNPs 2592 3359 1070 9 259 335 107 25 33 10 2 1

https://doi.org/10.1590/0103-8478cr20230027

Atenção odontológica durante a gestação e a saúde do recém-nascido: um estudo transversal recémnascido recém nascido recém-nascido
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MARIOTTI, Camila

; SANTOS, Camila Maura Morais Lima dos

; BULGARELI, Jaqueline Vilela

; PARANHOS, Luiz Renato

; HERVAL, Álex Moreira

Revista de Odontologia da UNESP

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2024, Volume 53 elocation e20240006

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

Resumo Objetivo Verificar a existência de relação entre a atenção odontológica à gestante e as condições bucais maternas e de saúde do recém-nascido. Material e método Realizou-se um estudo transversal com puérperas identificadas em uma maternidade no estado de Minas Gerais, em que foram coletados dados de atenção odontológica durante a gestação, condições de saúde bucal materna, Índice de Apgar do recém-nascido e variáveis de confundimento. Os dados foram analisados inicialmente de forma descritiva e a correlação entre a atenção odontológica e o Índice de Apgar foi testada por meio do teste de Pearson. Resultado Foram analisados os dados coletados das 144 puérperas e seus bebês, mas não foram encontradas correlações entre o Índice de Apgar e nenhuma das variáveis de cuidado odontológico, variáveis maternas e do recém-nascido coletadas no estudo. Conclusão Não foram observadas correlações do Índice de Apgar com nenhuma variável de cuidado odontológico, variáveis maternas e do recém-nascido. recémnascido. recémnascido recém nascido. nascido Realizouse Realizou se Gerais gestação materna confundimento Pearson 14 bebês odontológico 1

Abstract Aim To verify the existence of a relationship between dental care for pregnant women and maternal oral conditions and the health of the newborn. Material and method A cross-sectional study was carried out with mothers identified in a maternity hospital in the state of Minas Gerais, in which data on dental care during pregnancy, maternal oral health conditions, Apgar score of the newborn and confounding variables were collected. The data were initially analyzed descriptively and the adaptation between dental care and the Apgar score was tested using the Pearson test. Result Data collected from 144 postpartum women and their babies were analyzed, but no correlations were found between the Apgar score and any of the dental care, maternal and newborn variables collected in the study. Conclusion No correlations of the Apgar Score with any dental care variables, maternal and newborn variables were observed. crosssectional cross sectional Gerais pregnancy test 14 observed 1

https://doi.org/10.1590/1807-2577.00624

Anatomical and histochemical characterization of vegetative organs of Brazilian species of Renealmia (Zingiberaceae) Zingiberaceae (Zingiberaceae
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Gevú, Kathlyn Vasconcelos

; Lima, Helena Regina Pinto

; Alexandrino, Camilla Ribeiro

; Cunha, Maura da

Rodriguésia

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2024, Volume 75 elocation e01462023

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

Resumo Renealmia abrange aproximadamente 75 espécies de plantas herbáceas e rizomatosas, oriundas de regiões africanas e neotropicais, conhecidas por sua diversidade de metabólitos. Este estudo visou caracterizar a anatomia e histoquímica dos órgãos vegetativos de três espécies nativas do Brasil: Renealmia breviscapa e Renealmia nicolaioides, coletadas na Floresta Amazônica, no Acre, e Renealmia chrysotricha, encontrada em uma floresta Atlântica, no Rio de Janeiro. Amostras foram fixadas e processadas por técnicas convencionais de anatomia vegetal, incluindo testes histoquímicos para identificação das classes de substâncias presentes nos órgãos vegetativos. Características como idioblastos oleíferos, estrutura foliar dorsiventral, estômatos tetracíticos, tricomas unicelulares e presença de cristais prismáticos foram comuns entre as espécies de Renealmia estudadas, revelando-se significativas para a família. Foram identificados caracteres distintivos nos órgãos vegetativos das três espécies, como distribuição celular do floema radicular, cobertura do tecido dos rizomas, diferentes tipos e distribuição de idioblastos e tricomas fenólicos tanto nos rizomas quanto nas folhas, presença ou ausência de pecíolo, além da camada subepidérmica na região intercostal das folhas. Destaca-se também a importância do conteúdo mineral como característica diagnóstica do gênero Renealmia. Este estudo proporciona um avanço no conhecimento das características anatômicas distintivas das três espécies de Renealmia em diferentes ambientes, tanto na Floresta Atlântica quanto na Floresta Amazônica. 7 rizomatosas neotropicais metabólitos Brasil nicolaioides Amazônica Acre chrysotricha Janeiro vegetal oleíferos dorsiventral tetracíticos estudadas revelandose revelando se família radicular folhas pecíolo Destacase Destaca ambientes

Abstract Renealmia comprises approximately 85 herbaceous and rhizomatous plants in Africa and America known for their metabolite diversity. This study characterized the anatomy and histochemistry of the vegetative organs of three native Brazilian Renealmia species, R. breviscapa and R. nicolaioides, collected from the Amazon Forest in Acre and R. chrysotricha from the Atlantic Forest in Rio de Janeiro. Samples were fixed and processed using conventional plant anatomy and micromorphology techniques, including histochemical tests to identify classes of compounds in vegetative organs. Characteristics including oil idioblasts, dorsiventral leaf structure, tetracytic stomata, unicellular trichomes, and prismatic crystals were common among the studied species of Renealmia, and thus significant for the family. Distinctive characteristics were identified in the vegetative organs of the three species, including the cellular distribution of root phloem, covering of rhizome tissue, different types and distributions of idioblasts and phenolic trichomes in rhizomes and leaves, presence or absence of petiole, and subepidermal layer in the intercostal region of leaves. Mineral content importance as a diagnostic characteristic of the genus is also emphasized. The results of this study advance the understanding of the distinctive anatomical characteristics of the three species of Renealmia in different environments, two in the Atlantic Forest and one in the Amazon Forest. 8 diversity R nicolaioides Janeiro techniques structure stomata family phloem tissue leaves petiole emphasized environments

https://doi.org/10.1590/2175-7860202475041

Comprehensive analysis of the HCK gene in myeloid neoplasms: Insights into biological functions, prognosis, and response to antineoplastic agents neoplasms functions prognosis
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Carvalho, Maria Fernanda Lopes

; Almeida, Bruna Oliveira de

; Bueno, Maura Lima Pereira

; Vicari, Hugo Passos

; Lima, Keli

; Rego, Eduardo Magalhães

; Roversi, Fernanda Marconi

; Machado-Neto, João Agostinho

Hematology, Transfusion and Cell Therapy

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2024, Volume 46 Nº 3 Páginas 273 - 282

Resumo: En | Texto: En | PDF: En

Abstract Myeloid neoplasms result from molecular alterations in hematopoietic stem cells, with acute myeloid leukemia (AML) being one of the most aggressive and with a poor prognosis. Hematopoietic cell kinase (HCK) is a proto-oncogene that encodes a protein-tyrosine kinase of the Scr family, and it is highly expressed in AML. The present study investigated HCK expression in normal hematopoietic cells across myeloid differentiation stages and myeloid neoplasm patients. Within the AML cohort, we explored the impact of HCK expression on clinical outcomes and its correlation with clinical, genetic, and laboratory characteristics. Furthermore, we evaluated the association between HCK expression and the response to antineoplastic agents using ex vivo assay data from AML patients. HCK expression is higher in differentiated subpopulations of myeloid cells. High HCK expression was observed in patients with chronic myelomonocytic leukemia, chronic myeloid leukemia, and AML. In patients with AML, high levels of HCK negatively impacted overall and disease-free survival. High HCK expression was also associated with worse molecular risk groups and white blood cell count; however, it was not an independent prognostic factor. In functional genomic analyses, high HCK expression was associated with several biological and molecular processes relevant to leukemogenesis. HCK expression was also associated with sensitivity and resistance to several drugs currently used in the clinic. In conclusion, our analysis confirmed the differential expression of HCK in myeloid neoplasms and its potential association with unfavorable molecular risks in AML. We also provide new insights into HCK biological functions, prognosis, and response to antineoplastic agents. (AML prognosis (HCK protooncogene proto oncogene proteintyrosine protein tyrosine family cohort genetic characteristics Furthermore diseasefree disease free survival count however factor analyses leukemogenesis clinic conclusion functions

https://doi.org/10.1016/j.htct.2023.11.007

Streptococcus equi subspecies zooepidemicus: an emergent cause of meningoencephalitis in Northeastern Brazil zooepidemicus
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Farias, Luis Arthur Brasil Gadelha

; Sousa, Marcos Maciel

; Cavalcante, Karene Ferreira

; Jucá, Marina Pinheiro Catunda

; Castro, Aldenise de Olinda

; Mello, Liana Perdigão

; Mesquita, Rafael Ferreira

; Bandeira, Silviane Praciano

; Marchi, Ana Paula

; Coelho, Tânia Mara Silva

; Lima Neto, Antônio Silva

; Arruda, Érico Antonio Gomes de

; Costa, Silvia Figueiredo

; Oliveira, Maura Salaroli de

; Perdigão Neto, Lauro Vieira

Revista do Instituto de Medicina Tropical de São Paulo

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2024, Volume 66 elocation e51

Resumo: En | Texto: En | PDF: En

ABSTRACT This study describes an outbreak of Streptococcus equi subspecies zooepidemicus infections that caused meningoencephalitis and bacteremia related to unpasteurized milk consumption in northeastern Brazil. Epidemiological investigations and a brief literature review were conducted. Strains with possible neurotropism had not been identified in Brazil before these cases; however, in 2023, another case of meningoencephalitis caused by Streptococcus equi sp. zooepidemicus was described, revealing the need to maintain surveillance and highlighting that these neurotropic strains continue to circulate in the environment. conducted cases however 2023 sp described environment 202 20 2

https://doi.org/10.1590/s1678-9946202466051

Field dissipation and leaching potential of indaziflam in soil columns from coffee-cultivated areas with different soil cover materials coffeecultivated coffee cultivated
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Lima, Alessandro C.

; Fontes, Daniel R.

; Brochado, Maura G. S.

; Reis, Marcelo R.

; Mendes, Kassio F.

Advances in Weed Science

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2024, Volume 42 elocation e020240025

Resumo: En | Texto: En | PDF: En

Abstract Background Pre-emergence (PRE) herbicides, such as indaziflam, are commonly used in coffee crops for weed control. However, the influence of soil cover materials on herbicide dissipation and leaching remains unclear. Objective This study evaluated indaziflam dissipation and leaching in two coffee-cultivated areas with different soil cover materials to determine their compatibility with indaziflam. Methods The field dissipation study was performed in a sandy clay Oxisol (OXIsc) and clay Oxisol (OXIcl) using a recommended indaziflam dose (75 g a.i. ha−1) with three soil cover materials (crop debris, organic compost, bare soil) applied at 5 t ha−1. Indaziflam residues were measured at eight intervals (0–210 days after application—DAA) using high-performance liquid chromatography. Dissipation time (DT50) was estimated. Leaching potential was assessed in a greenhouse using PVC columns and simulated rainfall (100 mm). Soybean was used as a bioindicator to measure injury and biomass reduction at various soil depths. Results Indaziflam DT50 ranged from 95–119 days in OXIsc and 135–161 days in OXIcl. Soil cover materials did not affect dissipation, indicating prolonged herbicide activity. Indaziflam remained in the 0–5 cm soil layer, proving minimal soybean injury and biomass reduction below this depth. Injury in the 0–5 cm layer decreased from 85–90% at 0 DAE to 70–85% at 21 DAE in OXIsc, and from 88–95% to 70–80% in OXIcl. Conclusion Organic compost and crop debris did not alter Indaziflam dissipation or leaching, making these soil covers compatible with indaziflam applications under the study conditions. Preemergence Pre emergence PRE (PRE herbicides control However unclear coffeecultivated cultivated (OXIsc OXIcl (OXIcl 75 (7 ai i a.i ha−1 ha1 ha 1 0–210 0210 210 (0–21 applicationDAA application DAA application—DAA highperformance high performance chromatography DT (DT50 estimated 100 (10 mm. mm . mm) depths DT5 95119 95 119 95–11 135161 135 161 135–16 activity 05 0– depth 8590 85 90 85–90 7085 70 70–85 2 8895 88 88–95 7080 80 70–80 conditions 7 ( ha− 0–21 021 (0–2 (DT5 10 (1 9511 9 11 95–1 13516 13 16 135–1 859 8 85–9 708 70–8 889 88–9 0–2 02 (0– (DT 951 95– 1351 135– 85– 70– 88– (0

https://doi.org/10.51694/advweedsci/2024;42:00030

The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia COVID19 COVID 19 COVID-1 Emergência Vascular Infectologia COVID1 1 COVID-
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Falavigna, Maicon

; Araujo, Cintia Laura Pereira de

; Barbosa, Alexandre Naime

; Belli, Karlyse Claudino

; Colpani, Verônica

; Dal-Pizzol, Felipe

; Silva, Rosemeri Maurici da

; Azevedo, Luciano César Pontes de

; Dias, Maria Beatriz Souza

; Amaral, José Luiz Gomes do

; Dorneles, Gilson Pires

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Machado, Flávia Ribeiro

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Parahiba, Suena Medeiros

; Rosa, Regis Goulart

; Santos, Vania Cristina Canuto

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Stein, Cinara

; Carvalho, Carlos Roberto Ribeiro de

Critical Care Science

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Set 2023, Volume 35 Nº 3 Páginas 243 - 255

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

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos. Objetivo COVID19 COVID 19 COVID-1 Brasil Métodos especialistas metodologistas baseouse baseou se eou GRADE ADOLOPMENT eCOVID19 eCOVID e-COVID-1 RecMap Resultados Chegaramse Chegaram 2 baricitinibe invasiva anticoagulantes tromboembolismo imdevimabe bacteriana hidroxicloroquina convalescente ritonavir rendesivir Conclusão COVID19, 19, condicional usados recursos COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy. Objective COVID19 COVID 19 COVID-1 Brazil Methods Experts methodologists guideline andor ADOLOPMENT eCOVID19 eCOVID e e-COVID-1 platform Results Twentyone Twenty one generated authorization imdevimab infection hydroxychloroquine plasma colchicine made Conclusion recommended recommendation evidencebased economy COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

https://doi.org/10.5935/2965-2774.20230136-en

Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance COVID19 COVID 19 COVID-1 healthcareassociated healthcare associated infections COVID1 1 COVID-
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Freire, Maristela Pinheiro

; Assis, Denise Brandão de

; Tavares, Bruno de Melo

; Brito, Valquiria O.C.

; Marinho, Igor

; Lapchik, Milton

; Guedes, Ana Rubia

; Madalosso, Geraldine

; Oliveira, Maura Salaroli

; Lima, Antonio Carlos Pedroso de

; Levin, Anna S.

Clinics

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2023, Volume 78 elocation 100231

Resumo: En | Texto: En | PDF: En

Abstract Background This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions HAI increased during COVID-19. The microorganisms’ susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use. HealthcareAssociated Healthcare Associated (HAI ICU (ICU COVID19 COVID 19 COVID-1 prepandemic pre period CentralLineAssociated Line VentilatorAssociated Ventilator VAP, , VAP) 201 2020 beds (CVC rate MechanicalVentilation Mechanical Ventilation (MV timeseries time series models 22 onset size nonprofit non profit private, private private) ≤ ( 50%. 50 50% . 50%) > 35%. 35 35% 35%) polymyxin glycopeptides COVID19. 19. largespectrum large spectrum COVID1 1 COVID- 20 202 2 5 3

https://doi.org/10.1016/j.clinsp.2023.100231

Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19: Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia e Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Stein, Cinara

; Amaral, José Luiz Gomes do

; Azevedo, Luciano Cesar Pontes de

; Belli, Karlyse Claudino

; Colpani, Verônica

; Cunha, Clóvis Arns da

; Dal-Pizzol, Felipe

; Dias, Maria Beatriz Souza

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Monteiro, José Tadeu

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Prado, Clementina Corah Lucas

; Santos, Vania Cristina Canuto

; Silva, Rosemeri Maurici da

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Vidal, Ávila Teixeira

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Machado, Flávia Ribeiro

; Carvalho, Carlos Roberto Ribeiro de

Revista Brasileira de Terapia Intensiva

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Mar 2022, Volume 34 Nº 1 Páginas 1 - 12

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

RESUMO Objetivos: Há diversas terapias sendo utilizadas ou propostas para a COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é elaborar recomendações para subsidiar decisões sobre o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: Um grupo de 27 membros, formado por especialistas, representantes do Ministério da Saúde e metodologistas, integra essa diretriz. Foi utilizado o método de elaboração de diretrizes rápidas, tomando por base a adoção e/ou a adaptação de recomendações a partir de diretrizes internacionais existentes (GRADE ADOLOPMENT), apoiadas pela plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Foram geradas 16 recomendações. Entre elas, estão recomendações fortes para o uso de corticosteroides em pacientes em uso de oxigênio suplementar, para o uso de anticoagulantes em doses de profilaxia para tromboembolismo e para não uso de antibacterianos nos pacientes sem suspeita de infecção bacteriana. Não foi possível fazer uma recomendação quanto à utilização do tocilizumabe em pacientes hospitalizados com COVID-19 em uso de oxigênio, pelas incertezas na disponibilidade e de acesso ao medicamento. Foi feita recomendação para não usar azitromicina, casirivimabe + imdevimabe, cloroquina, colchicina, hidroxicloroquina, ivermectina, lopinavir/ ritonavir, plasma convalescente e rendesivir. Conclusão: Até o momento, poucas terapias se provaram efetivas no tratamento do paciente hospitalizado com COVID-19, sendo recomendados apenas corticosteroides e profilaxia para tromboembolismo. Diversos medicamentos foram considerados ineficazes, devendo ser descartados, de forma a oferecer o melhor tratamento pelos princípios da medicina baseada em evidências e promover economia de recursos não eficazes.

ABSTRACT Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.

https://doi.org/10.5935/0103-507x.20220001-pt

10.

Brazilian guidelines for the treatment of outpatients with suspected or confirmed COVID-19. A joint guideline of the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Medical Association (AMB), Brazilian Society of Angiology and Vascular Surgery (SBACV), Brazilian Society of Geriatrics and Gerontology (SBGG), Brazilian Society of Infectious Diseases (SBI), Brazilian Society of Family and Community Medicine (SBFMC), and Brazilian Thoracic Society (SBPT)
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Falavigna, Maicon

; Belli, Karlyse Claudino

; Barbosa, Alexandre Naime

; Zavascki, Alexandre Prehn

; Nastri, Ana Catharina de Seixas Santos

; Santana, Christiane Machado

; Stein, Cinara

; Gräf, Débora Dalmas

; Cadegiani, Flavio Adsuara

; Guimarães, Hélio Penna

; Monteiro, José Tadeu

; Ferreira, Juliana Carvalho

; de Azevedo, Luciano Cesar Pontes

; Magri, Marcelo Mihailenko Chaves

; Sobreira, Marcone Lima

; Dias, Maria Beatriz Gandra de Souza

; de Oliveira, Maura Salaroli

; Corradi, Mirian de Freitas Dal Ben

; Rosa, Regis

; Heinzelmann, Ricardo Souza

; da Silva, Rosemeri Maurici

; Belfort Junior, Rubens

; Cimerman, Sergio

; Colpani, Verônica

; Veiga, Viviane Cordeiro

; de Carvalho, Carlos Roberto Ribeiro

Brazilian Journal of Infectious Diseases

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2022, Volume 26 Nº 2 elocation 102347

Resumo: En | Texto: En | PDF: En

ABSTRACT Background Several therapies have been used or proposed for the treatment of COVID-19, although their effectiveness and safety have not been properly evaluated. The purpose of this document is to provide recommendations to support decisions about the drug treatment of outpatients with COVID-19 in Brazil. Methods A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines. A rapid guideline development method was used, based on the adoption and/or adaptation of recommendations from existing international guidelines combined with additional structured searches for primary studies and new recommendations whenever necessary (GRADE-ADOLOPMENT). The rating of quality of evidence and the drafting of recommendations followed the GRADE method. Results Ten technologies were evaluated, and 10 recommendations were prepared. Recommendations were made against the use of anticoagulants, azithromycin, budesonide, colchicine, corticosteroids, hydroxychloroquine/chloroquine alone or combined with azithromycin, ivermectin, nitazoxanide, and convalescent plasma. It was not possible to make a recommendation regarding the use of monoclonal antibodies in outpatients, as their benefit is uncertain and their cost is high, with limitations of availability and implementation. Conclusion To date, few therapies have demonstrated effectiveness in the treatment of outpatients with COVID-19. Recommendations are restricted to what should not be used, in order to provide the best treatment according to the principles of evidence-based medicine and to promote resource savings by aboiding ineffective treatments.

https://doi.org/10.1016/j.bjid.2022.102347

11.

Polo Científico Productivo de Matanzas: mecanismo de integración de la ciencia y la producción
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Díaz Lima, Mariela

; Ruiz Soto, Rachel

; Fernández Valle, Oscar

; Ochoa Ramírez, Eva

; Guerra Sánchez, Maura

; Martínez Abreu, Judit

Revista Médica Electrónica

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Jun 2021, Volume 43 Nº 3 Páginas 789 - 803

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT The Unit of Science, Technology and Innovation of the Territorial Delegation of the Ministry of Science, Technology and Environment in Matanzas promotes, since January 19 2018, the revival of the Productive Scientific Pole as a form of giving a better use to science done in Matanzas province and integrating the research centers and enterprises efforts in pursuit of the socioeconomic development of the territory. Currently, the province is involved in an effort for ensuring that every organization assumes its responsibility in setting in motion the Productive Scientific Pole with the delegation of the Ministry of Sciences, Technology and Environment as the coordinating entity. This paper is written with the aim of assessing the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory. The current paper assesses the importance of the Productive Scientific Pole in increasing the impact of science and technique in solving the productive problems of the Matanzas territory.

RESUMEN La Unidad de Ciencia, Tecnología e Innovación de la Delegación Territorial del Ministerio de Ciencia, Tecnología y Medio Ambiente en Matanzas, promueve desde el 19 de enero de 2018 la revitalización del Polo Científico Productivo, como forma de procurar un mejor uso a la ciencia matancera e integrar los esfuerzos de los centros de investigación y empresas en pos del desarrollo socioeconómico del territorio. Actualmente, la provincia se encuentra envuelta en un esfuerzo por lograr que cada organismo se responsabilice con la puesta en marcha del Polo Científico Productivo, con la Delegación Territorial del Ministerio de Ciencia, Tecnología y Medio Ambiente como entidad coordinadora. El presente trabajo valora la significación del Polo Científico Productivo en la elevación del impacto de la ciencia y la técnica en la solución de los problemas productivos del territorio matancero.

12.

Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
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Gonçalves, Fabio Augusto Rodrigues

; Besen, Bruno Adler Maccagnan Pinheiro

; Lima, Clarice Antunes de

; Corá, Aline Pivetta

; Pereira, Antônio José Rodrigues

; Perazzio, Sandro Félix

; Gouvea, Christiane Pereira

; Fonseca, Luiz Augusto Marcondes

; Trindade, Evelinda Marramon

; Sumita, Nairo Massakazu

; Duarte, Alberto José da Silva

; Lichtenstein, Arnaldo

; Bonfa, Eloisa

; Utiyama, Edivaldo M.

; Segurado, Aluisio C.

; Perondi, Beatriz

; Miethke-Morais, Anna

; Montal, Amanda C.

; Harima, Leila

; Fusco, Solange R. G.

; Silva, Marjorie F.

; Rocha, Marcelo C.

; Marcilio, Izabel

; Rios, Izabel Cristina

; Kawano, Fabiane Yumi Ogihara

; Jesus, Maria Amélia de

; Kallas, Ésper George

; Carmo, Carolina

; Tanaka, Clarice

; Souza, Heraldo Possolo de

; Marchini, Julio F. M.

; Carvalho, Carlos

; Ferreira, Juliana C.

; Levin, Anna Sara Shafferman

; Oliveira, Maura Salaroli

; Guimarães, Thaís

; Lázari, Carolina dos Santos

; Sabino, Ester

; Magri, Marcello M. C.

; Barros-Filho, Tarcisio E. P.

; Francisco, Maria Cristina Peres Braido

; Costa, Silvia F.

Clinics

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2021, Volume 76 elocation e3547

Resumo: En | Texto: En | PDF: En

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

https://doi.org/10.6061/clinics/2021/e3547

13.

Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology
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MONT’ALVERNE, Francisco José Arruda

; LIMA, Fabrício Oliveira

; NOGUEIRA, Raul Gomes

; FREITAS, Carlos Clayton Macedo de

; NETO, Octávio Marques Pontes

; SILVA, Gisele Sampaio

; OLIVEIRA, Maura Salaroli de

; FRUDIT, Michel

; CALDAS, Jose Guilherme Mendes Pereira

; ABUD, Daniel Giansante

; CONFORTO, Adriana Bastos

; CARVALHO, Fernanda Martins Maia

; DIAS, Francisco Antunes

; BAZAN, Rodrigo

; AVELAR, Wagner Mauad

; MORO, Carla Heloísa Cabral

; MAGALHÃES, Pedro Silva Correa de

; MIRANDA, Maramelia

; BARBOSA, Leandro de Assis

; FIOROT JUNIOR, José Antonio

; CARDOSO, Fabrício Buchdid

; REBELLO, Leticia Costa

; PARENTE, Bruno de Sousa Mendes

; FARIA, Mário de Barros

; FREITAS, Gabriel Rodriguez de

; ZÉTOLA, Viviane de Hiroki Flumignan

; OLIVEIRA-FILHO, Jamary

; BEZERRA, Daniel da Cruz

; RODRIGUES, Jorge Luis Nobre

; KUSTER, Gustavo

; MARTINS, Sheila

; CARVALHO, João José Freitas de

Arquivos de Neuro-Psiquiatria

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Jul 2020, Volume 78 Nº 7 Páginas 440 - 449

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

RESUMO Introdução: A pandemia causada pelo novo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2, COVID-19) apresenta novos e importantes desafios à gestão de saúde no Brasil. Além da difícil missão de prestar atendimento aos milhares de pacientes infectados pelo COVID-19, os sistemas de saúde têm que manter a assistência às emergências médicas comuns em períodos sem pandemia, tais como o acidente vascular cerebral (AVC), que continuam ocorrendo e requerem tratamento com presteza e eficiência. A alocação de recursos materiais e humanos para o enfrentamento à pandemia não pode comprometer o atendimento ao AVC agudo, uma emergência cujo tratamento é tempo-dependente e se não realizado implica em importante impacto na mortalidade e incapacitação a longo prazo. Objetivo: Este trabalho resume as recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, da Sociedade Brasileira de Doenças Cerebrovasculares e da Sociedade Brasileira de Neurorradiologia para o tratamento do AVC agudo e para a realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19, incluindo o uso adequado de ferramentas de triagem e equipamentos de proteção pessoal (para pacientes e profissionais de saúde), além da alocação apropriada de pacientes.

ABSTRACT Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.

https://doi.org/10.1590/0004-282x20200053 2310 downloads

14.

Phenolic compounds from the rhizome of Renealmia nicolaioides Loes.: a new diarylheptanoid
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GEVÚ, KATHLYN V.

; CARVALHO, MÁRIO G. DE

; SILVA, ILNA G. DA

; LIMA, HELENA R.P.

; CASTRO, ROSANE N.

; CUNHA, MAURA DA

Anais da Academia Brasileira de Ciências

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2019, Volume 91 Nº 1 elocation e20180312

Resumo: En | Texto: En | PDF: En

Abstract: This study aims to identify phenolic compounds in dichloromethane and methanolic extracts of the rhizome of Renealmia nicolaioides collected in the North Region of Brazil. Two known diarylheptanoids, 1,7-bis(4-hydroxyphenyl)-(1E)-1-hepten-3-one (1), and 5R-1,7-bis(4-hydroxyphenyl)-1E-hepten-5-ol (2), and a new one (1R,2S,5S)-2-hydroxy-1,7(p-hydroxyphenyl)-centrolobine (3), as well as one flavonoid, 3-metoxi-quercetin (4) were isolated by chromatographic procedure and identified by spectroscopic techniques (1H and13C NMR, HRMS and CD). The acetyl derivative of 2 was used to confirm its structure. All four compounds are reported for the first time for this genus, and this is the first occurrence of compound 1 as a natural metabolite. The results reported here are unprecedented for the genus Renealmia.

https://doi.org/10.1590/0001-3765201920180312 1314 downloads

15.

Inspiratory loading exercises on respiratory muscle function in post-operative gastroplasty patients: a randomized clinical trial
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Rocha, Maura Rigoldi Simões da

; Merino, Daniela Faleiros Bertelli

; Souza, Stefane Cristina de

; Montebelo, Maria Imaculada de Lima

; Rasera Júnior, Irineu

; Pazzianotto-Forti, Eli Maria

Fisioterapia em Movimento

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2019, Volume 32 elocation e003213

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

Resumo Introdução: O pós-operatório de gastroplastia pode alterar a mecânica respiratória e predispor a complicações respiratórias. Objetivo: Avaliar os efeitos de exercícios com carga inspiratória na função muscular respiratória e na prevalência de atelectasias após gastroplastia. Método: 40 voluntárias foram alocadas randomicamente em: Grupo Controle (GC), que recebeu Fisioterapia Respiratória Convencional (FRC) e Grupo Carga Inspiratória (GCI), que executou exercícios com carga inspiratória linear pressórica com 40% da pressão inspiratória máxima (PImáx), associados à FRC. Os tratamentos foram realizados duas vezes no pós-operatório imediato e três vezes no primeiro dia pós-operatório. Além da PImáx, foram avaliadas a pressão inspiratória nasal (PIN) e a pressão inspiratória máxima sustentada (PImáxS) antes e após o tratamento. Foi realizada análise de variância seguida de ajuste de Bonferroni, e o nível de significância estatística foi de 5% (p < 0,05). Resultados: Não houve diferença significativa nos valores de PIN e na PImáxS no GCI quando comparados o pré e pós-operatório, diferentemente do GC, no qual esses valores foram significativamente menores além de diferença entre os grupos no valor de PIN. A prevalência de atelectasias foi de 5% para GCI e 15% para GC, sem diferenças intergrupos. Conclusão: Houve manutenção da força muscular inspiratória e da resistência dos músculos respiratórios no grupo que realizou exercícios com carga inspiratória, associado a FRC com baixo índice de atelectasias após gastroplastia.

Abstract Introduction: The gastroplasty post-operative period can alter respiratory mechanics and predispose patients to respiratory complications. Objective: The objective was to evaluate the effects of exercises with inspiratory load on respiratory muscle function and on the prevalence of atelectasis after gastroplasty. Method: 40 participants were randomly allocated into two groups: Control Group (CG), its members underwent conventional respiratory physical therapy (CRP) and the Inspiratory Load Group (ILG), its members performed exercises with linear inspiratory pressure load, with 40% of the maximum inspiratory pressure (MIP), associated with CRP. Therapy procedures were conducted twice during the immediate post-operative period and thrice on the first post-operative day. In addition to evaluating the MIP, the nasal inspiratory pressure (NIP) and the sustained maximum inspiratory pressure (SMIP) were evaluated before and after treatment. Analysis of variance followed by the Bonferroni correction were applied considering a 5% significance level (p < 0.05). Results: There was no significant difference in NIP and SMIP values when the pre- and post-operative periods were compared for the ILG; however, these values were significantly lower for the CG, also with intergroup differences in NIP values. Atelectasis prevalence was 5% for ILG and 15% for CG, with no intergroup difference. Conclusion: The inspiratory muscle strength and resistance of the respiratory muscles were maintained in the group that performed exercises with inspiratory load associated with CRP, with a low rate of atelectasis after gastroplasty.

Resumen Introducción: El postoperatorio de gastroplastia puede alterar la mecánica respiratoria y predisponer a complicaciones respiratorias. Objetivo: Evaluar los efectos de ejercicios con carga inspiratoria en la función muscular respiratoria y en la prevalencia de atelectasias después de la gastroplastia. Método: 40 voluntarias fueron asignadas en: Grupo Control (GC), que recibió Fisioterapia Respiratoria Convencional (FRC) y Grupo Carga Inspiratoria (GCI), que ejecutó ejercicios con carga inspiratoria, realizados con carga lineal inspiratoria con un 40% de la presión inspiratoria máxima (PIM) asociados a la FRC. Ambos tratamientos se realizaron dos veces en el postoperatorio inmediato y tres veces en el primer día postoperatorio. Además de la PIM, se evaluaron la presión inspiratoria nasal (PIN) y la presión inspiratoria máxima sostenida (PImáxS) antes y después del tratamiento. Se realizó el análisis de varianza seguida de ajuste de Bonferroni. Se adoptó nivel de significancia estadística del 5% (p < 0,05). Resultados: No hubo diferencia significativa en los valores de PIN y en la PImáxS en el GCI cuando se compararon en el pre y en postoperatorio, a diferencia del GC, en el cual estos valores fueron significativamente menores más allá de diferencia entre los grupos en el valor de PIN. La prevalencia de atelectasias fue de 5% para GCI y 15% para GC, sin diferencia entre grupos. Conclusión: Hubo mantenimiento de la fuerza muscular inspiratoria y de la resistencia de los músculos respiratorios en el grupo que realizó ejercicios con carga inspiratoria, asociados a la FRC, con bajo índice de atelectasias tras gastroplastia.

https://doi.org/10.1590/1980-5918.032.ao13 2003 downloads

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