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Evidence of restorative therapies in the treatment of Peyronie disease: A narrative review disease
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Mesquita, Francesco Costantini
; Barros, Rodrigo
; Lima, Thiago Fernandes Negris
; Velasquez, David
; Favorito, Luciano A.
; Pozzi, Edoardo
; Dornbush, James
; Miller, David
; Petrella, Francis
; Ramasamy, Ranjith
.
ABSTRACT Objective: To describe the evidence of Platelet Rich Plasma (PRP), Stem cells therapy (SCT) and Extracorporeal shockwave therapy (ESWL) for the treatment of Peyronies disease (PD), including information from the main urological society guidelines. Materials and Methods: A literature review of PubMed articles published between 2000 and 2023 was conducted, utilizing keywords such as "Peyronie's Disease", "Penile curvature", "Platelet Rich Plasma", "Stem cells", and "Extracorporeal shockwave therapy". Only full-text articles in English were included, excluding case reports and opinions. Results: A considerable number of clinical trials were conducted using PRP penile injections for therapy of PD, showing reduction of curvature, plaque size and improvement in quality of life. Preclinical studies in rats have shown the potential benefit of adipose-derived stem cells, with improvements in erectile function and fibrosis. Human studies with mesenchymal stem cells demonstrated promising results, with reduction of curvature and plaque size. ESWL effects on PD were investigated in randomized clinical trials and demonstrated no significant impact in curvature or plaque size, but reasonable effect on pain control. Conclusion: Restorative therapies has emerged as an innovative treatment option for PD and the results from current studies appear to be promising and demonstrated good safety profile. Unfortunately, due to scarce evidence, PRP and SCT are still considered experimental by American Urological Association (AUA) and European Association of Urology (EAU) guidelines. ESWT is recommended, by the same guidelines, for pain control only. More high-quality studies with long-term follow-up outcomes are needed to evaluate efficacy and reproducibility of those therapies. Objective PRP, , (PRP) (SCT (ESWL (PD) guidelines Methods 200 202 Peyronie s Disease, Disease Disease" Penile curvature" Plasma, Plasma" cells" therapy. . therapy" fulltext full text included opinions Results life adiposederived adipose derived fibrosis Conclusion profile Unfortunately AUA (AUA EAU (EAU recommended only highquality high longterm long term followup follow up (PRP (PD 20 2
2.
Echocardiogram in Critically ill Patients with COVID-19: ECOVID Study COVID19 COVID 19 COVID-19 COVID1 1 COVID-1 COVID-
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Gomes, Bruno Ferraz de Oliveira
; Cantisano, Armando Luis
; Menezes, Iliana Regina Ribeiro
; Azevedo, Anny de Sousa
; Silva, Thiago Moreira Bastos da
; Silva, Valdilene Lima
; Dutra, Giovanni Possamai
; Paula, Suzanna Andressa Morais de
; Mendes, Barbara Ferreira da Silva
; Carmo Junior, Plinio Resende do
; Pereira, Basilio de Bragança
; Petriz, Joao Luiz Fernandes
; Oliveira, Glaucia Maria Moraes de
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram. COVID19 COVID 19 COVID-1 ICU. . (ICU) signalssymptoms signals symptoms signals/symptoms outcomes RTPCRconfirmed RT PCR confirmed COVID19, 19, included andor or effusion analyzed Students Student s ttest, ttest t test, test t-test chisquare, chisquare chi square, square chi-square 005 0 05 0.0 significant 14 criteria 7 52.9% 529 52 9 (52.9% observed 35 function analysis age disease failure SAPS 3. 3) model inhospital hospital RR 2.10 210 2 10 95 1.044.24 104424 1.04 4.24 1 04 4 24 1.04-4.24 2.3 23 1.144.78. 114478 1.14 4.78 78 1.14-4.78) addition COVID1 COVID- (ICU 00 0. 52.9 5 (52.9 2.1 21 044 1.044.2 10442 104 1.0 424 4.2 1.04-4.2 2. 144 1.144.78 11447 114 1.1 478 4.7 1.14-4.78 52. (52. 1.044. 1044 1. 42 4. 1.04-4. 1.144.7 1144 11 47 1.14-4.7 (52 1.044 1.04-4 1.144. 1.14-4. (5 1.04- 1.144 1.14-4 ( 1.14-
3.
Parasitism by Amblyomma rotundatum on Teiidae lizards in the eastern part of the state of Acre, Brazil Acre
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Tojal, Simone Delgado
; Costa, Ivaneide Nunes da
; Aguirre, André de Abreu Rangel
; Martins, Thiago Fernandes
; Labruna, Marcelo Bahia
; Meneguetti, Dionatas Ulises de Oliveira
; Bernarde, Paulo Sérgio
; Cruz, Karoline Silva da
; Lima, Jônatas Machado
; Prolo Júnior, Sergio Luiz
; Camargo, Luís Marcelo de Aranha
.
Revista Brasileira de Parasitologia Veterinária
- Métricas do periódico
Abstract The aim of the present study was to report on the occurrence of parasitism by Amblyomma rotundatum ticks on two species of Teiidae lizards and test the presence of rickettsiae in the collected ticks, in the western Brazilian Amazon region. Ticks were collected in July 2019, from a fragment of terra firme forest in the municipality of Senador Guiomard, Acre, Brazil. Two lizards that were infested by immature stages of ticks were caught using mist net and Tomahawk traps. Ectoparasites were collected manually, and the lizard specimens were identified and released at the same location where they had been caught. Three nymphs and 49 larvae were collected from Ameiva ameiva, while 25 nymphs and nine larvae were collected from Tupinambis cuzcoensis, which are both in the family Teiidae. The ticks were identified morphologically as belonging to the genus Amblyomma. Nymphs were identified at species level through molecular analysis, resulting in the tick species Amblyomma rotundatum. This is the first record of parasitism by the tick A. rotundatum on T. cuzcoensis lizard, and the first report of an association between A. rotundatum and the lizard species A. ameiva and T. cuzcoensis in Acre, in the western part of the Amazon region. region 2019 Guiomard Acre Brazil traps manually 4 2 analysis A T 201 20
Resumo O objetivo do presente estudo foi relatar a ocorrência de parasitismo por carrapatos Amblyomma rotundatum em duas espécies de lagartos Teiidae, e testar a presença de riquétsias nos carrapatos coletados, na região da Amazônia Ocidental brasileira. Os carrapatos foram coletados em julho de 2019, em um fragmento de floresta de terra firme no município de Senador Guiomard, Acre, Brasil. Dois lagartos infestados por estágios imaturos de carrapatos foram capturados com rede de neblina e armadilhas Tomahawk. Os ectoparasitos foram coletados manualmente, e os espécimes de lagartos foram identificados e soltos no mesmo local onde foram capturados. Três ninfas e 49 larvas foram coletadas de Ameiva ameiva, enquanto 25 ninfas e nove larvas foram coletadas de Tupinambis cuzcoensis, ambas da família Teiidae. Os carrapatos foram identificados morfologicamente como pertencentes ao gênero Amblyomma. As ninfas foram identificadas em nível de espécie por meio de análise molecular, resultando na espécie de carrapato Amblyomma rotundatum. Este é o primeiro registro de parasitismo pelo carrapato A. rotundatum em lagarto T. cuzcoensis, e o primeiro relato de associação entre A. rotundatum e as espécies de lagartos A. ameiva e T. cuzcoensis, no Acre, na parte ocidental da região amazônica. Teiidae brasileira 2019 Guiomard Acre Brasil Tomahawk manualmente 4 2 cuzcoensis molecular A T amazônica 201 20
4.
Diversity of rickettsiae in ticks (Acari: Ixodidae) collected from wild vertebrates in part of the Amazon, Cerrado, and Pantanal biomes in Brazil Acari (Acari Ixodidae Amazon Cerrado
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Prati, Anny Carolina
; Maia, Maerle Oliveira
; Martins, Thiago Fernandes
; Morgado, Thaís Oliveira
; Corrêa, Sandra Helena Ramiro
; Mendes, Edson Junior Figueiredo
; Ferraz, Rosa Helena dos Santos
; Mudrek, Jessica Rhaiza
; Strüssmann, Christine
; Ramos, Dirceu Guilherme de Souza
; Semedo, Thiago Borges Fernandes
; Minetto, Make Kawatake
; Aguiar, Daniel Moura de
; Pacheco, Richard Campos
; Melo, Andréia Lima Tomé
.
Revista Brasileira de Parasitologia Veterinária
- Métricas do periódico
Abstract Ticks parasitizing 102 wild animals in the states of Mato Grosso and Goiás, Brazil were collected between 2015 and 2018. A total of 2338 ticks (865 males, 541 females, 823 nymphs, and 109 larvae) belonging to four genera (Amblyomma, Dermacentor, Haemaphysalis, and Rhipicephalus) and at least 21 species were identified. DNA extraction and a molecular survey for rickettsial agents were performed on 650 ticks. The results revealed parasitism by the following species: Rickettsia amblyommatis in Amblyomma cajennense s.s., A. cajennense s.l., Amblyomma coelebs, Amblyomma humerale, Amblyomma longirostre, Amblyomma nodosum, Amblyomma scalpturatum, Amblyomma sculptum, and Amblyomma romitii; Rickettsia parkeri in Amblyomma nodosum, Amblyomma ovale, Amblyomma scalpturatum, and Amblyomma triste; Rickettsia rhipicephali in Haemaphysalis juxtakochi; Rickettsia sp. in A. cajennense s.s., A. nodosum, and A. sculptum, and lastly, ‘Candidatus Rickettsia andeanae’ in Amblyomma parvum and Rhipicephalus microplus. This study expands the body of knowledge about tick parasitism among wild animals, including new data concerning tick-host associations, and provides information about the epidemiology of tick-borne pathogens in the Center-West region of Brazil. 10 Goiás 201 2018 233 865 (86 males 54 females 82 nymphs larvae Amblyomma, (Amblyomma Dermacentor 2 identified 65 ss s s.s. sl l s.l. coelebs humerale longirostre nodosum scalpturatum sculptum romitii ovale triste juxtakochi sp lastly Candidatus andeanae microplus tickhost host associations tickborne borne CenterWest Center West 1 20 23 86 (8 5 8 6 s.s s.l (
Resumo Foram coletados carrapatos parasitando 102 animais silvestres nos estados de Mato Grosso e Goiás, Brasil, entre 2015 e 2018. Um total de 2338 carrapatos (865 machos, 541 fêmeas, 823 ninfas e 109 larvas) pertencentes a quatro gêneros (Amblyomma, Dermacentor, Haemaphysalis e Rhipicephalus) e pelo menos 21 espécies foram identificadas. A extração de DNA e pesquisa molecular para agentes riquétsiais foram realizadas em 650 carrapatos. Os resultados revelaram parasitismo pelas seguintes espécies: Rickettsia amblyommatis em Amblyomma cajennense s.s., A. cajennense s.l., Amblyomma coelebs, Amblyomma humerale, Amblyomma longirostre, Amblyomma nodosum, Amblyomma scalpturatum, Amblyomma sculptum e Amblyomma romitii; Rickettsia parkeri em Amblyomma nodosum, Amblyomma ovale, Amblyomma scalpturatum e Amblyomma triste; Rickettsia rhipicephali em Haemaphysalis juxtakochi; Rickettsia sp. em A. cajennense s.s., A. nodosum e A. sculptum e, por último, ‘Candidatus Rickettsia andeanae’ em Amblyomma parvum e Rhipicephalus microplus. Este estudo amplia o conhecimento sobre o parasitismo de carrapatos em animais silvestres, incluindo-se novos dados sobre associações carrapato-hospedeiro. Fornece, ainda, informações sobre a epidemiologia de patógenos transmitidos por carrapatos na região Centro-Oeste do Brasil. 10 Goiás Brasil 201 2018 233 865 (86 machos 54 fêmeas 82 larvas Amblyomma, (Amblyomma Dermacentor 2 identificadas 65 ss s s.s. sl l s.l. coelebs humerale longirostre romitii ovale triste juxtakochi sp último Candidatus andeanae microplus incluindose incluindo se carrapatohospedeiro. carrapatohospedeiro carrapato hospedeiro. hospedeiro carrapato-hospedeiro Fornece ainda CentroOeste Centro Oeste 1 20 23 86 (8 5 8 6 s.s s.l (
5.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
; Jesuíno, Isabella de Andrade
; Reis, Luiz Fernando Lima
; Mattos, Renata Rodrigues de
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Spadoni, Clayse Carla da Silva
; Moro, Elisângela Emilene
; Bueno, Flávia Regina
; Sampaio, Camila Santana Justo Cintra
; Silva, Débora Patrício
; Baldassare, Franca Pellison
; Silva, Ana Cecilia Alcantara
; Veiga, Thabata
; Barbante, Leticia
; Lambauer, Marianne
; Campos, Viviane Bezerra
; Santos, Elton
; Santos, Renato Hideo Nakawaga
; Laranjeiras, Ligia Nasi
; Valeis, Nanci
; Santucci, Eliana
; Miranda, Tamiris Abait
; Patrocínio, Ana Cristina Lagoeiro do
; Carvalho, Andréa de
; Sousa, Eduvirgens Maria Couto de
; Sousa, Ancelmo Honorato Ferraz de
; Malheiro, Daniel Tavares
; Bezerra, Isabella Lott
; Rodrigues, Mirian Batista
; Malicia, Julliana Chicuta
; Silva, Sabrina Souza da
; Gimenes, Bruna dos Passos
; Sesin, Guilhermo Prates
; Zavascki, Alexandre Prehn
; Sganzerla, Daniel
; Medeiros, Gregory Saraiva
; Santos, Rosa da Rosa Minho dos
; Silva, Fernanda Kelly Romeiro
; Cheno, Maysa Yukari
; Abrahão, Carolinne Ferreira
; Oliveira Junior, Haliton Alves de
; Rocha, Leonardo Lima
; Nunes Neto, Pedro Aniceto
; Pereira, Valéria Chagas
; Paciência, Luis Eduardo Miranda
; Bueno, Elaine Silva
; Caser, Eliana Bernadete
; Ribeiro, Larissa Zuqui
; Fernandes, Caio Cesar Ferreira
; Garcia, Juliana Mazzei
; Silva, Vanildes de Fátima Fernandes
; Santos, Alisson Junior dos
; Machado, Flávia Ribeiro
; Souza, Maria Aparecida de
; Ferronato, Bianca Ramos
; Urbano, Hugo Corrêa de Andrade
; Moreira, Danielle Conceição Aparecida
; Souza-Dantas, Vicente Cés de
; Duarte, Diego Meireles
; Coelho, Juliana
; Figueiredo, Rodrigo Cruvinel
; Foreque, Fernanda
; Romano, Thiago Gomes
; Cubos, Daniel
; Spirale, Vladimir Miguel
; Nogueira, Roberta Schiavon
; Maia, Israel Silva
; Zandonai, Cassio Luis
; Lovato, Wilson José
; Cerantola, Rodrigo Barbosa
; Toledo, Tatiana Gozzi Pancev
; Tomba, Pablo Oscar
; Almeida, Joyce Ramos de
; Sanches, Luciana Coelho
; Pierini, Leticia
; Cunha, Mariana
; Sousa, Michelle Tereza
; Azevedo, Bruna
; Dal-Pizzol, Felipe
; Damasio, Danusa de Castro
; Bainy, Marina Peres
; Beduhn, Dagoberta Alves Vieira
; Jatobá, Joana D’Arc Vila Nova
; Moura, Maria Tereza Farias de
; Rego, Leila Rezegue de Moraes
; Silva, Adria Vanessa da
; Oliveira, Luana Pontes
; Sodré Filho, Eliene Sá
; Santos, Silvana Soares dos
; Neves, Itallo de Lima
; Leão, Vanessa Cristina de Aquino
; Paes, João Lucidio Lobato
; Silva, Marielle Cristina Mendes
; Oliveira, Cláudio Dornas de
; Santiago, Raquel Caldeira Brant
; Paranhos, Jorge Luiz da Rocha
; Wiermann, Iany Grinezia da Silva
; Pedroso, Durval Ferreira Fonseca
; Sawada, Priscilla Yoshiko
; Prestes, Rejane Martins
; Nascimento, Glícia Cardoso
; Grion, Cintia Magalhães Carvalho
; Carrilho, Claudia Maria Dantas de Maio
; Dantas, Roberta Lacerda Almeida de Miranda
; Silva, Eliane Pereira
; Silva, Antônio Carlos da
; Oliveira, Sheila Mara Bezerra de
; Golin, Nicole Alberti
; Tregnago, Rogerio
; Lima, Valéria Paes
; Silva, Kamilla Grasielle Nunes da
; Boschi, Emerson
; Buffon, Viviane
; Machado, André Sant’Ana
; Capeletti, Leticia
; Foernges, Rafael Botelho
; Carvalho, Andréia Schubert de
; Oliveira Junior, Lúcio Couto de
; Oliveira, Daniela Cunha de
; Silva, Everton Macêdo
; Ribeiro, Julival
; Pereira, Francielle Constantino
; Salgado, Fernanda Borges
; Deutschendorf, Caroline
; Silva, Cristofer Farias da
; Gobatto, Andre Luiz Nunes
; Oliveira, Carolaine Bomfim de
; Dracoulakis, Marianna Deway Andrade
; Alvaia, Natália Oliveira Santos
; Souza, Roberta Machado de
; Araújo, Larissa Liz Cardoso de
; Melo, Rodrigo Morel Vieira de
; Passos, Luiz Carlos Santana
; Vidal, Claudia Fernanda de Lacerda
; Rodrigues, Fernanda Lopes de Albuquerque
; Kurtz, Pedro
; Shinotsuka, Cássia Righy
; Tavares, Maria Brandão
; Santana, Igor das Virgens
; Gavinho, Luciana Macedo da Silva
; Nascimento, Alaís Brito
; Pereira, Adriano J
; Cavalcanti, Alexandre Biasi
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
6.
Impacto do Alto Risco Cardiovascular na Mortalidade Hospitalar em Pacientes Internados em Terapia Intensiva por COVID-19
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Gomes, Bruno Ferraz de Oliveira
; Petriz, João Luiz Fernandes
; Menezes, Iliana Regina Ribeiro
; Azevedo, Anny de Sousa
; Silva, Thiago Moreira Bastos da
; Silva, Valdilene Lima
; Peres, Leticia de Sousa
; Pereira, David Fernandes Pedro
; Dutra, Giovanni Possamai
; Paula, Suzanna Andressa Morais de
; Mendes, Bárbara Ferreira da Silva
; Carmo Junior, Plinio Resende do
; Pereira, Basilio de Bragança
; Oliveira, Gláucia Maria Moraes de
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
Resumo Fundamento Alguns estudos demonstraram uma maior prevalência de óbitos em portadores de fatores de risco cardiovascular (FRC) durante internação por COVID-19. Objetivos Avaliar o impacto do alto risco cardiovascular em pacientes internados em terapia intensiva por COVID-19 Métodos Estudo retrospectivo com pacientes admitidos em terapia intensiva, com diagnóstico confirmado de COVID-19 por RT-PCR e com pelo menos uma dosagem de troponina durante a internação. Os critérios para definição de paciente de alto risco cardiovascular (ARC) foram: histórico de doença cardiovascular estabelecida (infarto, AVC ou doença arterial periférica), diabetes, doença renal crônica com clearance < 60ml/min ou presença de 3 FRC (hipertensão, tabagismo, dislipidemia ou idade > 65 anos). O desfecho primário deste estudo é mortalidade hospitalar por todas as causas. P<0,05 foi considerado significativo. Resultados Foram incluídos 236 pacientes, média de idade= 61,14±16,2 anos, com 63,1% homens, 55,5% hipertensos e 33,1% diabéticos. Um total de 47,4% dos pacientes apresentavam ARC. Observou-se um aumento significativo da mortalidade conforme aumento do número de fatores de risco (0 FRC: 5,9%; 1 FRC: 17,5%; 2 FRC: 32,2% e ≥3 FRC: 41,2%; p=0,001). Na regressão logística ajustada para gravidade (escore SAPS3), o grupo de alto risco cardiovascular e troponina elevada apresentou maior ocorrência de mortalidade hospitalar (OR 40,38; IC95% 11,78-138,39). Pacientes sem alto risco cardiovascular, mas com troponina elevada, também exibiram associação significativa com o desfecho primário (OR 16,7; IC95% 4,45-62,74). Conclusão Em pacientes internados em terapia intensiva por COVID-19, a presença de alto risco cardiovascular afeta a mortalidade hospitalar somente em pacientes que apresentaram elevação de troponina.
Abstract Background Some studies have shown a higher prevalence of deaths in patients with cardiovascular risk factors (CRF) during hospitalization for COVID-19. Objectives To assess the impact of high cardiovascular risk in patients hospitalized in intensive care for COVID-19 Methods Retrospective study with patients admitted to an intensive care unit, with a diagnosis of COVID-19 confirmed by RT-PCR, and with at least one troponin measurement during hospitalization. The criteria for defining high cardiovascular risk (HCR) patients were: history of established cardiovascular disease (myocardial infarction, stroke, or peripheral arterial disease), diabetes, chronic kidney disease with clearance < 60ml/min, or presence of 3 CRFs (hypertension, smoking, dyslipidemia, or age > 65 years). The primary outcome of this study is all-cause in-hospital mortality. P<0.05 was considered significant. Results This study included 236 patients, mean age = 61.14±16.2 years, with 63.1% men, 55.5% hypertensive, and 33.1% diabetic; 47.4% of the patients also presented HCR. A significant increase in mortality was observed as the number of risk factors increased (0 FRC: 5.9%; 1 FRC: 17.5%; 2 FRC: 32.2% and ≥3 FRC: 41.2%; p=0.001). In the logistic regression adjusted for severity (SAPS3 score), the HCR and myocardial injury group had a higher occurrence of in-hospital mortality (OR 40.38; 95% CI 11.78-138.39). Patients without HCR but with myocardial injury also exhibited a significant association with the primary outcome (OR 16.7; 95% CI 4.45-62.74). Conclusion In patients hospitalized in intensive care for COVID-19, HCR impacts in-hospital mortality only in patients with myocardial injury.
7.
Aesthetic assessment of breast reconstruction in the eyes of plastic surgeons versus nonplastic physicians
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Siqueira, Hianga Fayssa Fernandes
; Teixeira, Jorge
; Lessa Filho, Reginaldo
; Brito, Erika de Abreu Costa
; Lima, Marcela
; Moura, Alex Rodrigues
; Figueiredo, Tarcizo
; Oliveira, Thiago
; Vasconcelos, Ana Alice Santana
; Lima, Carlos Anselmo
.
Revista da Associação Médica Brasileira
- Métricas do periódico
SUMMARY OBJECTIVE: The aim of this study was to evaluate the perception of the aesthetic result of breast reconstruction surgery from the perspective of plastic surgeons compared with physicians who are not specialists in plastic surgery. METHODS: Twenty patients who underwent breast reconstruction after mastectomy had their aesthetic results evaluated by 16 plastic surgeons and 16 nonplastic physicians, yielding a total of 620 ratings (320 ratings from plastic surgeons and 320 ratings from other specialists). For all analyses, the level of rejection adopted for the null hypothesis was 5% (p-value <0.05). RESULTS: Significant differences were observed between the two groups. On average, medical professionals who specialized in plastic surgery always obtained higher scores than other physicians. However, no significant differences were found in the assessment of the aesthetic outcome of breast reconstruction according to the sex of the rating medical professional for any of the assessments considered in this study. A strong positive linear correlation between the time since training in the medical specialty of plastic surgery (r=0.750, p=0.001) and the mean aesthetic outcome score was observed in this study. CONCLUSION: Plastic surgeons assessed the aesthetic results of breast reconstruction more positively than nonplastic physicians.
8.
Twenty-five-centimeter pre-grazing canopy height in palisade grass and forage peanut
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Ferreira, Igor Machado
; Homem, Bruno Grossi Costa
; Lima, Italo Braz Gonçalves de
; Dubeux Junior, José Carlos Batista
; Bernardes, Thiago Fernandes
; Danés, Marina de Arruda Camargo
; Casagrande, Daniel Rume
.
ABSTRACT: Short-term grazing behavior variables are sensitive to the canopy structure and have an impact on daily forage intake. This study evaluated the effect of pre- and post-grazing canopy heights on the forage harvesting process at a patch scale in a mixture of Brachiaria brizantha (Hochst. ex A. Rich.) Stapf. syn. Urochloa brizantha R.D. Webster cv. Marandu (palisade grass) and Arachis pintoi Krapov. & W.C. Greg. cv. Belomonte (forage peanut). Treatments were allocated to a split-plot arrangement in a completely randomized design. The plots, in their entirety, consisted of two pre-grazing canopy heights: 25 cm (CH25) and 35 cm (CH35); subplots consisted of three levels of defoliation severity: no defoliation (DS0); 20% depletion of pre-grazing canopy height (DS20); and 40% depletion of pre-grazing canopy height (DS40), with eight replications. Heifers were allowed to graze the patches (0.7 × 0.7 m) and their grazing behavior was recorded. Canopy structure measurements were taken both before and after grazing. Patches from CH35 presented greater stem mass for grass (p = 0.001) and legume (p = 0.002) than did patches from CH25. Bite rate, bite mass and instantaneous intake rate were greater for CH25 than for CH35 (p < 0.001, p = 0.068, and p = 0.074), and bite mass and instantaneous intake rate were lower for DS20 compared to DS0 (p = 0.032 and p = 0.016). Greater stem mass in the grazing strata negatively influenced the instantaneous intake rate.
https://doi.org/10.1590/1678-992x-2020-0090
232 downloads
9.
Coxsackievirus A6 strains causing an outbreak of hand-foot-and-mouth disease in Northeastern Brazil in 2018
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Luchs, Adriana
; Azevedo, Lais Sampaio de
; Souza, Ellen Viana de
; Medeiros, Roberta Salzone
; Souza, Yasmin França Viana Pires de
; Teixeira, Dalane Loudal Florentino
; Carneiro, Thiago Franco de Oliveira
; Alencar, Gabriela Maria Fernandes de
; Morais, Fernanda Lúcia de Sousa Leite
; Pinto, Diana de Fátima Alves
; Okay, Thelma Suely
; Yamamoto, Lidia
; Morais, Vanessa dos Santos
; Araújo, Emerson Luiz Lima
; Leal, Elcio
; Costa, Antonio Charlys da
.
Revista do Instituto de Medicina Tropical de São Paulo
- Métricas do periódico
ABSTRACT Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks.
10.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
11.
Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba
; Rodrigues, Cibele Isaac Saad
; Bortolotto, Luiz Aparecido
; Mota-Gomes, Marco Antônio
; Brandão, Andréa Araujo
; Feitosa, Audes Diógenes de Magalhães
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Amodeo, Celso
; Mion Júnior, Décio
; Barbosa, Eduardo Costa Duarte
; Nobre, Fernando
; Guimarães, Isabel Cristina Britto
; Vilela-Martin, José Fernando
; Yugar-Toledo, Juan Carlos
; Magalhães, Maria Eliane Campos
; Neves, Mário Fritsch Toros
; Jardim, Paulo César Brandão Veiga
; Miranda, Roberto Dischinger
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C
; Alessi, Alexandre
; Lucena, Alexandre Jorge Gomes de
; Avezum, Alvaro
; Sousa, Ana Luiza Lima
; Pio-Abreu, Andrea
; Sposito, Andrei Carvalho
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Nogueira, Armando da Rocha
; Dinamarco, Nelson
; Eibel, Bruna
; Forjaz, Cláudia Lúcia de Moraes
; Zanini, Claudia Regina de Oliveira
; Souza, Cristiane Bueno de
; Souza, Dilma do Socorro Moraes de
; Nilson, Eduardo Augusto Fernandes
; Costa, Elisa Franco de Assis
; Freitas, Elizabete Viana de
; Duarte, Elizabeth da Rosa
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Cesarino, Evandro José
; Marques, Fabiana
; Argenta, Fábio
; Consolim-Colombo, Fernanda Marciano
; Baptista, Fernanda Spadotto
; Almeida, Fernando Antonio de
; Borelli, Flávio Antonio de Oliveira
; Fuchs, Flávio Danni
; Plavnik, Frida Liane
; Salles, Gil Fernando
; Feitosa, Gilson Soares
; Silva, Giovanio Vieira da
; Guerra, Grazia Maria
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Back, Isabela de Carlos
; Oliveira Filho, João Bosco de
; Gemelli, João Roberto
; Mill, José Geraldo
; Ribeiro, José Marcio
; Lotaif, Leda A. Daud
; Costa, Lilian Soares da
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano Ferreira
; Martin, Luis Cuadrado
; Scala, Luiz César Nazário
; Almeida, Madson Q.
; Gowdak, Marcia Maria Godoy
; Klein, Marcia Regina Simas Torres
; Malachias, Marcus Vinícius Bolívar
; Kuschnir, Maria Cristina Caetano
; Pinheiro, Maria Eliete
; Borba, Mario Henrique Elesbão de
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Coelho, Otavio Rizzi
; Vitorino, Priscila Valverde de Oliveira
; Ribeiro Junior, Renault Mattos
; Esporcatte, Roberto
; Franco, Roberto
; Pedrosa, Rodrigo
; Mulinari, Rogerio Andrade
; Paula, Rogério Baumgratz de
; Okawa, Rogério Toshiro Passos
; Rosa, Ronaldo Fernandes
; Amaral, Sandra Lia do
; Ferreira-Filho, Sebastião R.
; Kaiser, Sergio Emanuel
; Jardim, Thiago de Souza Veiga
; Guimarães, Vanildo
; Koch, Vera H.
; Oigman, Wille
; Nadruz, Wilson
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
https://doi.org/10.36660/abc.20201238
10948 downloads
12.
Hypofractionated radiotherapy recommendations for localized prostate cancer in Brazil
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Palhares, Daniel Moore Freitas
; Pimentel, Leonardo Cunha Furbino
; Castilho, Marcus Simões
; Costa, Andréa Barleze da
; Reisner, Márcio Lemberg
; Kuhnen, Felipe Quintino
; Pássaro, Anderson
; Leite, Elton Trigo Teixeira
; Faustino, Fábio de Lima Costa
; Obst, Fernando Mariano
; Costa, Flávio Napoleão Buarque Barbosa Ferro
; Pioner, Giovani Thomaz
; Carvalho, Ícaro Thiago de
; Silva, João Luís Fernandes da
; Morikawa, Lisa Karina Kokay
; Zanuncio, Pedro Henrique da Rocha
; Hanriot, Rodrigo de Morais
; Rosa, Arthur Accioly
.
Revista da Associação Médica Brasileira
- Métricas do periódico
SUMMARY OBJECTIVE: Several prospective randomized trials have shown that hypofractionation has the same efficacy and safety as the conventional fractionation in the treatment of localized prostate cancer. There are many benefits of hypofractionation, including a more convenient schedule for the patients and better use of resources, which is especially important in low- and middle-income countries like Brasil. Based on these data, the Brazilian Society of Radiotherapy (Sociedade Brasileira de Radioterapia) organized this consensus to guide and support the use of hypofractionated radiotherapy for localized prostate cancer in Brasil. METHODS: The relevant literature regarding moderate hypofractionation (mHypo) and ultra-hypofractionation (uHypo) was reviewed and discussed by a group of experts from public and private centers of different parts of Brasil. Several key questions concerning clinical indications, outcomes and technological requirements for hypofractionation were discussed and voted. For each question, consensus was reached if there was an agreement of at least 75% of the panel members. RESULTS: The recommendations are described in this article. CONCLUSION: This initiative will assist Brazilian radiation oncologists and medical physicists to safely treat localized prostate cancer patients with hypofractionation.
https://doi.org/10.1590/1806-9282.67.01.002
368 downloads
13.
Parasitism by Amblyomma humerale (Acari: Ixodidae) on Chelonoidis denticulatus (Testudines: Testudinidae) in the Atlantic Forest
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Revista Brasileira de Parasitologia Veterinária
- Métricas do periódico
Resumo O presente estudo relata os padrões de parasitismo de Amblyomma humerale em jabuti-tinga, Chelonoidis denticulatus, na Mata Atlântica do Sudeste do Brasil. Os jabutis foram amostrados de forma ocasional, entre julho de 2005 e janeiro de 2020. Foram amostrados sete jabutis e coletados 81 carrapatos adultos (media = 11,57 ± 6,90 carrapatos/hospedeiro), sendo 72 machos (88,9%) e nove fêmeas (11,1%), resultando em uma razão sexual de 8:1 (machos:fêmeas). Os machos encontravam-se agrupados e aderidos à carapaça. As fêmeas ocorreram principalmente isoladas e fixadas a áreas de tegumento coriáceo (n = 7; 77,8%), especialmente as fêmeas ingurgitadas (100%). Sugere-se que a diferença entre os locais de fixação seja uma estratégia das fêmeas fecundadas, para evitar a remoção mecânica por atrito com o ambiente, uma vez que aumentam consideravelmente seu volume quando ingurgitadas, deslocando-se para locais mais abrigados na superfície do hospedeiro. Os padrões de parasitismo de C. denticulatus por A. humerale foram compatíveis com aqueles observados na Amazônia e na transição Amazônia-Cerrado. O presente trabalho contribui com informações acerca da história de vida e da relação parasito-hospedeiro entre as duas espécies, contribuindo para o entendimento dos padrões de parasitismo de A. humerale em C. denticulatus na Mata Atlântica do sudeste do Brasil.
Abstract The present study reports on patterns of parasitism by Amblyomma humerale on yellow-footed tortoise, Chelonoidis denticulatus, in the Atlantic Forest of southeastern Brazil. The tortoises were sampled occasionally, from July 2005 to January 2020. We collected 81 adult ticks from seven tortoises (mean = 11.57 ± 6.90 ticks/host), of which 72 were males (88.9%) and nine females (11.1%), resulting in an 8:1 sex ratio (males:females). Males were found in clusters, attached to the carapace. Females occurred mainly isolated, attached to coriaceous integumental areas (n = 7; 77.8%), especially the engorged females (100%). We suggest that the difference between attachment sites is a strategy used by fertilized females to avoid mechanical removal from their host through friction with elements of the environment. Because they undergo a considerable increase of volume when engorged, they move to more sheltered places on their host's surface. The parasitism patterns by A. humerale on C. denticulatus were compatible with those observed in the Amazon region and in the Cerrado-Amazonia transition. The present work provides information about the life history and host-parasite interface of the two species and contributes to understanding the parasitism patterns by A. humerale on C. denticulatus in the Atlantic Forest of southeastern Brazil.
https://doi.org/10.1590/s1984-29612021044
215 downloads
14.
Trabalho em equipes multiprofissionais na atenção primária no Ceará: porosidade entre avanços e desafios
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Machado, Maria de Fátima Antero Sousa
; Xavier, Samyra Paula Lustoza
; Rodrigues, Andreza de Lima
; Lima, Thiago Fernandes
; Silva, Lielma Carla Chagas da
; Moita, Marina Pereira
; Dias, Maria Socorro de Araújo
.
RESUMO Com o objetivo de analisar a atuação das equipes multiprofissionais conformadas nos Núcleos Ampliados de Apoio à Família e Atenção Básica, frente às dimensões clínico-assistencial e técnico-pedagógica no contexto da Atenção Primária à Saúde no Brasil, delineou-se estudo multicêntrico, de natureza qualitativa, realizado no período de 2018 a 2020, em três municípios no estado do Ceará. A coleta de dados ocorreu através de observação e grupo focal com as equipes multiprofissionais. Os registros das observações e dos discursos dos grupos focais foram tabulados no software Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®). Na Classificação Hierárquica Descendente, obteve-se um aproveitamento de 75,46% do corpus textual, formando cinco classes, cujos vocábulos têm associação estatisticamente relevante (p<0,0001). Os resultados evidenciam avanços na atuação das equipes multiprofissionais na produção do cuidado integral dos indivíduos e coletivos, a partir de ações de planejamento e tomada de decisões partilhadas com vistas à melhoria da qualidade de vida destes. Outrossim, identifica-se uma ênfase na dimensão clínico- -assistencial do cuidado, o que torna a dimensão técnico-pedagógica um desafio. Contudo, reconhece-se o potencial indutor da atuação das equipes para um trabalho colaborativo e orientado pela interprofissionalidade, corroborando o fortalecimento da Atenção Primária à Saúde.
ABSTRACT In order to analyze the performance of the multiprofessional teamwork at the Family Primary Health Care Expanded Support Centers, regarding the clinical-assistance and technical-pedagogical dimensions in Brazilian Primary Health Care, a multicentered study was outlined. This study is qualitative and descriptive in nature, and it was carried out between 2018 and 2020 in three northeast Brazilian towns. Data were collected through observation and focus groups with multiprofessional teams which worked in Primary Health Care. Observations were made during the baseline phase, follow-ups one and two. Documentation of observations and focal group’s speech were tabulated using the Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®) software. 106 text units were identified in the Descending Hierarchical Classification, with 807 follow-ups, 28.304 occurrences, 1.809 active forms with average frequency ≥3:737, chi2≥57,64, and 75.46% use of textual statistics, which formed five classes of statistically relevant words (p<0,0001). The results show advances in the work done by the multiprofessional teams on the production of comprehensive care of both individuals and collectivity, due to action plans and collaborative decision seeking improvements in the quality of life of individuals and collectivity. It is also possible to identify emphasis on the clinical-assistance dimension of care and that makes the technical-pedagogical dimension a challenge. However, we highlight the teams’ collaborative driving force that was guided by the interprofessionality, corroborating, thus, the strengthening of Primary Health Care.
15.
Trabalho em equipes multiprofissionais na atenção primária no Ceará: porosidade entre avanços e desafios
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Machado, Maria de Fátima Antero Sousa
; Xavier, Samyra Paula Lustoza
; Rodrigues, Andreza de Lima
; Lima, Thiago Fernandes
; Silva, Lielma Carla Chagas da
; Moita, Marina Pereira
; Dias, Maria Socorro de Araújo
.
RESUMO Com o objetivo de analisar a atuação das equipes multiprofissionais conformadas nos Núcleos Ampliados de Apoio à Família e Atenção Básica, frente às dimensões clínico-assistencial e técnico-pedagógica no contexto da Atenção Primária à Saúde no Brasil, delineou-se estudo multicêntrico, de natureza qualitativa, realizado no período de 2018 a 2020, em três municípios no estado do Ceará. A coleta de dados ocorreu através de observação e grupo focal com as equipes multiprofissionais. Os registros das observações e dos discursos dos grupos focais foram tabulados no software Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®). Na Classificação Hierárquica Descendente, obteve-se um aproveitamento de 75,46% do corpus textual, formando cinco classes, cujos vocábulos têm associação estatisticamente relevante (p<0,0001). Os resultados evidenciam avanços na atuação das equipes multiprofissionais na produção do cuidado integral dos indivíduos e coletivos, a partir de ações de planejamento e tomada de decisões partilhadas com vistas à melhoria da qualidade de vida destes. Outrossim, identifica-se uma ênfase na dimensão clínico- -assistencial do cuidado, o que torna a dimensão técnico-pedagógica um desafio. Contudo, reconhece-se o potencial indutor da atuação das equipes para um trabalho colaborativo e orientado pela interprofissionalidade, corroborando o fortalecimento da Atenção Primária à Saúde.
ABSTRACT In order to analyze the performance of the multiprofessional teamwork at the Family Primary Health Care Expanded Support Centers, regarding the clinical-assistance and technical-pedagogical dimensions in Brazilian Primary Health Care, a multicentered study was outlined. This study is qualitative and descriptive in nature, and it was carried out between 2018 and 2020 in three northeast Brazilian towns. Data were collected through observation and focus groups with multiprofessional teams which worked in Primary Health Care. Observations were made during the baseline phase, follow-ups one and two. Documentation of observations and focal group’s speech were tabulated using the Interface de R pour L Analyses Multidimensionnelles de Textes L de Questionnaires (IRAMUTEQ®) software. 106 text units were identified in the Descending Hierarchical Classification, with 807 follow-ups, 28.304 occurrences, 1.809 active forms with average frequency ≥3:737, chi2≥57,64, and 75.46% use of textual statistics, which formed five classes of statistically relevant words (p<0,0001). The results show advances in the work done by the multiprofessional teams on the production of comprehensive care of both individuals and collectivity, due to action plans and collaborative decision seeking improvements in the quality of life of individuals and collectivity. It is also possible to identify emphasis on the clinical-assistance dimension of care and that makes the technical-pedagogical dimension a challenge. However, we highlight the teams’ collaborative driving force that was guided by the interprofessionality, corroborating, thus, the strengthening of Primary Health Care.
https://doi.org/10.1590/0103-1104202113104
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