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Abstract Mucopolysaccharidosis type IIIB (MPS IIIB) is caused by deficiency of alpha-N-acetylglucosaminidase, leading to storage of heparan sulphate. The disease is characterized by intellectual disability and hyperactivity, among other neurological and somatic features. Here we studied retrospective data from a total of 19 MPS IIIB patients from Brazil, aiming to evaluate disease progression. Mean age at diagnosis was 7.2 years. Speech delay was one of the first symptoms to be identified, around 2-3 years of age. Behavioral alterations include hyperactivity and aggressiveness, starting around age four. By the end of the first decade, patients lost acquired abilities such as speech and ability to walk. Furthermore, as disease progresses, respiratory, cardiovascular and joint abnormalities were found in more than 50% of the patients, along with organomegaly. Most common cause of death was respiratory problems. The disease progression was characterized in multiple systems, and hopefully these data will help the design of appropriate clinical trials and clinical management guidelines. alphaNacetylglucosaminidase, alphaNacetylglucosaminidase alpha N acetylglucosaminidase, acetylglucosaminidase alpha-N-acetylglucosaminidase sulphate features 1 Brazil 72 7 2 7. identified 23 3 2- aggressiveness four decade walk Furthermore progresses 50 organomegaly problems systems guidelines 5

https://doi.org/10.1590/1678-4685-gmb-2023-0285

An adult with cystathionine beta-synthase deficiency, camptodactyly-arthropathy-coxa vara-pericarditis syndrome, and deafness: A case report betasynthase beta synthase deficiency camptodactylyarthropathycoxa camptodactyly arthropathy coxa varapericarditis vara pericarditis syndrome deafness
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Donis, Karina Carvalho

; Kalil, Marco Antônio Baptista

; Poswar, Fabiano

; Kok, Fernando

; Kohem, Charles Lubianca

; Poloni, Soraia

; Borsatto, Taciane

; Vairo, Filippo Pinto e

; Pinheiro, Franciele Cabral

; Schwartz, Ida Vanessa Doederlein

Genetics and Molecular Biology

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2024, Volume 47 Nº 1 elocation e20220335

Resumo: En | Texto: En | PDF: En

Abstract Massive sequencing platforms allow the identification of complex clinical phenotypes involving more than one autosomal recessive disorder. In this study, we report on an adult patient, born to a related couple (third degree cousins), referred for genetic evaluation due to ectopia lentis, deafness and previous diagnosis of juvenile idiopathic arthritis. He was biochemically diagnosed as having Classic Homocystinuria (HCU); Sanger sequencing of the CBS gene showed the genotype NM_000071.2(CBS):c.[833T>C];[833T>C], compatible with the diagnosis of pyridoxine-responsive HCU. As he also had symptoms not usually associated with HCU, exome sequencing was performed. In addition to the variants found in the Sanger sequencing, the following variants were identified: NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A]; and the NM_005807.6(PRG4):c.[3756dup]:[3756dup], confirming the diagnosis of autosomal recessive nonsyndromic deafness and Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome (CACP), respectively. Genomic analysis allowed the refinement of the diagnosis of a complex case and improvement of the patient’s treatment. disorder study patient third cousins, cousins , cousins) lentis arthritis HCU (HCU) NM_000071.2CBSc.833T>C833T>C, NM0000712CBSc833TC833TC NMCBScTCTC NM_000071.2 c. 833T>C NM 000071 2 c 833T C T NM_000071.2(CBS):c.[833T>C];[833T>C] pyridoxineresponsive pyridoxine responsive performed identified NM_001256317.1TMPRSS3c.413C>A413C>A NM0012563171TMPRSS3c413CA413CA NMTMPRSScCACA NM_001256317.1 TMPRSS3 413C>A 001256317 1 413C A TMPRSS NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A] NM_005807.6PRG4c.3756dup3756dup, NM0058076PRG4c3756dup3756dup NMPRGcdupdup NM_005807.6 PRG4 3756dup 005807 6 PRG dup NM_005807.6(PRG4):c.[3756dup]:[3756dup] CamptodactylyArthropathyCoxa Camptodactyly Arthropathy Coxa VaraPericarditis Vara Pericarditis CACP, CACP (CACP) respectively patients s treatment (HCU 2CBSc C833T CBSc NM_000071.2CBSc.833T>C833T>C TC NM0000712 NM_000071. 833TC 00007 NM_000071.2(CBS):c.[833T>C];[833T>C 1TMPRSS3c A413C CA NM0012563171 NM_001256317. 413CA 00125631 NM_001256317.1(TMPRSS3):c.[413C>A];[413C>A 6PRG4c 3756dup3756dup NM_005807.6PRG4c.3756dup3756dup NM0058076 NM_005807. 00580 NM_005807.6(PRG4):c.[3756dup]:[3756dup (CACP CT NM000071 NM_000071 0000 TMPRSSc AC NM001256317 NM_001256317 0012563 PRGc dupdup NM005807 NM_005807 0058 NM00007 NM_00007 000 NM00125631 NM_00125631 001256 NM00580 NM_00580 005 NM0000 NM_0000 00 NM0012563 NM_0012563 00125 NM0058 NM_0058 NM000 NM_000 0 NM001256 NM_001256 0012 NM005 NM_005 NM00 NM_00 NM00125 NM_00125 001 NM0 NM_0 NM0012 NM_0012 NM_ NM001 NM_001

https://doi.org/10.1590/1678-4685-gmb-2022-0335

Asthma in the Brazilian Unified Health Care System: an epidemiological analysis from 2008 to 2021 System 200 202 20 2
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Pinheiro, David Halen Araújo

; Souza, João Victor Hermógenes de

; Justo, Alberto Fernando Oliveira

; Carvalho-Pinto, Regina Maria

; Lima, Fabiano Francisco de

; Carvalho, Celso R F

Jornal Brasileiro de Pneumologia

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2024, Volume 50 Nº 2 elocation e20230364

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To analyze the number of hospitalizations, the length of hospital stay, and mortality due to asthma, as well as the costs to the Unified Health Care System in Brazil between 2008 and 2021. Methods: This was a cross-sectional epidemiological study using data from the Information Technology Department of the Brazilian Unified Health Care System. Proportional hospitalization and death rates were estimated per 100,000 population by age, microregion, and year. Results: The number of hospitalizations and deaths due to asthma decreased from 2008 to 2021 (205,392 vs. 55,009 and 822 vs. 327, respectively). In addition, a between-sex difference was observed in asthma-related hospitalizations in 2008, and more men were hospitalized in 2021 (51.8%). Asthma mortality rates were similar for both sexes (50.0% each) in 2008, and a slight increase was observed in women’s deaths in 2021 (52.9%). Even so, approximately one death/day and more than 55,000 hospitalizations were observed yearly, with a mean length of hospital stay of three days. Additionally, the Southeast region allocated more financial resources to asthma-related hospitalizations. Conclusions: Our results showed that the number of deaths and hospitalizations due to asthma substantially declined during the study period. Objective 200 Methods crosssectional cross sectional 100000 100 000 100,00 age microregion year Results 202 205,392 205392 205 392 (205,39 vs 55009 55 009 55,00 82 327 respectively. respectively . respectively) addition betweensex sex asthmarelated related 51.8%. 518 51.8% 51 8 (51.8%) 50.0% 500 50 0 (50.0 each womens women s 52.9%. 529 52.9% 52 9 (52.9%) so deathday day 55000 yearly days Additionally Conclusions period 20 10000 10 00 100,0 205,39 20539 39 (205,3 5500 5 55,0 32 51.8 (51.8% 50.0 (50. 52.9 (52.9% 2 1000 1 100, 205,3 2053 3 (205, 550 55, 51. (51.8 50. (50 52. (52.9 205, (205 (51. (5 (52. (20 (51 ( (52 (2

https://doi.org/10.36416/1806-3756/e20230364

Effect of palm kernel cake inclusion on intake, digestibility, nitrogen balance, feeding behavior, and weight gain of feedlot heifers intake digestibility balance behavior
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Abreu Filho, George

; Silva, Fabiano Ferreira da

; Azevêdo, José Augusto Gomes

; Silva, João Wilian Dias

; Paixão, Tarcísio Ribeiro

; Costa, Gabriel Dallapicola da

; Santos, Laize Vieira

; Silva, Ana Paula Gomes da

; Carvalho, Gleidson Giordano Pinto de

; Lima Júnior, Dorgival Morais de

; Silva, Robério Rodrigues

Revista Brasileira de Zootecnia

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2024, Volume 53 elocation e20230132

Resumo: En | Texto: En | PDF: En

ABSTRACT The objective of this study was to examine the effect of the increasing levels of inclusion of palm kernel cake (PKC) in the diet on the performance of feedlot heifers. Forty-eight Nelore heifers with an initial weight of 274 ± 4.58 kg, at 24 months of age, were confined for 98 days in a feedlot. The animals were allocated to the four treatments in a completely randomized design. Treatments consisted of PKC levels of 0 (control), 10, 20, and 30% in the total dry matter of the diet. The roughage:concentrate ratio in the diets was 30:70. Ether extract intake increased, whereas the intakes of non-fiber carbohydrates and total digestible nutrients decreased with the inclusion of PKC. The apparent digestibility of all nutrients decreased, as well as the amounts of nitrogen digested and retained. Microbial protein synthesis and its efficiency also declined. The inclusion of up to 20% PKC increased feeding time and reduced rumination time of heifers. Intake and rumination efficiencies decreased with the inclusion of PKC in the diet. Final weight and average daily gain did not change, but feed efficiency increased with the inclusion of PKC. The inclusion of up to 30% PKC in the diet of feedlot heifers is recommended. (PKC Fortyeight Forty eight 27 458 4 58 4.5 kg 2 age 9 design control, control , (control) 10 20 30 roughageconcentrate roughage concentrate 3070. 3070 70. 70 30:70 nonfiber non fiber retained declined change recommended 45 5 4. (control 1 3 307 7 30:7 30:

https://doi.org/10.37496/rbz5320230132

Brazilian Psychiatric Association treatment guidelines for generalized anxiety disorder: perspectives on pharmacological and psychotherapeutic approaches disorder
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Baldaçara, Leonardo

; Paschoal, Ana Beatriz

; Pinto, Aldo Felipe

; Loureiro, Fabiano Franca

; Antonio, Luiz Antonio Vesco Gaiotto

; Veiga, Diogo de Lacerda

; Almeida, Thales Marcon

; dos Santos, Diogo Cesar

; Malloy-Diniz, Leandro Fernandes

; de Mello, Marcelo Feijó

; de Mello, Andrea Feijó

; Sanches, Marsal

; Gandarela, Lucas Marques

; Bernik, Márcio Antonini

; Nardi, Antonio E.

; da Silva, Antônio Geraldo

; Uchida, Ricardo R.

Brazilian Journal of Psychiatry

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2024, Volume 46 elocation e20233235

Resumo: En | Texto: En | PDF: En

Generalized anxiety disorder is a highly prevalent mental disorder. Previous data indicate that more than 18 million Brazilians suffer from this condition. Traditionally, generalized anxiety disorder has been considered a mild mental health disorder, despite its links to lower life expectancy, cardiovascular disease, and suicide. The aim of this article is to combine elements of systematic and critical reviews to produce a synthesis of the best evidence about generalized anxiety disorder treatment. Systematic reviews, meta-analyses, and randomized controlled trials were included. The descriptor used in the search was “generalized anxiety disorder,” which resulted in 4,860 articles and seven other studies, of which 59 were selected. Antidepressants and benzodiazepines were indicated, as was pregabalin, and atypical antipsychotics, such as quetiapine, have been studied. Individual cognitive behavior therapy (third wave) has proven effective. There is extensive literature on many effective treatments for generalized anxiety disorder. The present review summarizes the therapeutic possibilities, emphasizing those available in Brazil. Further studies are needed to compare other available medications, assess psychotherapies and new treatments in greater depth, as well as to assess the ideal duration of therapy. Registration number: PROSPERO CRD42021288323. 1 condition Traditionally expectancy disease suicide treatment metaanalyses, metaanalyses meta analyses, analyses meta-analyses included 4860 4 860 4,86 5 selected indicated pregabalin antipsychotics quetiapine studied third wave possibilities Brazil medications depth number CRD42021288323 CRD 486 86 4,8 CRD4202128832 48 8 4, CRD420212883 CRD42021288 CRD4202128 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

https://doi.org/10.47626/1516-4446-2023-3235

Brazilian consensus recommendations on the diagnosis and treatment of autoimmune encephalitis in the adult and pediatric populations
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Dutra, Lívia Almeida

; Silva, Pedro Victor de Castro

; Ferreira, João Henrique Fregadolli

; Marques, Alexandre Coelho

; Toso, Fabio Fieni

; Vasconcelos, Claudia Cristina Ferreira

; Brum, Doralina Guimarães

; Pereira, Samira Luisa dos Apóstolos

; Adoni, Tarso

; Rocha, Leticia Januzi de Almeida

; Sampaio, Leticia Pereira de Brito

; Sousa, Nise Alessandra de Carvalho

; Paolilo, Renata Barbosa

; Pizzol, Angélica Dal

; Costa, Bruna Klein da

; Disserol, Caio César Diniz

; Pupe, Camila

; Valle, Daniel Almeida do

; Diniz, Denise Sisterolli

; Abrantes, Fabiano Ferreira de

; Schmidt, Felipe da Rocha

; Cendes, Fernando

; Oliveira, Francisco Tomaz Meneses de

; Martins, Gabriela Joca

; Silva, Guilherme Diogo

; Lin, Katia

; Pinto, Lécio Figueira

; Santos, Mara Lúcia Schimtz Ferreira

; Gonçalves, Marcus Vinícius Magno

; Krueger, Mariana Braatz

; Haziot, Michel Elyas Jung

; Barsottini, Orlando Graziani Povoas

; Nascimento, Osvaldo José Moreira do

; Nóbrega, Paulo Ribeiro

; Proveti, Priscilla Mara

; Castilhos, Raphael Machado do

; Daccach, Vanessa

; Glehn, Felipe von

Arquivos de Neuro-Psiquiatria

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2024, Volume 82 Nº 7 elocation s00441788586

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

Abstract Background Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis. Objective With the support of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, ABN) and the Brazilian Society of Child Neurology (Sociedade Brasileira de Neurologia Infantil, SBNI), a consensus on the diagnosis and treatment of AIE in Brazil was developed using the Delphi method. Methods A total of 25 panelists, including adult and child neurologists, participated in the study. Results The panelists agreed that patients fulfilling criteria for possible AIE should be screened for antineuronal antibodies in the serum and cerebrospinal fluid (CSF) using the tissue-based assay (TBA) and cell-based assay (CBA) techniques. Children should also be screened for anti-myelin oligodendrocyte glucoprotein antibodies (anti-MOG). Treatment should be started within the first 4 weeks of symptoms. The first-line option is methylprednisolone plus intravenous immunoglobulin (IVIG) or plasmapheresis, the second-line includes rituximab and/or cyclophosphamide, while third-line treatment options are bortezomib and tocilizumab. Most seizures in AIE are symptomatic, and antiseizure medications may be weaned after the acute stage. In anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, the panelists have agreed that oral immunosuppressant agents should not be used. Patients should be evaluated at the acute and postacute stages using functional and cognitive scales, such as the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Modified Rankin Scale (mRS), and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). Conclusion The present study provides tangible evidence for the effective management of AIE patients within the Brazilian healthcare system. (AIE antigens symptoms complaints disorders young prognosis Academia ABN Sociedade Infantil SBNI, SBNI , SBNI) method 2 neurologists CSF (CSF tissuebased tissue based TBA (TBA cellbased cell CBA (CBA techniques antimyelin anti myelin antiMOG. antiMOG MOG . (anti-MOG) firstline line IVIG (IVIG plasmapheresis secondline second andor cyclophosphamide thirdline third tocilizumab symptomatic stage antiNmethylDaspartate N methyl D aspartate antiNMDAR NMDAR (anti-NMDAR used scales MiniMental Mini Mental MMSE, MMSE (MMSE) MoCA, MoCA (MoCA) mRS, mRS (mRS) CASE. CASE (CASE) system (anti-MOG (MMSE (MoCA (mRS (CASE

Resumo Antecedentes Encefalites autoimunes (EAIs) são um grupo de doenças inflamatórias caracterizadas pela presença de anticorpos contra antígenos neuronais e gliais, que ocasionam sintomas psiquiátricos subagudos, queixas de memória e distúrbios anormais do movimento. A maioria dos pacientes é jovem, e o atraso no tratamento está associado a pior prognóstico. Objetivo Com o apoio da Academia Brasileira de Neurologia (ABN) e da Sociedade Brasileira de Neurologia Infantil (SBNI), desenvolvemos um consenso sobre o diagnóstico e o tratamento da EAIs no Brasil utilizando a metodologia Delphi. Métodos Um total de 25 especialistas, incluindo neurologistas e neurologistas infantis, foram convidados a participar. Resultados Os especialistas concordaram que os pacientes com critérios de possíveis EAIs devem ser submetidos ao rastreio de anticorpos antineuronais no soro e no líquido cefalorraquidiano (LCR) por meio das técnicas de ensaio baseado em tecidos (tissue-based assay, TBA, em inglês) e ensaio baseado em células (cell-based assay, CBA, em inglês). As crianças também devem ser submetidas ao rastreio de de anticorpo contra a glicoproteína da mielina de oligodendrócitos (anti-myelin oligodendrocyte glycoprotein, anti-MOG, em inglês). O tratamento deve ser iniciado dentro das primeiras 4 semanas dos sintomas, sendo as opções de primeira linha metilprednisolona combinada com imunoglobulina intravenosa (IGIV) ou plasmaférese. O tratamento de segunda linha inclui rituximabe e ciclofosfamida. Bortezomib e tocilizumab são opções de tratamento de terceira linha. A maioria das crises epilépticas nas EAIs são sintomáticas, e os fármacos anticrise podem ser desmamadas após a fase aguda. Em relação à encefalite antirreceptor de N-metil-D-aspartato (anti-N-methyl-D-aspartate receptor, anti-NMDAR, em inglês), os especialistas concordaram que agentes imunossupressores orais não devem ser usados. Os pacientes devem ser avaliados na fase aguda e pós-aguda mediante escalas funcionais e cognitivas, como Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Modified Rankin Scale (mRS), e Clinical Assessment Scale in Autoimmune Encephalitis (CASE). Conclusão Esta pesquisa oferece evidências tangíveis do manejo efetivo de pacientes com EAIs no sistema de saúde Brasileiro. (EAIs gliais subagudos movimento jovem prognóstico ABN (ABN SBNI, SBNI , (SBNI) Delphi 2 infantis participar LCR (LCR tissuebased tissue based assay TBA inglês cellbased cell CBA inglês. . antimyelin anti myelin glycoprotein antiMOG, antiMOG MOG, MOG anti-MOG IGIV (IGIV plasmaférese ciclofosfamida sintomáticas NmetilDaspartato N metil D aspartato antiNmethylDaspartate methyl aspartate receptor antiNMDAR, antiNMDAR NMDAR, NMDAR anti-NMDAR inglês, usados pósaguda pós cognitivas MiniMental Mini Mental MMSE, MMSE (MMSE) MoCA, MoCA (MoCA) mRS, mRS (mRS) CASE. CASE (CASE) Brasileiro (SBNI (MMSE (MoCA (mRS (CASE

https://doi.org/10.1055/s-0044-1788586

Factors Associated with Readmission within 30 Days after Discharge and In-Hospital Mortality after Proximal Femoral Fracture Surgery in the Elderly: Retrospective Cohort 3 InHospital In Hospital Elderly
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Pinto, Alex Fabiano Dias

; Teatini, Clarissa Moreira

; Avelar, Núbia Carelli Pereira de

; Leopoldino, Amanda Aparecida Oliveira

; Moura, Isabel Cristina Gomes

Revista Brasileira de Ortopedia

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Abr 2023, Volume 58 Nº 2 Páginas 222 - 230

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

Abstract Objective To evaluate the factors associated with readmission within 30 days after discharge (R30) and in-hospital mortality (IHM) in elderly patients undergoing proximal femur fracture surgery (PFF). Methods Retrospective cohort with data from 896 medical records of elderly (≥ 60 years) patients submitted to PFF surgery in a Brazilian hospital between November 2014 and December, 2019. The patients included were followed-up from the date of hospitalization for surgery up to 30 days after discharge. As independent variables, we evaluated gender, age, marital status, pre- and postoperative hemoglobin (Hb), international normalized ratio, time of hospitalization related to the surgery, door-surgery time, comorbidities, previous surgeries, use of medications, and the American Society of Anesthesiologists (ASA) score. Results The incidence of R30 was 10.2% (95% confidence interval [CI]: 8.3-12.3%), and the incidence of IHM was 5.7% (95%CI: 4.3-7.4%). Regarding R30, hypertension (odds ratio [OR]: 1.71; 95%CI: 1.03–2.96), and regular use of psychotropic drugs (OR: 1.74; 95%CI: 1.12–2.72) were associated in the adjusted model. In the case of IHM, higher chances were associated with chronic kidney disease (CKD) (OR: 5.80; 95%CI: 2.64–12.31), longer hospitalization time (OR: 1.06; 95%CI: 1.01–1.10), and R30 (OR: 3.60; 95%CI: 1.54–7.96). Higher preoperative Hb values were associated with a lower chance of mortality (OR: 0.73; 95%CI: 0.61–0.87). Conclusion Findings suggest that the occurrence of these outcomes is associated with comorbidities, medications, and Hb. 3 R (R30 inhospital (IHM PFF. . (PFF) 89 ≥ ( 6 years 201 December 2019 followedup followed variables gender age status pre Hb, , (Hb) doorsurgery door comorbidities surgeries medications ASA (ASA score R3 102 10 2 10.2 95% 95 (95 CI [CI] 8.312.3%, 83123 8.3 12.3% 8 12 8.3-12.3%) 57 5 7 5.7 95%CI 95CI (95%CI 4.37.4%. 4374 4.3 7.4% 4 4.3-7.4%) odds OR [OR] 1.71 171 1 71 1.03–2.96, 103296 1.03–2.96 03 96 1.03–2.96) (OR 1.74 174 74 1.12–2.72 112272 72 model CKD (CKD 5.80 580 80 2.64–12.31, 2641231 2.64–12.31 64 31 2.64–12.31) 1.06 106 06 1.01–1.10, 101110 1.01–1.10 01 1.01–1.10) 3.60 360 1.54–7.96. 154796 1.54–7.96 54 1.54–7.96) 0.73 073 0 73 0.61–0.87. 061087 0.61–0.87 61 87 0.61–0.87) (R3 (PFF 20 (Hb 10. 9 (9 [CI 312 8.312.3% 8312 83 8. 123 12.3 8.3-12.3% 5. 37 4.37.4% 437 43 4. 7.4 4.3-7.4% [OR 1.7 17 10329 1.03–2.9 1.12–2.7 11227 5.8 58 264123 2.64–12.3 1.0 10111 1.01–1.1 3.6 36 15479 1.54–7.9 0.7 07 06108 0.61–0.8 (R 8.312.3 831 12. 8.3-12.3 4.37.4 7. 4.3-7.4 1. 1032 1.03–2. 1.12–2. 1122 26412 2.64–12. 1011 1.01–1. 3. 1547 1.54–7. 0. 0610 0.61–0. 8.312. 8.3-12. 4.37. 4.3-7. 103 1.03–2 1.12–2 112 2641 2.64–12 101 1.01–1 154 1.54–7 061 0.61–0 8.312 8.3-12 4.37 4.3-7 1.03– 1.12– 11 264 2.64–1 1.01– 15 1.54– 0.61– 8.31 8.3-1 4.3- 1.03 1.12 26 2.64– 1.01 1.54 0.61 8.3- 1.1 2.64 1.5 0.6 2.6 2.

Resumo Objetivo Avaliar os fatores associados à reinternação em até 30 dias após a alta (R30) e à mortalidade intra-hospitalar (MIH) em idosos submetidos a cirurgia por fratura do fêmur proximal (FFP). Métodos Coorte retrospectiva com dados de 896 prontuários de idosos (≥ 60 anos) submetidos a cirurgia de FFP em hospital brasileiro, no período entre novembro de 2014 a dezembro de 2019. Os pacientes incluídos foram acompanhados desde a data de internação para a cirurgia até 30 dias após a alta. Como variáveis independentes, foram avaliados o sexo, idade, estado civil, hemoglobina (Hb) pré e pós-operatória, razão normalizada internacional, tempo da internação relacionada à cirurgia, tempo porta cirurgia, comorbidades, cirurgias prévias, uso de medicamentos e escore da American Society of Anesthesiologists (ASA). Resultados A incidência de R30 foi de 10,2% (intervalo de confiança [IC] 95%: 8,3–12,3%) e a de MIH foi 5,7% (IC95%: 4,3–7,4%). Referente a R30, no modelo ajustado, associaram-se ter hipertensão (odds ratio [OR]: 1,71; IC95%: 1,03–2,96), uso regular de medicamentos psicotrópicos (OR: 1,74; IC95%: 1,12–2,72). Tratando-se da MIH, maiores chances estiveram associadas à doença renal crônica (DRC) (OR: 5,80; IC95%: 2,64–12,31), maior tempo de internação (OR: 1,06; IC95%: 1,01–1,10) e R30 (OR: 3,60; IC95%: 1,54–7,96). Maiores valores de Hb pré-operatória associaram-se à menor chance de mortalidade (OR: 0,73; IC95%: 0,61–0,87). Conclusão Os achados sugerem que a ocorrência destes desfechos está associada à comorbidades, medicamentos e Hb. 3 R (R30 intrahospitalar intra hospitalar (MIH FFP. . (FFP) 89 ≥ ( 6 anos brasileiro 201 2019 independentes sexo idade civil (Hb pósoperatória, pósoperatória pós operatória, operatória pós-operatória internacional comorbidades prévias ASA. ASA (ASA) R3 102 10 2 10,2 intervalo IC [IC 95% 95 8,3–12,3% 83123 8 12 57 5 7 5,7 IC95% IC95 (IC95% 4,3–7,4%. 4374 4,3–7,4% 4 4,3–7,4%) ajustado associaramse associaram se odds OR [OR] 1,71 171 1 71 1,03–2,96, 103296 1,03–2,96 , 03 96 1,03–2,96) (OR 1,74 174 74 1,12–2,72. 112272 1,12–2,72 72 1,12–2,72) Tratandose Tratando DRC (DRC 5,80 580 80 2,64–12,31, 2641231 2,64–12,31 64 31 2,64–12,31) 1,06 106 06 1,01–1,10 101110 01 3,60 360 1,54–7,96. 154796 1,54–7,96 54 1,54–7,96) préoperatória 0,73 073 0 73 0,61–0,87. 061087 0,61–0,87 61 87 0,61–0,87) (R3 (FFP 20 (ASA 10, 9 8,3–12,3 8312 5, IC9 (IC95 437 4,3–7,4 [OR 1,7 17 10329 1,03–2,9 11227 1,12–2,7 5,8 58 264123 2,64–12,3 1,0 1,01–1,1 10111 3,6 36 15479 1,54–7,9 0,7 07 06108 0,61–0,8 (R 8,3–12, 831 (IC9 43 4,3–7, 1, 1032 1,03–2, 1122 1,12–2, 26412 2,64–12, 1,01–1, 1011 3, 1547 1,54–7, 0, 0610 0,61–0, 8,3–12 83 (IC 4,3–7 103 1,03–2 112 1,12–2 2641 2,64–12 1,01–1 101 154 1,54–7 061 0,61–0 8,3–1 4,3– 1,03– 11 1,12– 264 2,64–1 1,01– 15 1,54– 0,61– 8,3– 4,3 1,03 1,12 26 2,64– 1,01 1,54 0,61 8,3 4, 1,1 2,64 1,5 0,6 8, 2,6 2,

https://doi.org/10.1055/s-0043-1768624

Use of Iron Ore Tailing as Raw Material for Two Products: Sodium Silicate and Geopolymers Products
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Prates, Caroline D.

; Lima, Athos S.

; Ferreira, Igor C.

; Paula, Fabiano G. F. de

; Pinto, Paula S.

; Ardisson, José D.

; Lago, Rochel M.

; Teixeira, Ana Paula C.

Journal of the Brazilian Chemical Society

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2023, Volume 34 Nº 6 Páginas 809 - 818

Resumo: En | Texto: En | PDF: En

In this work, iron ore tailing (IOT) was used for the production of two different materials: sodium silicate and geopolymers. Initially, reactions of IOT with NaOH were carried out by hydrothermal reaction in autoclave at 200 °C (1:1.5 and 1:2.5 SiO2:NaOH molar ratio) and reaction times of 4 and 8 h. X-ray fluorescence by dispersive energy (XRF), X-ray diffraction (XRD), Mössbauer spectroscopy, scanning electron microscopy (SEM-EDS) and titrations showed that IOT:NaOH ratios of 1:2.5 and reaction time 8 h completely dissolved the quartz from the IOT, obtaining a solid fraction consisting mainly of hematite and an aqueous phase of sodium silicate, which showed contents of ca. 23% SiO2 and 19% Na2O. This sodium silicate obtained was then combined with IOT (25 and 50 wt.%) to produce geopolimeric material with excellent physico-chemical properties, fast curing time and very good compressive strength results, which ranged from 41 to 58 MPa and many potential applications. work (IOT materials geopolymers Initially 20 C 11.5 115 1 1.5 5 (1:1. 12.5 125 2.5 2 1:2. SiO2NaOH SiONaOH SiO ratio Xray X ray XRF, XRF , (XRF) XRD, XRD (XRD) spectroscopy SEMEDS SEM EDS (SEM-EDS IOTNaOH ca 23 19 Na2O NaO Na O 25 (2 wt.% wt physicochemical physico chemical properties results applications 11 11. 15 1. (1:1 12 12. 2. 1:2 (XRF (XRD ( wt. (1: 1: (1

https://doi.org/10.21577/0103-5053.20220149

Complications in the guided bone regeneration technique associated with the d-PTFE membrane: case report
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HEGGENDORN, Fabiano Luiz

; DE FIGUEIREDO FILHO, Basílio Pires

; PIRES, Jorge Luis da Silva

; SANTOS, Paulo Gonçalo Pinto dos

RGO - Revista Gaúcha de Odontologia

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2022, Volume 70 elocation e20220046

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

RESUMO A regeneração óssea guiada visa o ganho de volume ósseo vertical e horizontal em rebordos atróficos, sendo utilizadas diferentes técnicas regenerativas associadas a biomateriais, podendo apresentar ocasionais complicações pós-cirúrgicas. O objetivo do relato de caso foi descrever as sucessivas abordagens para minimizar e eliminar as complicações apresentadas no pós-operatório de paciente submetida à técnica de regeneração óssea guiada. Na primeira cirurgia foi utilizada a membrana de politetrafluoretileno expandido denso (PTFE-d), suportada pela técnica da tenda e enxerto plaquetário autógeno, para realizar a técnica de regeneração óssea guiada. Após três meses, constatou-se a exposição da membrana, sendo removida a membrana e os parafusos de contenção no sétimo mês, com instalação de três implantes Hexágono Interno nas áreas dos dentes 13, 14 e 15. As roscas expostas foram recobertas com as hidroxiapatitas reabsorvíeis e recobertas com membrana PTFE-d. A radiografia panorâmica pós-operatória de quatro meses sugeriu osseointegração dos implantes. A técnica de regeneração óssea guiada associada à membrana de PTFE-d possibilitou a neoformação óssea propiciando a instalação de implantes osseointegrados em posição estética e funcional. A exposição das bordas da membrana permitiu a penetração de fluídos e contaminação, sugerindo o agravamento dos sinais de infecção e secreção purulenta. Ao contrário, a exposição de áreas centrais, não acarretou sinais inflamatórios e infecciosos.

ABSTRACT Guided bone regeneration aims to gain vertical and horizontal bone volume in atrophic ridges, using different regenerative techniques associated with biomaterials, with occasional post-surgical complications. The objective of the case report was to describe the successive approaches to minimize and eliminate the complications presented in the postoperative period of a patient submitted to the guided bone regeneration technique. In the first surgery, the dense expanded polytetrafluoroethylene membrane (d-PTFE), supported by the tent technique and autogenous platelet graft, was used to perform the guided bone regeneration technique. After three months, the membrane was exposed, with the membrane and the retaining screws removed in the seventh month, with the installation of three Internal Hexagon implants in the areas of teeth 13, 14 and 15. The exposed threads were covered with hydroxyapatites resorbable and covered with d-PTFE membrane. A four-month postoperative panoramic radiograph suggested implant osseointegration. The guided bone regeneration technique associated with the d-PTFE membrane enabled bone neoformation, enabling the installation of osseointegrated implants in an aesthetic and functional position. The exposure of the edges of the membrane allowed the penetration of fluids and contamination, suggesting the worsening of the signs of infection and purulent secretion. On the contrary, the exposure of central areas did not cause inflammatory and infectious signs.

https://doi.org/10.1590/1981-86372022004620200217

10.

Tromboprofilaxia na cirurgia de varizes dos membros inferiores no Brasil
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Ribeiro, Alcides José Araújo

; Mendes-Pinto, Daniel

; Erzinger, Fabiano Luiz

; Fiorelli, Rossano Kepler Alvim

; Fiorelli, Stênio Karlos Alvim

; Ribeiro, Andrea Campos de Oliveira

; Marques, Marcos Arêas

Jornal Vascular Brasileiro

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2022, Volume 21 elocation e20210172

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

Resumo Contexto Apesar de todo o investimento na profilaxia primária do tromboembolismo venoso (TEV) em pacientes cirúrgicos nos últimos anos, ainda não existem diretrizes específicas para aqueles que serão submetidos a procedimentos para tratamento de varizes de membros inferiores. Objetivos Avaliar o perfil de conduta de profilaxia do TEV pelos cirurgiões vasculares brasileiros para procedimentos de tratamento de varizes de membros inferiores. Métodos Pesquisa de levantamento por envio de questionário eletrônico a cirurgiões vasculares brasileiros. Os respondentes foram divididos entre os que realizam tratamento de veias safenas por cirurgia convencional e os que realizam termoablação para fim de comparação entre os grupos. Resultados Entre os 765 respondentes, o tratamento de escolha das veias safenas foi a cirurgia convencional para 405 (53%), espuma ecoguiada para 44 (6%) e termoablação (endolaser ou radiofrequência) para 199 (26%). Os cirurgiões que realizam termoablação prescrevem mais farmacoprofilaxia após o procedimento que aqueles que preferem cirurgia convencional (67/199, 34% vs. 112/405, 28%; p = 0,002). O grupo termoablação estratifica o paciente quanto ao risco de TEV com mais frequência que o grupo cirurgia convencional (102/199, 51% vs. 179/405, 44%; p =0,004). Ambos os grupos usam mais frequentemente enoxaparina como medicação para profilaxia, porém o grupo termoablação usa mais anticoagulantes orais diretos proporcionalmente que o grupo cirurgia convencional (26% vs. 10%, p < 0,001). Conclusões Cirurgiões vasculares brasileiros que fizeram o tratamento de veias safenas por termoablação prescrevem farmacoprofilaxia com maior frequência e por um período mais prolongado do que os que realizaram o tratamento por cirurgia convencional.

Abstract Background Despite all the investment in primary venous thromboembolism (VTE) prophylaxis for surgical patients in recent years, there are still no specific guidelines for those who undergo procedures to treat lower limb varicose veins. Objectives To evaluate the profile of VTE prophylaxis practices among Brazilian vascular surgeons conducting lower limb varicose vein procedures. Methods Survey design, sending an electronic questionnaire to Brazilian vascular surgeons. Respondents were divided between those who perform saphenous vein treatment with conventional surgery and those who perform thermoablation for the purpose of comparison between groups. Results Of 765 respondents, 405 (53%) treat saphenous veins with conventional surgery for, 44 (6%) with foam, and 199 (26%) with thermoablation (endolaser or radiofrequency). Surgeons who perform thermoablation prescribed more pharmacoprophylaxis after varicose vein surgery than those who perform conventional surgery (67/199, 34% vs. 112/405, 28%; p = 0.002). The thermoablation group stratifies patients for thromboembolism risk more frequently than the conventional surgery group (102/199, 51% vs. 179/405, 44%; p = 0.004). Both groups use enoxaparin as the most frequent drug for prophylaxis, but the thermoablation group uses proportionally more direct oral anticoagulants than the conventional surgery group (26% vs. 10%, p<0.001). Conclusions Brazilian vascular surgeons who perform saphenous vein treatment by thermoablation prescribe pharmacoprophylaxis more frequently and for a longer period than those who use conventional surgery.

https://doi.org/10.1590/1677-5449.202101721

11.

Immunosuppressors and immunomodulators in Neurology - Part I: a guide for management of patients underimmunotherapy
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Abrantes, Fabiano Ferreira

; Moraes, Marianna Pinheiro Moraes de

; Albuquerque Filho, José Marcos Vieira de

; Alencar, Jéssica Monique Dias

; Lopes, Alexandre Bussinger

; Pinto, Wladimir Bocca Vieira de Rezende

; Souza, Paulo Victor Sgobbi de

; Oliveira, Enedina Maria Lobato de

; Oliveira, Acary de Souza Bulle de

; Pedroso, José Luiz

; Barsottini, Orlando Graziani Povoas

Arquivos de Neuro-Psiquiatria

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Nov 2021, Volume 79 Nº 11 Páginas 1012 - 1025

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

RESUMO Pacientes com doenças autoimunes exigem uma constante preocupação com os riscos e benefícios do tratamento imunossupressor ou imunomodulador. O conhecimento das rotinas no uso de cada uma dessas drogas é fundamental para o bom desfecho clínico, evitando a piora da doença ou efeitos colaterais. As drogas imunossupressoras e imunomoduladoras agem em diferentes pontos da resposta imunológica a fim de controlar a doença para qual são indicadas. O conhecimento do mecanismo de ação, principais posologias, efeitos adversos e os riscos de infecções e neoplasias relacionadas ao uso dessas medicações são fundamentais para um tratamento seguro. Cada uma delas apresenta um perfil específico de complicações e o manejo deve ser individualizado em diferentes cenários ao longo do seguimento do paciente. O uso de medicações para profilaxia primária de infecções e a vacinação são pontos essenciais no planejamento do tratamento, prevenindo potenciais complicações infecciosas ao longo do acompanhamento. O uso de imunossupressores e imunomoduladores é uma frequente realidade no dia-a-dia do neurologista, e o conhecimento das características de cada droga é crucial para o sucesso do tratamento. A realização de uma rotina antes, durante e depois do uso dessas medicações evita complicações relacionadas com o tratamento e alcança um melhor controle da doença.

ABSTRACT For patients with autoimmune diseases, the risks and benefits of immunosuppressive or immunomodulatory treatment are a matter of continual concern. Knowledge of the follow-up routine for each drug is crucial, in order to attain better outcomes and avoid new disease activity or occurrence of adverse effects. To achieve control of autoimmune diseases, immunosuppressive and immunomodulatory drugs act on different pathways of the immune response. Knowledge of the mechanisms of action of these drugs and their recommended doses, adverse reactions and risks of infection and malignancy is essential for safe treatment. Each drug has a specific safety profile, and management should be adapted for different circumstances during the treatment. Primary prophylaxis for opportunistic infections and vaccination are indispensable steps during the treatment plan, given that these prevent potential severe infectious complications. General neurologists frequently prescribe immunosuppressive and immunomodulatory drugs, and awareness of the characteristics of each drug is crucial for treatment success. Implementation of a routine before, during and after use of these drugs avoids treatment-related complications and enables superior disease control.

https://doi.org/10.1590/0004-282x-anp-2020-0593 1 downloads

12.

Endurance and high-intensity interval training improve the levels of anxiety and quality of life in overweight men
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Sousa, Ricardo Augusto Leoni De

; Lima, Neumir Sales de

; Amorim, Fabiano Trigueiro

; Gripp, Fernando

; Magalhães, Caíque Olegário Diniz e

; Pinto, Samuel Henrique

; Dias-Peixoto, Marco Fabrício

; Monteiro-Junior, Renato Sobral

; Bourbeau, Kelsey

; Cassilhas, Ricardo Cardoso

Revista da Associação Médica Brasileira

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Ago 2021, Volume 67 Nº 8 Páginas 1177 - 1181

Resumo: Pt | Texto: Pt | PDF: Pt

SUMMARY OBJECTIVE Body mass index (BMI) values of 25 kg/m2 or more have been associated with poor cognitive outcomes, reduced health-related quality of life (HRQoL), and mental health disorders. Participating in regular exercise may improve these negative outcomes. However, the optimal exercise prescription remains to be clarified. The purpose of the present study is to compare the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on HRQoL, depression, and anxiety levels in middle-aged overweight men. METHODS Twenty-five sedentary, overweight men participated in the 8-week training intervention. Subjects were randomized into MICT or HIIT and performed exercise sessions three times per week for 8 weeks. Participants answered the Physical Activity Readiness Questionnaire, the Short Form-36 survey, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Statistical analysis was carried out using the GraphPad Prism 7.0, and the level of significance was set at 5% to quantitative variables. RESULTS HRQoL scores were enhanced to all domains of both the groups. MICT and HIIT did not significantly change the depression levels in middle-aged overweight men (p>0.05). Nevertheless, MICT was capable to reduce the anxiety levels in middle-aged overweight men (p<0.05). However, there was not a significant change in the anxiety levels at the HIIT group. CONCLUSIONS HIIT may be a useful treatment to improve the HRQoL, but MICT alone can positively impact the anxiety levels in middle-aged overweight men.

https://doi.org/10.1590/1806-9282.20210608 112 downloads

13.

Dental fluorosis severity in children 8-12 years old and associated factors
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Saldarriaga, Alexandra

; Rojas-Gualdrón, Diego

; Restrepo, Manuel

; Santos-Pinto, Lourdes

; Jeremias, Fabiano

Acta Odontológica Latinoamericana

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Jun 2021, Volume 34 Nº 2 Páginas 156 - 165

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

ABSTRACT The aim of this study was to determine the frequency and severity of dental fluorosis (DF) and the association between severity and risk factors. In a cross-sectional study, 8- to 12-year-old children, born in a Colombian district, were evaluated according to the Thylstrup and Fejerskov Index (TFI) by two calibrated examiners. Molar Incisor Hypomineralization (MIH) and dental caries (DC) were also evaluated. Ordinal logistic regression was applied (p<0.05). Risk factors and lifestyle factors were collected using a questionnaire answered by parents. DF was detected in 76 (98.7%) of the children (average of 18.4 ±1.81 permanent teeth affected). Grade TF2 was the most frequently observed (34.8%); TF5 was observed in all age groups; TF6- TF7 were observed in 12-year-olds. No association was found between DF severity and DC (Odds Ratio (OR)=1.35; 95%CI: 0.56-3.26) or MIH (OR=1.39; 95%CI: 0.43-4.46). DF severity was significantly associated with use of an indoor wood stove for food preparation (OR = 9.34; 95%CI: 1.11-78.57) and use of a pea-sized volume of toothpaste (OR = 27.42; 95%CI: 1.57-477.36). Prevalence of DC was 38.1% and prevalence of MIH was 14.4%. In this population, the frequency of DF was high and severity was associated with use of an indoor wood stove for food preparation and toothpaste amount used during childhood.

RESUMEN El objetivo de este estudio fue determinar la prevalencia y severidad de la Fluorosis Dental (FD) y la asociación de la severidad con factores de riesgo. Mediante un estudio transversal, niños (8-12 años-de-edad), nacidos en Ayapel (El Cedro-Colombia) fueron evaluados por 2 examinadores calibrados, según los criterios del índice de Thylstrup y Fejerskov (TFI) para FD. También se evaluaron la Hipomineralización molar-incisiva (HMI) y la caries dental (CD). Se aplicó un cuestionario de factores de riesgo y estilo de vida, a los padres/responsables de los niños. Se utilizó un modelo de regresión logística ordinal (p<0.05). Se encontró FD en 76 (98.7%) niños (con una media de dientes permanentes afectados de 18.4 ±1.81). La severidad categoría TF2 fue la más observada (34.8%) en los dientes evaluados. Las lesiones que presentan pérdida estructural moderada TF 6-7, fueron evidenciadas en el grupo de edad de 12 años. No se encontró asociación entre la severidad y la CD (OR=1.35; IC95%:0.56-3.26) o con HIM (OR=1.39; IC95%:0.43-4.46). Se encontró una asociación significativa con la severidad de la FD en los niños que utilizaban fogón de leña-interno para la preparación de los alimentos (OR=9.34; IC95%:1.11-78.57) y utilizaban un volumen de crema dental del tamaño de una alverja- pequeña (OR=27.42; IC95%:1.57-477.36). la prevalencia de CD fue 38.1% y de HMI fue 14.4%. La frecuencia de la FD fue alta y la severidad mostró correlación con la utilización de fogón de leña interno para la preparación de los alimentos y la cantidad de crema-dental utilizada.

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14.

Inheritance pattern of molar-incisor hypomineralization
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JEREMIAS, Fabiano

; BUSSANELI, Diego Girotto

; RESTREPO, Manuel

; PIERRI, Ricardo Augusto Gonçalves

; SOUZA, Juliana Feltrin de

; FRAGELLI, Camila Maria Bullio

; SECOLIN, Rodrigo

; MAURER-MORELLI, Claudia Vianna

; CORDEIRO, Rita de Cassia Loiola

; SCAREL-CAMINAGA, Raquel Mantuaneli

; SANTOS-PINTO, Lourdes

Brazilian Oral Research

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2021, Volume 35 elocation e035

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to investigate the segregation patterns of molar incisor hypomineralization (MIH) in families, given the evidence that its etiology is influenced by genetics. Clinically, MIH may be detected in parents and/or siblings of MIH-affected children. Our study included children with at least one first permanent molar affected by MIH (proband) and their first-degree relatives (parents and siblings). The participants were examined clinically to detect MIH, according to the European Academy of Paediatric Dentistry criteria (2003). A total of 101 nuclear families (391 individuals) were studied. Proband diagnosis was followed by MIH classification of the subject, his parents and siblings, as affected, unaffected, or unknown. Segregation analysis was performed using the multivariate logistic regression model of the Statistical Analysis for Genetic Epidemiology package, and segregation models (general transmission, environmental, major gene, dominant, codominant and recessive models). The Akaike information criterion (AIC) was used to evaluate the most parsimonious model. In all, 130 affected individuals, 165 unaffected individuals, and 96 unknown individuals were studied. Severe MIH was found in 50.7% of the cases. A segregation analysis performed for MIH revealed the following different models: environmental and dominance (p = 0.05), major gene (p = 0.04), codominant (p = 0.15) and recessive models (p = 0.03). According to the AIC values, the codominant model was the most parsimonious (AIC = 308.36). Our results suggest that the codominant model could be the most likely for inheriting MIH. This result strengthens the evidence that genetic factors, such as multifactorial complex defect, influence MIH.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0035 763 downloads

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Elimination of SARS-CoV-2 in nasopharynx and oropharynx after use of an adjuvant gargling and rinsing protocol with an antiseptic mouthwash
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Vilhena, Fabiano Vieira

; Orcina, Bernardo da Fonseca

; Lemos, Lúcio

; Less, Jeanette Cecília Fournier

; Pinto, Isabella

; Santos, Paulo Sérgio da Silva

einstein (São Paulo)

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2021, Volume 19 elocation eCE6999

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

https://doi.org/10.31744/einstein_journal/2021ce6999

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