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VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation): protocol for a multicenter randomized open-label trial of watchful waiting versus antimicrobial therapy for ventilator-associated tracheobronchitis VentilatorAssociated Ventilator Associated Evaluation Evaluation) openlabel open label ventilatorassociated ventilator associated
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Tomazini, Bruno Martins
; Besen, Bruno Adler Maccagnan Pinheiro
; Dietrich, Camila
; Gandara, Ana Paula Rossi
; Silva, Debora Patrícia
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Mattos, Renata Rodrigues de
; Reis, Luiz Fernando Lima
; Roepke, Roberta Muriel Longo
; Duarte, Carlos Sérgio Luna Gomes
; Nassar Júnior, Antônio Paulo
; Veiga, Viviane Cordeiro
; Arns, Beatriz
Nascimento, Giovanna Marssola
Pereira, Adriano José
Cavalcanti, Alexandre Biasi
Machado, Flávia Ribeiro
Azevedo, Luciano Cesar Pontes













ABSTRACT Background Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. Methods VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. Conclusion The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development. Ventilatorassociated Ventilator associated units unknown VentilatorAssociated Associated Evaluation ventilatorassociated ventilator ventilation randomized controlled openlabel, openlabel open label, label open-label shock diagnosis ventilationfree 2 pneumoniafree survival intentiontotreat intention treat perprotocol per protocol 20 margin 15 1 5 1. ventilatorfree standards highvisibility high visibility dissemination development
RESUMO Contexto A traqueobronquite associada ao ventilador é uma condição comum entre pacientes ventilados invasivamente em unidades de terapia intensiva, para a qual se desconhece atualmente a melhor estratégia de tratamento. Desenhamos o estudo VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) para avaliar se uma estratégia de tratamento antibiótico de espera vigilante não é inferior ao tratamento antibiótico de rotina para traqueobronquite associada ao ventilador em relação aos dias sem ventilador mecânico. Métodos O VATICAN é um estudo randomizado, controlado, aberto e multicêntrico de não inferioridade. Os pacientes com suspeita de traqueobronquite associada ao ventilador sem evidência de pneumonia associada ao ventilador ou instabilidade hemodinâmica devido a uma provável infecção serão designados para uma estratégia de espera vigilante, sem administração profilática de antimicrobianos contra traqueobronquite associada ao ventilador e prescrição de antimicrobianos somente em casos de pneumonia associada ao ventilador, sepse ou choque séptico, ou outro diagnóstico infeccioso, ou para uma estratégia de tratamento antimicrobiano de rotina por 7 dias. O desfecho primário será o número de dias sem ventilador mecânico em 28 dias, e um desfecho secundário importante será a sobrevida sem pneumonia associada ao ventilador. Por meio de uma estrutura de intenção de tratar com análise de sensibilidade por protocolo, a análise do desfecho primário abordará a não inferioridade com margem de 20%, o que se traduz em uma diferença de 1,5 dia sem ventilador. Outras análises seguirão uma estrutura de análise de superioridade. Conclusão O VATICAN seguirá todos os padrões éticos nacionais e internacionais. O objetivo é publicar o estudo em um periódico geral de alta visibilidade e apresentá-lo em conferências de cuidados intensivos e doenças infecciosas para divulgação. Estes resultados provavelmente serão imediatamente aplicáveis à beira do leito após a conclusão do estudo e fornecerão informações com baixo risco de viés para o desenvolvimento de diretrizes. intensiva VentilatorAssociated Ventilator Associated Evaluation randomizado controlado séptico infeccioso 2 protocolo 20 20% 15 1 5 1, superioridade internacionais apresentálo apresentá lo divulgação diretrizes
2.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
Slipinski, Adam
Linzmeier, Adelita M.
Calor, Adolfo R.
Garda, Adrian A.
Kury, Adriano B.
Fernandes, Agatha C.S.
Agudo-Padrón, Aisur I.
Akama, Alberto
Silva Neto, Alberto M. da
Burbano, Alejandro L.
Menezes, Aleksandra
Pereira-Colavite, Alessandre
Anichtchenko, Alexander
Lees, Alexander C.
Bezerra, Alexandra M.R.
Domahovski, Alexandre C.
Pimenta, Alexandre D.
Aleixo, Alexandre L.P.
Marceniuk, Alexandre P.
Paula, Alexandre S. de
Somavilla, Alexandre
Specht, Alexandre
Camargo, Alexssandro
Newton, Alfred F.
Silva, Aline A.S. da
Santos, Aline B. dos
Tassi, Aline D.
Aragão, Allan C.
Santos, Allan P.M.
Migotto, Alvaro E.
Mendes, Amanda C.
Cunha, Amanda
Chagas Júnior, Amazonas
Sousa, Ana A.T. de
Pavan, Ana C.
Almeida, Ana C.S.
Peronti, Ana L.B.G.
Henriques-Oliveira, Ana L.
Prudente, Ana L.
Tourinho, Ana L.
Pes, Ana M.O.
Carmignotto, Ana P.
Wengrat, Ana P.G. da Silva
Dornellas, Ana P.S.
Molin, Anamaria Dal
Puker, Anderson
Morandini, André C.
Ferreira, André da S.
Martins, André L.
Esteves, André M.
Fernandes, André S.
Roza, André S.
Köhler, Andreas
Paladini, Andressa
Andrade, Andrey J. de
Pinto, Ângelo P.
Salles, Anna C. de A.
Gondim, Anne I.
Amaral, Antonia C.Z.
Rondón, Antonio A.A.
Brescovit, Antonio
Lofego, Antônio C.
Marques, Antonio C.
Macedo, Antonio
Andriolo, Artur
Henriques, Augusto L.
Ferreira Júnior, Augusto L.
Lima, Aurino F. de
Barros, Ávyla R. de A.
Brito, Ayrton do R.
Romera, Bárbara L.V.
Vasconcelos, Beatriz M.C. de
Frable, Benjamin W.
Santos, Bernardo F.
Ferraz, Bernardo R.
Rosa, Brunno B.
Sampaio, Brunno H.L.
Bellini, Bruno C.
Clarkson, Bruno
Oliveira, Bruno G. de
Corrêa, Caio C.D.
Martins, Caleb C.
Castro-Guedes, Camila F. de
Souto, Camilla
Bicho, Carla de L.
Cunha, Carlo M.
Barboza, Carlos A. de M.
Lucena, Carlos A.S. de
Barreto, Carlos
Santana, Carlos D.C.M. de
Agne, Carlos E.Q.
Mielke, Carlos G.C.
Caetano, Carlos H.S.
Flechtmann, Carlos H.W.
Lamas, Carlos J.E.
Rocha, Carlos
Mascarenhas, Carolina S.
Margaría, Cecilia B.
Waichert, Cecilia
Digiani, Celina
Haddad, Célio F.B.
Azevedo, Celso O.
Benetti, Cesar J.
Santos, Charles M.D. dos
Bartlett, Charles R.
Bonvicino, Cibele
Ribeiro-Costa, Cibele S.
Santos, Cinthya S.G.
Justino, Cíntia E.L.
Canedo, Clarissa
Bonecker, Claudia C.
Santos, Cláudia P.
Carvalho, Claudio J.B. de
Gonçalves, Clayton C.
Galvão, Cleber
Costa, Cleide
Oliveira, Cléo D.C. de
Schwertner, Cristiano F.
Andrade, Cristiano L.
Pereira, Cristiano M.
Sampaio, Cristiano
Dias, Cristina de O.
Lucena, Daercio A. de A.
Manfio, Daiara
Amorim, Dalton de S.
Queiroz, Dalva L. de
Queiroz, Dalva L. de
Colpani, Daniara
Abbate, Daniel
Aquino, Daniel A.
Burckhardt, Daniel
Cavallari, Daniel C.
Prado, Daniel de C. Schelesky
Praciano, Daniel L.
Basílio, Daniel S.
Bená, Daniela de C.
Toledo, Daniela G.P. de
Takiya, Daniela M.
Fernandes, Daniell R.R.
Ament, Danilo C.
Cordeiro, Danilo P.
Silva, Darliane E.
Pollock, Darren A.
Muniz, David B.
Gibson, David I.
Nogueira, David S.
Marques, Dayse W.A.
Lucatelli, Débora
Garcia, Deivys M.A.
Baêta, Délio
Ferreira, Denise N.M.
Rueda-Ramírez, Diana
Fachin, Diego A.
Souza, Diego de S.
Rodrigues, Diego F.
Pádua, Diego G. de
Barbosa, Diego N.
Dolibaina, Diego R.
Amaral, Diogo C.
Chandler, Donald S.
Maccagnan, Douglas H.B.
Caron, Edilson
Carvalho, Edrielly
Adriano, Edson A.
Abreu Júnior, Edson F. de
Pereira, Edson H.L.
Viegas, Eduarda F.G.
Carneiro, Eduardo
Colley, Eduardo
Eizirik, Eduardo
Santos, Eduardo F. dos
Shimbori, Eduardo M.
Suárez-Morales, Eduardo
Arruda, Eliane P. de
Chiquito, Elisandra A.
Lima, Élison F.B.
Castro, Elizeu B. de
Orlandin, Elton
Nascimento, Elynton A. do
Razzolini, Emanuel
Gama, Emanuel R.R.
Araujo, Enilma M. de
Nishiyama, Eric Y.
Spiessberger, Erich L.
Santos, Érika C.L. dos
Contreras, Eugenia F.
Galati, Eunice A.B.
Oliveira Junior, Evaldo C. de
Gallardo, Fabiana
Hernandes, Fabio A.
Lansac-Tôha, Fábio A.
Pitombo, Fabio B.
Dario, Fabio Di
Santos, Fábio L. dos
Mauro, Fabio
Nascimento, Fabio O. do
Olmos, Fabio
Amaral, Fabio R.
Schunck, Fabio
Godoi, Fábio S. P. de
Machado, Fabrizio M.
Barbo, Fausto E.
Agrain, Federico A.
Ribeiro, Felipe B.
Moreira, Felipe F.F.
Barbosa, Felipe F.
Silva, Fenanda S.
Cavalcanti, Fernanda F.
Straube, Fernando C.
Carbayo, Fernando
Carvalho Filho, Fernando
Zanella, Fernando C.V.
Jacinavicius, Fernando de C.
Farache, Fernando H.A.
Leivas, Fernando
Dias, Fernando M.S.
Mantellato, Fernando
Vaz-de-Mello, Fernando Z.
Gudin, Filipe M.
Albuquerque, Flávio
Molina, Flavio B.
Passos, Flávio D.
Shockley, Floyd W.
Pinheiro, Francielly F.
Mello, Francisco de A.G. de
Nascimento, Francisco E. de L.
Franco, Francisco L.
Oliveira, Francisco L. de
Melo, Francisco T. de V.
Quijano, Freddy R.B.
Salles, Frederico F.
Biffi, Gabriel
Queiroz, Gabriel C.
Bizarro, Gabriel L.
Hrycyna, Gabriela
Leviski, Gabriela
Powell, Gareth S.
Santos, Geane B. dos
Morse, Geoffrey E.
Brown, George
Mattox, George M.T.
Zimbrão, Geraldo
Carvalho, Gervásio S.
Miranda, Gil F.G.
Moraes, Gilberto J. de
Lourido, Gilcélia M.
Neves, Gilmar P.
Moreira, Gilson R.P.
Montingelli, Giovanna G.
Maurício, Giovanni N.
Marconato, Gláucia
Lopez, Guilherme E.L.
Silva, Guilherme L. da
Muricy, Guilherme
Brito, Guilherme R.R.
Garbino, Guilherme S.T.
Flores, Gustavo E.
Graciolli, Gustavo
Libardi, Gustavo S.
Proctor, Heather C.
Gil-Santana, Helcio R.
Varella, Henrique R.
Escalona, Hermes E.
Schmitz, Hermes J.
Rodrigues, Higor D.D.
Galvão Filho, Hilton de C.
Quintino, Hingrid Y.S.
Pinto, Hudson A.
Rainho, Hugo L.
Miyahira, Igor C.
Gonçalves, Igor de S.
Martins, Inês X.
Cardoso, Irene A.
Oliveira, Ismael B. de
Franz, Ismael
Fernandes, Itanna O.
Golfetti, Ivan F.
S. Campos-Filho, Ivanklin
Oliveira, Ivo de S.
Delabie, Jacques H.C.
Oliveira, Jader de
Prando, Jadila S.
Patton, James L.
Bitencourt, Jamille de A.
Silva, Janaina M.
Santos, Jandir C.
Arruda, Janine O.
Valderrama, Jefferson S.
Dalapicolla, Jeronymo
Oliveira, Jéssica P.
Hájek, Jiri
Morselli, João P.
Narita, João P.
Martin, João P.I.
Grazia, Jocélia
McHugh, Joe
Cherem, Jorge J.
Farias Júnior, José A.S.
Fernandes, Jose A.M.
Pacheco, José F.
Birindelli, José L.O.
Rezende, José M.
Avendaño, Jose M.
Duarte, José M. Barbanti
Ribeiro, José R. Inácio
Mermudes, José R.M.
Pujol-Luz, José R.
Santos, Josenilson R. dos
Câmara, Josenir T.
Teixeira, Joyce A.
Prado, Joyce R. do
Botero, Juan P.
Almeida, Julia C.
Kohler, Julia
Gonçalves, Julia P.
Beneti, Julia S.
Donahue, Julian P.
Alvim, Juliana
Almeida, Juliana C.
Segadilha, Juliana L.
Wingert, Juliana M.
Barbosa, Julianna F.
Ferrer, Juliano
Santos, Juliano F. dos
Kuabara, Kamila M.D.
Nascimento, Karine B.
Schoeninger, Karine
Campião, Karla M.
Soares, Karla
Zilch, Kássia
Barão, Kim R.
Teixeira, Larissa
Sousa, Laura D. do N.M. de
Dumas, Leandro L.
Vieira, Leandro M.
Azevedo, Leonardo H.G.
Carvalho, Leonardo S.
Souza, Leonardo S. de
Rocha, Leonardo S.G.
Bernardi, Leopoldo F.O.
Vieira, Letícia M.
Johann, Liana
Salvatierra, Lidianne
Oliveira, Livia de M.
Loureiro, Lourdes M.A. El-moor
Barreto, Luana B.
Barros, Luana M.
Lecci, Lucas
Camargos, Lucas M. de
Lima, Lucas R.C.
Almeida, Lucia M.
Martins, Luciana R.
Marinoni, Luciane
Moura, Luciano de A.
Lima, Luciano
Naka, Luciano N.
Miranda, Lucília S.
Salik, Lucy M.
Bezerra, Luis E.A.
Silveira, Luis F.
Campos, Luiz A.
Castro, Luiz A.S. de
Pinho, Luiz C.
Silveira, Luiz F.L.
Iniesta, Luiz F.M.
Tencatt, Luiz F.C.
Simone, Luiz R.L.
Malabarba, Luiz R.
Cruz, Luiza S. da
Sekerka, Lukas
Barros, Lurdiana D.
Santos, Luziany Q.
Skoracki, Maciej
Correia, Maira A.
Uchoa, Manoel A.
Andrade, Manuella F.G.
Hermes, Marcel G.
Miranda, Marcel S.
Araújo, Marcel S. de
Monné, Marcela L.
Labruna, Marcelo B.
Santis, Marcelo D. de
Duarte, Marcelo
Knoff, Marcelo
Nogueira, Marcelo
Britto, Marcelo R. de
Melo, Marcelo R.S. de
Carvalho, Marcelo R. de
Tavares, Marcelo T.
Kitahara, Marcelo V.
Justo, Marcia C.N.
Botelho, Marcia J.C.
Couri, Márcia S.
Borges-Martins, Márcio
Felix, Márcio
Oliveira, Marcio L. de
Bologna, Marco A.
Gottschalk, Marco S.
Tavares, Marcos D.S.
Lhano, Marcos G.
Bevilaqua, Marcus
Santos, Marcus T.T.
Domingues, Marcus V.
Sallum, Maria A.M.
Digiani, María C.
Santarém, Maria C.A.
Nascimento, Maria C. do
Becerril, María de los A.M.
Santos, Maria E.A. dos
Passos, Maria I. da S. dos
Felippe-Bauer, Maria L.
Cherman, Mariana A.
Terossi, Mariana
Bartz, Marie L.C.
Barbosa, Marina F. de C.
Loeb, Marina V.
Cohn-Haft, Mario
Cupello, Mario
Martins, Marlúcia B.
Christofersen, Martin L.
Bento, Matheus
Rocha, Matheus dos S.
Martins, Maurício L.
Segura, Melissa O.
Cardenas, Melissa Q.
Duarte, Mércia E.
Ivie, Michael A.
Mincarone, Michael M.
Borges, Michela
Monné, Miguel A.
Casagrande, Mirna M.
Fernandez, Monica A.
Piovesan, Mônica
Menezes, Naércio A.
Benaim, Natalia P.
Reategui, Natália S.
Pedro, Natan C.
Pecly, Nathalia H.
Ferreira Júnior, Nelson
Silva Júnior, Nelson J. da
Perioto, Nelson W.
Hamada, Neusa
Degallier, Nicolas
Chao, Ning L.
Ferla, Noeli J.
Mielke, Olaf H.H.
Evangelista, Olivia
Shibatta, Oscar A.
Oliveira, Otto M.P.
Albornoz, Pablo C.L.
Dellapé, Pablo M.
Gonçalves, Pablo R.
Shimabukuro, Paloma H.F.
Grossi, Paschoal
Rodrigues, Patrícia E. da S.
Lima, Patricia O.V.
Velazco, Paul
Santos, Paula B. dos
Araújo, Paula B.
Silva, Paula K.R.
Riccardi, Paula R.
Garcia, Paulo C. de A.
Passos, Paulo G.H.
Corgosinho, Paulo H.C.
Lucinda, Paulo
Costa, Paulo M.S.
Alves, Paulo P.
Roth, Paulo R. de O.
Coelho, Paulo R.S.
Duarte, Paulo R.M.
Carvalho, Pedro F. de
Gnaspini, Pedro
Souza-Dias, Pedro G.B.
Linardi, Pedro M.
Bartholomay, Pedro R.
Demite, Peterson R.
Bulirsch, Petr
Boll, Piter K.
Pereira, Rachel M.M.
Silva, Rafael A.P.F.
Moura, Rafael B. de
Boldrini, Rafael
Silva, Rafaela A. da
Falaschi, Rafaela L.
Cordeiro, Ralf T.S.
Mello, Ramon J.C.L.
Singer, Randal A.
Querino, Ranyse B.
Heleodoro, Raphael A.
Castilho, Raphael de C.
Constantino, Reginaldo
Guedes, Reinaldo C.
Carrenho, Renan
Gomes, Renata S.
Gregorin, Renato
Machado, Renato J.P.
Bérnils, Renato S.
Capellari, Renato S.
Silva, Ricardo B.
Kawada, Ricardo
Dias, Ricardo M.
Siewert, Ricardo
Brugnera, Ricaro
Leschen, Richard A.B.
Constantin, Robert
Robbins, Robert
Pinto, Roberta R.
Reis, Roberto E. dos
Ramos, Robson T. da C.
Cavichioli, Rodney R.
Barros, Rodolfo C. de
Caires, Rodrigo A.
Salvador, Rodrigo B.
Marques, Rodrigo C.
Araújo, Rodrigo C.
Araujo, Rodrigo de O.
Dios, Rodrigo de V.P.
Johnsson, Rodrigo
Feitosa, Rodrigo M.
Hutchings, Roger W.
Lara, Rogéria I.R.
Rossi, Rogério V.
Gerstmeier, Roland
Ochoa, Ronald
Hutchings, Rosa S.G.
Ale-Rocha, Rosaly
Rocha, Rosana M. da
Tidon, Rosana
Brito, Rosangela
Pellens, Roseli
Santos, Sabrina R. dos
Santos, Sandra D. dos
Paiva, Sandra V.
Santos, Sandro
Oliveira, Sarah S. de
Costa, Sávio C.
Gardner, Scott L.
Leal, Sebastián A. Muñoz
Aloquio, Sergio
Bonecker, Sergio L.C.
Bueno, Sergio L. de S.
Almeida, Sérgio M. de
Stampar, Sérgio N.
Andena, Sérgio R.
Posso, Sergio R.
Lima, Sheila P.
Gadelha, Sian de S.
Thiengo, Silvana C.
Cohen, Simone C.
Brandão, Simone N.
Rosa, Simone P.
Ribeiro, Síria L.B.
Letana, Sócrates D.
Santos, Sonia B. dos
Andrade, Sonia C.S.
Dávila, Stephane
Vaz, Stéphanie
Peck, Stewart B.
Christo, Susete W.
Cunha, Suzan B.Z.
Gomes, Suzete R.
Duarte, Tácio
Madeira-Ott, Taís
Marques, Taísa
Roell, Talita
Lima, Tarcilla C. de
Sepulveda, Tatiana A.
Maria, Tatiana F.
Ruschel, Tatiana P.
Rodrigues, Thaiana
Marinho, Thais A.
Almeida, Thaís M. de
Miranda, Thaís P.
Freitas, Thales R.O.
Pereira, Thalles P.L.
Zacca, Thamara
Pacheco, Thaynara L.
Martins, Thiago F.
Alvarenga, Thiago M.
Carvalho, Thiago R. de
Polizei, Thiago T.S.
McElrath, Thomas C.
Henry, Thomas
Pikart, Tiago G.
Porto, Tiago J.
Krolow, Tiago K.
Carvalho, Tiago P.
Lotufo, Tito M. da C.
Caramaschi, Ulisses
Pinheiro, Ulisses dos S.
Pardiñas, Ulyses F.J.
Maia, Valéria C.
Tavares, Valeria
Costa, Valmir A.
Amaral, Vanessa S. do
Silva, Vera C.
Wolff, Vera R. dos S.
Slobodian, Verônica
Silva, Vinícius B. da
Espíndola, Vinicius C.
Costa-Silva, Vinicius da
Bertaco, Vinicius de A.
Padula, Vinícius
Ferreira, Vinicius S.
Silva, Vitor C.P. da
Piacentini, Vítor de Q.
Sandoval-Gómez, Vivian E.
Trevine, Vivian
Sousa, Viviane R.
Sant’Anna, Vivianne B. de
Mathis, Wayne N.
Souza, Wesley de O.
Colombo, Wesley D.
Tomaszewska, Wioletta
Wosiacki, Wolmar B.
Ovando, Ximena M.C.
Leite, Yuri L.R.








ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
3.
Agricultural traits and popping expansion of the popcorn hybrid IAC 125 under different plant densities and irrigation water depth levels 12 1
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Stipp, Oelcio José
; Possato Junior, Omar
Rossi, Evandrei
Rosa, Jocimar Costa
Uhdre, Renan Santos
Rizzardi, Diego Ary
Freitas, Paulo Sergio Lourenço de
Pinto, Ronald José Barth

ABSTRACT. Popcorn (Zea mays L. everta) is a specialty crop with a higher aggregate economic value than that of common maize. In Brazil, national literature is still incipient and contradictory in terms of plant population management and water requirements. Furthermore, the interaction between these factors has not been reported, despite the increasing cultivation of popcorn. The objective of this trial was to determine whether agricultural traits and popping expansion from hybrid IAC 125 could be affected by plant density and levels of irrigation water, in addition to determining the significance level of the interaction between both factors. We investigated five plant populations (40,000, 55,000, 70,000, 85,000, and 100,000 plants ha-1) and five different levels of water depth in 2014/2015 [574.86 (without supplementary irrigation), 609.86, 644.86, 679.86 (control), and 714.86 mm] and 2015/2016 [857.4 (without supplementary irrigation), 867.26, 886.60, 916.78 (control), and 959.81 mm] using a complete block design with split-plot, comprising a main plot (for plant populations) and subplot (for water depth), with six replicates for each set. We found increasing linear effects from grain yield under population density and levels of water depth, but this interaction was not significant. Moreover, the popping expansion for the main effects and the interaction between plant populations and water depth, were not significant. ABSTRACT Zea L everta maize Brazil requirements Furthermore reported popcorn 12 40,000, 40000 40 000 (40,000 55000 55 55,000 70000 70 70,000 85000 85 85,000 100000 100 100,00 ha1 ha 1 ha-1 20142015 2014 2015 2014/201 574.86 57486 574 86 [574.8 without irrigation, , irrigation) 60986 609 609.86 64486 644 644.86 67986 679 679.8 control, control (control) 71486 714 714.8 mm 20152016 2016 2015/201 857.4 8574 857 4 [857. 86726 867 26 867.26 88660 886 60 886.60 91678 916 78 916.7 95981 959 81 959.8 splitplot, splitplot split plot, split-plot depth) set significant Moreover 40,000 4000 00 (40,00 5500 5 55,00 7000 7 70,00 8500 8 85,00 10000 10 100,0 ha- 2014201 201 2014/20 574.8 5748 57 [574. 6098 609.8 6448 64 644.8 6798 67 679. (control 7148 71 714. 2015201 2015/20 857. [857 8672 2 867.2 8866 88 6 886.6 9167 91 916. 9598 95 959. 40,00 400 0 (40,0 550 55,0 700 70,0 850 85,0 1000 100, 201420 20 2014/2 574. [574 609. 644. 201520 2015/2 [85 867. 886. 9 40,0 (40, 55, 70, 85, 20142 2014/ [57 20152 2015/ [8 40, (40 [5 [ (4 (
4.
Use of electrical impedance tomography to set positive end-expiratory pressure in a pediatric patient with severe acute respiratory distress syndrome endexpiratory end expiratory
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Frade, Marcela Lopes
; Vale, Luciana Assis Pires Andrade
; Corrêa, Letícia Candançan
; Rossi, Felipe de Souza
; Terra, Celso de Moraes
; Colleti Junior, José
.






5.
Do it fast! Early access to specialized care improved long-term outcomes in rheumatoid arthritis: data from the REAL multicenter observational study
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Albuquerque, Cleandro Pires
; Reis, Ana Paula Monteiro Gomides
Santos, Ana Beatriz Vargas
Bértolo, Manoel Barros
Louzada Júnior, Paulo
Giorgi, Rina Dalva Neubarth
Radominski, Sebastião Cezar
Guimarães, Maria Fernanda B. Resende
Bonfiglioli, Karina Rossi
Sauma, Maria de Fátima L Cunha
Pereira, Ivânio Alves
Brenol, Claiton Viegas
Mota, Licia Maria Henrique
Santos Neto, Leopoldo
Pinheiro, Geraldo Rocha Castelar

Abstract Background Early rheumatoid arthritis (RA) offers an opportunity for better treatment outcomes. In real-life settings, grasping this opportunity might depend on access to specialized care. We evaluated the effects of early versus late assessment by the rheumatologist on the diagnosis, treatment initiation and long-term outcomes of RA under real-life conditions. Methods Adults meeting the ACR/EULAR (2010) or ARA (1987) criteria for RA were included. Structured interviews were conducted. The specialized assessment was deemed “early” when the rheumatologist was the first or second physician consulted after symptoms onset, and “late” when performed afterwards. Delays in RA diagnosis and treatment were inquired. Disease activity (DAS28-CRP) and physical function (HAQ-DI) were evaluated. Student's t, Mann-Whitney U, chi-squared and correlation tests, and multiple linear regression were performed. For sensitivity analysis, a propensity score-matched subsample of early- vs. late-assessed participants was derived based on logistic regression. The study received ethical approval; all participants signed informed consent. Results We included 1057 participants (89.4% female, 56.5% white); mean (SD) age: 56.9 (11.5) years; disease duration: 173.1 (114.5) months. Median (IQR) delays from symptoms onset to both RA diagnosis and initial treatment coincided: 12 (6–36) months, with no significant delay between diagnosis and treatment. Most participants (64.6%) first sought a general practitioner. Notwithstanding, 80.7% had the diagnosis established only by the rheumatologist. Only a minority (28.7%) attained early RA treatment (≤ 6 months of symptoms). Diagnostic and treatment delays were strongly correlated (rho 0.816; p < 0.001). The chances of missing early treatment more than doubled when the assessment by the rheumatologist was belated (OR 2.77; 95% CI: 1.93, 3.97). After long disease duration, late-assessed participants still presented lower chances of remission/low disease activity (OR 0.74; 95% CI: 0.55, 0.99), while the early-assessed ones showed better DAS28-CRP and HAQ-DI scores (difference in means [95% CI]: −0.25 [−0.46, −0.04] and − 0.196 [−0.306, −0.087] respectively). The results in the propensity-score matched subsample confirmed those observed in the original (whole) sample. Conclusions Early diagnosis and treatment initiation in patients with RA was critically dependent on early access to the rheumatologist; late specialized assessment was associated with worse long-term clinical outcomes.
6.
Adaptability and stability of corn hybrids for the south of the Amazon biome via GGE biplot
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Lima, Joameson Antunes
; Rossi, Ana Aparecida Bandini
; Santos, Talles de Oliveira
; Penna, Guilherme Ferreira
; Tardin, Flávio Dessaune
; Trindade, Roberto dos Santos
; Guimarães, Paulo Evaristo de Oliveira
; Godinho, Vicente de Paulo Campos
; Amaral Junior, Antônio Teixeira do
; Cordeiro, Angelo Gabriel Mendes
; Santos, Renan Colavite dos
; Jesus, Marry Suelly Ferreira de
; Pogalsky, Letícia de Souza
; Tiago, Auana Vicente
; Pedri, Eliane Moreno de
; Ferreira, Edimilson Leonardo
; Zanetti, Géssica Tais
.

















Abstract The objective of this work was to select maize hybrids using the GGE biplot analysis, as well as to evaluate their stability and adaptability in different environments of the North and Midwest regions of Brazil. Thirty-six maize hybrids were evaluated in 2018, in the following five environments in the Northern and Midwestern regions, respectively: in the municipality of Vilhena, in the state of Rondônia; and in the municipalities of Sorriso, Sinop, Alta Floresta, and Carlinda, in the Northern region of the state of Mato Grosso. The experimental design was a randomized complete block design. The analysis of variance was performed, and adaptability and stability were estimated by the GGE biplot method based on grain yield performance. A significant interaction between genotypes and environments was detected, and the biplot analysis was efficient in explaining 62.74% of the total variation in the first two principal components, with the formation of three macroenvironments. The 1P2227, 'BRS 3042', and 1P2265 hybrids showed high yield, responsiveness, and stability in the evaluated environments. The DKB310VTPRO2 hybrid was the most unstable genotype. The recommended hybrids are: DKB310 for the Sorriso and Vilhena macroenvironment; 1M1810 and 1O2106 for the Carlinda environment; and 1M1807 for the Sinop environment.
Resumo O objetivo deste trabalho foi selecionar híbridos de milho, por meio da análise GGE biplot, bem como avaliar sua estabilidade e adaptabilidade em diferentes ambientes das regiões Centro-Oeste e Norte do Brasil. Trinta e seis híbridos de milho foram avaliados em 2018, nos seguintes cinco ambientes das regiões Norte e Centro-Oeste, respectivamente: no município de Vilhena, no estado de Rondônia; e nos municípios de Sorriso, Sinop, Alta Floresta e Carlinda, na região norte do estado de Mato Grosso. O delineamento experimental foi em blocos completos ao acaso. Realizou-se a análise de variância, e estimaramse a adaptabilidade e a estabilidade pelo método GGE biplot com base na produtividade. Detectou-se interação significativa entre genótipos e ambientes, e a análise biplot foi eficiente para explicar 62,74% da variação total nos dois primeiros componentes principais, com a formação de três macroambientes. Os híbridos 1P2227, 'BRS 3042' e 1P2265 apresentam alta produtividade, capacidade de resposta e estabilidade nos ambientes avaliados. O híbrido DKB310VTPRO2 foi o genótipo mais instável. Os híbridos recomendados são: DKB310 para o macroambiente Sorriso e Vilhena; 1M1810 e 1O2106 para o ambiente Carlinda; e 1M1807 para o ambiente Sinop.
7.
Decreasing delays in the diagnosis and treatment of rheumatoid arthritis in Brazil: a nationwide multicenter observational study
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Albuquerque, Cleandro Pires de
; Reis, Ana Paula Monteiro Gomides
Santos, Ana Beatriz Vargas
Bértolo, Manoel Barros
Louzada Júnior, Paulo
Giorgi, Rina Dalva Neubarth
Radominski, Sebastião Cezar
Guimarães, Maria Fernanda B. Resende
Bonfiglioli, Karina Rossi
Sauma, Maria de Fátima L. da Cunha
Pereira, Ivânio Alves
Brenol, Claiton Viegas
Mota, Licia Maria Henrique da
Santos Neto, Leopoldo
Pinheiro, Geraldo R. Castelar

Abstract Background Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil. Methods Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann–Kendall trend test, chi-squared tests with Cramer’s V effect sizes and analysis of variance were conducted. Results We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = - 0.677, p < 0.001) and treatment (tau = - 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011–2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4–12) and 11 (5–17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window. Conclusion The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.
8.
Effects of therapeutic ultrasound and paraffin with or without vacuum massage on biomechanical properties of grafted skin after burn: a randomized controlled trial
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Gonçalves, Adriana da Costa
; Guirro, Rinaldo Roberto de Jesus
; Rossi, Lidia Aparecida
; Farina Junior, Jayme Adriano
; Carvalho, Camila Silva de
; Ferro, Ana Paula
; Guirro, Elaine Caldeira de Oliveira
.







Revista da Associação Médica Brasileira
- Métricas do periódico
SUMMARY OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.
9.
Epidemiological characterization of notified human brucellosis cases in Southern Brazil
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Bernardi, Fabricio
; Possa, Marina Gabriela
; Rossi, Camila Elizandra
; Benevenuto, Luíz Guilherme Dercore
; Nascif Junior, Iucif Abrão
; Jesus, Jacqueline de
; Oliveira, Barbara Cardoso de
; Zanelatto, Carla
; Sena, Joice Gama
; Fonseca-Alves, Carlos Eduardo
; Elias, Fabiana
.











Revista do Instituto de Medicina Tropical de São Paulo
- Métricas do periódico
ABSTRACT Brucellosis is one of the most important and widespread bacterial zoonotic diseases worldwide, and it is transmitted to humans from various sources, including direct contact with infected animals and the ingestion of contaminated products, including unpasteurized milk. There are only a few epidemiological studies on said disease in humans in Western Santa Catarina, a region instantiated by agriculture. Thus, the objective of this study was to characterize the epidemiological aspects of human brucellosis reported in Western Santa Catarina from 2013 to 2018. The data were provided by the Epidemiological Surveillance Board (Diretoria de Vigilancia Epidemiologica). The frequency of the disease in humans and the epidemiological profile of confirmed human cases were evaluated. Cases that were screened positive and those that were confirmed and submitted to the therapeutic protocol were analyzed. During the study period, 3,671 people were tested, of which 12.34% were screened positive (453/ 3,671) and 3.40% were confirmed (125/3,671). The year with the highest number of people testing positive was 2015 (123 cases), and 2018 was the year with the highest number of confirmed cases (39 cases). Confirmed cases predominated in males (48.8%), self-declared white (22.4%), aged 20-59 years old (60%), with incomplete primary education (22.4%), of rural origin (59.2%), with occupational contact with cattle (64.8%), engaged in professions directly linked to agricultural and livestock activities (55.5%), and who reported consumption of unpasteurized dairy products (59.2%). No seasonal variation was observed in case numbers. The results demonstrated that brucellosis is an endemic disease in Western Santa Catarina.
10.
Weaning and concentrate supplementation on the characteristics of carcass cuts and longissimus muscle of Suffolk lambs finished on pasture
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Fernandes, Sergio Rodrigo
; Monteiro, Alda Lúcia Gomes
Silva, Marina Gabriela Berchiol da
Silva, Cláudio José Araújo da
Zanotelli, Júlia Marina
Rossi Junior, Paulo
Pinto, Pedro Henrique Nicolau

ABSTRACT. The aim of this study was to evaluate the influence of weaning and concentrate supplementation on the characteristics of carcass cuts and longissimus muscle of Suffolk lambs finished on a Tifton 85 (Cynodon spp.) pasture. Weaning and concentrate supplementation strategies were evaluated in four finishing systems: i) non-weaned and non-supplemented lambs; ii) non-weaned lambs supplemented with concentrate in creep feeding; iii) weaned and non-supplemented lambs; and iv) weaned lambs supplemented with concentrate. In the systems with weaning, lambs were weaned at 46 ± 6 days of age. In the systems with supplementation, the concentrate was offered daily at 2% of lambs’ body weight. Weaning led to a decrease, whereas supplementation led to an increase in carcass cut weights. Supplemented lambs had lower yields of neck and uncovered ribs, and higher yields of breast + flank and loin. The characteristics of loin eye and fat thickness over the longissimus muscle presented lower values in weaned lambs and higher values in supplemented lambs. Keeping lambs with their dams and offering concentrate supplementation until slaughter are strategies recommended to obtain heavier cuts with increased muscularity and fat content.
11.
MULTIPLE CHOICE METHOD WITH GENETIC ALGORITHM FOR THE FORMATION OF SOCCER TEAMS
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Salles, Sérgio Augusto Faria
; da Hora, Henrique Rego Monteiro
; Erthal Júnior, Milton
; Velasco, André Soares
; Croce, Paulo Rossi
.





ABSTRACT For soccer managers, player selection lineups are a key process for better performance, both on financial and sports matters. However, to determine a quality solution to this problem it becomes more complex, as the number of alternatives and criteria increases and the number of viable solutions grows ex ponentially. This paper proposes a multicriteria method with genetic algorithm for the evaluation of soccer teams based on Brazilian Championship data. A team complementation percentage was calculated con sidering a total of 322 athletes and 18 criteria. The results presented a 3-6-1 format as the ideal for this case study, obtaining a team complementation value of 43.04%. The method adaptability for the decision-maker is highlighted, showing it was possible to determinate the most complementary team according to the desired tactical formation and importance attributed for each criterion.
12.
Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos
; Feitosa Filho, Gilson Soares
; Petriz, João Luiz
; Furtado, Remo Holanda de Mendonça
; Précoma, Dalton Bertolim
; Lemke, Walmor
; Lopes, Renato Delascio
; Timerman, Ari
; Marin Neto, José A.
; Bezerra Neto, Luiz
; Gomes, Bruno Ferraz de Oliveira
; Santos, Eduardo Cavalcanti Lapa
; Piegas, Leopoldo Soares
; Soeiro, Alexandre de Matos
; Negri, Alexandre Jorge de Andrade
; Franci, Andre
; Markman Filho, Brivaldo
; Baccaro, Bruno Mendonça
; Montenegro, Carlos Eduardo Lucena
; Rochitte, Carlos Eduardo
; Barbosa, Carlos José Dornas Gonçalves
; Virgens, Cláudio Marcelo Bittencourt das
; Stefanini, Edson
; Manenti, Euler Roberto Fernandes
; Lima, Felipe Gallego
; Monteiro Júnior, Francisco das Chagas
; Correa Filho, Harry
; Pena, Henrique Patrus Mundim
; Pinto, Ibraim Masciarelli Francisco
; Falcão, João Luiz de Alencar Araripe
; Sena, Joberto Pinheiro
; Peixoto, José Maria
; Souza, Juliana Ascenção de
; Silva, Leonardo Sara da
; Maia, Lilia Nigro
; Ohe, Louis Nakayama
; Baracioli, Luciano Moreira
; Dallan, Luís Alberto de Oliveira
; Dallan, Luis Augusto Palma
Mattos, Luiz Alberto Piva e
Bodanese, Luiz Carlos
Ritt, Luiz Eduardo Fonteles
Canesin, Manoel Fernandes
Rivas, Marcelo Bueno da Silva
Franken, Marcelo
Magalhães, Marcos José Gomes
Oliveira Júnior, Múcio Tavares de
Filgueiras Filho, Nivaldo Menezes
Dutra, Oscar Pereira
Coelho, Otávio Rizzi
Leães, Paulo Ernesto
Rossi, Paulo Roberto Ferreira
Soares, Paulo Rogério
Lemos Neto, Pedro Alves
Farsky, Pedro Silvio
Cavalcanti, Rafael Rebêlo C.
Alves, Renato Jorge
Kalil, Renato Abdala Karam
Esporcatte, Roberto
Marino, Roberto Luiz
Giraldez, Roberto Rocha Corrêa Veiga
Meneghelo, Romeu Sérgio
Lima, Ronaldo de Souza Leão
Ramos, Rui Fernando
Falcão, Sandra Nivea dos Reis Saraiva
Dalçóquio, Talia Falcão
Lemke, Viviana de Mello Guzzo
Chalela, William Azem
Mathias Júnior, Wilson






































Arquivos Brasileiros de Cardiologia
- Métricas do periódico
https://doi.org/10.36660/abc.20210180
3052 downloads
13.
Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real- life study
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Vicente, Gustavo Nogueira Schincariol
; Pereira, Ivânio Alves
Castro, Gláucio Ricardo Werner de
Mota, Licia Maria Henrique da
Carnieletto, Ana Paula
Souza, Dhara Giovanna Santin de
Gama, Fabiana Oenning da
Santos, Ana Beatriz Vargas
Albuquerque, Cleandro Pires de
Bértolo, Manoel Barros
Louzada Júnior, Paulo
Giorgi, Rina Dalva Neubarth
Radominski, Sebastião Cezar
Guimarães, Maria Fernanda Brandão Resende
Bonfiglioli, Karina Rossi
Sauma, Maria de Fátima Lobato da Cunha
Brenol, Claiton Viegas
Pinheiro, Geraldo da Rocha Castelar

Abstract Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs. Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher’s Exact tests. Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003). Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.
https://doi.org/10.1186/s42358-021-00186-4
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14.
Recommendations of the Brazilian Society of Rheumatology for the use of JAK inhibitors in the management of rheumatoid arthritis
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Bonfiglioli, Karina Rossi
; Mota, Licia Maria Henrique da
Ribeiro, Ana Cristina de Medeiros
Kakehasi, Adriana Maria
Laurindo, Ieda Maria Magalhães
Giorgi, Rina Dalva Neubarth
Duarte, Angela Luzia Branco Pinto
Reis, Ana Paula Monteiro Gomides
Souza, Mariana Peixoto Guimarães Ubirajara e Silva de
Brenol, Claiton Viegas
Pinheiro, Geraldo da Rocha Castelar
Albuquerque, Cleandro Pires de
Castro, Charlles Heldan de Moura
Pinto, Gustavo Luiz Behrens
Verztman, Jose Fernando
Muniz, Luciana Feitosa
Bertolo, Manoel Barros
Pinto, Maria Raquel da Costa
Louzada Júnior, Paulo
Cruz, Vitor Alves
Pereira, Ivanio Alves
Freitas, Max Vitor Carioca de
Cruz, Bóris Afonso
Paiva, Eduardo
Monticielo, Odirlei
Provenza, José Roberto
Xavier, Ricardo Machado

Abstract Rheumatoid arthritis (RA) is a chronic and autoimmune systemic inflammatory disease that can cause irreversible joint deformities, with increased morbidity and mortality and a significant impact on the quality of life of the affected individual. The main objective of RA treatment is to achieve sustained clinical remission or low disease activity. However, up to 40% of patients do not respond to available treatments, including bDMARDs. New therapeutic targets for RA are emerging, such as Janus kinases (JAKs). These are essential for intracellular signaling (via JAK-STAT) in response to many cytokines involved in RA immunopathogenesis. JAK inhibitors (JAKi) have established themselves as a highly effective treatment, gaining increasing space in the therapeutic arsenal for the treatment of RA. The current recommendations aim to present a review of the main aspects related to the efficacy and safety of JAKis in RA patients, and to update the recommendations and treatment algorithm proposed by the Brazilian Society of Rheumatology in 2017.
15.
COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro
; Uchôa, Caroline Louise Mesquita
; Mazzoco, Marina Flaborea
; Cruz, Isabella D'Andrea Garcia da
; Echegaray, Mariana V.F.
; Humes, Eduardo de Castro
; Silveira, Júlia Belizário
; Santi, Talita Di
; Miguel, Euripedes Constantino
; Corchs, Felipe
; Fatori, Daniel
Campello, Guilherme
Oliveira, Gabriel M. de
Argolo, Felipe C.
Ferreira, Felipe de M.
Machado, Gustavo
Argeu, Adriana
Oliveira, Graça Maria Ramos de
Serafim, Antônio de Pádua
Siqueira, Luciana de Lima
Rossi, Luciane de
Rios, Izabel Cristina
Oliveira, Talita Rodrigues de
Antoniazzi, Leilane C. K.
Gagliotti, Daniel Augusto Mori
Abelama Neto, Emílio
Oliveira Junior, Paulo Novais de
Correia, Aline Villalobo
Gonçalves, Luca Schilling
Tortato, Liana Silva
Busato, Wagner Machado Moraes
Guimarães-Fernandes, Flávio
Alves, Marcos
Leite Netto, Oswaldo Ferreira
Schoueri, Patrícia de Campos Lindenberg
Roque, Márcio de Assis
Merlin, Silvia Stahl
Boer, Giovana Cardoso Machado
Sallet, Paulo Clemente
Malbergier, André
Spedo, Mariana Abrahão
Kamitsuji, Carla Satie
Faria, Elizabeth de
Moreira, Moacyr Vergara de Godoy
Kaufman, Arthur
Abdo, Carmita
Scanavino, Marco de Tubino
Lancman, Selma
Tavares, Hermano
Polanczyk, Guilherme
Brunoni, André R.
Forlenza, Orestes V.
Barros-Filho, Tarcísio Eloy Pessoa de










OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.
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