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ABSTRACT COVID-19 generates respiratory symptoms that can cause more severe symptoms in patients with risk factors, so early detection and care is necessary. In a context of social isolation and high demand for health services, one of the recently developed monitoring methods is telemonitoring, which allows remote surveillance of patients. The objective of the research was to perform a panoramic review of the different experiences regarding telemonitoring of patients with COVID-19 at national and international level. Articles in English and Spanish published from January 1, 2020 to May 7, 2022 in the PubMed, SciELO and Google Scholar search sites were reviewed. The search was performed with the keywords "telemonitoring", "patients", "COVID-19" and "pandemic". Of the 160 articles found, four were discarded because they were duplicates and 126 because they were not directly related to the topic. Of the 30 selected, 24 had research results and six were used for theoretical-conceptual aspects related to the objective of the study. The implementation of remote monitoring for the follow-up of patients with a confirmed or suspected diagnosis of COVID-19 has proven to be feasible, low cost, within the reach of the patient and medical personnel. Also, remote monitoring reduces the use of hospital resources and identifies disease progression in a timely manner. At present, prospective-analytical studies are still lacking to determine precisely what could be improved in remote care systems.

RESUMEN La COVID-19 genera síntomas respiratorios que pueden causar cuadros de mayor severidad en pacientes con factores de riesgo, por lo que es necesario realizar una detección y atención temprana. En un contexto de aislamiento social y gran demanda de los servicios de salud uno de los métodos de seguimiento desarrollado últimamente es la telemonitorización que permite la vigilancia remota de los pacientes. El objetivo de la investigación fue realizar una revisión panorámica sobre las diferentes experiencias en cuanto a telemonitoreo de pacientes con COVID-19 a nivel nacional e internacional. Se revisaron artículos en inglés y español publicados desde el 1 de enero de 2020 hasta el 7 de mayo de 2022 en los sitios de búsqueda PubMed, SciELO y Google Scholar. La indagación se ejecutó con las palabras clave “telemonitoreo”, “pacientes”, “COVID-19” y “pandemia”. De los 160 artículos encontrados, se descartaron cuatro que estaban duplicados y 126 por no tener relación directa con el tema. De los 30 seleccionados, 24 contaban con resultados de investigación y seis se emplearon para los aspectos teórico-conceptuales relacionados con el objetivo del estudio. La implementación del monitoreo remoto para el seguimiento de pacientes con diagnóstico confirmado o sospechoso de COVID-19 ha demostrado ser factible, de bajo costo, estar al alcance del paciente y del personal médico. Asimismo, la monitorización remota reduce el uso de los recursos hospitalarios e identifica oportunamente el progreso de la enfermedad. Actualmente, aún faltan estudios prospectivos-analíticos que permitan determinar con precisión lo que se podría mejorar en los sistemas de atención remota.

Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de

; Hammond, Naomi

; Li, Yang

; Azevedo, Luciano Cesar Pontes de

; Cavalcanti, Alexandre Biasi

; Taniguchi, Leandro

; Gobatto, André

; Japiassú, André Miguel

; Bafi, Antonio Tonete

; Mazza, Bruno Franco

; Noritomi, Danilo Teixeira

; Dal-Pizzol, Felipe

; Bozza, Fernando

; Salluh, Jorge Ibrahin Figueira

; Westphal, Glauco Adrieno

; Soares, Márcio

; Assunção, Murillo Santucci César de

; Lisboa, Thiago

; Lobo, Suzana Margarete Ajeje

; Barbosa, Achilles Rohlfs

; Ventura, Adriana Fonseca

; Souza, Ailson Faria de

; Silva, Alexandre Francisco

; Toledo, Alexandre

; Reis, Aline

; Cembranel, Allan

; Rea Neto, Alvaro

; Gut, Ana Lúcia

; Justo, Ana Patricia Pierre

; Santos, Ana Paula

; Albuquerque, André Campos D. de

; Scazufka, André

; Rodrigues, Antonio Babo

; Fernandino, Bruno Bonaccorsi

; Silva, Bruno Goncalves

; Vidal, Bruno Sarno

; Pinheiro, Bruno Valle

; Pinto, Bruno Vilela Costa

; Feijo, Carlos Augusto Ramos

; Abreu Filho, Carlos de

; Bosso, Carlos Eduardo da Costa Nunes

; Moreira, Carlos Eduardo Nassif

; Ramos, Carlos Henrique Ferreira

; Tavares, Carmen

; Arantes, Cidamaiá

; Grion, Cintia

; Mendes, Ciro Leite

; Kmohan, Claudio

; Piras, Claudio

; Castro, Cristine Pilati Pileggi

; Lins, Cyntia

; Beraldo, Daniel

; Fontes, Daniel

; Boni, Daniela

; Castiglioni, Débora

; Paisani, Denise de Moraes

; Pedroso, Durval Ferreira Fonseca

; Mattos, Ederson Roberto

; Brito Sobrinho, Edgar de

; Troncoso, Edgar M. V.

; Rodrigues Filho, Edison Moraes

; Nogueira, Eduardo Enrico Ferrari

; Ferreira, Eduardo Leme

; Pacheco, Eduardo Souza

; Jodar, Euzebio

; Ferreira, Evandro L. A.

; Araujo, Fabiana Fernandes de

; Trevisol, Fabiana Schuelter

; Amorim, Fábio Ferreira

; Giannini, Fabio Poianas

; Santos, Fabrício Primitivo Matos

; Buarque, Fátima

; Lima, Felipe Gallego

; Costa, Fernando Antonio Alvares da

; Sad, Fernando Cesar dos Anjos

; Aranha, Fernando G.

; Ganem, Fernando

; Callil, Flavio

; Costa Filho, Francisco Flávio

; Dall´Arto, Frederico Toledo Campo

; Moreno, Geovani

; Friedman, Gilberto

; Moralez, Giulliana Martines

; Silva, Guilherme Abdalla da

; Costa, Guilherme

; Cavalcanti, Guilherme Silva

; Betônico, Gustavo Navarro

; Reis, Hélder

; Araujo, Helia Beatriz N.

; Hortiz Júnior, Helio Anjos

; Guimaraes, Helio Penna

; Urbano, Hugo

; Maia, Israel

; Santiago Filho, Ivan Lopes

; Farhat Júnior, Jamil

; Alvarez, Janu Rangel

; Passos, Joel Tavares

; Paranhos, Jorge Eduardo da Rocha

; Marques, José Aurelio

; Moreira Filho, José Gonçalves

; Andrade, Jose Neto

; Sobrinho, José Onofre de C

; Bezerra, Jose Terceiro de Paiva

; Alves, Juliana Apolônio

; Ferreira, Juliana

; Gomes, Jussara

; Sato, Karina Midori

; Gerent, Karine

; Teixeira, Kathia Margarida Costa

; Conde, Katia Aparecida Pessoa

; Martins, Laércia Ferreira

; Figueirêdo, Lanese

; Rezegue, Leila

; Tcherniacovsk, Leonardo

; Ferraz, Leone Oliveira

; Cavalcante, Liane

; Rabelo, Ligia

; Miilher, Lilian

; Garcia, Lisiane

; Tannous, Luana

; Hajjar, Ludhmila Abrahão

; Paciência, Luís Eduardo Miranda

; Cruz Neto, Luiz Monteiro da

; Bley, Macia Valeria

; Sousa, Marcelo Ferreira

; Puga, Marcelo Lourencini

; Romano, Marcelo Luz Pereira

; Nobrega, Marciano

; Arbex, Marcio

; Rodrigues, Márcio Leite

; Guerreiro, Márcio Osório

; Rocha, Marcone

; Alves, Maria Angela Pangoni

; Rosa, Maria Doroti

; Dias, Mariza D’Agostino

; Martins, Miquéias

; Oliveira, Mirella de

; Moretti, Miriane Melo Silveira

; Matsui, Mirna

; Messender, Octavio

; Santarém, Orlando Luís de Andrade

; Silveira, Patricio Júnior Henrique da

; Vassallo, Paula Frizera

; Antoniazzi, Paulo

; Gottardo, Paulo César

; Correia, Paulo

; Ferreira, Paulo

; Torres, Paulo

; Silva, Pedro Gabrile M. de Barros e

; Foernges, Rafael

; Gomes, Rafael

; Moraes, Rafael

; Nonato filho, Raimundo

; Borba, Renato Luis

; Gomes, Renato V

; Cordioli, Ricardo

; Lima, Ricardo

; López, Ricardo Pérez

; Gargioni, Ricardo Rath de Oliveira

; Rosenblat, Richard

; Souza, Roberta Machado de

; Almeida, Roberto

; Narciso, Roberto Camargo

; Marco, Roberto

; waltrick, Roberto

; Biondi, Rodrigo

; Figueiredo, Rodrigo

; Dutra, Rodrigo Santana

; Batista, Roseane

; Felipe, Rouge

; Franco, Rubens Sergio da Silva

; Houly, Sandra

; Faria, Sara Socorro

; Pinto, Sergio Felix

; Luzzi, Sergio

; Sant’ana, Sergio

; Fernandes, Sergio Sonego

; Yamada, Sérgio

; Zajac, Sérgio

; Vaz, Sidiner Mesquita

; Bezerra, Silvia Aparecida Bezerra

; Farhat, Tatiana Bueno Tardivo

; Santos, Thiago Martins

; Smith, Tiago

; Silva, Ulysses V. A.

; Damasceno, Valnei Bento

; Nobre, Vandack

; Dantas, Vicente Cés de Souza

; Irineu, Vivian Menezes

; Bogado, Viviane

; Nedel, Wagner

; Campos Filho, Walther

; Dantas, Weidson

; Viana, William

; Oliveira Filho, Wilson de

; Delgadinho, Wilson Martins

; Finfer, Simon

; Machado, Flavia Ribeiro

Revista Brasileira de Terapia Intensiva

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Abr 2021, Volume 33 Nº 2 Páginas 206 - 218

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

RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.

Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.

https://doi.org/10.5935/0103-507x.20210028 273 downloads

Variaciones de los tiempos de reacción frente a cambios de perspectiva y tamaño de los estímulos 2D y 3D en atención selectiva
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Torres-Tejeda, Sergio

; Portilla-Fernández, José Antonio

; Mugruza-Vassallo, Carlos Andrés

; Córdoba-Berrios, Luz Libertad

Revista mexicana de ingeniería biomédica

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Abr 2020, Volume 41 Nº 1 Páginas 91 - 104

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

Abstract When facing a goal-stimulus, people have a certain degree of attention. Therefore, when stimulus has changes in 2D or 3D configuration, in which cases one would react faster or slower? The present research evaluated the influence of the changes in the characteristics of the stimuli in reaction time experiments in visual attention tasks in videogames made in Unity 3D. For this, a comparison was made between two videogame experiments. The first videogame experiment was divided into two blocks that showed stimuli a block in 2D videogame and another in 3D videogame respectively to the participants and collected their reaction times against these stimuli. The second videogame experiment increase the number of blocks (from two to eight) to explain the differences in the reaction times obtained in the first experiment either by the size or the relative angle of 3D presentation of the stimuli, for which some characteristics of the blocks of the first experiment. The results, after comparing the different scenarios, have shown that the modification of the characteristics changed selective attention, because the reaction times of the first experiment vary in comparison to those of the second experiment depending on the change made (between 65 and 67 ms of difference for 2D and between 53 and 77 ms for 3D). On the discussion, one can question the commercial spheres of 2D stimuli in the so-called neuromarketing or sports. In both scenarios, the present work suggests evaluating for each case changes in their presentations or tools in a consequent control the reaction time of potential users, and this translates into a level of attention control.

Resumen Frente a un estímulo objetivo, las personas procesan mediante la atención selectiva antes de realizar toma de decisiones. Si ese estímulo sufre algún cambio en su configuración 2D o 3D, ¿en qué casos una persona reacciona más rápido o más lento? La presente investigación evaluó la influencia de los cambios en las características de los estímulos en experimentos de tiempos de reacción en tareas de atención visual en videojuegos creados en Unity 3D. Para estudiar esas características, se realizó una comparación entre dos experimentos de videojuegos. El primer experimento se dividió en dos bloques: uno mostraba estímulos en 2D y otro en 3D. Se recolectó el tiempo de reacción de los participantes frente a esos estímulos y se obtuvo que el tiempo de reacción fue mayor en 3D en 28.33 ms. En el segundo experimento se incrementaron los bloques (de dos a ocho) para explicar las diferencias de los tiempos de reacción obtenidas en el primer experimento sea por el tamaño o el ángulo relativo que otorga una diferente perspectiva geométrica de presentación de los estímulos en 3D, para lo cual se modificaron algunas características de los estímulos del primer experimento. Los resultados después de comparar los distintos escenarios muestran que la modificación de las características tiene una influencia en la atención selectiva, pues los tiempos de reacción del primer experimento varían en comparación a los del segundo experimento dependiendo del cambio realizado (entre 65 y 67 ms de diferencia para 2D y entre 53 y 77 ms para 3D). En la discusión, se analiza el ámbito de los estímulos en 2D y 3D en el neuromarketing o el deporte ante los cambios de tamaño y ángulo de la cámara. En ambos escenarios, el presente trabajo sugiere evaluar para cada caso la modificación en sus presentaciones o herramientas en un consiguiente incremento del tiempo de reacción de los potenciales usuarios o equivalentemente en un nivel bajo de atención.

https://doi.org/10.17488/rmib.41.1.7 939 downloads

Characteristics of follicular and mantle cell lymphoma in Brazil: prognostic impact of clinical parameters and treatment conditions in two hospitals
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Assis-Mendonça, Guilherme Rossi

; Crepaldi, André Henrique

; Delamain, Márcia Torresan

; Moreira, Adriana Helena

; Costa, Felipe D'Almeida

; Lima, Vladmir Cláudio Cordeiro de

; Souza, Cármino Antonio de

; Soares, Fernando Augusto

; Vassallo, José

Hematology, Transfusion and Cell Therapy

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Out 2018, Volume 40 Nº 4 Páginas 343 - 353

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: Follicular and mantle cell lymphoma are low-grade B-cell malignancies that lack good responses to chemoimmunotherapy. This study aimed to assess retrospectively clinicopathological features and to determine independent prognostic factors for follicular and mantle cell lymphoma patients treated at two Brazilian medical centers: the Hematology and Hemotherapy Center of the Universidade Estadual de Campinas (Unicamp), a public university hospital, and AC. Camargo Cancer Center, a specialized cancer center. Methods: Two hundred and twenty-seven follicular and 112 mantle cell lymphoma cases were diagnosed between 1999 and 2016. Archived paraffin blocks were retrieved and reviewed. Corresponding demographics and clinical data were recovered from medical charts. Outcome analyses considered both overall and event-free survival. Results: For follicular lymphoma treated with the R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, prednisone) and R-CVP (rituximab, cyclophosphamide, vincristine sulfate, prednisone) regimens, both B-symptoms (p-value < 0.01 for overall and event-free survival) and high-risk Follicular Lymphoma International Prognostic Index (p-value < 0.01 for overall survival) were independently associated to worse prognosis. Maintenance with rituximab improved the prognosis (p-value < 0.01 for overall survival). For mantle cell lymphoma, B-symptoms (p-value = 0.03 for overall survival and event-free survival) and bone marrow infiltration (p-value = 0.01 for overall survival) independently predicted reduced survival, and rituximab at induction increased both event-free and overall survival (p-value < 0.01 in both analyses). Combinations of these deleterious features could identify extremely poor prognostic subgroups. The administration of rituximab was more frequent in the AC. Camargo Cancer Center, which was the institution associated with better overall survival for both neoplasias. Conclusion: This study represents the largest cohort of follicular and mantle cell lymphoma in South America thus far. Some easily assessable clinical variables were able to predict prognosis and should be considered in low-income centers. In addition, the underuse of rituximab in the Brazilian public health system should be reconsidered in future health policies.

https://doi.org/10.1016/j.htct.2018.02.004 697 downloads

Response to cytotoxic chemotherapy and overall survival in non-small cell lung cancer patients with positive or negative ERCC1 expression
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Honma, Helen Naemi

; Perroud Jr, Maurício Wesley

; Morcillo, André Moreno

; Vassallo, José

; Zambon, Lair

Jornal Brasileiro de Pneumologia

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Mai 2018, Volume 44 Nº 3 Páginas 245 - 246

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

https://doi.org/10.1590/s1806-37562017000000236 1593 downloads

Hydrothermal alteration of volcanic rocks hosting the Late Jurassic-Early Cretaceous San Nicolás VMS deposit, southern Zacatecas, Mexico
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Vassallo, Luis F.

; Aranda-Gómez, José Jorge

; Solorio-Munguía, José Gregorio

Revista mexicana de ciencias geológicas

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Ago 2015, Volume 32 Nº 2 Páginas 254 - 272

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

Abstract San Nicolás is a Late Jurassic-Early Cretaceous, stratiform ZnCu-Ag-Au volcanogenic massive sulfide (VMS) deposit located in central Mexico, with a total resource of 99 Mt of ore grading 1.36 % Cu, 1.64 % Zn, 0.41 g/t Au and 24 g/t Ag. At San Nicolás mining district the ore deposits are related with submarine graben-horst structures produced by the opening of the Gulf of México. San Nicolás VMS deposit is at the right side of a graben structure, fed through a normal growing fault called "La Panza". The host-rock succession consists of a variably altered rhyolite lava dome in the hanging wall and a basaltdacite-dominated volcano-sedimentary sequence in the footwall. The sulfide deposit and hosting volcanic sequence were metamorphosed under lower greenschist facies. A laterally continuous footwall alteration zone extends beneath the entire district (~80 km2) and to a stratigraphic level at least 200 m below the several ore lenses. The bulk of this zone is occupied by feldspar-destructive, muscovite-biotite-chlorite-rich, mottled alteration facies with disseminated pyrite. The ore mineralization was controlled by a fault zone with intense quartz-pyrite alteration and represents the principal fluid pathway during mineralizing hydrothermal activity. Locally, quartz-K feldspar alteration facies occur on the edges of the system, whereas calcareous alteration and chloritepyrite alteration facies occur in the upper part of footwall volcanics, next to sulfide lenses. Porphyritic basalts, plus basaltic pillow lavas and volcanic breccias in the hanging wall are unaltered or weakly altered. Carbonate alteration (formation of dolomite and/or ankerite) probably represents the initial phase of hydrothermal activity. This was followed by diffuse upwelling of acidic hydrothermal fluids causing dissolution of underlying limestones and destruction of primary feldspars, precipitation of pyrite, and formation of sericite, chlorite, and clay minerals. Subsequently, intense quartzpyrite alteration was directly associated with mineralization. The San Nicolás footwall alteration zone shows systematic geochemical changes with increasing proximity to the ore bodies. These include Na depletion and elevated Mg, S, AI (AI=100*[MgO+K2O]/ [MgO+K2O+Na2O+CaO]), CCPI(CCPI=100*[MgO+FeO]/ [MgO+FeO+Na2O+K2O]),as well as Mo, Bi, and As. These geochemical features can be used in exploration for massive sulfide deposits as guides to ore, at the district scale, and in discrimination of prospective hydrothermal from unprospective diagenetic alteration systems at the regional scale.

Resumen San Nicolás es un depósito estratiforme de sulfuros masivos vulcanogénicos de edad Jurásico Superior-Cretácico Inferior con Zn-Cu-Ag-Au, localizado en la parte central de México, con reservas de 99 millones de toneladas con leyes de 1.36 % de Cu, 1.64 % de Zn, 0.41 g/t Au y 24 g/t Ag. En el distrito minero de San Nicolás los depósitos minerales están relacionados con estructuras submarinas de horst-grabenes producidos por la apertura del Golfo de México: el depósito de San Nicolás se ubica en la parte derecha de una estructura de graben, alimentado por medio de una falla normal de crecimiento llamada "La Panza". La sucesión de rocas encajonantes variablemente alteradas consiste de un domo riolítico en la parte superior (bloque de techo) y una secuencia volcano-sedimentaria predominantemente de basaltos y dacitas en la parte inferior (bloque del piso). El depósito de sulfuros y sus rocas encajonantes fueron metamorfizadas en grado de fácies de esquistos verdes. Lateralmente, en el bloque del piso, se extiende una zona de alteración en todo el distrito (~80 km2) y a un nivel estratigráfico hacia abajo de los mantos de hasta 200 m. La mayor parte de esta zona es ocupada por facies de destrucción de feldespatos, muscovita-biotita-clorita y alteración punteada con diseminación de pirita. La zona de la falla presenta una alteración intensa de cuarzo-pirita y representa el camino principal de los fluidos durante la actividad hidrotermal mineralizante. Localmente hay facies de cuarzo-feldespato potásico en los bordes del sistema, y la alteración calcárea y las facies de clorita-pirita se presentan en la parte superior de las rocas volcánicas del bloque del piso, al lado de los mantos de sulfuros. Basaltos porfiríticos, lavas almohadilladas y brechas volcánicas en el bloque de techo están inalterados o levemente alterados. La alteración calcárea (formación de dolomita y/o anquerita) probablemente representa la fase inicial de la actividad hidrotermal. Lo anterior fue seguido por una difusión ascendente de fluidos ácidos lo cual causó la disolución de las calizas subyacientes de formaciones conocidas y la destrucción de los feldespatos primarios, precipitación de pirita y formación de sericita, clorita y de minerales arcillosos. Posteriormente, una fuerte alteración cuarzo-pirita se relaciona con la mineralización. La zona alterada del bloque del piso de San Nicolás muestra cambios geoquímicos sistemáticos con una variación de la distancia a la proximidad a los cuerpos minerales. Esto incluye una disminución de Na y elevación de Mg, S, Al, (AI=100*[MgO+K2O]/[MgO+K2O+Na2O+CaO]), CCPI(CCPI=100*[MgO+FeO]/[MgO+FeO+Na2O+K2O]), Mo, Bi y As. Estas características geoquímicas pueden ser usadas en la exploración por sulfuros masivos (MVS) como guías hacia las menas, en la escala de distrito y como vector discriminador de prospectos hidrotermales de sistemas diagenéticos alterados no prospectivos a escala regional.

2000 downloads

Nova classificação dos carcinomas da mama: procurando o luminal A
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Serra, Katia Piton

; Ramalho, Susana

; Torresan, Renato

; Vassallo, Jose

; Sarian, Luis Otávio Zanatta

; Silva, Geisilene Russano de Paiva

; Derchain, Sophie

Revista Brasileira de Ginecologia e Obstetrícia

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Dez 2014, Volume 36 Nº 12 Páginas 575 - 580

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

OBJETIVO:Comparar a distribuição das pacientes segundo os subtipos clínico-patológicos de carcinomas de mama luminais like segundo o consenso de St. Gallen 2011 e 2013.MÉTODOS:Foram selecionadas 142 pacientes com carcinoma invasivo da mama que eram positivas para receptor de estrógeno, diagnosticadas e tratadas no estado de São Paulo, região Sudeste do Brasil. A expressão dos receptores de estrógeno, progesterona (RP) e Ki-67 foi avaliada por imunoistoquímica em microarranjo de tecidos. A expressão de HER-2 foi avaliada por hibridização fluorescente in situ.RESULTADOS:Observamos que 29 casos classificados como luminais A na classificação de St. Gallen 2011 eram luminais B na classificação de 2013. Dentre os 65 casos luminais B like da classificação de 2013, além dos 29 (45%) casos que migraram, observamos 15 casos (20%) com Ki-67 >14% e pelo menos 20% das células coradas; e 21 casos (35%) com Ki-67 >14% e RP positivo em mais de 20% das células coradas.CONCLUSÕES:Comparando a distribuição das pacientes com carcinomas luminais da mama segundo a classificação de St. Gallen 2011 e 2013 observamos que houve um aumento no número de carcinomas da mama luminais B like. Consequentemente, estima-se um aumento nas indicações de quimioterapia adjuvante e no custo do tratamento.

PURPOSE:To compare the distributions of patients with clinical-pathological subtypes of luminal B-like breast cancer according to the 2011 and 2013 St. Gallen International Breast Cancer Conference Expert Panel.METHODS:We studied 142 women with breast cancer who were positive to estrogen receptor and had been treated in São Paulo state, southeast Brazil. The expression of the following receptors was assessed by immunohistochemistry: estrogen, progesterone (PR) and Ki-67. The expression of HER-2 was measured by fluorescent in situ hybridization analysis in tissue microarray.RESULTS:There were 29 cases of luminal A breast cancers according to the 2011 St. Gallen International Breast Cancer Conference Expert Panel that were classified as luminal B-like in the 2013 version. Among the 65 luminal B-like breast cancer cases, 29 (45%) were previous luminal A tumors, 15 cases (20%) had a Ki-67 >14% and were at least 20% PR positive and 21 cases (35%) had Ki-67 >14% and more than 20% were PR positive.CONCLUSIONS:The 2013 St. Gallen consensus updated the definition of intrinsic molecular subtypes and increased the number of patients classified as having luminal B-like breast cancer in our series, for whom the use of cytotoxic drugs will probably be proposed with additional treatment cost.

https://doi.org/10.1590/SO100-720320140005158 18184 downloads

Primary myelofibrosis: risk stratification by IPSS identifies patients with poor clinical outcome
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Benites, Bruno Deltreggia

; Lima, Carolina Silva Costa

; Lorand-Metze, Irene

; Delamain, Marcia Torresan

; Oliveira, Gislaine Borba

; Almeida, Daiane de

; Souza, Carmino Antonio de

; Vassallo, Jose

; Pagnano, Katia Borgia Barbosa

Clinics

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2013, Volume 68 Nº 3 Páginas 339 - 343

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To evaluate whether risk scores used to classify patients with primary myelofibrosis and JAK-2 V617F mutation status can predict clinical outcome. METHODS: A review of clinical and laboratory data from 74 patients with primary myelofibrosis diagnosed between 1992 and 2011. The IPSS and Lille scores were calculated for risk stratification and correlated with overall survival. RESULTS: A V617F JAK2 mutation was detected in 32 cases (47%), with no significant correlation with overall survival. The patients were classified according to the scores: Lille - low, 53 (73.%); intermediate, 13 (18%); and high, 5 (7%); and IPSS- low, 15 (26%); intermediate-1, 23 (32%); intermediate-2, 19 (26%); and high, 15 (31%). Those patients presenting a higher risk according to the IPSS (high and intermediate-2) had a significantly shorter overall survival relative to the low risk groups (intermediate-1 and low) (p = 0.02). CONCLUSIONS: These results emphasize the importance of the IPSS prognostic score for risk assessment in predicting the clinical outcome of primary myelofibrosis patients.

https://doi.org/10.6061/clinics/2013(03)OA09 2578 downloads

Foxp3 expression is associated with aggressiveness in differentiated thyroid carcinomas
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Cunha, Lucas Leite

; Morari, Elaine Cristina

; Nonogaki, Suely

; Soares, Fernando Augusto

; Vassallo, José

; Ward, Laura Sterian

Clinics

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2012, Volume 67 Nº 5 Páginas 483 - 488

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Forkhead box P3 (FoxP3) expression has been observed in human cancer cells but has not yet been reported in thyroid cells. We investigated the prognostic significance of both FoxP3 expression and intratumoral FoxP3+ lymphocyte infiltration in differentiated thyroid carcinoma cells. METHODS: We constructed a tissue microarray with 385 thyroid tissues, including 266 malignant tissues (from 253 papillary thyroid carcinomas and 13 follicular carcinomas), 114 benign lesions, and 5 normal thyroid tissues. RESULTS: We determined the expression of FoxP3 in both tumor cells and tumor-infiltrating lymphocytes using immunohistochemical techniques. Cellular expression of FoxP3 was evident in 71% of benign and 91.9% of malignant tissues. The nuclear and cytoplasmic expression patterns were quantified separately. A multivariate logistic regression analysis indicated that cytoplasmic FoxP3 expression is an independent risk factor for thyroid malignancy. Cytoplasmic FoxP3 staining was inversely correlated with patient age. Nuclear FoxP3 staining was more intense in younger patients and in tumors presenting with metastasis at diagnosis. FoxP3+ lymphocytes were more frequent in tumors smaller than 2 cm, those without extrathyroidal invasion, and in patients with concurrent chronic lymphocytic thyroiditis. CONCLUSIONS: We demonstrated FoxP3 expression in differentiated thyroid carcinoma cells and found evidence that this expression may exert an important influence on several features of tumor aggressiveness.

https://doi.org/10.6061/clinics/2012(05)13 2787 downloads Citado 1 vez em SciELO

10.

Philadelphia-negative chronic myeloproliferative neoplasms
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Bittencourt, Rosane Isabel

; Vassallo, Jose

; Chauffaille, Maria de Lourdes Lopes Ferrari

; Xavier, Sandra Guerra

; Pagnano, Katia Borgia

; Nascimento, Ana Clara Kneese

; De Souza, Carmino Antonio

; Chiattone, Carlos Sergio

Revista Brasileira de Hematologia e Hemoterapia

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2012, Volume 34 Nº 2 Páginas 140 - 149

Resumo: En | Texto: En | PDF: En

Chronic myeloproliferative diseases without the Philadelphia chromosome marker (Ph-), although first described 60 years ago, only became the subject of interest after the turn of the millennium. In 2001, the World Health Organization (WHO) defined the classification of this group of diseases and in 2008 they were renamed myeloproliferative neoplasms based on morphological, cytogenetic and molecular features. In 2005, the identification of a recurrent molecular abnormality characterized by a gain of function with a mutation in the gene encoding Janus kinase 2 (JAK2) paved the way for greater knowledge of the pathophysiology of myeloproliferative neoplasms. The JAK2 mutation is found in 90-98% of polycythemia vera and in about 50% essential thrombocytosis and primary myelofibrosis. In addition to the JAK2 mutation, other mutations involving TET2 (ten-eleven translocation), LNK (a membrane-bound adaptor protein); IDH1/2 (isocitrate dehydrogenase 1/2 enzyme); ASXL1 (additional sex combs-like 1) genes were found in myeloproliferative neoplasms thus showing the importance of identifying molecular genetic alterations to confirm diagnosis, guide treatment and improve our understanding of the biology of these diseases. Currently, polycythemia vera, essential thrombocytosis, myelofibrosis, chronic neutrophilic leukemia, chronic eosinophilic leukemia and mastocytosis are included in this group of myeloproliferative neoplasms, but are considered different situations with individualized diagnostic methods and treatment. This review updates pathogenic aspects, molecular genetic alterations, the fundamental criteria for diagnosis and the best approach for each of these entities.

https://doi.org/10.5581/1516-8484.20120034 4020 downloads

11.

LAS REDES TRANSEUROPEAS DE TRANSPORTE, RTE-T
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Vassallo-Magro, José Manuel

; Baeza-Muñoz, María de los Ángeles

International Law

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Dez 2011, Nº 19 Páginas 39 - 73

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

Las redes transeuropeas de transporte (RTE-T) contribuyen al buen funcionamiento del mercado internacional dentro de la Unión Europea y a reforzar la cohesión económica y social. El objetivo de este artículo es analizar la política de infraestructuras de la Unión Europea, tanto la planificación de las RTE-T como los instrumentos financieros previstos para su desarrollo. En los últimos años, la Unión Europea ha adoptado medidas que contribuirán a mejorar la política comunitaria de infraestructuras; sin embargo, esas medidas no son suficientes para garantizar el desarrollo de estas infraestructuras. Es necesario que la Unión Europea adquiera más competencias en el desarrollo de las infraestructuras transfronterizas.

Trans-European Transport Networks (TEN-T) contribute to improve the competitiveness of the international markets within the European Union, EU, and strengthen the economic and social development of its countries. The aim of this paper is to analyze the infrastructure policy promoted by the EU. To that end, we describe and assess both the planning process of the TEN-T, and the financial instruments implemented by the EU to foster them. In the last decades some steps have been conducted to improve the EU infrastructure policy. However, these measures have not been sufficient to ensure the development of such infrastructures. In order to solve this problem, in the future, the EU should play a greater role in developing cross-border infrastructure.

1563 downloads

12.

Classificação dos tumores hematopoéticos e linfoides de acordo com a OMS: padronização da nomenclatura em língua portuguesa, 4ª edição
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Zerbini, Maria Cláudia Nogueira

; Soares, Fernando Augusto

; Morais, José Carlos

; Vassallo, José

; Velloso, Elvira Deolinda Rodrigues Pereira

; Chaufaille, Maria de Lourdes L. F

; Chiattone, Carlos Sergio

; Aldred, Vera Lucia

; Siqueira, Sheila Aparecida Coelho

; Alves, Antonio Correia

; Castelli, Jussara Bianchi

; Oliveira, Claudia Regina Gomes Mendes Cardim de

; Menezes, Yara de

; Paes, Roberto Pinto

Jornal Brasileiro de Patologia e Medicina Laboratorial

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Dez 2011, Volume 47 Nº 6 Páginas 643 - 648

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

INTRODUÇÃO: A classificação da Organização Mundial da Saúde (OMS) para os tumores do tecido hematopoético e linfoide (4ª edição, 2008) representa uma revisão atualização da 3ª edição publicada em 2001. A tradução da nomenclatura utilizada para identificar as entidades descritas deve ser clara, precisa e uniforme no sentido de reproduzir de forma correta as diversas entidades clinicopatológicas para clínicos, patologistas e pesquisadores envolvidos na área da onco-hematopatologia. OBJETIVO: Os autores apresentam uma proposta de atualização e padronização terminológica em língua portuguesa, com base na OMS/2008

INTRODUCTION: The World Health Organization (WHO) classification of hematopoietic and lymphoid tissue (4th edition, 2008) tumors constitutes an updated review of the 3rd edition published in 2001. The translation of the nomenclature used to describe the entities should be clear, precise and uniform so that clinicians, pathologists and researchers involved in the onco-hematopathological area may identify them accurately. OBJECTIVE: With this purpose, the authors present an updated proposal and a terminological standardization in Portuguese based on WHO/2008

17976 downloads

13.

Interleukin-10 but not interleukin-18 may be associated with the immune response against well-differentiated thyroid cancer
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Cunha, Lucas Leite

; Tincani, Alfio Jose

; Assumpção, Ligia Vera Montalli da

; Soares, Fernando Augusto

; Vassallo, José

; Ward, Laura Sterian

Clinics

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2011, Volume 66 Nº 7 Páginas 1203 - 1208

Resumo: En | Texto: En | PDF: En

OBJECTIVES: The aim of this study was to investigate the role of the interleukin-18 +105A/C and interleukin-10 -1082A/G germline polymorphisms in the development and outcome of differentiated thyroid carcinoma associated or not with concurrent thyroiditis. METHODS: We studied 346 patients with differentiated thyroid carcinomas, comprising 292 papillary carcinomas and 54 follicular carcinomas, who were followed up for 12-298 months (mean 76.10 ± 68.23 months) according to a standard protocol. We genotyped 200 patients and 144 control individuals for the interleukin-18 +105A/C polymorphism, and we genotyped 183 patients and 137 controls for the interleukin-10 -1082A/G polymorphism. RESULTS: Interleukin-18 polymorphisms were not associated with chronic lymphocytic thyroiditis or any clinical or pathological feature of tumor aggressiveness. However, there was an association between the presence of interleukin-10 variants and chronic lymphocytic thyroiditis. Chronic lymphocytic thyroiditis was present in 21.74% of differentiated thyroid carcinoma patients, most frequently affecting women previously diagnosed with Hashimoto's thyroiditis who had received a lower 131I cumulative dose and did not present lymph node metastases. CONCLUSIONS: We conclude that the inheritance of a G allele at the interleukin-10 -1082A/G polymorphism may favor a concurrent thyroid autoimmunity in differentiated thyroid carcinoma patients, and this autoimmunity may favor a better prognosis for these patients.

2145 downloads Citado 1 vez em SciELO

14.

Cirugía cardíaca reparadora en recién nacidos: Experiencia de 5 años en cirugía neonatal con circulación extracorpórea
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Magliola, Ricardo

; Althabe, María

; Moreno, Guillermo

; Lenz, Ana M.

; Pilan, María L.

; Landry, Luis

; Balestrini, María

; Charroqui, Alberto

; Vassallo, Juan C.

; Salgado, Gladys

; Martín, Analía

; Barretta, Jorge

; Cornelis, Javier

; García Delucis, Pablo

; Suárez, José

; Laura, Juan P.

Archivos argentinos de pediatría

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Out 2009, Volume 107 Nº 5 Páginas 417 - 422

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

Introduction. Four hundred newborns die every year in our country suffering from congenital heart disease. Definitive surgical repair, whenever possible, is nowadays the optimal therapeutic strategy. Our goal is to describe mortality and morbidity in neonatal surgery with cardiopulmonary bypass in a tertiary public hospital in Argentina. Patients and methods. Descriptive, retrospective study. Every patient, younger than 45 days, with cardiac surgery requiring cardiopulmonary bypass, at the Garrahan Hospital between 2004 and 2008 was included. Demographic, surgical and postoperative data were collected. Adjusted mortality risk analysis, and descriptive statistics from the most frequent diagnosis were performed. Results are expressed as median and rank or percentage. Results. 200 newborns were operated, 62% males. Median age was 21 days (r 1- 45) and median weight 3.1 kg (r 1.6-6.2). Total anomalous pulmonary venous return, transposition of great arteries an hypoplastic left heart syndrome diagnoses accounted for 75% of the procedures. Median length of stay was 12 days (r 0-191), and 6 days of mechanical ventilation (r 0-180). Eighteen percent of the patients required peritoneal dialysis. Whole series mortality was 19% and fell to 14% in 2008. Unstable preoperative condition and postoperative complications increased mortality, OR= 2.23 (1.02-4.89) and OR= 10 (3.6-33.4), respectively. Conclusions. Our postoperative mortality is similar to those reported in foreign countries databases. Patients with unstable preoperative condition and post-operative complications had higher mortality.

Introducción. En nuestro país fallecen anualmente 400 niños con cardiopatía congénita, en el 1er mes de vida. La cirugía constituye la estrategia actual para su tratamiento. El objetivo es describir la mortalidad hospitalaria y las complicaciones de la cirugía cardíaca neonatal con circulación extracorpórea en un hospital público de alta complejidad. Pacientes y métodos. Estudio descriptivo retrospectivo. Se registraron datos demográficos, de la cirugía y del postoperatorio de los pacientes con circulación extracorpórea, menores de 45 días, operados en el Hospital Garrahan, entre 2004-2008. Se realizó un análisis por patologías y de mortalidad ajustado por riesgo. Los resultados se expresan en mediana e intervalo, o en porcentaje, según corresponda. Resultados. Se operaron 200 recién nacidos, 62% varones. La edad fue 21 (1- 45) días y el peso 3,1 (1,6-6,2) kg. Anomalía total de retorno venoso pulmonar, transposición de grandes arterias y síndrome de corazón izquierdo hipoplásico concentraron el 75% de las cirugías. El tiempo de internación fue 12 (0-191) días, con 6 (0-180) días de ventilación mecánica, y 18% de los pacientes requirieron diálisis. La mortalidad global fue 19% y 14% en el último año analizado. Los pacientes en mala condición preoperatoria, así como los que presentaron complicaciones, exhibieron una mortalidad mayor (OR= 2,23 [1,02-4,89] y OR= 10 [3,6-33,4], respectivamente). Conclusiones. La mortalidad postoperatoria es similar a la comunicada en bases de datos del exterior. Los pacientes con mala condición preoperatoria y aquellos con complicaciones presentaron mayor mortalidad en nuestra serie.

1418 downloads Citado 3 vezes em SciELO

15.

Síndromes mielodisplásicas e mielodisplásicas/mieloproliferativas
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Vassallo, José

; Magalhães, Silvia M. M.

Revista Brasileira de Hematologia e Hemoterapia

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Ago 2009, Volume 31 Nº 4 Páginas 267 - 272

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

As síndromes mielodisplásicas (SMD) representam um grupo heterogêneo de doenças hematológicas caracterizadas por hematopoese ineficaz e risco aumentado de evolução para leucemia mieloide aguda. Neste artigo educativo são apresentados aspectos gerais da sua fisiopatologia, diagnóstico, apresentação histopatológica e seu papel no diagnóstico diferencial, classificação e estratificação prognóstica. Ressalta-se a importância da avaliação clínica e laboratorial, que inclui avaliação do sangue periférico e medula óssea: morfologia - aspirado medular e biópsia óssea -, citogenética, imunofenotipagem, além de dados evolutivos. O diagnóstico definitivo, em especial nos casos de baixo risco, deve considerar a exclusão de causas não clonais que podem, através de alterações dismielopoéticas reativas, simular a mielodisplasia, tais como infecções virais, principalmente pelo HIV. A nova classificação revisada da Organização Mundial da Saúde (OMS-2008) é apresentada e discutida.

Myelodysplastic syndromes (MDS) represent a heterogeneous group of hematologic disorders characterized by ineffective hematopoiesis and an increased risk of developing acute myeloid leukemia. In this educational article the general aspects of the physiopathology, diagnosis, and histopathological features of MDS and their role in differential diagnosis, classification and prognostic categorization are presented. The importance of clinical and laboratory evaluations, including peripheral blood and bone marrow analyses, including morphology - aspirate and core biopsy, cytogenetics, immunophenotype and careful serial follow-up is emphasized. Definite diagnosis of MDS, especially in low-risk subtypes, should consider the exclusion of disorders with reactive bone marrow alterations, such as viral infections for example HIV. The new revised World Health Organization (WHO-2008) classification is presented and discussed.

76128 downloads Citado 1 vez em SciELO

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