MEDICINA BASEADA EM EVIDÊNCIA

O artigo registra as conferências do congresso internacional de inovação tecnológica nas ciências da saúde: a sustentabilidade das práticas integrativas a agroecologia, mais especificamente a conferência Medicina baseada em evidência. A conferência apontou o uso de cálculos probabilísticos através de revisões sistemáticas da bibliografia científica para desenhar os benefícios, magnitude e utilidade das decisões terapêuticas. O evento aconteceu de 15 a 18 de novembro de 2017 no IFBA SAJ sob a direção da Universidade Federal do Recôncavo da Bahia. Palavras-chave: Probabilidade. Decisões terapêuticas. Medicina Baseada em Evidência

Probabilistic dietary risk assessment of triazole and dithiocarbamate fungicides for the Brazilian population.

Residue data for triazoles (TR) and dithiocarbamates (DT) in 30,786 samples of 30 foods were obtained from mainly two national monitoring programs, and consumption data from a national survey conducted among persons aged 10 years or older About 16% of the samples contained TR, mainly grape (53.5%), and 16.2% contained DT, mainly apple (59.3%). Flusilazole was the index compound for the acute effects of TR for women of child-bearing-age (cranium-facial malformation and skeletal variation), cyproconazole for the chronic effects of TR (hepatoxicity), and ethylene-bis-dithitiocarbamates (EBDC) for DT (thyroid toxicity). Exposures were estimated using the Monte Carlo Risk Assessment software. Different models were tested, and a Model-Then-Add approach was found to best estimate the chronic exposures to DT and TR. At the 99.9th percentile (P99.9), the cumulative acute TR intakes accounted for up to 0.5% of the flusilazole ARfD, mainly from beans and rice consumption. The chronic TR and DT intakes accounted for 1 and 6.7% of the respective index compound ADIs, with beans and rice accounting for most of the TR intake (∼70%), and apple for about 51-56% of the DT intake. The estimated risks from the exposure to TR and DT indicate no health concern for the Brazilian population

Dentifrice Containing Extract of Rosmarinus officinalis Linn.: An Antimicrobial Evaluation

Abstract This study aimed to evaluate the antimicrobial activity of a dentifrice containing an alcoholic extract of rosemary on oral bacteria, compared to a commercially available herbal dentifrice. Standard strains of Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 9811) and Lactobacillus rhamnosus (ATCC 7469) were used, as well as different toothpastes based on rosemary (TR), on propolis (TH), triclosan (positive control) (TPC) and non-fluoridated dentifrice (negative control) (TNC). Bacteria were seeded in Petri dishes and paper discs soaked with dilutions of dentifrice placed on the plates. The inhibition halos were analyzed. It was observed that TR did not show statistical difference in relation to the TH to inhibit S. mutans and S. oralis, while TH was more active against L. rhamnosus. The toothpaste containing rosemary extract had the ability to inhibit the growth of S. mutans, S. oralis and L. rhamnosus, revealing an antimicrobial activity similar to commercially available toothpastes for inhibition of S. mutans and S. oralis

Assessment of speckle tracking strain predictive value for myocardial fibrosis in subjects with Chagas disease

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-05-12T12:36:51Z No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-05-12T12:51:06Z (GMT) No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5)Made available in DSpace on 2016-05-12T12:51:06Z (GMT). No. of bitstreams: 1 Macedo CT Assessment....pdf: 661652 bytes, checksum: a14aaf455b6a4c89eef253f8b95079bc (MD5) Previous issue date: 2015Hospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, BrasilHospital São Rafael. Departamento de Cardiologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilBackground: One of the most challenging issues of chronic Chagas disease is to provide earlier detection of heart involvement. Two-dimensional speckle tracking (2-D ST) echocardiography, a new imagingmodalitywith useful applications in several cardiac diseases, has been validated for subjects with myocardial infarction against cardiac magnetic resonance (CMR). Here we hypothesize that the longitudinal global strain (LGS) has an incremental value to ejection fraction for predicting myocardial fibrosis in subjects with Chagas disease. Methods: This observational study comprised 58 subjectswith Chagas disease, confirmed by two positive serologic tests. All subjects underwent conventional Doppler echocardiogramplus speckle tracking strain, and cardiacmagnetic resonance. Results: The ROC curve analysis revealed that both LGS (area under the curve: 0.78, p=0.001) and ejection fraction (area under the curve: 0.82, p b 0.001)were significant predictors ofmyocardial fibrosis. Regarding the percentage of fibrosis, a high correlation was observed with both ejection fraction assessed by echocardiography (r =0.70, p b 0.001) and LGS (r = 0.64, p b 0.001). However, when adjusted through multiple linear regression, the LGS lost statistical significance as a predictor of myocardial fibrosis (p = 0.111). Conclusions: LGS has no incremental value to conventional ejection fractionmeasurement in the prediction ofmyocardial fibrosis in subjects with Chagas disease

Lack of association between serum syndecan-4, myocardial fibrosis and ventricular dysfunction in subjects with chronic Chagas disease

<div><p>Background</p><p>Syndecan-4 is a transmembrane glycoprotein associated with inflammation and fibrosis. Increased syndecan-4 levels were previously detected after acute myocardial infarction and in subjects with heart failure. However, the levels of syndecan-4 in subjects with Chagas disease have not so far been investigated. The aim of this study was to investigate the potential role of serum sydencan-4 as a novel biomarker for myocardial fibrosis and cardiac dysfunction in subjects with Chagas disease.</p><p>Methods</p><p>This study comprised subjects with Chagas disease (n = 56), being 14 (25%) with the indeterminate form, 16 (29%) with the cardiac form without ventricular dysfunction, and 26 (46%) with the cardiac form with ventricular dysfunction.</p><p>Results</p><p>Syndecan-4 serum concentrations did not correlate with presence or absence of myocardial fibrosis (P = 0.386) nor disease severity in subjects with Chagas disease (P = 0.918). Additionally, no correlation was found either between the degree of myocardial fibrosis and serum syndecan-4 [r = 0.08; P = 0.567] or between left ventricular ejection fraction and syndecan-4 [r = 0.02; P = 0.864]. In contrast, NT-proBNP levels correlated with ejection fraction and myocardial fibrosis.</p><p>Conclusions</p><p>Our results demonstrate the lack of correlations between serum syndecan-4, myocardial fibrosis and cardiac dysfunction in subjects with Chagas disease. Further studies are required to show if syndecan-4 concentrations can be marker for prognosis assessment or disease progression.</p></div

Correlation between percentage of myocardial fibrosis assessed by cardiovascular MRI and concentration of syndecan-4 and NT-ProBNP.

<p>A: Pearson’s correlation, r = 0.08, P = 0.567. B: Pearson’s correlation, r = 0.469, P<0.001.</p

Echocardiographic and CMR findings in subjects with Chagas disease.

<p>Echocardiographic and CMR findings in subjects with Chagas disease.</p

Correlation between LVEF and serum concentration of syndecan-4 and NT-ProBNP.

<p>A: Pearson’s correlation, LVEF assessed by Simpson’s method, r = 0.02, P = 0.864. B = Pearson’s correlation, LVEF assessed by Simpson’s method, r = 0.687, P<0.001.</p

Clinical and demographic characteristics of subjects with Chagas disease.

<p>Clinical and demographic characteristics of subjects with Chagas disease.</p

Echocardiographic data in subjects with heart failure.

<p>Echocardiographic data in subjects with heart failure.</p