Gordura corporal estimada por equações baseadas em parâmetros antropométricos correlaciona-se com a bioimpedância elétrica em pacientes submetidos à cirurgia bariátrica

Introduction: predictive equations to estimate body fat based on simple anthropometric parameters are easy to use in the clinical practice. Objective: to evaluate the relationship between predictive equations based on anthropometric parameters and bioelectrical impedance to estimate body fat in individuals undergoing bariatric surgery. Methods: a prospective and longitudinal study carried out with individuals undergoing bariatric surgery. Body weight, body mass index, waist circumference and body fat percentage estimated by anthropometric parameters and by impedance were evaluated at three moments, one month before, two and six months after surgery. Data were analyzed by one-way ANOVA for repeated measures with Holm-Sidak´s post hoc or Friedman test with Tukey´s post hoc, and Pearson or Spearman correlations, according to data distribution. Significance level adopted 5%. Results: twenty-five subjects composed the final sample. All anthropometric parameters reduced significantly over time (p<0.001). Except for Lean et al equation before surgery, the body fat percentage estimated by other formulas showed a strong correlation with impedance in all moments, with the highest correlation strength observed in Gómez-Ambrosi et al. equation. Conclusion: in the present study, the equations used showed a good correlation with bioelectrical impedance, and the Gómez-Ambrosi et al. equation as a better option to the use of bioimpedance to assess changes in body fat percentage of patients undergoing bariatric surgery for the treatment of severe obesity.Introdução: equações preditivas que estimam o percentual de gordura baseadas em parâmetros antropométricos simples são de fácil utilização na prática clínica. Objetivo: avaliar a relação entre equações preditivas baseadas em parâmetros antropométricos e a bioimpedância elétrica para estimar a gordura corporal de indivíduos submetidos à cirurgia bariátrica. Método: estudo prospectivo e longitudinal, realizado com indivíduos submetidos à cirurgia bariátrica. Peso corporal, índice de massa corporal, circunferência da cintura e o percentual de gordura corporal estimado por parâmetros antropométricos e pela bioimpedância foram avaliados em três momentos, 1 mês antes, no 2º e 6º meses após a cirurgia. Os dados foram analisados pela ANOVA de uma via para medidas repetidas com post hoc de Holm-Sidak ou teste de Friedman com post hoc de Tukey, e correlações de Pearson ou Spearman, de acordo com a distribuição dos dados. Nível de significância adotado 5%. Resultados: participaram do estudo 25 pacientes. Todos os parâmetros antropométricos reduziram significativamente ao longo dos momentos (p<0.001). Com exceção da equação de Lean e colaboradores antes da cirurgia, o percentual de gordura estimado pelas demais fórmulas apresentaram forte correlação com a bioimpedância em todos os momentos, com a maior força de correlação observada na equação de Gómez-Ambrosi e colaboradores. Conclusão: no presente estudo, as equações utilizadas apresentaram boa correlação com a bioimpedância, sendo a equação de Gómez-Ambrosi a melhor alternativa ao uso da bioimpedância para avaliar as alterações da gordura corporal de pacientes submetidos a cirurgia bariátrica para o tratamento da obesidade grave

IMPACTO DA PANDEMIA NA QUALIDADE DE VIDA DE INTEGRANTES DO ENSINO SUPERIOR DO MARANHÃO

Objective: Identify the impact of social isolation on the quality of life of the academic community (students, teachers and administrative staff) of a public university in Maranhão during the Covid-19 pandemic. Methods: Cross-sectional study, sample of 436 respondents composed of 298 (68.3%) students, 95 (21.8%) teachers, 43 (9.9%) administrative staff. To assess quality of life, the WHOQOL-bref questionnaire and questions about screen time and physical activity before and during the pandemic were applied virtually. Mean descriptive values, standard deviation, percentage and Chi-Square test were used for descriptive analysis, considering significant differences, p value <0.05. RESULTS: In the physical, psychological, and environmental domains, students, teachers and public servants were within the regular classification, in the social relations domain, only male teachers were classified as good, all others were in the regular classification. Regarding the practice of exercises, there is a reduction during the pandemic and an increase in screen time. Conclusions: Social isolation during the COVID-19 pandemic had an impact on the behavior of the investigated academic community, especially with regard to the quality of life shown in the physical, psychological and environmental domains, in addition to the longer screen time and reduced practice of physical activity.Objetivo: Identificar el impacto del aislamiento social en la calidad de vida de la comunidad académica (estudiantes, profesores y personal administrativo) de una universidad pública de Maranhão durante la pandemia de COVID-19. Métodos: Estudio transversal, muestra de 436 encuestados compuesta por 298 (68,3%) estudiantes, 95 (21,8%) docentes, 43 (9,9%) servidores administrativos. Para evaluar la calidad de vida, se aplicó de manera virtual el cuestionario WHOQOL-bref, preguntas sobre el tiempo de pantalla y la actividad física antes y durante la pandemia. Se utilizó el análisis descriptivo para los valores de media, desviación estándar, porcentaje y prueba de Chi-Cuadrado, considerando como diferencias significativas, el valor p <0,05. Resultados: En el dominio físico, psicológico y ambiental, estudiantes, docentes y funcionarios estuvieron dentro de la clasificación regular, en el dominio de las relaciones sociales, sólo los maestros varones calificaron con el bien, todos los demás estuvieron en la clasificación regular. Con respecto a la práctica de ejercicios, hay una reducción durante la pandemia y un aumento en el tiempo de pantalla. Conclusiones: El aislamiento social durante la pandemia de COVID-19 tuvo un impacto en el comportamiento de la comunidad académica investigada, especialmente en lo que respecta a la calidad de vida evidenciada en los dominios físico, psicológico y ambiental, además de mayor tiempo de pantalla y reducción en la práctica de actividad física.Objetivo: Identificar o impacto do isolamento social na qualidade de vida da comunidade acadêmica (estudantes, docentes e servidores administrativos) de uma universidade pública do Maranhão durante a pandemia da COVID-19. Métodos: Estudo transversal, amostra de 436 respondentes composta por 298 (68,3%) estudantes, 95 (21,8%) docentes, 43 (9,9%) servidores administrativos. Para avaliar a qualidade de vida, foi aplicado virtualmente o questionário WHOQOL-bref, questões sobre tempo em tela e prática de atividade física antes e durante a pandemia. Empregou-se para análise descritiva valores de média, desvio padrão, porcentagem e teste Qui-Quadrado, considerando-se como diferenças significantes, p-valor <0,05. Resultados: No domínio físico, psicológico, e meio ambiente os estudantes, docentes e servidores ficaram dentro da classificação regular, no domínio relações sociais, apenas os docentes do sexo masculino se classificaram com boa, todos outros ficaram na classificação regular. Com relação a prática de exercícios nota-se uma redução durante a pandemia e uma elevação no tempo de tela. Conclusões: O isolamento social durante a pandemia de COVID-19 teve um impacto no comportamento da comunidade acadêmica investigada em especial quanto a qualidade de vida evidenciado nos domínios físico, psicológico e do meio ambiente, além do maior tempo em tela e redução da prática da atividade física

An extensive reef system at the Amazon River mouth

Large rivers create major gaps in reef distribution along tropical shelves. The Amazon River represents 20% of the global riverine discharge to the ocean, generating up to a 1.3 x 10(6)-km(2) plume, and extensive muddy bottoms in the equatorial margin of South America. As a result, a wide area of the tropical North Atlantic is heavily affected in terms of salinity, pH, light penetration, and sedimentation. Such unfavorable conditions were thought to imprint a major gap in Western Atlantic reefs. We present an extensive carbonate system off the Amazon mouth, underneath the river plume. Significant carbonate sedimentation occurred during lowstand sea level, and still occurs in the outer shelf, resulting in complex hard-bottom topography. A permanent near-bottom wedge of ocean water, together with the seasonal nature of the plume's eastward retroflection, conditions the existence of this extensive (similar to 9500 km(2)) hard-bottom mosaic. The Amazon reefs transition from accretive to erosional structures and encompass extensive rhodolith beds. Carbonate structures function as a connectivity corridor for wide depth-ranging reef-associated species, being heavily colonized by large sponges and other structure-forming filter feeders that dwell under low light and high levels of particulates. The oxycline between the plume and subplume is associated with chemoautotrophic and anaerobic microbial metabolisms. The system described here provides several insights about the responses of tropical reefs to suboptimal and marginal reef-building conditions, which are accelerating worldwide due to global changes.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenadoria de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERS)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)BrasoilMCTIBrazilian NavyU.S. NSFGordon and Betty Moore Foundation (GBMF)Univ Fed Rio de Janeiro UFRJ, Inst Biol, BR-21941599 Rio De Janeiro, RJ, BrazilUniv Fed Rio de Janeiro, COPPE, Inst Alberto Luiz Coimbra Posgrad & Pesquisa Engn, Lab Sistemas Avancados Gestao Prod, BR-21941972 Rio de Janeiro, RJ, BrazilInst Pesquisas Jardim Bot Rio de Janeiro, BR-22460030 Rio De Janeiro, RJ, BrazilUniv Sao Paulo, Inst Oceanog, BR-05508120 Sao Paulo, SP, BrazilUniv Fed Espirito Santo, Dept Oceanog, BR-29199970 Vitoria, ES, BrazilUniv Estadual Norte Fluminense, Lab Ciencias Ambientais, Ctr Biociencias & Biotecnol, BR-28013602 Campos Dos Goytacazes, RJ, BrazilUniv Fed Fluminense, Inst Geociencias, BR-24210346 Niteroi, RJ, BrazilUniv Fed Fluminense, Inst Biol, BR-24210130 Niteroi, RJ, BrazilUniv Fed Rio de Janeiro, Museo Nacl, BR-20940040 Rio De Janeiro, RJ, BrazilFed Univ Para, Inst Estudos Costeiros, BR-68600000 Braganca, PA, BrazilUniv Fed Sao Paulo, Dept Ciencias Mar, BR-11070100 Santos, SP, BrazilUniv Fed Pernambuco, Dept Oceanog, BR-50670901 Recife, PE, BrazilUniv Georgia, Dept Marine Sci, Athens, GA 30602 USAUniv Fed Paraiba, BR-58297000 Rio Tinto, PB, BrazilUniv Estadual Santa Cruz, Dept Ciencias Biol, BR-45650000 Ilheus, BA, BrazilUniv Fed Sao Paulo, Dept Ciencias Mar, BR-11070100 Santos, SP, BrazilU.S. NSF: OCE-0934095GBMF: 2293GBMF: 2928Web of Scienc

IV Brazilian Guidelines for autoantibodies on HEp-2 cells

Objective: the Fourth Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) was held in Vitoria, Espirito Santo, and aimed to discuss strategies and recommendations about the technique, standardization, interpretation and quality control of the indirect immunofluorescence reaction on HEp-2 cells.Methods: Twenty three ANA experts from university centers and private laboratories in different areas from Brazil discussed and agreed upon recommendations for the fourth edition of the Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells.Results and conclusion: the 4th ANA Consensus included three novel patterns into the existing algorithm (cytoplasmic Rods and Rings, nuclear Quasi-homogeneous, and CENP-F). Emphasis was given to the need of attention in describing the peculiar mixed pattern elicited by anti-DNA topoisomerase I (Scl-70) autoantibodies, comprising nuclear fine specked, nucleolar homogeneous pattern, NOR staining in metaphase plates, and cytoplasmic fine speckled patterns. the group also emphasized the need for continuous quality control in indirect immunofluorescence assays, the establishment of screening dilutions, as well as conjugate titration. An alert was made regarding the heterogeneity of commercial kits in defining patterns and the use of solid phase methodologies to determine the presence of autoantibodies. (C) 2014 Elsevier Editora Ltda. All rights reserved.Objetivo: O IV Consenso Brasileiro para Pesquisa de Autoanticorpos em Células HEp-2 (FAN) realizado em Vitória (ES), no dia 18 de setembro de 2012, objetivou discutir estratégias e recomendações relacionadas ao procedimento técnico, à padronização e à interpretação dos resultados da pesquisa de autoanticorpos em células HEp-2. Métodos: Participaram do evento 23 pesquisadores e especialistas de Universidades e laboratórios brasileiros. Foram abordados diferentes tópicos, discutidos amplamente a fim de se estabelecer recomendações específicas. Resultados e conclusão: O IV Consenso integrou à árvore de decisão o padrão citoplasmático em Anéis e Bastões, o padrão nuclear pontilhado Quasi-homogêneo (QH) e o padrão misto CENP-F. Discutiu-se ainda a necessidade de atenção para a classificação do padrão misto relacionado à presença de anticorpos anti-DNA topoisomerase I (Scl-70), compreendendo os componentes nuclear pontilhado fino, nucleolar homogêneo, NOR na placa metafásica e citoplasmático pontilhado fino. Foram sugeridas diretrizes para o controle de qualidade do teste, diluição de triagem e diluição de esgotamento, e foi emitido alerta quanto à necessidade de atenção em relação à heterogeneidade de substratos disponíveis no mercado e a utilização de metodologias automatizadas para detecção de autoanticorpos.Albert Einstein Medicina DiagnosticaAlka TecnologiaAmaral Costa LaboratorioConselho Federal de BiomedicinaDASAEuroimmun BrasilGrupo FleuryHemagenMedivaxOlimpusPadrao Laboratorio ClinicPontificia Universidade Catolica de Goias - PUC-GoiasSociedade Brasileira de Patologia Clinica e Medicina LaboratorialSociedade Brasileira de ReumatologiaThermo ScientificWama DiagnosticaWerfen Group - Werfen MedicalHermes PardiniConselho Regional de Biomedicina - 3a RegiaoPUC Goias, Goiania, Go, BrazilFleury Med & Saude, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Discipline Rheumatol, São Paulo, BrazilUniv Fed Uberlandia, Hosp Clin, Serv Rheumatol, BR-38400 Uberlandia, MG, BrazilClin Doencas Reumat Porto Alegre, Ctr Diagnost Med & Rheuma, Porto Alegre, RS, BrazilAmaral Costa Med Diagnost, Belem, PA, BrazilUniv São Paulo, Fac Med, Hosp Clin, Lab Invest Med, São Paulo, BrazilUniv São Paulo, Fac Med, Hosp Clin, Lab Cent, São Paulo, BrazilHosp Israelita Albert Einstein, Dept Clin Pathol, São Paulo, BrazilInst Hermes Pardini, Belo Horizonte, MG, BrazilUniv São Paulo, Fac Med, São Paulo, BrazilUniv Fed Minas Gerais, Fac Med, Belo Horizonte, MG, BrazilUniv Catolica Brasilia, Brasilia, DF, BrazilUniv Fed Goias, Fac Med, Goiania, Go, BrazilUniv Sul Santa Catarina UNISUL, Florianopolis, SC, BrazilUniv Vale do Itajai UNIVALE, Florianopolis, SC, BrazilUniv Fed Espirito Santo, Vitoria, ES, BrazilEBMSP, Salvador, BA, BrazilGrp DASA, São Paulo, BrazilEscola Super Ciencias Saude Dist Fed, Brasilia, DF, BrazilLab Sabin, Brasilia, DF, BrazilUniversidade Federal de São Paulo UNIFESP, Discipline Rheumatol, São Paulo, BrazilWeb of Scienc

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised