Comprehensive geriatric assessment as a morbimortality predictor in patients vulnerable to the chemotherapy treatment

Objectives: to determine the predictive value of the Comprehensive geriatric assessment (CGA) regarding toxicity and mortality in elderly cancer patients classified as vulnerable who were submitted to chemotherapy. Method: A prospective cohort study was performed with data gathered from the database already built by the anchor project and available online. Tables of the frequency of distribution of the studied variables were created. The chi-square test was used in the univariate analysis, and the Fisher test when indicated. The level of significance of 5% were considered and all the tests were applied with a confidence of 95%. Results: The frequency of patients classified as vulnerable by CGA was 40.2%, and the mortality rate in the total number of patients was 37%. The association between nutritional status and mortality (p=0.003) was observed, where most of the denuded patients (51.4%) died during follow-up, and most patients (46.5%) had some type of complication. Conclusion: There was an association between the increase in mortality in patients vulnerable to chemotherapy (p=0,046), when compared to healthy patients. The results of this study follow the literature on the use of CGA can help oncologists and geriatricians in their decision making.Objetivos: O objetivo desse estudo foi determinar o valor preditivo da Avaliação Geriátrica Ampla (AGA) em relação à toxicidade e mortalidade nos pacientes oncológicos idosos classificados como vulneráveis, submetidos à quimioterapia. Método: Foi realizado um estudo de coorte prospectivo com coleta de informações extraídas de banco de dados já construído do projeto ÂNCORA e disponível online. Foram construídas tabelas de distribuição de frequência das variáveis estudadas e na análise univariada foi usado o chi-quadrado e Teste de Fisher, quando indicado. Por fim, considerou-se o nível de significância de 5% e todos os testes foram aplicados com 95% de confiança. Resultados: Em uma amostra total de 254 pacientes, o percentual de mortalidade foi de 37% e de intercorrências foi de 46,5%, sendo infecção a mais frequente. Houve associação entre o déficit nutricional e o aumento da mortalidade (p=0,003). Conclusão: Observou-se associação estatística entre o aumento da mortalidade em pacientes vulneráveis que realizaram quimioterapia (p=0,046), quando comparados aos pacientes saudáveis. Os resultados deste estudo reforçam constatações da literatura como o uso da AGA pode ajudar oncologistas e geriatras em suas tomadas de decisão

Anemia da doença crônica: uma revisão da fisiopatologia, do diagnóstico e do tratamento / Anemia of chronic disease: a review of pathophysiology, diagnosis and treatment

A anemia da doença crônica é uma patologia desenvolvida a partir de um quadro inflamatório associado a doenças crônicas, infecciosas ou não, e até alguns tipos de câncer. Os objetivos mais importantes dessa revisão são: abordar os principais aspectos relacionados a manifestação clínica da anemia da doença crônica, elucidar sobre a fisiopatologia e diagnóstico da doença e, ainda, explicar sobre as possíveis opções de tratamento disponíveis para a anemia da doença crônica. Busca-se, também, descrever fatores relevantes sobre o metabolismo do ferro no organismo e o processo inflamatório envolvido na patologia. Para produzir o trabalho, foi realizado um estudo do tipo secundário, a partir da revisão descritiva e qualitativa da literatura nas bases eletrônicas de dados Google Acadêmico, PubMed, Scientific Eletronic Library Online (Scielo), New England Journal of Medicine (NEJM) e Journal of the American Medical Association (JAMA). A pesquisa incluiu 12 artigos, entre os anos de 2002 e 2020. Caracterizada por ser um distúrbio multifatorial, a anemia da doença crônica tem como principais causas a redução da produção renal de eritropoietina, a redução da sobrevida dos eritrócitos para cerca de 80 dias, a menor resposta dos precursores eritróides à eritropoietina e, principalmente, o sequestro de ferro, o qual é resultado da interação das citocinas inflamatórias com o hormônio hepcidina, produzido pelo fígado. Esses fatores levam a ferro sérico baixo e ferritina sérica normal ou alta. Nesse sentido, esse estudo é importante para o entendimento da anemia de doença crônica, uma vez que a abordagem busca uma atualização quanto ao que se conhece sobre a doença, sendo isso essencial para a diminuição de sub-diagnósticos e para que os pacientes possam obter melhor qualidade de vida. 

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Use of flunixin meglumine in Santa Inês ewes submitted to laparoscopic and transcervical insemination

The objective of this work was to evaluate the use of flunixim meglumine in Santa Ines ewes submitted to artificial insemination (AI). Forty-four Santa Inês ewes were synchronized and inseminated at fixed times, by the transcervical or laparoscopic route, between 52 and 58 hours after sponge removal. The ewes were split into two treatment groups, to receive intramuscular injections of 2 mL of saline (control treatment) or 2.2 mg/kg flunixin meglumine (FM treatment), twice a day between days 9 and 19 after AI. The pregnancy diagnosis was performed by ultrasound 30 days after the AI. The chi-square test was used to compare the pregnancy rate between the control and flunixin meglumine treatment and between type of insemination, while the t-test, at 5% probability was used to compare the average weight and body condition, using the SAS statistical software. Flunixin meglumine was not effect in increasing the pregnancy rate in Santa Ines ewes undergoing laparoscopic and transcervical insemination

Eventos adversos durante transporte intra-hospitalar de pacientes críticos em hospital de grande porte

RESUMO Objetivo: Descrever a incidência de eventos clínicos e não clínicos durante o transporte intra-hospitalar de pacientes críticos e analisar os fatores de risco associados. Métodos: Estudo de coorte, com coleta retrospectiva, no período de outubro de 2016 a outubro de 2017, tendo sido analisados todos os transportes intra-hospitalares para fins diagnósticos e terapêuticos em hospital de grande porte, que contava com seis unidades de terapia intensiva adulto, sendo avaliados os eventos adversos e os fatores de risco relacionados. Resultados: No período, foram realizados 1.559 transportes intra-hospitalares, em 1.348 pacientes, com média de idade de 66 ± 17 anos, tempo médio de transporte de 43 ± 34 minutos. Durante o transporte, 19,8% dos pacientes estavam em uso de drogas vasoativas; 13,7% em uso de sedativos e 10,6% estavam sob ventilação mecânica. Eventos clínicos ocorreram em 117 transportes (7,5%) e não clínicos em 125 transportes (8,0%). Falhas de comunicação foram prevalentes, no entanto, aplicando-se análise multivariada, uso de sedativos, noradrenalina e nitroprussiato, e o tempo de transporte maior que 36,5 minutos estiveram associados a eventos adversos clínicos. Uso de dobutamina e tempo de transporte superior a 36,5 minutos estiveram associados a eventos não clínicos. Ao final do transporte, 98,1% dos pacientes apresentaram condições clínicas inalteradas em relação ao seu estado basal. Conclusão: Transportes intra-hospitalares estão relacionados à alta incidência de eventos adversos; o tempo de transporte e a utilização de sedativos e drogas vasoativas estiveram relacionados a esses eventos

Realistic Facial Three-Dimensional Reconstruction from CT Images and 2D Photographic Images for Surgical-Orthognathic Planning

Orthognathic surgery is a procedure used to correct intermaxillary discrepancies, thus promoting significant improvements in chewing and breathing. During the surgical planning stage, orthodontists often use two-dimensional imaging techniques. The assessment is based on CBCT images and dental cast models to overcome these limitations; however, the evaluation of soft tissues remains complex. The aim of the present study was to develop a co-registration method of CBCT and photo images that would result in realistic facial image reconstruction. CBCT images were three-dimensionally rendered, and the soft tissues were subsequently segmented resulting in the cranial external surface. A co-registration between the obtained surface and a frontal photo of the subject was then carried out. From this mapping, a photorealistic model capable of replicating the features of the face was generated. To assess the quality of this procedure, seven orthodontists were asked to fill in a survey on the models obtained. The survey results showed that orthodontists consider the three-dimensional model obtained to be realistic and of high quality. This process can automatically obtain a three-dimensional model from CBCT images, which in turn may enhance the predictability of surgical-orthognathic planning

Patient-Reported Outcomes of Maxillomandibular Surgery for Obstructive Sleep Apnea Treatment: A Scoping Review

(1) Background: The present scoping review aims to scrutinize all existing patient-reported outcomes and assess the perspectives of obstructive sleep apnea patients after maxillomandibular surgery. (2) Methods: The review was carried out according to the extensions for scoping reviews using the PRISMA-ScR guidelines. Several databases were used to carry out the initial search. This study included randomized controlled trials, cohort studies, cross-sectional and case-control studies. The included studies considered patients with obstructive sleep apnea who were submitted to orthognathic surgery as the main subjects, and the patient’s perception of quality of life, satisfaction, treatment experience and side effects were assessed. (3) Results: From 1407 examined articles, a total of 16 were included. Most of the included studies used more than one questionnaire to assess quality of life, except for five articles. The most commonly referred instruments were the Epworth Sleepiness Scale, SF-36, the Functional Outcomes of Sleep and Ottawa Sleep Apnea. The most commonly assessed outcomes were sleep quality, daytime function, facial aesthetics, dental function and emotional health. (4) Conclusions: The number of variables that can be evaluated from a patient’s perspective are endless, as are the tools available to assess them. Not all of these tools, which are generally questionnaires, assess all the various outcomes, and some do not compare the pre- and post-surgical situations. Most of them are generic and lack specificity for obstructive sleep apnea

Bone Mineral Density through DEXA and CBCT: A Systematic Review with Meta-Analysis

Dual-energy X-ray absorptiometry is used to determine bone density in several pathologies, namely osteoporosis and fracture risk in post-menopausal women. The aim of this study was to identify, appraise and synthesize all available evidence about the correlation between Dual Energy X-ray Absorptiometry (DEXA) and Cone Beam Computed Tomography (CBCT) techniques through a systematic review. A systematic literature search was conducted in the following databases: PubMed via MEDLINE, Cochrane Library, EMBASE andWeb of Science Core Collection, along with several sources of grey literature. The Cochrane Risk of Bias Tools were used to perform the qualitative assessment of the selected studies. A total of 913 articles were initially scrutinized and 11 were included for qualitative analysis, of which 3 were included in a meta-analysis. Most of the included studies revealed a low risk of bias (7 out of 11). A strong correlation (min r = 0.46 max r = 0.62) between DEXA and CBCT values were found. Thus, opportunistic CBCT scans may be used to assess the bone mineral density and fracture risk, improving the ability to track disease progression and providing better care

RELAÇÃO ENTRE OS FATORES ASSOCIADOS ÀS PARASITOSES GASTROINTESTINAIS, DESEMPENHO E ESTADO FISIOLÓGICO DE OVELHAS SANTA INÊS

With the purpose of verifying the relationship between score Famacha©, fecal egg counts (FEC), packed cell volume (PCV) and performance variables of sheep in differences physiological status (empty, pregnant and lactation), breeding in Quissamã, Rio de Janeiro. The study was conducted during one year using 60 adult females of Santa Ines sheep, created in semi extensive system. In each 14 days were collected stool samples for parasitological examinations and blood samples for hematological examinations. The animals were also weighed and evaluated for body condition score. There were significant difference between the evaluated characteristics due to the physiological state (p<0,05). The correlations of greater magnitude presented were between FEC and VG (-0,40) in the three physiological states. The correlations between weight, body score, fecal eggs counts and packed cell volume were low (0,12 e -0,17), near to zero in late pregnancy and lactation. In general, the magnitude of the correlations between the characteristics were similar in the three physiological states. The body condition score were more associated with other characteristics than with the weight of the animal. By presenting a negative correlation with the average packed cell volume, the method Famacha© can be indicated as a practical and sustainable to assess the degree of anemia in sheep after infections with Haemonchus spp.O objetivo foi de verificar a correlação entre os escores de Famacha©, contagem de ovos por grama de fezes (OPG), volume globular (VG) e variáveis de desempenho, de ovelhas em diferentes estados fisiológicos (vazias, gestantes e lactantes), criadas no município de Quissamã, estado de Rio de Janeiro. O estudo foi realizado durante um ano, utilizando 60 fêmeas adultas da raça Santa Inês, criadas em sistema semiextensivo. A cada 14 dias foram coletadas, de cada animal, amostras de fezes e de sangue. Os animais também foram pesados (PV) e avaliados quanto ao escore de condição corporal (EC). Houve diferença significativa entre as características avaliadas devido ao estado fisiológico (p<0,05). Durante a fase de lactação, as ovelhas apresentam maiores valores de OPG e Famacha© e menores médias para PV, EC e VG. As correlações de maior magnitude foram entre OPG e VG (-0,40) nos três estados fisiológicos. As correlações entre PV, EC e OPG foram baixas (0,12 e -0,17), próximas de zero no final da gestação e na lactação. Em geral, a magnitude das correlações entre as características foi similar nos três estados fisiológicos. As correlações entre EC mostraram-se mais associadas às demais características, do que o peso do animal. Por apresentar uma correlação negativa média com o volume globular, o método Famacha© pode ser indicado como uma forma prática e sustentável de avaliar o grau de anemia dos ovinos após infeções por Haemonchus spp