Correlação entre achados imagenológicos e histopatológicos de lesões não palpáveis de mama em pacientes atendidos em hospital de referência da Amazônia / Correlation between imaging and histopathological findings of non-palpable breast lesions in patients seen at a referral hospital in the Amazônia

Objetivo: Apresentar a correlação de achados em exames de imagem com a classificação de BIRADS® e os resultados histológicos de lesões não palpáveis, de pacientes em um hospital de referência em diagnóstico e tratamento do câncer na cidade de Manaus-AM. Métodos: Trata-se de um estudo retrospectivo, observacional e transversal, realizado por meio de revisão de prontuários médicos da Fundação do Centro de Controle de Oncologia do Estado do Amazonas (FCECON) na cidade de Manaus de pacientes atendidas de janeiro a outubro de 2018.  Resultados: A amostra foi composta por 48 pacientes. 100% das lesões nas categorias I e II eram lesões malignas, apesar do exame de imagem sugerir lesões benignas. Das lesões categoria III, aproximadamente 33% eram malignas e 67% benignas. Das lesões categoria IV, 57,5% eram malignas, já nas de categoria V, as lesões malignas representaram 77,8%. Conclusão: O rastreamento utilizando mamografia ou ultrassonografia com classificação BI-RADS® se mostrou um método seguro para investigar lesões suspeitas não-palpáveis de mama e em nosso serviço as taxas de malignidade por categoria foram compatíveis com as encontradas na literatura

eHealth promoting stoma self-care for people with an elimination ostomy: focus group study

Background: The construction of an elimination stoma has a physical, psychological, and social impact on the person. The development of stoma self-care competence contributes to the adaptation to a new health condition and improvement of quality of life. eHealth refers to everything associated with information and communication technology and health care, including telemedicine, mobile health, and health informatics. The use of eHealth platforms by the person with an ostomy, as a digital application that includes websites and mobile phone apps, can bring scientific knowledge and well-informed practices to individuals, families, and communities. It also allows functionalities that enable the person to describe and identify early signs and symptoms and precursors of complications and to be guided to an adequate health response for their problems. Objective: This study aimed to define the most relevant content and features to promote ostomy self-care integrated into an eHealth platform as a digital app or website to be used by patients for self-management of stoma care. Methods: We developed a descriptive, exploratory study with a qualitative approach using the focus group methodology, which was oriented to reach a consensus of at least 80%. A convenience sample of 7 participants consisting of stomatherapy nurses was used. The focus group discussion was recorded, and field notes were taken. The focus group meeting was fully transcribed, and a qualitative analysis was performed. The research question was: Which content and features for ostomy self-care promotion should be integrated into an eHealth platform as a digital app or website? Results: An eHealth platform, which can be a smartphone app or website, for people with ostomy should provide content aimed at promoting self-care, namely in the field of knowledge and self-monitoring, as well as the possibility of interacting with a stomatherapy care nurse. Conclusions: The stomatherapy nurse has a decisive role in promoting adaptation to life with a stoma, namely through the promotion of stoma self-care. Technological evolution has emerged as a useful tool to enhance nursing interventions and promote self-care competence. The development of an eHealth platform aimed at promoting ostomy self-care should include the capabilities for telehealth and help with decision-making regarding self-monitoring and seeking differentiated care.info:eu-repo/semantics/publishedVersio

Índices prognósticos não convencionais estão relacionados às complicações clínicas e aos índices prognósticos da Doença Hepática Crônica / Unconventional prognostic indexes are related to clinical complications and prognostic indexes of Chronic Liver Disease

Introdução: a Doença Hepática Crônica (DHC) é caracterizada pela lesão crônica do parênquima hepático, sendo responsáveis por mais de dois milhões de mortes anualmente no mundo todo. Objetivo: avaliar a associação entre os escores ALBI e PALBI e às complicações clínicas e aos índices prognósticos convencionais da DHC em pacientes com DHC atendidos a nível ambulatorial. Métodos: estudo observacional e transversal composto por 90 pacientes maiores de 18 anos. Foram coletados dados sociodemográficos, clínicos e exames bioquímicos. O MELD e Child-Pugh foram coletados a partir de informações no prontuário. Já os escores ALBI e PALBI, utilizaram em seu cálculo as concentrações séricas de albumina, bilirrubina e plaquetas. Foram utilizados os testes t de Student para amostras independentes, para comparação de duas médias e a análise de variância (ANOVA) one-way com comparações múltiplas pelo pós-teste de Tukey, para comparação de 3 médias. Para a associação utilizou-se os testes de qui-quadrado de Pearson e exato de Fisher. Considerou-se significante p < 0,05. Resultados: Evidenciou-se associação do escore ALBI e PALBI a presença de edema e varizes de esôfago e ao índice prognóstico Child-Pugh, bem como a correlação direta desses escores a valores de INR e MELD. Os escores ALBI e PALBI apresentaram maiores valores médios no tercil 3 do MELD e na classe C do Child-Pugh. Conclusão: Os escores ALBI e PALBI apresentaram relação com os índices prognósticos convencionais de gravidade da doença hepática, Child-Pugh e MELD, bem como a presença de complicações clínicas, edema e varizes esofágicas

Dermatite atópica em crianças e o papel da microbiota intestinal na fisiopatologia da doença

A dermatite atópica é uma doença crônica de etiologia multifatorial que afeta hoje 15 a 20% das crianças pelo mundo. Por se tratar de uma doença altamente prugirinosa, as manifestações na infância podem afetar fortemente o curso de desenvolvimento da criança e, consequentemente, a sua qualidade de vida e de todos os envolvidos. Assim, surge a necessidade de uma maior atenção sobre as possíveis formas de prevenção, tratamento e, primariamente, à etiologia por trás dos distúrbios cutâneos. Nessa linha, a relação entre a dermatite atópica infantil e a microbiota intestinal vem ganhando força em meio a hipóteses e teorias ainda pouco conhecidas. Considerando a relevância do assunto, o presente estudo tem por objetivo relacionar a dermatite atópica infantil com a atuação na microbiota intestinal e destacar as principais condutas frente à doença. Tratando-se, portanto, de uma revisão integrativa de literatura embasada em 28 artigos científicos e dados epidemiológicos entre 2011 e 2019, mediante busca nas de dados PubMed e Bireme com os descritores: “atopic eczema”, “etiology”, microbiota gastrointestinal, “probiotic supplement”. Dessa forma, foi possível, não só esclarecer a fisiopatologia da doença, como também evidenciar tópicos a serem aprofundados e chamar a atenção da comunidade científica atual

Helicobacter pylori infection in infants and toddlers in South America: concordance between [¹³C] urea breath test and monoclonal H. pylori stool antigen test

Accurate noninvasive tests for diagnosing Helicobacter pylori infection in very young children are strongly required. We investigated the agreement between the [¹³C] urea breath test ([¹³C]UBT) and a monoclonal ELISA (HpSA) for detection of H. pylori antigen in stool. From October 2007 to July 2011, we enrolled 414 infants (123 from Brazil and 291 from Peru) of ages 6 to 30 months. Breath and stool samples were obtained at intervals of at least 3 months from Brazilian (n = 415) and Peruvian (n = 908) infants. [¹³C]UBT and stool test results concurred with each other in 1,255 (94.86%) cases (kappa coefficient = 0.90; 95% confidence interval [CI] = 0.87 to 0.92). In the H. pylori-positive group, delta-over-baseline (DOB) and optical density (OD) values were positively correlated (r = 0.62; P < 0.001). The positivity of the tests was higher (P < 0.001; odds ratio [OR] = 6.01; 95% CI = 4.50 to 8.04) in Peru (546/878; 62.2%) than in Brazil (81/377; 21.5%) and increased with increasing age in Brazil (P = 0.02), whereas in Peru it decreased with increasing age (P < 0.001). The disagreement between the test results was associated with birth in Brazil and female gender but not with age and diarrhea. Our results suggest that both [¹³C]UBT and the stool monoclonal test are reliable for diagnosing H. pylori infection in very young children, which will facilitate robust epidemiological studies in infants and toddlers

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Growth of seven perennial plant species adapted to the Brazilian Semi-Arid

Measuring plant height (y) and canopy diameter (x) in trees may not be an easy task, but stem diameter (z) can be more easily evaluated. This work's objective was two-fold: evaluate the growth of species adapted to the Brazilian Semi-Arid Region in the first two years of age, and obtain linear equations to estimate y and x from z, in those species. A random block design with four replications was employed. The values for x, z, and y were measured biannually from October/2003 to March/2005. Prosopis juliflora and Mimosa caesalpiniaefolia showed the highest stem diameter and plant height values, respectively, and both showed the highest canopy diameter. In the equations to estimate plant height from the stem diameter the value of the coefficient of determination (R²) ranged from 0.76 (Tamarindus indica and Leucaena leucocephala) to 0.92 (Prosopis juliflora and Azadirachta indica). In the equations that allowed to estimate the crown diameter from the stem diameter the R² value ranged from 0.70 (Leucaena leucocephala) to 0.92 (Azadirachta indica)

Simultaneous occurrence of Epstein-Barr virus (EBV) in periodontal pockets and in oral squamous cell carcinoma: a cross-sectional study

CAPES/coordenação de aperfeiçoamento de pessoal de nível superior Finance Code 001/coordenação de aperfeiçoamento de pessoal de nível superiorUniversidade Federal do Pará. School of Dentistry. Laboratory of Pathology and Immunohistochemistry. Belém, PA, Brazil / Universidade Federal de Minas Gerais. School of Dentistry. Department of Oral Surgery and Pathology. Belo Horizonte, MG, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Vírus Epstein-Barr. Ananindeua, PA, Brasil.Hospital Metropolitano Odilon Behrens. Department of Stomatology & Oral and Maxillofacial Surgery. Belo Horizonte, MG, Brazil.Universidade Federal do Pará. School of Dentistry. Laboratory of Pathology and Immunohistochemistry. Belém, PA, Brazil.Universidade Federal do Pará. Laboratory of Virology. Belém, PA, Brazil.Universidade Federal de Minas Gerais. Hospital das Clínicas. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. School of Dentistry. Department of Oral Surgery and Pathology. Belo Horizonte, MG, Brazil.Universidade Federal do Pará. Laboratory of Virology. Belém, PA, Brazil.Universidade Federal do Pará. School of Dentistry. Laboratory of Pathology and Immunohistochemistry. Belém, PA, Brazil.Universidade Federal de Minas Gerais. School of Dentistry. Department of Oral Surgery and Pathology. Belo Horizonte, MG, Brazil.Universidade Federal do Pará. School of Dentistry. Laboratory of Pathology and Immunohistochemistry. Belém, PA, Brazil.Objectives: This study aimed to investigate the detection of Epstein-Barr virus (EBV) in oral squamous cell carcinoma (OSCC) and to verify the concordance of EBV-DNA frequency in subgingival sites and in the OSCC. Methods: A cross-sectional study with 30 OSCC patients, aged from 44 to 88 years old, was conducted. Samples were collected in subgingival sites and at the OSCC, then submitted to DNA isolation, qPCR, and genotyping. Descriptive statistic was performed to report the frequency of EBV-DNA in all samples, and McNemar test was applied to verify the concordance among the EBV-DNA frequency in both sites. Results: The individuals presented 62 years old in average, and the majority were male (66.6%). EBV-DNA was detected in 56.7% OSCC lesions. Among the subgroup of 19 dentate individuals, high concordance (73.7%) in both EBV-DNA detection and the absence in subgingival sites and OSCC was observed, and it was statistically significant (p < 0.05). Conclusions: We report the notable occurrence of EBV-DNA in OSCC; also, the presence of EBV in periodontal sites may contribute to find it in OSCC, although the possible contribution of EBV in the OSCC remains to be investigated