123 results on '"Moreira MC"'
Search Results
2. DESCRIPTIVE ANALYSIS OF HEMATOPOIETIC STEM CELL TRANSPLANTS PERFORMED IN A PUBLIC SERVICE BETWEEN 1984 AND 2023
- Author
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Costa-Junior, LC, primary, Izu, M, additional, Salgado, JDC, additional, Lim-Santos, PCJ, additional, Rodrigues-Moreira, MC, additional, and Lerner, D, additional
- Published
- 2023
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3. AVALIAÇÃO DA SEGURANÇA DO PROCEDIMENTO DE RASPAGEM E ALISAMENTO RADICULAR ENTRE OS DIAS D+90 E D+130 EM PACIENTES QUE REALIZARAM TRANSPLANTE DE CÉLULAS TRONCO HEMATOPOIÉTICAS ALOGÊNICO
- Author
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Pagliarone, MJ, Costa, MA, Innocentini, LMAR, Ferrari, TC, Costa, TCM, Mesquita, CC, Corrêa, MEP, Eduardo, FP, Bezinelli, LM, Hamerschlak, N, Antunes, HS, Moreira, MC, Lermontov, S, Flowers, ME, and Macedo, LD
- Published
- 2024
- Full Text
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4. Pre-engraftment clinically significant CMV infection after allogeneic hematopoietic stem cell transplantation and its impact on engraftment
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Valentim Mr, Rivello J, Moreira Mc, Maiolino A, Bigni R, Almeida A, Dalcolmo S, B.L. Gaio, and Garnica M
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surgical procedures, operative ,Text mining ,business.industry ,medicine.medical_treatment ,Immunology ,medicine ,Hematopoietic stem cell transplantation ,business - Abstract
Pre-engraftment cytomegalovirus infection (CMVi) is a challenge in patients receiving allogeneic stem cell transplantation (Allo-HCT), as few data have been reported on its clinical importance. This study describes the clinical outcomes of pre-engraftment CMVi and compares them with those of episodes developing after engraftment in HCT patients. We performed a retrospective study of patients who underwent Allo-HCT from 2016 to 2020, including 111 recipients monitored by real-time PCR assay. Clinically significant CMVi (csCMVi) was documented in 81 (73%) patients. There were 29 (26%) cases of pre-engraftment csCMVi. No significant difference was observed regarding virological features, but patients with pre-engraftment csCMVi had a delayed start in treatment (24 vs. 12 days, p
- Published
- 2021
5. Association of uric acid levels before start of conditioning with mortality after allogeneic hematopoietic stem cell transplantation - a prospective, non-interventional study of the EBMT Transplant Complication Working Party
- Author
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Duarte, RF, Kaynar, LEYLAGÜL, Penack, O, Peczynski, C, van, der, Finke, J, Ganser, A, Schoemans, H, Pavlu, J, Niittyvuopio, R, Schroyens, W, Blau, IW, Sierra, J, Cortelezzi, A, Wulf, G, Turlure, P, Rovira, M, Ozkurt, Z, Pascual-Cascon, MJ, Moreira, MC, Clausen, J, Greinix, H, Basak, GW, HUS Comprehensive Cancer Center, Hematologian yksikkö, Clinicum, and Department of Oncology
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Science & Technology ,Transplantation Conditioning ,3122 Cancers ,EBMT Transplant Complication Working Party ,Hematopoietic Stem Cell Transplantation ,Graft vs Host Disease ,Hematology ,Articles ,PREVENTION ,Uric Acid ,VERSUS-HOST-DISEASE ,Humans ,Transplantation, Homologous ,Human medicine ,Prospective Studies ,Life Sciences & Biomedicine ,Retrospective Studies ,Stem Cell Transplantation - Abstract
Uric acid is a danger signal contributing to inflammation. Its relevance to allogeneic stem cell transplantation (alloSCT) derives from preclinical models where the depletion of uric acid led to improved survival and reduced graft-versus-host disease (GvHD). In a clinical pilot trial, peri-transplant uric acid depletion reduced acute GvHD incidence. This prospective international multicenter study aimed to investigate the association of uric acid serum levels before start of conditioning with alloSCT outcome. We included patients with acute leukemia, lymphoma or myelodysplastic syndrome receiving a first matched sibling alloSCT from peripheral blood, regardless of conditioning. We compared outcomes between patients with high and low uric acid levels with univariate- and multivariate analysis using a cause-specific Cox model. Twenty centers from 10 countries reported data on 366 alloSCT recipients. There were no significant differences in terms of baseline comorbidity and disease stage between the high- and low uric acid group. Patients with uric acid levels above median measured before start of conditioning did not significantly differ from the remaining in terms of acute GvHD grades II-IV incidence (Hazard ratio [HR] 1.5, 95% Confidence interval [CI]: 1.0-2.4, P=0.08). However, they had significantly shorter overall survival (HR 2.8, 95% CI: 1.7-4.7, P
- Published
- 2020
6. Trinucleotide repeats in 202 families with ataxia: a small expanded (CAG)n allele at the SCA17 locus
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Silveira, I, Miranda, C, Guimarães, L, Moreira, MC, Alonso, I, Mendonça, P, Ferro, A, Pinto-Basto, J, Coelho, J, Ferreirinha, F, Poirier, J, and Parreira, E, et al.
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Portugal ,Brasil ,Spinocerebellar Ataxias - Abstract
BACKGROUND: Ten neurodegenerative disorders characterized by spinocerebellar ataxia (SCA) are known to be caused by trinucleotide repeat (TNR) expansions. However, in some instances the molecular diagnosis is considered indeterminate because of the overlap between normal and affected allele ranges. In addition, the mechanism that generates expanded alleles is not completely understood. OBJECTIVE: To examine the clinical and molecular characteristics of a large group of Portuguese and Brazilian families with ataxia to improve knowledge of the molecular diagnosis of SCA. PATIENTS AND METHODS: We have (1) assessed repeat sizes at all known TNR loci implicated in SCA; (2) determined frequency distributions of normal alleles and expansions; and (3) looked at genotype-phenotype correlations in 202 unrelated Portuguese and Brazilian patients with SCA. Molecular analysis of TNR expansions was performed using polymerase chain reaction amplification. RESULTS: Patients from 110 unrelated families with SCA showed TNR expansions at 1 of the loci studied. Dominantly transmitted cases had (CAG)(n) expansions at the Machado-Joseph disease gene (MJD1) (63%), at SCA2 (3%), the gene for dentatorubropallidoluysian atrophy (DRPLA) (2%), SCA6 (1%), or SCA7 (1%) loci, or (CTG)(n) expansions at the SCA8 (2%) gene, whereas (GAA)(n) expansions in the Freidreich ataxia gene (FRDA) were found in 64% of families with recessive ataxia. Isolated patients also had TNR expansions at the MJD1 (6%), SCA8 (6%), or FRDA (8%) genes; in addition, an expanded allele at the TATA-binding protein gene (TBP), with 43 CAGs, was present in a patient with ataxia and mental deterioration. Associations between frequencies of SCA2 and SCA6 and a frequency of large normal alleles were found in Portuguese and Brazilian individuals, respectively. Interestingly, no association between the frequencies of DRPLA and large normal alleles was found in the Portuguese group. CONCLUSIONS: Our results show that (1) a significant number of isolated cases of ataxia are due to TNR expansions; (2) expanded DRPLA alleles in Portuguese families may have evolved from an ancestral haplotype; and (3) small (CAG)(n) expansions at the TBP gene may cause SCA17.
- Published
- 2002
7. Challenges of systematization of nursing care in palliative care in cancer: a complexity perspective.
- Author
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da Silva MM and Moreira MC
- Abstract
Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2010
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8. Teaching medical oncology in nursing in Brazil and the contribution from Escolo Paulista de Enfermagem at the Federal University of São Paulo.
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de Gutiérrez MGR, De Domenico EBL, Moreira MC, and da Silva LMG
- Published
- 2009
9. Research in oncological nursing: a study of the publications in national periodicals.
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Moreira MC, Camargo TC, de Carvalho V, de Figueirédo CF, da Rosa LD, and de Fátima Bolzan M
- Published
- 2006
10. Note on the classification of theLeishmaniasp. responsible for cutaneous leishmaniasis in the East Central Region of Brazil
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Raquel Lopes de Oliveira, Gerais Bb, Moreira Mc, Barbosa W, Rassi Dm, J. A. M. O. Souza, and M. A. M Souza
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030231 tropical medicine ,Buoyant density ,Biology ,Central region ,Microbiology ,Leishmania sp ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Cutaneous leishmaniasis ,Cricetinae ,030225 pediatrics ,parasitic diseases ,medicine ,Animals ,Humans ,Parasite hosting ,skin and connective tissue diseases ,Leishmaniasis ,Skin ,Leishmania ,medicine.disease ,Rats ,Infectious Diseases ,Parasitology ,Taxonomy (biology) ,Brazil - Abstract
The authors studied a species of Leishmania which is the causative agent of cutaneous leishmaniasis in Mato Grosso, Brazil. The parasite displays unusual characteristics which do not fit exactly into either the L. mexicana or L. brasiliensis complexes. The buoyant density DNA resembles that of the L. mexicana complex but the culture and hamster inoculation results resemble those of the L. brasiliensis complex. Further comparative studies are required to elucidate the relationship of the Mato Grosso Leishmania to the L. mexicana complex.
- Published
- 1976
11. Assessment, regionalization, and modeling rainfall erosivity over Brazil: Findings from a large national database.
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de Sousa Teixeira DB, Cecílio RA, Moreira MC, Pires GF, and Fernandes Filho EI
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In this study, we used a large national database to assess the rainfall erosivity (RE) patterns in time and space over the Brazilian territory. Thereby, RE and erosivity density (ED) values were obtained for 5166 rainfall gauges. Also, the concentration of the RE throughout the year and the RE's gravity center locations were analyzed. Finally, homogeneous regions regarding RE values were delimited and estimative regression models were established. The results show that Brazil's mean annual RE value is 5620 MJ mm ha
-1 h-1 year-1 , with considerable spatial variation over the country. The highest RE magnitudes were found for the north region, while the northeast region shows the lowest values. Regarding the RE's distribution throughout the year, in the southern region of Brazil, it is more equitable, while in some spots of the northeastern region, it is irregularly concentrated in specific months. Further analyses revealed that for most of the months, the RE's gravity centers for Brazil are in the Goiás State and that they present a north-south migration pattern throughout the year. Complementarily, the ED magnitudes allowed the identification of high-intensity rainfall spots. Additionally, the Brazilian territory was divided into eleven homogeneous regions regarding the RE patterns and for each defined region, a regression model was established and validated. These models' statistical metrics were considered satisfactory and, thus, can be used to estimate RE values for the whole country using monthly rainfall depths. Finally, all database produced are available for download. Therefore, the values and maps shown in this study are relevant for improving the accuracy of soil loss estimates in Brazil and for the establishment of soil and water conservation planning on a national scale., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)- Published
- 2023
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12. Statistical process control in assessing water quality in the Doce river basin after the collapse of the Fundão dam (Mariana, Brazil).
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Silva GJD, Borges AC, Moreira MC, and Rosa AP
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- Brazil, Environmental Monitoring, Escherichia coli, Rivers, Water Quality, Disasters, Water Pollutants, Chemical analysis
- Abstract
The process of extracting information from data generated in environmental monitoring programs is often carried out using statistical tools, with Statistical Process Control (SPC) showing great potential for application in environmental monitoring. In November 2015, millions of cubic metres of tailings were dumped into the basin of the River Doce with the collapse of the Fundão dam. A study of the impact of this incident requires new approaches in data monitoring and processing, so it was sought to evaluate, using SPC tools, changes in water quality in the basin of the River Doce following the collapse of the dam. Using process charts and the process capability index (PCI), water quality parameters in the Doce and Carmo rivers were evaluated between 2009 and 2020. There, turbidity has improved since 2018, and Mn since 2016. Control charts showed that by December 2020 dissolved Fe was still not within normal pre-event fluctuation patterns. The PCI value showed that the situation worsened after the event for each of the parameters, with the lowest values for Mn and E. coli. By using a reference period, SPC makes it possible to infer the permanence of the impact of extreme pollution on the waterbody, which can be used in the routine monitoring of water quality in such events., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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13. Pre-engraftment Cytomegalovirus DNAemia after allogeneic hematopoietic stem cell transplantation and its impact on engraftment.
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Garnica M, Dalcolmo S, Gaio B, de Almeida AR, Rivello J, Bigni R, Valentim MR, Moreira MC, and Maiolino A
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- Cytomegalovirus genetics, DNA, Viral, Humans, Retrospective Studies, Cytomegalovirus Infections, Hematopoietic Stem Cell Transplantation
- Published
- 2022
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14. High rate of hypomorphic variants as the cause of inherited ataxia and related diseases: study of a cohort of 366 families.
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Benkirane M, Marelli C, Guissart C, Roubertie A, Ollagnon E, Choumert A, Fluchère F, Magne FO, Halleb Y, Renaud M, Larrieu L, Baux D, Patat O, Bousquet I, Ravel JM, Cuntz-Shadfar D, Sarret C, Ayrignac X, Rolland A, Morales R, Pointaux M, Lieutard-Haag C, Laurens B, Tillikete C, Bernard E, Mallaret M, Carra-Dallière C, Tranchant C, Meyer P, Damaj L, Pasquier L, Acquaviva C, Chaussenot A, Isidor B, Nguyen K, Camu W, Eusebio A, Carrière N, Riquet A, Thouvenot E, Gonzales V, Carme E, Attarian S, Odent S, Castrioto A, Ewenczyk C, Charles P, Kremer L, Sissaoui S, Bahi-Buisson N, Kaphan E, Degardin A, Doray B, Julia S, Remerand G, Fraix V, Haidar LA, Lazaro L, Laugel V, Villega F, Charlin C, Frismand S, Moreira MC, Witjas T, Francannet C, Walther-Louvier U, Fradin M, Chabrol B, Fluss J, Bieth E, Castelnovo G, Vergnet S, Meunier I, Verloes A, Brischoux-Boucher E, Coubes C, Geneviève D, Lebouc N, Azulay JP, Anheim M, Goizet C, Rivier F, Labauge P, Calvas P, and Koenig M
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- Cohort Studies, DNA Copy Number Variations genetics, Humans, Peroxins, Receptors, Cytoplasmic and Nuclear, United States, Exome Sequencing, Cerebellar Ataxia, Genomics
- Abstract
Purpose: Diagnosis of inherited ataxia and related diseases represents a real challenge given the tremendous heterogeneity and clinical overlap of the various causes. We evaluated the efficacy of molecular diagnosis of these diseases by sequencing a large cohort of undiagnosed families., Methods: We analyzed 366 unrelated consecutive patients with undiagnosed ataxia or related disorders by clinical exome-capture sequencing. In silico analysis was performed with an in-house pipeline that combines variant ranking and copy-number variant (CNV) searches. Variants were interpreted according to American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines., Results: We established the molecular diagnosis in 46% of the cases. We identified 35 mildly affected patients with causative variants in genes that are classically associated with severe presentations. These cases were explained by the occurrence of hypomorphic variants, but also rarely suspected mechanisms such as C-terminal truncations and translation reinitiation., Conclusion: A significant fraction of the clinical heterogeneity and phenotypic overlap is explained by hypomorphic variants that are difficult to identify and not readily predicted. The hypomorphic C-terminal truncation and translation reinitiation mechanisms that we identified may only apply to few genes, as it relies on specific domain organization and alterations. We identified PEX10 and FASTKD2 as candidates for translation reinitiation accounting for mild disease presentation., (© 2021. The Author(s), under exclusive licence to the American College of Medical Genetics and Genomics.)
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- 2021
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15. Effect of environmental covariable selection in the hydrological modeling using machine learning models to predict daily streamflow.
- Author
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Reis GB, da Silva DD, Fernandes Filho EI, Moreira MC, Veloso GV, Fraga MS, and Pinheiro SAR
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- Brazil, Linear Models, Machine Learning, Hydrology, Rivers
- Abstract
There are different methods for predicting streamflow, and, recently machine learning has been widely used for this purpose. This technique uses a wide set of covariables in the prediction process that must undergo a selection to increase the precision and stability of the models. Thus, this work aimed to analyze the effect of covariable selection with Recursive Feature Elimination (RFE) and Forward Feature Selection (FFS) in the performance of machine learning models to predict daily streamflow. The study was carried out in the Piranga river basin, located in the State of Minas Gerais, Brazil. The database consisted of an 18-year-old historical series (2000-2017) of streamflow data at the outlet of the basin and the covariables derived from the streamflow of affluent rivers, precipitation, land use and land cover, products from the MODIS sensors, and time. The highly correlated covariables were eliminated and the selection of covariables by the level of importance was carried out by the RFE and FFS methods for the Multivariate Adaptive Regression (EARTH), Multiple Linear Regression (MLR), and Random Forest (RF) models. The data were partitioned into two groups: 75% for training and 25% for validation. The models were run 50 times and had their performance evaluated by the Nash Sutcliffe efficiency coefficient (NSE), Determination coefficient (R
2 ), and Root of Mean Square Error (RMSE). The three models tested showed satisfactory performance with both covariable selection methods, however, all of them proved to be inaccurate for predicting values associated with maximum streamflow events. The use of FFS, in most cases, improved the performance of the models and reduced the number of selected covariables. The use of machine learning to predict daily streamflow proved to be efficient and the use of FFS in the selection of covariables enhanced this efficiency., (Copyright © 2021 Elsevier Ltd. All rights reserved.)- Published
- 2021
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16. Hope and trust in times of Zika: the views of caregivers and healthcare workers at the forefront of the epidemic in Brazil.
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Simas C, Penn-Kekana L, Kuper H, Lyra TM, Moreira MEL, de Albuquerque MDSV, de Araújo TVB, de Melo APL, Figueira Mendes CH, Nunes Moreira MC, Ferreira do Nascimento MA, Pimentel C, Pinto M, Valongueiro S, and Larson H
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- Brazil epidemiology, Caregivers, Child, Health Personnel, Humans, Latin America, Trust, Epidemics, Zika Virus, Zika Virus Infection
- Abstract
This article investigates how hope and trust played out for two groups at the forefront of the Zika epidemic: caregivers of children with congenital Zika syndrome and healthcare workers. We conducted 76 in-depth interviews with members of both groups to examine hope and trust in clinical settings, as well as trust in public institutions, in the health system and in the government of Brazil. During and after the Zika epidemic, hope and trust were important to manage uncertainty and risk, given the lack of scientific evidence about the neurological consequences of Zika virus infection. The capacity of healthcare workers and caregivers to trust and to co-create hope seems to have allowed relationships to develop that cushioned social impacts, reinforced adherence to therapeutics and enabled information flow. Hope facilitated parents to trust healthcare workers and interventions. Hope and trust appeared to be central in the establishment of support networks for caregivers. At the same time, mistrust in the government and state institutions may have allowed rumours and alternative explanations about Zika to spread. It may also have strengthened activism in mother's associations, which seemed to have both positive and negative implications for healthcare service delivery. The findings also point to distrust in international health actors and global health agenda, which can impact community engagement in future outbreak responses in Brazil and other countries in Latin America., (© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
- Published
- 2020
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17. COVID-19 in hematology: data from a hematologic and transplant unit.
- Author
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Garnica M, Valetim MR, Furtado P, Moreira MC, Bigni R, Vinhas S, Dias PC, Fellows I, and Martins W
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During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient's prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times., (© 2020 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda.)
- Published
- 2020
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18. Efficacy of Manual Therapy on Pain, Impact of Disease, and Quality of Life in the Treatment of Fibromyalgia: A Systematic Review.
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Schulze NB, Salemi MM, de Alencar GG, Moreira MC, and de Siqueira GR
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- Fibromyalgia complications, Humans, Pain etiology, Quality of Life, Fibromyalgia therapy, Musculoskeletal Manipulations methods, Pain Management methods, Treatment Outcome
- Abstract
Background: Myofascial mobilization has been used as an intervention for patients with fibromyalgia (FM) for acting on ascending nociceptive pathways possibly involved in the central sensitization process, modulating the pain experience. However, there is still a gap in its efficacy compared with another hands-on approach because manual therapy has nonspecific effects, such as placebo., Objectives: This systematic review aims to review the scientific literature for an overview of the efficacy of manual therapy in pain, disease impact, and quality of life in patients with FM compared with control or other treatments through randomized clinical trials., Study Design: This study involved systematic review of published randomized controlled trials (RCTs)., Setting: This study examined all RCTs evaluating the effect of manual therapy on pain, impact of disease, and quality of life for patients with FM., Methods: Systematic review. The research was performed in 9 databases: MEDLINE/PubMed, CINAHL, Web of Science, Scopus, ScienceDirect, Lilacs, SciELO, PEDro, and Cochrane. Searches were carried out from the end of the project until September 2019, with no language and year restrictions. Randomized controlled clinical trials that used the following outcome measures were included: Visual Analog Scale, Fibromyalgia Impact Questionnaire, and SF-36 Quality of Life Questionnaire. The risk of bias and quality of studies was assessed using the PEDro scale; the Cochrane risk-of-bias tool; and Grading of Recommendations Assessment, Development, and Evaluation System., Results: Seven studies were included (368 patients). The quantitative analysis was performed on 4 studies because of the lack of data in the others. Myofascial release was the most used modality. The level of evidence ranged from very low to moderate, mainly because of the inconsistency and inaccuracy of results., Limitations: The present systematic review presented limitations because of the heterogeneity of the included studies and only a short-term analysis of the intervention results. It was observed that other information, such as pressure, repetition, and/or sustaining manual therapy techniques, could be better described in future protocols, aiming at a better comparison between the techniques and their subsequent reproducibility., Conclusions: Current evidence of manual therapy in patients with FM, based on a very low to moderate quality of evidence, was inconclusive and insufficient to support and recommend the use of manual therapy in this population. To date, only general osteopathic treatment has achieved clinically relevant pain improvement when compared with control.
- Published
- 2020
19. Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas.
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Peiter PC, Pereira RDS, Nunes Moreira MC, Nascimento M, Tavares MFL, Franco VDC, Carvajal Cortês JJ, Campos DS, and Barcellos C
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- Brazil epidemiology, Child, Child, Preschool, Cross-Sectional Studies, Epidemics statistics & numerical data, Female, Geography, Medical, Humans, Infant, Male, Microcephaly epidemiology, Pregnancy, Pregnancy Complications, Infectious epidemiology, Socioeconomic Factors, Zika Virus Infection epidemiology, Zika Virus Infection therapy, Health Services Accessibility statistics & numerical data, Microcephaly virology, Zika Virus pathogenicity
- Abstract
Since 2015 Brazil has experienced the social repercussions of the Zika virus epidemic, thus raising a debate about: difficulties of diagnosis; healthcare access for children with Zika Congenital Syndrome (ZCS); the search for benefits by affected families; social and gender inequalities; and a discussion on reproductive rights, among others. The objective of this article is to analyse access to specialized health services for the care of children born with ZCS in three North-eastern states of Brazil. This is an exploratory cross-sectional study which analyses recorded cases of microcephaly at the municipal level between 2015 and 2017. Most of the cases of ZCS were concentrated on the Northeast coast. Rio Grande do Norte and Paraiba had the highest incidence of microcephaly in the study period. The states of Bahia, Paraiba and Rio Grande do Norte were selected for their high incidence of microcephaly due to the Zika Virus. Socio-territorial vulnerability was stratified using access to microcephaly diagnosis and treatment indicators. The specialized care network was mapped according to State Health Secretaries Protocols. A threshold radius of 100 km was stablished as the maximum distance from municipalities centroids to specialised health care for children with microcephaly. Prenatal coverage was satisfactory in most of the study area, although availability of ultrasound equipment was uneven within states and health regions. Western Bahia had the lowest coverage of ultrasound equipment and lacked health rehabilitation services. ZCS's specialized health services were spread out over large areas, some of which were outside the affected patients' home municipalities, so displacements were expensive and very time consuming, representing an extra burden for the affected families. This study is the first to address accessibility of children with microcephaly to specialised health care services and points to the urgent need to expand coverage of these services in Brazil, especially in the northeastern states, which are most affected by the epidemic., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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20. Association of uric acid levels before start of conditioning with mortality after allogeneic hematopoietic stem cell transplantation - a prospective, non-interventional study of the EBMT Transplant Complication Working Party.
- Author
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Penack O, Peczynski C, van der Werf S, Finke J, Ganser A, Schoemans H, Pavlu J, Niittyvuopio R, Schroyens W, Kaynar L, Blau IW, van der Velden W, Sierra J, Cortelezzi A, Wulf G, Turlure P, Rovira M, Ozkurt Z, Pascual-Cascon MJ, Moreira MC, Clausen J, Greinix H, Duarte RF, and Basak GW
- Subjects
- Humans, Prospective Studies, Retrospective Studies, Transplantation Conditioning adverse effects, Transplantation, Homologous, Uric Acid, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects
- Abstract
Uric acid is a danger signal contributing to inflammation. Its relevance to allogeneic stem cell transplantation (alloSCT) derives from preclinical models where the depletion of uric acid led to improved survival and reduced graft- versus -host disease (GvHD). In a clinical pilot trial, peri-transplant uric acid depletion reduced acute GvHD incidence. This prospective international multicenter study aimed to investigate the association of uric acid serum levels before start of conditioning with alloSCT outcome. We included patients with acute leukemia, lymphoma or myelodysplastic syndrome receiving a first matched sibling alloSCT from peripheral blood, regardless of conditioning. We compared outcomes between patients with high and low uric acid levels with univariate- and multivariate analysis using a cause-specific Cox model. Twenty centers from 10 countries reported data on 366 alloSCT recipients. There were no significant differences in terms of baseline comorbidity and disease stage between the high- and low uric acid group. Patients with uric acid levels above median measured before start of conditioning did not significantly differ from the remaining in terms of acute GvHD grades II-IV incidence (Hazard ratio [HR] 1.5, 95% Confidence interval [CI]: 1.0-2.4, P =0.08). However, they had significantly shorter overall survival (HR 2.8, 95% CI: 1.7-4.7, P <0.0001) and progression free survival (HR 1.6, 95% CI: 1.1-2.4, P =0.025). Non-relapse mortality was significantly increased in alloSCT recipients with high uric acid levels (HR 2.7, 95% CI: 1.4-5.0, P =0.003). Finally, the incidence of relapse after alloSCT was increased in patients with higher uric acid levels (HR 1.6, 95% CI: 1.0-2.5, P =0.04). We conclude that high uric acid levels before the start of conditioning correlate with increased mortality after alloSCT., (Copyright© 2020 Ferrata Storti Foundation.)
- Published
- 2020
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21. Hydrological modelling in small ungauged catchments.
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Comini UB, Silva DDD, Moreira MC, and Pruski FF
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- Brazil, Seasons, Water Supply, Rivers, Water Movements
- Abstract
The knowledge of the frequency and magnitude of low flow events is necessary to mitigate social, economic and ecological impacts inside the basin. However, the measurement network in Brazil is still restricted to large drainage areas, while basins with less than 300 km2 remain ungauged. Among different flow estimation methods, we used a rainfall-runoff model designed specifically to estimate flow rates during the dry season in small ungauged basins: the Silveira Method (SM). We tested the model performance for the São Bartolomeu river basin (Minas Gerais, Brazil), a small ungauged basin that experienced severe droughts and water supply shortages in 2014-2016. We tested eleven different scenarios based on the time and duration of drought periods used to estimate the model parameters. In the best scenario, the model underestimated low flow rates by 31% for Q95 and was considered suitable to predict local low flow. Finally, the model results suggest that a water volume higher than the river can support has been granted concession during the dry season, which may lead to an unsustainable water supply scenario soon. This result showed the capacity of SM as a complementary tool for the evaluation of water potential in small basins.
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- 2020
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22. Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party.
- Author
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Penack O, Peczynski C, van der Werf S, Finke J, Ganser A, Schoemans H, Pavlu J, Niittyvuopio R, Schroyens W, Kaynar L, Blau IW, van der Velden WJFM, Sierra J, Cortelezzi A, Wulf G, Turlure P, Rovira M, Ozkurt Z, Pascual-Cascon MJ, Moreira MC, Clausen J, Greinix H, Duarte RF, and Basak GW
- Subjects
- Adolescent, Adult, Aged, Female, Hematologic Neoplasms blood, Humans, Male, Middle Aged, Peripheral Blood Stem Cell Transplantation adverse effects, Postoperative Complications epidemiology, Prospective Studies, Transplantation Conditioning, Transplantation, Homologous, Young Adult, Biomarkers, Tumor blood, Ferritins blood, Graft vs Host Disease epidemiology, Hematologic Neoplasms therapy, Peripheral Blood Stem Cell Transplantation mortality
- Abstract
Elevated serum ferritin levels occur due to iron overload or during inflammation and macrophage activation. A correlation of high serum ferritin levels with increased mortality after alloSCT has been suggested by several retrospective analyses as well as by two smaller prospective studies. This prospective multicentric study aimed to study the association of ferritin serum levels before start of conditioning with alloSCT outcome. Patients with acute leukemia, lymphoma or MDS receiving a matched sibling alloSCT for the first time were considered for inclusion, regardless of conditioning. A comparison of outcomes between patients with high and low ferritin level was performed using univariate analysis and multivariate analysis using cause-specific Cox model. Twenty centers reported data on 298 alloSCT recipients. The ferritin cut off point was determined at 1500 μg/l (median of measured ferritin levels). In alloSCT recipients with ferritin levels above cut off measured before the start of conditioning, overall survival (HR = 2.5, CI = 1.5-4.1, p = 0.0005) and progression-free survival (HR = 2.4, CI = 1.6-3.8, p < 0.0001) were inferior. Excess mortality in the high ferritin group was due to both higher relapse incidence (HR = 2.2, CI = 1.2-3.8, p = 0.007) and increased non-relapse mortality (NRM) (HR = 3.1, CI = 1.5-6.4, p = 0.002). NRM was driven by significantly higher infection-related mortality in the high ferritin group (HR = 3.9, CI = 1.6-9.7, p = 0.003). Acute and chronic GVHD incidence or severity were not associated to serum ferritin levels. We conclude that ferritin levels can serve as routine laboratory biomarker for mortality risk assessment before alloSCT., (Copyright © 2020 Penack, Peczynski, van der Werf, Finke, Ganser, Schoemans, Pavlu, Niittyvuopio, Schroyens, Kaynar, Blau, van der Velden, Sierra, Cortelezzi, Wulf, Turlure, Rovira, Ozkurt, Pascual-Cascon, Moreira, Clausen, Greinix, Duarte and Basak.)
- Published
- 2020
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23. Development of an annual drought classification system based on drought severity indexes.
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Lima RPC, Silva DDD, Moreira MC, Passos JBMC, Coelho CD, and Elesbon AAA
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- Algorithms, Brazil, Environmental Monitoring methods, Reference Values, Rivers, Seasons, Time Factors, Droughts classification, Droughts statistics & numerical data, Rain
- Abstract
In order to characterize the occurrence and intensity of droughts in the Doce River Basin, as well as to develop a system for its classification, four different drought indexes were evaluated: Percent of Normal Precipitation (PNP), Deciles Method (DM), Rainfall Anomaly Index (RAI) and Standardized Precipitation Index (SPI). The indices were calculated annually, based on precipitation data from 89 rainfall stations of the Brazilian National Water Agency (ANA). Nine analysis units (AUs) were determined in the basin and the Thiessen Polygons method was used to obtain the average precipitation in the respective drainage areas. The indices were calculated for each AU and then related to the drought intensity classes. An overall classification of the indices was proposed for the drought classification system for a 30-year base period, from 1985 to 2015. The most critical hydrological years of the Doce River Basin in relation to the drought were 1994/1995, 2000/2001 and 2014/2015, the latter being the most critical of the last 30 years. The results show that the annual drought classification system proved to be efficient in the identification of events, allowing to verify that the Doce River Basin presents a severe climatic drought condition, on average, every seven years.
- Published
- 2019
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24. Degree of complexity of nurse care: associations in clinical oncology in breast cancer.
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Silva LGD and Moreira MC
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- Cross-Sectional Studies, Female, Humans, Medical Oncology, Middle Aged, Oncology Nursing, Retrospective Studies, Breast Neoplasms nursing, Nursing Care standards, Systems Analysis
- Abstract
Objective: It was to evaluate the degree of complexity of nursing care required for breast cancer patients who are readmitted to hospital., Methods: Cross-sectional study whose 108 subjects were breast cancer patients in unplanned readmission into the oncological unit of hospital in Brazil. Used for documentary analysis and the data analyzed statistically., Results: The predominant degrees of complexity of complexity of nursing care were semi-intensive (36.1%) and intensive care (36.1%). In the multivariate analysis, only performance status (p<0.001) and arterial hypertension (p=0.024) remained associated with the degree of complexity., Conclusions: The degree of complexity of patients readmitted was predominantly semi-intensive and intensive. This evaluation implies in the management of the care by means of the knowledge of the the profile breast cancer patients in hospital readmission and the detection of the characteristics associated to the degree of complexity.
- Published
- 2018
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25. Median preoptic nucleus excitatory neurotransmitters in the maintenance of hypertensive state.
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Mourão AA, de Mello ABS, Dos Santos Moreira MC, Rodrigues KL, Lopes PR, Xavier CH, Gomes RM, Freiria-Oliveira AH, Blanch GT, Colombari E, and Pedrino GR
- Subjects
- Animals, Disease Models, Animal, Male, Rats, Inbred SHR, Rats, Wistar, Angiotensin II metabolism, Glutamic Acid metabolism, Hypertension metabolism, Preoptic Area metabolism, Receptors, Neurotransmitter metabolism
- Abstract
The crucial role of the median preoptic nucleus (MnPO) in the maintenance of hydroelectrolytic balance and autonomic regulation have been highlighted. Recently, the participation of the MnPO in the control of sympathetic nerve activity was demonstrated in essential hypertension model. However, peculiarities on the neurochemical changes underlying the differential role of MnPO during hypertension remain to be clarified. Therefore, this study aimed to investigate the main excitatory pathways that modulate MnPO neurons in hypertensive rats. Spontaneously hypertensive rats (SHR) and rats submitted previously to the Goldblatt protocol (two kidneys; one clip; 2K1C) were used. Rats of both groups (250 to 350 g, n = 6) were anesthetized with urethane (1.2 g/kg,i.v.) and instrumented to record mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA). Nanoinjection (100 nl) of saline (NaCl, 150 mM), losartan (AT1 receptor antagonist; 10 mM) and kynurenic acid (glutamate receptor antagonist; 50 mM) into the MnPO were performed. In 2K1C rats, glutamatergic blockade promoted decreases in MAP and RSNA (-19.1 ± 0.9 mmHg, -21.6 ± 2.8%, p < 0.05) when compared to saline (-0.4 ± 0.6 mmHg, 0.2 ± 0.7%, p < 0.05). Angiotensinergic inhibition also reduced these parameters (-11.5 ± 1.2 mmHg, -10.5 ± 1.0%, p < 0.05) in 2K1C. In SHR, Kynurenic acid nanoinjections produced hypotension and sympathoinhibition (-21.0 ± 2.5 mmHg, -24.7 ± 2.4%, p < 0.05), as well losartan nanoinjections (-9.7 ± 1.2 mmHg; p < 0.05) and RSNA (-12.0 ± 2.4%, p < 0.05). These findings support the conclusion that a tonic excitatory neurotransmission exerted by angiotensin II, and mostly by glutamate in the MnPO could participate in the modulation of blood pressure and RSNA independent on whether hypertension is primarily neurogenic or is secondary to stenosis in renal artery., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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26. [Letter to the Editor about the article "Reconsidering the 'Decline' of Dental Student Empathy within the Course in Latin America"].
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Santiago LM, Moreira MC, and Silva I
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- Latin America, Empathy, Students, Dental
- Published
- 2018
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27. Clinical, Biomarker, and Molecular Delineations and Genotype-Phenotype Correlations of Ataxia With Oculomotor Apraxia Type 1.
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Renaud M, Moreira MC, Ben Monga B, Rodriguez D, Debs R, Charles P, Chaouch M, Ferrat F, Laurencin C, Vercueil L, Mallaret M, M'Zahem A, Pacha LA, Tazir M, Tilikete C, Ollagnon E, Ochsner F, Kuntzer T, Jung HH, Beis JM, Netter JC, Djamshidian A, Bower M, Bottani A, Walsh R, Murphy S, Reiley T, Bieth É, Roelens F, Poll-The BT, Lourenço CM, Jardim LB, Straussberg R, Landrieu P, Roze E, Thobois S, Pouget J, Guissart C, Goizet C, Dürr A, Tranchant C, Koenig M, and Anheim M
- Subjects
- Adolescent, Adult, Apraxias complications, Apraxias diagnostic imaging, Apraxias genetics, Ataxia complications, Ataxia diagnostic imaging, Cogan Syndrome complications, Cogan Syndrome diagnostic imaging, Disability Evaluation, Female, Humans, International Cooperation, Male, Middle Aged, Retrospective Studies, TRPC Cation Channels genetics, Young Adult, alpha-Fetoproteins metabolism, Apraxias congenital, Ataxia genetics, Cogan Syndrome genetics, DNA-Binding Proteins genetics, Genetic Association Studies, Mutation genetics, Nuclear Proteins genetics
- Abstract
Importance: Ataxia with oculomotor apraxia type 1 (AOA1) is an autosomal recessive cerebellar ataxia due to mutations in the aprataxin gene (APTX) that is characterized by early-onset cerebellar ataxia, oculomotor apraxia, axonal motor neuropathy, and eventual decrease of albumin serum levels., Objectives: To improve the clinical, biomarker, and molecular delineation of AOA1 and provide genotype-phenotype correlations., Design, Setting, and Participants: This retrospective analysis included the clinical, biological (especially regarding biomarkers of the disease), electrophysiologic, imaging, and molecular data of all patients consecutively diagnosed with AOA1 in a single genetics laboratory from January 1, 2002, through December 31, 2014. Data were analyzed from January 1, 2015, through January 31, 2016., Main Outcomes and Measures: The clinical, biological, and molecular spectrum of AOA1 and genotype-phenotype correlations., Results: The diagnosis of AOA1 was confirmed in 80 patients (46 men [58%] and 34 women [42%]; mean [SD] age at onset, 7.7 [7.4] years) from 51 families, including 57 new (with 8 new mutations) and 23 previously described patients. Elevated levels of α-fetoprotein (AFP) were found in 33 patients (41%); hypoalbuminemia, in 50 (63%). Median AFP level was higher in patients with AOA1 (6.0 ng/mL; range, 1.1-17.0 ng/mL) than in patients without ataxia (3.4 ng/mL; range, 0.8-17.2 ng/mL; P < .01). Decreased albumin levels (ρ = -0.532) and elevated AFP levels (ρ = 0.637) were correlated with disease duration. The p.Trp279* mutation, initially reported as restricted to the Portuguese founder haplotype, was discovered in 53 patients with AOA1 (66%) with broad white racial origins. Oculomotor apraxia was found in 49 patients (61%); polyneuropathy, in 74 (93%); and cerebellar atrophy, in 78 (98%). Oculomotor apraxia correlated with the severity of ataxia and mutation type, being more frequent with deletion or truncating mutations (83%) than with presence of at least 1 missense variant (17%; P < .01). Mean (SD) age at onset was higher for patients with at least 1 missense mutation (17.7 [11.4] vs 5.2 [2.6] years; P < .001)., Conclusions and Relevance: The AFP level, slightly elevated in a substantial fraction of patients, may constitute a new biomarker for AOA1. Oculomotor apraxia may be an optional finding in AOA1 and correlates with more severe disease. The p.Trp279* mutation is the most frequent APTX mutation in the white population. APTX missense mutations may be associated with a milder phenotype.
- Published
- 2018
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28. Influence of the colon in liver regeneration of rats submitted to hepatectomy and colectomy.
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Moreira MC, Azevedo ÍM, Oliveira CN, and Medeiros ADC
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- Animals, Male, Rats, Rats, Wistar, Colectomy, Colon physiology, Hepatectomy, Liver Regeneration physiology
- Abstract
Objective: to evaluate whether colectomy, associated with 70% hepatectomy, influences liver regeneration in rats., Methods: we distributed 18 Wistar rats in three groups of six animals each. In group I (sham), we performed laparotomy; In group II, colectomy + 70% hepatectomy; In group III, only 70% hepatectomy. On the 6th postoperative day, we collected blood by cardiac puncture under anesthesia, followed by euthanasia. We performed serum dosages of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin and alkaline phosphatase (AF), hepatocyte growth factor (HGF) and transforming growth factor-α (TGF-α). We calculated liver regeneration by the formula: liver weight ratio per 100g body weight at the time of euthanasia / liver weight preoperatively projected for 100g body weight × 100., Results: ALT and AST levels were significantly lower in group II when compared with group III (p<0.001). Albuminemia showed significantly higher levels in group II. Levels of HGF and TGF-α in group II were significantly higher than in group III. The percentage of hepatic regeneration was significantly higher in group II than in group III., Conclusion: Colectomy performed simultaneously with 70% hepatectomy had a positive influence on liver regeneration in rats. Further research is needed to reveal the molecular mechanisms of this effect and to characterize the colon influence in liver physiology.
- Published
- 2017
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29. Neuronal circuits involved in osmotic challenges.
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Dos Santos Moreira MC, Naves LM, Marques SM, Silva EF, Rebelo AC, Colombari E, and Pedrino GR
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- Animals, Blood Pressure drug effects, Blood Pressure physiology, Body Fluids drug effects, Body Fluids physiology, Central Nervous System drug effects, Heart Rate drug effects, Heart Rate physiology, Homeostasis drug effects, Humans, Kidney drug effects, Kidney physiology, Osmosis drug effects, Saline Solution, Hypertonic administration & dosage, Shock, Hemorrhagic drug therapy, Shock, Hemorrhagic physiopathology, Central Nervous System physiology, Homeostasis physiology, Nerve Net physiology, Osmosis physiology
- Abstract
The maintenance of plasma sodium concentration within a narrow limit is crucial to life. When it differs from normal physiological patterns, several mechanisms are activated in order to restore body fluid homeostasis. Such mechanisms may be vegetative and/or behavioral, and several regions of the central nervous system (CNS) are involved in their triggering. Some of these are responsible for sensory pathways that perceive a disturbance of the body fluid homeostasis and transmit information to other regions. These regions, in turn, initiate adequate adjustments in order to restore homeostasis. The main cardiovascular and autonomic responses to a change in plasma sodium concentration are: i) changes in arterial blood pressure and heart rate; ii) changes in sympathetic activity to the renal system in order to ensure adequate renal sodium excretion/absorption, and iii) the secretion of compounds involved in sodium ion homeostasis (ANP, Ang-II, and ADH, for example). Due to their cardiovascular effects, hypertonic saline solutions have been used to promote resuscitation in hemorrhagic patients, thereby increasing survival rates following trauma. In the present review, we expose and discuss the role of several CNS regions involved in body fluid homeostasis and the effects of acute and chronic hyperosmotic challenges.
- Published
- 2017
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30. Palliative Cancer Care in Brazil: The Perspective of Nurses and Physicians.
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da Silva MM, Büscher A, and Moreira MC
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- Adult, Brazil, Female, Humans, Male, Middle Aged, Nurses statistics & numerical data, Physicians statistics & numerical data, Qualitative Research, Attitude of Health Personnel, Neoplasms therapy, Nurses psychology, Palliative Care, Physicians psychology
- Abstract
Background: Palliative care is a recent development in health worldwide. In Brazil, a growing number of people with cancer require palliative care, emphasizing the need for investment in this aspect of health to increase the quality of life of patients during the dying process. As a developing country, Brazil lacks knowledge regarding the themes, material and financial resources, and policies of palliative care., Objective: The aim of this study was to provide insights into the Brazilian palliative care system from the perspectives of nurses and physicians., Methods: This was a descriptive and qualitative study, conducted at the palliative care unit of the Instituto Nacional de Câncer in Brazil. Twelve professionals, among them 8 nurses and 4 physicians, were interviewed in November 2013. The data were analyzed using the thematic analysis method. Ethical aspects were respected., Results: The perspectives of the participants were characterized by 3 themes regarding the initial phase of development of palliative cancer care in Brazil: (1) controversies about when palliative cancer care should be initiated, (2) the World Health Organization recommendations and current practices, and (3) the need to invest in palliative cancer care education in Brazil., Conclusions: The development of palliative care is in the initial stages, and there is a possibility for growth due to recent advances., Implications for Practice: Knowledge about these challenges to palliative care could contribute to the development of strategies, such as the establishment of service organizations and networks, as well as educational and political investments for the advancement of palliative care.
- Published
- 2017
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31. When participation of children and youth with disabilities is not merely activity: a study of the literature.
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Santos TV, Moreira MC, and Gomes R
- Subjects
- Adolescent, Child, Humans, Disabled Children, Social Participation
- Abstract
This article analyzes the approach to children and adolescent participation in disability studies. Methodologically, it combines a literature review and a theme-based content analysis to look at which dimensions of participation are explored in the literature. As the result of this study we highlight four areas: Sports, Quality of Life/Well-Being, School and Participation Metrics. We find that the focus is on participation as performing activities within a given context, with very few broader discussions about the domain as a human value related to socialization and the development of a support network, the management of independence and levels of dependence.
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- 2016
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32. Acute and chronic Graft-versus-host disease after hematopoietic stem cell transplantation.
- Author
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Funke VA, Moreira MC, and Vigorito AC
- Subjects
- Acute Disease, Chronic Disease, Female, Graft vs Host Disease classification, Humans, Male, Risk Factors, Severity of Illness Index, Graft vs Host Disease etiology, Graft vs Host Disease therapy, Hematopoietic Stem Cell Transplantation adverse effects
- Abstract
graft-versus-host disease (GVHD) is one of the main complications of hematopoietic stem cell transplantation, affecting about 50% to 80% of the patients. Acute GVHD and its clinical manifestations are discussed in this article, as well as the new NIH criteria for the diagnosis and classification of chronic GVHD. Therapy for both chronic and acute GVHD is an important field of discussion, as there is no proven superiority for the majority of therapies used after primary treatment has failed. Hence, this review is meant to be a useful consultation tool for hematologists dealing with this complex transplantation procedure complication.
- Published
- 2016
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33. Association of exercise training and angiotensin-converting enzyme 2 activator improves baroreflex sensitivity of spontaneously hypertensive rats.
- Author
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Lopes PR, Moreira MC, Marques SM, Pinto IS, Macedo LM, Silva CC, Freiria-Oliveira AH, Rebelo AC, Reis AA, Rosa DA, Ferreira-Neto ML, Castro CH, and Pedrino GR
- Subjects
- Angiotensin-Converting Enzyme 2, Animals, Blood Pressure physiology, Diminazene agonists, Diminazene pharmacology, Heart Rate physiology, Hypertension physiopathology, Male, Rats, Rats, Inbred SHR, Signal Transduction drug effects, Baroreflex drug effects, Diminazene analogs & derivatives, Hypertension drug therapy, Peptidyl-Dipeptidase A pharmacology, Physical Conditioning, Animal physiology
- Abstract
The present study sought to determine cardiovascular effects of aerobic training associated with diminazene aceturate (DIZE), an activator of the angiotensin converting enzyme 2, in spontaneously hypertensive rats (SHRs). Male SHRs (280-350 g) were either subjected to exercise training or not (sedentary group). The trained group was subjected to 8 weeks of aerobic training on a treadmill (five times a week, lasting 60 min at an intensity of 50-60% of maximum aerobic speed). In the last 15 days of the experimental protocol, these groups were redistributed into four groups: i) sedentary SHRs with daily treatment of 1 mg/kg DIZE (S+D1); ii) trained SHRs with daily treatment of 1 mg/kg DIZE (T+D1); iii) sedentary SHRs with daily treatment of vehicle (S+V); and iv) trained SHRs with daily treatment of vehicle (T+V). After treatment, SHRs were anesthetized and subjected to artery and femoral vein cannulation prior to the implantation of ECG electrode. After 24 h, mean arterial pressure (MAP) and heart rate (HR) were recorded; the baroreflex sensitivity and the effect of double autonomic blockade (DAB) were evaluated in non-anesthetized SHRs. DIZE treatment improved baroreflex sensitivity in the T+D1 group as compared with the T+V and S+D1 groups. The intrinsic heart rate (IHR) and MAP were reduced in T+D1 group as compared with T+V and S+D1 groups. Hence, we conclude that the association of exercise training with DIZE treatment improved baroreflex function and cardiovascular regulation.
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- 2016
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34. Translation, Cross-Cultural Adaptation, and Validation of the Lee Chronic Graft-versus-Host Disease Symptom Scale in a Brazilian Population.
- Author
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Vasconcellos de Souza C, Vigorito AC, Miranda ECM, Garcia C Jr, Rensi Colturato VA, Mauad MA, Rodrigues Moreira MC, da Silva Bouzas LF, Lermontov S, Hamerschlak N, Rodrigues M, Carlos de Almeida Barros J, Chiattone R, Lee SJ, and Flowers MED
- Subjects
- Adult, Aged, Brazil, Chronic Disease, Cross-Cultural Comparison, Female, Humans, Language, Male, Middle Aged, Quality of Life, Statistics, Nonparametric, Young Adult, Graft vs Host Disease diagnosis, Severity of Illness Index
- Abstract
The Lee Chronic Graft-versus-Host Disease (GVHD) Symptom Scale is a patient-reported instrument developed and validated in English to measure the symptoms and functional impact of cGVHD. This tool has not yet been validated in a Latin American population, however. The Brazil-Seattle Chronic GVHD Consortium conducted a multicenter study at 5 Brazilian institutions to validate the Lee cGVHD Symptom Scale in adults with cGVHD. Study objectives included the translation and validation of the instrument in Brazilian Portuguese and evaluation of the correlation with other quality of life (QoL) tools, including the Medical Outcomes Study Short Form 36 (SF-36) and Functional Assessment of Chronic Illness Therapy with Bone Marrow Transplant subscale (FACT-BMT). Translation and validation were done according to the American Association of Orthopedic Surgeons Outcome Committee guidelines. Spearman's correlation coefficient was used to measure construct validity. Reliability was assessed using Cronbach's α and intraclass correlation coefficients. Between April 2011 and August 2012, 47 patients with cGVHD based on the 2005 National Institutes of Health criteria (29 males [62%], 18 females [38%]; median age, 48 years; range, 23 to 69 years) were enrolled in this study. The reliability of the Lee cGVHD Symptom Scale was adequate (Cronbach's α = 0.62 to 0.83). The correlations between similar domains of the Lee cGVHD Symptom Scale, SF-36, and FACT-BMT were moderate to high. Our data indicate that the Brazilian Portuguese version of the Lee cGVHD Symptom Scale is valid and reliable and can be used in clinical trials of cGVHD in Brazil., (Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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35. Do the carotid body chemoreceptors mediate cardiovascular and sympathetic adjustments induced by sodium overload in rats?
- Author
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Pedrino GR, Mourão AA, Moreira MC, da Silva EF, Lopes PR, Fajemiroye JO, Schoorlemmer GH, Sato MA, Reis ÂA, Rebelo AC, and Cravo SL
- Subjects
- Animals, Male, Rats, Rats, Wistar, Carotid Body metabolism, Sodium Chloride administration & dosage
- Abstract
Acute plasma hypernatremia induces several cardiovascular and sympathetic responses. It is conceivable that these responses contribute to rapid sodium excretion and restoration of normal conditions. Afferent pathways mediating these responses are not entirely understood. The present study analyses the effects of acute carotid chemoreceptor inactivation on cardiovascular and sympathetic responses induced by infusion of hypertonic saline (HS). All experiments were performed on anesthetized male Wistar rats instrumented for recording of arterial blood pressure (ABP), renal blood flow (RBF) and renal sympathetic nerve activity (RSNA). Animals were subjected to sham surgery or carotid chemoreceptor inactivation by bilateral ligation of the carotid body artery (CBA). In sham rats (n=8), intravenous infusion of HS (3 M NaCl, 1.8 ml/kg b.wt.) elicited a transient increase (9±2mmHg) in ABP, and long lasting (30 min) increases in RBF (138±5%) and renal vascular conductance (RVC) (128±5%) with concurrent decrease in RSNA (-19±4%). In rats submitted to CBA ligation (n=8), the pressor response to HS was higher (24±2mmHg; p<0.05). However, RBF and RVC responses to HS infusion were significantly reduced (113±5% and 93±4%, respectively) while RSNA was increased (13±2%). When HS (3M NaCl, 200μl) was administrated into internal carotid artery (ICA), distinct sympathetic and cardiovascular responses were observed. In sham-group, HS infusion (3M NaCl, 200μl) into ICA promoted an increase in ABP (26±8mmHg) and RSNA (29±13%). In CBA rats, ABP (-3±5.6mmHg) remained unaltered despite sympathoinhibition (-37.6±5.4%). These results demonstrate that carotid body chemoreceptors play a role in the development of hemodynamic and sympathetic responses to acute HS infusion., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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36. Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population.
- Author
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Müller Jdos S, Falcão IR, Couto MC, Viana Wda S, Alves IB, Viola DN, Woods CG, and Rêgo RF
- Subjects
- Adult, Aged, Animals, Brazil epidemiology, Chronic Disease epidemiology, Chronic Disease psychology, Comorbidity, Cross-Sectional Studies, Educational Status, Female, Fishes, Humans, Male, Middle Aged, Musculoskeletal Diseases etiology, Musculoskeletal Diseases psychology, Occupational Diseases etiology, Occupational Diseases psychology, Prevalence, Seafood, Self Report, Shellfish, Workforce, Young Adult, Fisheries, Health Surveys, Musculoskeletal Diseases epidemiology, Occupational Diseases epidemiology, Occupational Health statistics & numerical data, Quality of Life
- Abstract
Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the "Physical Health" domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen's work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil's economy and food system.
- Published
- 2016
- Full Text
- View/download PDF
37. Lines of male care geared to sexual health, reproduction and paternity.
- Author
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Gomes R, Albernaz L, Ribeiro CR, Moreira MC, and Nascimento M
- Subjects
- Female, Health Promotion methods, Humans, Male, Paternity, Pregnancy, Reproduction, Family Relations, Fathers psychology, Prenatal Care methods, Sexual Health
- Abstract
The article seeks to propose principles for male care geared to sexual health, reproduction and paternity, as well as present a blueprint for the involvement of men in prenatal care. The proposal of the authors was submitted to a consensus building process with invited experts. The main results presented include: (a) the principles of lines of male care geared to sexual health, reproduction and paternity; and (b) a blueprint for the involvement of men in prenatal care. The conclusion drawn is that the cultural preconceptions of how males should lead their lives, including their social relations and roles as fathers interfere in health care actions and touch on three main points: (a) the idea of man as a collaborator in the promotion of the health of his partner while pregnant and/or his offspring; (b) the idea of paternity being strongly linked to being the financial provider;, ((c) the hiatus generated between the traditional concept of paternity and the new family and gender patterns.)
- Published
- 2016
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38. Does the median preoptic nucleus contribute to sympathetic hyperactivity in spontaneously hypertensive rats?
- Author
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Mourão AA, Moreira MC, Melo AB, Lopes PR, Rebelo AC, Rosa DA, Freiria-Oliveira AH, Colombari E, and Pedrino GR
- Subjects
- Animals, Blood Pressure drug effects, Electrocardiography drug effects, Injections, Intraventricular, Male, Microinjections, Muscimol pharmacology, Neural Inhibition drug effects, Preoptic Area drug effects, Rats, Rats, Inbred SHR, Preoptic Area physiopathology, Sympathetic Nervous System physiopathology
- Abstract
The present study sought to determine the involvement of median preoptic nucleus (MnPO) in the regulation of the cardiovascular function and renal sympathetic activity in normotensive (NT) and spontaneously hypertensive rats (SHR). MnPO inhibition evoked by Muscimol (4mM) nanoinjections, elicited fall in MAP and renal sympathoinhibition in NT-rats. Surprisingly, in SHRs these responses were greater than in NT-rats. These results demonstrated, for the first time that MnPO was involved in the tonic control of sympathetic activity in NT and SHRs. Furthermore, our data suggest the MnPO involvement in the increased sympathetic outflow and consequent arterial hypertension observed in SHRs., (Copyright © 2016 Elsevier B.V. All rights reserved.)
- Published
- 2016
- Full Text
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39. Environmental flow in the River Ondas basin in Bahia, Brazilian Cerrado.
- Author
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de Souza Castro ER, Moreira MC, and da Silva DD
- Subjects
- Biodiversity, Brazil, Conservation of Natural Resources, Ecosystem, Environmental Monitoring methods, Humans, Models, Theoretical, Rivers, Water Movements
- Abstract
This paper aimed to estimate the environmental flow of a water basin located in the Brazilian Cerrado using the bidimensional model River2D. The study was carried out in a stretch of the lower portion of the River Ondas in the western part of the state of Bahia, Brazil. To carry out the ecohydrological modeling, the following were used: topobathymetry, hydraulic characterization, the streamflows with the probability of non-exceedances (Q50, Q60, Q70, Q80, Q90, and Q95), and the Habitat Suitability Index for species of the genus Hypostomus. In the River2D, the weighted usable areas (WUAs) pertaining to the streamflows associated with different non-exceedances were simulated for the later construction of optimization and identification matrices of the streamflows that maximize the habitat area throughout the year. For juvenile Hypostomus, WUA increased as streamflow increased, with higher values associated with Q50. For adult specimens, lower WUA values were observed associated with Q50, while higher values were associated with Q95, which shows a preference for lower streamflows. The environmental flows found for the stretch of the River Ondas varied over the course of the year. The lowest environmental flows were observed in September (30.31 m(3) s(-1)) and October (29.98 m(3) s(-1)), while the highest were observed in February (44.22 m(3) s(-1)) and March (43.16 m(3) s(-1)). The environmental flow regime obtained restricts the water availability in the basin, for the purpose of water capture, which shows the importance of ecohydrological studies in forming a basis for water resource management actions.
- Published
- 2016
- Full Text
- View/download PDF
40. ["Are men coming to the clinic now?!" Healthcare strategies for men].
- Author
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Moreira MC, Gomes R, and Ribeiro CR
- Subjects
- Brazil, Delivery of Health Care, Female, Health Personnel, Humans, Male, Paternal Behavior, Qualitative Research, Sexuality, Men's Health trends, Prenatal Care statistics & numerical data
- Abstract
This is a qualitative study from the perspective of dialectical hermeneutics on healthcare strategies for men in the view of health professionals. The authors drew on 18 semi-structured interviews addressing male sexuality, men's healthcare, participation in prenatal care, and fatherhood. Three thematic lines were established, based on an understanding of the interviews as a whole, independently of both the specific themes mentioned above and the region. The themes provide structure for and are structured by ideas that traverse the various interviews. Themes of male sexuality associated with healthcare and fatherhood further evoke the private dimension, referred to the home's geographic boundaries. These ideas people the cultural repertoire on maleness; the novelty lies in unlinking sexuality from sexual relations and sexual health from transmission and contagion in the interpretation of our material.
- Published
- 2016
- Full Text
- View/download PDF
41. Involvement of sinoaortic afferents in renal sympathoinhibition and vasodilation induced by acute hypernatremia.
- Author
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Silva EF, Sera CT, Mourão AA, Lopes PR, Moreira MC, Ferreira-Neto ML, Colombari DA, Cravo SL, and Pedrino GR
- Subjects
- Afferent Pathways physiopathology, Animals, Arterial Pressure, Baroreflex, Disease Models, Animal, Hypernatremia blood, Male, Rats, Wistar, Sodium blood, Sympathectomy, Sympathetic Nervous System surgery, Time Factors, Aorta innervation, Carotid Sinus innervation, Hypernatremia physiopathology, Kidney innervation, Neural Inhibition, Sympathetic Nervous System physiopathology, Vasodilation
- Abstract
Despite the abundance of evidence that supports the important role of aortic and carotid afferents to short-term regulation of blood pressure and detection of variation in the arterial PO2 , PCO2 and pH, relatively little is known regarding the role of these afferents during changes in the volume and composition of extracellular compartments. The present study sought to determine the involvement of these afferents in the renal vasodilation and sympathoinhibition induced by hypertonic saline (HS) infusion. Sinoaortic-denervated and sham male Wistar rats were anaesthetised with intravenous (i.v.) urethane (1.2 g/kg body weight (bw)) prior to the measurement of the mean arterial pressure (MAP), renal vascular conductance (RVC) and renal sympathetic nerve activity (RSNA). In the sham group, the HS infusion (3 mol/L NaCl, 1.8 mL/kg bw, i.v.) induced transient hypertension (12 ± 4 mmHg from baseline, peak at 10 min; P < 0.05), an increase in RVC (127 ± 9% and 150 ± 13% from baseline, at 20 and 60 min respectively; P < 0.05) and a decrease in RSNA (-34 ± 10% and -29 ± 5% from baseline, at 10 and 60 min respectively; P < 0.05). In sinoaortic-denervated rats, HS infusion promoted a sustained pressor response (30 ± 5 and 17 ± 6 mmHg of baseline values, at 10 and 30 min respectively; P < 0.05) and abolished the increase in RVC (85 ± 8% from baseline, at 10 min) and decrease in RSNA (-4 ± 3% from baseline, at 10 min). These results suggest that aortic and carotid afferents are involved in cardiovascular and renal sympathoinhibition responses induced by acute hypernatremia., (© 2015 Wiley Publishing Asia Pty Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
42. Fatherhood and parenting as health issues facing the rearrangements of gender.
- Author
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Ribeiro CR, Gomes R, and Moreira MC
- Subjects
- Family Health, Fathers, Female, Humans, Male, Paternity, Sexuality, Father-Child Relations, Gender Identity, Parenting
- Abstract
In this theoretical essay we aim to discuss paternity as a health issue in the context of contemporary gender roles by considering two lines of argument: (a) paternity, parenting and rearrangements of gender roles; and (b) paternity and parenting as a mutual relationship based on care. In our discussion, we highlight the inclusion of men in the health system from the point of view of paternity. At present this appears to be operating in an instrumental manner, with the mother-infant dyad still a major concern and men not being viewed as individuals with rights to health. Thus, we seek to question the system itself, in relation to its perceptions of the current state of paternity, by taking into consideration recent discussions about gender and sexuality as well as and new family arrangements that may challenge beliefs about the roles of families, fathers and mothers, which have impacts on care. Among other aspects, we conclude that we need to reinvent ourselves because we were not raised under the aegis of diversity and we were also not trained as professionals with a basis in the current problematic divisions that exist between father/mother and sex/gender, among many other previous certainties, all of which does not always help us to promote actions in the area of health.
- Published
- 2015
- Full Text
- View/download PDF
43. Health team: negotiations and limits of autonomy, belonging and the acknowledgement of others.
- Author
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da Silva EM and Moreira MC
- Subjects
- Humans, Negotiating, Patient Care Team
- Abstract
The scope of this paper was to establish the significance of teamwork within the complex interaction in a Neonatal Unit. The techniques used for data collection were document analysis, participant observation and interviews. Twenty-four professionals working in a public and highly complex Neonatal Unit in the city of Rio de Janeiro were interviewed. The data were analyzed using the thematic approach of the content analysis technique, based on the literature on humanization, health work processes, teamwork and ergology. The conclusion drawn is that even in the neonatal environment, the construction of teamwork is established when the care model is geared to the logic responding to the health needs of individuals, taking into consideration the babies and their families, encompassing negotiations, limits of autonomy and notions of belonging and the recognition of others.
- Published
- 2015
- Full Text
- View/download PDF
44. [Children with tuberculosis: situations and interactions in family health care].
- Author
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Machado Dde C, Moreira MC, and Sant'Anna CC
- Subjects
- Attitude of Health Personnel, Brazil, Caregivers, Child, Humans, Qualitative Research, Surveys and Questionnaires, Tuberculosis diagnosis, Tuberculosis therapy, Child Health Services, Family Health, Primary Health Care, Tuberculosis psychology
- Abstract
This qualitative study analyzed meanings associated with tuberculosis (TB) in children. Interviews were conducted with lay caregivers and health professionals in six health situations in a vulnerable territory. Data collection was followed by thematic content analysis and interpretation in consultation with the literature concerning the concepts of stigma, childhood illness, and preservation of the façade. The results showed that the discussion on the meanings of TB in children involves relativity of the core family concept and valuation of their network of relationships. The complexity of TB in children requires an expanded understanding of their health situation and interactions among the surrounding relationships. The health professional's role in identifying and managing possibilities for care and diagnostic and therapeutic difficulties is an important tool for health promotion in children.
- Published
- 2015
- Full Text
- View/download PDF
45. Does the sympathetic nervous system contribute to the pathophysiology of metabolic syndrome?
- Author
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Moreira MC, Pinto IS, Mourão AA, Fajemiroye JO, Colombari E, Reis ÂA, Freiria-Oliveira AH, Ferreira-Neto ML, and Pedrino GR
- Abstract
The metabolic syndrome (MS), formally known as syndrome X, is a clustering of several risk factors such as obesity, hypertension, insulin resistance, and dislypidemia which could lead to the development of diabetes and cardiovascular diseases (CVD). The frequent changes in the definition and diagnostic criteria of MS are indications of the controversy and the challenges surrounding the understanding of this syndrome among researchers. Obesity and insulin resistance are leading risk factors of MS. Moreover, obesity and hypertension are closely associated to the increase and aggravation of oxidative stress. The recommended treatment of MS frequently involves change of lifestyles to prevent weight gain. MS is not only an important screening tool for the identification of individuals at high risk of CVD and diabetes but also an indicator of suitable treatment. As sympathetic disturbances and oxidative stress are often associated with obesity and hypertension, the present review summarizes the role of sympathetic nervous system and oxidative stress in the MS.
- Published
- 2015
- Full Text
- View/download PDF
46. Prevalence of neck and upper limb musculoskeletal disorders in artisan fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil.
- Author
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Falcão IR, Couto MC, Lima VM, Pena PG, Andrade LL, Müller Jdos S, Alves IB, Viana Wda S, and Rêgo Rde C
- Subjects
- Adult, Animals, Brazil epidemiology, Cross-Sectional Studies, Female, Humans, Prevalence, Risk Factors, Shellfish, Aquaculture, Musculoskeletal Diseases epidemiology, Occupational Diseases epidemiology
- Abstract
This study was conducted in an artisanal fishing community. The main health complaints included musculoskeletal disorders (MSD) attributable to working conditions. The present work found a prevalence of neck and distal upper limb MSD among the artisan fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil. This was a cross-sectional cohort epidemiological study involving 209 artisanal fisherwomen/shellfish gatherers. The Brazilian version of the Job Content Questionnaire (JCQ), the Nordic Musculoskeletal Questionnaire (NMQ) and a survey listing physical demands adapted to shellfish gathering were used for the study. The MSD values obtained in some part of the body, neck or shoulder, and distal upper limb were 94.7%, 71.3% and 70.3%, respectively. The shellfish gatherers were found to work long shifts despite the high prevalence of MSD. The factors that cause these women to keep performing such activities include the need to make a living and provide food for their families through the sale and consumption of seafood.
- Published
- 2015
- Full Text
- View/download PDF
47. Global diversity lines - a five-continent reference panel of sequenced Drosophila melanogaster strains.
- Author
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Grenier JK, Arguello JR, Moreira MC, Gottipati S, Mohammed J, Hackett SR, Boughton R, Greenberg AJ, and Clark AG
- Subjects
- Alleles, Animals, Cluster Analysis, Gene Frequency, Genetics, Population, Genome, Genotype, High-Throughput Nucleotide Sequencing, Linkage Disequilibrium, Polymorphism, Single Nucleotide, Principal Component Analysis, Drosophila melanogaster genetics, Genetic Variation
- Abstract
Reference collections of multiple Drosophila lines with accumulating collections of "omics" data have proven especially valuable for the study of population genetics and complex trait genetics. Here we present a description of a resource collection of 84 strains of Drosophila melanogaster whose genome sequences were obtained after 12 generations of full-sib inbreeding. The initial rationale for this resource was to foster development of a systems biology platform for modeling metabolic regulation by the use of natural polymorphisms as perturbations. As reference lines, they are amenable to repeated phenotypic measurements, and already a large collection of metabolic traits have been assayed. Another key feature of these strains is their widespread geographic origin, coming from Beijing, Ithaca, Netherlands, Tasmania, and Zimbabwe. After obtaining 12.5× coverage of paired-end Illumina sequence reads, SNP and indel calls were made with the GATK platform. Thorough quality control was enabled by deep sequencing one line to >100×, and single-nucleotide polymorphisms and indels were validated using ddRAD-sequencing as an orthogonal platform. In addition, a series of preliminary population genetic tests were performed with these single-nucleotide polymorphism data for assessment of data quality. We found 83 segregating inversions among the lines, and as expected these were especially abundant in the African sample. We anticipate that this will make a useful addition to the set of reference D. melanogaster strains, thanks to its geographic structuring and unusually high level of genetic diversity., (Copyright © 2015 Grenier et al.)
- Published
- 2015
- Full Text
- View/download PDF
48. High sodium intake during postnatal phases induces an increase in arterial blood pressure in adult rats.
- Author
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Moreira MC, da Silva EF, Silveira LL, de Paiva YB, de Castro CH, Freiria-Oliveira AH, Rosa DA, Ferreira PM, Xavier CH, Colombari E, and Pedrino GR
- Subjects
- Animal Nutritional Physiological Phenomena, Animals, Animals, Newborn, Baroreflex, Energy Intake, Female, Furosemide, Heart Rate, Humans, Infant, Newborn, Male, Rats, Wistar, Arterial Pressure, Diet, Hypertension etiology, Infant Nutritional Physiological Phenomena, Sodium administration & dosage, Sodium pharmacology, Sodium Chloride, Dietary administration & dosage, Sodium Chloride, Dietary pharmacology
- Abstract
Epigenetic studies suggest that diseases that develop in adulthood are related to certain conditions to which the individual is exposed during the initial stages of life. Experimental evidence has demonstrated that offspring born to mothers maintained on high-Na diets during pregnancy have higher mean arterial pressure (MAP) in adulthood. Although these studies have demonstrated the importance of prenatal phases to hypertension development, no evidence regarding the role of high Na intake during postnatal phases in the development of this pathology has been reported. Therefore, in the present study, the effects of Na overload during childhood on induced water and Na intakes and on cardiovascular parameters in adulthood were evaluated. Experiments were carried out in two groups of 21-d-old rats: experimental group, maintained on hypertonic saline (0.3 m-NaCl) solution and food for 60 d, and control group, maintained on tap water and food. Later, both groups were given water and food for 15 d (recovery period). After the recovery period, chronic cannulation of the right femoral artery was performed in unanaesthetised rats to record baseline MAP and heart rate (HR). The experimental group was found to have increased basal MAP (98.6 (sem 2.6) v. 118.3 (sem 2.7) mmHg, P< 0.05) and HR (365.4 (sem 12.2) v. 398.2 (sem 7.5) beats per min, P< 0.05). There was a decrease in the baroreflex index in the experimental group when compared with that in the control group. A water and Na intake test was performed using furosemide. Na depletion was found to induce an increase in Na intake in both the control and experimental groups (12.1 (sem 0.6) ml and 7.8 (sem 1.1), respectively, P< 0.05); however, this increase was of lower magnitude in the experimental group. These results demonstrate that postnatal Na overload alters behavioural and cardiovascular regulation in adulthood.
- Published
- 2014
- Full Text
- View/download PDF
49. Resilience and death: the nursing professional in the care of children and adolescents with life-limiting illnesses.
- Author
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dos Santos RA and Moreira MC
- Subjects
- Adolescent, Child, Chronic Disease nursing, Humans, Adaptation, Psychological, Attitude of Health Personnel, Attitude to Death, Nurses psychology, Pediatric Nursing, Resilience, Psychological, Terminal Care psychology
- Abstract
The purpose of this article is to analyze the resilience of the nursing staff in providing care for children and adolescents with chronic diseases, including coping with their deaths. The participants of this qualitative research were nursing professionals working in the pediatric ward of a hospital in the city of Rio de Janeiro, Brazil. The data collection was obtained by applying the resilience scale, by returning the scales in groups, and by semi-structured interviews. The relationship between professional resilience and coping with the process of children and adolescent's deaths stood out in the analysis based on data obtained from group and individual interviews. The care given to children and adolescents with life-limiting illnesses triggers resilience-related answers concerning alternatives that oscillate between individual reactions (religious and psychological support), and the search for an incipient collective support based on personal relationships. This study points out that this subject must be strategically handled to train this professional, who must be able to rely on support from the collective environment, presumed within the professional health care training and in the management of humanization at the hospital.
- Published
- 2014
- Full Text
- View/download PDF
50. [Violence against children and adolescents with disabilities: narratives with guardianship councilors].
- Author
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Moreira MC, Bastos OM, Bastos LC, Soares AH, Souza Wda S, and Sanchez RN
- Subjects
- Adolescent, Child, Counseling, Human Rights, Humans, Interviews as Topic, Legal Guardians, Narration, Disabled Children, Violence
- Abstract
The article is based on Thompson's indepth hermeneutics with emphasis on meanings produced from narrative analysis of 15 guardianship councilors, seeking to interpret the significance of the councilor's function and ensuring the rights of children and adolescents with disabilities. The conclusion drawn is that certain generic discourses on this theme are presented as an inflexible core which reinforces the invisibility of the population and renders it more vulnerable. At the other extreme, the generic category of being "special" highlights the difficulties of the guardianship councilor in seeking strategies in the institutional network (health, leisure, education) for ensuring the rights and needs of this segment and their families, when failing to differentiate between the various categories of disability. Finally, the acquisition of knowledge by counselors related to this clientele depends greatly on the proximity of these counselors to health institutions that contribute in formulating strategies for guaranteeing rights that form networks. The situations of vulnerability to which counselors are exposed in the relationship between their mandate to respond to the violations suffered by the juvenile segment, and impotence to resolve them are stressed.
- Published
- 2014
- Full Text
- View/download PDF
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