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Implementation of a High-Risk Outpatient Clinic for Children with Complex Congenital Heart Disease in a Reference Service in Brazil

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Congenital Heart Disease 2023年第6期18卷 649-656页

作者： Gustavo Foronda Vanessa Ferreira Amorim de Melo Claudia Regina Pinheiro de Castro Grau Ingrid Magatti Piva glaucia maria penha tavares Ana Cristina Sayuri Tanaka Nana Miura Department of Pediatric Cardiology and Adult Congenital Heart Diseases Heart Institute of the University of São PauloSão PauloBrazil Foronda Clinic São PauloBrazil Institute of Orthopedics and Traumatology University of São PauloSão PauloBrazil Department of Echocardiography Heart Institute of the University of São PauloSão PauloBrazil

Background:Children with congenital heart disease(CHD),even after surgical approaches,and especially those who undergo staged procedures in theﬁrst months of life,remain vulnerable to readmissions and complications,requiring very close monitoring and differentiated intervention ***:Descriptive and exploratory study,of the experience report type,which presents the process of building the high-risk outpatient clinic for complex congenital heart diseases(AAR)at the Instituto do Coração(InCor).Results:Report of the path taken to structure the AAR,demonstrating the organization,interface with the multidisciplinary team,admission and discharge criteria,training,and patient proﬁ*** theseﬁve years of care,275 patients were treated,59.65%with biventricular interstage physiology,followed by univentricular interstage physiology(34.55%),residual defects after surgical procedures(3.63%),tumors with risk of mechanical obstruction(1.45%)and patients with an intrauterine approach(0.72%).The signiﬁcant number of critical patients who were successfully discharged from hospital(44.72%),the low mortality rate due to sudden deaths at home and the high adherence to follow-up cor-roborate the impact of this specialized ***:Despite the limitations of the study,this experi-ence report showed that with few resources,there is the possibility of organizing an AAR with differentiated care,with the objective of early detection and treatment of residual injuries,identiﬁcation of early interventions,edu-cation of parents for follow-up of their children,resulting in individualized treatment,promoting a better quality of life for this population.

关键词： Congenital heart defects ambulatory care heart defects

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Prevalence,phenotype and medication for the pediatric inflammatory bowel disease population of a state in Southeastern Brazil

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World Journal of Clinical Pediatrics 2022年第4期11卷 341-350页

作者： Adalberta Lima Martins Renata de SáBrito Fróes maria da penha Zago-Gomes Pharmaceutical Assistance Health Department of Espírito SantoVitoria 29052-210Espírito SantoBrazil Department of Gastroenterology GastromedRio de Janeiro 22640-100Rio de JaneiroBrazil Departament of Medical Clinical Hospital Universitário Cassiano Antonio MoraesVitoria 29042-755Espírito SantoBrazil

BACKGROUND Inflammatory bowel disease(IBD)can lead to social and economic impacts *** Brazil,where its adult prevalence is increasing,the epidemiology of the pediatric population is not well known,although there is a documented increase in pediatric IBD incidence *** has continental dimensions,and Espírito Santo is a state of southeastern Brazil,the region with the highest demographic densities and is the economically most important in the *** To assess the prevalence,incidence,phenotype and medications in a Southeastern Brazilian pediatric *** Data were retrieved from the Public Medication-Dispensing System of the Department of Health in Espírito Santo state from documentation required to have access to highly expensive medication from August 1,2012 to July 31,*** were 1048 registered patients with IBD of all ages,and of these patients,the cases≤17 years were *** data were obtained through the analysis of administrative requests for these medications and included medical reports,endoscopy exams,histopathology and imaging tests,which followed the Clinical Protocols and Therapeutic Guidelines of the Brazilian *** confirmed cases of IBD were included in the *** There were 55 pediatric patients/1048 registered patients(5.34%),with Crohn's disease(CD)representing 30/55(55%),ulcerative colitis(UC)24/55(43.6%)and 1 unclassified IBD,a significant difference from adult patients(P=0.004).The prevalence of IBD in pediatric patients was 5.02 cases/100.000 inhabitants;the incidence in 2014 was 1.36 cases/100.000 *** mean age at diagnosis was 12.2 years(±4.2).There were 7 children diagnosed up to 6 years old,7 between 7 to 10 years old and 41 between 11 and≤17 years *** was no difference in the distribution of UC and CD between these age categories(P=0.743).There was no difference in gender distribution in relation to *** and adolescents with UC had a predominance of

关键词： Inflammatory bowel disease Pediatric Prevalence Phenotype Brazil

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Prediction of Pulmonary Arterial Pressure Level after Repair of Congenital Cardiac Communications and Discharge from the Hospital: Role of Down Syndrome and Early Postoperative Hemodynamics

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Congenital Heart Disease 2022年第3期17卷 351-363页

作者： Eloisa Sassa Carvalho maria Francilene SSouza Kelly Cristina O.Abud Claudia R.P.Castro Juliano G.penha Ana maria Thomaz Vanessa A.Guimaraes Antonio Augusto Lopes Heart Institute(InCor) University of Sao Paulo School of MedicineSão PauloBrazil

Background:Postoperative pulmonary hypertension limits the success of surgical treatment in some patients with unrestrictive congenital cardiac *** patients at risk of developing postoperative pulmonary hypertension is important to individualize follow-up ***:We analyzed a prospective cohort of 52 pediatric patients(age 3 to 35 months)looking for perioperative predictors of mildly elevated pulmonary arterial pressure 6 months after surgery,defined as a systolic pressure greater than 30 mmHg by transthoracic *** corresponds to a mean pulmonary arterial pressure of>20 ***,echocardiographic and hemodynamic parameters were *** hemodynamics was assessed by directly measuring pulmonary and systemic arterial pressures using indwelling *** postoperative pulmonary hemodynamics was defined as the mean pulmonary/systemic mean arterial pressure ratio(PAP/SAP)obtained per patient during the first 6 h of postoperative ***:Among the factors that were investigated as possible predictors,perioperative hemodynamics and the presence of Down syndrome were initially selected using univariate analysis(p0.35 was 76%sensitive and 74%specific at predicting a systolic pulmonary arterial pressure of>30 mmHg 6 months after surgery(hazard ratio with 95%CI 8.972[2.428–33.158],p=0.002).Conclusion:The hypertensive early postoperative behavior of the pulmonary circulation was strongly but not exclusively associated with Down syndrome,and it was char

关键词： Pulmonary hypertension congenital heart disease Down syndrome pediatric cardiac surgery

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Frontal assessment battery: A tool for screening minimal hepatic encephalopathy?

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World Journal of Hepatology 2016年第30期8卷 1262-1268页

作者： Karina Zamprogno de Souza maria penha Zago-Gomes the Center of Health Science Federal University of Espírito Santo

AIM To apply the Frontal Assessment Battery to cirrhotic patients with or without overt hepatic encephalopathy(OHE) and controls. METHODS The frontal assessment battery(FAB) was applied to 87 patients with liver cirrhosis(16 with and 71 without OHE) and 40 control subjects without cirrhosis treated at the alcohol and liver outpatient clinics and the gastroenterology ward of the Cassiano Ant?nio de Moraes University Hospital(Hospital Universitário Cassiano Ant?nio de Moraes- HUCAM), Espírito Santo, *** The average FAB score was lower for the cirrhotic than for the non-cirrhotic patients(10.6 ± 3.67 vs 12.25 ± 2.72, P = 0.015). The FAB score was lower for the cirrhotic patients with OHE than for the patients without OHE(8.25 ± 4.55 vs 11.14 ± 3.25, P = 0.027). The total FAB score was lower for the cirrhotic patients without OHE than for the non-cirrhotic patients, although this difference was not significant(11.14 ± 3.25 vs 12.25 ± 2.72, P = 0.067). Nevertheless, the difference in the scores on the subtest that assessed the ability to inhibit a response previously conditioned to a stimulus was significant(1.72 ± 0.93 vs 2.2 ± 0.85, P = 0.011).CONCLUSION The present study indicates that the FAB is a promising tool for outpatient minimal HE screening and the assessment of HE severity.

关键词：行政功能正面的脑叶肝的 encephalopathy 最小的肝的 encephalopathy 肝肝硬化正面的评价电池

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Molecular evaluation of glutathione S transferase family genes in patients with sporadic colorectal cancer

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World Journal of Gastroenterology 2018年第39期24卷 4462-4471页

作者： Gabriela Helena Rodrigues-Fleming glaucia maria de Mendonca Fernandes Anelise Russo Patrícia Matos Biselli-Chicote Joao Gomes Netinho Erika Cristina Pavarino Eny maria Goloni-Bertollo Genetics and Molecular Biology Research Unit-UPGEM Sao Jose do Rio Preto Medical SchoolFAMERPSao Jose do Rio PretoSP 15090-000Brazil Department of Surgery and Coloproctology Sao Joes do Rio Preto Medical SchoolFAMERPSao Joes do Rio PretoSP 15090-000Brazil

AIM To evaluate the association between polymorphismsin glutathione S transferases(GSTs) and the risk of sporadic colorectal cancer(SCRC), tumor progression and the survival of *** A case-control study of 970 individuals from the Brazilian population was conducted(232 individuals from the case group with colorectal cancer and 738 individuals from the control group without a history of cancer). PCR multiplex and PCR-RFLP techniques were used to genotype the GST polymorphisms. The tumors were categorized according to the TNM classification: tumor extension(T), affected lymph nodes(N), and presence of metastasis(M). Logistic regression, multiple logistic regression and survival analysis were used to analyze the data. The results are presented in terms of odds ratio(OR) and 95% confidence interval(CI). The level of significance was set at 5%(P ≤ 0.05).RESULTS Age equal to or over 62 years(OR = 8.79; 95%CI: 5.90-13.09, P < 0.01) and female gender(OR = 2.91; 95%CI: 1.74-4.37; P < 0.01) were associated with increased risk of SCRC. Analysis of the polymorphisms revealed an association between the GSTM1 polymorphisms and a risk of SCRC(OR = 1.45; 95%CI: 1.06-2.00; P = 0.02), as well as between GSTT1 and a reduced risk of the disease(OR = 0.65; 95%CI: 0.43-0.98; P = 0.04). An interaction between the presence of the wild-type allele of GSTP1 Ile105 Val polymorphism and tobacco consumption on risk of SCRC(OR = 2.33; 95%CI: 1.34-4.05; P = 0.05) was observed. There was an association between the GSTM1 null genotype and the presence of advanced tumors(OR = 2.33; 95%CI: 1.23-4.41; P = 0.009), as well as increased risk of SCRC in the presence of a combination of GSTT1 non-null/GSTM1 null genotypes(OR = 1.50; 95%CI: 1.03-2.19; P = 0.03) and GSTT1 non-null/GSTM1 null/GSTP1 Val~*(OR = 1.85; 95%CI: 1.01-3.36, P = 0.04). Combined GSTT1 non-null/GSTM1 null genotypes(OR = 2.40; 95%CI: 1.19-4.85; P = 0.01) and GSTT1 non-null/GSTM1 null/GSTP1 Val~*(OR = 2.92; 95%CI: 1.05-8.12; P

关键词： Colorectal neoplasms Smoking Alcohol Glutathione S transferase Genetic polymorphisms

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Infestation of Diatraea saccharalis(Fabr.)during Five Consecutive Cycles of Sugarcane Crop Succeeding Leguminous Crops

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Agricultural Sciences 2015年第1期6卷 14-21页

作者： Edmilson Jose Ambrosano Andre Luiz Lourencao Elaine Bahia Wutke Fabricio Rossi Fabio Luis Ferreira Dias Silvio tavares glaucia maria Bovi Ambrosano Department of Regional Center South Pole APTA/Agronomic Institute of Campinas/IACPiracicabaBrazil Department of Plant Diseases APTA/Agronomic Institute of Campinas/IACCampinasBrazil Department of Grains and Fibers APTA/Agronomic Institute of Campinas/IACCampinasBrazil Department of Biosystem Engineering University of Sao Paulo/FZEAPirassunungaBrazil Department of Social Dentistry University of Campinas/FOPPiracicabaBrazil

The area cultivated with sugarcane in Brazil is expanding, and increasingly using legumes cover crop in new deployed areas and in those which were reformed. Long-term trials were carried out in Piracicaba, Sao Paulo, Brazil, to evaluate the effect of leguminous green manure on the natural infestation of Diatraea saccharalis (Fabr.) during five cropping cycles of sugarcane “IAC 87-3396”. This study was carried out from October 1999 to October 2005 in Piracicaba, Sao Paulo, Brazil, at coordinates 22°42''S and 47°38''W, 560 m above sea level, in soil classified as Typic Paleudult. Green manure crops were assigned to five treatments: peanuts (Arachis hypogaea L.) (cultivar “IAC-Tatu” and “IAC-Caiapó”), sunn hemp (Crotalaria juncea L.) (cultivar “IAC 1”) and velvet-bean [Mucuna aterrima (Piper & Tracy) Holland] (cultivar “common”). A treatment without any green manure or weed was used as the control. The previous sugarcane crop was destroyed and the soil was prepared in a conventional way (using plow and harrow) before the leguminous crops were sowed. Thirty days after the sowing, weeds were removed and, 120 days later, the crops were cut and its biomass was deposited on the soil surface without incorporation. Experimental plots comprised five rows of sugarcane, each one measuring 10 m long and spaced 1.40 m apart. The sugarcane was harvested 18 months after biomass deposit, on October 25th, 2001 and its stalks were collected at intervals of approximately 12 months in: 07/09/2002, 08/01/2003, 11/07/2004 and 10/06/2005. At harvest, the masses were determined from a sample of sugarcane, cut from three rows (2 m long) in the center of the plot. The losses caused by the sugarcane borer were estimated by the intensity of the infestation by randomly observing and collecting sugarcane stems from each plot. A great reduction in the number of stalks and in the yield was noted proportionally to the intensity of the infestation of the borer in the sugarcane crop grown after the vel

关键词： Arachis hypogaea L. Crotalaria juncea L. Mucuna aterrima(Piper&Tracy)Holland Saccharum spp. Sugarcane Borer

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CYP1A1,CYP2E1 and EPHX1 polymorphisms in sporadic colorectal neoplasms

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World Journal of Gastroenterology 2016年第45期22卷 9974-9983页

作者： glaucia maria M Fernandes Anelise Russo Marcela Alcantara Proenca Nathalia Fernanda Gazola Gabriela Helena Rodrigues Patrícia Matos Biselli-Chicote Ana Elizabete Silva Joao Gomes Netinho érika Cristina Pavarino Eny maria Goloni-Bertollo Genetics and Molecular Biology Research Unit-UPGEM Department of Molecular Biology Sao José do Rio Preto Medical School FAMERP Departament of Biology UNESP-Sao Paulo State University Departament of Surgery and Coloproctology Service Sao José do Rio Preto Medical School FAMERP

AIM To investigate the contribution of polymorphisms in the CYP1A1, CYP2E1 and EPHX1 genes on sporadic colorectal cancer(SCRC) risk. METHODS Six hundred forty-one individuals(227 patients with SCRC and 400 controls) were enrolled in the study. The variables analyzed were age, gender, tobacco and alcohol consumption, and clinical and histopathological tumor parameters. The CYP1A1 *2A, CYP1A1 *2C CYP2E1 *5B and CYP2E1 *6 polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). The EPHX1 Tyr113 His, EPHX1 His139 Arg and CYP1A1 *2C polymorphisms were detected by real-time PCR. Chisquared test and binary logistic regression were used in the statistical analysis. Haplotype analysis was conducted using the Haploview program, version *** Age over 6 2 years was a risk factor for SCRC development(OR = 7.54, 95%CI: 4.94-11.50, P < 0.01). Male individuals were less susceptible to SCRC(OR = 0.55, 95%CI: 0.35-0.85, P < 0.01). The CYP2E1*5B polymorphism was associated with SCRC in the codominant(heterozygous genotype: OR = 2.66, 95%CI: 1.64-4.32, P < 0.01), dominant(OR = 2.82, 95%CI: 1.74-4.55, P < 0.01), overdominant(OR = 2.58, 95%CI: 1.59-4.19, P < 0.01), and log-additive models(OR = 2.84, 95%CI: 1.78-4.52, P < 0.01). The CYP2E1*6 polymorphism was associated with an increased SCRC risk in codominant(heterozygous genotype: OR = 2.81, 95%CI: 1.84-4.28, P < 0.01; homozygous polymorphic : OR = 7. 3 2, 9 5 % C I : 1.85-28.96, P < 0.01), dominant(OR = 2.97, 95%CI: 1.97-4.50, P < 0.01), recessive(OR = 5.26, 95%CI: 1.35-20.50, P = 0.016), overdominant(OR = 2.64, 95%CI: 1.74-4.01, P < 0.01), and log-additive models(OR = 2.78, 95%CI: 1.91-4.06, P < 0.01). The haplotype formed by the minor alleles of the CYP2E1*5B(C) and CYP2E1*6(A) polymorphisms was associated with SCRC(P = 0.002). However, the CYP1A1 *2A, CYP1A1 *2C, EPHX1 Tyr113 His and EPHX1 His139 Arg polymorphisms were not associated with *** In conclusion, the

关键词： Single-nucleotide polymorphisms Colorectal neoplasms Cytochrome P-450 CYP2E1 Cytochrome P-450 CYP1A1 Epoxide hydrolases 1

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Antibiofilm and immunomodulatory resorbable nanofibrous filing for dental pulp regenerative procedures

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Bioactive Materials 2022年第10期7卷 173-186页

作者： Mauricio Gonçalves da Costa Sousa Gabriela Conceiçao de Almeida Danilo Cesar Martins Mota Rosiane Andrade da Costa Simoni Campos Dias Samuel Nunes Limberger Frank Ko Li Ting Lin Evan FHaney Hashem Etayash Beverlie Baquir Michael J.Trimble Ya Shen Zheng Su Markus Haapasalo Daniel Pletzer Letícia Chaves de Souza glaucia Schuindt Teixeira Renato M.Silva Robert E.W.Hancock Octavio Luiz Franco Taia maria Berto Rezende Post-Graduation Program in Genomic Sciences and Biotechnology Catholic University of BrasíliaBrasíliaBrazil Dentistry Course Catholic University of BrasíliaBrasíliaBrazil Post-Graduation Program in Health Sciences University of BrasíliaBrazil LIMA Chemistry InstituteUniversity of Brasília-UNBBrasíliaBrazil Animal Biology Department Campus Darcy RibeiroUniversidade de BrasíliaBrazil Department of Materials Engineering Faculty of Applied ScienceUniversity of British ColumbiaVancouverCanada Department of Microbiology and Immunology University of British ColumbiaVancouverBCCanada Department of Oral Biological and Medical Sciences Faculty of DentistryUniversity of British ColumbiaVancouverCanada Department of Microbiology and Immunology University of OtagoDunedinNew Zealand Department of Endodontics School of DentistryUniversity of Texas Health Science Center at HoustonHoustonUSA Department of Prosthesis Faculty of DentistryRio de Janeiro State UniversityRio de JaneiroBrazil Post-Graduation Program in Biotechnology Catholic University Dom BoscoCampo GrandeMato Grosso do SulBrazil

Multifunctional scaffolds with host defense peptides designed for regenerative endodontics are desirable nanobiotechnological tools for ***,different scaffolds were tested for use during the pulp revascularization process,including poly(vinyl alcohol)-PVA hydrogels or resins,collagen hydrogels and poly(vinyl alcohol)PVA/Chitosan(PVA/CS)*** on time to degradation(21 days),nanofibers were chosen to be incorporated with ciprofloxacin and IDR-1002(each at 50 mg/g).Nanofibers containing ciprofloxacin and IDR-1002 had anti-biofilm activity against Enterococcus faecalis,Staphylococcus aureus and a multispecies oral biofilm,besides anti-inflammatory *** in vivo subcutaneous tissue response to tooth fragments filled with nanofibers demonstrated a pulp-like tissue formation,when compared to empty teeth ***,we designed a strong antimicrobial,immunomodulatory and regenerative candidate for pulp revascularization and regeneration procedures.

关键词： Regenerative endodontics Scaffolds Nanofibers Host defense peptides Ciprofloxacin IDR-1002

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Importance-performance analysis: Revisiting a tool for the evaluation of clinical services

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Health 2014年第5期6卷 285-291页

作者： Juliana Rocha Goncalves Andres Pinto Marilia Jesus Batista Antonio Carlos Pereira glaucia maria Bovi Ambrosano Department of Community Oral Health Piracicaba Dental SchoolUniversity of Campinas—UNICAMP PiracicabaBrazil Department of Oral and Maxillofacial Medicine and Diagnostic Sciences University Hospitals Case Medical Center and School of Dental MedicineCase Western Reserve UniversityClevelandUSA

The importance-performance analysis method (IPA) is used in market research in order to measure the level of customer satisfaction. The aim of this study was to evaluate and highlight the use of IPA as a management tool to measure quality of dental services. We suggest that this method can be easily implemented in a dental educational setting, as a performance outcome measure that includes patient input. The study was conducted in a dental service through a valid questionnaire, SERVQUAL. This instrument explores levels of service quality perceived by patients. It was conducted in four companies in Brazil in 2011 (derived from different industry segments;two from textiles, one from hospital care and the other from the manufacturing industry) in two States (S?o Paulo and Minas Gerais). These companies were covered by the same dental managed care organization which contracted with independent dentists to provide care. The study was divided into two stages: the first, in which beneficiaries answered the questionnaire prior to receiving dental treatment, and the second when the same beneficiaries answered after completing their dental treatment. Data obtained from SERVQUAL generated graphs that were used to characterize the IPA matrix using several dimensions of care. The Assurance Dimension had the highest average in both expectation and perception. The Reliability dimension showed the value of the most negative GAP among the dimensions, and the best value occurred in the Responsiveness dimension. The IPA tool may be effective in Dental Medicine since it highlights the key points to be improved in the delivery of dental services in a clinical setting.

关键词： Quality of Health Care Quality Indicators Health Care Dental Health Education Health Services Evaluation

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Hair Growth Promoting Effect of Trichoxidil<up>TM</up>: A New Natural Compound for Hair Loss

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Journal of Cosmetics, Dermatological Sciences and Applications 2020年第4期10卷 176-190页

作者： glaucia Labinas Fernando Amaral Valeria maria de Souza Antunes Maira Jardim Leonardo Mendes Bella Carlos Rocha Oliveira Universidade Anhembi Morumbi S&#227 o Paulo Brazil

Background: Androgenetic alopecia (AGA) is a most common condition of hair loss. Thus, the present study aimed to investigate the effect of TrichoxidilTM, a phytocomplex obtained from a blend of essential oils, in the treatment of hair loss caused by AGA. Methods: The CCD1072Sk cells were cultured for the 24-hour cell viability assessment and cytotoxicity of TrichoxidilTM. The expression of mRNA levels from KGF, IGF-1, and VEGF in fibroblasts was evaluated by RT-qPCR. Thirty-three volunteers, diagnosed with AGA, men and women, aged between 25 and 50 years, were divided into Control group, without treatment (n = 5);TrichosolTM vehicle group, without active (n = 5);Hydroalcoholic vehicle group, without active (n = 4);TrichosolTM vehicle group, with 2.5% minoxidil (n = 5);Hydroalcoholic vehicle group, with 2.5% minoxidil (n = 5);TrichosolTM group with 2.5% TrichoxidilTM (n = 5) and Hydroalcoholic vehicle group with 2.5% TrichoxidilTM (n = 4) to dermoscopic and histologic. Results: Fibroblasts exhibited higher proliferation when treated with higher concentrations of TrichoxidilTM. TrichoxidilTM significantly increased the expression of KGF, IGF-1, and VEGF mRNA in fibroblasts cells. Analysis of the capillary density showed that TrichoxidilTM associated with TrichosolTM vehicle, was the most effective association. In addition, it was observed an increased more effectively the percentage of anagen phase and reduction of the telogen when compared to other formulations. Conclusion: TrichoxidilTM promoted proliferative effects and positively modulated the expression of growth factors IGF-1, VEGF, and KGF, being a promising candidate for the treatment of hair loss caused by AGA.

关键词： TrichoxidilTM Hair Growth Anagen Telogen KGF IGF-1

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