Effect of Slower vs Faster Intravenous Fluid Bolus Rates on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial.

Importance: Slower intravenous fluid infusion rates could reduce the formation of tissue edema and organ dysfunction in critically ill patients; however, there are no data to support different infusion rates during fluid challenges for important outcomes such as mortality.

Objective: To determine the effect of a slower infusion rate vs control infusion rate on 90-day survival in patients in the intensive care unit (ICU).

Design, Setting, And Participants: Unblinded randomized factorial clinical trial in 75 ICUs in Brazil, involving 11 052 patients requiring at least 1 fluid challenge and with 1 risk factor for worse outcomes were randomized from May 29, 2017, to March 2, 2020.

Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission.

Aims: To evaluate a telemonitoring strategy based on automated text messaging and telephone support after heart failure (HF) hospitalization.

Methods And Results: The MESSAGE-HF study is a prospective multicentre, randomized, nationwide trial enrolling patients from 30 clinics in all regions of Brazil. HF patients with reduced left ventricular ejection fraction (<40%) and access to mobile phones are eligible after an acute decompensated HF hospitalization.

Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial.

Importance: Intravenous fluids are used for almost all intensive care unit (ICU) patients. Clinical and laboratory studies have questioned whether specific fluid types result in improved outcomes, including mortality and acute kidney injury.

Objective: To determine the effect of a balanced solution vs saline solution (0.

Association mapping of a locus that confers southern stem canker resistance in soybean and SNP marker development.

Background: Southern stem canker (SSC), caused by Diaporthe aspalathi (E. Jansen, Castl. & Crous), is an important soybean disease that has been responsible for severe losses in the past.

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial.

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD.

Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group).

Effect of a Multifaceted Quality Improvement Intervention on the Prescription of Evidence-Based Treatment in Patients at High Cardiovascular Risk in Brazil: The BRIDGE Cardiovascular Prevention Cluster Randomized Clinical Trial.

Importance: Studies have found that patients at high cardiovascular risk often fail to receive evidence-based therapies in community practice.

Objective: To evaluate whether a multifaceted quality improvement intervention can improve the prescription of evidence-based therapies.

Design, Setting, And Participants: In this 2-arm cluster randomized clinical trial, patients with established atherothrombotic disease from 40 public and private outpatient clinics (clusters) in Brazil were studied.

Rationale and design for a cluster randomized quality-improvement trial to increase the uptake of evidence-based therapies for patients at high cardiovascular risk: The BRIDGE-Cardiovascular Prevention trial.

Background: Translating evidence into clinical practice in the management of high cardiovascular risk patients is challenging. Few quality improvement interventions have rigorously evaluated their impact on both patient care and clinical outcomes.

Objectives: The main objectives are to evaluate the impact of a multifaceted educational intervention on adherence to local guidelines for the prescription of statins, antiplatelets and angiotensin converting enzyme inhibitors or angiotensin II receptor blockers for high cardiovascular risk patients, as well as on the incidence of major cardiovascular events.

Atorvastatin for high-risk statin-naïve patients undergoing noncardiac surgery: The Lowering the Risk of Operative Complications Using Atorvastatin Loading Dose (LOAD) randomized trial.

Unlabelled: Preliminary evidence suggests that statins may prevent major perioperative vascular complications.

Methods: We randomized 648 statin-naïve patients who were scheduled for noncardiac surgery and were at risk for a major vascular complication. Patients were randomized to a loading dose of atorvastatin or placebo (80 mg anytime within 18hours before surgery), followed by a maintenance dose of 40 mg (or placebo), started at least 12hours after the surgery, and then 40 mg/d (or placebo) for 7days.

The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial).

This article reports the rationale for the Brazilian Cardioprotective Nutritional Program (BALANCE Program) Trial. This pragmatic, multicenter, nationwide, randomized, concealed, controlled trial was designed to investigate the effects of the BALANCE Program in reducing cardiovascular events. The BALANCE Program consists of a prescribed diet guided by nutritional content recommendations from Brazilian national guidelines using a unique nutritional education strategy, which includes suggestions of affordable foods.

Nutritional, metabolic and cardiovascular correlations of morning cortisol in health care workers in a gastroenterology service.

Background: Workplace stress has been associated with obesity. Diminished body weight has also been anticipated in some contexts.

Objective: In a cohort of healthcare personnel, morning cortisol was compared to nutritional and metabolic variables, aiming to identify the correlates of such marker.

Healthy eating index for pregnancy: adaptation for use in pregnant women in Brazil.

Objective: To evaluate dietary quality in a sample of pregnant women based on one simple and objective parameter.

Methods: Pregnant women (n = 712), between 16 and 36 weeks, attending primary care clinics in Porto Alegre and Bento Gonçalves, Southern Brazil, in 2010 were recruited to take part. The Healthy Eating Index for Brazilian Pregnancy (HEIP-B) was created, derived from the American instrument called Alternate Healthy Eating Index for Pregnancy (AHEI-P).

Dietary patterns during pregnancy and the association with sociodemographic characteristics among women attending general practices in southern Brazil: the ECCAGe Study.

The assessment of the relationship between food intake and sociodemographic factors is crucial for developing effective public health policies. The present study aimed to examine dietary patterns in pregnant women and the association between these patterns and sociodemographic characteristics. Pregnant women attending general practices in southern Brazil (n = 712) answered a questionnaire and a food-frequency questionnaire with 88 items.

Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial.

Objective: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease.

Method: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians.

Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil--ECCAGE study.

Background: Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression.

Socioeconomic, demographic and nutritional factors associated with maternal weight gain in general practices in Southern Brazil.

In order to describe adequacy of weight gain during pregnancy and its association with pre-pregnancy nutritional status and other factors, a cohort study of pregnant women enrolled at 16-36 weeks of gestation and followed up until delivery was carried out in prenatal care in primary care services in Rio Grande do Sul State, Brazil. Maternal weight was recorded at each prenatal care visit. Weight gain was classified as "adequate," "insufficient" or "excessive" (Institute of Medicine).

Violence and depressive symptoms during pregnancy: a primary care study in Brazil.

Aim: To estimate the prevalence of violence, depressive symptoms, and associated factors during pregnancy in women attending antenatal care in Brazil.

Methods: Violence was assessed using a modified version of the abuse assessment screen (ASS), and depressive symptoms were evaluated using the primary care evaluation of mental disorders (PRIME-MD). Participants were pregnant women attending 18 primary care units in Rio Grande do Sul, Brazil, between June 2006 and April 2007.

Inappropriate eating behaviors during pregnancy: prevalence and associated factors among pregnant women attending primary care in southern Brazil.

Objective: To examine the prevalence of inappropriate eating behaviors and associated factors among pregnant women in primary care.

Method: The Eating Disorder Examination Questionnaire was used to assess eating disorders and the Primary Care Evaluation of Mental Disorders was used to examine anxiety and depressive symptoms. Body mass index (BMI) and pregestational weight were also assessed.

Dietary fibre intake of pregnant women attending general practices in southern Brazil--the ECCAGE Study.

Background: Increase in fibre intake during pregnancy may reduce weight gain, glucose intolerance, dyslipidaemia, pre-eclampsia and constipation. Few studies have evaluated adequacy of fibre intake during pregnancy.

Objective: To assess, through an FFQ, the dietary fibre intake of pregnant women receiving prenatal care from general public practices and compare it with current guidelines.