Pesquisa | SciELO

Abstract Objective COVID-19 is associated with an elevated risk of thromboembolism and excess mortality. Difficulties with best anticoagulation practices and their implementation motivated the current analysis of COVID-19 patients who developed Venous Thromboembolism (VTE). Method This is a post-hoc analysis of a COVID-19 cohort, described in an economic study already published. The authors analyzed a subset of patients with confirmed VTE. We described the characteristics of the cohort, such as demographics, clinical status, and laboratory results. We tested differences amid two subgroups of patients, those with VTE or not, with the competitive risk Fine and Gray model. Results Out of 3186 adult patients with COVID-19, 245 (7.7%) were diagnosed with VTE, 174 (5.4%) of them during admission to the hospital. Four (2.3% of these 174) did not receive prophylactic anticoagulation and 19 (11%) discontinued anticoagulation for at least 3 days, resulting in 170 analyzed. During the first week of hospitalization, the laboratory most altered results were C-reactive protein and D-dimer. Patients with VTE were more critical, had a higher mortality rate, worse SOFA score, and, on average, 50% longer hospital stay. Conclusion Proven VTE incidence in this severe COVID-19 cohort was 7.7%, despite 87% of them complying completely with VTE prophylaxis. The clinician must be aware of the diagnosis of VTE in COVID-19, even in patients receiving proper prophylaxis.

https://doi.org/10.1016/j.clinsp.2023.100178

Safety and immunogenicity of influenza A(H3N2) component vaccine in juvenile systemic lupus erythematosus
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Aikawa, Nadia Emi

; Borba, Eduardo Ferreira

; Balbi, Verena Andrade

; Sallum, Adriana Maluf Elias

; Buscatti, Izabel Mantovani

; Campos, Lucia Maria Arruda

; Kozu, Kátia Tomie

; Garcia, Cristiana Couto

; Capão, Artur Silva Vidal

; Proença, Adriana Coracini Tonacio de

; Leon, Elaine Pires

; Duarte, Alberto José da Silva

; Lopes, Marta Heloisa

; Silva, Clovis Artur

; Bonfá, Eloisa

Advances in Rheumatology

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2023, Volume 63 elocation 55

Resumo: En | Texto: En | PDF: En

Abstract Introduction Seasonal influenza A (H3N2) virus is an important cause of morbidity and mortality in the last 50 years in population that is greater than the impact of H1N1. Data assessing immunogenicity and safety of this virus component in juvenile systemic lupus erythematosus (JSLE) is lacking in the literature. Objective To evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in JSLE. Methods 24 consecutive JSLE patients and 29 healthy controls (HC) were vaccinated with influenza A/Singapore/ INFIMH-16-0019/2016(H3N2)-like virus. Influenza A (H3N2) seroprotection (SP), seroconversion (SC), geometric mean titers (GMT), factor increase in GMT (FI-GMT) titers were assessed before and 4 weeks post-vaccination. Disease activity, therapies and adverse events (AE) were also evaluated. Results JSLE patients and controls were comparable in current age [14.5 (10.1–18.3) vs. 14 (9–18.4) years, p = 0.448] and female sex [21 (87.5%) vs. 19 (65.5%), p = 0.108]. Before vaccination, JSLE and HC had comparable SP rates [22 (91.7%) vs. 25 (86.2%), p = 0.678] and GMT titers [102.3 (95% CI 75.0–139.4) vs. 109.6 (95% CI 68.2–176.2), p = 0.231]. At D30, JSLE and HC had similar immune response, since no differences were observed in SP [24 (100%) vs. 28 (96.6%), p = 1.000)], SC [4 (16.7%) vs. 9 (31.0%), p = 0.338), GMT [162.3 (132.9–198.3) vs. 208.1 (150.5–287.8), p = 0.143] and factor increase in GMT [1.6 (1.2–2.1) vs. 1.9 (1.4–2.5), p = 0.574]. SLEDAI-2K scores [2 (0–17) vs. 2 (0–17), p = 0.765] and therapies remained stable throughout the study. Further analysis of possible factors influencing vaccine immune response among JSLE patients demonstrated similar GMT between patients with SLEDAI < 4 compared to SLEDAI ≥ 4 ( p = 0.713), as well as between patients with and without current use of prednisone ( p = 0.420), azathioprine ( p = 1.0), mycophenolate mofetil ( p = 0.185), and methotrexate ( p = 0.095). No serious AE were reported in both groups and most of them were asymptomatic (58.3% vs. 44.8%, p = 0.958). Local and systemic AE were alike in both groups ( p > 0.05). Conclusion This is the first study that identified adequate immune protection against H3N2-influenza strain with additional vaccine-induced increment of immune response and an adequate safety profile in JSLE. ( www.clinicaltrials.gov , NCT03540823).

https://doi.org/10.1186/s42358-023-00339-7

Patient with agammaglobulinemia produces anti-SARS-CoV-2 reactive T-cells after CoronaVac vaccine
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Oshiro, Telma Miyuki

; Silva, Lais Teodoro da

; Ortega, Marina Mazzilli

; Perazzio, Sandro Felix

; Duarte, Alberto Jose da Silva

; Carneiro-Sampaio, Magda

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2022, Volume 77 elocation 100007

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.clinsp.2022.100007

Cost-Effective Trap qPCR Approach to Evaluate Telomerase Activity: an Important Tool for Aging, Cancer, and Chronic Disease Research
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Pinto, Thalyta Nery Carvalho

; Fernandes, Juliana Ruiz

; Arruda, Liã Barbara

; Duarte, Alberto José da Silva

; Benard, Gil

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2021, Volume 76 elocation e2432

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Telomeres are a terminal “DNA cap” that prevent chromosomal fusion and degradation. However, aging is inherent to life, and so is the loss of terminal sequences. Telomerase is a specialized reverse transcriptase encoded by self-splicing introns that counteract chromosome erosion. Telomerase activity is observed during early embryonic development, but after the blastocyst stage, the expression of telomerase reduces. The consequences of either insufficient or unrestrained telomerase activity underscore the importance of ongoing studies aimed at elucidating the regulation of telomerase activity in humans. In the present study, we aimed to standardize a simplified telomerase repeat-amplification protocol (TRAP) assay to detect telomerase activity in unstimulated and PHA-stimulated mononuclear cells. METHODS and RESULTS: Our optimized qPCR-based can efficiently evaluate telomerase activity. Quantification of protein and DNA between unstimulated and PHA-stimulated peripheral blood mononuclear cells revealed cellular activation and cell-cycle entry. The assay also showed that relative telomerase activity is significantly different between these two conditions, supporting the applicability of the assay. Furthermore, our findings corroborated that telomerase activity decreases with age. CONCLUSIONS: Telomeres and telomerase are implicated in aging and development of chronic diseases and cancer; however, difficulty in accessing commercial kits to investigate these aspects is a critical constraint in health surveillance studies. Our optimized assay was successfully used to differentiate telomerase activity between unstimulated and stimulated cells, clearly showing the reactivation of telomerase upon cell activation. This assay is affordable, reproducible, and can be executed in resource-limited settings.

https://doi.org/10.6061/clinics/2021/e2432 639 downloads

Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
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Gonçalves, Fabio Augusto Rodrigues

; Besen, Bruno Adler Maccagnan Pinheiro

; Lima, Clarice Antunes de

; Corá, Aline Pivetta

; Pereira, Antônio José Rodrigues

; Perazzio, Sandro Félix

; Gouvea, Christiane Pereira

; Fonseca, Luiz Augusto Marcondes

; Trindade, Evelinda Marramon

; Sumita, Nairo Massakazu

; Duarte, Alberto José da Silva

; Lichtenstein, Arnaldo

; Bonfa, Eloisa

; Utiyama, Edivaldo M.

; Segurado, Aluisio C.

; Perondi, Beatriz

; Miethke-Morais, Anna

; Montal, Amanda C.

; Harima, Leila

; Fusco, Solange R. G.

; Silva, Marjorie F.

; Rocha, Marcelo C.

; Marcilio, Izabel

; Rios, Izabel Cristina

; Kawano, Fabiane Yumi Ogihara

; Jesus, Maria Amélia de

; Kallas, Ésper George

; Carmo, Carolina

; Tanaka, Clarice

; Souza, Heraldo Possolo de

; Marchini, Julio F. M.

; Carvalho, Carlos

; Ferreira, Juliana C.

; Levin, Anna Sara Shafferman

; Oliveira, Maura Salaroli

; Guimarães, Thaís

; Lázari, Carolina dos Santos

; Sabino, Ester

; Magri, Marcello M. C.

; Barros-Filho, Tarcisio E. P.

; Francisco, Maria Cristina Peres Braido

; Costa, Silvia F.

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2021, Volume 76 elocation e3547

Resumo: En | Texto: En | PDF: En

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

https://doi.org/10.6061/clinics/2021/e3547

Efficacy of vitamin D supplementation among persons living with HIV/AIDS in São Paulo city, Brazil
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Almeida-Afonso, Rosa

; Finamor, Danilo

; Fonseca, Luiz Augusto M.

; Veiga, Ana P. Rocha

; Monteiro, Mariana A.

; Magri, Marcello

; Duarte, Alberto JS

; Casseb, Jorge

Brazilian Journal of Infectious Diseases

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2021, Volume 25 Nº 3 elocation 101598

Resumo: En | Texto: En | PDF: En

ABSTRACT Hypovitaminosis D is now considered a pandemic, especially among more vulnerable populations and in HIV-infected subjects, with 80% presenting levels below 30 ng/mL. As there is no consensus on the more adequate dosage needed to correct such deficiency, the objective of this study was to evaluate 25 (OH) vitamin D supplementation in HIV-1 patients deficient of vitamin D. A total of 73 HIV-1-infected patients were included, drawn from a cohort of 435 patients; 37 patients were randomized to the active group, supplemented once a week with 50,000 UI vitamin D by mouth (group 1) and 36 to the placebo group (group 2). The study period ranged from June 2016 to September 2017. Variables involved in vitamin D metabolism and risk factors associated with hypovitaminosis were evaluated. The mean age was 45 years and 31.5 % were women. Vitamin D supplementation was effective in normalizing serum levels after six months in group 1 (mean 35 ng/mL compared to 21 ng/mL for the placebo group; p= 0.04). No patient reached blood levels considered toxic (>100 UI). Efavirenz use can negatively influence vitamin D levels and supplementation is necessary as a likely adjunct to improving CD4+ T cells, resulting in greater effectiveness of the treatment. A weekly oral dose of 50,000 IU of vitamin D was sufficient to normalize the vitamin deficiency, safely and with good adherence among persons living with HIV/AIDS in Brazil.

https://doi.org/10.1016/j.bjid.2021.101598 39 downloads

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa

; Pereira, Maria Fernanda Badue

; Santos, Angélica Carreira dos

; Fink, Thais Toledo

; Paula, Camila Sanson Yoshino de

; Litvinov, Nadia

; Schvartsman, Claudio

; Delgado, Artur Figueiredo

; Gibelli, Maria Augusta Bento Cicaroni

; Carvalho, Werther Brunow de

; Odone Filho, Vicente

; Tannuri, Uenis

; Carneiro-Sampaio, Magda

; Grisi, Sandra

; Duarte, Alberto José da Silva

; Antonangelo, Leila

; Francisco, Rossana Pucineli Vieira

; Okay, Thelma Suely

; Batisttella, Linamara Rizzo

; Carvalho, Carlos Roberto Ribeiro de

; Brentani, Alexandra Valéria Maria

; Silva, Clovis Artur

; Eisencraft, Adriana Pasmanik

; Rossi Junior, Alfio

; Fante, Alice Lima

; Cora, Aline Pivetta

; Reis, Amelia Gorete A. de Costa

; Ferrer, Ana Paula Scoleze

; Andrade, Anarella Penha Meirelles de

; Watanabe, Andreia

; Gonçalves, Angelina Maria Freire

; Waetge, Aurora Rosaria Pagliara

; Silva, Camila Altenfelder

; Ceneviva, Carina

; Lazari, Carolina dos Santos

; Abellan, Deipara Monteiro

; Santos, Emilly Henrique dos

; Sabino, Ester Cerdeira

; Bianchini, Fabíola Roberta Marim

; Alcantara, Flávio Ferraz de Paes

; Ramos, Gabriel Frizzo

; Leal, Gabriela Nunes

; Rodriguez, Isadora Souza

; Pinho, João Renato Rebello

; Carneiro, Jorge David Avaizoglou

; Paz, Jose Albino

; Ferreira, Juliana Carvalho

; Ferranti, Juliana Ferreira

; Ferreira, Juliana de Oliveira Achili

; Framil, Juliana Valéria de Souza

; Silva, Katia Regina da

; Kanunfre, Kelly Aparecida

; Bastos, Karina Lucio de Medeiros

; Galleti, Karine Vusberg

; Cristofani, Lilian Maria

; Suzuki, Lisa

; Campos, Lucia Maria Arruda

; Perondi, Maria Beatriz de Moliterno

; Diniz, Maria de Fatima Rodrigues

; Fonseca, Maria Fernanda Mota

; Cordon, Mariana Nutti de Almeida

; Pissolato, Mariana

; Peres, Marina Silva

; Garanito, Marlene Pereira

; Imamura, Marta

; Dorna, Mayra de Barros

; Luglio, Michele

; Rocha, Mussya Cisotto

; Aikawa, Nadia Emi

; Degaspare, Natalia Viu

; Sakita, Neusa Keico

; Udsen, Nicole Lee

; Scudeller, Paula Gobi

; Gaiolla, Paula Vieira de Vincenzi

; Severini, Rafael da Silva Giannasi

; Rodrigues, Regina Maria

; Toma, Ricardo Katsuya

; Paula, Ricardo Iunis Citrangulo de

; Palmeira, Patricia

; Forsait, Silvana

; Farhat, Sylvia Costa Lima

; Sakano, Tânia Miyuki Shimoda

; Koch, Vera Hermina Kalika

; Cobello Junior, Vilson

Clinics

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2021, Volume 76 elocation e3488

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

https://doi.org/10.6061/clinics/2021/e3488

SARS-CoV-2 recombinant proteins stimulate distinct cellular and humoral immune response profiles in samples from COVID-19 convalescent patients
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Silva, Laís Teodoro da

; Ortega, Marina Mazzilli

; Tiyo, Bruna Tiaki

; Viana, Isabelle Freire Tabosa

; Lima, Tayná Evily de

; Tozetto-Mendoza, Tania Regina

; Oliveira, Luanda Mara da Silva

; Teixeira, Franciane Mouradian Emidio

; Lins, Roberto Dias

; Almeida, Alexandre de

; Mendes-Correa, Maria Cassia

; Duarte, Alberto Jose da Silva

; Oshiro, Telma Miyuki

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2021, Volume 76 elocation e3548

Resumo: En | Texto: En | PDF: En

OBJECTIVES: In this preliminary study we investigated cellular and humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood samples from 14 recovered coronavirus disease 2019 (COVID-19) patients and compared them to those in samples from 12 uninfected/unvaccinated volunteers. METHODS: Cellular immunity was assessed by intracellular detection of IFN-γ in CD3+ T lymphocytes after stimulation with SARS-CoV-2 spike (S1), nucleocapsid (NC), or receptor-binding domain (RBD) recombinant proteins or overlapping peptide pools covering the sequence of SARS-CoV-2 spike, membrane and nucleocapsid regions. The humoral response was examined by ELISAs and/or chemiluminescence assays for the presence of serum IgG antibodies directed to SARS-CoV-2 proteins. RESULTS: We observed differences between humoral and cellular immune profiles in response to stimulation with the same proteins. Assays of IgG antibodies directed to SARS-CoV-2 NC, RBD and S1/S2 recombinant proteins were able to differentiate convalescent from uninfected/unvaccinated groups. Cellular immune responses to SARS-CoV-2 protein stimuli did not exhibit a specific response, as T cells from both individuals with no history of contact with SARS-CoV-2 and from recovered donors were able to produce IFN-γ. CONCLUSIONS: Determination of the cellular immune response to stimulation with a pool of SARS-CoV-2 peptides but not with SARS-CoV-2 proteins is able to distinguish convalescent individuals from unexposed individuals. Regarding the humoral immune response, the screening for serum IgG antibodies directed to SARS-CoV-2 proteins has been shown to be specific for the response of recovered individuals.

https://doi.org/10.6061/clinics/2021/e3548

10.

Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.

; Marques, Heloisa H.S.

; Gualano, Bruno

; Lindoso, Livia

; Bain, Vera

; Astley, Camilla

; Martins, Fernanda

; Matheus, Denise

; Matsuo, Olivia M.

; Suguita, Priscila

; Trindade, Vitor

; Paula, Camila S.Y.

; Farhat, Sylvia C.L.

; Palmeira, Patricia

; Leal, Gabriela N.

; Suzuki, Lisa

; Odone Filho, Vicente

; Carneiro-Sampaio, Magda

; Duarte, Alberto José S.

; Antonangelo, Leila

; Batisttella, Linamara R.

; Polanczyk, Guilherme V.

; Pereira, Rosa Maria R.

; Carvalho, Carlos Roberto R.

; Buchpiguel, Carlos A.

; Latronico, Ana Claudia

; Seelaender, Marilia

; Silva, Clovis Artur

; Pereira, Maria Fernanda B.

; Sallum, Adriana M. E.

; Brentani, Alexandra V. M.

; Neto, Álvaro José S.

; Ihara, Amanda

; Santos, Andrea R.

; Canton, Ana Pinheiro M.

; Watanabe, Andreia

; Santos, Angélica C. dos

; Pastorino, Antonio C.

; Franco, Bernadette D. G. M.

; Caruzo, Bruna

; Ceneviva, Carina

; Martins, Carolina C. M. F.

; Prado, Danilo

; Abellan, Deipara M.

; Benatti, Fabiana B.

; Smaria, Fabiana

; Gonçalves, Fernanda T.

; Penteado, Fernando D.

; Castro, Gabriela S. F. de

; Gonçalves, Guilherme S.

; Roschel, Hamilton

; Disi, Ilana R.

; Marques, Isabela G.

; Castro, Inar A.

; Buscatti, Izabel M.

; Faiad, Jaline Z.

; Fiamoncini, Jarlei

; Rodrigues, Joaquim C.

; Carneiro, Jorge D. A.

; Paz, Jose A.

; Ferreira, Juliana C.

; Ferreira, Juliana C. O.

; Silva, Katia R.

; Bastos, Karina L. M.

; Kozu, Katia

; Cristofani, Lilian M.

; Souza, Lucas V. B.

; Campos, Lucia M. A.

; Silva Filho, Luiz Vicente R. F.

; Sapienza, Marcelo T.

; Lima, Marcos S.

; Garanito, Marlene P.

; Santos, Márcia F. A.

; Dorna, Mayra B.

; Aikawa, Nadia E.

; Litvinov, Nadia

; Sakita, Neusa K.

; Gaiolla, Paula V. V.

; Pasqualucci, Paula

; Toma, Ricardo K.

; Correa-Silva, Simone

; Sieczkowska, Sofia M.

; Imamura, Marta

; Forsait, Silvana

; Santos, Vera A.

; Zheng, Yingying

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2021, Volume 76 elocation e3511

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.

https://doi.org/10.6061/clinics/2021/e3511

11.

Supervisors’ perceptions on errors of nursing students in clinical clerkship: a qualitative research
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Santos, Ana Paula Sousa

; Tavares, Márcio Filipe Moniz

; Duarte, Alberto Carlos Marques

; Sousa, Fábio Alexandre Melo do Rego

Revista Brasileira de Enfermagem

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2021, Volume 74 Nº 2 elocation e20200675

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivos: comparar a percepção de supervisores pedagógicos e de supervisores clínicos sobre os erros cometidos por estudantes de enfermagem em estágio clínico. Métodos: estudo qualitativo exploratório-descritivo, desenvolvido com 105 participantes. Coleta de dados realizada com questionário com perguntas abertas. Análise de conteúdo realizada segundo modelo conceptual de erros de estudantes em ensino clínico. Resultados: os supervisores pedagógicos percebem, em ordem decrescente, os erros nas competências transversais, na execução de cuidados e de medicação. Os supervisores clínicos percebem, por ordem decrescente, a execução de cuidados, de medicação e as competências transversais. Considerações Finais: verificou-se coincidência e complementaridade nas percepções de supervisores clínicos e de supervisores pedagógicos, embora não na mesma ordem, em relação aos erros cometidos. O estudo apresenta contribuições relativas ao conhecimento existente em relação aos erros de medicação, que não são os mais percebidos, e os de competências transversais, que assumem posição de destaque.

ABSTRACT Objectives: to compare pedagogical supervisors’ and clinical supervisors’ perceptions about the errors made by nursing students in clinical clerkship. Methods: a qualitative exploratory-descriptive study developed with 105 participants. Data collection was performed with a questionnaire with open-ended questions. Content analysis performed according to the conceptual model of student errors in clinical teaching. Results: pedagogical supervisors perceive, in descending order, errors in transversal competencies, in the execution of care and medication. Clinical supervisors perceive, in descending order, the execution of care, medication, and transversal competencies. Final Considerations: there was coincidence and complementarity in clinical supervisors’ and pedagogical supervisors’ perceptions, although not in the same order, regarding the errors made. This study presents contributions related to the existing knowledge in relation to medication errors, which are not the most perceived, and those of transversal competencies, which take on a prominent position.

RESUMEN Objetivos: comparar la percepción de los supervisores pedagógicos y supervisores clínicos sobre los errores cometidos por los estudiantes de enfermería en práctica clínica. Métodos: estudio cualitativo exploratorio-descriptivo, desarrollado con 105 participantes. Recolección de datos realizada con un cuestionario con preguntas abiertas. Análisis de contenido realizado según el modelo conceptual de errores del alumno en educación clínica. Resultados: los supervisores pedagógicos perciben, en orden decreciente, los errores en las competencias transversales, en la ejecución de los cuidados y la medicación. Los supervisores clínicos perciben, en orden decreciente, la ejecución de cuidados, medicación y habilidades transversales. Consideraciones Finales: hubo coincidencia y complementariedad en las percepciones de los supervisores clínicos y los supervisores pedagógicos, aunque no en el mismo orden, sobre los errores cometidos. El estudio presenta aportes relacionados con el conocimiento existente en relación a los errores de medicación, que no son los más percibidos, y los de habilidades transversales, que asumen un lugar destacado.

https://doi.org/10.1590/0034-7167-2020-0675 223 downloads

12.

Prevalence of anti-SARS-CoV-2 antibodies in outpatients of a large public university hospital in Sao Paulo, Brazil
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Oliveira, Luanda Mara da Silva

; Tiyo, Bruna Tiaki

; Silva, Lais Teodoro da

; Fonseca, Luiz Augusto Marcondes

; Rocha, Rosana Coura

; Santos, Vera Aparecida dos

; Ceneviva, Carina

; Bedin, Anderson Aparecido

; Almeida, Alexandre de

; Duarte, Alberto José da Silva

; Oshiro, Telma Miyuki

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e91

Resumo: En | Texto: En | PDF: En

ABSTRACT Coronavirus disease 19 (COVID-19) is caused by SARS-Cov-2 and the manifestations of this infection range from an absence of symptoms all the way up to severe disease leading to death. To estimate the prevalence of past infection in a population, the most readily available method is the detection of antibodies against the virus. This study has investigated the prevalence of anti-SARS-CoV-2 antibodies in outpatients of the Hospital das Clinicas, in Sao Paulo city (Brazil), which is a large university hospital belonging to the public health system that cares for patients with complex diseases who need tertiary or quaternary medical care. Our serological inquiry was carried out for 6 weeks, with once-a-week blood sampling and included 439 patients from several outpatient services. Overall, 61 patients tested positive for anti-SARS-CoV-2 IgG (13.9%); 56.1 % of the patients live in Sao Paulo city, with the remaining living in other towns of the metropolitan area; 32.8% of the patients testing positive for IgG antibodies to SARS-CoV-2 were asymptomatic, 55.7% developed mild or moderate disease and 11.5% had to be hospitalized. The prevalence of SARS-CoV-2 positive serology was lower among patients who had received the seasonal influenza vaccine compared to the ones who did not. These findings may indicate that those individuals care more about health issues, and/or that they have a better access to health care and/or a better quality of health care service. The large proportion of patients who were unaware of having had contact with SARS-CoV-2 deserves attention, reflecting the scarcity of tests performed in the population.

https://doi.org/10.1590/s1678-9946202062091 1104 downloads

13.

Sensitivity of the Wondfo One Step COVID-19 test using serum samples
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Santos, Vera Aparecida dos

; Rafael, Mayra Matias

; Sabino, Ester Cerdeira

; Duarte, Alberto José da Silva

Clinics

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2020, Volume 75 elocation e2013

Resumo: En | Texto: En | PDF: En

https://doi.org/10.6061/clinics/2020/e2013 5396 downloads

14.

Fighting HIV/AIDS in a developing country: lessons from a small cohort from the largest Brazilian city
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Casseb, Jorge

; Veiga, Ana Paula R.

; Magri, Marcello M. C.

; Monteiro, Mariana A.

; Rocha, Rosana C.

; Gascon, Maria Rita P.

; Domingues-Ferreira, Mauricio

; Polis, Thales J. B.

; Nascimento, Najara A. de Lima

; Limongelli, Isadora

; Oliveira, Ícaro S.

; Prandi, Gabriela Caetano

; Costa, Livia M. C. B. Villares

; Fonseca, Luiz A. M.

; Duarte, Alberto J. S.

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e58

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/s1678-9946202062058 221 downloads

15.

Ecological niche and occupation by gray fox (Urocyon cinereoargenteus) at Las Barajitas Canyon, Sonora
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Armenta-Méndez, Lucila

; Gallo-Reynoso, Juan Pablo

; Macías-Duarte, Alberto

; Montiel-Herrera, Marcelino

; Villarruel-Sahagún, Leopoldo

Therya

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2018, Volume 9 Nº 1 Páginas 53 - 60

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Hutchinson defines ecological niche considering the relevance of the environment in the n-dimensional space, according to the patterns of species presence in it. For Peterson and collaborators, these patterns set the basis for niche modeling, since they directly affect the proportion of sites occupied by species. To determine the ecological variables that would favor the conservation of biodiversity at the landscape level, the ecological niche and site occupation by the gray fox (Urocyon cinereoargenteus) were simulated using photo-trapping monitoring at Las Barajitas Canyon, Sonora, Mexico. The potential habitat of the fox was modeled with the program MaxEnt, and the occupation (ψ) and probability of detection (p) were estimated with the program MARK. Vegetation was sampled using the quadrants and Braun-Blanquet methods to estimate importance values for the main plants for inclusion in the presence-absence models, as well as to know the state of the vegetation, using the species accumulation function. The sampling effort over one-year was 124 days/night-trap, obtaining 575 photographs of the gray fox. The analysis of the activity pattern revealed that the gray fox is a nocturnal-twilight species. The evaluation of the vegetation sampled evidenced the dominance of the Ruellia-Jatropha-Bursera association. The plant species accumulation function showed a positive linear relationship (r² = 0.97). In accordance with the information criteria (AICc), positive correlations were found between the sympatric species cacomixtle and coyote, and seasonality (i.e. spring and autumn), resulting in ψ = 38.5 % and p = 7.7 %. The spatial dynamics of plant communities and the relationships between animal species observed in this study indicate that, Las Barajitas Canyon is a suitable environment for the gray fox, since the Area Under the Curve (AUC) obtained was close to 1 (0.873).

Resumen: Hutchinson define el nicho ecológico incluyendo la importancia del medio ambiente en un espacio n-dimensional, en función de los patrones de presencia de las especies. Para Peterson y colaboradores, estos patrones constituyen la base para su modelación, ya que afectan directamente en la proporción de sitios ocupados por las especies. Para determinar las variables ecológicas que pudieran favorecer la conservación de la biodiversidad a nivel de paisaje, se simuló el nicho ecológico y la ocupación de la zorra gris (Urocyon cinereoargenteus) mediante un monitoreo de foto-trampeo en el Cañón de Las Barajitas, Sonora, México. Se modeló su hábitat potencial con el programa MaxEnt y se estimaron la ocupación (ψ) y la probabilidad de su detección (p) con el programa MARK. Se muestreó la vegetación por los métodos de cuadrantes y de Braun-Blanquet, para generar valores de importancia de las principales plantas e incluirlos en los modelos de presencia-ausencia, así como conocer el estado de la vegetación, usando la función de acumulación de especies. El esfuerzo de un año de muestreo fue de 124 días/noche trampa, obteniendo 575 fotografías de zorra gris. El análisis de los patrones de actividad colocó a la zorra gris como especie nocturna-crepuscular. La evaluación de la vegetación muestreada presentó una dominancia de la asociación Ruellia-Jatropha-Bursera. La función de la acumulación de especies vegetales mostró una relación lineal positiva (r² = 0.97). De acuerdo con los criterios de información (AICc), se encontraron correlaciones positivas entre especies simpátricas, el cacomixtle y el coyote y la estacionalidad, primavera y otoño, resultando en ψ = 38.5 % y p = 7.7 %. La dinámica espacial de comunidades vegetales y relaciones de fauna observadas en este estudio indican que, el Cañón de Las Barajitas es un ambiente adecuado para la zorra gris, ya que el valor del área bajo la curva (AUC) resultó cercano a 1 (0.873).

https://doi.org/10.12933/therya-18-546 1084 downloads

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