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ABSTRACT BACKGROUND: We aimed to describe the clinical characteristics of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Curitiba, Brazil. METHODS: Upper respiratory samples from 1077 HCWs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription polymerase chain reaction from June 16, 2020 to December 9, 2020. RESULTS: Overall, 32.7% of HCWs were infected. The positivity rates in symptomatic and asymptomatic HCWs were 39.2% and 15.9%, respectively. Hospital departments categorized as high-risk for exposure had the highest number of infected HCWs. CONCLUSIONS: Early diagnosis and isolation of infected HCWs remain key in controlling SARS-CoV-2 transmission because HCWs in close contact with COVID-19 patients are more likely to be infected than those who are not.

https://doi.org/10.1590/0037-8682-0265-2021

[SciELO Preprints] - Neurological complications in patients with SARS-CoV-2 infection: a systematic review
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Munhoz, Renato Puppi Pedroso, José Luiz Nascimento, Fábio Augusto Almeida, Sergio Monteiro de Barsottini, Orlando Graziani Povoas Cardoso, Francisco Eduardo Teive, Hélio A Ghizoni

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Publication date: 2020-05-15

Abstract: En Pt

Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.

Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.

https://doi.org/10.1590/0004-282X20200051

Neurological complications in patients with SARS-CoV-2 infection: a systematic review
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MUNHOZ, Renato Puppi

; PEDROSO, José Luiz

; NASCIMENTO, Fábio Augusto

; ALMEIDA, Sergio Monteiro de

; BARSOTTINI, Orlando Graziani Povoas

; CARDOSO, Francisco Eduardo C

; TEIVE, Hélio A Ghizoni

Arquivos de Neuro-Psiquiatria

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may 2020, Volume 78 N. 5 Pages 290 - 300

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.

ABSTRACT Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.

https://doi.org/10.1590/0004-282x20200051 11488 downloads

Cognitive impairment and major depressive disorder in HIV infection and cerebrospinal fluid biomarkers
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Almeida, Sergio Monteiro de

Arquivos de Neuro-Psiquiatria

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sep 2013, Volume 71 N. 9B Pages 689 - 692

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A alteração cognitiva e a desordem depressiva maior (MDD) são complicações comuns da AIDS no sistema nervoso central (CNS). Suas frequências, em pacientes com AIDS são 36 % e 45 %, respectivamente. O diagnósticos de alteração cognitiva pelo HIV é feito por critérios clínicos, não há nenhum teste único de laboratório ou biomarcador que estabeleçam o diagnóstico. Os fatores inflamatórios relacionados com dano neuronal indireto e com a patofisiologia da infecção do HIV no CNS, são os fatores estudados como biomarcadores. No presente nenhum biomarcador é estabelecido para o diagnóstico de alteração cognitiva pelo HIV, muito ainda tem para ser feito. Nesta revisão abordaremos alguns biomarcadores no líquido cefalorraquidiano que podem auxiliar no diagnóstico da alteração cognitiva e HIV. Da mesma forma o diagnostico de depressão no contexto da aids pode ser desafiante, identificar um biomarcador que possa ajudar no diagnóstico seria muito importante, embora os riscos de desenvolvimento de MDD e a neurobiologia ainda sejam pobremente entendidos.

Cognitive impairment and major depressive disorder (MDD) are common HIV-1 central nervous system (CNS) complications. Their frequencies in AIDS patients are 36% and 45%, respectively. The diagnoses of HIV cognitive impairment are made by clinical criteria, no single laboratory test or biomarker establishes the diagnosis. Factors of indirect neuronal injury related with the pathophysiology of the HIV infection in the CNS, are the factors studied as biomarkers. In the present no biomarker is established to the diagnosis of HIV cognitive impairment, much still needs to be done. We review in this paper some biomarkers in cerebrospinal fluid that could be valuable to the diagnosis of HIV cognitive impairment. Diagnosing depression in the context of HIV can be challenging, to identify a biomarker that could help in the diagnosis would be very important, although MDD risks and neurobiology are still poorly understood.

https://doi.org/10.1590/0004-282X20130152 3245 downloads

Rotavirus infection in a tertiary hospital: laboratory diagnosis and impact of immunization on pediatric hospitalization
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Pereira, Luciane Aparecida

; Raboni, Sonia Mara

; Nogueira, Meri B

; Vidal, Luine R

; Almeida, Sergio Monteiro de

; Debur, Maria C

; Cruz, Cristina

Brazilian Journal of Infectious Diseases

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jun 2011, Volume 15 N. 3 Pages 215 - 219

Abstract: En | Text: En | PDF: En

BACKGROUND AND OBJECTIVES: Rotavirus (RV) is the main etiological agent of diarrhea in childhood; its laboratory diagnosis is crucial to guide the clinical management and prevention of its spread. RV immunization was introduced in Brazilian 6-month-old children in 2006. The present study was aimed to evaluate three methodologies used for human RV detection in stool samples obtained from patients hospitalized due to gastroenteritis in a teaching hospital and report the impact of RV immunization in hospitalization by diarrhea. METHODS: 293 stool samples collected in the 2001-2008 period were analyzed by enzyme immunoassay (EIA), latex agglutination (LA) and polyacrylamide gel electrophoresis (PAGE). RESULTS: Rotavirus was detected in 34.8% of samples by LA assay, 28.3% of samples by EIA assay and in 25.6% of samples by PAGE assay. Considering the PAGE method as gold standard, the sensitivity, specificity and accuracy of EIA were 94.6%, 94.4% and 94.5%, and to LA were 82.6%, 81.6% and 81.9%, respectively. CONCLUSION: These results indicate that antigen detection by EIA is a rapid, sensitive and specific method, and could be used in large-scale applications for screening stool samples suspected of RV infection. This study showed decreased incidence of RV infection in hospitalized children prior to the implementation of the national immunization program against RV.

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Frequency of depression among patients with neurocysticercosis
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Almeida, Sergio Monteiro de

; Gurjão, Solange Aparecida

Arquivos de Neuro-Psiquiatria

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feb 2010, Volume 68 N. 1 Pages 76 - 80

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Neurocysticercose (NCC) é uma infecção do sistema nervoso central comum causada por metacestodes da Taenia solium. OBJETIVO: investigar a ocorrência de depressão nos pacientes com NCC forma calcificada. O grupo de estudo é formado por 114 pacientes subdivididos em quatro grupos: NCC com epilepsia, NCC sem epilepsia, epilepsia sem NCC e cefaléia crônica. MÉTODO: A presença de depressão foi determinada e quantificada pela Escala de Depressão de Hamilton (HRSD-21). RESULTADOS: A porcentagem de pacientes com depressão foi: grupo 1 (83%); grupo 2 (88%); grupo 3 (92%); grupo 4 (100%). A maioria dos pacientes apresentou depressão moderada. CONCLUSÃO: A incidência da depressão em todos os grupos foi mais elevada do que na população geral, contudo não houve diferença entre os grupos estudados. É possível que, de uma maneira geral, os pacientes portadores de doença crônica apresentarem a depressão em intensidade similar. NCC está associada com a presença de depressão.

Neurocysticercosis (NCC) is a common central nervous system infection caused by Taenia solium metacestodes. OBJECTIVE: To investigate the occurrence of depression in patients with calcified NCC form. The study group consisted of 114 patients subdivided in four groups: NCC with epilepsy, NCC without epilepsy, epilepsy without NCC and chronic headache. METHOD: Depression was evaluated and quantified by the Hamilton Rating Scale for Depression (HRSD-21). RESULTS: Percentage of patients with depression was as follows: group 1 (83%); group 2 (88%); group 3 (92%); group 4 (100%). The majority of patients had moderate depression. CONCLUSION: Incidence of depression in all groups was higher than in the general population. It is possible that, in a general way, patients with chronic diseases would have depression with similar intensity. NCC is associated with the presence of depression.

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Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes
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Rossoni, Andrea Maciel de Oliveira

; Dalla Costa, Libera Maria

; Berto, Denize Bonato

; Farah, Sônia Santos

; Gelain, Marilene

; Brandileone, Maria Cristina de Cunto

; Ramos, Vitor Hugo Mariano

; Almeida, Sergio Monteiro de

Arquivos de Neuro-Psiquiatria

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sep 2008, Volume 66 N. 3a Pages 509 - 515

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Este estudo teve como objetivo avaliar as taxas de resistência de Streptococcus pneumoniae, isolados de pacientes com meningite, à penicilina G, ceftriaxona e vancomicina; avaliar possíveis fatores de risco para resistência antimicrobiana; descrever os sorotipos encontrados e sugerir a terapêutica empírica inicial para meningite. Foram isoladas 100 amostras de S. pneumoniae, encontrando-se 15% de resistência à penicilina, 1% à cefalosporina e 0% à vancomicina. Os sorotipos mais encontrados foram 14 (19%), 3 e 23F (10% cada). Analisando-se os resistentes, o sorotipo 14 (44%) também foi o mais freqüente. Os fatores de risco para resistência de S. pneumoniae encontrados foram: idade menor que um ano (p=0,01) e o uso prévio de antibiótico (p=0,046). As taxas de resistência encontradas, moderada a penicilina, baixa para cefalosporina e nula para vancomicina, sugerem como terapêutica empírica inicial para tratamento da meningite bacteriana aguda de origem comunitária, a cefalosporina de terceira geração isoladamente.

The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from April 2001 to august 2002 have been evaluated. One hundred S. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. The serotypes most found were 14 (19%), 3 and 23F (10% each). When only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. The risk factors found in relation to the S. pneumoniae resistance were: age under one year old (p=0.01) and previous use of antibiotic (p=0.046). The resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.

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Human immunodeficiency virus and the central nervous system
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Almeida, Sergio Monteiro de

; Letendre, Scott

; Ellis, Ron

Brazilian Journal of Infectious Diseases

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feb 2006, Volume 10 N. 1 Pages 41 - 50

Abstract: En | Text: En | PDF: En

The pandemic of HIV/AIDS continues to grow daily. Incident cases among women, intravenous drug users and ethnic minorities comprise the fastest growing segment of the HIV-infected population, and the number of HIV-infected individuals over the age of 50 is growing rapidly. Today, the central nervous system and the immune system are seen as main targets of HIV infection. Significant progress in the knowledge and treatment of AIDS has been obtained in recent years. The neurological manifestations directly related to HIV are acute viral meningitis, chronic meningitis, HIV-associated dementia (HAD), vacuolar myelopathy, and involvement of the peripheral nervous system.

19098 downloads Cited 1 time in SciELO

Long-term evolution of papilledema in idiopathic intracranial hypertension: observations concerning two cases
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Piovesan, Elcio Juliato

; Lange, Marcos Cristiano

; Piovesan, Liciane do Rocio Maia

; Almeida, Sergio Monteiro de

; Kowacs, Pedro André

; Werneck, Lineu Cesar

Arquivos de Neuro-Psiquiatria

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jun 2002, Volume 60 N. 2B Pages 453 - 457

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Cefaléias com características crônica, diária, acompanhadas de edema de papila e tinitus pulsátil, sem nenhum achado neuroradiológico ou citobioquímico no líquor, são altamente sugestivas de hipertensão intracraniana idiopática (HII). Entretanto a ausência do papiledema não invalida o seu diagnóstico. A razão pela qual alguns pacientes não desenvolvem papiledema na HII é desconhecida, porém algumas hipóteses relacionadas com propriedades intrínsecas da bainha do nervo óptico têm sido propostas. Neste estudo relatamos dois pacientes do sexo feminino que apresentaram diagnóstico de HII com papiledema, evoluindo para resolução do papiledema sem a devida resolução da HII. O comportamento do nervo óptico (NO) frente ao aumento da pressão intracraniana foi avaliado neste estudo a partir de um monitoramento intermitente criterioso da pressão intracraniana. Concluímos que o NO submetido a um período de hipertensão intracraniana pode adaptar-se a este ambiente promovendo uma resolução do papiledema para normalidade papilar. A presença ou ausência de papiledema na HII pode estar relacionada ao período no qual seu diagnóstico é realizado.

Chronic headaches, associated with papilledema and pulsatile tinnitus without any neuroradiologic, cytobiochemical or cerebrospinal fluid abnormalities are suggestive of idiopathic intracranial hypertension (IIH). However the absence of the papilledema does not rule out this diagnosis. The reason why some patients do not develop papilledema in IIH is ignored, however there are some hypotheses concerning the structure of the optical nerve. In this study we described two female patients that presented diagnosis of IIH with papilledema, with subsequent resolution of papilledema without the due resolution of intracranial hypertension. The long-term behavior of the optic nerve (ON) facing an increased intracranial pressure was evaluated through repeated measurements of the intracranial pressure. We concluded that the ON submitted to high intracranial pressure for a certain lenght of time can adapt itself with subsequent disappearance of the papilledema. The presence or not of papilledema in IIH can be related to the period in which the diagnosis is accomplished.

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