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1.
[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães
Barroso, Weimar Kunz Sebba
Mion Júnior, Décio
Nobre, Fernando
Mota-Gomes, Marco Antonio
Jardim, Paulo Cesar Brandão Veiga
Amodeo, Celso
Camargo, Adriana
Alessi, Alexandre
Sousa, Ana Luiza Lima
Brandão, Andréa Araujo
Pio-Abreu, Andrea
Sposito, Andrei Carvalho
Pierin, Angela Maria Geraldo
Paiva, Annelise Machado Gomes de
Spinelli, Antonio Carlos de Souza
Machado, Carlos Alberto
Poli-de-Figueiredo, Carlos Eduardo
Rodrigues, Cibele Isaac Saad
Forjaz, Cláudia Lúcia de Moraes
Sampaio, Diogo Pereira Santos
Barbosa, Eduardo Costa Duarte
Freitas, Elizabete Viana de
Cestário , Elizabeth do Espírito Santo
Muxfeldt, Elizabeth Silaid
Lima Júnior, Emilton
Campana, Erika Maria Gonçalves
Feitosa, Fabiana Gomes Aragão Magalhães
Consolim-Colombo, Fernanda Marciano
Almeida, Fernando Antônio de
Silva, Giovanio Vieira da
Moreno Júnior, Heitor
Finimundi, Helius Carlos
Guimarães, Isabel Cristina Britto
Gemelli, João Roberto
Barreto Filho, José Augusto Soares
Vilela-Martin, José Fernando
Ribeiro, José Marcio
Yugar-Toledo, Juan Carlos
Magalhães, Lucélia Batista Neves Cunha
Drager, Luciano Ferreira
Bortolotto, Luiz Aparecido
Alves, Marco Antonio de Melo
Malachias, Marcus Vinícius Bolívar
Neves, Mario Fritsch Toros
Santos, Mayara Cedrim
Dinamarco, Nelson
Moreira Filho, Osni
Passarelli Júnior, Oswaldo
Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira
Miranda, Roberto Dischinger
Bezerra, Rodrigo
Pedrosa, Rodrigo Pinto
Paula, Rogério Baumgratz de
Okawa, Rogério Toshiro Passos
Póvoa, Rui Manuel dos Santos
Fuchs, Sandra C.
Inuzuka, Sayuri
Ferreira-Filho, Sebastião R.
Paffer Fillho, Silvio Hock de
Jardim, Thiago de Souza Veiga
Guimarães Neto, Vanildo da Silva
Koch, Vera Hermina
Gusmão, Waléria Dantas Pereira
Oigman, Wille
Nadruz, Wilson
Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population.
Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care.
It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations.
Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced.
Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM).
Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance.
Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.
La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial.
La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización.
Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones.
Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA.
La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA).
Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia.
Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.
A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial.
A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização.
Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações.
Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA.
A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA).
Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz).
Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.
2.
Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba
; Rodrigues, Cibele Isaac Saad
; Bortolotto, Luiz Aparecido
; Mota-Gomes, Marco Antônio
; Brandão, Andréa Araujo
; Feitosa, Audes Diógenes de Magalhães
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Amodeo, Celso
; Mion Júnior, Décio
; Barbosa, Eduardo Costa Duarte
; Nobre, Fernando
; Guimarães, Isabel Cristina Britto
; Vilela-Martin, José Fernando
; Yugar-Toledo, Juan Carlos
; Magalhães, Maria Eliane Campos
; Neves, Mário Fritsch Toros
; Jardim, Paulo César Brandão Veiga
; Miranda, Roberto Dischinger
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C
; Alessi, Alexandre
; Lucena, Alexandre Jorge Gomes de
; Avezum, Alvaro
; Sousa, Ana Luiza Lima
; Pio-Abreu, Andrea
; Sposito, Andrei Carvalho
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Nogueira, Armando da Rocha
; Dinamarco, Nelson
; Eibel, Bruna
; Forjaz, Cláudia Lúcia de Moraes
; Zanini, Claudia Regina de Oliveira
; Souza, Cristiane Bueno de
; Souza, Dilma do Socorro Moraes de
; Nilson, Eduardo Augusto Fernandes
; Costa, Elisa Franco de Assis
; Freitas, Elizabete Viana de
; Duarte, Elizabeth da Rosa
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Cesarino, Evandro José
; Marques, Fabiana
; Argenta, Fábio
; Consolim-Colombo, Fernanda Marciano
; Baptista, Fernanda Spadotto
; Almeida, Fernando Antonio de
; Borelli, Flávio Antonio de Oliveira
; Fuchs, Flávio Danni
; Plavnik, Frida Liane
; Salles, Gil Fernando
; Feitosa, Gilson Soares
; Silva, Giovanio Vieira da
; Guerra, Grazia Maria
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Back, Isabela de Carlos
; Oliveira Filho, João Bosco de
; Gemelli, João Roberto
; Mill, José Geraldo
; Ribeiro, José Marcio
; Lotaif, Leda A. Daud
; Costa, Lilian Soares da
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano Ferreira
; Martin, Luis Cuadrado
; Scala, Luiz César Nazário
; Almeida, Madson Q.
; Gowdak, Marcia Maria Godoy
; Klein, Marcia Regina Simas Torres
; Malachias, Marcus Vinícius Bolívar
; Kuschnir, Maria Cristina Caetano
; Pinheiro, Maria Eliete
; Borba, Mario Henrique Elesbão de
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Coelho, Otavio Rizzi
; Vitorino, Priscila Valverde de Oliveira
; Ribeiro Junior, Renault Mattos
; Esporcatte, Roberto
; Franco, Roberto
; Pedrosa, Rodrigo
; Mulinari, Rogerio Andrade
; Paula, Rogério Baumgratz de
; Okawa, Rogério Toshiro Passos
; Rosa, Ronaldo Fernandes
; Amaral, Sandra Lia do
; Ferreira-Filho, Sebastião R.
; Kaiser, Sergio Emanuel
; Jardim, Thiago de Souza Veiga
; Guimarães, Vanildo
; Koch, Vera H.
; Oigman, Wille
; Nadruz, Wilson
.
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https://doi.org/10.36660/abc.20201238
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3.
Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides
; Moreira, Henrique Turin
; Nakamuta, Juliana Sanajotti
; Simões, Marcus Vinicius
; Casas, Alberto de Almeida Las
; Costa, Altamiro Reis da
; Assis, Amberson Vieira de
; Durães, André Rodrigues
; Pereira-Barretto, Antonio Carlos
; Ravessa, Antonio Delduque de Araujo
; Macedo, Ariane Vieira Scarlatelli
; Biselli, Bruno
; Pinto, Carolina Maria Nogueira
; Filho, Conrado Roberto Hoffmann
; Costantini, Costantino Roberto
; Almeida, Dirceu Rodrigues
; Santos Jr, Edval Gomes dos
; Soliva Junior, Erwin
; Figueiredo, Estevão Lanna
; Albuquerque, Felipe Neves de
; Paulitsch, Felipe
; Neuenschwander, Fernando Carvalho
; Figueiredo Neto, José Albuquerque de
; Brito, Flavio de Souza
; Lopes, Heno Ferreira
; Villacorta, Humberto
; Souza Neto, João David de
; Sepulveda, João Mariano
; Ayoub, José Carlos Aidar
; Vilela-Martin, José F.
; Cardoso, Juliano Novaes
; Uemura, Laercio
; Moura, Lidia Zytynski
; Maia, Lilia Nigro
; Oliveira, Lucia Brandão de
; Maia, Lucimir
; Silva, Luís Beck da
; Gowdak, Luís Henrique Wolff
; Danzmann, Luiz Claudio
; Andrade, Marcus
; Braile-Sternieri, Maria Christiane Valeria Braga
; Moreira, Maria da Consolação Vieira
; França Neto, Olimpio R
; Filho, Otavio Rizzi Coelho
; Esteves, Paulo Frederico
; Raupp-da-Rosa, Priscila
; Silva, Ricardo Jorge de Queiroz e
; Mourilhe-Rocha, Ricardo
; Viégas, Ruy Felipe Melo
; Rassi, Salvador
; Mangili, Sandrigo
; Kaiser, Sergio Emanuel
; Martins, Silvia Marinho
; Kawabata, Vitor Sergio
.
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OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.
https://doi.org/10.6061/clinics/2021/e1991
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4.
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
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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.
5.
6ª DIRETRIZES DE MONITORIZAÇÃO AMBULATORIAL DA PRESSÃO ARTERIAL E 4ª DIRETRIZES DE MONITORIZAÇÃO RESIDENCIAL DA PRESSÃO ARTERIAL
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Brandão, Andrea A.
; Alessi, Alexandre
; Feitosa, Audes Magalhães
; Machado, Carlos Alberto
; Figueiredo, Carlos Eduardo Poli de
; Amodeo, Celso
; Rodrigues, Cibele Isaac Saad
; Forjaz, Claudia Lucia de Moraes
; Giorgi, Dante Marcelo Artigas
; Mion Júnior, Décio
; Coelho, Eduardo Barbosa
; Nobre, Fernando
; Lima Júnior, Emilton
; Plavnik, Frida Liane
; Silva, Giovanio Vieira da
; Chaves Júnior, Hilton
; Barbosa, Eduardo Costa Duarte
; Vilela-Martin, José Fernando
; Ribeiro, José Marcio
; Gusmão, Josiane Lima de
; Toledo, Juan Carlos Yugar
; Bortolotto, Luiz Aparecido
; Scala, Luiz Cesar Nazário
; Gomes, Marco Antônio Mota
; Malachias, Marcus Vinícius Bolívar
; Neves, Mario Fritsch Toros
; Wajngarten, Mauricio
; Gus, Miguel
; Passarelli Júnior, Oswaldo
; Jardim, Paulo Cesar Brandão Veiga
; Miranda, Roberto Dischinger
; Paula, Rogério Baumgratz de
; Ferreira Filho, Sebastião Rodrigues
; Andrade, Solange
; Geleilete, Tufik J. M.
; Koch, Vera Hermina K.
; Souza, Weimar Kunz Sebba Barroso de
; Oigman, Wille
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https://doi.org/10.5935/abc.20180074
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6.
Correlation between Plasmodium vivax variants in Belém, Pará State, Brazil and symptoms and clearance of parasitaemia
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Machado, Ricardo Luiz Dantas
; Figueiredo Filho, Alberto Ferreira de
; Calvosa, Vanja Sueli Pachiano
; Figueredo, Maria Cristina
; Nascimento, José Maria
; Póvoa, Marinete Marins
.
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The aim of this study was to determine how different types of P. vivax affect clinical symptoms and parasitaemia clearance. Blood was collected from individuals from Pará State, Brazil. The patients were treated as chloroquine plus primaquine. P. vivax were typed daily till D7 and again on D30. Now we can confirm a previously reported correlation between P. vivax genotype and response to chloroquine. Clinical symptoms do not allow for objective identification of different P. vivax types in the Brazilian Amazon, since the VK247 and P. vivax-like have only been detected in mixed infections.
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7.
Performance of an immunochromatography test for vivax malaria in the Amazon region, Brazil
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Figueiredo Filho, Alberto Ferreira
; Figueredo, Maria Cristina
; Nascimento, José Maria
; Calvosa, Vanja Suely Pachiano
; Póvoa, Marinete Marins
; Machado, Ricardo Luiz Dantas
.
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Avaliação do teste ICT malaria Pf/PvTM para o diagnóstico da malária por P. vivax em Belém, Estado do Pará. Foram comparados os resultados do teste imunocromatográfico com a gota espessa (GE) e avaliados o comportamento desse teste, estocado a três temperaturas distintas (25(0)C/ 30(0)C/ 37(0)C), 24 horas antes de seu uso. A sensibilidade do ICT malaria Pf/PvTM foi de 61,8% com especificidade de 100%, valores preditivo positivo e negativo de 100% e 71,8%, respectivamente, e acurácia de 80,67%. A sensibilidade desse teste foi independente da densidade parasitária. Este teste necessita de reavaliação para melhorar o seu comportamento no diagnóstico da malária por P. vivax.
The study was carried out to evaluate the diagnostic performance of the ICT malaria Pf/PvTM test for vivax malaria diagnosis in Belém, Amazon region, Brazil. The results of blood malaria parasites examination using an immunochromatography test were compared with thick blood film (TBF) examination. It was also evaluated the performance of this test storaged at three different temperatures (25°C, 30°C, and 37°C) for 24 hours before use. Overall sensitivity of ICT Pf/PvTM was 61.8% with a specificity of 100%, positive and negative predictive value of 100% and 71.8%, respectively and accuracy of 80.6%. The test sensitivity was independent of the parasite density. This test needs to be further reviewed in order to have better performance for P. vivax malaria diagnosis.
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8.
Performance of an immunochromatography test for vivax malaria in the Amazon region, Brazil
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Figueiredo Filho, Alberto Ferreira
; Figueredo, Maria Cristina
; Nascimento, José Maria
; Calvosa, Vanja Suely Pachiano
; Póvoa, Marinete Marins
; Machado, Ricardo Luiz Dantas
.
![ORCID](https://search.scielo.org/static/image/authorIcon-orcid.png)
![ORCID](https://search.scielo.org/static/image/authorIcon-orcid.png)
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Avaliação do teste ICT malaria Pf/PvTM para o diagnóstico da malária por P. vivax em Belém, Estado do Pará. Foram comparados os resultados do teste imunocromatográfico com a gota espessa (GE) e avaliados o comportamento desse teste, estocado a três temperaturas distintas (25(0)C/ 30(0)C/ 37(0)C), 24 horas antes de seu uso. A sensibilidade do ICT malaria Pf/PvTM foi de 61,8% com especificidade de 100%, valores preditivo positivo e negativo de 100% e 71,8%, respectivamente, e acurácia de 80,67%. A sensibilidade desse teste foi independente da densidade parasitária. Este teste necessita de reavaliação para melhorar o seu comportamento no diagnóstico da malária por P. vivax.
The study was carried out to evaluate the diagnostic performance of the ICT malaria Pf/PvTM test for vivax malaria diagnosis in Belém, Amazon region, Brazil. The results of blood malaria parasites examination using an immunochromatography test were compared with thick blood film (TBF) examination. It was also evaluated the performance of this test storaged at three different temperatures (25°C, 30°C, and 37°C) for 24 hours before use. Overall sensitivity of ICT Pf/PvTM was 61.8% with a specificity of 100%, positive and negative predictive value of 100% and 71.8%, respectively and accuracy of 80.6%. The test sensitivity was independent of the parasite density. This test needs to be further reviewed in order to have better performance for P. vivax malaria diagnosis.
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