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Correlation between ABO blood type, susceptibility to SARS-CoV-2 infection and COVID-19 disease severity: A systematic review type SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- COVID19 COVID 19 COVID-1 severity SARS-CoV COVID1 1 COVID-
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Soares, Danyela Martins Bezerra
; Araújo, David Augusto Batista Sá
; Souza, Jorge Luiz de Brito de
; Maurício, Rebeca Bessa
; Soares, Emanuela Martins Bezerra
; Alves Neto, Franklin de Castro
; Pinheiro, Maria Suelly Nogueira
; Gama, Vitor Carneiro de Vasconcelos
; Braga Neto, Pedro
; Nóbrega, Paulo Ribeiro
; Aragão, Gislei Frota
.
ABSTRACT Objectives: To verify the association between the ABO blood type and the risk of SARS-CoV-2 infection and COVID-19 disease severity. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the 2020 PRISMA Checklist and flow diagram, and articles selected for review were analyzed using the Newcastle-Ottawa Quality Rating Scale. The research question was: "Would the ABO blood group influence the risk of infection and clinical course of patients infected with SARS-CoV-2?", The following databases were used: Embase, PubMed, Virtual Health Library (VHL), Web of Science, Science-Direct and Scopus. The protocol for this review was registered in the Prospective Register of Systematic Reviews (PROSPERO), number CRD42021245945. Results: We found 798 articles across PubMed, Embase, Scopus, Web of Science, Science Direct and Virtual Health Library and 54 articles were included in the final analysis. Among 30 studies evaluating the risk of COVID-19 infection, 21 found significant correlations with ABO blood groups, 14 of them revealing an increased risk in blood group A and 15 studies showing a decreased risk in blood group O. Most studies found no significant correlation with disease severity or mortality. Conclusion: The qualitative assessment of available information suggests that blood group A may be a risk factor for COVID-19 infection and that blood group O may have a protective effect. We were unable to determine a clear association between the ABO blood group and mortality. These conclusions are based on highly heterogenous evidence. Objectives SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- COVID19 COVID 19 COVID-1 Methods MetaAnalyses Meta Analyses PRISMA, , (PRISMA) 202 diagram NewcastleOttawa Newcastle Ottawa Scale Would SARSCoV2, SARS-CoV-2?" used Embase PubMed VHL, VHL (VHL) ScienceDirect Scopus PROSPERO, PROSPERO (PROSPERO) CRD42021245945 CRD Results 79 5 analysis 3 groups 1 mortality Conclusion effect evidence SARS-CoV COVID1 COVID- (PRISMA 20 SARS-CoV-2? (VHL (PROSPERO CRD4202124594 7 CRD420212459 CRD42021245 CRD4202124 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4
2.
Transplante de Fígado no Brasil entre 2010 e 2021: Sobrevida de 30 Dias 201 2021 3 20 202 2
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Nascimento, Sheila Maria de Luna
; Fabris, Maria Eduarda Miranda
; Barros, Juliana Maldonado
; Ribeiro, Livia Maria
; Frizanco, Amanda Bitanti
; Santiago, Ana Liz Palombo
; Hoffmann-Santos, Hugo Dias
; Nogueira, Paulo Luiz Batista
.
RESUMO Introdução: No Brasil, o Sistema Único de Saúde, é responsável por mais de 95% transplantes hepáticos, disponibilizando de modo mais igualitário um serviço essencial à saúde. Todavia, há carência de órgãos frente à crescente demanda e desafios para alcançar o sucesso do procedimento, devido a gravidade das doenças de base que impactam na sobrevida pós cirurgia. Objetivo: Investigar a taxa de transplante de fígado em todas as unidades federativas do Brasil entre os anos de 2010 e 2021, bem como avaliar sua relação com sobrevida dos pacientes submetidos ao procedimento. Metodologia: Trata-se de um estudo epidemiológico, observacional, analítico do tipo coorte não concorrente, com dados obtidos do Sistema de Informações Hospitalares referentes a hospitalizações que realizaram transplante de fígado, em todas as unidades da federação (UF) do Brasil entre janeiro de 2010 e dezembro de 2021. Resultados: Foram realizados no país 17.254 transplantes de fígado, à um custo total de R$ 1.657.439.379,00 financiado pelo SUS em pacientes com idade média de 53,78 anos. O sexo feminino apresentou probabilidade de sobrevida menor que pacientes do sexo masculino. Quanto ao período 15 dias de internação hospitalar, os pacientes sem diagnóstico de insuficiência hepática apresentaram probabilidade de sobrevida de 86,4% (IC95% = 85,7 - 87,2) e os pacientes com diagnóstico de insuficiência hepática com probabilidade de sobrevida de 81,7% (IC95% = 80,0 - 83,4). A letalidade descrita foi de 12,29% e não houve diferença de sobrevida quanto a faixa etária (p=0,13), período de internação (p=0,31), doença alcoólica do fígado (p=0,14) e fibrose e cirrose hepática (p=0,22). A probabilidade de sobrevida foi estatisticamente semelhante entre transplantados que receberam fígado de doador falecido ou vivo. Conclusão: A quantidade de doadores permanece insuficientes frente a extensa lista de espera. O impacto das condições de base na sobrevida após cirurgia, observa-se desfecho negativo maior nos pacientes com insuficiência hepática e no sexo feminino. Introdução Saúde 95 hepáticos saúde Todavia procedimento cirurgia Objetivo 201 2021 Metodologia Tratase Trata se epidemiológico observacional concorrente UF (UF Resultados 17254 17 254 17.25 R 165743937900 1 657 439 379 00 1.657.439.379,0 5378 53 78 53,7 masculino hospitalar 864 86 4 86,4 IC95% IC95 IC (IC95 857 85 7 85, 87,2 872 87 2 817 81 81,7 800 80 0 80, 83,4. 834 83,4 . 83 83,4) 1229 12 29 12,29 p=0,13, p013 p p=0,13 , 13 (p=0,13) p=0,31, p031 p=0,31 31 (p=0,31) p=0,14 p014 14 (p=0,14 p=0,22. p022 p=0,22 22 (p=0,22) vivo Conclusão espera observase observa 9 20 202 1725 25 17.2 16574393790 65 43 37 1.657.439.379, 537 5 53, 8 86, IC9 (IC9 87, 81, 83, 122 12,2 p01 p=0,1 (p=0,13 p03 p=0,3 3 (p=0,31 (p=0,1 p02 p=0,2 (p=0,22 172 17. 1657439379 6 1.657.439.379 (IC 12, p0 p=0, (p=0,3 (p=0, (p=0,2 165743937 1.657.439.37 p=0 (p=0 16574393 1.657.439.3 p= (p= 1657439 1.657.439. (p 165743 1.657.439 16574 1.657.43 1657 1.657.4 165 1.657. 16 1.657 1.65 1.6 1.
ABSTRACT Introduction: In Brazil, the Unified Health System is responsible for more than 95% of liver transplants, providing a more equal service essential to health. However, there is a shortage of organs due to the growing demand and challenges to achieve the success of the procedure, due to the severity of the underlying diseases that impact on post-surgery survival. Objective: To investigate the rate of liver transplantation in all federative units of Brazil between 2010 and 2021, as well as to evaluate its relationship with survival of patients undergoing the procedure. Methodology: This is an epidemiological, observational, analytical study of the non-concurrent cohort type, with data obtained from the Hospital Information System regarding hospitalizations that underwent liver transplantation, in all units of the federation (UF) of Brazil between January 2010 and December 2021. Results: A total of 17,254 liver transplants were performed in the country, at a total cost of R$ 1,657,439,379.00 financed by SUS in patients with a mean age of 53.78 years. Females had a lower probability of survival than male patients. Regarding the 15-day hospital stay, patients without a diagnosis of liver failure had a survival probability of 86.4% (95%CI = 85.7 - 87.2) and patients with a diagnosis of liver failure had a survival probability of 81.7% (95%CI = 80.0 - 83.4). The lethality described was 12.29% AND there was no difference in survival regarding age (p=0.13), length of hospital stay (p=0.31), alcoholic liver disease (p=0.14) and fibrosis and cirrhosis of the liver (p=0.22). The probability of survival was statistically similar among transplant recipients who received liver from a deceased or living donor. Conclusion: The number of donors remains insufficient in the face of the extensive waiting list. The impact of baseline conditions on survival after surgery shows a higher negative outcome in patients with liver failure and in the female sex. Introduction 95 health However procedure postsurgery post Objective 201 2021 Methodology epidemiological observational nonconcurrent non concurrent type UF (UF Results 17254 17 254 17,25 country R 165743937900 1 657 439 379 00 1,657,439,379.0 5378 53 78 53.7 years 15day day 15 864 86 4 86.4 95%CI 95CI CI 857 85 7 85. 87.2 872 87 2 817 81 81.7 800 80 0 80. 83.4. 834 83.4 . 83 83.4) 1229 12 29 12.29 p=0.13, p013 p p=0.13 , 13 (p=0.13) p=0.31, p031 p=0.31 31 (p=0.31) p=0.14 p014 14 (p=0.14 p=0.22. p022 p=0.22 22 (p=0.22) donor Conclusion list sex 9 20 202 1725 25 17,2 16574393790 65 43 37 1,657,439,379. 537 5 53. 8 86. 87. 81. 83. 122 12.2 p01 p=0.1 (p=0.13 p03 p=0.3 3 (p=0.31 (p=0.1 p02 p=0.2 (p=0.22 172 17, 1657439379 6 1,657,439,379 12. p0 p=0. (p=0.3 (p=0. (p=0.2 165743937 1,657,439,37 p=0 (p=0 16574393 1,657,439,3 p= (p= 1657439 1,657,439, (p 165743 1,657,439 16574 1,657,43 1657 1,657,4 165 1,657, 16 1,657 1,65 1,6 1,
3.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
; Jesuíno, Isabella de Andrade
; Reis, Luiz Fernando Lima
; Mattos, Renata Rodrigues de
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Spadoni, Clayse Carla da Silva
; Moro, Elisângela Emilene
; Bueno, Flávia Regina
; Sampaio, Camila Santana Justo Cintra
; Silva, Débora Patrício
; Baldassare, Franca Pellison
; Silva, Ana Cecilia Alcantara
; Veiga, Thabata
; Barbante, Leticia
; Lambauer, Marianne
; Campos, Viviane Bezerra
; Santos, Elton
; Santos, Renato Hideo Nakawaga
; Laranjeiras, Ligia Nasi
; Valeis, Nanci
; Santucci, Eliana
; Miranda, Tamiris Abait
; Patrocínio, Ana Cristina Lagoeiro do
; Carvalho, Andréa de
; Sousa, Eduvirgens Maria Couto de
; Sousa, Ancelmo Honorato Ferraz de
; Malheiro, Daniel Tavares
; Bezerra, Isabella Lott
; Rodrigues, Mirian Batista
; Malicia, Julliana Chicuta
; Silva, Sabrina Souza da
; Gimenes, Bruna dos Passos
; Sesin, Guilhermo Prates
; Zavascki, Alexandre Prehn
; Sganzerla, Daniel
; Medeiros, Gregory Saraiva
; Santos, Rosa da Rosa Minho dos
; Silva, Fernanda Kelly Romeiro
; Cheno, Maysa Yukari
; Abrahão, Carolinne Ferreira
; Oliveira Junior, Haliton Alves de
; Rocha, Leonardo Lima
; Nunes Neto, Pedro Aniceto
; Pereira, Valéria Chagas
; Paciência, Luis Eduardo Miranda
; Bueno, Elaine Silva
; Caser, Eliana Bernadete
; Ribeiro, Larissa Zuqui
; Fernandes, Caio Cesar Ferreira
; Garcia, Juliana Mazzei
; Silva, Vanildes de Fátima Fernandes
; Santos, Alisson Junior dos
; Machado, Flávia Ribeiro
; Souza, Maria Aparecida de
; Ferronato, Bianca Ramos
; Urbano, Hugo Corrêa de Andrade
; Moreira, Danielle Conceição Aparecida
; Souza-Dantas, Vicente Cés de
; Duarte, Diego Meireles
; Coelho, Juliana
; Figueiredo, Rodrigo Cruvinel
; Foreque, Fernanda
; Romano, Thiago Gomes
; Cubos, Daniel
; Spirale, Vladimir Miguel
; Nogueira, Roberta Schiavon
; Maia, Israel Silva
; Zandonai, Cassio Luis
; Lovato, Wilson José
; Cerantola, Rodrigo Barbosa
; Toledo, Tatiana Gozzi Pancev
; Tomba, Pablo Oscar
; Almeida, Joyce Ramos de
; Sanches, Luciana Coelho
; Pierini, Leticia
; Cunha, Mariana
; Sousa, Michelle Tereza
; Azevedo, Bruna
; Dal-Pizzol, Felipe
; Damasio, Danusa de Castro
; Bainy, Marina Peres
; Beduhn, Dagoberta Alves Vieira
; Jatobá, Joana D’Arc Vila Nova
; Moura, Maria Tereza Farias de
; Rego, Leila Rezegue de Moraes
; Silva, Adria Vanessa da
; Oliveira, Luana Pontes
; Sodré Filho, Eliene Sá
; Santos, Silvana Soares dos
; Neves, Itallo de Lima
; Leão, Vanessa Cristina de Aquino
; Paes, João Lucidio Lobato
; Silva, Marielle Cristina Mendes
; Oliveira, Cláudio Dornas de
; Santiago, Raquel Caldeira Brant
; Paranhos, Jorge Luiz da Rocha
; Wiermann, Iany Grinezia da Silva
; Pedroso, Durval Ferreira Fonseca
; Sawada, Priscilla Yoshiko
; Prestes, Rejane Martins
; Nascimento, Glícia Cardoso
; Grion, Cintia Magalhães Carvalho
; Carrilho, Claudia Maria Dantas de Maio
; Dantas, Roberta Lacerda Almeida de Miranda
; Silva, Eliane Pereira
; Silva, Antônio Carlos da
; Oliveira, Sheila Mara Bezerra de
; Golin, Nicole Alberti
; Tregnago, Rogerio
; Lima, Valéria Paes
; Silva, Kamilla Grasielle Nunes da
; Boschi, Emerson
; Buffon, Viviane
; Machado, André Sant’Ana
; Capeletti, Leticia
; Foernges, Rafael Botelho
; Carvalho, Andréia Schubert de
; Oliveira Junior, Lúcio Couto de
; Oliveira, Daniela Cunha de
; Silva, Everton Macêdo
; Ribeiro, Julival
; Pereira, Francielle Constantino
; Salgado, Fernanda Borges
; Deutschendorf, Caroline
; Silva, Cristofer Farias da
; Gobatto, Andre Luiz Nunes
; Oliveira, Carolaine Bomfim de
; Dracoulakis, Marianna Deway Andrade
; Alvaia, Natália Oliveira Santos
; Souza, Roberta Machado de
; Araújo, Larissa Liz Cardoso de
; Melo, Rodrigo Morel Vieira de
; Passos, Luiz Carlos Santana
; Vidal, Claudia Fernanda de Lacerda
; Rodrigues, Fernanda Lopes de Albuquerque
; Kurtz, Pedro
; Shinotsuka, Cássia Righy
; Tavares, Maria Brandão
; Santana, Igor das Virgens
; Gavinho, Luciana Macedo da Silva
; Nascimento, Alaís Brito
; Pereira, Adriano J
; Cavalcanti, Alexandre Biasi
.
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
4.
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
.
https://doi.org/10.36660/abc.20201238
10948 downloads
5.
Posicionamento Brasileiro sobre Hipertensão Arterial Resistente – 2020
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Yugar-Toledo, Juan Carlos
; Moreno Júnior, Heitor
; Gus, Miguel
; Rosito, Guido Bernardo Aranha
; Scala, Luiz César Nazário
; Muxfeldt, Elizabeth Silaid
; Alessi, Alexandre
; Brandão, Andrea Araújo
; Moreira Filho, Osni
; Feitosa, Audes Diógenes de Magalhães
; Passarelli Júnior, Oswaldo
; Souza, Dilma do Socorro Moraes de
; Amodeo, Celso
; Barroso, Weimar Kunz Sebba
; Gomes, Marco Antônio Mota
; Paiva, Annelise Machado Gomes de
; Barbosa, Eduardo Costa Duarte
; Miranda, Roberto Dischinger
; Vilela-Martin, José Fernando
; Nadruz Júnior, Wilson
; Rodrigues, Cibele Isaac Saad
; Drager, Luciano Ferreira
; Bortolotto, Luiz Aparecido
; Consolim-Colombo, Fernanda Marciano
; Sousa, Márcio Gonçalves de
; Borelli, Flávio Antonio de Oliveira
; Kaiser, Sérgio Emanuel
; Salles, Gil Fernando
; Azevedo, Maria de Fátima de
; Magalhães, Lucélia Batista Neves Cunha
; Póvoa, Rui Manoel dos Santos
; Malachias, Marcus Vinícius Bolívar
; Nogueira, Armando da Rocha
; Jardim, Paulo César Brandão Veiga
; Jardim, Thiago de Souza Veiga
.
https://doi.org/10.36660/abc.20200198
9626 downloads
6.
Benefícios Metabólicos e Inflamatórios da Abreviação do Jejum Pré-operatório em Cirurgia Pediátrica
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Carvalho, Carlos Augusto Leite de Barros
; Carvalho, Augusto Aurélio de
; Preza, Antônio D'Oliveira Gonçalves
; Nogueira, Paulo Luiz Batista
; Mendes, Katia Bezerra Veloso
; Dock-Nascimento, Diana Borges
; Aguilar-Nascimento, José Eduardo
.
RESUMO Objetivo: Avaliar os efeitos metabólicos e inflamatórios da abreviação do jejum pré-operatório em crianças pré-escolares. Métodos: Quarenta crianças foram prospectivamente randomizadas em um grupo chamado jejum (jejum absoluto a partir de 00:00h) e outro chamado de carboidrato (CHO - em que as crianças eram autorizadas a ingerir uma bebida contendo carboidrato duas horas antes da operação). Foram colhidas amostras sanguíneas no pré e pós-operatório imediatos, para dosagens de albumina, interleucina 6, glicemia, insulina, proteína C reativa, e calculada resistência a insulina pelo índice de HOMA-IR. Resultados: O tempo de jejum pré-operatório foi significativamente menor no grupo submetido a abreviação do jejum (11:24h vs 2:49h, p<0,001). Os valores da PCR foram significativamente menores no grupo CHO, tanto no pré quanto no pós-operatório (p=0,05 e p=0,02, respectivamente). Os valores da razão PCR/Albumina foram significativamente menores no grupo CHO no período pré-operatório (p=0,03). Quatro pacientes (21%) do grupo jejum tornaram-se hiperglicêmicos no pré-operatório, enquanto nenhum teve hiperglicemia no grupo CHO (p=0,04). Não houveram diferenças estatisticamente significativas nos valores de albumina, interleucina-6, insulina e índice de HOMA entre os grupos. Não houve nenhum evento adverso no trabalho. Conclusão: A abreviação do jejum pré-operatório através do uso de bebidas contendo carboidratos melhora a resposta metabólica e inflamatória no peri-operatório de crianças pré-escolares submetidas a cirurgia eletiva de herniorrafia inguinal.
ABSTRACT Objective: To investigate the metabolic/inflammatory impact of reducing the preoperative fasting time in preschool children. Methods: Forty children were randomly assigned to a fasting group (absolute fasting after 00:00) and a carbohydrate (CHO) group (allowed to ingest, two hours before surgery, a carbohydrate-rich beverage). Blood samples were collected right before and after surgery to quantify the levels of albumin, interleukin-6, glucose, insulin, C-reactive protein and to calculate insulin resistance by the HOMA-IR index. Results: Preoperative fasting time in the CHO group were shorter than in the fasting group (2.49h vs. 11.24h, p <0.001). Pre- and post-surgical CRP levels were significantly lower in the CHO group (p = 0.05 and p = 0.02, respectively). The preoperative CRP/albumin ratios in the CHO group were lower than in the fasting group (p = 0.03). Four patients (21%) in the fasting group but none in the CHO group were hyperglycemic before surgery (p = 0.04). The two groups had similar levels of albumin, interleukin-6, insulin and HOMA index. There were no adverse events. Conclusion: Reducing the preoperative fasting time with carbohydrate-rich beverages improves the perioperative metabolic and inflammatory responses of preschool children undergoing inguinal hernia surgery.
https://doi.org/10.1590/0100-6991e-20202353
3137 downloads
7.
Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol
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Ferreira, Juliana C.
; Ho, Yeh-Li
; Besen, Bruno A.M.P.
; Malbuisson, Luiz M.S.
; Taniguchi, Leandro U.
; Mendes, Pedro V.
; Costa, Eduardo L.V.
; Park, Marcelo
; Daltro-Oliveira, Renato
; Roepke, Roberta M.L.
; Silva Jr, João M.
; Carmona, Maria José C.
; Carvalho, Carlos Roberto Ribeiro
; Hirota, Adriana
; Kanasiro, Alberto Kendy
; Crescenzi, Alessandra
; Fernandes, Amanda Coelho
; Miethke-Morais, Anna
; Bellintani, Arthur Petrillo
; Canasiro, Artur Ribeiro
; Carneiro, Bárbara Vieira
; Zanbon, Beatriz Keiko
; Batista, Bernardo Pinheiro De Senna Nogueira
; Nicolao, Bianca Ruiz
; Besen, Bruno Adler Maccagnan Pinheiro
; Biselli, Bruno
; Macedo, Bruno Rocha De
; Toledo, Caio Machado Gomes De
; Pompilio, Carlos Eduardo
; Carvalho, Carlos Roberto Ribeiro De
; Mol, Caroline Gomes
; Stipanich, Cassio
; Bueno, Caue Gasparotto
; Garzillo, Cibele
; Tanaka, Clarice
; Forte, Daniel Neves
; Joelsons, Daniel
; Robira, Daniele
; Costa, Eduardo Leite Vieira
; Silva Júnior, Elson Mendes Da
; Regalio, Fabiane Aliotti
; Segura, Gabriela Cardoso
; Marcelino, Gustavo Brasil
; Louro, Giulia Sefrin
; Ho, Yeh-Li
; Ferreira, Isabela Argollo
; Gois, Jeison de Oliveira
; Silva Junior, Joao Manoel Da
; Reusing Junior, Jose Otto
; Ribeiro, Julia Fray
; Ferreira, Juliana Carvalho
; Galleti, Karine Vusberg
; Silva, Katia Regina
; Isensee, Larissa Padrao
; Oliveira, Larissa dos Santos
; Taniguchi, Leandro Utino
; Letaif, Leila Suemi
; Lima, Lígia Trombetta
; Park, Lucas Yongsoo
; Chaves Netto, Lucas
; Nobrega, Luciana Cassimiro
; Haddad, Luciana
; Hajjar, Ludhmila
; Malbouisson, Luiz Marcelo
; Pandolfi, Manuela Cristina Adsuara
; Park, Marcelo
; Carmona, Maria José Carvalho
; Andrade, Maria Castilho Prandini H De
; Santos, Mariana Moreira
; Bateloche, Matheus Pereira
; Suiama, Mayra Akimi
; Oliveira, Mayron Faria de
; Sousa, Mayson Laercio
; Louvaes, Michelle
; Huemer, Natassja
; Mendes, Pedro
; Lins, Paulo Ricardo Gessolo
; Santos, Pedro Gaspar Dos
; Moreira, Pedro Ferreira Paiva
; Guazzelli, Renata Mello
; Reis, Renato Batista Dos
; Oliveira, Renato Daltro De
; Roepke, Roberta Muriel Longo
; Pedro, Rodolpho Augusto De Moura
; Kondo, Rodrigo
; Rached, Samia Zahi
; Fonseca, Sergio Roberto Silveira Da
; Borges, Thais Sousa
; Ferreira, Thalissa
; Cobello Junior, Vilson
; Sales, Vivian Vieira Tenório
; Ferreira, Willaby Serafim Cassa
.
OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital’s electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.
https://doi.org/10.6061/clinics/2020/e2294
1957 downloads
8.
CHANGING PARADIGMS IN PREOPERATIVE FASTING: RESULTS OF A JOINT EFFORT IN PEDIATRIC SURGERY
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CARVALHO, Carlos Augusto Leite de Barros
; CARVALHO, Augusto Aurélio de
; NOGUEIRA, Paulo Luiz Batista
; AGUILAR-NASCIMENTO, José Eduardo de
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
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RESUMO Racional: Trabalhos atuais associam longos períodos de jejum com diversas consequências adversas. A abreviação do jejum de 2 h para líquidos claros associado ao uso de bebidas contendo carboidratos atenua resposta endocrinometabólica ao trauma, porém frequentemente as crianças são orientadas a não ingerir alimentos a partir das 00:00 h do dia anterior à operação, independente do horário do procedimento cirúrgico. Objetivo: Avaliar a segurança de um protocolo de abreviação do jejum pré-operatório, com o uso de bebida contendo carboidratos, e realimentação precoce. Métodos: Foram avaliados prospectivamente 36 crianças submetidas a procedimentos cirúrgicos eletivos de pequeno e médio porte. Cinco foram posteriormente excluídos do estudo. Todos os 31 remanescentes receberam suplemento nutricional com maltodextrina 12,5% em 150 ml de água aproximadamente 2 h antes do procedimento. Foram coletados dados do tempo de jejum pré-operatório, complicações anestésicas e tempo de realimentação. Resultados: Vinte e três (74,2%) eram do gênero masculino, com idade mediana de cinco anos e peso mediano de 20 kg. O tempo mediano de jejum pré-operatório foi de 145 min e o tempo mediano para realimentação foi de 135 min. Não houve eventos adversos durante a anestesia ou operação. No período pós-operatório, duas (6,5%) crianças vomitaram. Conclusão: A abreviação de jejum pré-operatório para 2 h com uso de bebida contendo carboidratos, em operações eletivas de crianças, é seguro e não está associado ao maior risco de broncoaspiração pulmonar. Realimentação precoce pode ser prescrita nos procedimentos cirúrgicos analisados.
ABSTRACT Background: Current researches associate long fasting periods to several adverse consequences. The fasting abbreviation to 2 h to clear liquids associated with the use of drinks containing carbohydrates attenuates endocrinometabolic response to surgical trauma, but often is observed children advised to not intake food from 00:00 h till the scheduled surgical time, regardless of what it is. Aim: To evaluate the safety of a protocol of preoperative fasting abbreviation with a beverage containing carbohydrates, and early postoperative feeding in children underwent elective small/mid-size surgical procedures during a national task-force on pediatric surgery. Methods: Thirty-six patients were prospectively included, and for several reasons five were excluded. All 31 who remained in the study received a nutritional supplement containing 150 ml of water plus 12.5% maltodextrin 2 h before the procedure. Data of the pre-operative fasting time, anesthetic complications and time of postoperative refeeding, were collected. Results: Twenty-three (74.2%) were males, the median age was 5 y, and the median weight was 20 kg. The median time of pre-operative fasting was 145 min and the time of post-operative refeeding was 135 min. There were no adverse effects on the anesthetic procedures or during surgery. Post-operatively, two children (6.5%) vomited. Conclusion: The abbreviation of pre-operative fasting to 2 h with beverage containing carbohydrate in pediatric surgery is safe. Early refeeding in elective small/mid-size procedures can be prescribed.
https://doi.org/10.1590/0102-6720201700010003
5023 downloads
9.
Validation of the gastroschisis experimental model and the influence of the mother's diet enriched with glutamine in the fetal morphology
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Caporossi, Cervantes
; Nogueira, Paulo Luiz Batista
; Marques, José Carlos Costa
; Assis, Rafael Moraes de
; Aguilar-Nascimento, José Eduardo de
.
PURPOSE: To validate the gastroschisis experimental model in female rats and the effects on the glutamine fetal morphology during pregnancy.METHODS: Twelve pregnant rats Wistar were separated in two groups: Group I (n = 6 rats, 71 fetuses) took glutamine and Group II (n = 6 rats, 75 fetuses) took isocaloric supplementation. At the 18th day of pregnancy, female rats were taken to hysterotomy and the fetuses which were selected for the act of gastroschisis were partially removed from the womb and by the laparotomy technique, the exclusion of the intestine was done. After that, fetuses were put in the womb cavity again and the rats' abdomen sutured. At the 21st day of pregnancy, date before delivery, by C-section ordinary animals and the ones with gastroschisis were removed and studied separately. The morphometrical parameters studied were the body weight (PC); the intestine weight (PI); the intestine length (CI) and its relations (PI/PC, PI/CI e PC-PI).RESULTS: The intestine weight (PI) and the intestine length (CI) were different in fetuses with gastroschisis (p<0.05), however no difference between the groups regarding supplementation with glutamine.CONCLUSIONS: The gastroschisis experimental model is valid and reproducible. The nutritional therapy with glutamine did not change the morphometrical parameters.
https://doi.org/10.1590/S0102-86502014000300003
2816 downloads
10.
Seasonality of viral respiratory infections in Southeast of Brazil: the influence of temperature and air humidity
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Gardinassi, Luiz Gustavo
; Simas, Paulo Vitor Marques
; Salomão, João Batista
; Durigon, Edison Luiz
; Trevisan, Dirce Maria Zanetta
; Cordeiro, José Antonio
; Lacerda, Mauricio Nogueira
; Rahal, Paula
; Souza, Fátima Pereira de
.
Viruses are the major cause of lower respiratory tract infections in childhood and the main viruses involved are Human Respiratory Syncytial Virus (HRSV), Human Metapneumovirus (HMPV), Influenzavirus A and B (FLUA and FLUB), Human Parainfluenza Virus 1, 2 and 3 (HPIV1, 2 and 3) and Human Rhinovirus (HRV). The purposes of this study were to detect respiratory viruses in hospitalized children younger than six years and identify the influence of temperature and relative air humidity on the detected viruses. Samples of nasopharyngeal washes were collected from hospitalized children between May/2004 and September/2005. Methods of viral detection were RT-PCR, PCR and HRV amplicons were confirmed by hybridization. Results showed 54% (148/272) of viral positivity. HRSV was detected in 29% (79/272) of the samples; HRV in 23.1% (63/272); HPIV3 in 5.1% (14/272); HMPV in 3.3% (9/272); HPIV1 in 2.9% (8/272); FLUB in 1.4% (4/272), FLUA in 1.1% (3/272), and HPIV2 in 0.3% (1/272). The highest detection rates occurred mainly in the spring 2004 and in the autumn 2005. It was observed that viral respiratory infections tend to increase as the relative air humidity decreases, showing significant association with monthly averages of minimal temperature and minimal relative air humidity. In conclusion, viral respiratory infections vary according to temperature and relative air humidity and viral respiratory infections present major incidences it coldest and driest periods.
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