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1.
Recommendations on cutaneous and hematological manifestations of Sjögren’s disease by the Brazilian Society of Rheumatology Sjögrens Sjögren s
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Pugliesi, Alisson
; Egypto, Danielle Christinne Soares do
; Duffles, Guilherme
; Cantali, Diego Ustárroz
; Pasoto, Sandra Gofinet
; Oliveira, Fabiola Reis
; Valim, Valeria
; Lopes, Maria Lucia Lemos
; Miyamoto, Samira Tatiyama
; Fernandes, Marilena Leal Mesquita Silvestre
; Fialho, Sonia Cristina de Magalhães Souza
; Pinheiro, Aysa César
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Ribeiro, Sandra Lucia Euzébio
; Libório-Kimura, Tatiana Nayara
; Santos, Maria Carmen Lopes Ferreira Silva
; Gennari, Juliana D´Agostino
; Pernanbuco, Roberta
; Capobiano, Karina Gatz
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Rocha-Filho, César Ramos
; Rocha, Aline Pereira da
; Trevisani, Virginia Fernandes Moça
.
Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1
2.
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,
3.
Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)
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Trevisani, Virginia Fernandes Moça
; Pinheiro, Aysa César
; Fialho, Sonia Cristina de Magalhães Souza
; Fernandes, Marilena Leal Mesquita Silvestre
; Pugliesi, Alisson
; Pasoto, Sandra Gofinet
; Lopes, Maria Lucia Lemos
; Guedes, Lissiane Karine Noronha
; Miyamoto, Samira Tatiyama
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Fidelix, Tania
; Ribeiro, Sandra Lúcia Euzébio
; Brito, Danielle Christinne Soares Egypto de
; Libório-Kimura, Tatiana Nayara
; Santos, Maria Carmen Lopes Ferreira Silva
; Cantali, Diego Ustárroz
; Gennari, Juliana D.’Agostino
; Capobianco, Karina Gatz
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Rocha, Aline Pereira da
; Rocha Filho, César Ramos
; Oliveira, Fabiola Reis
; Valim, Valeria
.
Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.
4.
Predominance of Leishmania (Leishmania) amazonensis DNA in Lutzomyia longipalpis sand flies (Diptera: Psychodidae) from an endemic area for leishmaniasis in Northeastern Brazil
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Carvalho-Silva, Reyllane
; Ribeiro-da-Silva, Rosa Cristina
; Cruz, Léo Nava Piorsky Dominici
; Oliveira, Maxcilene da Silva de
; Amoedo, Pedro Marinho
; Rebêlo, José Manuel Macário
; Guimarães-e-Silva, Antonia Suely
; Pinheiro, Valéria Cristina Soares
.
Revista do Instituto de Medicina Tropical de São Paulo
- Journal Metrics
ABSTRACT Leishmaniasis is a serious public health concern in the Northeastern region of Brazil, where the sand fly fauna is well studied, although few species have been identified as competent vectors. The detection of Leishmania spp. parasites in wild-caught sand flies could help sanitary authorities draw strategies to avoid the transmission of the parasites and, therefore, the incidence of leishmaniases. We detected Leishmania DNA in wild-caught sand flies and correlated that data with aspects of sand fly ecology in the Caxias municipality, Maranhao State, Brazil. The sand flies were sampled in the peridomicile (open areas in the vicinity of human residences) and intradomicile (inside the residences) from July/2019 to March/2020. Leishmania DNA was detected in females, targeting a fragment of the Internal Transcribed Spacer (ITS1) from ribosomal DNA. Among the fourteen species of sand flies identified, five (Lutzomyia longipalpis, Nyssomyia whitmani, Evandromyia evandroi, Micropygomyia trinidadensis, and Micropygomyia quinquefer) harbored DNA of Leishmania (Leishmania) amazonensis. The most abundant species in rural (Ny. whitmani: 35.2% and Ev. evandroi: 32.4%) and urban areas (Lu. longipalpis: 89.8%) are the permissive vectors of L. (L.) amazonensis, especially Ny. whitmani, a known vector of causative agents of cutaneous leishmaniasis. Although Lu. longipalpis is the vector of L. (L.) infantum, which was not detected in this study, its permissiveness for the transmission of L. (L.) amazonensis has been reported. We suspect that visceral leishmaniasis and cutaneous leishmaniasis are caused by L. (L.) amazonensis, and the transmission may be occurring through Lu. longipalpis, at least in the urban area.
5.
Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary sjogren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian Society of Rheumatology (articular, pulmonary and renal)
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Trevisani, Virginia Fernandes Moça
; Pugliesi, Alisson
; Pasoto, Sandra Gofinet
; Lopes, Maria Lucia Lemos
; Guedes, Lissiane Karine Noronha
; Miyamoto, Samira Tatiyama
; Fernandes, Marilena Leal Mesquita Silvestre
; Fialho, Sonia Cristina de Magalhães Souza
; Pinheiro, Aysa César
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Fidelix, Tania
; Ribeiro, Sandra Lúcia Euzébio
; Brito, Danielle Christinne Soares Egypto de
; Libório-Kimura, Tatiana Nayara
; Santos, Maria Carmen Lopes Ferreira Silva
; Cantali, Diego Ustárroz
; Gennari, Juliana D’Agostino
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Rocha-Filho, César Ramos
; Oliveira, Fabiola Reis
; Rocha, Aline Pereira da
; Valim, Valeria
.
Abstract Sjogren’s Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.
6.
Posicionamento Brasileiro sobre o Uso da Multimodalidade de Imagens na Cardio-Oncologia – 2021
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Melo, Marcelo Dantas Tavares de
; Paiva, Marcelo Goulart
; Santos, Maria Verônica Câmara
; Rochitte, Carlos Eduardo
; Moreira, Valéria de Melo
; Saleh, Mohamed Hassan
; Brandão, Simone Cristina Soares
; Gallafrio, Claudia Cosentino
; Goldwasser, Daniel
; Gripp, Eliza de Almeida
; Piveta, Rafael Bonafim
; Silva, Tonnison Oliveira
; Santo, Thais Harada Campos Espirito
; Ferreira, Waldinai Pereira
; Salemi, Vera Maria Cury
; Cauduro, Sanderson A.
; Barberato, Silvio Henrique
; Lopes, Heloísa M. Christovam
; Pena, José Luiz Barros
; Rached, Heron Rhydan Saad
; Miglioranza, Marcelo Haertel
; Pinheiro, Aurélio Carvalho
; Vrandecic, Bárbara Athayde Linhares Martins
; Cruz, Cecilia Beatriz Bittencourt Viana
; Nomura, César Higa
; Cerbino, Fernanda Mello Erthal
; Costa, Isabela Bispo Santos da Silva
; Coelho Filho, Otavio Rizzi
; Carneiro, Adriano Camargo de Castro
; Burgos, Ursula Maria Moreira Costa
; Fernandes, Juliano Lara
; Uellendahl, Marly
; Calado, Eveline Barros
; Senra, Tiago
; Assunção, Bruna Leal
; Freire, Claudia Maria Vilas
; Martins, Cristiane Nunes
; Sawamura, Karen Saori Shiraishi
; Brito, Márcio Miranda
; Jardim, Maria Fernanda Silva
; Bernardes, Renata Junqueira Moll
; Diógenes, Tereza Cristina
; Vieira, Lucas de Oliveira
; Mesquita, Claudio Tinoco
; Lopes, Rafael Willain
; Segundo Neto, Elry Medeiros Vieira
; Rigo, Letícia
; Marin, Valeska Leite Siqueira
; Santos, Marcelo José
; Grossman, Gabriel Blacher
; Quagliato, Priscila Cestari
; Alcantara, Monica Luiza de
; Teodoro, José Aldo Ribeiro
; Albricker, Ana Cristina Lopes
; Barros, Fanilda Souto
; Amaral, Salomon Israel do
; Porto, Carmen Lúcia Lascasas
; Barros, Marcio Vinícius Lins
; Santos, Simone Nascimento dos
; Cantisano, Armando Luís
; Petisco, Ana Cláudia Gomes Pereira
; Barbosa, José Eduardo Martins
; Veloso, Orlando Carlos Glória
; Spina, Salvador
; Pignatelli, Ricardo
; Hajjar, Ludhmilla Abrahão
; Kalil Filho, Roberto
; Lopes, Marcelo Antônio Cartaxo Queiroga
; Vieira, Marcelo Luiz Campos
; Almeida, André Luiz Cerqueira
.
https://doi.org/10.36660/abc.20200266
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7.
2021 recommendations of the Brazilian Society of Rheumatology for the gynecological and obstetric care of patients with Sjogren’s syndrome
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Oliveira, Fabiola Reis
; Valim, Valeria
; Pasoto, Sandra Gofinet
; Fernandes, Marilena Leal Mesquita Silvestre
; Lopes, Maria Lucia Lemos
; Souza Fialho, Sonia Cristina de Magalhães
; Pinheiro, Aysa César
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Fidelix, Tania
; Ribeiro, Sandra Lucia Euzébio
; Brito, Danielle Christinne Soares Egypto de
; Libório, Tatiana
; Santos, Maria Carmen Lopes Ferreira Silva
; Tanure, Leandro
; Gennari, Juliana DAgostino
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Rocha Filho, César Ramos
; Miyamoto, Samira Tatiyama
; Guedes, Lissiane Karine Noronha
; Pugliesi, Alisson
; Trevisani, Virginia Fernandes Moça
.
Abstract Sjogren’s syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.
https://doi.org/10.1186/s42358-021-00208-1
54 downloads
8.
Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato
; Ferreira, Gilda Aparecida
; Gomides Reis, Ana Paula Monteiro
; Reis Neto, Edgard Torres
; Abreu, Mirhelen Mendes
; Albuquerque, Cleandro Pires
; Araújo, Nafice Costa
; Bacchiega, Ana Beatriz
; Bianchi, Dante Valdetaro
; Bica, Blanca
; Bonfa, Eloisa Duarte
; Borba, Eduardo Ferreira
; Brito, Danielle Christinne Soares Egypto
; Duarte, Ângela Luzia Branco Pinto
; Santo, Rafaela Cavalheiro Espírito
; Fernandes, Paula Reale
; Guimarães, Mariana Peixoto
; Gomes, Kirla Wagner Poti
; Kakehasi, Adriana Maria
; Klumb, Evandro Mendes
; Lanna, Cristina Costa Duarte
; Marques, Claudia Diniz Lopes
; Monticielo, Odirlei André
; Mota, Licia Maria Henrique
; Munhoz, Gabriela Araújo
; Paiva, Eduardo Santos
; Pereira, Helena Lucia Alves
; Provenza, José Roberto
; Ribeiro, Sandra Lucia Euzébio
; Rocha Junior, Laurindo Ferreira
; Sampaio, Camila Santana Justo Cintra
; Sampaio, Vanderson Souza
; Sato, Emília Inoue
; Skare, Thelma
; de Souza, Viviane Angelina
; Valim, Valeria
; Lacerda, Marcus Vinícius Guimarães
; Xavier, Ricardo Machado
; Pinheiro, Marcelo Medeiros
.
Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).
https://doi.org/10.1186/s42358-021-00217-0
22 downloads
9.
Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren's syndrome (Part I): glandular manifestations (systematic review)
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Trevisani, Virginia Fernandes Moça
; Pasoto, Sandra Gofinet
; Fernandes, Marilena Leal Mesquita Silvestre
; Lopes, Maria Lucia Lemos
; Fialho, Sonia Cristina de Magalhães Souza
; Pinheiro, Aysa César
; Santos, Laura Caldas dos
; Appenzeller, Simone
; Fidelix, Tania
; Ribeiro, Sandra Lucia Euzébio
; Brito, Danielle Christinne Soares Egypto de
; Libório, Tatiana
; Santos, Maria Carmen Lopes Ferreira Silva
; Tanure, Leandro
; Gennari, Juliana D Agostino
; Civile, Vinicius Tassoni
; Pinto, Ana Carolina Pereira Nunes
; Oliveira, Fabiola Reis
; Sousa, Jaqueline Martins de
; Miyamoto, Samira Tatiyama
; Valim, Valeria
.
Abstract Background: Primary Sjögren's syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is common due to the nonspecific clinical manifestations of disease. The aim of the present study was to develop recommendations for the diagnosis of glandular manifestations of pSS based on evidence and expert opinion. Main body of the abstract: We conducted a systematic literature review to retrieve the best evidence available on the accuracy of diagnostic tests for pSS. We also held two in-person meetings with experts (rheumatologists, pathologists, ophthalmologists and dentists) to establish their level of agreement using the Delphi method. Ultimately, we generated 18 recommendations that aim to facilitate the diagnosis of the glandular manifestations of pSS. Conclusion: The diagnosis of glandular manifestations of pSS is complex and multidisciplinary. It requires specific knowledge in the field of ophthalmology, immunology, pathology and imaging, making it compulsory for the rheumatologist to work with professionals from these different areas in order to improve accuracy and early diagnosis. Glandular dysfunction tests, ANA, RF, Anti-Ro, protein electrophoresis, urinalysis, blood count, C-Reactive protein, complement, testing for syphilis and viruses (HCV, HIV) and SGUS should be investigated when dryness or systemic manifestation are present. Minor salivary gland biopsy is recommended for all anti-Ro negative or incomplete criteria cases.
https://doi.org/10.1186/s42358-019-0102-8
878 downloads
10.
Isolation and molecular characterization of Bacillus thuringiensis found in soils of the Cerrado region of Brazil, and their toxicity to Aedes aegypti larvae
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Lobo, Katiane dos Santos
; Soares-da-Silva, Joelma
; Silva, Maria Cleoneide da
; Tadei, Wanderli Pedro
; Polanczyk, Ricardo Antonio
; Pinheiro, Valéria Cristina Soares
.
ABSTRACT This study investigated the potential of Bacillus thuringiensis isolates obtained in the Cerrado region of the Brazilian state of Maranhão for the biological control of Aedes aegypti larvae. The isolates were obtained from soil samples and the identification of the B. thuringiensis colonies was based on morphological characteristics. Bioassays were run to assess the pathogenicity and toxicity of the different strains of the B. thuringiensis against third-instar larvae of A. aegypti. Protein profiles were obtained by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Polymerase chain reaction assays were used to detect the toxin genes found in the bacterial isolates. Overall, 12 (4.0%) of the 300 isolates obtained from 45 soil samples were found to present larvicidal activity, with the BtMA-104, BtMA-401 and BtMA-560 isolates causing 100% of mortality. The BtMA-401 isolate was the most virulent, with the lowest median lethal concentration (LC50) (0.004 × 107 spores/mL), followed by the Bacillus thuringiensis var. israelensis standard (0.32 × 107 spores/mL). The protein profiles of BtMA-25 and BtMA-401 isolates indicated the presence of molecular mass consistent with the presence of the proteins Cry4Aa, Cry11Aa and Cyt1, similar to the profile of Bacillus thuringiensis var. israelensis IPS-82. Surprisingly, however, none of the cry and cyt genes analyzed were amplified in the isolate BtMA-401. The results of the present study revealed the larvicidal potential of B. thuringiensis isolates found in the soils of the Cerrado region from Maranhão, although further research will be necessary to better elucidate and describe other genes associated with the production of insecticidal toxins in these isolates.
https://doi.org/10.1016/j.rbe.2017.11.004
2328 downloads
11.
Distribution of pulmonary tuberculosis in Rio de Janeiro (Brazil): a spatial analysis
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Rodrigues, Nádia Cristina Pinheiro
; Andrade, Mônica Kramer de Noronha
; O'Dwyer, Gisele
; Flynn, Matthew
; Braga, José Ueleres
; Almeida, Andréa Sobral de
; Bastos, Leonardo Soares
; Lino, Valéria Teresa Saraiva
.
Resumo O objetivo deste estudo foi analisar a distribuição espacial da tuberculose (TB) endêmica no Rio de Janeiro 2002-2011. Estudo retrospectivo realizado no Estado do Rio de Janeiro, 2002-2011. Técnicas de análise espacial foram utilizadas para descrever a distribuição de incidência de tuberculose no estado. Modelo de regressão multinível de Poisson foi utilizado para acessar a relação de tuberculose e os fatores: “sexo”, “faixa etária” e “ano de diagnóstico” (fatores de nível individual). A “Densidade demográfica” e o “município de residência” também foram incluídos no modelo como fatores de nível contextual. Houve redução da tuberculose endêmica ao longo dos anos. As maiores taxas de incidência se concentraram no litoral sul do estado, abrangendo capital e cidades vizinhas. Observamos a formação de cluster significativo com altas taxas de incidência de TB no litoral sul do estado e cluster de baixa incidência na região nordeste do estado. O risco de tuberculose foi maior no início de 2000, no sexo masculino e na faixa etária 40-59. As megacidades são áreas de risco importantes para a disseminação da tuberculose. Estes achados poderiam ser usados para planejar medidas de controle de acordo com as características de cada região.
Abstract The aim of this study was to analyze the spatial distribution of the tuberculosis endemic in Rio de Janeiro State from 2002 to 2011. A retrospective study was conducted in the state of Rio de Janeiro from 2002 to 2011. Spatial analysis techniques were used to describe the distribution of tuberculosis incidence in the state. Multilevel Poisson regression model was used to access the relationship of tuberculosis and the following factors: “sex”, “age-group” and “diagnostic year” (individual-level factors). Demographic density and municipality were also included in the model as contextual-level factors. A reduction in endemic tuberculosis was observed over the years. The highest incidence rates were concentrated on the south coast of the state, covering Rio de Janeiro City (capital) and neighboring cities. We detected a significant clustering of high TB incidence rates on the south coast of the state and a cluster of low incidence in the northeastern region of state. The risk of tuberculosis was higher in early 2000s, in males and in 40-59 age group. Metropolitan regions are important risk areas for the spread of tuberculosis. These findings could be used to plan control measures according to the characteristics of each region.
https://doi.org/10.1590/1413-812320172212.0143016
110 downloads
12.
Distribution of pulmonary tuberculosis in Rio de Janeiro (Brazil): a spatial analysis
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Rodrigues, Nádia Cristina Pinheiro
; Andrade, Mônica Kramer de Noronha
; O'Dwyer, Gisele
; Flynn, Matthew
; Braga, José Ueleres
; Almeida, Andréa Sobral de
; Bastos, Leonardo Soares
; Lino, Valéria Teresa Saraiva
.
Resumo O objetivo deste estudo foi analisar a distribuição espacial da tuberculose (TB) endêmica no Rio de Janeiro 2002-2011. Estudo retrospectivo realizado no Estado do Rio de Janeiro, 2002-2011. Técnicas de análise espacial foram utilizadas para descrever a distribuição de incidência de tuberculose no estado. Modelo de regressão multinível de Poisson foi utilizado para acessar a relação de tuberculose e os fatores: “sexo”, “faixa etária” e “ano de diagnóstico” (fatores de nível individual). A “Densidade demográfica” e o “município de residência” também foram incluídos no modelo como fatores de nível contextual. Houve redução da tuberculose endêmica ao longo dos anos. As maiores taxas de incidência se concentraram no litoral sul do estado, abrangendo capital e cidades vizinhas. Observamos a formação de cluster significativo com altas taxas de incidência de TB no litoral sul do estado e cluster de baixa incidência na região nordeste do estado. O risco de tuberculose foi maior no início de 2000, no sexo masculino e na faixa etária 40-59. As megacidades são áreas de risco importantes para a disseminação da tuberculose. Estes achados poderiam ser usados para planejar medidas de controle de acordo com as características de cada região.
Abstract The aim of this study was to analyze the spatial distribution of the tuberculosis endemic in Rio de Janeiro State from 2002 to 2011. A retrospective study was conducted in the state of Rio de Janeiro from 2002 to 2011. Spatial analysis techniques were used to describe the distribution of tuberculosis incidence in the state. Multilevel Poisson regression model was used to access the relationship of tuberculosis and the following factors: “sex”, “age-group” and “diagnostic year” (individual-level factors). Demographic density and municipality were also included in the model as contextual-level factors. A reduction in endemic tuberculosis was observed over the years. The highest incidence rates were concentrated on the south coast of the state, covering Rio de Janeiro City (capital) and neighboring cities. We detected a significant clustering of high TB incidence rates on the south coast of the state and a cluster of low incidence in the northeastern region of state. The risk of tuberculosis was higher in early 2000s, in males and in 40-59 age group. Metropolitan regions are important risk areas for the spread of tuberculosis. These findings could be used to plan control measures according to the characteristics of each region.
https://doi.org/10.1590/1413-812320172212.0143016
1790 downloads
13.
ERICA: prevalence of metabolic syndrome in Brazilian adolescents
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Kuschnir, Maria Cristina C
; Bloch, Katia Vergetti
; Szklo, Moyses
; Klein, Carlos Henrique
; Barufaldi, Laura Augusta
; Abreu, Gabriela de Azevedo
; Schaan, Beatriz
; Veiga, Gloria Valeria da
; Silva, Thiago Luiz Nogueira da
; Vasconcellos, Maurício T L de
; Moraes, Ana Júlia Pantoja de
; Oliveira, Ana Mayra Andrade de
; Tavares, Bruno Mendes
; Oliveira, Cecília Lacroix de
; Cunha, Cristiane de Freitas
; Giannini, Denise Tavares
; Belfort, Dilson Rodrigues
; Santos, Eduardo Lima
; Leon, Elisa Brosina de
; Oliveira, Elizabete Regina Araújo
; Fujimori, Elizabeth
; Borges, Ana Luíza
; Magliano, Erika da Silva
; Vasconcelos, Francisco de Assis Guedes
; Azevedo, George Dantas
; Brunken, Gisela Soares
; Guimarães, Isabel Cristina Britto
; Faria Neto, José Rocha
; Oliveira, Juliana Souza
; Carvalho, Kenia Mara B de
; Gonçalves, Luis Gonzaga de Oliveira
; Monteiro, Maria Inês
; Santos, Marize M
; Muniz, Pascoal Torres
; Jardim, Paulo César B Veiga
; Ferreira, Pedro Antônio Muniz
; Montenegro Jr, Renan Magalhães
; Gurgel, Ricardo Queiroz
; Vianna, Rodrigo Pinheiro
; Vasconcelos, Sandra Mary
; Martins, Stella Maris Seixas
; Goldberg, Tamara Beres Lederer
.
RESUMO OBJETIVO Determinar a prevalência de síndrome metabólica e de seus componentes em adolescentes brasileiros. MÉTODOS Foram avaliados 37.504 adolescentes, participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), estudo transversal de âmbito nacional e de base escolar. Os adolescentes, de 12 a 17 anos de idade, residiam em municípios com mais de 100 mil habitantes. A amostra foi estratificada e conglomerada em escolas e turmas. Os critérios da International Diabetes Federation foram utilizados para definir síndrome metabólica. Prevalências de síndrome metabólica foram estimadas segundo sexo, faixa etária, tipo de escola e estado nutricional. RESULTADOS Dos 37.504 adolescentes, 50,2% eram do sexo feminino; 54,3% tinham de 15 a 17 anos e 73,3% estudavam em escolas públicas. A prevalência nacional de síndrome metabólica foi 2,6% (IC95% 2,3-2,9), discretamente maior no sexo masculino e naqueles de 15 a 17 anos na maioria das macrorregiões. A prevalência foi a maior nos residentes na macrorregião Sul, nas adolescentes mais jovens e nos adolescentes mais velhos. A prevalência foi maior nas escolas públicas (2,8% [IC95% 2,4-3,2]) que nas escolas privadas (1,9% [IC95% 1,4-2,4]) e nos adolescentes obesos em comparação aos não obesos. As combinações de componentes mais frequentes, respondendo por 3/4 das combinações, foram: circunferência de cintura elevada, HDL-colesterol baixo e pressão arterial elevada, seguida de circunferência da cintura elevada, lipoproteína de alta densidade (HDL-c) baixo e triglicerídeos elevados, e wpor circunferência da cintura elevada, HDL baixa e triacilgliceróis e pressão arterial elevados. A HDL baixa foi o segundo componente mais frequente, mas a maior prevalência de síndrome metabólica (26,8%) foi observada na presença de triglicerídeos elevado. CONCLUSÕES O ERICA é o primeiro estudo nacional a apresentar prevalências de síndrome metabólica e descrever a participação dos seus componentes. Apesar de a prevalência da síndrome metabólica ter sido baixa, as altas prevalências de alguns componentes e de participação de outros na composição da síndrome torna importante o diagnóstico precoce de tais alterações, mesmo que não agrupadas na síndrome metabólica.
ABSTRACT OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
https://doi.org/10.1590/s01518-8787.2016050006701
1789 downloads
14.
ERICA: prevalences of hypertension and obesity in Brazilian adolescents
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Bloch, Katia Vergetti
; Klein, Carlos Henrique
; Szklo, Moyses
; Kuschnir, Maria Cristina C
; Abreu, Gabriela de Azevedo
; Barufaldi, Laura Augusta
; Veiga, Gloria Valeria da
; Schaan, Beatriz
; Silva, Thiago Luiz Nogueira da
; Moraes, Ana Julia Pantoja
; Oliveira, Ana Mayra Andrade de
; Tavares, Bruno Mendes
; Magliano, Erika da Silva
; Oliveira, Cecília Lacroix de
; Cunha, Cristiane de Freitas
; Giannini, Denise Tavares
; Belfort, Dilson Rodrigues
; Santos, Eduardo Lima
; Leon, Elisa Brosina de
; Oliveira, Elizabete Regina Araújo
; Fujimori, Elizabeth
; Borges, Ana Luíza
; Vasconcelos, Francisco de Assis Guedes
; Azevedo, George Dantas
; Brunken, Gisela Soares
; Guimarães, Isabel Cristina Britto
; Faria Neto, José Rocha
; Oliveira, Juliana Souza
; Carvalho, Kenia Mara B. de
; Gonçalves, Luis Gonzaga de Oliveira
; Monteiro, Maria Inês
; Santos, Marize M.
; Jardim, Paulo César B. Veiga
; Ferreira, Pedro Antônio Muniz
; Montenegro Jr., Renan Magalhães
; Gurgel, Ricardo Queiroz
; Vianna, Rodrigo Pinheiro
; Vasconcelos, Sandra Mary
; Goldberg, Tamara Beres Lederer
.
RESUMO OBJETIVO Estimar as prevalências de hipertensão arterial e obesidade e a fração atribuível populacional de hipertensão arterial devida à obesidade em adolescentes brasileiros. MÉTODOS Foram avaliados dados dos participantes do Estudo de Riscos Cardiovasculares em Adolescentes, estudo seccional l nacional de base escolar. A amostra foi dividida em 32 estratos geográficos e conglomerados de escolas e turmas, com representatividade nacional, macrorregional e de capitais. Obesidade foi classificada pelo índice de massa corporal segundo idade e sexo. Considerou-se hipertensão arterial a média da pressão arterial sistólica ou diastólica maior ou igual ao percentil 95 da curva de referência. Foram estimadas prevalências e intervalos de confiança de 95% (IC95%) de hipertensão arterial e de obesidade, nacionais e nas macrorregiões do País, por sexo e grupo etário, assim como as frações de hipertensão atribuíveis à obesidade na população. RESULTADOS Foram avaliados 73.399 estudantes, 55,4% do sexo feminino, com média de idade 14,7 anos (DP = 1,6). A prevalência de hipertensão arterial foi 9,6% (IC95% 9,0-10,3); sendo as mais baixas observadas nas regiões Norte, 8,4% (IC95% 7,7-9,2) e Nordeste, 8,4% (IC95% 7,6-9,2) e a mais alta na região Sul, 12,5% (IC95% 11,0-14,2). A prevalência de obesidade foi 8,4% (IC95% 7,9-8,9), mais baixa na região Norte e mais alta na Sul. As prevalências de hipertensão arterial e obesidade foram maiores no sexo masculino. Adolescentes com obesidade tiveram prevalência de hipertensão arterial mais elevada, 28,4% (IC95% 25,5-31,2), do que aqueles com sobrepeso, 15,4% (IC95% 13,8-17,0), ou eutróficos, 6,3% (IC95% 5,6-7,0). A fração de hipertensão arterial atribuível à obesidade foi de 17,8%. CONCLUSÕES O ERICA foi o primeiro estudo brasileiro com representatividade nacional a estimar a prevalência de hipertensão arterial aferida em adolescentes. A fração da prevalência de hipertensão arterial atribuível à obesidade mostrou que cerca de 1/5 dos hipertensos poderiam não ser hipertensos se não fossem obesos.
ABSTRACT OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.
https://doi.org/10.1590/s01518-8787.2016050006685
1511 downloads
15.
ERICA: prevalences of hypertension and obesity in Brazilian adolescents
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Facebook Twitter
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- Google+
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- Metrics
Bloch, Katia Vergetti
; Klein, Carlos Henrique
; Szklo, Moyses
; Kuschnir, Maria Cristina C
; Abreu, Gabriela de Azevedo
; Barufaldi, Laura Augusta
; Veiga, Gloria Valeria da
; Schaan, Beatriz
; Silva, Thiago Luiz Nogueira da
; Moraes, Ana Julia Pantoja
; Oliveira, Ana Mayra Andrade de
; Tavares, Bruno Mendes
; Magliano, Erika da Silva
; Oliveira, Cecília Lacroix de
; Cunha, Cristiane de Freitas
; Giannini, Denise Tavares
; Belfort, Dilson Rodrigues
; Santos, Eduardo Lima
; Leon, Elisa Brosina de
; Oliveira, Elizabete Regina Araújo
; Fujimori, Elizabeth
; Borges, Ana Luíza
; Vasconcelos, Francisco de Assis Guedes
; Azevedo, George Dantas
; Brunken, Gisela Soares
; Guimarães, Isabel Cristina Britto
; Faria Neto, José Rocha
; Oliveira, Juliana Souza
; Carvalho, Kenia Mara B. de
; Gonçalves, Luis Gonzaga de Oliveira
; Monteiro, Maria Inês
; Santos, Marize M.
; Jardim, Paulo César B. Veiga
; Ferreira, Pedro Antônio Muniz
; Montenegro Jr., Renan Magalhães
; Gurgel, Ricardo Queiroz
; Vianna, Rodrigo Pinheiro
; Vasconcelos, Sandra Mary
; Goldberg, Tamara Beres Lederer
.
RESUMO OBJETIVO Estimar as prevalências de hipertensão arterial e obesidade e a fração atribuível populacional de hipertensão arterial devida à obesidade em adolescentes brasileiros. MÉTODOS Foram avaliados dados dos participantes do Estudo de Riscos Cardiovasculares em Adolescentes, estudo seccional l nacional de base escolar. A amostra foi dividida em 32 estratos geográficos e conglomerados de escolas e turmas, com representatividade nacional, macrorregional e de capitais. Obesidade foi classificada pelo índice de massa corporal segundo idade e sexo. Considerou-se hipertensão arterial a média da pressão arterial sistólica ou diastólica maior ou igual ao percentil 95 da curva de referência. Foram estimadas prevalências e intervalos de confiança de 95% (IC95%) de hipertensão arterial e de obesidade, nacionais e nas macrorregiões do País, por sexo e grupo etário, assim como as frações de hipertensão atribuíveis à obesidade na população. RESULTADOS Foram avaliados 73.399 estudantes, 55,4% do sexo feminino, com média de idade 14,7 anos (DP = 1,6). A prevalência de hipertensão arterial foi 9,6% (IC95% 9,0-10,3); sendo as mais baixas observadas nas regiões Norte, 8,4% (IC95% 7,7-9,2) e Nordeste, 8,4% (IC95% 7,6-9,2) e a mais alta na região Sul, 12,5% (IC95% 11,0-14,2). A prevalência de obesidade foi 8,4% (IC95% 7,9-8,9), mais baixa na região Norte e mais alta na Sul. As prevalências de hipertensão arterial e obesidade foram maiores no sexo masculino. Adolescentes com obesidade tiveram prevalência de hipertensão arterial mais elevada, 28,4% (IC95% 25,5-31,2), do que aqueles com sobrepeso, 15,4% (IC95% 13,8-17,0), ou eutróficos, 6,3% (IC95% 5,6-7,0). A fração de hipertensão arterial atribuível à obesidade foi de 17,8%. CONCLUSÕES O ERICA foi o primeiro estudo brasileiro com representatividade nacional a estimar a prevalência de hipertensão arterial aferida em adolescentes. A fração da prevalência de hipertensão arterial atribuível à obesidade mostrou que cerca de 1/5 dos hipertensos poderiam não ser hipertensos se não fossem obesos.
ABSTRACT OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.
https://doi.org/10.1590/s01518-8787.2016050006685
18629 downloads
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