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1.
Prognosis indicators of equine acute abdomen in south Brazil
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Pradella, Gabriela Döwich
; Andrade, Adriana Oliveira
; Tassinari, Wagner de Souza
; Lübeck, Irina
; Martins, Natálie Rodrigues
; Dutra, Natália Lima Brasil
; Duarte, Claudia Acosta
.
RESUMO: Os casos de abdome agudo estão entre as doenças mais prevalentes e desafiadoras na medicina equina. O diagnóstico inclui a realização de anamnese e avaliação clínica detalhada do paciente, permitindo a coleta de diversas informações importantes e, adicionalmente, a utilização de exames complementares ajuda a definir o diagnóstico e prognóstico de cada caso. O objetivo principal deste trabalho foi aplicar a análise de correspondência múltipla (ACM) em dados referentes ao exame clínico e desfecho de cavalos com cólica encaminhados para um hospital no Rio Grande do Sul, Brasil. Foram incluídos 58 cavalos na análise e foi possível identificar diferenças significativas entre os grupos, sobreviventes e não sobreviventes. Relacionado aos sinais clínicos, os casos de óbito distinguem-se por dor intensa, falta de motilidade, alteração da mucosa, tempo de preenchimento capilar maior que 2seg., frequência cardíaca maior que 48bpm e presença de refluxo nasogástrico. Como exames complementares, o hematócrito e o lactato sanguíneo demonstraram diferença significativa entre os grupos. Os parâmetros cardiovasculares, como batimento cardíaco, coloração de mucosas e tempo de preenchimento capilar, foram as variáveis com maior contribuição para diferenciar animais que não sobreviveram dos que receberam alta hospitalar. Assim, a avaliação clínica não deve ser subestimada e os exames complementares devem ser utilizados em conjunto para buscar um melhor prognóstico. A ACM permitiu visualizar os dados e prever o desfecho dos pacientes. RESUMO equina paciente adicionalmente caso (ACM Sul Brasil 5 grupos clínicos distinguemse distinguem se intensa motilidade mucosa 2seg seg 2seg. bpm nasogástrico cardiovasculares cardíaco hospitalar Assim pacientes
ABSTRACT: Acute abdomen cases are among the most prevalent and challenging illnesses in equine medicine. The diagnosis includes anamnesis and detailed clinical evaluation of the patient, allowing the gathering of several important information and, additionally, the use of complementary exams helps to define the diagnosis and prognosis of each case. This research applied the multiple correspondence analysis (MCA) in data referring to clinical examination information and outcome of horses with colic referred to a hospital in Rio Grande do Sul, Brazil. Fifty eight horses were included in the analysis and, it was possible to identify significant differences between the groups, survivors and non-survivors. Related to clinical signs, non-survivor cases are distinguished by severe pain, lack of motility, mucosal alteration, capillary refill time greater than 2sec, heart rate more than 48bpm and presence of nasogastric reflux. As complementary exams, hematocrits and blood lactate demonstrate significative difference among the groups. The cardiovascular parameters, including heart rate, mucosal color and capillary refill time, were the variables with the greatest contribution to discriminate animals that non-survive from those that were discharged. Thus, clinical evaluation should not be underestimated and complementary exams should be used in conjunction to seek a better prognosis. The MCA allowed to visualize the data and predict the outcome of the patients. ABSTRACT medicine patient additionally case (MCA Sul Brazil groups nonsurvivors. nonsurvivors non survivors. non-survivors signs nonsurvivor survivor pain motility alteration 2sec sec bpm reflux parameters nonsurvive survive discharged Thus patients
2.
Choroid plexus carcinoma in a horse: case report horse
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Almeida, Mariana de Oliveira
; Queiroz, Daniela Junqueira de
; Dória, Renata Gebara Sampaio
; Souza, Adriana Coelho de
; Silva, Ketherson Rodrigues
; Bariani Junior, Antonio Fernando
.
RESUMO: As neoplasias neuroepiteliais presentes no sistema ventricular originam-se das células que revestem o plexo coroide e podem ser benignas ou malignas, como é o caso do carcinoma de plexo coroide. Um equino, de quatro anos de idade, apresentando quadro neurológico com síndrome encefálica de quinze dias de evolução, foi encaminhado para atendimento veterinário. Ao exame apresentava apatia, ataxia severa, desvio lateral de cabeça, andar em círculos, pressão da cabeça contra obstáculos, diminuição do tônus da cauda, anosmia, ausência da resposta de ameaça visual, ausência de sensibilidade na face e hipotonia de língua. Líquido cefalorraquidiano apresentava pleocitose mista, aumento de proteína e diminuição de glicose. Após o óbito o animal foi diagnosticado com carcinoma de plexo coroide em terceiro ventrículo após exame histopatológico e imunohistoquímico. Conclui-se que equinos podem apresentar tumores em SNC, como o carcinoma de plexo coroide, com sintomatologia clínica inespecífica, tratamento clínico inefetivo e diagnóstico conclusivo realizado no exame post mortem. RESUMO originamse originam se malignas equino idade evolução veterinário apatia severa círculos obstáculos cauda anosmia visual língua mista glicose imunohistoquímico Concluise Conclui SNC inespecífica mortem
ABSTRACT: Neuroepithelial neoplasms present in the ventricular system originate from the cells lining the choroid plexus and can be benign or malignant, such as choroid plexus carcinoma. A four-year-old equine presenting with a fifteen-day history of neurological symptoms was sent for veterinary evaluation. Upon examination, the horse exhibited apathy, severe ataxia, head tilt, circling behavior, head pressing, decreased tail tone, anosmia, absence of menace response, lack of facial sensitivity, and lingual hypotonia. Cerebrospinal fluid analysis revealed mixed pleocytosis, increased protein, and decreased glucose. Following the animal’s death, histopathological and immunohistochemical examinations confirmed the diagnosis of choroid plexus carcinoma in the third ventricle. It is concluded that horses may develop central nervous system tumors, such as choroid plexus carcinoma, with nonspecific clinical symptoms, ineffective clinical treatment, and a conclusive diagnosis established postmortem. ABSTRACT malignant fouryearold four year old fifteenday fifteen day evaluation examination apathy ataxia tilt behavior pressing tone anosmia response sensitivity hypotonia pleocytosis protein glucose animals animal s death ventricle tumors treatment postmortem
3.
Vaccination coverage, barriers and vaccine hesitancy in children up to 24 months old: a population survey in a state capital in the Western Amazon
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Macedo, Thaiane Rodrigues de Oliveira
; Borges, Maria Fernanda de Sousa Oliveira
; Silva, Ilce Ferreira da
; França, Ana Paula
; Moraes, José Cássio de
; Silva, Adriana Ilha da
; Ramos Jr., Alberto Novaes
; França, Ana Paula
; Oliveira, Andrea de Nazaré Marvão
; Boing, Antonio Fernando
; Domingues, Carla Magda Allan Santos
; Oliveira, Consuelo Silva de
; Maciel, Ethel Leonor Noia
; Guibu, Ione Aquemi
; Mirabal, Isabelle Ribeiro Barbosa
; Barbosa, Jaqueline Caracas
; Lima, Jaqueline Costa
; Moraes, José Cássio de
; Luhm, Karin Regina
; Caetano, Karlla Antonieta Amorim
; Lima, Luisa Helena de Oliveira
; Antunes, Maria Bernadete de Cerqueira
; Teixeira, Maria da Gloria
; Teixeira, Maria Denise de Castro
; Borges, Maria Fernanda de Sousa Oliveira
; Queiroz, Rejane Christine de Sousa
; Gurgel, Ricardo Queiroz
; Barata, Rita Barradas
; Azevedo, Roberta Nogueira Calandrini de
; Oliveira, Sandra Maria do Valle Leone de
; Teles, Sheila Araújo
; Gama, Silvana Granado Nogueira da
; Mengue, Sotero Serrate
; Simões, Taynãna César
; Nascimento, Valdir
; Araújo, Wildo Navegantes de
.
ABSTRACT Objective To estimate vaccination coverage, identify barriers and hesitancy to vaccinating children up to 24 months, born between 2017-2018, living in the urban area of Rio Branco, Acre, Brazil. Methods Population survey carried out from 2020 to 2021, which assessed sociodemographic characteristics and vaccination status among children. Results Among 451 included children, vaccination coverage was below 80%. Meningococcal C vaccine had the lowest coverage for administered doses (76.3%; 95%CI 70.5;81.3) and doses on time (27.4%; 95%CI 23.1;32.1). The statements “vaccines cause serious adverse reactions” (26.4%; 95%CI 18.1;36.8) and “you don’t need vaccination for diseases that no longer exist” (22%; 95%CI 15.7;29.8) were the most frequent regarding vaccination hesitancy. Lack of vaccines was the main barrier to care (86.6%; 95%CI 71.8;94.3). Conclusion Vaccination coverage in children born in 2017-2018 was below the target recommended for the full schedule of administered doses, both valid and timely administered.
RESUMO Objetivo Estimar a cobertura vacinal, identificar barreiras e hesitação à vacinação em crianças com até 24 meses, nascidas em 2017 e 2018, residentes na área urbana de Rio Branco-AC. Métodos Inquérito populacional realizado de 2020 a 2021, que avaliou as características sociodemográficas e a situação vacinal em crianças nascidas entre 2017 e 2018. Resultados Entre as 451 crianças estudadas, as coberturas vacinais foram inferiores a 80%. A menor cobertura para doses aplicadas (76,3%; IC95% 70,5;81,3) e oportunas (27,4%; IC95% 23,1;32,1) foi para o reforço da meningocócica C. As afirmações “vacinas causam reações adversas graves” (26,4%; IC95% 18,1;36,8) e “não precisa da vacina para doenças que não existem mais” (22%; IC95% 15,7;29,8) foram as mais frequentes quanto à hesitação vacinal. A falta da vacina foi a principal barreira assistencial (86,6%; IC95% 71,8;94,3). Conclusão As coberturas vacinais em crianças nascidas em 2017 e 2018 ficaram abaixo da meta preconizada nos esquemas completos de doses aplicadas, válidas e oportunas.
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4.
Leishmania (Sauroleishmania) tarentolae versus pathogenic species: comparative evaluation of protease activity, glycoconjugates, resistance to complement and metabolome composition Sauroleishmania (Sauroleishmania species activity glycoconjugates
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Andrade, Filipe Fideles Duarte
; Vitório, Jéssica Gardone
; Canuto, Gisele André Baptista
; Nunes, Fernanda Freire Campos
; Rodrigues, Isabela Aurora
; Almeida, Ana Paula Martins Morais
; Nascimento, Frederico Crepaldi
; Costa, Adriana Oliveira
; Vieira, Tamara da Silva
; Silva, Ana Carolina Carvalho
; André, Leiliane Coelho
; Gontijo, Célia Maria Ferreira
; Junqueira, Caroline
; Toledo, Juliano Simões de
; Fernandes, Ana Paula
; Soares, Rodrigo Pedro
.
BACKGROUND Leishmania tarentolae is a non-pathogenic species found in lizards representing an important model for Leishmania biology. However, several aspects of this Sauroleishmania remain unknown to explain its low level of virulence. OBJECTIVES We reported several aspects of L. tarentolae biology including glycoconjugates, proteolytic activities and metabolome composition in comparison to pathogenic species (Leishmania amazonensis, Leishmania braziliensis, Leishmania infantum and Leishmania major). METHODS Parasites were cultured for extraction and purification of lipophosphoglycan (LPG), immunofluorescence probing with anti-gp63 and resistance against complement. Parasite extracts were also tested for proteases activity and metabolome composition. FINDINGS Leishmania tarentolae does not express LPG on its surface. It expresses gp63 at lower levels compared to pathogenic species and, is highly sensitive to complement-mediated lysis. This species also lacks intracellular/extracellular activities of proteolytic enzymes. It has metabolic differences with pathogenic species, exhibiting a lower abundance of metabolites including ABC transporters, biosynthesis of unsaturated fatty acids and steroids, TCA cycle, glycine/serine/threonine metabolism, glyoxylate/dicarboxylate metabolism and pentose-phosphate pathways. MAIN CONCLUSIONS The non-pathogenic phenotype of L. tarentolae is associated with alterations in several biochemical and molecular features. This reinforces the need of comparative studies between pathogenic and non-pathogenic species to elucidate the molecular mechanisms of virulence during host-parasite interactions. nonpathogenic non However L glycoconjugates amazonensis braziliensis major. major . major) LPG, , (LPG) antigp63 antigp anti gp anti-gp6 complement surface gp6 complementmediated mediated lysis intracellularextracellular intracellular extracellular enzymes transporters steroids cycle glycineserinethreonine glycine serine threonine glyoxylatedicarboxylate glyoxylate dicarboxylate pentosephosphate pentose phosphate pathways features hostparasite host parasite interactions (LPG antigp6 anti-gp
5.
Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023 202 20 2
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Feitosa, Audes Diogenes de Magalhães
; Barroso, Weimar Kunz Sebba
; Mion Junior, Decio
; Nobre, Fernando
; Mota-Gomes, Marco Antonio
; Jardim, Paulo Cesar Brandão Veiga
; Amodeo, Celso
; Oliveira, Adriana Camargo
; Alessi, Alexandre
; Sousa, Ana Luiza Lima
; Brandão, Andréa Araujo
; Pio-Abreu, Andrea
; Sposito, Andrei C.
; 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, Claudia Lucia de Moraes
; Sampaio, Diogo Pereira Santos
; Barbosa, Eduardo Costa Duarte
; Freitas, Elizabete Viana de
; Cestario, Elizabeth do Espirito 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 F.
; 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
; Vitorino, Priscila Valverde de Oliveira
; Miranda, Roberto Dischinger
; Bezerra, Rodrigo
; Pedrosa, Rodrigo Pinto
; Paula, Rogerio Baumgratz de
; Okawa, Rogério Toshiro Passos
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C.
; Lima, Sandro Gonçalves de
; Inuzuka, Sayuri
; Ferreira-Filho, Sebastião Rodrigues
; Fillho, Silvio Hock de Paffer
; Jardim, Thiago de Souza Veiga
; Guimarães Neto, Vanildo da Silva
; Koch, Vera Hermina Kalika
; Gusmão, Waléria Dantas Pereira
; Oigman, Wille
; Nadruz Junior, Wilson
.
6.
Adjuvant antimicrobial photodynamic therapy improves periodontal health and reduces inflammatory cytokines in patients with type 1 diabetes mellitus
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CUNHA, Paula de Oliveira
; GONSALES, Isabela Rodrigues
; GREGHI, Sebastião Luiz Aguiar
; SANT’ANA, Adriana Campos Passanezi
; HONÓRIO, Heitor Marques
; NEGRATO, Carlos Antonio
; ZANGRANDO, Mariana Schutzer Ragghianti
; DAMANTE, Carla Andreotti
.
Abstract Antimicrobial photodynamic therapy (aPDT) is an adjuvant treatment to scaling and root planing (SRP) which improves periodontal health. It may be beneficial to patients with systemic diseases, such as type 1 diabetes mellitus. Objective This randomized clinical trial evaluated the adjunctive effect of aPDT on the periodontal treatment of patients with type 1 diabetes (T1D). Methodology 38 patients were included in the study and divided into four groups: DSRP – T1D patients treated with SRP; CSRP – normoglycemic patients treated with SRP; DPDT – T1D patients treated with SRP + aPDT (methylene blue and red laser); CPDT – normoglycemic patients treated with SRP + aPDT. , Periodontal clinical parameters and inflammatory cytokines in crevicular fluid were recorded at baseline and then after 1, 3 and 6 months. The clinical endpoint for treatment was evaluated after 6 months. Results Adjuvant aPDT treatment resulted in reduction of probing depth after 3 months (0.38 mm - p<0.05) on T1D patients and in control group after 6 months (0.66 mm - p<0.05). Reduction of clinical attachment levels was similar for both treatments in control patients (p>0.05). There was a significant reduction of TNF-α in crevicular fluid in both groups treated with aPDT (p<0.05). The T1D (65%) and normoglycemic (72%) groups achieved the clinical endpoint after both treatments (p>0.05). Conclusions Adjuvant aPDT provided additional benefits in improving periodontal clinical parameters and reducing inflammatory cytokines in both T1D and normoglycemic patients. However, normoglycemic patients showed greater clinical improvements compared to T1D patients following adjuvant aPDT treatment. (aPDT (SRP health diseases mellitus T1D. TD . T D (T1D) methylene laser laser) 0.38 038 0 (0.3 p<0.05 p005 p 05 0.66 066 66 (0.6 p<0.05. p>0.05. p>0.05 (p>0.05) TNFα TNF α (p<0.05) 65% 65 (65% 72% 72 (72% However (T1D 0.3 03 (0. p<0.0 p00 0.6 06 p>0.0 (p>0.05 (p<0.05 (65 7 (72 0. (0 p<0. p0 p>0. (p>0.0 (p<0.0 (6 (7 ( p<0 p>0 (p>0. (p<0. p< p> (p>0 (p<0 (p> (p< (p
7.
Adequação Alimentar de Indivíduos com Doença Cardiovascular Conforme Diretrizes Clínicas no Programa Alimentar Brasileiro Cardioprotetor
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Brito, Luciana
; Sahade, Viviane
; Marcadenti, Aline
; Torreglosa, Camila Ragne
; Weber, Bernardete
; Bersch-Ferreira, Ângela Cristine
; Rodrigues, Isa Galvão
; Sousa, Antônio Carlos Sobral
; Gomes, Adriana Barros
; Pinheiro, Josilene Maria Ferreira
; Vasconcelos, Sandra Mary Lima
; Carlos, Daniele Maria de Oliveira
; Figueiredo Neto, José Albuquerque de
; Dantas, Clenise de Farias
; Daltro, Carla
.
Resumo Fundamento Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. Objetivo Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). Métodos Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. Resultados Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). Conclusões A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos. alcançado DCV , (DCV) Brasil SBC . (SBC) DICA BR 2 005 0 05 0,05 64 pacientes desvio padrão 631 63 1 63, 9,4 94 9 4 (9,4 anos 502 50 50,2 feminino observouse observou se 52,3%, 523 52,3% 52 3 (52,3%) 70,9%, 709 70,9% 70 (70,9%) 38,8% 388 38 8 (38,8% 22,4%. 224 22,4% 22 (22,4%) Observouse Observou 59,2% 592 59 (59,2% 52,6%. 526 52,6% 6 (52,6%) sódio 72,9%, 729 72,9% 72 (72,9%) 13 13% disso 28,1% 281 28 (28,1% 70,5%. 705 70,5% 5 (70,5%) secundária estruturadas (DCV (SBC 00 0,0 9, (9, 50, 52,3 (52,3% 70,9 7 (70,9% 38,8 (38,8 22,4 (22,4% 59,2 (59,2 52,6 (52,6% 72,9 (72,9% 28,1 (28,1 70,5 (70,5% 0, (9 52, (52,3 70, (70,9 38, (38, 22, (22,4 59, (59, (52,6 72, (72,9 28, (28, (70,5 ( (52, (70, (38 (22, (59 (72, (28 (52 (70 (3 (22 (5 (72 (2 (7
Abstract Background Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. Objective To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). Methods Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. Results 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). Conclusions Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals. achieved CVD, , (CVD) Brazil SBC. . (SBC) Crosssectional Cross sectional DICA BR, BR BR) 24hour hour 24 005 0 05 0.0 significant 64 studied standard deviation 631 63 1 63. 9.4 94 9 4 (9.4 years 502 50 2 50.2 female 52.3%, 523 52.3% 52 3 (52.3%) 70.9%, 709 70.9% 70 (70.9%) 38.8%, 388 38.8% 38 8 (38.8%) 22.4% 224 22 (22.4% lowprotein protein 59.2% 592 59 (59.2% 52.6%. 526 52.6% 6 (52.6%) 72.9%, 729 72.9% 72 (72.9%) 13 reduction Furthermore 28.1% 281 28 (28.1% 70.5%. 705 70.5% 5 (70.5%) prevention (CVD (SBC 00 0. 9. (9. 50. 52.3 (52.3% 70.9 7 (70.9% 38.8 (38.8% 22.4 (22.4 59.2 (59.2 52.6 (52.6% 72.9 (72.9% 28.1 (28.1 70.5 (70.5% (9 52. (52.3 70. (70.9 38. (38.8 22. (22. 59. (59. (52.6 72. (72.9 28. (28. (70.5 ( (52. (70. (38. (22 (59 (72. (28 (52 (70 (38 (2 (5 (72 (7 (3
8.
To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis B B2 positive outcomes
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Resende, Gustavo Gomes
; Saad, Carla Goncalves Schahin
; Marques, Claudia Diniz Lopes
; Ribeiro, Sandra Lúcia Euzébio
; Gavi, Maria Bernadete Renoldi de Oliveira
; Yazbek, Michel Alexandre
; Marinho, Adriana de Oliveira
; Menin, Rita de Cássia
; Ochtrop, Manuella Lima Gomes
; Soares, Andressa Miozzo
; Cavalcanti, Nara Gualberto
; Carneiro, Jamille Nascimento
; Werner de Castro, Glaucio Ricardo
; Fernandes, José Mauro Carneiro
; Souza, Elziane da Cruz Ribeiro E
; Alvarenga, Corina Quental de Menezes
; Vieira, Rejane Maria Rodrigues de Abreu
; Machado, Natalia Pereira
; Ximenes, Antônio Carlos
; Gazzeta, Morgana Ohira
; Albuquerque, Cleandro Pires de
; Skare, Thelma Larocca
; Keiserman, Mauro Waldemar
; Kohem, Charles Lubianca
; Benacon, Gabriel Sarkis
; Rocha, Vítor Florêncio Santos
; Lage, Ricardo da Cruz
; Malheiro, Olivio Brito
; Golebiovski, Rywka Tenenbaum Medeiros
; Oliveira, Thauana Luiza
; Duque, Ruben Horst
; Londe, Ana Carolina
; Pinheiro, Marcelo de Medeiros
; Sampaio-Barros, Percival Degrava
.
Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±
9.
Oral and pharyngeal phases of swallowing in removable complete denture wearers
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Montaldi, Marina Rodrigues
; Silva, Cláudia Helena Lovato da
; Ribeiro, Adriana Barbosa
; Araujo, Camila Borba de
; Fortes, Caroline Vieira
; Dantas, Roberto Oliveira
.
RESUMO Objetivo: Comparar a dinâmica da deglutição e trânsito do bolo alimentar na cavidade oral e na faringe entre usuários de próteses totais bem adaptadas e indivíduos dentados. Métodos: Vinte e sete usuários de prótese total (43 a 77 anos), avaliados com e sem as próteses, e 26 controles (41 a 74 anos) foram examinados com estudo videofluoroscópico da deglutição com bolos líquido, pastosos e sólido (biscoito e torrada), em duplicata e em sequência aleatória. Resultados: Resíduos orais após a deglutição líquida (em 56% das deglutições), na consistência purê (em 71% das deglutições) e com torradas (em 41% das deglutições), foram mais frequentes do que nos controles (líquido 13%, purê 43 % e torradas 15% das deglutições, p ≤ 0,04). Em usuários de próteses os tempos de trânsito oral, trânsito faríngeo e trânsito pelo esfíncter superior do esôfago foram mais longos com o bolo líquido; os tempos de trânsito faríngeo e orofaríngeo foram mais longos com o bolo purê; e o tempo de trânsito orofaríngeo foi mais longo com o biscoito. Os resultados da avaliação sem próteses foram mais próximos dos controles ao engolir bolo pastoso. A aspiração laríngea não foi observada em nenhum dos indivíduos. Conclusão: Usuários de próteses totais removíveis tendem a ter maior tempo de trânsito faríngeo do que indivíduos dentados. Embora resíduo oral e longo trânsito faríngeo aumentem o risco de aspiração para vias aéreas, isso não foi observado nesta investigação. Objetivo dentados Métodos (4 7 anos, anos , 2 41 líquido biscoito torrada, torrada torrada) aleatória Resultados 56 deglutições 71 13 13% 4 15 0,04. 004 0,04 . 0 04 0,04) pastoso Conclusão aéreas investigação ( 5 1 00 0,0 0,
ABSTRACT Objective: To compare swallowing and bolus transit time through the oral cavity and pharynx between well-fitted complete denture wearers and toothed individuals. Methods: Altogether, 27 complete denture wearers (43 to 77 years old) and 26 controls (41 to 74 years old) were examined with videofluoroscopic swallowing study using liquid, pureed, and solid (crackers and toasts) bolus, twice and in a random sequence. Denture wearers were assessed with and without dentures. Results: Individuals wearing dentures had oral residues after swallowing liquid (in 56% of swallows) and pureed boluses (in 71% of swallows) and with toasts (in 41% of swallows), more often than controls (liquid 13%, pureed 43% and toast 15% of swallows, p ≤ 0.04). In denture wearers, the oral, upper esophageal sphincter, and pharyngeal transit times were longer after swallowing liquid bolus; the pharyngeal and oropharyngeal transit times were longer after swallowing pureed bolus; and the oropharyngeal transit time was longer after eating crackers. Assessment results without dentures were closer to that of controls when swallowing pureed bolus. Laryngeal aspiration was not observed in any of the individuals. Conclusion: Removable complete denture wearers tend to have longer pharyngeal transit time than toothed individuals. Although oral residues and longer pharyngeal transit in individuals wearing dentures increase the risk of airway aspiration, this investigation did not verify such a condition. Objective wellfitted well fitted Methods Altogether 2 43 (4 7 old 41 crackers sequence Results 56 swallows 71 , 13 13% 15 0.04. 004 0.04 . 0 04 0.04) sphincter Conclusion condition 4 ( 5 1 00 0.0 0.
10.
Adequação do Consumo de Ácidos Graxos entre Pacientes em Prevenção Cardiovascular Secundária
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Marcadenti, Aline
; Machado, Rachel H. Vieira
; Santos, Renato Hideo Nakagawa
; Kasai, Caio Cesar dos Santos
; Kovacs, Cristiane
; Bello, Annie
; de Matos, Cristina H.
; Bertacco, Renata Torres Abib
; Souza, Gabriela C.
; Schirmann, Gabriela da S.
; Nagano, Francisca Eugenia Zaina
; Poloni, Soraia
; Kik, Raquel Milani El
; Feres, Naoel Hassan
; Rodrigues, Isa G.
; Sousa, Antônio Carlos Sobral
; Pinheiro, Josilene M. F.
; Vasconcelos, Sandra Mary Lima
; Carlos, Daniele Maria de Oliveira
; Souza, Viviane Sahade
; Gomes, Adriana Barros
; Figueiredo Neto, José Albuquerque de
; Moriguchi, Emilio Hideyuki
; Izar, Maria Cristina
; Pinto, Sônia Lopes
; Bressan, Josefina
; de Souza, Simone Raimondi
; Kumbier, Magali C.
; de Araújo, Celme Barroncas Passos
; Torreglosa, Camila R.
; Weber, Bernardete
; Bersch-Ferreira, Ângela Cristine
.
Resumo Fundamento: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. Objetivo: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. Métodos: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS), <7%. Na análise estatística foi considerando nível de significância de 5%. Resultados: Nenhum participante aderiu a todas as recomendações de forma simultânea e mais da metade (1482 [62,9%]) não aderiu a nenhuma recomendação. A adesão exclusivamente à recomendação de AGS foi a mais prevalente, sendo cumprida por 659 (28%) dos participantes, seguida da adesão exclusivamente à recomendação de AGP (178 [7,6%]) e de AGM (5 [0,2%]). Não houve associação entre o número de comorbidades e a adesão às recomendações nutricionais (p =0,269). Os participantes da região Nordeste do país apresentaram maior proporção de adesão às recomendações para consumo de AGS (38,42%), e menor para ingestão de AGPI (3,52%) (p <0,001) em comparação às demais. Conclusões: Na amostra avaliada, evidenciou-se baixa adesão às recomendações nutricionais para consumo de ácidos graxos. Fundamento cardiovasculares Objetivo Métodos 235 Brazilian Trial. Trial . Trial" alimentar avaliados considerada Cardiologia poliinsaturados poli insaturados (AGPI 10 ≥10 diária AGM, , (AGM) 20 AGS, (AGS) 7 <7% 5 5% Resultados 1482 (148 62,9% 629 62 9 [62,9%] prevalente 65 28% 28 (28% 178 (17 7,6% 76 6 [7,6%] ( 0,2%. 02 0,2% 0 2 [0,2%]) p =0,269. 0269 =0,269 269 =0,269) 38,42%, 3842 38,42% 38 42 (38,42%) 3,52% 352 3 52 (3,52% <0,001 0001 001 demais Conclusões avaliada evidenciouse evidenciou 23 1 ≥1 (AGM (AGS <7 148 (14 62,9 [62,9% (28 17 (1 7,6 [7,6% 0,2 [0,2%] 026 =0,26 26 384 38,42 4 (38,42% 3,52 35 (3,52 <0,00 000 00 ≥ < 14 62, [62,9 (2 7, [7,6 0, [0,2% =0,2 38,4 (38,42 3,5 (3,5 <0,0 [62, [7, [0,2 =0, 38, (38,4 3, (3, <0, [62 [7 [0, =0 (38, (3 <0 [6 [ [0 = (38
Background: Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. Objective: To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. Methods: Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. Results: No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. Conclusions: Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption. Background Objective Methods Crosssectional Cross sectional 2358 2 358 2,35 Trial. Trial . Trial" assessed (PUFA 10 ≥10 MUFA, , (MUFA) 20% 20 SFA, (SFA) 7 <7 Cardiology 5 analysis Results simultaneously 1,482 1482 1 482 (1,48 62.9% 629 62 9 [62.9%] prevalent 65 28% 28 (28% 178 (17 7.6% 76 6 [7.6%] ( 0.2% 02 0 [0.2%] p 0.269. 0269 0.269 269 0.269) 38.42% 3842 38 42 (38.42% 3.52% 352 3 52 (3.52% <0.001 0001 001 regions Conclusions sample 235 35 2,3 ≥1 (MUFA (SFA < 1,48 148 48 (1,4 62.9 [62.9% (28 17 (1 7.6 [7.6% 0.2 [0.2% 026 0.26 26 38.42 384 4 (38.42 3.52 (3.52 <0.00 000 00 23 2, ≥ 1,4 14 (1, 62. [62.9 (2 7. [7.6 0. [0.2 38.4 (38.4 3.5 (3.5 <0.0 1, [62. [7. [0. 38. (38. 3. (3. <0. [62 [7 [0 (38 (3 <0 [6 [
11.
Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves
; Guimarães, Camila
; Rêgo, Jozelia
; Machado, Ketty Lysie Libardi Lira
; Miyamoto, Samira Tatiyama
; Burian, Ana Paula Neves
; Dias, Laiza Hombre
; Pretti, Flavia Zon
; Batista, Danielle Cristina Filgueira Alves
; Mill, José Geraldo
; Oliveira, Yasmin Gurtler Pinheiro de
; Gadelha, Carolina Strauss Estevez
; Gouveia, Maria da Penha Gomes
; Moulin, Anna Carolina Simões
; Souza, Bárbara Oliveira
; Aguiar, Laura Gonçalves Rodrigues
; Vieira, Gabriel Smith Sobral
; Grillo, Luiza Lorenzoni
; Lima, Marina Deorce de
; Pasti, Laís Pizzol
; Surlo, Heitor Filipe
; Faé, Filipe
; Moulaz, Isac Ribeiro
; Macabú, Mariana de Oliveira
; Ribeiro, Priscila Dias Cardoso
; Magalhães, Vanessa de Oliveira
; Aguiar, Mariana Freitas de
; Biegelmeyer, Erika
; Peixoto;, Flávia Maria Matos Melo Campos
; Kayser, Cristiane
; Souza, Alexandre Wagner Silva de
; Castro, Charlles Heldan de Moura
; Ribeiro, Sandra Lúcia Euzébio
; Telles, Camila Maria Paiva França
; Bühring, Juliana
; Lima, Raquel Lima de
; Santos, Sérgio Henrique Oliveira Dos
; Dias, Samuel Elias Basualto
; Melo, Natália Seixas de
; Sanches, Rosely Holanda da Silva
; Boechat, Antonio Luiz
; Sartori, Natália Sarzi
; Hax, Vanessa
; Dória, Lucas Denardi
; Rezende, Rodrigo Poubel Vieira de
; Baptista, Katia Lino
; Fortes, Natália Rodrigues Querido
; Melo, Ana Karla Guedes de
; Melo, Tâmara Santos
; Vieira, Rejane Maria Rodrigues de Abreu
; Vieira, Adah Sophia Rodrigues
; Kakehasi, Adriana Maria
; Tavares, Anna Carolina Faria Moreira Gomes
; Landa, Aline Teixeira de
; Costa, Pollyana Vitoria Thomaz da
; Azevedo, Valderilio Feijó
; Martins-Filho, Olindo Assis
; Peruhype-Magalhães, Vanessa
; Pinheiro, Marcelo de Medeiros
; Monticielo, Odirlei André
; Reis-neto, Edgard Torres Dos
; Ferreira, Gilda Aparecida
; Souza, Viviane Angelina de
; Teixeira-Carvalho, Andréa
; Xavier, Ricardo Machado
; Sato, Emilia Inoue
; Valim, Valeria
; Pileggi, Gecilmara Salviato
; Silva, Nilzio Antonio da
.
Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26
12.
Vaccination coverage, barriers and vaccine hesitancy in children up to 24 months old: a population survey in a state capital in the Western Amazon coverage 2 old
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Macedo, Thaiane Rodrigues de Oliveira
; Borges, Maria Fernanda de Sousa Oliveira
; Silva, Ilce Ferreira da
; França, Ana Paula
; Moraes, José Cássio de
; Silva, Adriana Ilha da
; Ramos Jr., Alberto Novaes
; França, Ana Paula
; Oliveira, Andrea de Nazaré Marvão
; Boing, Antonio Fernando
; Domingues, Carla Magda Allan Santos
; Oliveira, Consuelo Silva de
; Maciel, Ethel Leonor Noia
; Guibu, Ione Aquemi
; Mirabal, Isabelle Ribeiro Barbosa
; Barbosa, Jaqueline Caracas
; Lima, Jaqueline Costa
; Moraes, José Cássio de
; Luhm, Karin Regina
; Caetano, Karlla Antonieta Amorim
; Lima, Luisa Helena de Oliveira
; Antunes, Maria Bernadete de Cerqueira
; Teixeira, Maria da Gloria
; Teixeira, Maria Denise de Castro
; Borges, Maria Fernanda de Sousa Oliveira
; Queiroz, Rejane Christine de Sousa
; Gurgel, Ricardo Queiroz
; Barata, Rita Barradas
; Azevedo, Roberta Nogueira Calandrini de
; Oliveira, Sandra Maria do Valle Leone de
; Teles, Sheila Araújo
; Gama, Silvana Granado Nogueira da
; Mengue, Sotero Serrate
; Simões, Taynãna César
; Nascimento, Valdir
; Araújo, Wildo Navegantes de
.
RESUMO Objetivo Estimar a cobertura vacinal, identificar barreiras e hesitação à vacinação em crianças com até 24 meses, nascidas em 2017 e 2018, residentes na área urbana de Rio Branco-AC. Métodos Inquérito populacional realizado de 2020 a 2021, que avaliou as características sociodemográficas e a situação vacinal em crianças nascidas entre 2017 e 2018. Resultados Entre as 451 crianças estudadas, as coberturas vacinais foram inferiores a 80%. A menor cobertura para doses aplicadas (76,3%; IC95% 70,5;81,3) e oportunas (27,4%; IC95% 23,1;32,1) foi para o reforço da meningocócica C. As afirmações “vacinas causam reações adversas graves” (26,4%; IC95% 18,1;36,8) e “não precisa da vacina para doenças que não existem mais” (22%; IC95% 15,7;29,8) foram as mais frequentes quanto à hesitação vacinal. A falta da vacina foi a principal barreira assistencial (86,6%; IC95% 71,8;94,3). Conclusão As coberturas vacinais em crianças nascidas em 2017 e 2018 ficaram abaixo da meta preconizada nos esquemas completos de doses aplicadas, válidas e oportunas. 2 meses 201 BrancoAC. BrancoAC Branco AC. AC Branco-AC 202 2021 45 estudadas 80 80% 76,3% 763 76 3 (76,3% IC95 IC 70,581,3 705813 70,5 81,3 70 5 81 70,5;81,3 27,4% 274 27 4 (27,4% 23,132,1 231321 23,1 32,1 23 1 32 23,1;32,1 C vacinas graves 26,4% 264 26 (26,4% 18,136,8 181368 18,1 36,8 18 36 8 18,1;36,8 22% 22 (22% 15,729,8 157298 15,7 29,8 15 7 29 15,7;29,8 86,6% 866 86 6 (86,6% 71,894,3. 718943 71,8 94,3 . 71 94 71,8;94,3) 20 76,3 (76,3 IC9 581 70,581, 70581 705 70, 813 81, 70,5;81, 27,4 (27,4 132 23,132, 23132 231 23, 321 32, 23,1;32, 26,4 (26,4 136 18,136, 18136 181 18, 368 36, 18,1;36, (22 729 15,729, 15729 157 15, 298 29, 15,7;29, 86,6 (86,6 894 71,894,3 71894 718 71, 943 94, 9 71,8;94,3 76, (76, 58 70,581 7058 70,5;81 27, (27, 13 23,132 2313 23,1;32 26, (26, 18,136 1813 18,1;36 (2 72 15,729 1572 15,7;29 86, (86, 89 71,894, 7189 71,8;94, (76 70,58 70,5;8 (27 23,13 23,1;3 (26 18,13 18,1;3 ( 15,72 15,7;2 (86 71,894 71,8;94 (7 70,5; 23,1; 18,1; 15,7; (8 71,89 71,8;9 71,8;
ABSTRACT Objective To estimate vaccination coverage, identify barriers and hesitancy to vaccinating children up to 24 months, born between 2017-2018, living in the urban area of Rio Branco, Acre, Brazil. Methods Population survey carried out from 2020 to 2021, which assessed sociodemographic characteristics and vaccination status among children. Results Among 451 included children, vaccination coverage was below 80%. Meningococcal C vaccine had the lowest coverage for administered doses (76.3%; 95%CI 70.5;81.3) and doses on time (27.4%; 95%CI 23.1;32.1). The statements “vaccines cause serious adverse reactions” (26.4%; 95%CI 18.1;36.8) and “you don’t need vaccination for diseases that no longer exist” (22%; 95%CI 15.7;29.8) were the most frequent regarding vaccination hesitancy. Lack of vaccines was the main barrier to care (86.6%; 95%CI 71.8;94.3). Conclusion Vaccination coverage in children born in 2017-2018 was below the target recommended for the full schedule of administered doses, both valid and timely administered. 2 months 20172018, 20172018 2017 2018, 2018 Branco Acre Brazil 202 2021 45 80 80% 76.3% 763 76 3 (76.3% 95CI CI 95 70.581.3 705813 70.5 81.3 70 5 81 70.5;81.3 27.4% 274 27 4 (27.4% 23.132.1. 231321 23.1 32.1 . 23 1 32 23.1;32.1) reactions 26.4% 264 26 (26.4% 18.136.8 181368 18.1 36.8 18 36 8 18.1;36.8 you dont don t exist 22% 22 (22% 15.729.8 157298 15.7 29.8 15 7 29 15.7;29.8 86.6% 866 86 6 (86.6% 71.894.3. 718943 71.8 94.3 71 94 71.8;94.3) 2017-201 2017201 201 20 76.3 (76.3 9 581 70.581. 70581 705 70. 813 81. 70.5;81. 27.4 (27.4 132 23.132.1 23132 231 23. 321 32. 23.1;32.1 26.4 (26.4 136 18.136. 18136 181 18. 368 36. 18.1;36. (22 729 15.729. 15729 157 15. 298 29. 15.7;29. 86.6 (86.6 894 71.894.3 71894 718 71. 943 94. 71.8;94.3 2017-20 201720 76. (76. 58 70.581 7058 70.5;81 27. (27. 13 23.132. 2313 23.1;32. 26. (26. 18.136 1813 18.1;36 (2 72 15.729 1572 15.7;29 86. (86. 89 71.894. 7189 71.8;94. 2017-2 20172 (76 70.58 70.5;8 (27 23.132 23.1;32 (26 18.13 18.1;3 ( 15.72 15.7;2 (86 71.894 71.8;94 2017- (7 70.5; 23.13 23.1;3 18.1; 15.7; (8 71.89 71.8;9 23.1; 71.8;
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13.
Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV
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Oliveira, Iara Katrynne Fonsêca
; Teixeira, Nayra do Socorro Caldas Carvalho de Almeida
; Rêgo, Beatriz de Mello Pereira
; Aires, Isabel Oliveira
; Rodrigues, Renata Rios Torres
; Araújo, Robson Eduardo da Silva
; Lima, Carlos Henrique Ribeiro
; Sousa, Rosana Rodrigues de
; Carvalho, Cecília Maria Resende Gonçalves de
; Costa, Dorcas Lamounier
; Santos, Marize Melo dos
; Paz, Suzana Maria Rebelo Sampaio da
; Paiva, Adriana de Azevedo
.
Abstract Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 % CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.
Resumen Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.
14.
[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.
15.
AGED PEOPLE'S HEALTH NEEDS IN THE FACE OF LONG COVID-19 AND ACCESS TO HEALTH SERVICES PEOPLES PEOPLE S COVID19 COVID 19 COVID-1 COVID1 1 COVID-
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Cavalaro, Jessika de Oliveira
; Gallo, Adriana Martins
; Derhun, Flávia Maria
; Marques, Francielle Renata Danielli Martins
; Baccon, Wanessa Cristina
; Pires, Graziele Adrieli Rodrigues
; Salci, Maria Aparecida
; Carreira, Lígia
.
RESUMEN Objetivo: averiguar las necesidades de salud de los adultos mayores que tuvieron Covid-19 prolongado y detalles del acceso al sistema de salud para suplir estos requerimientos. Método: estudio cualitativo y exploratorio realizado con 41 adultos mayores que tuvieron Covid-19 en 2020 y presentaron síntomas residuales 18 meses después de la infección. La recolección de datos tuvo lugar entre febrero y julio de 2022 por medio de entrevistas telefónicas semiestructuradas; en el análisis se utilizaron las técnicas analíticas de codificación inicial y focalizada y la base conceptual se fundamentó en el atributo “Accesibilidad” de la Atención Primaria de la Salud. Resultados: surgieron cuatro categorías en el análisis de los resultados, a saber: Comprender la necesidad de atención profesional; Reconocer los requerimientos que llevaron a los adultos mayores a procurar un servicio de salud; Percibir la disponibilidad de los servicios; y Analizar la capacidad de pago. Conclusión: la población anciana desarrolló requerimientos de la salud específicos relacionados con Covid-19 prolongado y los servicios de salud públicos y privados presentan cierta heterogeneidad en relación al enfoque de esta nueva condición, puesto que la atención basada en directrices propuestas por órganos oficiales no es unánime en los servicios públicos, privados y de Operadoras de Planes de Salud. Objetivo Covid19 Covid 19 Covid-1 Método 4 202 1 infección semiestructuradas Accesibilidad “Accesibilidad Salud Resultados resultados saber profesional pago Conclusión condición Covid1 Covid- 20 2
ABSTRACT Objective: to understand the health needs of aged people who had long Covid-19 and details about access to the health system to meet these demands. Method: an exploratory and qualitative study carried out with 41 aged individuals who had Covid-19 in 2020 and presented residual symptoms 18 months after the infection. Data collection took place between February and July 2022 through semi-structured interviews via telephone calls. In the analysis, initial and focused coding analytical techniques were used and the conceptual basis was grounded on the Primary Health Care “Accessibility” attribute. Results: four categories emerged when analyzing the results, namely: Understanding the need for professional care; Recognizing the demands that led aged people to seek health services; Understanding availability of the services; and Analyzing payment capacity. Conclusion: the aged population has developed specific health demands related to long Covid-19, and public and private health services are heterogeneous in their approach to this new condition, as care based on guidelines proposed by official bodies is not unanimous in public and private services and Health Plan Operators. Objective Covid19 Covid 19 Covid-1 Method 4 202 1 infection semistructured semi structured calls analysis Accessibility “Accessibility attribute Results results namely capacity Conclusion Covid19, 19, condition Operators Covid1 Covid- 20 2
RESUMO Objetivo: conhecer as necessidades de saúde dos idosos que tiveram a Covid longa e o acesso ao sistema de saúde para atender essas demandas. Método: estudo qualitativo exploratório, realizado com 41 idosos que tiveram Covid-19 no ano de 2020 e apresentaram sintomas residuais após 18 meses da infecção. A coleta de dados ocorreu entre fevereiro e julho de 2022 por meio de entrevistas semiestruturadas via telefone. Na análise foram utilizadas as técnicas de codificação inicial e focalizada e a base conceitual se fundamentou no atributo “Acessibilidade” da Atenção Primária à Saúde. Resultados: na análise dos resultados emergiram quatro categorias: Compreendendo a necessidade de atendimento profissional; Reconhecendo as demandas que levaram os idosos a buscar o serviço de saúde; Percebendo a disponibilidade dos serviços; e Analisando a capacidade de pagamento. Conclusão: a população idosa desenvolveu demandas específicas de saúde relacionadas à Covid longa, e os serviços de saúde público e privado possuem heterogeneidade quanto à abordagem dessa nova condição, uma vez que o atendimento pautado em diretrizes propostas por órgãos oficiais não é unânime nos serviços públicos, privados e Operadoras de Plano de Saúde. Objetivo Método exploratório 4 Covid19 19 Covid-1 202 1 infecção telefone Acessibilidade “Acessibilidade Saúde Resultados categorias profissional pagamento Conclusão condição públicos Covid1 Covid- 20 2
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