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Abstract Immunodiagnostic tests for detecting dengue virus infections encounter challenges related to cross-reactivity with other related flaviviruses. Our research focuses on the development of a synthetic multiepitope antigen tailored for dengue immunodiagnostics. Selected dengue epitopes involved structural linearity and dissimilarity from the proteomes of Zika and Yellow fever viruses which served for computationally modeling the three-dimensional protein structure, resulting in the design of two proteins: rDME-C and rDME-BR. Both proteins consist of seven epitopes, separated by the GPGPG linker, and a carboxy-terminal 6 × -histidine tag. The molecular weights of the final proteins rDME-C and rDME-BR are 16.83 kDa and 16.80 kDa, respectively, both with an isoelectric point of 6.35. The distinguishing factor between the two proteins lies in the origin of their epitope sequences, where rDME-C is based on the reference dengue proteome, while rDME-BR utilizes sequences from prevalent Dengue genotypes in Brazil from 2008 to 2019. PyMol analysis revealed exposure of epitopes in the secondary structure. Successful expression of the antigens was achieved in soluble form and fluorescence experiments indicated a disordered structure. In subsequent testing, rDME-BR and rDME-C antigens were assessed using an indirect Elisa protocol against Dengue infected serum, previously examined with a commercial diagnostic test. Optimal concentrations for antigens were determined at 10 µg/mL for rDME-BR and 30 µg/mL for rDME-C, with serum dilutions ranging from 1:50 to 1:100. Both antigens effectively detected IgM and IgG antibodies in Dengue fever patients, with rDME-BR exhibiting higher sensitivity. Our in-house test showed a sensitivity of 77.3 % and 82.6 % and a specificity of 89.4 % and 71.4 % for rDME-C and rDEM-BR antigens. No cross-reactivity was observed with serum from Zika-infected mice but with COVID-19 serum samples. Our findings underscore the utility of synthetic biology in crafting Dengue-specific multiepitope proteins and hold promise for precise clinical diagnosis and monitoring responses to emerging Dengue vaccines. crossreactivity cross reactivity flaviviruses immunodiagnostics threedimensional three dimensional structure rDMEC rDME C rDMEBR. rDMEBR BR. BR linker carboxyterminal carboxy terminal histidine tag 1683 16 83 16.8 1680 80 respectively 635 35 6.35 proteome 200 2019 testing 1 µgmL µg mL 3 rDMEC, C, 150 50 1:5 1100. 1100 100. 100 1:100 patients inhouse house 773 77 77. 826 82 82. 894 89 4 89. 714 71 71. rDEMBR rDEM Zikainfected COVID19 COVID 19 COVID-1 samples Denguespecific specific vaccines 168 8 16. 63 6.3 20 201 15 5 1: 110 1:10 7 COVID1 COVID- 6. 2 11 1:1

https://doi.org/10.1016/j.bjid.2024.103746

COVID-19 outcomes in people living with HIV: Peering through the waves COVID19 COVID 19 COVID-1 HIV COVID1 1 COVID-
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Sales, Thaís Lorenna Souza

; Souza-Silva, Maíra Viana Rego

; Delfino-Pereira, Polianna

; Neves, João Victor Baroni

; Sacioto, Manuela Furtado

; Assis, Vivian Costa Morais de

; Duani, Helena

; Oliveira, Neimy Ramos de

; Sampaio, Natália da Cunha Severino

; Ramos, Lucas Emanuel Ferreira

; Schwarzbold, Alexandre Vargas

; Jorge, Alzira de Oliveira

; Scotton, Ana Luiza Bahia Alves

; Castro, Bruno Mateus de

; Silva, Carla Thais Cândida Alves da

; Ramos, Carolina Marques

; Anschau, Fernando

; Botoni, Fernando Antonio

; Grizende, Genna Maira Santos

; Nascimento, Guilherme Fagundes

; Ruschel, Karen Brasil

; Menezes, Luanna Silva Monteiro

; Castro, Luís César de

; Nasi, Luiz Antônio

; Carneiro, Marcelo

; Godoy, Mariana Frizzo de

; Nogueira, Matheus Carvalho Alves

; Guimarães Júnior, Milton Henriques

; Ziegelmann, Patricia Klarmann

; Almeida, Rafaela Charão de

; Francisco, Saionara Cristina

; Silveira Neto, Sidney Teodoro

; Araújo, Silvia Ferreira

; Avelino-Silva, Thiago Junqueira

; Aliberti, Márlon Juliano Romero

; Pires, Magda Carvalho

; Silva, Eduardo Sérgio da

; Marcolino, Milena Soriano

Clinics

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2023, Volume 78 elocation 100223

Abstract: En | Text: En | PDF: En

Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group. COVID19 COVID 19 COVID-1 infection (202 2021. . 2021) records unit death sex comorbidities up 41. 41 4 1 4:1) ChiSquare Chi Square Fishers Fisher s study 17101 17 101 17,10 hospitalized 13 0.76% 076 0 76 (0.76% 5 IQR (IQR 43.064.0 430640 43.0 64.0 43 64 43.0;64.0 202 46.063.5 460635 46.0 63.5 46 63 46.0;63.5 (PLHIV differences inhospital 27.9% 279 27 9 (27.9 vs 17.7% 177 7 0.049, 0049 0.049 , 049 0.049) 25.0% 250 25 (25.0 25.1% 251 0.999. 0999 0.999 999 0.999) pandemic however group COVID1 COVID- (20 4:1 1710 10 17,1 0.76 07 (0.76 064 43.064. 43064 430 43. 640 64. 6 43.0;64. 20 063 46.063. 46063 460 46. 635 63. 46.0;63. 27.9 2 (27. 17.7 004 0.04 04 25.0 (25. 25.1 099 0.99 99 (2 4: 171 17, 0.7 (0.7 06 43.064 4306 43.0;64 46.063 4606 46.0;63 27. (27 17. 00 0.0 25. (25 09 0.9 ( 0. (0. 43.06 43.0;6 46.06 46.0;6 (0 43.0; 46.0;

https://doi.org/10.1016/j.clinsp.2023.100223

Quality of life of nurse practitioners during the COVID-19 pandemic
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Caliari, Juliano de Souza

; Santos, Mariana Alvina dos

; Andrechuk, Carla Renata Silva

; Campos, Kétrya Raiany Costa

; Ceolim, Maria Filomena

; Pereira, Flávia Helena

Revista Brasileira de Enfermagem

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2022, Volume 75 Suppl. 1 elocation e20201382

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

RESUMO Objetivo: avaliar a qualidade de vida dos profissionais de enfermagem durante a pandemia de COVID-19 e analisar os fatores relacionados. Métodos: estudo transversal e analítico, realizado com profissionais de enfermagem. Utilizaram-se questionário de caracterização sociodemográfica, atividades do trabalho e mudanças percebidas com a pandemia e WHOQOL-bref. Para comparar os grupos de interesse, adotou-se a análise de covariância. Resultados: participaram 572 profissionais, os quais apresentaram escore total médio de qualidade de vida de 56,79 (DP=13,56). Na relação das variáveis com o WHOQOL-bref, ter dois ou mais vínculos de trabalho e ser enfermeiro estavam associados à melhor qualidade de vida, mas ser mulher e cumprir carga horária superior a 50 horas semanais associou-se à pior percepção do construto. Conclusões: os fatores analisados indicam menor percepção de qualidade de vida associados ao domínio social, sendo necessárias intervenções que reduzam os prejuízos à saúde dos profissionais e contribuam com a qualidade da assistência oferecida.

ABSTRACT Objective: to assess the quality of life of nurse practitioners during the COVID-19 pandemic and analyze related factors. Methods: cross-sectional and analytical study carried out with nurse practitioners. A questionnaire on sociodemographic characterization, work activities and changes perceived with the pandemic and WHOQOL-bref were used. To compare the groups of interest, analysis of covariance was used. Results: 572 professionals participated, who had a mean total quality of life score of 56.79 (SD=13.56). In the relationship of variables with WHOQOL-bref, having two or more jobs and being a nurse were associated with better quality of life, but being a woman and working more than 50 hours a week was associated with a worse perception of the construct. Conclusions: the factors analyzed indicate a lower perception of quality of life associated with the social domain, requiring interventions that reduce the damage to professionals’ health and contribute to quality of care provided.

RESUMEN Objetivo: evaluar la calidad de vida de los profesionales de enfermería durante la pandemia del COVID-19 y analizar los factores relacionados. Métodos: estudio transversal y analítico realizado con profesionales de enfermería. Se utilizó un cuestionario sobre caracterización sociodemográfica, actividades laborales y cambios percibidos con la pandemia y WHOQOL-bref. Para comparar los grupos de interés se utilizó el análisis de covarianza. Resultados: participaron 572 profesionales, quienes tuvieron una puntuación media de calidad de vida total de 56,79 (DE=13,56). En la relación de las variables con el WHOQOL-bref, tener dos o más trabajos y ser enfermera se asociaron a una mejor calidad de vida, pero ser mujer y trabajar más de 50 horas semanales se asoció a una peor percepción del constructo. Conclusiones: los factores analizados indican una menor percepción de la calidad de vida asociada al dominio social, requiriendo intervenciones que reduzcan el daño a la salud de los profesionales y contribuyan a la calidad de la atención brindada.

https://doi.org/10.1590/0034-7167-2020-1382 477 downloads

Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions
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Viana, Stéphanie de Souza Costa

; Souza, Natália Pereira dos Santos

; Aliberti, Márlon Juliano Romero

; Jacob-Filho, Wilson

einstein (São Paulo)

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2022, Volume 20 elocation eAO8024

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible.

https://doi.org/10.31744/einstein_journal/2022ao8024

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

Arquivos Brasileiros de Cardiologia

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oct 2021, Volume 117 N. 4 Pages 845 - 909

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

https://doi.org/10.36660/abc.20200266 103 downloads

Epidemiological study in Brazilian women highlights that syphilis remains a public health problem
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Barbosa, Marcelo dos Santos

; Lima, Leticya Aparecida de

; Ribeiro, Suzana Meira

; Croda, Julio

; Queiroz, Júlio Henrique Ferreira de Sá

; Ortolani, Lais Gonçalves

; Negrão, Fábio Juliano

; Souza, Elaine Costa

; Silva, Kesia Esther da

; Souza, Ronaldo Omizolo de

; Simionatto, Simone

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e4

Abstract: En | Text: En | PDF: En

ABSTRACT Syphilis, an infectious disease considered a global public health concern, can cause stillbirths and neonatal deaths. This highlights the importance of continuous surveillance studies among women of reproductive age. A cross-sectional study was carried out to analyze the prevalence and risk factors associated with Treponema pallidum infection in women assisted by primary health care units in Dourados, a city located in Mato Grosso do Sul State, Brazil, which borders Paraguay. A questionnaire was applied to a population-based sample, blood samples were collected for syphilis testing and multivariable analyses were performed to screen associations with T. pallidum infection. The prevalence of T. pallidum infection was 6.04%. Bivariate analysis showed that women referring multiple sexual partners (c2: 6.97 [p=0.014]), income less 2 minimal wages (c2: 15.93 [p=0.003]), who did not have high school (c2: 12.64 [p=0.005]), and reporting history of STIs (c2: 7.30 [p=0.018]) are more likely to have syphilis. In the multivariate analysis, a highest prevalence ratio was observed in women with income less than 2 minimal wages (PR: 0.96 [95% CI: 0.85 - 0.97]), and who did not have high school (PR: 0.94 [95% CI: 0.90 - 0.98]). In addition, 80% of the women reported irregular use of condoms and 63.89% declared having sexual intercourses with multiple partners, which creates more opportunities for the transmission of the infection. These results highlight the need for healthcare systems to implement initiatives to monitor syphilis screening and the commitment of patients and their sexual partners to the treatment in order to achieve a decrease of new cases.

https://doi.org/10.1590/s1678-9946202163004 803 downloads

Prevalence of congenital anomalies at birth among live births in the state of Maranhão from 2001 to 2016: temporal and spatial analysis
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Reis, Luzivan Costa

; Barbian, Márcia Helena

; Cardoso-dos-Santos, Augusto César

; Silva, Elis Vanessa de Lima

; Boquett, Juliano André

; Schuler-Faccini, Lavínia

Revista Brasileira de Epidemiologia

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2021, Volume 24 Suppl. 1 elocation e210020

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

RESUMO: Objetivos: Analisar as prevalências ao nascimento e a distribuição espacial e temporal das anomalias congênitas (ACs) entre nascidos vivos no estado do Maranhão nos anos de 2001 a 2016; descrever variáves de interesse demográficas, gestacionais e neonatais. Métodos: Estudo ecológico, de base populacional, a partir de dados secundários do Sistema de Informações sobre Nascidos Vivos (SINASC). Foram calculadas prevalências ao nascimento anuais de ACs totais e por grupos. Análises espaciais utilizaram o cálculo de Indicadores Locais de Associação Espacial (LISA) e o Índice Global de Moran I, e mapas interativos foram gerados. Variáveis de interesse demográficos, gestacionais e neonatais disponíveis no SINASC foram descritas no grupo dos recém-nascidos com ACs. Resultados: Neste estudo, foram incluídos 1.831.830 nascidos vivos, 6.110 com ACs (33,4/10 mil). Maiores frequências ocorreram nos anos mais recentes. Aglomerados espaciais foram observados em anos específicos. As prevalências de nascidos vivos com anomalias foram diferentes entre categorias de variáveis consideradas como fatores de risco para esse desfecho. Conclusão: A prevalência ao nascimento de nascidos com ACs foi inferior ao esperado para defeitos maiores na espécie humana (3%). O pico temporal de registros em 2015/2016 está provavelmente relacionado ao aumento de microcefalia causada pela infecção gestacional por vírus Zika. Os aglomerados espaciais provavelmente se deveram a variações ao acaso pelo número pequeno de nascimentos, pois não se repetem em outros anos. Estudos como este são base para o estabelecimento de programas de vigilância de defeitos congênitos.

ABSTRACT: Objectives: To analyze the prevalence at birth and the spatial and temporal distribution of congenital anomalies (CAs) among live births in the state of Maranhão in 2001 to 2016. To describe demographic, gestational and neonatal variables of interest. Methods: Ecological, population-based study, using secondary data from the Live Birth Information System (SINASC). Annual prevalence of total and per-group CAs was calculated. Spatial analyzes were based on the Local Indicators of Spatial Association (LISA) and the Moran I Index, and interactive maps were generated. Demographic, gestational and neonatal variables of interest available from SINASC were described in the group of newborns with CAs. Results: 1,831,830 live births, 6,110 with CAs (33.4/10,000) were included. Higher frequencies occurred in more recent years. Spatial clusters have been observed in specific years. The prevalence of newborns with CAs was different between categories of variables considered as risk factors for this outcome. Conclusion: The prevalence at birth of total CAs was lower than expected for major human defects (3%). The temporal peak of records in 2015/2016 is probably related to the increase in CAs caused by gestational infection by the Zika virus. The spatial clusters were probably due to variations at random due to the small number of births as they are not repeated in other years. Studies like this are the basis for the establishment of CA surveillance programs.

https://doi.org/10.1590/1980-549720210020.supl.1

Prevalence of congenital anomalies at birth among live births in the state of Maranhão from 2001 to 2016: temporal and spatial analysis
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Reis, Luzivan Costa

; Barbian, Márcia Helena

; Cardoso-dos-Santos, Augusto César

; Silva, Elis Vanessa de Lima

; Boquett, Juliano André

; Schuler-Faccini, Lavínia

Revista Brasileira de Epidemiologia

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2021, Volume 24 Suppl. 1 elocation e210020

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

https://doi.org/10.1590/1980-549720210020.supl.1 830 downloads

Bundle for the prevention and management of complications of neutropenia in cancer patients
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Amaral, Rosilene Aparecida Costa

; Oliveira, Patrícia Peres de

; Fonseca, Deborah Franscielle da

; Schlosser, Thalyta Cristina Mansano

; Moraes, Juliano Teixeira

; Silveira, Edilene Aparecida Araújo da

; Santos, Kelli Borges dos

Revista Brasileira de Enfermagem

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2021, Volume 74 N. 2 elocation e20200195

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

RESUMO Objetivos: construir e avaliar o conteúdo de um bundle para a prevenção e manejo das complicações de pacientes oncológicos neutropênicos. Métodos: estudo metodológico, construído em quatro etapas: scoping review; construção do bundle; avaliação do material por especialistas (desenvolvido segundo a psicometria de Pasquali); teste piloto em uma Unidade de Assistência de Alta Complexidade em Oncologia. Para avaliação de conteúdo, aplicou-se a técnica de Delphi em duas rodadas, e considerou-se válidos aqueles itens com Coeficiente de Validação de Conteúdo (CVC) >0,78 e consenso >80,0%. Os dados foram analisados por meio da estatística descritiva e inferencial. Resultados: todos os requisitos do bundle alcançaram concordância entre os juízes superior a 80,0%, além de níveis de avaliação estatisticamente significativos. Ao final da técnica de Delphi, o bundle se apresentou expressivamente válido com CVC = 0,92 e CVC = 0,93, respectivamente. Conclusões: o conteúdo do bundle demonstrou ser válido e ter alta credibilidade.

ABSTRACT Objectives: to construct and assess bundle content for the prevention and management of complications in neutropenia in cancer patients. Methods: a methodological study developed in four stages: scoping review; bundle construction; material assessment by experts (developed according to Pasquali’s psychometry); pilot test in a High Complexity Assistance Unit in Oncology. For content assessment, the Delphi technique was applied in two rounds and those items with Content Validation Coefficient (CVC)> 0.78 and agreement> 80.0% were considered valid. Data were analyzed using descriptive and inferential statistics. Results: all bundle requirements reached agreement between judges above 80.0%, in addition to statistically significant levels of assessment. At the end of the Delphi technique, bundle was significantly valid with CVC = 0.92 and CVC = 0.93, respectively. Conclusions: bundle content proved to be valid and highly credible.

RESUMEN Objetivos: construir y evaluar el contenido de un bundle para la prevención y el manejo de complicaciones en pacientes con cáncer neutropénico. Métodos: estudio metodológico, construido en cuatro etapas: revisión del alcance; construcción de bundle; evaluación del material por especialistas (desarrollado según la psicometría de Pasquali); prueba piloto en una Unidad Asistencial de Alta Complejidad en Oncología. Para la evaluación de contenido se aplicó la técnica Delphi en dos rondas, considerándose válidos aquellos ítems con Coeficiente de Validación de Contenido (CVC)> 0,78 y consenso> 80,0%. Los datos se analizaron mediante estadística descriptiva e inferencial. Resultados: todos los requisitos del bundle alcanzaron acuerdos entre jueces superiores al 80,0%, además de niveles de evaluación estadísticamente significativos. Al final de la técnica Delphi, el bundle fue significativamente válido con CVC = 0,92 y CVC = 0,93, respectivamente. Conclusiones: el contenido del bundle demostró ser válido y tener una alta credibilidad.

https://doi.org/10.1590/0034-7167-2020-0195 406 downloads

10.

[SciELO Preprints] - Prevalence at birth of congenital anomalies among live births in the state of Maranhão from 2001 to 2016: temporal and spatial analysis
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Reis, Luzivan Costa Barbian, Márcia Helena Cardoso-dos-Santos, Augusto César Silva, Elis Vanessa de Lima Boquett, Juliano André Schuler-Faccini, Lavínia

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Publication date: 2020-12-14

Abstract: En Pt

Objectives: To analyze the prevalence at birth and the spatial and temporal distribution of congenital anomalies (CAs) among live births in the state of Maranhão in the years 2001 to 2016. To describe demographic, gestational and neonatal variables of interest. Methods: Ecological, population-based study, using secondary data from the Information System on Live Births (SINASC). Annual prevalence of total and per group CAs was calculated. Spatial analyzes used the calculation of Local Indicators of Spatial Association and the Moran I Index and interactive maps were generated. Demographic, gestational and neonatal variables of interest available at SINASC were described in the group of newborns with CAs. Results: 1,831,830 live births, 6,110 with CAs (33.4/10,000) were included. Higher frequencies have occurred in more recent years. Spatial clusters have been observed in specific years. The prevalence of births of babies with CAs was different between categories of variables considered as risk factors for this outcome. Conclusion: The prevalence at birth of total CAs was lower than expected for the human species for major defects (3%). The temporal peak of records in 2015/2016 is probably related to the increase in CAs caused by gestational infection by Zika virus. The spatial clusters were probably due to variations at random due to the small number of births as they are not repeated in other years. Studies like this are the basis for the establishment of CA surveillance programs.

Objetivos: Analisar as prevalências ao nascimento e a distribuição espacial e temporal das anomalias congênitas entre nascidos vivos no estado do Maranhão nos anos de 2001 a 2016. Descrever variáves de interesse demográficas, gestacionais e neonatais. Métodos: Estudo ecológico, de base populacional, a partir de dados secundários do Sistema de Informações sobre Nascidos Vivos. Foram calculadas prevalências ao nascimento anuais de ACs totais e por grupos. Análises espaciais utilizaram o cálculo de Indicadores de Associação Espacial Locais e o Índice de Moran I e mapas interativos foram gerados. Variáveis de interesse demográficos, gestacionais e neonatais disponíveis no SINASC foram descritas no grupo dos recém-nascidos com ACs. Resultados: Foram incluídos 1.831.830 nascidos vivos, 6.110 com anomalias congênitas (33,4/10.000). Maiores frequências ocorreram nos anos mais recentes. Aglomerados espaciais foram observados em anos específicos. As prevalências de nascidos vivos com anomalias foi diferente entre categorias de variáveis consideradas como fatores de risco para este desfecho. Conclusão: A prevalência ao nascimento de nascidos com anomalias congênitas  foi  inferior ao esperado para defeitos maiores na espécie humana (3%).  O pico temporal de registros em 2015/2016 está provavelmente relacionado ao aumento de microcefalia causada pela infecção gestacional por vírus Zika. Os aglomerados espaciais provavelmente se deveram a variações ao acaso pelo número pequeno de nascimentos pois não se repetem em outros anos. Estudos como este são base para o estabelecimento de programas de vigilância de defeitos congênitos.

https://doi.org/10.1590/1980-549720210020.supl.1

11.

Traditional chest drainage versus drainage by thoracotomy: a prospective randomized study
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Bachichi, Thiago Gangi

; Leão, Luiz Eduardo Villaça

; Perfeito, João Alessio Juliano

; Miotto, Andre

; Holanda, Caio Santos

; Costa Jr, Altair da Silva

einstein (São Paulo)

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2020, Volume 18 elocation eAO4409

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

RESUMO Objetivo Comparar a drenagem torácica pela mesma intercostotomia à drenagem tradicional em pacientes submetidos à toracotomia poupadora lateral. Métodos Foram avaliados 40 pacientes maiores de 18 anos submetidos a toracotomias poupadoras laterais eletivas. Eles foram separados em dois grupos de 20 pacientes cada, sendo um submetido à drenagem torácica pelo mesmo espaço intercostal da toracotomia e o outro à drenagem tradicional. Resultados No grupo da drenagem pela mesma intercostotomia, a mediana de tempo de internação em unidade de terapia intensiva foi de 1,5 dia (1,0 a 2,0 dias) e de 2,0 dias (1,25 a 3,0 dias) na drenagem tradicional (p=0,060). As medianas do tempo de internação (p=0,527) e de drenagem (p=0,547) foram ambas de 4 dias, no primeiro grupo, e de 2 e 5,5 dias, no grupo com drenagem tradicional. As doses utilizadas de dipirona e de tramadol não apresentaram diferenças estatísticas entre os grupos (p=0,201 e p=0,341). As médias da escala de dor foram 4,24 no primeiro dia pós-operatório do grupo com a drenagem proposta e 3,95 nos drenados da forma tradicional (p=0,733); no terceiro pós-operatório, foi de 3,18 para o grupo drenado pela incisão e de 3,11 nos drenados da forma tradicional (p=0,937). No 15º dia após a cirurgia, a drenagem pela incisão foi de 1,53 e a tradicional de 2,11 (p=0,440); no 30º pós-operatório, foi de 0,71 e 0,84, respectivamente, para a incisão e a forma tradicional (p=0,787). Em relação às complicações, os grupos foram semelhantes, com 30% na drenagem proposta e 25% na drenagem tradicional (p=0,723). Conclusão A drenagem pelo mesmo espaço intercostal foi exequível e não apresentou inferioridade à técnica tradicional no período pós-operatório estudado de 30 dias.

ABSTRACT Objective To compare the chest tube drainage by the same thoracotomy intercostal space with the traditional approach in patients undergoing muscle-sparing thoracotomy. Methods We evaluated 40 patients aged ≥18 years who underwent elective muscle sparing thoracotomies. Patients were divided into two groups of 20 patients. One group underwent thoracic drainage by the same intercostal space of thoracotomy and the other by traditional chest drainage approach. Results The mean length of hospital stay for the intercostal drainage group in the intensive care unit was 1.5 day (1.0 to 2.0 days) and 2.0 days (25.1 to 3.0 days) for the traditional chest drainage group (p=0.060). The intercostal drainage group had mean length of hospital stay (p=0.527) and drainage (p=0.547) of 4 days, and the traditional chest drainage group and 2 and 5.5 days, respectively. Dipirona and tramadol doses did not differ between groups (p=0.201 and p=0.341). The mean pain scale values on first postoperative was 4.24 in the drainage by the same intercostal group and 3.95 in the traditional chest drainage (p=0.733). In third postoperative day, mean was 3.18 for the first group and 3.11 for the traditional group (p=0.937). In the 15th day after surgery, drainage by the incision was 1.53 and the traditional chest drainage was 2.11 (p=0.440), 30th days after drainage by incision was 0.71 and traditional chest drainage was 0.84 (p=0.787). Complications, for both groups were similar with 30% in proposed drainage and 25% in traditional approach (p=0.723). Conclusion Drainage by the same thoracotomy intercostal space was feasible and results 30 days after surgery were not inferior to those of the traditional chest drainage approach.

https://doi.org/10.31744/einstein_journal/2020ao4409 1549 downloads

12.

Hypotensive Response to Continuous Aerobic and High-Intensity Interval Exercise Matched by Volume in Sedentary Subjects
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Boeno, Francesco Pinto

; Ramis, Thiago Rozales

; Farinha, Juliano Boufleur

; Moritz, Cesar

; Santos, Vagner Pereira dos

; Oliveira, Alvaro Reischak de

; Teixeira, Bruno Costa

International Journal of Cardiovascular Sciences

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feb 2019, Volume 32 N. 1 Pages 48 - 54

Abstract: En | Text: En | PDF: En

Abstract Background: Systemic arterial hypertension (SAH) is one of the main risk factors for heart disease. Among the benefits linked to different modalities of physical exercise, post-exercise hypotension (PEH) is a key point for exercise prescription in this condition. Objective: To investigate and compare PEH in response to continuous aerobic exercise (CONT) and high-intensity interval exercise (HIIE), matched by volume, in sedentary individuals. Methods: A randomized cross-over study, composed of sedentary, healthy male subjects submitted to two acute physical exercise protocols matched by volume, HIIE and CONT, on a treadmill. Hemodynamic measures for the evaluation of PEH were performed pre, immediately after exercise and every five minutes thereafter, during one hour of recovery. Two-way ANOVA with repeated measurements was used for comparisons between groups and Bonferroni post hoc test as appropriate. P < 0.05 was considered significant. Results: Both exercise protocols promoted significant PEH, with reductions in systolic blood pressure (SBP) and mean arterial pressure (MAP). HIIE promoted a reduction of SBP and MAP at the 15th minute, whereas the same effect was observed at the 30th following CONT. Conclusion: Both HIIE and CONT, matched by volume, promote PEH of similar magnitude. However, PEH occurs earlier following HIIE, suggesting a better time / effectiveness ratio, and an additional beneficial effect of this modality.

https://doi.org/10.5935/2359-4802.20180084 1359 downloads

13.

Comparative study of transepidermal water loss in patients with and without hyperhidrosis by closed-chamber measurer in an air-conditioned environment
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Miotto, Andre

; Honda, Pedro Augusto Antunes

; Bachichi, Thiago Gangi

; Holanda, Caio Santos

; Evangelista Neto, Ernesto

; Perfeito, João Alessio Juliano

; Leão, Luiz Eduardo Villaça

; Costa Jr, Altair da Silva

einstein (São Paulo)

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2018, Volume 16 N. 4 elocation eAO4312

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

RESUMO Objetivo Avaliar a diferença entre a perda transepidérmica de água aferida entre pacientes com e sem diagnóstico de hiperidrose, em ambiente climatizado. Métodos Foram selecionados 20 pacientes com diagnóstico de hiperidrose e 20 hígidos, submetidos à aferição de maneira quantitativa, com mensurador de câmara fechada, em seis locais previamente estabelecidos. Resultados As medidas realizadas mostraram valores diferentes de perda transepidérmica de água em pessoas hígidas e naquelas com hiperidrose, principalmente em mãos e pés. No Grupo Controle, a mediana das aferições em mãos foi 46,4g/m2/hora (p25: 36,0; p75: 57,6), enquanto, no Grupo Hiperidrose, obtivemos a mediana de 123,5g/m2/hora (p25: 54,3; p75: 161,2) – p<0,001. Já nos pés, a mediana no Grupo Controle foi 41,5g/m2/hora (p25: 31,3; p75: 63,5) e, no Grupo Hiperidrose, foi 61,2g/m2/hora (p25: 32,3; p75: 117) – p<0,02. As medidas das regiões axilares também mostraram diferença. No Grupo Controle, obtivemos mediana 14,8g/m2/hora (p25: 11,8; p75: 19,0) e, no Hiperidrose, 83,5g/m2/hora (p25: 29,5; p75: 161,7) – p<0,001. Conclusão A mensuração da perda transepidérmica de água é suficiente para diagnóstico e acompanhamento de pacientes com hiperidrose.

ABSTRACT Objective To evaluate the difference in transepidermal water loss in patients diagnosed with hyperhidrosis and healthy subjects, in an air-conditioned environment. Methods Twenty patients diagnosed with hyperhidrosis and 20 healthy subjects were subjected to quantitative assessment using a closed-chamber device, in six previously established sites. Results The measurements showed different transepidermal water loss values for healthy subjects and patients with hyperhidrosis, especially in the hands and feet. In the Control Group, the median for the hands was 46.4g/m2/hour (p25: 36.0; p75: 57.6), while in the Hyperhidrosis Group, the median was 123.5g/m2/hour (p25: 54.3; p75: 161.2) – p<0.001. For the feet, the Control Group had a median of 41.5g/m2/hour (p25: 31.3; p75: 63.5) and the Hyperhidrosis Group, 61.2g/m2/hour (p25: 32.3; p75: 117) – p<0.02. Measurements of the axillas also showed differences. In the Control Group, the median was 14.8g/m2/hour (p25: 11.8; p75: 19.0) and, in the Hyperhidrosis Group, 83.5g/m2/hour (p25: 29.5; p75: 161.7) – p<0.001. Conclusion Measuring transepidermal water loss is sufficient for diagnosis and follow-up of patients with hyperhidrosis.

https://doi.org/10.31744/einstein_journal/2018ao4312 1099 downloads

14.

Forage mass and nutritive value of bermuda grass mixed to forage peanut or common vetch
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Olivo, Clair Jorge

; Santos, Juliano Costa dos

; Quatrin, Maurício Pase

; Simonetti, Gabriela Descovi

; Seibt, Daiane Cristine

; Diehl, Michelle Schalemberg

Acta Scientiarum. Animal Sciences

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sep 2016, Volume 38 N. 3 Pages 255 - 260

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

RESUMO O objetivo da pesquisa foi avaliar três sistemas forrageiros (SF), constituídos por capim bermuda (CB) + amendoim forrageiro + 75 kg de N ha-1; CB + ervilhaca + 75 kg de N ha-1 e CB + 150 kg de N ha-1. Para a avaliação foram usadas vacas em lactação da raça Holandesa. O delineamento experimental utilizado foi o inteiramente casualizado. Avaliaram-se a massa de forragem, as composições botânica e estrutural, a taxa de acúmulo de matéria seca e a taxa de lotação. Foram coletadas amostras pelo método de simulação de pastejo para analisar proteína bruta (PB), fibra em detergente neutro (FDN), digestibilidade in situ da matéria seca (DISMS), digestibilidade in situ da matéria orgânica (DISMO) e nutrientes digestíveis totais (NDT). Os valores médios de produção de forragem e taxa de lotação foram de 13,8; 15,3 e 16,1 t ha-1 e 5,6; 6,4 e 5,5 UA ha-1dia-1, para os respectivos SF. Os valores médios para PB e FDN foram de 16,4; 22,2 e 15,3%; 68,3; 65,7 e 66,3%; para DISMS, DISMO e NDT foram de 68,5; 70,3 e 66,4%; 64,3; 63,2 e 65,3%; 57,3; 58,3 e 57,5%, para os respectivos SF. Melhores resultados foram obtidos no consórcio de capim bermuda com ervilhaca.

ABSTRACT Three pasture-based systems (PS) with bermuda grass (BG) + forage peanut + 75 kg of N ha-1; BG + common vetch + 75 kg of N ha-1 and BG + 150 kg of N ha-1 were evaluated. Lactating Holstein cows were used for evaluation and the experimental design was completely randomized. Forage mass, botanical and structural composition, daily dry matter accumulation rate and stocking rate were evaluated. Samples were collected by hand-plucking method to analyze crude protein (CP), neutral detergent fiber (NDF), (ISDMD), in situ organic matter digestibility (ISOMD) and total digestible nutrients (TDN). Average forage production and stocking rate were 13.8; 15.3 and 16.1 t ha-1 and 5.6; 6.4 and 5.5 UA ha-1 day-1 for PS respectively. Average CP and NDF were 16.4; 22.2 and 15.3%; 68.3; 65.7 and 66.3%; for ISDMD, ISOMD and TDN were 68.5; 70.3 and 66.4%; 64.3; 63.2 and 65.3%; 57.3; 58.3 and 57.5%, for PS respectively. Best results were reported on bermuda grass mixed with common vetch.

https://doi.org/10.4025/actascianimsci.v38i3.30284 988 downloads

15.

Mortalidade por câncer do colo do útero no estado do Rio Grande do Norte, no período de 1996 a 2010: tendência temporal e projeções até 2030
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Sousa, Aretha Maria Virgínio de

; Teixeira, Cinthia Carla Alves

; Medeiros, Sidney da Silva

; Nunes, Samira Jucinara Claudino

; Salvador, Pétala Tuani Cândido de Oliveira

; Barros, Rosires Magali Bezerra de

; Lima, Fernanda Fabíola Santos de

; Nascimento, Gésica Gabriela Costa do

; Santos, Juliano dos

; Souza, Dyego Leandro Bezerra de

; Bezerra, Aline Patrícia dos Santos

; Meira, Karina Cardoso

Epidemiologia e Serviços de Saúde

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jun 2016, Volume 25 N. 2 Pages 311 - 322

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

Resumo OBJETIVO: analisar a tendência da mortalidade por câncer do colo do útero no estado do Rio Grande do Norte e em suas microrregiões de saúde, no período de 1996 a 2010, e realizar projeções para os quinquênios, de 2011 a 2030. MÉTODOS: estudo ecológico de series temporais; empregou-se regressão binomial negativa para análise das tendências e projeções. RESULTADOS: foram observadas taxas acima de 5,0 óbitos por 100 mil mulheres em todas as microrregiões, com tendência estacionária para o estado e ascendente nas microrregiões com piores condições socioeconômicas; as projeções indicaram redução nas taxas de mortalidade no estado, de 5,95/100 mil mulheres (2006-2010) para 3,67 (2026-2030), embora seja previsto aumento de 22% no número absoluto de óbitos. CONCLUSÃO: apesar da previsão de redução nas taxas de mortalidade, estas ainda apresentam-se elevadas, sinalizando a necessidade de revisão e fortalecimento do programa de controle do câncer do colo do útero no estado.

Abstract OBJECTIVE: to analyze cervical cancer mortality trends in the state of Rio Grande do Norte and its health micro-regions from 1996 to 2010, as well as to make projections for five-year periods from 2011 to 2030. METHODS: this was an ecological time series study; negative binomial regression was used to analyze trends and projections. RESULTS: rates above 5.0 deaths per 100,000 women were observed in all the micro-regions, with a stationary trend in the state as a whole and an upward trend in the micro-regions with the worst socioeconomic conditions; projections indicated reduction in mortality rates in the state, from 5.95/100,000 women (2006-2010) to 3.67 (2026-2030), although a 22% increase in the absolute number of deaths is expected. CONCLUSION: although a reduction in mortality rates is projected, they continue to be high, indicating the need for review and strengthening of the state's cervical cancer control program.

Resumen OBJETIVO: analizar la tendencia de mortalidad por cáncer de cuello de útero en el estado de Rio Grande del Norte (RN) y en sus microrregiones de salud, en el período de 1996 a 2010, así como realizar proyecciones para los períodos quinquenales entre 2011 y 2030. MÉTODOS: estudio ecológico de series de tiempo; se utilizó regresión binomial negativa para analizar tendencias y proyecciones. RESULTADOS: observamos tasas de 5.0 muertes por cada 100 mil mujeres en todas las microrregiones, con una tendencia estacionaria para el estado y ascendente en las microrregiones con peores condiciones socioeconómicas. Las proyecciones mostraron una reducción en las tasas de mortalidad en el estado, de 5.95/100 mil mujeres (2006-2010) para 3.67 (2026-2030), aunque se espere un aumento de 22% en el número absoluto de muertes. CONCLUSIÓN: a pesar del pronóstico de reducción de las tasas de mortalidad, estas siguen siendo altas, lo que indica la necesidad de revisar y fortalecer el programa de control de cáncer de cuello uterino en el estado.

https://doi.org/10.5123/s1679-49742016000200010 735 downloads

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