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[SciELO Preprints] - Association of anxiety and use of anxiolytics among health-related college students
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Pereira, Mara Dantas Pereira, Míria Dantas Santana, Michele Fraga de Silva, Joilson Pereira da Moraes Filho , João Alves de Rosa , Caique Anizio Santos da Antunes, Paola Fernanda Santos

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Publication date: 2023-12-15

Abstract: En Es Pt

The study aimed to analyze the association of anxiety and the use of anxiolytics among college students in the health area. This is a sectional study of the web-survey type, with a sample of 286 college students from some courses in the health area. Data collection occurred through electronic forms in Google forms sent by e-mail and Instagram social network. A higher frequency of clonazepam use (n= 31; 62%; p= 0.588) was associated with high trait anxiety. There was a preponderance of the use of the same drug (n= 30; 60%; p= 0.982) related to moderate state anxiety. These occurrences were more pronounced in female college students (42.3%) and those who attended public institutions (55.3%). Given this, it is concluded that higher education institutions should invest in awareness-raising actions on the use of anxiolytics and aimed at minimizing anxiety in this population. Portuguese version of the article: https://doi.org/10.1590/SciELOPreprints.4348

El estudio tuvo como objetivo analizar la asociación de la ansiedad y el uso de ansiolíticos entre los estudiantes universitarios del área de la salud. Se trata de un estudio seccional, de tipo encuesta web, con una muestra de 286 estudiantes universitarios de algunos cursos del área de la salud. La recopilación de datos se realizó mediante formularios electrónicos de Google enviados por correo electrónico y la red social Instagram. Se percibió una mayor frecuencia de uso de Clonazepam (n= 31; 62%; p= 0,588) asociada a la ansiedad de alto nivel. También hubo una preponderancia del uso del mismo fármaco (n= 30; 60%; p= 0,982) relacionado con la ansiedad estatal moderada. Estos sucesos fueron más pronunciados en las mujeres universitarias (42,3%) y que asistieron a instituciones públicas (55,3%). Ante esto, se concluye que las instituciones de educación superior deben invertir en acciones de sensibilización sobre el uso de ansiolíticos, y dirigidas a minimizar la ansiedad en esta población. Versión en portugués del artículo: https://doi.org/10.1590/SciELOPreprints.4348

O estudo objetivou analisar a associação da ansiedade e uso de ansiolíticos entre estudantes universitários da área saúde. Trata-se de um estudo seccional, do tipo web-survey, com amostra de 286 estudantes universitários de alguns cursos da área da saúde. A coleta de dados ocorreu por meio de formulários eletrônicos no Google forms enviados por e-mail e rede social Instagram. Percebeu-se uma frequência maior de uso de Clonazepam (n= 31; 62%; p= 0,588) associado à ansiedade traço alta. Assim como houve uma preponderância do uso do mesmo medicamento (n= 30; 60%; p= 0,982) relacionado à ansiedade estado moderada. Essas ocorrências foram mais acentuadas em estudantes universitárias do sexo feminino (42,3%) e que frequentavam instituições públicas (55,3%). Diante disso, conclui-se que as instituições de ensino superior devem investir em ações de conscientização sobre o uso de ansiolíticos, e que visem a minimização da ansiedade dessa população. Versão em Português do artigo: https://doi.org/10.1590/SciELOPreprints.4348

https://doi.org/10.1590/SciELOPreprints.4563

[SciELO Preprints] - Association of anxiety and use of anxiolytics among health-related college students
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Pereira, Mara Dantas Pereira, Míria Dantas Santana, Michele Fraga de Silva, Joilson Pereira da Moraes Filho , João Alves de Santos da Rosa , Caique Anizio Antunes, Paola Fernanda Santos

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Publication date: 2023-12-15

Abstract: En Es Pt

The study aimed to analyze the association of anxiety and use of anxiolytics among college students in the health area. This is a sectional study, of the web-survey type, with a sample of 286 college students from some courses in the health area. Data collection occurred through electronic forms in Google forms sent by e-mail and Instagram social network. It was noticed a higher frequency of Clonazepam use (n= 31; 62%; p= 0.588) associated with high trait anxiety. Just as there was a preponderance of the use of the same drug (n= 30; 60%; p= 0.982) related to moderate state anxiety. These occurrences were more pronounced in female college students (42.3%) and who attended public institutions (55.3%). Given this, it is concluded that higher education institutions should invest in awareness-raising actions on the use of anxiolytics, and aimed at minimizing anxiety in this population.

El estudio tuvo como objetivo analizar la asociación de la ansiedad y el uso de ansiolíticos entre los estudiantes universitarios del área de la salud. Se trata de un estudio seccional, de tipo encuesta web, con una muestra de 286 estudiantes universitarios de algunos cursos del área de la salud. La recopilación de datos se realizó mediante formularios electrónicos de Google enviados por correo electrónico y la red social Instagram. Se percibió una mayor frecuencia de uso de Clonazepam (n= 31; 62%; p= 0,588) asociada a la ansiedad de alto nivel. También hubo una preponderancia del uso del mismo fármaco (n= 30; 60%; p= 0,982) relacionado con la ansiedad estatal moderada. Estos sucesos fueron más pronunciados en las mujeres universitarias (42,3%) y que asistieron a instituciones públicas (55,3%). Ante esto, concluimos que las instituciones de educación superior deberían invertir en acciones de concienciación sobre el uso de ansiolíticos, y dirigidas a minimizar la ansiedad en esta población.

https://doi.org/10.1590/SciELOPreprints.4348

Dentistry consensus on HSCT – Part III: Special topics – Dentistry on HSCT
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Santos, Paulo Sérgio da Silva

; Granzotto, Fabiana Caramori Noal

; Antunes, Héliton Spindola

; Lima, Emilze Mafra de

; Varanda, Renata de Freitas

; Maccari, Karina

; Bezinelli, Leticia Mello

; Melo, Walmyr Ribeiro

; Soares Junior, Luiz Alberto Valente

; Macedo, Leandro Dorigan De

; Eduardo, Fernanda de Paula

Hematology, Transfusion and Cell Therapy

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sep 2023, Volume 45 N. 3 Pages 379 - 386

Abstract: En | Text: En | PDF: En

ABSTRACT Patients undergoing hematopoietic stem cell transplantation (HSCT) might present acute and late toxicities and the oral tissues are frequently affected. With the survival increasing, patients show late and long-term morbidities, and there is an important association between the general and the oral health. The first and second parts of this Consensus have showed the importance of the adequacy of oral health in the pre-HSCT, and the main alterations and oral care during the period of admission for HSCT. This third part aims to review specific themes of post-HSCT dental care, such as graft-versus-host disease (GVHD) and the pediatric patient. It also aims to review pertinent subjects, both during the HSCT period and post-HSCT, concerning quality of life, pain, cost-effectiveness, and remote care. Based on this review, it is evident the importance of the work of the dental surgeon (DS) in the follow-up and treatment of the HSCT patient, always collaborating with the whole multidisciplinary team.

https://doi.org/10.1016/j.htct.2023.04.004

Dental consensus on HSCT – Part II: dental Care during HSCT
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Gobbi, Marcella Ferreira

; Ferreira, Mariana Henriques

; Carvalho, Danielle Lima Corrêa de

; Silva, Geisa Badauy Lauria

; Macari, Karina Silva Moreira

; Neves, Lilian de Jesus

; Santos, Paulo Sérgio da Silva

; Soares Junior, Luiz Alberto Valente

; Melo, Walmyr Ribeiro

; Antunes, Héliton Spíndola

; Macedo, Leandro Dorigan De

; Eduardo, Fernanda de Paula

; Bezinelli, Leticia Mello

Hematology, Transfusion and Cell Therapy

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sep 2023, Volume 45 N. 3 Pages 368 - 378

Abstract: En | Text: En | PDF: En

ABSTRACT During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require professional oral care to act in the diagnosis and treatment of these conditions, as well as to develop prevention protocols to minimize patient's complications. Oral mucositis, opportunistic infections, bleeding, specific microbiota, taste, and salivary alterations are complications that can occur during HSCT and interfere with various aspects, such as pain control, oral intake, nutrition, bacteremia and sepsis, days of hospitalization and morbidity. Several guidelines have been published to address the role of professional oral care during the HSCT, we describe a consensus regarding these recommendations.

https://doi.org/10.1016/j.htct.2023.04.003

Brazilian dental consensus on dental management in hematopoietic stem cell transplantation−Part I−pre-HSCT
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Correa, Maria Elvira Pizzigati

; Granzotto, Fabiana Caramori Noal

; Innocentini, Lara Maria Alencar Ramos

; Reis, Thiago de Carvalho

; Lima, Emilze Mafra de

; Varanda, Renata de Freitas

; Santos, Paulo Sérgio da Silva

; Soares Junior, Luiz Alberto Valente

; Bezinelli, Leticia Mello

; Eduardo, Fernanda de Paula

; Melo, Walmyr Ribeiro

; Antunes, Héliton Spíndola

; Macedo, Leandro Dorigan De

Hematology, Transfusion and Cell Therapy

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sep 2023, Volume 45 N. 3 Pages 358 - 367

Abstract: En | Text: En | PDF: En

ABSTRACT The oral involvement in the Hematopoietic Stem Cell Transplantation is well described in the literature. The goal of the dental treatment and management of the oral lesions related to the HSCT is to reduce the harm caused by preexisting oral infection or even the worsening of oral acute/chronic GVHD and late effects. The aim of this guideline was to discuss the dental management of patients subjected to HSCT, considering three phases of the HSCT: pre-HSCT, acute phase, and late phase. The literature published from 2010 to 2020 was reviewed in order to identify dental interventions in this patient population. The selected papers were divided into three groups: pre-HSCT, acute and late, and were reviewed by the SBTMO Dental Committee's members. When necessary, an expertise opinion was considered for better translating the guideline recommendations to our population dental characteristics. This manuscript focused on the pre-HSCT dental management. The objective of the pre-HSCT dental management is to identify possible dental situations that On behalf of the Dental Committee of the Brazilian Society of Gene Therapy and Bone Marrow Transplantation (SBTMO) can worsening during the acute phase after the HSCT. Each guideline recommendations were made considering the Dentistry Specialties. The clinical consensus on dental management prior to HSCT provides professional health caregivers with clinical setting-specific information to help with the management of dental problems in patients to be subjected to HSCT.

https://doi.org/10.1016/j.htct.2023.04.001

[SciELO Preprints] - MOVIMENTO DAS REPRESENTAÇÕES SOCIAIS DOS PROFESSORES SOBRE CAMPO NO PERU E NO BRASIL
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Freitas, Erica Fernanda Justino de Rocha, Maria Isabel Antunes

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Publication date: 2023-04-25

Abstract: En Es Pt

This text describes part of the process of a doctoral research in Education developed at the Federal University of Minas Gerais. Considering the Pedagogy os Alternation as a historical instrument the struggles of peasant populations in Peru and Brazil for the right to education, it becomes relevant to discuss the relationships that are established in a educational context against hegemony that is committed to the issues of the peasant universe and press teachers to position themselves. In this way, the theorical references were studied in the light of the Social Representations in Movement that put in dialogue differents peasant educational realities, but similar in socio/ historical terms. The text presents reflections on the process of moving social representations about the field of teachers who work in context that generate change, pointing out representational movements of re-elaboration, maintenance and refusal. This text theoretically contributes to the understanding of the perspective of movement in studies on the Theory of Social Representations, based on the analysis of experiences on common objects in different educational contexts.

Este texto describe parte de los procesis de una investigación de doctorado en Educación desarrollada en la Universidade Federal de Minas Gerais. Considerando la Pedagogía de la Alternancia como un instrument histórico en la luchas de las problaciones campesinas de Perú y Brasil por el dereho a la educación, se vuelve relevante discutir las relaciones que se establecen en un context educativo contrahegemónico y comprometido con las cuestiones de la vida campesina y presiona a los maestros para que tomen una posición. De esta forma, los referents teóricos fueron estudiados a la luz de las Representaciones Sociales en Movimiento que ponen en diálogo realidades educativas campesinas diferentes, pero similares en términos socio/históricos. El texto presenta reflexiones sobre el processo de movimiento de las representaciones sociales sobre el campo de los docents que actúan en contextos generadores de cambio.

Este texto descreve parte dos processos de uma pesquisa de doutorado em Educação desenvolvida na Universidade Federal de Minas Gerais. Considerando a Pedagogia da Alternância um instrumento histórico nas lutas das populações camponesas no Peru e no Brasil pelo direito à educação, torna-se relevante discutir as relações que se estabelecem em um contexto educacional contra hegemônico que se compromete com as questões do universo camponês e pressiona os professores a se posicionarem. Dessa forma, os referenciais teóricos foram estudados à luz das Representações Sociais em Movimento que colocam em diálogo realidades educacionais camponesas distintas, mas semelhantes em termos sócio/históricos. O texto apresenta reflexões sobre o processo de movimentação das representações sociais sobre campo de professores que atuam em contextos geradores de mudança, apontando movimentos representacionais de reelaboração, de manutenção e de recusa. Este texto contribui teoricamente com a compreensão da perspectiva do movimento em estudos sobre a Teoria das Representações Sociais, a partir da análise de experiências sobre objetos comuns em diferentes contextos educativos.

https://doi.org/10.1590/SciELOPreprints.5540

DETERMINAÇÃO DE FOSFATIDILETANOL EM MANCHAS DE SANGUE SECO EM PAPEL POR UHPLC-MS/MS: AVALIAÇÃO DO CONSUMO DE ÁLCOOL EM DEPENDENTES QUÍMICOS
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Tegner, Mariane

; Guterres, Fernanda S.

; Ott, Isabela R.

; Motta, Lidiane T. da

; Schmitz, Deise T.

; Perassolo, Magda

; Linden, Rafael

; Antunes, Marina V.

Química Nova

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feb 2023, Volume 46 N. 2 Pages 199 - 206

Abstract: Pt | Text: Pt | PDF: Pt

We developed and validated an UHPLC-MS/MS method for the quantification of phosphatidylethanol (PEth) in dried blood spots (DBS). Sample preparation was a liquid extraction and chromatographic separation was performed in an Acquity C8 column. The mobile phases were 4 mM ammonium acetate in water (A) and acetonitrile (B) at 24:76 (v/v). The total analytical run time was 6 minutes, with retention time of 3.36 min for PEth and 4.13 min for phosphatidylpropanol. The method was linear from 10 to 3000 ng mL-1, specific, with, precise and accurate. The analyte was stable in DBS stored from -20 to 45 °C for 21 days. Matrix effect was compensated with the internal standard (-5.21% to + 6.09%). The method was applied in the evaluation of alcohol consumption in DBS from 25 chemical dependents. The PEth concentrations ranged from 14.5 to 2380.8 ng mL-1, with significant correlation with the self-report alcohol consumption AUDIT scores (r=0.41).

https://doi.org/10.21577/0100-4042.20170968

Knowledge regarding extracorporeal membrane oxygenation management among Brazilian pediatric intensivists: a cross-sectional survey
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Colleti Júnior, José

; Prata-Barbosa, Arnaldo

; Araujo, Orlei Ribeiro

; Tonial, Cristian Tedesco

; Oliveira, Felipe Rezende Caino de

; Souza, Daniela Carla de

; Lima-Setta, Fernanda

; Oliveira, Thiago Silveira Jannuzzi de

; Mello, Mary Lucy Ferraz Maia Fiuza de

; Amoretti, Carolina

; João, Paulo Ramos David

; Neves, Cinara Carneiro

; Oliveira, Norma Suely

; Costa, Cira Ferreira Antunes

; Garros, Daniel

Critical Care Science

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jan 2023, Volume 35 N. 1 Pages 57 - 65

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

ABSTRACT Objective: To assess Brazilian pediatric intensivists’ general knowledge of extracorporeal membrane oxygenation, including evidence for its use, the national funding model, indications, and complications. Methods: This was a multicenter cross-sectional survey including 45 Brazilian pediatric intensive care units. A convenience sample of 654 intensivists was surveyed regarding their knowledge on managing patients on extracorporeal membrane oxygenation, its indications, complications, funding, and literature evidence. Results: The survey addressed questions regarding the knowledge and experience of pediatric intensivists with extracorporeal membrane oxygenation, including two clinical cases and 6 optional questions about the management of patients on extracorporeal membrane oxygenation. Of the 45 invited centers, 42 (91%) participated in the study, and 412 of 654 (63%) pediatric intensivists responded to the survey. Most pediatric intensive care units were from the Southeast region of Brazil (59.5%), and private/for-profit hospitals represented 28.6% of the participating centers. The average age of respondents was 41.4 (standard deviation 9.1) years, and the majority (77%) were women. Only 12.4% of respondents had taken an extracorporeal membrane oxygenation course. Only 19% of surveyed hospitals have an extracorporeal membrane oxygenation program, and only 27% of intensivists reported having already managed patients on extracorporeal membrane oxygenation. Specific extracorporeal membrane oxygenation management questions were responded to by only 64 physicians (15.5%), who had a fair/good correct response rate (median 63.4%; range 32.8% to 91.9%). Conclusion: Most Brazilian pediatric intensivists demonstrated limited knowledge regarding extracorporeal membrane oxygenation, including its indications and complications. Extracorporeal membrane oxygenation is not yet widely available in Brazil, with few intensivists prepared to manage patients on extracorporeal membrane oxygenation and even fewer intensivists recognizing when to refer patients to extracorporeal membrane oxygenation centers.

RESUMO Objetivo: Avaliar os conhecimentos gerais dos intensivistas pediátricos brasileiros sobre oxigenação por membrana extracorpórea, incluindo evidências de uso, modelo de custeio nacional, indicações e complicações. Métodos: Este estudo foi um inquérito transversal multicêntrico que incluiu 45 unidades de terapia intensiva pediátrica brasileiras. Realizou-se inquérito de conveniência com 654 intensivistas quanto aos seus conhecimentos sobre manejo de pacientes em oxigenação por membrana extracorpórea, suas indicações, complicações, custeio e evidências bibliográficas. Resultados: O inquérito abordou questões relativas aos conhecimentos e à experiência dos intensivistas pediátricos sobre oxigenação por membrana extracorpórea, incluindo dois casos clínicos e seis questões facultativas sobre o manejo de pacientes em oxigenação por membrana extracorpórea. Dos 45 centros convidados, 42 (91%) participaram do estudo, e 412 (63%) dos 654 intensivistas pediátricos responderam ao inquérito. A maioria das unidades de terapia intensiva pediátrica eram da Região Sudeste do Brasil (59,5%), e os hospitais privados com fins lucrativos representavam 28,6% dos centros participantes. A média de idade dos respondentes era de 41,4 (desvio-padrão de 9,1) anos, e a maioria (77%) era mulher. Apenas 12,4% dos respondentes tinham formação em oxigenação por membrana extracorpórea. Dos hospitais pesquisados, apenas 19% tinham um programa de oxigenação por membrana extracorpórea, e apenas 27% dos intensivistas declararam já ter manejado pacientes em oxigenação por membrana extracorpórea. Apenas 64 médicos (15,5%) responderam a questões específicas sobre o manejo de oxigenação por membrana extracorpórea (mediana 63,4%; oscilando entre 32,8% e 91,9%). Conclusão: A maioria dos intensivistas pediátricos brasileiros demonstrou conhecimentos limitados de oxigenação por membrana extracorpórea, incluindo suas indicações e complicações. A oxigenação por membrana extracorpórea ainda não está amplamente disponível no Brasil, com poucos intensivistas preparados para o manejo de pacientes em oxigenação por membrana extracorpórea e ainda menos intensivistas capazes de reconhecer quando devem encaminhar pacientes para centros de oxigenação por membrana extracorpórea.

https://doi.org/10.5935/2965-2774.20230350-en

Diagnostic performance of anthropometric indicators used to assess excess body fat in adolescence
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Antunes, Nelma Maria Neves

; Silveira, Marise Fagundes

; Silva, Rosângela Ramos Veloso

; Rocha, Josiane Santos Brant

; Oliveira, Fernanda Piana Santos Lima de

; Ruas, Sélen Jaqueline Souza

; Borborema, Fabiana Aparecida Maia

; Duarte, Jose Henrique Pinto

; Rodrigues, Carolina Amaral Oliveira

; Brito, Maria Fernanda Santos Figueiredo

; Caldeira, Antônio Prates

; Pinho, Lucinéia de

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2021189

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

RESUMO Objetivo: Comparar o desempenho de indicadores antropométricos para identificar o excesso de gordura corporal (GC) em adolescentes. Métodos: Estudo metodológico com amostragem probabilística por conglomerados, por sorteio das escolas e turmas. A coleta de dados incluiu características sociodemográficas e medidas antropométricas. O índice de massa corporal (IMC), a relação cintura-estatura (RCE), o índice de conicidade (IC) e a circunferência da cintura (CC) foram calculados. O percentual de gordura corporal (%GC) foi calculado com base na espessura das dobras cutâneas e utilizado como padrão-ouro. Para analisar os dados, foram utilizadas estatísticas descritivas, teste t de Student, curva Receiver Operating Characteristic (ROC) e índice de Youden. Foi calculado o coeficiente de correlação entre os indicadores e o %GC. Resultados: Participaram do estudo 997 adolescentes de escolas municipais. Identificou-se, pelo IMC, que 10,6% dos adolescentes apresentavam sobrepeso e 4,7%, obesidade. O IMC, a CC e a RCE apresentaram a maior acurácia para predizer a gordura corporal. Todos os indicadores antropométricos apresentaram especificidade superior à sensibilidade para diagnosticar excesso de GC no sexo masculino. A CC apresentou a maior sensibilidade em ambos os sexos. O IC apresentou a menor área sob a curva ROC e a menor sensibilidade em ambos os sexos, mas especificidade equivalente aos demais indicadores. Conclusões: IMC, RCE e CC apresentaram a melhor capacidade de predizer excesso de GC em adolescentes e os melhores coeficientes de correlação. Essas ferramentas podem ser consideradas formas de rastreamento na identificação do excesso de GC em adolescentes.

Abstract Objective: To compare the performance of anthropometric indicators that identify excess body fat (BF) in adolescents. Methods: This is a methodological study that used probability cluster sampling through school and class draws. Data collection included sociodemographic characteristics and anthropometric measures. Body mass index (BMI), waist-to-height ratio (WtHR), conicity index (C index), and waist circumference (WC) were calculated. Body fat percentage (BF%) was calculated from skinfold thickness and used as the gold standard. To analyze the data, descriptive statistics, Student’s t-test, Receiver Operating Characteristic (ROC) curve, and Youden’s index were used, in addition to correlation coefficient calculation between the indicators and BF%. Results: A total of 997 adolescents enrolled in municipal secondary schools participated in the study. By calculating the BMI, we found that 10.6% of adolescents were overweight, and 4.7% were obese. BMI, WC, and WtHR had the highest accuracy to predict body fatness. All the anthropometric indicators had higher specificity than sensitivity to diagnose excess BF in males. WC had the highest sensitivity in both genders. C index had the smallest area under the ROC curve and the lowest sensitivity in both genders, but its specificity was equivalent to that of the other indicators. Conclusions: BMI, WtHR, and WC were the best anthropometric indicators to predict excess BF in adolescents and had the best correlation coefficients. These tools can be considered in the screening to detect excess BF in adolescents.

https://doi.org/10.1590/1984-0462/2023/41/2021189

10.

National Vaccine Coverage Survey 2020: methods and operational aspects
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Barata, Rita Barradas

; França, Ana Paula

; Guibu, Ione Aquemi

; Vasconcellos, Maurício Teixeira Leite de

; Moraes, José Cássio de

; Teixeira, Maria da Gloria Lima Cruz

; Domingues, Carla Magda Alan

; Borges, Maria Fernanda de Souza Oliveira

; de Azevedo, Roberta Nogueira Calandrini

; de Oliveira, Consuelo Silva

; Oliveira, Andrea de Nazaré Marvão

; Canales, Ivy Thereza

; Nascimento, Valdir

; Queiroz, Rejane Christine de Souza

; Lima, Luísa Helena de Oliveira

; Ramos Jr, Alberto Novaes

; Barbosa, Jaqueline Caracas

; Mirabal, Isabelle Ribeiro Barbosa

; Meira, Meiruska

; Antunes, Maria Bernadete de Cerqueira

; Teixeira, Maria Denise de Castro

; Gurgel, Ricardo Queiroz

; de Carvalho, Martha Suely Itaparica

; Cesar, Tayñana

; Maciel, Ethel Leonor Noia

; da Gama, Silvana Granado Nogueira

; Luhm, Karin Regina

; Boing, Antônio Fernando

; Mengue, Sotero Serrate

; de Oliveira, Sandra Maria do Valle Leone

; Lima, Jaqueline Costa

; Teles, Sheila Araújo

; Caetano, Karlla Antonieta Amorim

; de Araújo, Wildo Navegantes

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230031

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

RESUMO Objetivo: Inquérito nacional de cobertura vacinal aos 12 e 24 meses de idade foi realizado para investigar as quedas nas coberturas a partir de 2016. Métodos: Amostra de 37.836 nascidos vivos das coortes de 2017 e 2018 residentes nas capitais, Distrito Federal (DF) e 12 cidades com mais de 100 mil habitantes, acompanhados nos primeiros 24 meses por registros nas cadernetas de vacinação. Setores censitários foram estratificados segundo condições socioeconômicas, e o mesmo número de crianças foi incluído para cada estrato. Calcularem-se coberturas vacinais de cada vacina e coberturas completas aos 12 e 24 meses, doses aplicadas, válidas e oportunas. Fatores familiares, maternos e da criança associados à cobertura foram pesquisados. Os motivos para não vacinar analisados foram: contraindicações médicas, dificuldades de acesso, problemas no funcionamento do programa e hesitação vacinal. Resultados: Os resultados preliminares mostram que menos de 1% das crianças não foram vacinadas, as coberturas pelo esquema completo são menores que 75% em todas as capitais e no DF, as vacinas com mais de uma dose perdem cobertura progressivamente, há diferenças entre os estratos socioeconômicos, favoráveis aos estratos mais altos em algumas cidades e aos estratos mais baixos em outras. Conclusão: Houve realmente redução da cobertura vacinal em todas as capitais e no DF para as crianças nascidas em 2017 e 2018, denotando piora na execução do Programa Nacional de Imunizações durante os anos de 2017 a 2019. O inquérito realizado não mensurou os impactos da pandemia de COVID-19 que podem ter reduzido ainda mais as coberturas vacinais.

ABSTRACT Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

https://doi.org/10.1590/1980-549720230031

11.

Ischemic stroke mortality and time for hospital arrival: analysis of the first 90 days
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Moraes, Mariana de Almeida

; Jesus, Pedro Antônio Pereira de

; Muniz, Ludimila Santos

; Costa, Greice Alves

; Pereira, Larissa Vitória

; Nascimento, Letícia Melquiades

; Teles, Carlos Antônio de Souza

; Baccin, Camila Antunes

; Mussi, Fernanda Carneiro

Revista da Escola de Enfermagem da USP

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2023, Volume 57 elocation e20220309

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

ABSTRACT Objective: To analyze the association between time of arrival at a reference hospital and mortality of people with ischemic stroke. Method: Descriptive and inferential statistics were used. Modifying and confounding variables between time of arrival and mortality were observed in the multivariate analysis. The Akaike Information Criterion was used to choose the model. Statistical significance of 5% and risk correction using the Poisson Model were adopted. Results: Most participants arrived within 4.5 hours of symptom onset or wake up stroke to the referral hospital and 19.4% died. The score of the National Institute of Health Stroke Scale was a modifier. In the multivariate model stratified by scale score ≥14, arrival time >4.5h was associated with lower mortality; and age ≥60 years and having Atrial Fibrillation, to higher mortality. In the model stratified by score ≤13, previous Rankin ≥3, and presence of atrial fibrillation were predictors of mortality. Conclusion: The relationship between time of arrival and mortality up to 90 days was modified by the National Institute of Health Stroke Scale. Prior Rankin ≥3, atrial fibrillation, time to arrival ≤4.5h, and age ≥60 years contributed to higher mortality.

RESUMEN Objetivo: Analizar la asociación entre el tiempo de llegada a un hospital de referencia y la mortalidad de las personas con accidente cerebrovascular isquémico. Método: Fueron usadas estadísticas descriptivas e inferenciales. En el análisis multivariado se verificaron variables modificadoras y confusoras entre el tiempo de llegada y la mortalidad. Para la elección del modelo se utilizó el Criterio de Información de Akaike. Se adoptó la significación estadística del 5% y la corrección del riesgo mediante el Modelo de Poisson. Resultados: La mayoría de los participantes llegaron dentro de las 4,5 horas posteriores al inicio de los síntomas o wake up stroke al hospital de referencia y el 19,4% fallecieron. La puntuación de la escala National Institute of Health Stroke Scale fue un modificador. En el modelo multivariante estratificado por puntaje de escala ≥14, el tiempo de llegada >4,5 h se asoció con una menor mortalidad; y edad ≥60 años y con Fibrilación Auricular a mayor mortalidad. En el modelo estratificado por puntaje ≤13, Rankin previo ≥3 y tener fibrilación auricular fueron predictores de mortalidad. Conclusión: La relación entre tiempo de llegada y mortalidad hasta los 90 días fue modificada por puntaje de la escala National Institute of Health Stroke Scale. Rankin previo ≥3, fibrilación auricular, tiempo hasta la llegada ≤4,5 h y la edad ≥60 años contribuyeron a una mayor mortalidad.

RESUMO Objetivo: Analisar a associação entre tempo de chegada a hospital de referência e mortalidade de pessoas com Acidente Vascular Cerebral isquêmico. Método: Foram utilizadas estatísticas descritivas e inferenciais. Variáveis modificadoras e confundidoras entre tempo de chegada e mortalidade foram verificadas na análise multivariada. O Critério de Informação de Akaike foi utilizado para escolha do modelo. Adotou-se significância estatística de 5% e correção de risco pelo Modelo de Poisson. Resultados: A maioria dos participantes chegou em até 4,5 horas do início dos sintomas ou wake up stroke ao hospital de referência e 19,4% morreram. A pontuação da National Institute of Health Stroke Scale foi um modificador. No modelo multivariado estratificado por pontuação da escala ≥14, o tempo de chegada >4,5h estava associado a menor mortalidade; e idade ≥60 anos e ter Fibrilação Atrial, a maior mortalidade. No modelo estratificado por pontuação ≤13, Rankin prévio ≥3 e ter fibrilação atrial foram preditores de mortalidade. Conclusão: A relação entre tempo de chegada e mortalidade até 90 dias foi modificada pela pontuação da National Institute of Health Stroke Scale. Rankin prévio ≥3, fibrilação atrial, tempo de chegada ≤4,5h e idade ≥60 anos contribuíram para maior mortalidade.

https://doi.org/10.1590/1980-220x-reeusp-2022-0309en

12.

Arrival time at a referral hospital and functional disability of people with stroke: a cohort study
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Moraes, Mariana de Almeida

; Jesus, Pedro Antônio de

; Muniz, Ludimila Santos

; Baccin, Camila Antunes

; Barreto, Alexandra Bahia Mendonça

; Sales, Rilary Silva

; Pires, Cláudia Geovana da Silva

; Teles, Carlos Antônio de Souza

; Mussi, Fernanda Carneiro

Sao Paulo Medical Journal

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2023, Volume 141 N. 6 elocation e2022510

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Stroke is a major cause of death and functional disability worldwide. Knowledge of the associated factors is essential for defining education, management, and healthcare strategies. OBJECTIVE: To analyze the association between arrival time at a neurology referral hospital (ATRH) and functional disability in patients with ischemic stroke 90 days after the event. DESIGN AND SETTING: Prospective cohort study conducted at a public institution of higher education in Brazil. METHODS: This study included 241 people aged ≥ 18 years who presented ischemic stroke. The exclusion criteria were death, inability to communicate without companions who could answer the research questions, and > 10 days since ictus. Disability was assessed using the Rankin score (mR). Variables for which associations showed a P value ≤ 0.20 in bivariate analysis were tested as modifiers between ATRH and disability. Significant interaction terms were used for multivariate analysis. Multivariate logistic regression analysis was performed with all variables, arriving at the complete model and adjusted beta measures. The confounding variables were included in the robust logistic regression model, and Akaike’s Information Criterion was adopted to choose the final model. The Poisson model assumes a statistical significance of 5% and risk correction. RESULTS: Most participants (56.0%) arrived at the hospital within 4.5 hours of symptom onset, and 51.7% presented with mRs of 3 to 5 after 90 days of ictus. In the multivariate model, ATRH ≥ 4.5 hours and females were associated with more significant disability. CONCLUSIONS: Arrival at the referral hospital 4.5 hours after the onset of symptoms or wake-up stroke was an independent predictor of a high degree of functional disability.

https://doi.org/10.1590/1516-3180.2022.0510.r1.27022023

13.

National Vaccine Coverage Survey 2020: methods and operational aspects
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Barata, Rita Barradas

; França, Ana Paula

; Guibu, Ione Aquemi

; Vasconcellos, Maurício Teixeira Leite de

; Moraes, José Cássio de

; Teixeira, Maria da Gloria Lima Cruz

; Domingues, Carla Magda Alan

; Borges, Maria Fernanda de Souza Oliveira

; de Azevedo, Roberta Nogueira Calandrini

; de Oliveira, Consuelo Silva

; Oliveira, Andrea de Nazaré Marvão

; Canales, Ivy Thereza

; Nascimento, Valdir

; Queiroz, Rejane Christine de Souza

; Lima, Luísa Helena de Oliveira

; Ramos Jr, Alberto Novaes

; Barbosa, Jaqueline Caracas

; Mirabal, Isabelle Ribeiro Barbosa

; Meira, Meiruska

; Antunes, Maria Bernadete de Cerqueira

; Teixeira, Maria Denise de Castro

; Gurgel, Ricardo Queiroz

; de Carvalho, Martha Suely Itaparica

; Cesar, Tayñana

; Maciel, Ethel Leonor Noia

; da Gama, Silvana Granado Nogueira

; Luhm, Karin Regina

; Boing, Antônio Fernando

; Mengue, Sotero Serrate

; de Oliveira, Sandra Maria do Valle Leone

; Lima, Jaqueline Costa

; Teles, Sheila Araújo

; Caetano, Karlla Antonieta Amorim

; de Araújo, Wildo Navegantes

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230031

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

https://doi.org/10.1590/1980-549720230031

14.

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Abstract: En | Text: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.

https://doi.org/10.1590/0074-02760220259

15.

Factors associated with decision time to seek care in the face of ischemic stroke
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Muniz, Ludimila Santos

; Moraes, Mariana de Almeida

; Sales, Rilary Silva

; Ribeiro, Laís Silva

; Cunha, Brenda Silva

; Jesus, Pedro Antônio Pereira de

; Sampaio, Elieusa e Silva

; Baccin, Camila Rosalia Antunes

; Teles, Carlos Antônio de Souza

; Mussi, Fernanda Carneiro

Revista da Escola de Enfermagem da USP

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2023, Volume 57 elocation e20230075

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

ABSTRACT Objective: To verify the association between sociodemographic, clinical, environmental, cognitive, and emotional factors and the decision time of people with ischemic stroke to seek a health service after the onset of symptoms or wake up stroke. Method: Cross-sectional study carried out from March to October 2019, with 304 patients, in a public hospital, a reference in neurology. Data obtained through interview and from medical records. Decision time was analyzed as a geometric mean. In the bivariate and multivariate analyses, linear regression was used and the Akaike Information Criterion was used to select the best model. Statistical significance of 5% was adopted. Results: The geometric mean of decision time was 0.30h (95% CI 0.23–0.39). The final model explained this time in 41%, showing an increase of 0.5 min for people with arterial hypertension; 10.8 min for those who waited for symptoms to improve; 1.4 min for those who were alone at the onset of symptoms; 3.9 min for those at home; 3.2 min for the ones at work; and 2.1 for those on the street/public space. Conclusion: The mean decision time for seeking a health service was high and influenced by clinical, environmental, cognitive, and emotional variables. The results guide nurses regarding health education.

RESUMEN Objetivo: Verificar la asociación entre factores sociodemográficos, clínicos, ambientales, cognitivos, y emocionales y el tiempo de decisión de las personas con accidente cerebrovascular isquémico para buscar un servicio de salud luego del inicio de los síntomas o Wake up stroke Método: Estudio transversal realizado de marzo a octubre de 2019, con 304 pacientes, en un hospital público, referencia en neurología. Datos obtenidos por entrevista y de la historia clínica. El tiempo de decisión se analizó como una media geométrica. En los análisis bivariados y multivariados se utilizó la regresión lineal y el Criterio de Información de Akaike para seleccionar el mejor modelo. Se adoptó una significancia estadística del 5% Resultados: La media geométrica del tiempo de decisión fue de 0,30h (IC 95% 0,23-0,39). El modelo final explicó este tiempo en un 41%, mostrando un aumento de 0,5 min para las personas con hipertensión arterial, 10,8 min para las que esperaron a que los síntomas mejoraran, 1,4 min para las que estaban solas al inicio de los síntomas, 3, 9 min para las que estaban en casa, 3,2 min para los que estaban en el trabajo y 2,1 en la calle/vía pública Conclusión: El tiempo promedio de decisión para buscar un servicio de salud fue alto e influenciado por variables clínicas, ambientales, cognitivas y emocionales. Los resultados orientan a los enfermeros hacia la educación en salud.

RESUMO Objetivo: Verificar a associação entre fatores sociodemográficos, clínicos, ambientais, cognitivos e emocionais e o tempo de decisão de pessoas com acidente vascular cerebral isquêmico para procurar um serviço de saúde após o início dos sintomas ou Wake up stroke Método: Estudo transversal realizado de março a outubro de 2019, com 304 pacientes, em hospital público, referência em neurologia. Dados obtidos por entrevista e no prontuário. O tempo de decisão foi analisado em média geométrica. Nas análises bivariadas e multivariada foi usada a regressão linear e o Critério de Informação de Akaike foi usado na seleção do melhor modelo. Adotou- se significância estatística de 5% Resultados: A média geométrica do tempo de decisão foi de 0,30h (IC 95% 0,23-0,39). O modelo final explicou em 41% esse tempo, mostrando aumento de 0,5 min para pessoas com hipertensão arterial; 10,8 min para quem esperou os sintomas melhorarem; 1,4 min para quem estava sozinho no início dos sintomas; 3,9 min para quem estava em casa; 3,2 min no trabalho e 2,1 na rua/via pública Conclusão: A média do tempo de decisão para procura de serviço de saúde foi alta e influenciada por variáveis clínicas, ambientais, cognitivas e emocionais. Os resultados orientam enfermeiros para a educação em saúde.

https://doi.org/10.1590/1980-220x-reeusp-2023-0075en

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