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ABSTRACT BACKGROUND: The thrombin generation test (TGT) has shown promise for investigation of hemorrhagic and thrombotic diseases. However, despite its potential, it still needs standardization. Moreover, few studies have established reference values for TGT parameters. In Brazil, these values have not yet been established. OBJECTIVE: To determine TGT performance and reference intervals for TGT parameters in healthy individuals. DESIGN AND SETTING: Cross-sectional study conducted among participants in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). METHODS: The reference sample consisted of 620 healthy individuals. The calibrated automated thrombogram (CAT) method, under low and high tissue factor (TF) conditions, was used to assess thrombin generation. Test performance was analyzed using intra and interassay coefficients of variation (CV) and reference intervals were calculated using the nonparametric method proposed by the International Federation of Clinical Chemistry and the Clinical and Laboratory Standards Institute. RESULTS: The intraassay CV ranged from 1.4% to 2.2% and the interassay CV, 6.8% to 14.7%. The reference intervals for TGT parameters under low and high TF conditions were, respectively: lagtime: 3.0-10.3 and 1.4-3.7 min; endogenous thrombin potential (ETP): 1134.6-2517.9 and 1413.6-2658.0 nM.min; normalized ETP: 0.6-1.3 and 0.7-1.4; peak: 103.2-397.7 and 256.4-479.0 nM; normalized peak: 0.3-1.3 and 0.7-1.2; and time-to-peak: 5.6-16.0 and 3.4-6.7 min. These parameters were categorized relative to sex. Conclusion: TGT performance was adequate and the proposed reference intervals were similar to those of other studies. Our findings may be useful for consolidating the TGT, through contributing to its standardization and validation.

https://doi.org/10.1590/1516-3180.2021.0425.r1.07102021

Diferenças Raciais no Controle da Pressão Arterial em Usuários de Anti-Hipertensivos em Monoterapia: Resultados do Estudo ELSA-Brasil
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Sousa, Camila Tavares

; Ribeiro, Antonio

; Barreto, Sandhi Maria

; Giatti, Luana

; Brant, Luisa

; Lotufo, Paulo

; Chor, Dora

; Lopes, Antônio Alberto

; Mengue, Sotero Serrate

; Baldoni, André Oliveira

; Figueiredo, Roberta Carvalho

Arquivos Brasileiros de Cardiologia

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mar 2022, Volume 118 N. 3 Pages 614 - 622

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

Abstract Background It seems that the worst response to some classes of antihypertensive drugs, especially angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, on the part of the Black population, would at least partially explain the worse control of hypertension among these individuals. However, most of the evidence comes from American studies. Objectives This study aims to investigate the association between self-reported race/skin color and BP control in participants of the Longitudinal Study of Adult Health (ELSA-Brasil), using different classes of antihypertensive drugs in monotherapy. Methods The study involved a cross-sectional analysis, carried out with participants from the baseline of ELSA-Brasil. Blood pressure control was the response variable, participants with BP values ≥140/90 mmHg were considered out of control in relation to blood pressure levels. Race/skin color was self-reported (White, Brown, Black). All participants were asked about the continuous use of medication. Association between BP control and race/skin color was estimated through logistic regression. The level of significance adopted in this study was of 5%. Results Of the total of 1,795 users of antihypertensive drugs in monotherapy at baseline, 55.5% declared themselves White, 27.9% Brown, and 16.7% Black. Even after adjusting for confounding variables, Blacks using angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blocker (ARB), thiazide diuretics (thiazide DIU), and beta-blockers (BB) in monotherapy had worse blood pressure control compared to Whites. Conclusions Our results suggest that in this sample of Brazilian adults using antihypertensive drugs in monotherapy, the differences in blood pressure control between different racial groups are not explained by the possible lower effectiveness of ACEIs and ARBs in Black individuals.

Resumo Fundamento Aparentemente, a pior resposta a algumas classes de anti-hipertensivos, especialmente inibidores da enzima conversora da angiotensina e bloqueadores de receptor de angiotensina, pela população negra, explicaria, pelo menos parcialmente, o pior controle da hipertensão entre esses indivíduos. Entretanto, a maioria das evidências vêm de estudos norte-americanos. Objetivos Este estudo tem o objetivo de investigar a associação entre raça/cor da pele autorrelatadas e controle de PA em participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) utilizando várias classes de anti-hipertensivos em monoterapia. Métodos O estudo envolveu uma análise transversal, realizada com participantes da linha de base do ELSA-Brasil. O controle de pressão arterial foi a variável de resposta, participantes com valores de PA ≥140/90 mmHg foram considerados descontrolados em relação aos níveis de pressão arterial. A raça/cor da pele foi autorrelatada (branco, pardo, negro). Todos os participantes tiveram que responder perguntas sobre uso contínuo de medicamentos. A associação entre o controle de PA e raça/cor da pele foi estimada por regressão logística. O nível de significância adotado nesse estudo foi de 5%. Resultados Do total de 1.795 usuários de anti-hipertensivos em monoterapia na linha de base, 55,5% se declararam brancos, 27,9%, pardos e 16,7%, negros. Mesmo depois de padronizar em relação a variáveis de confusão, negros em uso de inibidores da enzima conversora de angiotensina (IECA), bloqueadores de receptor de angiotensina (BRA), diuréticos tiazídicos (DIU tiazídicos) e betabloqueadores (BB) in monoterapia tinham controle de pressão arterial pior em comparação a brancos. Conclusões Os resultados deste estudo sugerem que, nesta amostra de brasileiros adultos utilizando anti-hipertensivos em monoterapia, as diferenças de controle de pressão arterial entre os vários grupos raciais não são explicadas pela possível eficácia mais baixa dos IECA e BRA em indivíduos negros.

https://doi.org/10.36660/abc.20201180

Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil
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Santos, Laura Luiza Menezes

; Diniz, Maria de Fátima Haueisen Sander

; Goulart, Alessandra Carvalho

; Barreto, Sandhi Maria

; Figueiredo, Roberta Carvalho

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 2 Pages 213 - 221

Abstract: En | Text: En | PDF: En

Abstract BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. OBJECTIVES: To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. DESIGN AND SETTINGS: Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS: This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. RESULTS: The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. CONCLUSION: NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.

https://doi.org/10.1590/1516-3180.2021.0095.r2.22062021

Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil
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Santos, Laura Luiza Menezes

; Diniz, Maria de Fátima Haueisen Sander

; Goulart, Alessandra Carvalho

; Barreto, Sandhi Maria

; Figueiredo, Roberta Carvalho

Sao Paulo Medical Journal

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2022, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-3180.2021.0095.r2.22062021

Performance and reference intervals of thrombin generation test: results from the Brazilian longitudinal study of adult health (ELSA-Brasil). A cross-sectional study
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Rios, Danyelle Romana Alves

; Barreto, Sandhi Maria

; Ferreira, Letícia Gonçalves Resende

; Batista, Thaís Resende

; Silva, Ana Paula Ferreira

; de Oliveira Júnior, Wander Valadares

; Maluf, Chams Bicalho

; Carvalho, Maria das Graças

; Figueiredo, Roberta Carvalho

Sao Paulo Medical Journal

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2022, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-3180.2021.0425.r1.07102021

Sodium alendronate: proposal and reliability of indicators
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Silva, Ricardo Augusto dos Santos

; Baldoni, André Oliveira

; Alvim, Camila Pereira

; Obreli Neto, Paulo Roque

; Guidoni, Camilo Molino

; Silva, Isabella Ribeiro

; Figueiredo, Roberta Carvalho

Brazilian Journal of Pharmaceutical Sciences

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2022, Volume 58 elocation e19193

Abstract: En | Text: En | PDF: En

Abstract The present study proposes and evaluates the test-retest reliability of indicators of the correct use of sodium alendronate in elderly patients. This is a test-retest reliability study for use of sodium alendronate. Six questions to evaluate the correct use of this medicine were elaborated after analysis of information in the literature. Data collection was performed through questionnaires in face-to-face in-home interviews by previously trained interviewers. The participants were initially interviewed (test) when they agreed to participate in the study, and secondly (retest), after a period of 7 to 14 days from the first interview. The reliability of the questions was evaluated by means of the agreement percentage and the Kappa coefficient. Fifty-seven pairs (test-retest) were obtained. The mean age was 69.3 (SD = 6.9) years, the majority (92.5%) completed elementary education, and declared themselves white (50.9%). All the questions presented high concordance ranging from 79.0% to 98.3%. The Kappa values ranged from 0.1 (low) to 0.83 (very good). The agreement percentage and the Kappa values suggest adequate reliability of the proposed questions. We suggest that they can be used as a simple and quick way to evaluate the quality of sodium alendronate use among the elderly.

https://doi.org/10.1590/s2175-97902022e19193

CA-125 and CCL2 may indicate inflammation in peritoneal dialysis patients
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Oliveira Júnior, Wander Valadares de

; Turani, Sylvia Dias

; Marinho, Maria Aparecida Silva

; Pinto, Sérgio Wyton Lima

; Otoni, Alba

; Figueiredo, Roberta Carvalho

; Rios, Danyelle Romana Alves

Brazilian Journal of Nephrology

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dec 2021, Volume 43 N. 4 Pages 502 - 509

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

Abstract Introduction: Progressive structural changes in the peritoneal membrane occur over the course of treatment in peritoneal dialysis (PD), resulting in an increase in cytokines such as CCL2 and structural changes in peritoneal membrane triggering an increase in CA-125 in dialysate, which reflects a probable local inflammatory process, with possible loss of mesothelial cells. Thus, the current study aimed to evaluate the association between plasma and CCL2 and CA-125 dialysate levels in patients undergoing PD. Methods: Cross-sectional study was conducted with 41 patients undergoing PD. The assessments of CA-125 and CCL2 levels were performed using a capture ELISA. Correlations were estimated using Spearman's correlation and the investigation of the association between the explanatory variables (CCL2) and response variable (CA-125) was done for crude ratio of arithmetic means and adjusted utilizing generalized linear models. Results: A moderate positive correlation was observed between the levels of CA-125 and CCL2 in the dialysate (rho = 0.696). A statistically significant association was found between the levels in the CCL2 and CA-125 dialysate (RoM=1.31; CI = 1.20-1.43), which remained after adjustment for age (RoM = 1.31; CI=1.19-1.44) and for time in months of PD (RoM=1.34, CI=1.22-1.48). Conclusion: The association of CA-125 levels with CCL2 in the dialysate may indicate that the local inflammatory process leads to temporary or definitive changes in peritoneal membrane. A better understanding of this pathogenesis could contribute to the discovery of new inflammatory biomarkers.

Resumo Introdução: Alterações estruturais progressivas na membrana peritoneal ocorrem no decorrer do tratamento em diálise peritoneal (DP), resultando em um aumento de citocinas como CCL2 e alterações estruturais na membrana peritoneal desencadeando um aumento de CA-125 no dialisato, o que reflete um provável processo inflamatório local, com possível perda de células mesoteliais. Assim, o presente estudo teve como objetivo avaliar a associação entre CCL2 e CA-125 no plasma e no dialisato de pacientes submetidos à DP. Métodos: Foi realizado um estudo transversal com 41 pacientes submetidos à DP. As avaliações dos níveis de CA-125 e CCL2 foram realizadas utilizando ELISA de captura. As correlações foram estimadas usando a correlação de Spearman, e a investigação da associação entre as variáveis explicativas (CCL2) e a variável resposta (CA-125) foi feita pela razão bruta das médias aritméticas e ajustada utilizando modelos lineares generalizados. Resultados: Foi observada uma correlação positiva moderada entre os níveis de CA-125 e CCL2 no dialisato (rho = 0,696). Foi encontrada uma associação estatisticamente significativa entre os níveis no dialisato de CCL2 e CA-125 (RoM=1,31; IC = 1,20-1,43), que permaneceu após ajuste por idade (RoM = 1,31; IC=1,19-1,44) e pelo tempo de DP em meses (RoM=1,34, IC=1,22-1,48). Conclusão: A associação dos níveis de CA-125 com CCL2 no dialisato pode indicar que o processo inflamatório local leva a alterações temporárias ou definitivas na membrana peritoneal. Uma melhor compreensão desta patogênese pode contribuir para a descoberta de novos biomarcadores inflamatórios.

https://doi.org/10.1590/2175-8239-jbn-2020-0255

Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study
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Lima-Setta, Fernanda

; Magalhães-Barbosa, Maria Clara de

; Rodrigues-Santos, Gustavo

; Figueiredo, Elaine Augusta das Neves

; Jacques, Melissa de Lorena

; Zeitel, Raquel de Seixas

; Sapolnik, Roberto

; Borges, Cibelle Teixeira da Siva

; Lanziotti, Vanessa Soares

; Castro, Roberta Esteves Vieira de

; Bellinat, Ana Paula Novaes

; Silva, Thiago Peres da

; Oliveira, Felipe Rezende Caino de

; Reis, Bárbara Carvalho Santos dos

; Castro, Natália Almeida de Arnaldo Silva Rodriguez

; Macedo, João Henrique Garcia Cobas

; Scarlato, Ana Carolina Cabral Pinheiro

; Riveiro, Paula Marins

; Mota, Isabele Coelho Fonseca da

; Lorenzo, Vivian Botelho

; Lucena, Natalia Martins Lima de

; Azevedo, Zina Maria Almeida de

; Cunha, Antonio José L.A.

; Prata-Barbosa, Arnaldo

Jornal de Pediatria

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jun 2021, Volume 97 N. 3 Pages 354 - 361

Abstract: En | Text: En | PDF: En

Abstract Objective To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes of children with MIS-C. Method Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results Fifty-six patients were included, with the following conditions: Kawasaki-like disease (n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR 2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. -Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibiotics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5–6.5). The median length of PICU stay was six days (IQR 5–11), and one death occurred (1.8%). Conclusions Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae.

https://doi.org/10.1016/j.jped.2020.10.008

CA-125 and CCL2 may indicate inflammation in peritoneal dialysis patients
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Oliveira Júnior, Wander Valadares de

; Turani, Sylvia Dias

; Marinho, Maria Aparecida Silva

; Pinto, Sérgio Wyton Lima

; Otoni, Alba

; Figueiredo, Roberta Carvalho

; Rios, Danyelle Romana Alves

Brazilian Journal of Nephrology

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2021, N. ahead

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

https://doi.org/10.1590/2175-8239-jbn-2020-0255

10.

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

11.

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa

; Pereira, Maria Fernanda Badue

; Santos, Angélica Carreira dos

; Fink, Thais Toledo

; Paula, Camila Sanson Yoshino de

; Litvinov, Nadia

; Schvartsman, Claudio

; Delgado, Artur Figueiredo

; Gibelli, Maria Augusta Bento Cicaroni

; Carvalho, Werther Brunow de

; Odone Filho, Vicente

; Tannuri, Uenis

; Carneiro-Sampaio, Magda

; Grisi, Sandra

; Duarte, Alberto José da Silva

; Antonangelo, Leila

; Francisco, Rossana Pucineli Vieira

; Okay, Thelma Suely

; Batisttella, Linamara Rizzo

; Carvalho, Carlos Roberto Ribeiro de

; Brentani, Alexandra Valéria Maria

; Silva, Clovis Artur

; Eisencraft, Adriana Pasmanik

; Rossi Junior, Alfio

; Fante, Alice Lima

; Cora, Aline Pivetta

; Reis, Amelia Gorete A. de Costa

; Ferrer, Ana Paula Scoleze

; Andrade, Anarella Penha Meirelles de

; Watanabe, Andreia

; Gonçalves, Angelina Maria Freire

; Waetge, Aurora Rosaria Pagliara

; Silva, Camila Altenfelder

; Ceneviva, Carina

; Lazari, Carolina dos Santos

; Abellan, Deipara Monteiro

; Santos, Emilly Henrique dos

; Sabino, Ester Cerdeira

; Bianchini, Fabíola Roberta Marim

; Alcantara, Flávio Ferraz de Paes

; Ramos, Gabriel Frizzo

; Leal, Gabriela Nunes

; Rodriguez, Isadora Souza

; Pinho, João Renato Rebello

; Carneiro, Jorge David Avaizoglou

; Paz, Jose Albino

; Ferreira, Juliana Carvalho

; Ferranti, Juliana Ferreira

; Ferreira, Juliana de Oliveira Achili

; Framil, Juliana Valéria de Souza

; Silva, Katia Regina da

; Kanunfre, Kelly Aparecida

; Bastos, Karina Lucio de Medeiros

; Galleti, Karine Vusberg

; Cristofani, Lilian Maria

; Suzuki, Lisa

; Campos, Lucia Maria Arruda

; Perondi, Maria Beatriz de Moliterno

; Diniz, Maria de Fatima Rodrigues

; Fonseca, Maria Fernanda Mota

; Cordon, Mariana Nutti de Almeida

; Pissolato, Mariana

; Peres, Marina Silva

; Garanito, Marlene Pereira

; Imamura, Marta

; Dorna, Mayra de Barros

; Luglio, Michele

; Rocha, Mussya Cisotto

; Aikawa, Nadia Emi

; Degaspare, Natalia Viu

; Sakita, Neusa Keico

; Udsen, Nicole Lee

; Scudeller, Paula Gobi

; Gaiolla, Paula Vieira de Vincenzi

; Severini, Rafael da Silva Giannasi

; Rodrigues, Regina Maria

; Toma, Ricardo Katsuya

; Paula, Ricardo Iunis Citrangulo de

; Palmeira, Patricia

; Forsait, Silvana

; Farhat, Sylvia Costa Lima

; Sakano, Tânia Miyuki Shimoda

; Koch, Vera Hermina Kalika

; Cobello Junior, Vilson

Clinics

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2021, Volume 76 elocation e3488

Abstract: En | Text: En | PDF: En

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

https://doi.org/10.6061/clinics/2021/e3488

12.

Prevalência e fatores associados à presença de medicamentos vencidos em estoques caseiros
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Fernandes, Máyra Rodrigues

; Rocha, Rafaela Silva

; Silva, Isabella Ribeiro

; Figueiredo, Roberta Carvalho

; Baldoni, André Oliveira

Cadernos Saúde Coletiva

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sep 2020, Volume 28 N. 3 Pages 390 - 399

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

Abstract Background The storage of expired medications at home can cause potential damage to human health and the environment. Thus, studies that support intervention policies to minimize risks are essential. Objective To estimate the prevalence and factors associated with storage of expired medications at home. Method The cross-sectional study was conducted through interviews in the homes of Primary Health Care (PHC) users of a city in the center-west of Minas Gerais, Brazil. Prevalence estimates and their associations were performed using generalized linear models (MLGs). Results We found 4,203 medications stored in 423 homes, with an average of 10 medication/residence (SD=5.87). The prevalence of homes with expired medications was 45.4%, with antimicrobials and analgesics being the most prevalent. The presence of expired medications is associated with the presence of Over the Counter drugs (OTC) and antimicrobials at homes, and the behavior of keeping the unused drug in their home pharmacy. Conclusion Almost half of the homes have expired medications. And the presence of these drugs is associated with the therapeutic class and the behavior of the PHC user.

Resumo Introdução Medicamentos vencidos em farmácias caseiras são potenciais agentes causadores de danos à saúde humana e ao meio ambiente. Neste sentido, são essenciais estudos que subsidiem políticas de intervenção para minimização dos riscos. Objetivo Estimar a prevalência e os fatores associados aos medicamentos vencidos em estoques caseiros. Método O estudo transversal foi realizado por meio de entrevistas nas residências dos usuários da atenção primária à saúde (APS) de uma cidade do centro-oeste mineiro, Brasil. As estimativas de prevalência e suas associações foram realizadas por meio de modelos lineares generalizados (MLGs). Resultados Nos 423 estoques caseiros, foram encontrados 4.203 medicamentos, com uma média de 10 medicamentos/residência (DP = 5,87). A prevalência de residências com medicamentos vencidos foi de 45,4%, sendo os antimicrobianos e analgésicos os mais prevalentes. A presença de medicamentos vencidos está associada à presença de medicamentos isentos de prescrição (MIPs) e antimicrobianos nas residências e ao comportamento de guardar o medicamento em desuso em seu estoque caseiro. Conclusão Aproximadamente metade das residências possui medicamentos vencidos, e a presença deles está associada à classe terapêutica e ao comportamento do usuário.

https://doi.org/10.1590/1414-462x202028030535

13.

Volemia and kidney transplantation
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Vieira, Roberta Figueiredo

; Carmona, Maria José Carvalho

Revista Brasileira de Anestesiologia

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jun 2020, Volume 70 N. 3 Pages 191 - 193

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

https://doi.org/10.1016/j.bjane.2020.06.012

14.

Construction and validation of an educational gerontotechnology on frailty in elderly people
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Silva, Cynthia Roberta Dias Torres

; Felipe, Sarah Giulia Bandeira

; Carvalho, Khelyane Mesquita de

; Gouveia, Marcia Teles de Oliveira

; Silva Júnior, Fernando Lopes

; Figueiredo, Maria do Livramento Fortes

Revista Brasileira de Enfermagem

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2020, Volume 73 Suppl. 3 elocation e20200800

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

ABSTRACT Objective: to construct and validate an educational gerontechnology on frailty in elderly people. Method: a methodological study developed in three stages: educational video construction, validation by expert judges and elderly people. Validation was carried out by 22 judges and 22 elderly people. Educational Content Validation Instrument was used for judges and questions adapted from the Suitability Assessment of Materials questionnaire for elderly people. For validation, agreement criterion greater than 80% was considered, verified using Content Validation Index and binomial test. Results: the video addresses recommendations for elderly people at risk of frailty and health-promoting habits, using cordel literature. An agreement greater than 80% was verified in all items assessed by judges and the target audience. Conclusion: the video proved to be valid in terms of content and appearance by judges and elderly people, with the potential to mediate health-promoting educational practices in healthy aging.

RESUMEN Objetivo: construir y validar la gerontotecnología educativa sobre la fragilidad en ancianos. Método: estudio metodológico, desarrollado en tres etapas: construcción de un video educativo, validación por jueces expertos y ancianos. El proceso de validación fue realizado por 22 jueces y 22 ancianos. Se utilizó el Instrumento de Validación de Contenido Educativo para jueces y preguntas adaptadas del cuestionario Suitability Assessment of Materials para ancianos. Para la validación, se consideró el criterio de concordancia mayor al 80%, verificado a partir del Índice de Validación de Contenido y prueba binomial. Resultados: el video aborda las recomendaciones para ancianos en riesgo de fragilidad y hábitos que promueven la salud, utilizando literatura de cuerdas. Se verificó una concordancia superior al 80% en todos los ítems evaluados por los jueces y por el público objetivo. Conclusión: el video demostró ser válido en términos de contenido y apariencia por parte de jueces y ancianos, con el potencial de mediar en prácticas educativas promotoras de la salud en el envejecimiento saludable.

RESUMO Objetivo: construir e validar gerontotecnologia educativa sobre fragilidade em idosos. Métodos: estudo metodológico, desenvolvido em três etapas: construção de vídeo educativo, validação por juízes experts e idosos. O processo de validação foi realizado por 22 juízes e 22 idosos. Utilizaram-se Instrumento de Validação de Conteúdo Educacional para juízes e questões adaptadas do questionário Suitability Assessment of Materials para os idosos. Considerou-se, para a validação, o critério de concordância superior a 80%, verificados a partir do Índice de Validação de Conteúdo e teste binomial. Resultados: o vídeo aborda as recomendações para idosos em risco de fragilização e hábitos promotores da saúde, utilizando a literatura de cordel. Foi verificada concordância superior a 80% em todos os itens avaliados pelos juízes e pelo público-alvo. Conclusão: o vídeo se mostrou válido quanto ao conteúdo e aparência por juízes e pelos idosos, com potencial para mediar práticas educativas promotoras de saúde no envelhecimento saudável.

https://doi.org/10.1590/0034-7167-2020-0800

15.

Vulnerabilidade clínico-funcional de idosos em um centro de convivência
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Oliveira, Camila Evangelista de Sousa

; Felipe, Sarah Giulia Bandeira

; Silva, Cynthia Roberta Dias Torres da

; Carvalho, Daniela Bandeira de

; Silva-Júnior, Fernando

; Figueiredo, Maria do Livramento Fortes

; Santos, Ana Maria Ribeiro dos

; Gouveia, Márcia Teles de Oliveira

Acta Paulista de Enfermagem

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2020, Volume 33 elocation eAPE20190172

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

Abstract Objective To analyze the clinical and functional vulnerability of elderly people from a day center. Methods Cross-sectional study carried out with 216 elderly people of a day center in Teresina, state of Piauí, Brazil. Data collection took place between April and August 2018 by means of a questionnaire for sociodemographic and clinical characterization, the clock drawing test (CDT), the Timed up and Go Test (TUG) and the Clinical and Functional Vulnerability Index (IVCF-20). Linear regression with a forward selection was applied to identify the predictive variables of individual vulnerability. Results It was observed that 37% of the elderly people were identified as showing medium risk with regard to clinical and functional vulnerability and 11.1% of them had a high risk. Sociodemographic (individual and family income) and clinical characteristics (self-declared comorbidities, polypharmacy, urinary incontinence, BADL-dependence, falls, hospitalization, frequency of physical activities, health self-perception, frequent sadness and depression, cognition, oblivion of drug therapy and functional mobility) were associated with clinical and functional vulnerability (p<0.05). Conclusion The findings of our study enable the operationalization of public policies and strategies for early detection of clinical and functional vulnerability in elderly people and intervention measures aimed at promoting health and preventing illness based on comprehensive care.

Resumen Objetivo Analizar la vulnerabilidad clínico-funcional de ancianos que participan en un centro de convivencia. Métodos Estudio con diseño transversal, con 216 ancianos de un centro de convivencia en Teresina, estado de Piauí. La recolección de datos se realizó de abril a agosto de 2018, por medio de un cuestionario de caracterización sociodemográfica y clínica, del test del dibujo del reloj (TDR), del “ Timed Up and Go Test ” y del índice de vulnerabilidad clínico-funcional (IVCF-20). Se utilizó el modelo de regresión lineal forward para identificar las variables predictoras de vulnerabilidad individual. Resultados Se constató que el 37,0% de los ancianos fue clasificado con riesgo medio de vulnerabilidad clínico-funcional y el 11,1% con riesgo alto de vulnerabilidad. Las características sociodemográficas (ingresos individuales e ingresos familiares) y las características clínicas (comorbilidades autodeclaradas, polifarmacia, incontinencia urinaria, dependencia en ABVD, caídas, internación, frecuencia de actividad física, autopercepción de la salud, sentimientos de tristeza y depresión frecuente, cognición, olvido de tratamiento medicamentosos y movilidad funcional) se relacionan con la vulnerabilidad clínico-funcional (p<0,05). Conclusión Los descubrimientos de este estudio permiten la preparación de políticas públicas y estrategias para la identificación precoz de ancianos en condición de vulnerabilidad clínico-funcional y medidas de intervención orientadas a la promoción de la salud y prevención de enfermedades y empeoramiento basadas en el cuidado integral.

Resumo Objetivo Analisar a vulnerabilidade clínico-funcional de idosos participantes de um centro de convivência. Métodos Estudo com delineamento transversal, com 216 idosos de um centro de convivência em Teresina – PI. A coleta de dados ocorreu no período de abril a agosto de 2018, por meio do uso de um questionário para caracterização sociodemográfica e clínica, teste do desenho do relógio (TDR), “ Timed Up and Go Test ” e índice de vulnerabilidade clínico-funcional (IVCF-20). Utilizou-se o modelo de regressão linear forward para identificação das variáveis preditoras de vulnerabilidade individual. Resultados Constatou-se que 37,0% dos idosos foram classificados com médio risco para vulnerabilidade clínico-funcional e 11,1% com alto risco para vulnerabilidade. As características sociodemográficas (renda individual e renda familiar) e as características clínicas (comorbidades autodeclaradas, polifarmácia, incontinência urinária, dependência em ABVD, queda, hospitalização, frequência de atividade física, autopercepção de saúde, sentimento de tristeza e depressão frequente, cognição, esquecimento da terapia medicamentosa e mobilidade funcional associaram-se a vulnerabilidade clínico-funcional (p<0,05). Conclusão Os achados desse estudo possibilitam a operacionalização de políticas públicas e estratégias para a identificação precoce de idosos em condição de vulnerabilidade clinico funcional e medidas de intervenção direcionadas para a promoção da saúde e prevenção de doenças e agravos com base em um cuidado integral.

https://doi.org/10.37689/acta-ape/2020ao0172

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