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1.
Plataforma de Inteligência Cooperativa com a Atenção Primária à Saúde (Picaps): soluções tecnocientíficas em saúde digital no enfrentamento da COVID-19 e outras crises
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Martins, Wagner de Jesus
; Maia, Edward Torres
; Lima, Antonia Sheila Gomes
; Bonetti, Osvaldo Peralta
; Gonçalves, Lilian Silva
; Silva, João Paulo Almeida Brito da
; Barbosa, Daniel Fernandes
; Sanchez, Mauro Niskier
.








Resumo A chegada da COVID-19 ao Brasil gerou grande impacto no sistema de saúde, bem como em seus profissionais, com o elevado número de casos e informações constantemente publicadas. Nesse contexto, criou-se a Plataforma de Inteligência Cooperativa para a Atenção Primária à Saúde (Picaps), uma plataforma tecnológica que ajuda a sistematizar os processos de comunicação e negociação de atores, tendo como foco a ciência e a tecnologia. O presente trabalho tem como objetivo descrever os processos da Picaps, sendo esta constituída por um sistema colaborativo concebido como solução pública capaz de gerar inovações nas áreas de ciência, tecnologia e saúde para o enfrentamento da COVID-19 no Distrito Federal (DF). Nela integram-se processos de coleta e tratamento de dados, além da disseminação de informações visando o seu uso tanto em nível governamental quanto em nível societal. A Picaps pode ser vista como um poderoso instrumento governamental para auxiliar sociedades espalhadas pelo país, sobretudo as que se encontram em situação de vulnerabilidade, com capacidade de nortear o uso da inteligência cooperativa em ações de atenção primária e vigilância em saúde para construção de soluções inovadoras como respostas rápidas para o enfrentamento de crises sanitárias em tempos contemporâneos.
Abstract The arrival of COVID-19 in Brazil had a marked impact on the health network as well as on the professionals involved, due to the significant number of cases and constantly updated information. In this context, the Cooperative Intelligence Platform for Primary Health Care - Picaps - is set up as a technological platform that assists by systematizing the communication and negotiation processes among actors, with a focus on science and technology. This article sets out to describe the processes of Picaps, which consist of a collaborative system conceived of as a public solution capable of generating innovations in the areas of Science, Technology and Health, in order to tackle COVID-19 in territories with populations in socially vulnerable situations in the Federal District (DF). It integrates data collection and processing, as well as the dissemination of information for its use, both at the governmental and societal levels. Picaps can be seen as a powerful government instrument to help societies across the country, especially those in vulnerable situations, capable of assisting in the use of cooperative intelligence in primary care and health surveillance actions to build innovative solutions such as rapid responses to face health crises in modern times.
2.
Plataforma de Inteligência Cooperativa com a Atenção Primária à Saúde (Picaps): soluções tecnocientíficas em saúde digital no enfrentamento da COVID-19 e outras crises
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Martins, Wagner de Jesus
; Maia, Edward Torres
; Lima, Antonia Sheila Gomes
; Bonetti, Osvaldo Peralta
; Gonçalves, Lilian Silva
; Silva, João Paulo Almeida Brito da
; Barbosa, Daniel Fernandes
; Sanchez, Mauro Niskier
.








Abstract The arrival of COVID-19 in Brazil had a marked impact on the health network as well as on the professionals involved, due to the significant number of cases and constantly updated information. In this context, the Cooperative Intelligence Platform for Primary Health Care - Picaps - is set up as a technological platform that assists by systematizing the communication and negotiation processes among actors, with a focus on science and technology. This article sets out to describe the processes of Picaps, which consist of a collaborative system conceived of as a public solution capable of generating innovations in the areas of Science, Technology and Health, in order to tackle COVID-19 in territories with populations in socially vulnerable situations in the Federal District (DF). It integrates data collection and processing, as well as the dissemination of information for its use, both at the governmental and societal levels. Picaps can be seen as a powerful government instrument to help societies across the country, especially those in vulnerable situations, capable of assisting in the use of cooperative intelligence in primary care and health surveillance actions to build innovative solutions such as rapid responses to face health crises in modern times.
Resumo A chegada da COVID-19 ao Brasil gerou grande impacto no sistema de saúde, bem como em seus profissionais, com o elevado número de casos e informações constantemente publicadas. Nesse contexto, criou-se a Plataforma de Inteligência Cooperativa para a Atenção Primária à Saúde (Picaps), uma plataforma tecnológica que ajuda a sistematizar os processos de comunicação e negociação de atores, tendo como foco a ciência e a tecnologia. O presente trabalho tem como objetivo descrever os processos da Picaps, sendo esta constituída por um sistema colaborativo concebido como solução pública capaz de gerar inovações nas áreas de ciência, tecnologia e saúde para o enfrentamento da COVID-19 no Distrito Federal (DF). Nela integram-se processos de coleta e tratamento de dados, além da disseminação de informações visando o seu uso tanto em nível governamental quanto em nível societal. A Picaps pode ser vista como um poderoso instrumento governamental para auxiliar sociedades espalhadas pelo país, sobretudo as que se encontram em situação de vulnerabilidade, com capacidade de nortear o uso da inteligência cooperativa em ações de atenção primária e vigilância em saúde para construção de soluções inovadoras como respostas rápidas para o enfrentamento de crises sanitárias em tempos contemporâneos.
3.
Fortalecimento das ações de cuidado às pessoas com obesidade no contexto da pandemia de COVID-19: o caso do Brasil
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Oliveira, Thais Fonseca Veloso de
; Bortolini, Gisele Ane
; Carmo, Ariene Silva do
; Reis, Erika Cardoso dos
; Neves, Felipe Silva
; Lima, Ana Maria Cavalcante de
; Santin, Rafaella da Costa
; Silva, Sara Araújo da
; Spaniol, Ana Maria
; Marinho, Paloma Abelin Saldanha
; Bressan, Lilian Ânima
; Medeiros, Lorena Gonçalves Chaves
; Silva, Juliana Rezende Melo da
.













Abstract This descriptive ecological study sought to analyze the inductive role of a federal financial incentive passed on to Brazilian municipalities in 2020, during the COVID-19 pandemic, in increasing the number of individual consultations for the condition of obesity in primary health care (PHC). Secondary data obtained from the Health Information System for Primary Care and from the Food and Nutrition Surveillance System (SISVAN) were used. In 2021, 74.8% of the 5,504 municipalities that received the financial incentive, showed an increase in the number of individual obesity consultations in PHC, compared to 2020. The number of people identified with obesity and the number of individual visits for this condition were higher in 2021 than in the other years analyzed (2017 to 2020). Comparing 2021 with 2020 (year of receipt of the financial incentive), it was observed that the percentage of increase in the number of individual consultations for the condition of obesity was higher than the increase in the number of people identified with obesity in the SISVAN (77.6 % vs. 39.1%). In conclusion, federal financial incentives for municipalities, channeled to enhance care for people with obesity within the scope of PHC, are important mechanisms for inducing actions at the local level.
Resumo O presente estudo ecológico descritivo objetivou analisar o papel indutor de um incentivo financeiro federal repassado aos municípios brasileiros em 2020, em meio à pandemia de COVID-19, no aumento do número de atendimentos individuais para a condição de obesidade na atenção primária à saúde (APS). Utilizaram-se dados secundários, obtidos no Sistema de Informação em Saúde para a Atenção Básica e no Sistema de Vigilância Alimentar e Nutricional (SISVAN). Em 2021, 74,8% dos 5.504 municípios que receberam o incentivo financeiro apresentaram aumento no número de atendimentos individuais para a condição avaliada como obesidade na APS, em relação a 2020. O número de pessoas identificadas com obesidade e o número de atendimentos individuais para esta condição foram maiores em 2021 do que nos demais anos analisados (2017 a 2020). Na comparação de 2021 com 2020 (ano de recebimento do incentivo financeiro), observou-se que o percentual de aumento de atendimentos individuais foi superior ao percentual de aumento de pessoas com obesidade registradas no SISVAN (77,6% vs. 39,1%). Em conclusão, incentivos financeiros federais, canalizados para o fortalecimento do cuidado às pessoas com obesidade no âmbito da APS, figuram como importantes mecanismos de indução de ações em nível local.
4.
Fortalecimento das ações de cuidado às pessoas com obesidade no contexto da pandemia de COVID-19: o caso do Brasil
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Oliveira, Thais Fonseca Veloso de
; Bortolini, Gisele Ane
; Carmo, Ariene Silva do
; Reis, Erika Cardoso dos
; Neves, Felipe Silva
; Lima, Ana Maria Cavalcante de
; Santin, Rafaella da Costa
; Silva, Sara Araújo da
; Spaniol, Ana Maria
; Marinho, Paloma Abelin Saldanha
; Bressan, Lilian Ânima
; Medeiros, Lorena Gonçalves Chaves
; Silva, Juliana Rezende Melo da
.













Resumo O presente estudo ecológico descritivo objetivou analisar o papel indutor de um incentivo financeiro federal repassado aos municípios brasileiros em 2020, em meio à pandemia de COVID-19, no aumento do número de atendimentos individuais para a condição de obesidade na atenção primária à saúde (APS). Utilizaram-se dados secundários, obtidos no Sistema de Informação em Saúde para a Atenção Básica e no Sistema de Vigilância Alimentar e Nutricional (SISVAN). Em 2021, 74,8% dos 5.504 municípios que receberam o incentivo financeiro apresentaram aumento no número de atendimentos individuais para a condição avaliada como obesidade na APS, em relação a 2020. O número de pessoas identificadas com obesidade e o número de atendimentos individuais para esta condição foram maiores em 2021 do que nos demais anos analisados (2017 a 2020). Na comparação de 2021 com 2020 (ano de recebimento do incentivo financeiro), observou-se que o percentual de aumento de atendimentos individuais foi superior ao percentual de aumento de pessoas com obesidade registradas no SISVAN (77,6% vs. 39,1%). Em conclusão, incentivos financeiros federais, canalizados para o fortalecimento do cuidado às pessoas com obesidade no âmbito da APS, figuram como importantes mecanismos de indução de ações em nível local.
Abstract This descriptive ecological study sought to analyze the inductive role of a federal financial incentive passed on to Brazilian municipalities in 2020, during the COVID-19 pandemic, in increasing the number of individual consultations for the condition of obesity in primary health care (PHC). Secondary data obtained from the Health Information System for Primary Care and from the Food and Nutrition Surveillance System (SISVAN) were used. In 2021, 74.8% of the 5,504 municipalities that received the financial incentive, showed an increase in the number of individual obesity consultations in PHC, compared to 2020. The number of people identified with obesity and the number of individual visits for this condition were higher in 2021 than in the other years analyzed (2017 to 2020). Comparing 2021 with 2020 (year of receipt of the financial incentive), it was observed that the percentage of increase in the number of individual consultations for the condition of obesity was higher than the increase in the number of people identified with obesity in the SISVAN (77.6 % vs. 39.1%). In conclusion, federal financial incentives for municipalities, channeled to enhance care for people with obesity within the scope of PHC, are important mechanisms for inducing actions at the local level.
5.
Technical performance of a lateral flow immunoassay for detection of anti-SARS-CoV-2 IgG in the outpatient follow-up of non-severe cases and at different times after vaccination: comparison with enzyme and chemiluminescent immunoassays
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Barreira, Gabriel Acca
; Santos, Emilly Henrique dos
; Pereira, Maria Fernanda Bádue
; Rodrigues, Karen Alessandra
; Rocha, Mussya Cisotto
; Kanunfre, Kelly Aparecida
; Marques, Heloisa Helena de Sousa
; Okay, Thelma Suely
; Eisencraft, Adriana Pasmanik
Rossi Junior, Alfio
Fante, Alice Lima
Cora, Aline Pivetta
Costa Reis, Amelia Gorete A. de
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
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
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
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








Revista do Instituto de Medicina Tropical de São Paulo
- Journal Metrics
ABSTRACT This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme immunoassay (EIA). To this end, a total of 216 whole blood or serum samples from three groups were analyzed: the first group was composed of 68 true negative cases corresponding to blood bank donors, healthy young volunteers, and eight pediatric patients diagnosed with other coronavirus infections. The serum samples from these participants were obtained and stored in a pre-COVID-19 period, thus they were not expected to have COVID-19. In the second group of true positive cases, we chose to replace natural cases of COVID-19 by 96 participants who were expected to have produced anti-SARS-CoV-2 IgG antibodies 30-60 days after the vaccine booster dose. The serum samples were collected on the same day that LFIA were tested either by EIA or CLIA. The third study group was composed of 52 participants (12 adults and 40 children) who did or did not have anti-SARS-CoV-2 IgG antibodies due to specific clinical scenarios. The 12 adults had been vaccinated more than seven months before LFIA testing, and the 40 children had non-severe COVID-19 diagnosed using RT-PCR during the acute phase of infection. They were referred for outpatient follow-up and during this period the serum samples were collected and tested by CLIA and LFIA. All tests were performed by the same healthcare operator and there was no variation of LFIA results when tests were performed on finger prick whole blood or serum samples, so that results were grouped for analysis. LFIA’s sensitivity in detecting anti-SARS-CoV-2 IgG antibodies was 90%, specificity 97.6%, efficiency 93%, PPV 98.3%, NPV 86.6%, and likelihood ratio for a positive or a negative result were 37.5 and 0.01 respectively. There was a good agreement (Kappa index of 0.677) between LFIA results and serological (EIA or CLIA) results. In conclusion, LFIA analyzed in this study showed a good technical performance and agreement with reference serological assays (EIA or CLIA), therefore it can be recommended for use in the outpatient follow-up of non-severe cases of COVID-19 and to assess anti-SARS-CoV-2 IgG antibody production induced by vaccination and the antibodies decrease over time. However, LFIAs should be confirmed by using reference serological assays whenever possible.
6.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
Dal-Pizzol, Felipe
Bozza, Fernando
Salluh, Jorge Ibrahin Figueira
Westphal, Glauco Adrieno
Soares, Márcio
Assunção, Murillo Santucci César de
Lisboa, Thiago
Lobo, Suzana Margarete Ajeje
Barbosa, Achilles Rohlfs
Ventura, Adriana Fonseca
Souza, Ailson Faria de
Silva, Alexandre Francisco
Toledo, Alexandre
Reis, Aline
Cembranel, Allan
Rea Neto, Alvaro
Gut, Ana Lúcia
Justo, Ana Patricia Pierre
Santos, Ana Paula
Albuquerque, André Campos D. de
Scazufka, André
Rodrigues, Antonio Babo
Fernandino, Bruno Bonaccorsi
Silva, Bruno Goncalves
Vidal, Bruno Sarno
Pinheiro, Bruno Valle
Pinto, Bruno Vilela Costa
Feijo, Carlos Augusto Ramos
Abreu Filho, Carlos de
Bosso, Carlos Eduardo da Costa Nunes
Moreira, Carlos Eduardo Nassif
Ramos, Carlos Henrique Ferreira
Tavares, Carmen
Arantes, Cidamaiá
Grion, Cintia
Mendes, Ciro Leite
Kmohan, Claudio
Piras, Claudio
Castro, Cristine Pilati Pileggi
Lins, Cyntia
Beraldo, Daniel
Fontes, Daniel
Boni, Daniela
Castiglioni, Débora
Paisani, Denise de Moraes
Pedroso, Durval Ferreira Fonseca
Mattos, Ederson Roberto
Brito Sobrinho, Edgar de
Troncoso, Edgar M. V.
Rodrigues Filho, Edison Moraes
Nogueira, Eduardo Enrico Ferrari
Ferreira, Eduardo Leme
Pacheco, Eduardo Souza
Jodar, Euzebio
Ferreira, Evandro L. A.
Araujo, Fabiana Fernandes de
Trevisol, Fabiana Schuelter
Amorim, Fábio Ferreira
Giannini, Fabio Poianas
Santos, Fabrício Primitivo Matos
Buarque, Fátima
Lima, Felipe Gallego
Costa, Fernando Antonio Alvares da
Sad, Fernando Cesar dos Anjos
Aranha, Fernando G.
Ganem, Fernando
Callil, Flavio
Costa Filho, Francisco Flávio
Dall´Arto, Frederico Toledo Campo
Moreno, Geovani
Friedman, Gilberto
Moralez, Giulliana Martines
Silva, Guilherme Abdalla da
Costa, Guilherme
Cavalcanti, Guilherme Silva
Cavalcanti, Guilherme Silva
Betônico, Gustavo Navarro
Betônico, Gustavo Navarro
Reis, Hélder
Araujo, Helia Beatriz N.
Hortiz Júnior, Helio Anjos
Guimaraes, Helio Penna
Urbano, Hugo
Maia, Israel
Santiago Filho, Ivan Lopes
Farhat Júnior, Jamil
Alvarez, Janu Rangel
Passos, Joel Tavares
Paranhos, Jorge Eduardo da Rocha
Marques, José Aurelio
Moreira Filho, José Gonçalves
Andrade, Jose Neto
Sobrinho, José Onofre de C
Bezerra, Jose Terceiro de Paiva
Alves, Juliana Apolônio
Ferreira, Juliana
Gomes, Jussara
Sato, Karina Midori
Gerent, Karine
Teixeira, Kathia Margarida Costa
Conde, Katia Aparecida Pessoa
Martins, Laércia Ferreira
Figueirêdo, Lanese
Rezegue, Leila
Tcherniacovsk, Leonardo
Ferraz, Leone Oliveira
Cavalcante, Liane
Rabelo, Ligia
Miilher, Lilian
Garcia, Lisiane
Tannous, Luana
Hajjar, Ludhmila Abrahão
Paciência, Luís Eduardo Miranda
Cruz Neto, Luiz Monteiro da
Bley, Macia Valeria
Sousa, Marcelo Ferreira
Puga, Marcelo Lourencini
Romano, Marcelo Luz Pereira
Nobrega, Marciano
Arbex, Marcio
Rodrigues, Márcio Leite
Guerreiro, Márcio Osório
Rocha, Marcone
Alves, Maria Angela Pangoni
Alves, Maria Angela Pangoni
Rosa, Maria Doroti
Dias, Mariza D’Agostino
Martins, Miquéias
Oliveira, Mirella de
Moretti, Miriane Melo Silveira
Matsui, Mirna
Messender, Octavio
Santarém, Orlando Luís de Andrade
Silveira, Patricio Júnior Henrique da
Vassallo, Paula Frizera
Antoniazzi, Paulo
Gottardo, Paulo César
Correia, Paulo
Ferreira, Paulo
Torres, Paulo
Silva, Pedro Gabrile M. de Barros e
Foernges, Rafael
Gomes, Rafael
Moraes, Rafael
Nonato filho, Raimundo
Borba, Renato Luis
Gomes, Renato V
Cordioli, Ricardo
Lima, Ricardo
López, Ricardo Pérez
Gargioni, Ricardo Rath de Oliveira
Rosenblat, Richard
Souza, Roberta Machado de
Almeida, Roberto
Narciso, Roberto Camargo
Marco, Roberto
waltrick, Roberto
Biondi, Rodrigo
Figueiredo, Rodrigo
Dutra, Rodrigo Santana
Batista, Roseane
Felipe, Rouge
Franco, Rubens Sergio da Silva
Houly, Sandra
Faria, Sara Socorro
Pinto, Sergio Felix
Luzzi, Sergio
Sant’ana, Sergio
Fernandes, Sergio Sonego
Yamada, Sérgio
Zajac, Sérgio
Vaz, Sidiner Mesquita
Bezerra, Silvia Aparecida Bezerra
Farhat, Tatiana Bueno Tardivo
Santos, Thiago Martins
Smith, Tiago
Silva, Ulysses V. A.
Damasceno, Valnei Bento
Nobre, Vandack
Dantas, Vicente Cés de Souza
Irineu, Vivian Menezes
Bogado, Viviane
Nedel, Wagner
Campos Filho, Walther
Dantas, Weidson
Viana, William
Oliveira Filho, Wilson de
Delgadinho, Wilson Martins
Finfer, Simon
Machado, Flavia Ribeiro










RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
7.
Factors associated with quality of life of older adults with chronic pain
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Paz, Maressa Gonçalves da
; Souza, Layz Alves Ferreira de
; Tatagiba, Bruna da Silva Ferreira
; Serra, Joyce Rutyelle da
; Moura, Louise Amália de
; Barbosa, Maria Alves
; Pereira, Lilian Varanda
.







RESUMO Objetivo: Analisar os fatores associados à qualidade de vida (QV) em idosos com dor crônica. Método: Estudo transversal realizado com 239 idosos em atendimento ambulatorial no estado de Goiás, Brasil. O World Health Organization Quality of Life – Old (WHOQOL-OLD) contém seis domínios e foi aplicado para avaliar a qualidade de vida. Foram utilizadas regressão linear simples e múltipla na análise estatística. Resultados: Os fatores associados ao domínio Funcionamento dos sentidos foram idade (β = − 0,52), tempo de convívio (β = − 14,35; − 17,86; − 15,57) e intensidade da dor (β = − 1,70). Ao domínio Autonomia associaram-se a depressão (β = − 5,99) e a dor no tórax (β = − 6,17). A Participação social relacionou-se à escolaridade (β = − 0,64), diabetes mellitus (β = − 8,15), depressão (β = − 14,53), intensidade da dor (β = − 1,43) e à dor em MMII (β = − 5,94). Às Atividades passadas, presentes e futuras associou-se a depressão (β = − 6,94). O domínio Morte e morrer foi associado à hipertensão (β = − 8,40), enquanto o domínio Intimidade foi relacionado à depressão (β = − 5,99) e dor na cabeça/face (β = − 3,19). Conclusão: O tempo de convívio com a dor crônica e a localização dessa experiência, assim como a depressão, diabetes e HAS foram fatores que influenciaram com maior magnitude os domínios de QV dos idosos.
ABSTRACT Objective: To analyze the factors associated with quality of life of the older adults with chronic pain. Method: Cross-sectional study conducted with 239 older adults in outpatient care in the state of Goiás, Brazil. The World Health Organization Quality of Life–Old (WHOQOL-OLD) instrument contains six domains and was applied to assess quality of life. Simple and multiple linear regressions were used in the statistical analysis. Results: The factors associated with Sensory Abilities were age (β = - 0.52), time spent together (β = - 14.35; - 17.86; - 15.57), and pain intensity (β = - 1, 70). Autonomy was associated with depression (β = - 5.99) and chest pain (β = - 6.17). Social participation related to schooling (β = - 0.64), diabetes mellitus (β = - 8.15), depression (β = - 14.53), pain intensity (β = - 1.43), and lower limb pain (β = - 5.94). Past, present and future activities related to depression (β = - 6.94). Death and dying related to hypertension (β = - 8.40), while Intimacy to depression (β = - 5.99) and headache/face pain (β = - 3.19). Conclusion: The time experiencing chronic pain and the location of this experience, as well as depression, diabetes and systemic arterial hypertension were factors that had greater influence on the older adult’s Quality of Life domains.
RESUMEN Objetivo: Analizar los factores asociados a la calidad de vida (CV) de ancianos con dolor crónico. Método: Estudio transversal en el cual participaron 239 ancianos en atención ambulatoria en el estado de Goiás, Brasil. Para evaluar la calidad de vida, se aplicó el World Health Organization Quality of Life – Old (WHOQOL-OLD), que presenta seis dominios. Para el análisis estadístico, se utilizó la regresión lineal simple y múltiple. Resultados: Los factores asociados con el dominio Funcionamiento sensorial fueron la edad (β = − 0,52), el tiempo de convivencia (β = − 14,35; − 17,86; − 15,57) y la intensidad del dolor (β = − 1,70). El dominio Autonomía se asoció con la depresión (β = − 5,99) y el dolor torácico (β = − 6,17). La Participación social se relacionó con el nivel de estudios (β = − 0,64), diabetes mellitus (β = − 8,15), depresión (β = − 14,53), intensidad del dolor (β = − 1,43) y dolor en miembros inferiores (β = − 5,94). Las actividades pasadas, presentes y futuras se vincularon con la depresión (β = − 6,94). El dominio Muerte y morir se asoció con la hipertensión (β = − 8,40), mientras que el dominio Intimidad se relacionó con la depresión (β = − 5,99) y el dolor de cabeza/en la cara (β = − 3,19). Conclusión: El tiempo de convivencia con el dolor crónico y el local de esa experiencia, así como la depresión, diabetes y HAS, fueron los factores que más influyeron en los dominios de CV de los ancianos.
https://doi.org/10.1590/0034-7167-2020-0554
379 downloads
8.
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






















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.
9.
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
Brentani, Alexandra V. M.
Neto, Álvaro José S.
Ihara, Amanda
Santos, Andrea R.
Canton, Ana Pinheiro M.
Watanabe, Andreia
Santos, Angélica C. dos
Pastorino, Antonio C.
Franco, Bernadette D. G. M.
Caruzo, Bruna
Ceneviva, Carina
Martins, Carolina C. M. F.
Prado, Danilo
Abellan, Deipara M.
Benatti, Fabiana B.
Smaria, Fabiana
Gonçalves, Fernanda T.
Penteado, Fernando D.
Castro, Gabriela S. F. de
Gonçalves, Guilherme S.
Roschel, Hamilton
Disi, Ilana R.
Marques, Isabela G.
Castro, Inar A.
Buscatti, Izabel M.
Faiad, Jaline Z.
Fiamoncini, Jarlei
Rodrigues, Joaquim C.
Carneiro, Jorge D. A.
Paz, Jose A.
Ferreira, Juliana C.
Ferreira, Juliana C. O.
Silva, Katia R.
Bastos, Karina L. M.
Kozu, Katia
Cristofani, Lilian M.
Souza, Lucas V. B.
Campos, Lucia M. A.
Silva Filho, Luiz Vicente R. F.
Sapienza, Marcelo T.
Lima, Marcos S.
Garanito, Marlene P.
Santos, Márcia F. A.
Dorna, Mayra B.
Aikawa, Nadia E.
Litvinov, Nadia
Sakita, Neusa K.
Gaiolla, Paula V. V.
Pasqualucci, Paula
Toma, Ricardo K.
Correa-Silva, Simone
Sieczkowska, Sofia M.
Imamura, Marta
Forsait, Silvana
Santos, Vera A.
Zheng, Yingying





























OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
10.
Registro Multicêntrico de Takotsubo (REMUTA) – Aspectos Clínicos, Desfechos Intra-Hospitalares e Mortalidade a Longo Prazo
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Almeida Junior, Gustavo Luiz Gouvêa de
; Mansur Filho, João
; Albuquerque, Denilson Campos de
; Xavier, Sergio Salles
; Pontes, Álvaro
; Gouvêa, Elias Pimentel
Martins, Alexandre Bahia Barreiras
Nunes, Nágela S. V.
Carestiato, Lilian Vieira
Petriz, João Luiz Fernandes
Santos, Armando Márcio Gonçalves
Bandeira, Bruno Santana
Abufaiad, Bárbara Elaine de Jesus
Pacheco, Luciana da Camara
Oliveira, Maurício Sales de
Ribeiro Filho, Paulo Eduardo Campana
Sampaio, Pedro Paulo Nogueres
Duque, Gustavo Salgado
Camillis, Luiz Felipe
Marques, André Casarsa
Lourenço Jr, Francisco Carlos
Palazzo, José Ricardo
Costa, Cláudio Ramos da
Silva, Bibiana Almeida da
Zukowski, Cleverson Neves
Garcia, Romulo Ribeiro
Zonis, Fernanda de Carvalho
Paula, Suzana Andressa Morais de
Ferrari, Carolina Gravano Ferraz
Rangel, Bruno Soares da Silva
Ferreira, Roberto Muniz
Mendes, Bárbara Ferreira da Silva
Castro, Isabela Ribeiro Carvalho de
Souza, Leonardo Giglio Gonçalves de
Araújo, Luiz Henrique dos Santos
Giani, Alexandre





Resumo Fundamento A síndrome de takotsubo (takotsubo) é uma forma de cardiomiopatia adquirida. Dados nacionais sobre essa condição são escassos. O Registro REMUTA é o primeiro a incluir dados multicêntricos dessa condição no nosso país. Objetivo Descrever as características clínicas, prognóstico, tratamento intra-hospitalar e mortalidade hospitalar e em 1 ano de seguimento. Métodos Estudo observacional, retrospectivo, tipo registro. Incluídos pacientes internados com diagnóstico de takotsubo ou que desenvolveram esta condição durante internação por outra causa. Os desfechos avaliados incluíram fator desencadeador, análise dos exames, uso de medicações, complicações e óbito intra-hospitalar e em 1 ano de seguimento. O nível de significância adotado foi de 5%. Resultados Foram incluídos 169 pacientes, em 12 centros no Estado do Rio de Janeiro. A idade média foi de 70,9 ± 14,1 anos e 90,5% eram do sexo feminino; 63% dos casos foram de takotsubo primário e 37% secundário. Troponina I foi positiva em 92,5% dos pacientes e a mediana de BNP foi de 395 (176,5; 1725). Supradesnivelamento do segmento ST esteve presente em 28% dos pacientes. A fração de ejeção do ventrículo esquerdo teve mediana de 40 (35; 48)%. Observamos taxa de 25,7% de ventilação mecânica invasiva e 17,4% de choque. Suporte circulatório mecânico foi utilizado em 7,7%. A mortalidade intra-hospitalar foi de 10,6% e a mortalidade ao final de 1 ano foi de 16,5%. Takotsubo secundário e choque cardiogênico foram preditores independentes de mortalidade. Conclusão Os resultados do REMUTA mostram que takotsubo não se trata de patologia benigna como se pensava, especialmente no grupo de takotsubo secundário que acarreta elevada taxa de complicações e de mortalidade. (Arq Bras Cardiol. 2020; 115(2):207-216)
Abstract Background Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil. Objective To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up. Methods This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted. Results The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality. Conclusion The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216)
https://doi.org/10.36660/abc.20190166
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11.
Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system
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Carvalho, Roberta Feijó
; Carvalho, Anna Cristina Calçada
; Velarde, Luis Guillermo Coca
; Rossoni, Andrea Maciel de Oliveira
; Aurilio, Rafaela Baroni
; Sias, Selma Maria de Azevedo
; Schmidt, Christiane Mello
; Moreira, Adriana da Silva Rezende
; Martins, Pedro da Silva
; Gonçalves, Lorrayne Isidoro
; Martire, Terezinha Miceli
; Barbosa, Ana Paula Ferreira
; Santos, Ana Paula Quintanilha dos
; Romanelli, Roberta Maia de Castro
; Oliveira, Maria das Graças Rodrigues de
; Diniz, Lilian Martins Oliveira
; Carvalho, Andrea Lucchesi de
; Lucena, Sheila Cunha
; Cruz, Maria Letícia Santos
; Saavedra, Mariza Curto
; Tahan, Tony Tannous
; Rodrigues, Cristina de Oliveira
; Kritski, Afrânio Lineu
; Sant’Anna, Clemax Couto
; Cardoso, Claudete Aparecida Araújo
; Sant’Anna, Maria de Fátima Bazhuni Pombo
.


























Revista do Instituto de Medicina Tropical de São Paulo
- Journal Metrics
ABSTRACT The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1 st , 2004, to December 1 st , 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB.
https://doi.org/10.1590/s1678-9946202062081
664 downloads
12.
Molecular diagnosis of symptomatic toxoplasmosis: a 9-year retrospective and prospective study in a referral laboratory in São Paulo, Brazil
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Camilo, Lilian Muniz
Pereira-Chioccola, Vera Lucia
Gava, Ricardo
Meira-Strejevitch, Cristina da Silva
Vidal, Jose Ernesto
Mattos, Cinara Cássia Brandão de
Frederico, Fábio Batista
De Mattos, Luiz Carlos
Spegiorin, Lígia Cosentino Junqueira Franco
Murata, Fernando Henrique Antunes
Ferreira, Marina Neves
Barbosa, Deusenia Machado Ulisses
Gonçalves, Fausto da Silva
Dias, Cristiane Moraes
Catelan, Marcia Wakai
Siqueira, Rubens Camargo
Previato, Mariana
Barbosa, Amanda Pires
Cavallini, Danilo
ABSTRACT Symptomatic forms of toxoplasmosis are a serious public health problem and occur in around 10-20% of the infected people. Aiming to improve the molecular diagnosis of symptomatic toxoplasmosis in Brazilian patients, this study evaluated the performance of real time PCR testing two primer sets (B1 and REP-529) in detecting Toxoplasma gondii DNA. The methodology was assayed in 807 clinical samples with known clinical diagnosis, ELISA, and conventional PCR results in a 9-year period. All samples were from patients with clinical suspicion of several features of toxoplasmosis. According to the minimum detection limit curve (in CT), REP-529 had greater sensitivity to detect T. gondii DNA than B1. Both primer sets were retrospectively evaluated using 515 DNA from different clinical samples. The 122 patients without toxoplasmosis provided high specificity (REP-529, 99.2% and B1, 100%). From the 393 samples with positive ELISA, 146 had clinical diagnosis of toxoplasmosis and positive conventional PCR. REP-529 and B1 sensitivities were 95.9% and 83.6%, respectively. Comparison of REP-529 and B1 performances was further analyzed prospectively in 292 samples. Thus, from a total of 807 DNA analyzed, 217 (26.89%) had positive PCR with, at least one primer set and symptomatic toxoplasmosis confirmed by clinical diagnosis. REP-529 was positive in 97.23%, whereas B1 amplified only 78.80%. After comparing several samples in a Brazilian referral laboratory, this study concluded that REP-529 primer set had better performance than B1 one. These observations were based after using cases with defined clinical diagnosis, ELISA, and conventional PCR.
https://doi.org/10.1016/j.bjid.2017.07.003
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13.
Avaliação do uso de extratos vegetais para controle da hemoncose em ovinos naturalmente infectados
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Coêlho, Matheus Diniz Gonçalves
Xavier, Thalyta Baldim
Costa, Jaqueline Fabiana da
Maciel, Lucas Tobias Rodrigues
Bozo, Lilian Saito Ormachea
Coêlho, Francine Alves da Silva
Akisue, Gokithi
Resumo A ovinocultura no Brasil tem sido considerada uma importante prática econômica. Entretanto, há alguns problemas relacionados com esta prática, dentre os quais se destaca a hemoncose. Haemonchus contortus é tido como o principal helminto parasita de ovelhas, considerando-se o fato de ser o único hematófago direto, podendo causar anemia, perda de peso, edema submandibular, baixa qualidade da carne e da lã e óbito de uma grande porcentagem do rebanho. Atualmente, opta-se pelo tratamento alopático para controle da hemoncose, porém, devido ao uso repetitivo, observa-se desenvolvimento crescente de resistência. Neste sentido, a fitoterapia tem se destacado como uma alternativa promissora. Sendo assim, no presente trabalho objetivou-se avaliar a atividade anti-parasitária de três extratos vegetais: extratos hidroalcoólicos obtidos por percolação de Lepidium didymum e Momordica charantia, e extrato aquoso de Tagetes minuta. Animais da raça santa Inês foram triados para identificação de espécimes parasitados e separados em quatro grupos com seis animais cada, sendo um grupo controle sem tratamento, e os demais tratados com 200 mg/dia (5 mg/kg de peso corpóreo) com os três extratos, durante 5 dias. Após o tratamento foi realizada determinação de OPG (ovos por grama de fezes) pelo método MacMaster com modificação. Observou-se que o os animais dos grupos tratados com os extratos de L. didymum e M. charantia apresentaram redução significativa (p<0,05) do número de OPG observado, portanto, esses extratos podem ser úteis no tratamento da hemoncose ovina.
Abstract Sheep husbandry is considered an important economic practice in Brazil. However, there are problems associated with this practice. Haemonchosis stands out among these, and is known among sheep farmers for being a difficult disease to treat. Haemonchus contortus is considered the main helminth parasite of sheep, due to the fact that it is the only direct blood-sucking parasite, which can cause anemia, weight loss, submandibular swelling (mumps), low quality of meat and wool, and death of a large percentage of the herd. Currently, the predominant treatment is allopathic medicines, but resistance is increasing due to their repetitive use. In this sense, herbal medicine has emerged as a promising alternative. This study therefore aimed to evaluate the in vivo anti-parasitic activity of three plant extracts: hydroalcoholic extracts obtained by the percolation of Lepidium didymum and Momordica charantia and aqueous extract of Tagetes minuta. Animals of the Santa Inês breed were screened to identify parasitized specimens and separated into four groups of six animals each. One was used as an untreated control group, and the others were treated with 200 mg/day (5 mg/kg body weight) of the three extracts for 5 days. After treatment, EPG (eggs per gram of feces) was determined by the Mac Master method with modification. The animals in the groups treated with extracts of L. didymum and M. charantia showed a significant reduction (p <0.05) of EPG. These extracts may therefore be useful in the treatment of sheep haemonchosis.
https://doi.org/10.4136/ambi-agua.2020
2915 downloads
14.
Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment
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Marques, Claudia Diniz Lopes
Duarte, Angela Luzia Branco Pinto
Ranzolin, Aline
Dantas, Andrea Tavares
Cavalcanti, Nara Gualberto
Gonçalves, Rafaela Silva Guimarães
Rocha Junior, Laurindo Ferreira da
Valadares, Lilian David de Azevedo
Melo, Ana Karla Guedes de
Freire, Eutilia Andrade Medeiros
Teixeira, Roberto
Neto, Francisco Alves Bezerra
Medeiros, Marta Maria das Chagas
Carvalho, Jozélio Freire de
Santos, Mario Sergio F.
Océa, Regina Adalva de L. Couto
Levy, Roger A.
Andrade, Carlos Augusto Ferreira de
Pinheiro, Geraldo da Rocha Castelar
Abreu, Mirhelen Mendes
Verztman, José Fernando
Merenlender, Selma
Ribeiro, Sandra Lucia Euzebio
Costa, Izaias Pereira da
Pileggi, Gecilmara
Trevisani, Virginia Fernandes Moça
Lopes, Max Igor Banks
Brito, Carlos
Figueiredo, Eduardo
Queiroga, Fabio
Feitosa, Tiago
Tenório, Angélica da Silva
Siqueira, Gisela Rocha de
Paiva, Renata
Vasconcelos, José Tupinambá Sousa
Christopoulos, Georges
Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias, visto que metade dos casos evolui com artrite crônica, persistente e incapacitante. Os dados na literatura sobre terapêuticas específicas nas diversas fases da artropatia ocasionada pela infecção pelo vírus chikungunya (CHIKV) são limitados, não existem estudos randomizados de qualidade que avaliem a eficácia das diferentes terapias. Há algumas poucas publicações sobre o tratamento das manifestações musculoesqueléticas da febre chikungunya, porém com importantes limitações metodológicas. Os dados atualmente disponíveis não permitem conclusões favoráveis ou contrárias a terapêuticas específicas, bem como uma adequada avaliação quanto à superioridade entre as diferentes medicações empregadas. O objetivo deste trabalho foi elaborar recomendações para o tratamento da febre chikungunya no Brasil. Foi feita uma revisão da literatura com seleção de artigos baseados em evidência, nas bases de dados Medline, SciELO, PubMed e Embase e de resumos de anais de congressos, além da opinião dos especialistas para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Este artigo refere-se à parte 2 das Recomendações da Sociedade Brasileira de Reumatologia para Diagnóstico e Tratamento da Febre Chikungunya, que trata especificamente do tratamento.
Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.
https://doi.org/10.1016/j.rbre.2017.06.004
38509 downloads
15.
Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations
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Marques, Claudia Diniz Lopes
Duarte, Angela Luzia Branco Pinto
Ranzolin, Aline
Dantas, Andrea Tavares
Cavalcanti, Nara Gualberto
Gonçalves, Rafaela Silva Guimarães
Rocha Junior, Laurindo Ferreira da
Valadares, Lilian David de Azevedo
Melo, Ana Karla Guedes de
Freire, Eutilia Andrade Medeiros
Teixeira, Roberto
Bezerra Neto, Francisco Alves
Medeiros, Marta Maria das Chagas
Carvalho, Jozélio Freire de
Santos, Mario Sergio F.
Océa, Regina Adalva de L. Couto
Levy, Roger A.
Andrade, Carlos Augusto Ferreira de
Pinheiro, Geraldo da Rocha Castelar
Abreu, Mirhelen Mendes
Verztman, José Fernando
Merenlender, Selma
Ribeiro, Sandra Lucia Euzebio
Costa, Izaias Pereira da
Pileggi, Gecilmara
Trevisani, Virginia Fernandes Moça
Lopes, Max Igor Banks
Brito, Carlos
Figueiredo, Eduardo
Queiroga, Fabio
Feitosa, Tiago
Tenório, Angélica da Silva
Siqueira, Gisela Rocha de
Paiva, Renata
Vasconcelos, José Tupinambá Sousa
Christopoulos, Georges
Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias. Até 2013, as Américas haviam registrado apenas casos importados quando, em outubro desse mesmo ano, foram notificados os primeiros casos na Ilha de Saint Martin, no Caribe. No Brasil, os primeiros relatos autóctones foram confirmados em setembro de 2014 e até a semana epidemiológica 37 de 2016 já haviam sido registrados 236.287 casos prováveis de infecção pelo chikungunya vírus (CHIKV), 116.523 confirmados sorologicamente. As mudanças ambientais causadas pelo homem, o crescimento urbano desordenado e o número cada vez maior de viagens internacionais têm sido apontados como os fatores responsáveis pela reemergência de epidemias em grande escala. Caracterizada clinicamente por febre e dor articular na fase aguda, em cerca de metade dos casos existe evolução para a fase crônica (além de três meses), com dor persistente e incapacitante. O objetivo deste trabalho foi elaborar recomendações para diagnóstico e tratamento da febre chikungunya no Brasil. Para isso, foi feita revisão da literatura nas bases de dados Medline, SciELO e PubMed, para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Foram geradas 25 recomendações, divididas em três grupos temáticos: (1) diagnóstico clínico, laboratorial e por imagem; (2) situações especiais e (3) tratamento. Na primeira parte estão os dois primeiros temas e o tratamento na segunda.
Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.
https://doi.org/10.1016/j.rbre.2017.05.006
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