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Lower expression of NOTCH components in peripheral blood mononuclear cells of allogeneic hematopoietic cell transplant patients
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Colella, Marcos Paulo

; Morini, Beatriz Corey

; Niemann, Fernanda

; Lopes, Matheus Rodrigues

; Saad, Sara Olalla

; Favaro, Patricia

Hematology, Transfusion and Cell Therapy

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sep 2023, Volume 45 N. 3 Pages 324 - 329

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Chronic graft-versus-host disease (cGvHD) not only remains the main cause of late mortality after allogeneic hematopoietic cell transplant, but also has the capacity of causing severe organ impairment in those who survive. The Notch, a highly conserved ligand-receptor pathway, is involved in many immunological processes, including inflammatory and regulatory responses. Recently, mouse models have shown that the blockage of canonical Notch signaling prevents GvHD. Objective and Method: Due to the lack of data on the Notch pathway in human chronic GvHD, we sought to study the expression of NOTCH components in primary samples of patients who received allo-HCT and presented active cGvHD or a long-term clinical tolerance to cGvHD. Results: Our results showed a significantly lower expression of NOTCH components in both groups that received allo-HCT, independently of their cGvHD status, when compared to healthy controls. Conclusion: Moreover, there were no differences in gene expression levels between the active cGvHD and clinically tolerant groups. To our knowledge, this is one of the first studies performed in human primary samples and our data indicate that much remains to be learned regarding NOTCH signaling as a new regulator of GvHD. Introduction graftversushost graft versus host (cGvHD transplant survive ligandreceptor ligand receptor processes responses Recently GvHD Method alloHCT allo HCT longterm long term Results alloHCT, HCT, status controls Conclusion Moreover knowledge

https://doi.org/10.1016/j.htct.2022.05.005

A 14-Year Follow-Up Study of Sequelae in Primary Teeth and Permanent Successors After Dental Trauma
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Costa, Mariana Pires da

; Jural, Lucas Alves

; Silva, Leticia Lopes de Almeida da

; Parada, Matheus Cesar da Silva

; Leão, Anna Thereza Thome

; Luiz, Ronir Raggio

; Lenzi, Michele Machado

; Magno, Marcela Baraúna

; Soares, Thais Rodrigues Campos

; Maia, Lucianne Cople

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2023, Volume 23 elocation e220084

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth.

https://doi.org/10.1590/pboci.2023.035

Ischemic Stroke and Acute Myocardial Infarction: Trends in in-Hospital Mortality in Brazil from 1998 to 2018
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Santos, Júlio Martinez

; Martinez, Alessandra Barboza Resende

; Silva, Emerson de Jesus

; Santana, Gustavo Roberto

; Barbosa, Romero Henrique de Almeida

; Lima, David Fernandes

; Lopes, Matheus Rodrigues

; Lopes, Johnnatas Mikael

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220217

Abstract: En | Text: En | PDF: En

Abstract Background Ischemic stroke and acute myocardial infarction (AMI) are cardiovascular diseases with high morbidity and mortality rates in Brazil and worldwide. Their outcomes are influenced by public policies aimed at mitigating risk factors and by investments in infrastructure of emergency support and quality of hospital care. Objective To analyze the trend in the proportion of in-hospital deaths from ischemic stroke and AMI in Brazil as a way of evaluating the effectiveness of urgency and emergency services. Methods Ecological time series study using data from the Hospital Information System. The outcome was the proportion of in-hospital deaths from ischemic stroke and AMI with stratification by sex and state. Prais-Winsten regression was used to analyze the trend between 1998-2018 with α≤0,05. Results The proportion of deaths from AMI and ischemic stroke declined in the time series (p<0.001), decreasing annually by 0.17% and 0.25%, respectively. In 20 years, it reduced 43.76% (ischemic stroke) and 32.39% (AMI) in both sexes. However, the decline was more evident in the South and Southeast regions. Conclusion The reduction in hospital deaths from AMI and ischemic stroke was heterogeneous among Brazilian regions, which may be related to inequality in emergency services and hospital support.

https://doi.org/10.36660/ijcs.20220217

Physical Training Improves Cardiac Structure and Function of Rats After Doxorubicin-Induced Cardiomyopathy
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Souza, Fernanda Rodrigues

; Campos, Érica Carolina

; Lopes, Leandro Teixeira Paranhos

; Rodrigues, Clesnan Mendes

; Gonçalves, Danilo Lemes Naves

; Beletti, Marcelo Emílio

; Mantovani, Matheus Matioli

; Duarte, Poliana Rodrigues Alves

; Gonçalves, Alexandre

; Resende, Elmiro Santos

International Journal of Cardiovascular Sciences

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dec 2022, Volume 35 N. 6 Pages 718 - 726

Abstract: En | Text: En | PDF: En

Abstract Background: The use of doxorubicin in chemotherapy has been associated with cardiotoxicity and heart failure. Physical exercise produces favorable morphofunctional adaptations in the cardiovascular system and may reverse cardiac dysfunction in patients undergoing chemotherapy. Objective: To assess the effects of physical training on myocardial structure, cardiac function, and exercise tolerance in Wistar rats initiated after the onset of cardiotoxicity-induced cardiotoxicity. Methods: This study investigated 30 adult male Wistar rats randomly divided into four groups: control (C), exercise (EX), doxorubicin (DX), and doxorubicin and exercise (DXEX). The DX and DXEX groups received six doses of doxorubincin from 1.25 mg/kg body weight up to a cumulative dose of 7.5 mg/kg. Injections were administered intraperitoneally three times a week for two weeks; after this stage, the EX and DXEX groups started physical training (swimming) sessions three times a week with a load of 5% of their body weight. Echocardiography and exercise tolerance tests were performed. Generalized linear models were used in statistical analysis, and a p<0.05 was set as statistically significant. Results: Left ventricular shortening fraction and ejection fraction were reduced in the DX group compared to C, EX, and DXEX. The DXEX group showed greater tolerance to effort when compared to the DX and C groups. Conclusion: Physical training, initiated after the onset of doxorubicin-induced cardiotoxicity, improved cardiac function and exercise tolerance in rats.

https://doi.org/10.36660/ijcs.20210095

Atherosclerosis Complications in the Brazilian Population: An Ecological Time Series Study
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Silva, Emerson de Jesus

; Gomes Junior, Francieudo da Silva

; Firmiano, João Vitor Bezerra

; Silva, Nilson Roberto da

; Carlini, Wendel Aguiar

; Guedes, Marcello Barbosa Otoni Gonçalves

; Lopes, Matheus Rodrigues

; Lopes, Johnnatas Mikael

International Journal of Cardiovascular Sciences

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mar 2022, Volume 35 N. 2 Pages 243 - 252

Abstract: En | Text: En | PDF: En

Abstract Background: Atherosclerosis is a serious health problem, and several factors contribute to its occurrence. Longitudinal and qualified monitoring of primary health care (PHC) may contribute to the management of atherosclerosis and reduction of avoidable hospital admissions. Objectives: To estimate the trend in hospitalizations for atherosclerosis and the impact of PHC coverage on its evolution from 2008 to 2018 in Brazil. Methods: An ecological time series analytical study based on the outcomes of hospital admissions for atherosclerosis in Brazil. Time in years, PHC coverage, and Family Health Strategy (FHS) services were considered independent variables. A Prais–Winsten model was used to estimate the outcome trend, and α < 0.05 was adopted. Results: We observed a mean increase of 1.81 hospitalizations for atherosclerosis per 100 000 inhabitants annually (p = 0.002) in Brazil. This growth was evidenced in the Northeast (p < 0.001), Southeast (p = 0.003), and South (p < 0.001) regions, being stable in the North (p = 0.057) and Midwest (p = 0.62) regions. Men presented twice the growth in hospitalizations from the fifth decade of life on (p < 0.01). An inversely proportional relationship was observed for PHC coverage (B = -0.71; p < 0.001) and the proportion of FHS services (B = -0.59; p < 0.001) with the rate of admissions due to atherosclerosis in Brazil. Conclusions: Although hospitalizations for atherosclerotic complications are increasing in Brazil, they present regional and individual gender and age discrepancies, as well as a mitigating effect exerted by PHC coverage.

https://doi.org/10.36660/ijcs.20210117

Avaliação do autocuidado com os pés entre pacientes portadores de diabetes melito
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Lima, Lorrany Junia Lopes de

; Lopes, Matheus Rodrigues

; Botelho Filho, Carlos Alberto de Lima

; Cecon, Roberta Stofeles

Jornal Vascular Brasileiro

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2022, Volume 21 elocation e20210011

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

Resumo Contexto O pé diabético é uma complicação do diabetes melito (DM), sendo a maior causa de amputação dos membros inferiores. Objetivos Avaliar a prática de medidas de autocuidado com os pés, segundo sexo e escolaridade, em pacientes portadores de DM na região nordeste no estado da Bahia. Métodos Estudo quantitativo, observacional, analítico, transversal, realizado com 88 pacientes portadores de DM, em consulta de rotina, de fevereiro a março de 2020. A coleta de dados foi executada através da aplicação de questionários socioeconômico e do autocuidado com os pés (conhecimento sobre pé diabético, hábitos de cuidado/inspeção dos pés e procura pela Unidade de Saúde na presença de alterações com a saúde dos pés). Resultados Do total, 58% dos indivíduos desconhecia o termo “pé diabético”, porém possuíam cuidados mínimos adequados com os pés, como inspecioná-los (60,2%), hidratá-los (65,9%), não andar descalço (81,8%) e cortar as unhas (92%), apesar de 90,9% não utilizar sapatos considerados adequados. Houve relação entre menor nível de escolaridade e pior desempenho nas questões referentes a andar descalço, hidratar os pés, cortar as unhas, usar calçados adequados e identificar micoses (p < 0,05), porém não houve associação da realização das medidas de autocuidado e sexo. Conclusão Os portadores de DM entrevistados não realizaram todas as medidas de autocuidado com os pés e desconheciam o termo “pé diabético”. Houve associação entre menor escolaridade e menor capacidade de realização dessas medidas, o que sugere que o letramento em saúde seria importante para melhoria desse autocuidado, contribuindo para diminuição de complicações e amputações dos pés.

Abstract Background The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. Objectives To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. Methods This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). Results 58% of the sample did not know the term “diabetic foot”, but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. Conclusions Interviewed patientswith DM did not perform all foot self-care activities and did not know what the term “diabetic foot” means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.

https://doi.org/10.1590/1677-5449.210011

Adipose tissue-derived stromal/stem cells + cholecalciferol: a pilot study in recent-onset type 1 diabetes patients
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Dantas, Joana Rodrigues

; Araújo, Débora Batista

; Silva, Karina Ribeiro

; Souto, Débora Lopes

; Pereira, Maria de Fátima Carvalho

; Luiz, Ronir Raggio

; Mantuano, Matheus dos Santos

; Claudio-da-Silva, Cesar

; Gabbay, Monica Andrade Lima

; Dib, Sérgio Atala

; Couri, Carlos Eduardo Barra

; Maiolino, Angelo

; Rebelatto, Carmen Lúcia Kuniyoshi

; Daga, Débora Regina

; Senegaglia, Alexandra Cristina

; Brofman, Paulo Roberto Slud

; Baptista, Leandra S.

; Oliveira, José Egídio Paulo de

; Zajdenverg, Lenita

; Rodacki, Melanie

Archives of Endocrinology and Metabolism

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jun 2021, Volume 65 N. 3 Pages 342 - 351

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Adipose tissue-derived stromal/stem cells (ASCs) and vitamin D have immunomodulatory actions that could be useful for type 1 diabetes (T1D). We aimed in this study to investigate the safety and efficacy of ASCs + daily cholecalciferol (VIT D) for 6 months in patients with recent-onset T1D. Materials and methods: In this prospective, dual-center, open trial, patients with recent onset T1D received one dose of allogenic ASC (1 x 106 cells/kg) and cholecalciferol 2,000 UI/day for 6 months (group 1). They were compared to patients who received chol-ecalciferol (group 2) and standard treatment (group 3). Adverse events were recorded; C-peptide (CP), insulin dose and HbA1c were measured at baseline (T0), after 3 (T3) and 6 months (T6). Results: In group 1 (n = 7), adverse events included transient headache (all), mild local reactions (all), tachycardia (n = 4), abdominal cramps (n = 1), thrombophlebitis (n = 4), scotomas (n = 2), and central retinal vein occlusion at T3 (n = 1, resolution at T6). Group 1 had an increase in basal CP (p = 0.018; mean: 40.41+/-40.79 %), without changes in stimulated CP after mixed meal (p = 0.62), from T0 to T6. Basal CP remained stable in groups 2 and 3 (p = 0.58 and p = 0.116, respectively). Group 1 had small insulin requirements (0.31+/- 0.26 UI/kg) without changes at T6 (p = 0.44) and HbA1c decline (p = 0.01). At T6, all patients (100%; n = 7) in group 1 were in honeymoon vs 75% (n = 3/4) and 50% (n = 3/6) in groups 2 and 3, p = 0.01. Conclusions: Allogenic ASC + VIT D without immunosuppression was safe and might have a role in the preservation of β-cells in patients with recent-onset T1D. ClinicalTrials.gov: NCT03920397.

https://doi.org/10.20945/2359-3997000000368 236 downloads

Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology
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BRUCKI, Sonia Maria Dozzi

; ADONI, Tarso

; ALMEIDA, Carlos Mauricio Oliveira

; ANDRADE, Daniel Ciampi de

; ANGHINAH, Renato

; BARBOSA, Luciana Mendonça

; BAZAN, Rodrigo

; CARVALHO, Alzira Alves de Siqueira

; CARVALHO, William

; CHRISTO, Paulo Pereira

; COLETTA, Marcus Della

; CONFORTO, Adriana Bastos

; CORREA-NETO, Ylmar

; ENGELHARDT, Eliasz

; FRANÇA JUNIOR, Marcondes Cavalcante

; FRANCO, Clelia

; VON GLEHN, Felipe

; GOMES, Helio Rodrigues

; HOULY, Caroline Gomes de Barros

; KAUP, Alexandre Ottoni

; KOWACS, Fernando

; KANASHIRO, Aline

; LOPES, Victor Gonçalves

; MAIA, Débora

; MANREZA, Maria

; MARTINEZ, Alberto Rolim Muro

; MARTINEZ, Sandra Cristina Gonçalves

; NADER, Saulo Nardy

; NEVES, Luciana de Oliveira

; OKAMOTO, Ivan Hideyo

; OLIVEIRA, Rogério Adas Ayres de

; PEIXOTO, Fabiano de Melo

; PEREIRA, Cristiana Borges

; SABA, Roberta Arb

; SAMPAIO, Leticia Pereira de Brito

; SCHILLING, Lucas Porcello

; SILVA, Marcus Tulius Teixeira

; SILVA, Emanuelle Roberta

; SMID, Jerusa

; SOARES, Cristiane Nascimento

; SOBREIRA-NETO, Manoel

; SOUSA, Nise Alessandra de Carvalho

; SOUZA, Leonardo Cruz de

; TEIVE, Hélio Afonso Ghizoni

; TERRA, Vera Cristina

; VALE, Matheus

; VIEIRA, Vitor Mendes Grise

; ZANOTELI, Edmar

; PRADO, Gilmar

Arquivos de Neuro-Psiquiatria

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apr 2021, Volume 79 N. 4 Pages 354 - 369

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

RESUMO Os canabinoides compreendem os endocanabinoides, fitocanabinoides e os canabinoides sintéticos e desempenham ações no sistema nervoso central e periférico. Uma quantidade enorme de publicações tem sido lançada nos últimos anos, embora a cannabis seja conhecida por milênios. Os Departamentos Científicos da Academia Brasileira de Neurologia descreveram as evidências do uso médico em suas áreas. A literatura está em constantes mudanças e possíveis novas evidências podem surgir nos próximos dias ou meses. A prescrição dessas substâncias deve ser discutida com os pacientes e suas famílias, com conhecimento sobre eventos adversos e sua eficácia.

ABSTRACT Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.

https://doi.org/10.1590/0004-282x-anp-2020-0432 1049 downloads

Nuances between sedentary behavior and physical inactivity: cardiometabolic effects and cardiovascular risk
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Melo, Erika Andressa Simões de

; Ferreira, Laryssa Elza de Santana

; Cavalcanti, Rodolfo José Ferreira

; Botelho Filho, Carlos Alberto de Lima

; Lopes, Matheus Rodrigues

; Barbosa, Romero Henrique de Almeida

Revista da Associação Médica Brasileira

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feb 2021, Volume 67 N. 2 Pages 335 - 343

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: The aim of this study was to highlight the differences between the cardiometabolic effects and the cardiovascular risk of physical inactivity and sedentary behavior. METHODS: A narrative bibliographic review was conducted. In the research, national and international articles were selected from the PubMed, SciELO, and LILACS databases using the descriptors “sedentary lifestyle, cardiovascular risk, physical inactivity, sedentary behavior, and cardiovascular risks.” DISCUSSION: Both physical inactivity and sedentary behavior are related to metabolic and organic changes, promoting a chronic proinflammatory state, cardiac remodeling, increased body adiposity, and skeletal muscle dysfunction. It is possibly stated that both of them result in a higher risk of developing chronic diseases, resulting in higher global and cardiovascular morbidity and mortality, with nuances in their intrinsic effects. CONCLUSIONS: It is inferred that both physical inactivity and sedentary behavior are cardiovascular risk factors that can be modified with the correct clinical approach. It is necessary to differentiate physically inactive individuals from those with a high number of sedentary behaviors. These concepts need better clinical applicability to improve the prevention of primary and secondary cardiovascular risks.

https://doi.org/10.1590/1806-9282.67.02.20200746 164 downloads

10.

Relationship between vitamin D deficiency and psychophysiological variables: a systematic review of the literature
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Silva, Mariluce Rodrigues Marques

; Barros, Waleska Maria Almeida

; Silva, Mayara Luclécia da

; Silva, José Maurício Lucas da

; Souza, Ana Patrícia da Silva

; Silva, Ana Beatriz Januário da

; Fernandes, Matheus Santos de Sousa

; Souza, Sandra Lopes de

; Souza, Viviane de Oliveira Nogueira

Clinics

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2021, Volume 76 elocation e3155

Abstract: En | Text: En | PDF: En

Vitamin D is a fat-soluble vitamin that plays a role not only in calcium homeostasis, but also in several other functions, including cell growth and immune functions, and is considered a neurosteroid. Vitamin D deficiency is highly prevalent worldwide and has been suggested to be associated with an increased risk of emotional disorders. Therefore, the association between vitamin D levels and psychophysiological disorders, such as depression, anxiety, and mood, has been investigated. To list these variables, a bibliographical literature research was conducted in the MEDLINE/PubMed, Web of Science, Scopus, Science Direct and PsycINFO databases, between November and December 2020, with no year limits of publication. The studies involved humans aged between 18 and 59 years without associated diseases. This review presents evidence of the main variables involved in this association, main tools used to verify these variables, and methods used to verify circulating vitamin D levels in populations. Most studies have indicated that the main psychophysiological variables involved with vitamin D levels are depression and anxiety followed by mood, and an association has been observed between increased serum vitamin D levels and reduction in symptoms of depression, anxiety, and mood, and there is a heterogeneity of methods for assessing vitamin D. More studies are clearly needed to improve our understanding of their role in modulating the psychophysiological aspects of vitamin D levels.

https://doi.org/10.6061/clinics/2021/e3155 52 downloads

11.

Concordância entre dois instrumentos para avaliação do letramento em saúde
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Cangussú, Luana Resende

; Alho, Eduardo Antonio Sartori

; Cardoso, Felipe Esdras Lucas

; Tenório, Adirlene Pontes de Oliveira

; Barbosa, Romero Henrique de Almeida

; Lopes, Johnnatas Mikael

; Lopes, Matheus Rodrigues

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. 2 elocation e2020490

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

Resumo Objetivo Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA, respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); e a concordância de acertos encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e desenvolvimento de instrumentos específicos às condições de saúde que permitam obter resultado próximo ao real contexto dos indivíduos.

Abstract Objetivo To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. Methods This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. Results 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). Conclusion The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.

Resumen Objetivo Determinar la concordancia entre instrumentos de medición psicométrica short test of functional health literacy in adults (S-TOFHLA) y short assessment of health literacy for portuguese-speaking adults (SAHLPA-18) como estrategia para estimar la validez concurrente. Métodos estudio transversal realizado con usuarios del Sistema Único de Salud. Para testear la validez concurrente se aplicó un enfoque de concordancia con una prueba ponderada de Kappa para datos cualitativos. Resultados participaron 372 individuos. Se encontró que 66% y 62% de estos no tenía un nivel adecuado de letramiento según SAHLPA-18 y S-TOFHLA, respectivamente. Hubo una fuerte correlación entre los instrumentos (p<0.001; r=0.60), sin embargo 65.3% de concordancia, se consideró débil (Kappa=0.35; p<0.001). Conclusión Los instrumentos SAHLPA-18 y S-TOFHLA tienen diferentes construcciones y escasa concordancia. En la investigación se indica el uso de diferentes instrumentos para medir el nivel de letramiento y el desarrollo de instrumentos específicos a las condiciones de salud que permitan obtener resultados cercanos al contexto real de los individuos.

https://doi.org/10.1590/s1679-49742021000200004

12.

Concordância entre dois instrumentos para avaliação do letramento em saúde
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Cangussú, Luana Resende

; Alho, Eduardo Antonio Sartori

; Cardoso, Felipe Esdras Lucas

; Tenório, Adirlene Pontes de Oliveira

; Barbosa, Romero Henrique de Almeida

; Lopes, Johnnatas Mikael

; Lopes, Matheus Rodrigues

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. 2 elocation e2020490

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

https://doi.org/10.1590/s1679-49742021000200004 277 downloads

13.

Effect of Metabolic Syndrome on Parkinson's Disease: A Systematic Review
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Souza, Ana Patrícia da Silva

; Barros, Waleska Maria Almeida

; Silva, José Maurício Lucas

; Silva, Mariluce Rodrigues Marques

; Silva, Ana Beatriz Januário

; Fernandes, Matheus Santos de Sousa

; Santos, Maria Eduarda Rodrigues Alves dos

; Silva, Mayara Luclécia da

; Carmo, Taciane Silva do

; Silva, Roberta Karlize Pereira

; Silva, Karollainy Gomes da

; Souza, Sandra Lopes de

; Souza, Viviane de Oliveira Nogueira

Clinics

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2021, Volume 76 elocation e3379

Abstract: En | Text: En | PDF: En

Evidence shows that metabolic syndrome (MS) is associated with a greater risk of developing Parkinson's disease (PD) because of the increase in oxidative stress levels along with other factors such as neuroinflammation and mitochondrial dysfunction. However, because some studies have reported that MS is associated with a lower risk of PD, the relationship between MS and PD should be investigated. This study aimed to investigate the effect of MS on PD. Two authors searched five electronic databases, namely, MEDLINE, PubMed, Scopus, PsycINFO, Web of Science, and Science Direct, for relevant articles between September and October 2020. After screening the title and abstract of all articles, 34 articles were selected for full-text review. Finally, 11 articles meeting the eligibility criteria were included in the study. The quality of articles was critically evaluated using the Joanna Briggs Institute. Overall, we evaluated data from 23,586,349 individuals (including healthy individuals, with MS and PD) aged 30 years or more. In cohort studies, the follow-up period varied between 2 and 30 years. MS contributed considerably to the increase in the incidence of PD. In addition, obesity, a component of MS, alone can increase the probability of developing neurodegenerative diseases. However, despite few studies on MS and PD, changes in cognitive function and more rapid progression of PD disease has been documented in patients with MS using methods commonly used in research.

https://doi.org/10.6061/clinics/2021/e3379

14.

[SciELO Preprints] - Concordance between two instruments for health literacy assessment
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Cangussú, Luana Resende Alho, Eduardo Antonio Sartori Cardoso, Felipe Esdras Lucas Tenório, Adirlene Pontes de Oliveira Barbosa, Romero Henrique de Almeida Lopes, Johnnatas Mikael Lopes, Matheus Rodrigues

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Publication date: 2020-12-11

Abstract: En Pt

Objective: To determine the agreement between short test of functional health literacy in adults (S-TOFHLA) and short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) measurement instruments as a strategy to estimate concurrent validity. Methods: Cross-sectional study conducted with users of the Unified Health System. To test concurrent validity, an agreement approach with a weighted Kappa test for qualitative data was applied. Results: 372 individuals participated. It was found that 66% and 62% of these did not have an adequate level of literacy through SAHLPA-18 and S-TOFHLA, respectively. There was a strong correlation between the instruments (p<0.001; r=0.60), however 65.3% agreement, considered weak (Kappa=0.35; p<0.001). Conclusion: SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. The use of different instruments is indicated in research to measure the level of literacy and the development of instruments specific to health conditions that allow obtaining results close to the real context of individuals.

Objetivo: Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos: Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados: Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); entretanto, a concordância encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão: Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e o desenvolvimento de instrumentos específicos às condições de saúde presentes, que permitam obter resultados próximos ao real contexto dos indivíduos.

https://doi.org/10.1590/s1679-49742021000200004

15.

Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature
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Lopes, Cesar Castello Branco

; Brucki, Sonia Maria Dozzi

; Passos Neto, Carlos Eduardo Borges

; Corazza, Luiza Alves

; Baima, José Pedro Soares

; Fiorentino, Matheus Dalben

; Tatsch, João Fellipe Santos

; Martin, Maria da Graça Morais

; Lucato, Leandro Tavares

; Gomes, Hélio Rodrigues

; Rocha, Maria Sheila Guimarães

; Fortini, Ida

; Nitrini, Ricardo

; Castro, Luiz H.

Arquivos de Neuro-Psiquiatria

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dec 2020, Volume 78 N. 12 Pages 805 - 810

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

RESUMO Introdução: As manifestações neurológicas causadas pela COVID-19 ainda não estão completamente elucidadas. O comprometimento neurológico pode decorrer de um efeito viral direto em neurônios ou em células gliais, a efeito imunomediado em resposta à infecção viral, ou de um efeito secundário a estados de hipercoagulabilidade e danos endoteliais, assim como decorrente de complicações sistêmicas graves relacionadas a cuidados intensivos prolongados na unidade de terapia intensiva. Objetivo: Descrever dois pacientes com recuperação tardia do nível de consciência após a retirada da sedação associados à infecção grave pelo SARS-CoV-2, que apresentaram lesões multifocais de substância branca, compatíveis com o diagnóstico de encefalomielite disseminada aguda. Métodos: Estudo observacional, com relato de dois casos de infecção grave pela COVID-19, em dois hospitais terciários na cidade de São Paulo, Brasil. Resultados: Os pacientes foram submetidos à investigação sistêmica e neurológica para avaliação de estado alterado de consciência após retirada de sedação. A ressonância magnética de crânio evidenciou lesões multifocais no centro semioval, sugestivos de processo inflamatório desmielinizante. Análise liquórica evidenciou PCR negativo para SARS-CoV-2 em ambos os casos. Conclusão: Lesões multifocais de substância branca podem ocorrer em pacientes com COVID-19, possivelmente associadas a estados alterados de consciência. Estudos adicionais são necessários para determinar o processo fisiopatológico da infecção viral e dos estados inflamatórios e imunomediados na gênese das manifestações neurológicas causadas pela COVID-19.

ABSTRACT Background: Neurological manifestations of COVID-19 are still incompletely understood. Neurological manifestations may be due to direct viral effect on neurons and glial cells, to an immune-mediated response to the virus, or to a hypercoagulable state and associated endothelial damage, as well as to severe systemic disease with prolonged intensive care unit stay. Objective: To describe two patients with severe SARS-CoV-2 infection and delayed recovery of consciousness after sedation withdrawal, in whom MRI disclosed multifocal white matter brain lesions, compatible with the diagnosis of acute disseminated encephalomyelitis. Methods: Observational report of two cases of severe COVID-19 infection in patients from two tertiary hospitals in São Paulo, Brazil. Results: These patients underwent neurologic and systemic evaluation for delayed awakening after sedation withdrawal. MRI displayed multifocal centrum semiovale lesions, suggestive of demyelinating inflammation. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for SARS-CoV-2 was negative in both cases. Conclusion: A recurrent pattern of multifocal white matter lesions can occur in COVID-19 patients, possibly associated with delayed awakening. Additional studies are necessary to elucidate the role of the viral infection and of inflammatory and immune-mediated associated changes in neurological manifestations of COVID-19.

https://doi.org/10.1590/0004-282x20200186 2670 downloads

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