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HIV infection during pregnancy in the state of Rio de Janeiro, Brazil, 2021-2023
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Domingues, Rosa Maria Soares Madeira

; Dias, Marcos Augusto Bastos

; Esteves-Pereira, Ana Paula

; Luz, Paula Mendes

; Jalil, Emilia

; Rocha, Vania

; Rabello, Angela Cristina Vasconcelos de Andrade

; Friedman, Ruth Khalili

; Leal, Maria do Carmo

Revista Brasileira de Epidemiologia

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2025, Volume 28 elocation e250020

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

RESUMO Objetivos: Estimar a prevalência de infecção pelo vírus da imunodeficiência humana (HIV) em gestantes; analisar os desfechos gestacionais e maternos das mulheres com HIV; e avaliar indicadores de processo para prevenção da transmissão vertical do HIV segundo tipo de financiamento da internação hospitalar no estado do Rio de Janeiro. Métodos: Estudo seccional, com 1.923 mulheres, realizado no período 2021–2023. Foram realizadas entrevistas com mulheres e extraídos dados da caderneta da gestante e de prontuários hospitalares. Foi estimada a prevalência de infecção pelo HIV, dos desfechos gestacionais e maternos e da adequação de indicadores de processo do manejo do HIV com respectivos intervalos de confiança de 95% (IC95%) segundo tipo de financiamento (público ou privado) da internação hospitalar para parto ou abortamento. Resultados: Cobertura de assistência pré-natal, de realização de um e dois testes de HIV no pré-natal e de testagem na internação hospitalar de 93,7, 79,7, 45,8 e 78,2%, respectivamente. A prevalência de infecção pelo HIV foi estimada em 0,79% (IC95% 0,31–1,99). Apenas 40% das mulheres com HIV apresentavam registro de tratamento antirretroviral e 26% registro de exame de carga viral na caderneta da gestante. Mulheres com internação hospitalar com financiamento público eram mais vulneráveis socialmente e apresentaram menor cobertura de assistência pré-natal e de testagem com dois testes anti-HIV. Conclusão: Foram identificadas oportunidades perdidas no manejo das gestantes com HIV em internações com financiamento público e privado no Rio de Janeiro. A taxa de detecção foi superior à do Sistema de Informação de Agravos de Notificação e sugere subnotificação de casos.

ABSTRACT Objectives: To estimate the prevalence of HIV infection in pregnant women; analyze the gestational and maternal outcomes of women with HIV; and evaluate process indicators for the prevention of vertical transmission of HIV according to type of financing for hospital admission in the state of Rio de Janeiro (RJ). Methods: cross-sectional study with 1,923 women, conducted between 2021-2023. Interviews were carried out with women, and data was extracted from the pregnancy booklet and hospital records. The prevalence of HIV infection, gestational and maternal outcomes, and the adequacy of process indicators for the management of HIV infection were estimated with respective 95% confidence intervals (95%CI) according to the type of financing — public or private — for hospital admission for childbirth or abortion. Results: Coverage of prenatal care (PNC), HIV testing during PNC (one and two tests), and testing during hospital admission was 93.7, 79.7, 45.8, and 79.2%, respectively. The prevalence of HIV infection was estimated at 0.79% (95%CI 0.31–1.99). Only 40% of women with HIV had registered antiretroviral treatment and 26% had registered viral load tests in their pregnancy booklet. Women with public funding were more socially vulnerable and had less coverage of PNC and testing with two tests. Conclusion: Missed opportunities were identified in the management of pregnant women with HIV in public and private services in RJ. The detection rate was higher than that of the Notifiable Diseases Information System and suggests underreporting of cases.

https://doi.org/10.1590/1980-549720250020

HIV infection during pregnancy in the state of Rio de Janeiro, Brazil, 2021-2023
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Domingues, Rosa Maria Soares Madeira

; Dias, Marcos Augusto Bastos

; Esteves-Pereira, Ana Paula

; Luz, Paula Mendes

; Jalil, Emilia

; Rocha, Vania

; Rabello, Angela Cristina Vasconcelos de Andrade

; Friedman, Ruth Khalili

; Leal, Maria do Carmo

Revista Brasileira de Epidemiologia

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2025, Volume 28 elocation e250020

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

https://doi.org/10.1590/1980-549720250020

O aborto legal em casos de gravidez decorrente de violência sexual: percepções e vivências de médicas e médicos obstetras
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Lehnen, Ana Júlia Saldanha

; Rabello, Mariana

; Barros, Geiza Martins

; Cardoso, Fernanda Freitas Oliveira

Cadernos de Saúde Pública

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2024, Volume 40 N. 5 elocation e00124423

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

Resumo: Este estudo objetivou analisar as percepções de obstetras e residentes de ginecologia-obstetrícia, atuantes numa maternidade escola federal, sobre o aborto legal em casos de gravidez decorrente de violência sexual, desvelando suas motivações, resistências e sentimentos, e identificando suas experiências com o tema. A primeira etapa correspondeu ao preenchimento de um questionário autoaplicável. Os critérios de seleção foram: obstetras vinculados ao centro obstétrico; diretor da divisão médica; e residentes do programa de ginecologia-obstetrícia da instituição. Obtiveram-se 36 questionários respondidos. A segunda etapa correspondeu à realização de uma entrevista, tendo sido utilizado o critério de amostragem por saturação e foram entrevistados seis médicos. As entrevistas foram analisadas pelo método de análise de conteúdo, na modalidade temática. Os questionários retrataram que todos os participantes já haviam prestado assistência a mulheres em situação de violência sexual e que a maioria já havia participado da realização de um aborto legal. As entrevistas evidenciaram os dilemas enfrentados pelos profissionais na assistência a esses casos e a escassez da formação profissional em relação à temática. A palavra da mulher foi tida ora como objeto de suspeição em relação à veracidade do estupro, ora como capaz de suscitar afetação das profissionais em suas escutas, o que possibilitou que essas se aproximassem das vítimas e ofertassem uma assistência mais humanizada. Os resultados apontaram para a importância da temática ser abordada nos campos da saúde e da formação para além do enfoque técnico-científico, visando produzir novas estratégias de cuidado.

Resumen: El estudio tuvo como objetivo analizar las percepciones de obstetras y residentes de gineco-obstetricia de una maternidad escolar federal sobre el aborto legal en casos de embarazo resultante de violencia sexual, revelar sus motivaciones, resistencias y sentimientos, e identificar sus experiencias con el tema. La primera etapa consistió en completar un cuestionario autoadministrado. Los criterios de selección fueron los siguientes: obstetras vinculados al centro obstétrico; director de la división médica; y residentes del programa de gineco-obstetricia de la institución. Se obtuvieron 36 cuestionarios cumplimentados. La segunda etapa consistió en una entrevista, utilizando un criterio de muestreo por saturación. Se entrevistó a 6 médicos. Las entrevistas se analizaron mediante el método de análisis de contenido, en la modalidad temática. Los cuestionarios mostraron que todos los participantes ya habían brindado asistencia a mujeres en situación de violencia sexual y que la mayoría ya había participado en la realización de un aborto legal en estos casos. Las entrevistas pusieron de manifiesto los dilemas que enfrentan los profesionales en la asistencia a estos casos y la escasa formación profesional con relación al tema. La palabra de la mujer fue vista a veces como objeto de sospecha con respecto a la veracidad de la violación, y a veces como un objeto capaz de suscitar la afectación de las profesionales en sus escuchas, lo que les permitió acercarse a las víctimas y ofrecer una asistencia más humanizada. Los resultados señalaron la importancia de que la temática sea abordada en los campos de la salud y de la formación más allá del enfoque técnico-científico, con el objetivo de producir nuevas estrategias de cuidado.

Abstract: This study aimed to analyze the perceptions of obstetricians and gynecology-obstetrics residents at a federal school maternity hospital regarding legal abortion in cases of sexual violence pregnancy, understand their motivations, strengths, and feelings, and identify their experience with this topic. The first stage consisted of answering a self-administered questionnaire. The selection criteria were: obstetricians linked to the obstetric center, director of the medical division, and residents of the institution’s obstetrics-gynecology program. In total, 36 questionnaires were answered and returned. The second stage corresponded to an interview using a saturation sampling criterion. Six physicians were interviewed. The interviews were evaluated using a thematic content analysis. The questionnaires showed that all participants had already provided care to women in situations of sexual violence and that most of them had already participated in a legal abortion procedure in these cases. The interviews highlighted the dilemmas faced by professionals in providing care to these women and the lack of professional training to handle these cases. The speeches of women were sometimes seen as an object of suspicion regarding the veracity of sexual violence, and sometimes as an object that caused professionals to feel emotionally affected while listening to them, allowing professionals to approach the victims and offer more humanized care. The results pointed to the importance of addressing this topic in the areas of health and providing training beyond the technical-scientific focus in order to support the development of new care strategies.

https://doi.org/10.1590/0102-311xpt124423

O aborto legal em casos de gravidez decorrente de violência sexual: percepções e vivências de médicas e médicos obstetras
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Lehnen, Ana Júlia Saldanha

; Rabello, Mariana

; Barros, Geiza Martins

; Cardoso, Fernanda Freitas Oliveira

Cadernos de Saúde Pública

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2024, Volume 40 N. 5 elocation e00124423

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

https://doi.org/10.1590/0102-311xpt124423

Serology for visceral leishmaniasis: How trusty is the accuracy reported by the manufacturers? leishmaniasis manufacturers
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Freire, Mariana Lourenço

; Gonçalves, Maria Clara de Oliveira

; Silva, Allana Carolina Marques da

; Cota, Gláucia

; Rabello, Ana

; Assis, Tália Santana Machado de

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0358-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Timely and accurate diagnosis is one of the strategies for managing visceral leishmaniasis (VL). Given the specificities of this infection, which affects different vulnerable populations, the local assessment of the accuracy of the available diagnostic test is a requirement for the good use of resources. In Brazil, performance data are required for test registration with the National Regulatory Agency (ANVISA), but there are no minimum requirements established for performance evaluation. Here, we compared the accuracy reported in the manufacturer’s instructions of commercially available VL-diagnostic tests in Brazil, and the accuracies reported in the scientific literature which were obtained after test commercialization. The tests were identified via the electronic database of ANVISA, and their accuracy was obtained from the manufacturer’s instructions. A literature search for test accuracy was performed using two databases. A total of 28 VL diagnostic tests were identified through the ANVISA database. However, only 13 presented performance data in the manufacturer’s instructions, with five immunoenzymatic tests, three indirect immunofluorescence tests, one chemiluminescence test, and four rapid tests. For most tests, the manufacturers did not provide the relevant information, such as sample size, reference standards, and study site. The literature review identified accuracy data for only 61.5% of diagnostic tests registered in Brazil. These observations confirmed that there are significant flaws in the process of registering health technologies and highlighted one of the reasons for the insufficient control of policies, namely, the use of potentially inaccurate and inappropriate diagnostic tools for a given scenario. VL. . (VL) infection populations resources Brazil , (ANVISA) evaluation Here manufacturer s VLdiagnostic commercialization databases 2 However 1 information size standards site 615 61 5 61.5 policies namely scenario (VL (ANVISA 6 61.

https://doi.org/10.1590/0037-8682-0358-2022

Model Based System Engineering (MBSE) and design assurance process in the context of mitigation of design errors during the development of highly integrated and complex aerospace systems
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WASHIO, DOUGLAS H.

; SOUZA, MARCELO L. DE OLIVEIRA E

; RABELLO, ANA PAULA DE SÁ SANTOS

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Suppl. 2 elocation e20220859

Abstract: En | Text: En | PDF: En

Abstract Over the years, aircraft and spacecraft designs incorporated highly integrated and/or complex systems that can manage complex scenarios during its operation. In addition to the inherent complexity and/or high level of integration of those systems, the development process applied to aerospace programs is also challenged by other factors: program schedule, budget, multidisciplinary teams, new industry emerging technologies, large number of different processes and procedures that guide the activities along the development life cycle, and others. Given the fact many tasks executed during the development of such systems require human interaction, that yields the introduction of design errors that can contribute to the occurrence of non-desired system behaviors during operation phase. It is already recognized by the civil aviation industry that it is unfeasible to have a deterministic test set to demonstrate that such systems are completely free of such design errors. In that context, a huge effort is applied by the industry, by using qualitative methods to mitigate the occurrence of design errors during the development phases. This paper discusses how MBSE methodology applied together with a design assurance process could prevent such design errors, and presents an analysis showing how some events in aerospace industry where a design error was one of the contributing factors could be avoided.

https://doi.org/10.1590/0001-3765202320220859

Materialidade do livro: mapeamento e visualização temática na literatura em Ciência da Informação
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Amorim, Ana Karolina Alves

; Rabello, Rodrigo

RDBCI: Revista Digital de Biblioteconomia e Ciência da Informação

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2022, Volume 20 elocation e022021

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

ABSTRACT Introduction: The book is a symbolic object or a “semiophore”, which denotes its condition of being “beyond information”, involving, in addition, materiality and institutionality. Objective: To map authors, works and themes related or tangent to the subject “book’s materiality” in the scope of information science. Methodology: A mapping of the thematic coverage was carried out in national and international databases, then, the texts identified were analyzed and visualized using Voyant Tools tool. Results: 100 documents that covered the period between 1996 and 2020 were analyzed, with the highest occurrence of publication of book’s materiality thematic in the years of 2016, 2017 and 2018. In terms of terminology, expressions that lead to the understanding of the book as a documentary and symbolic support that contains information, stand out, and can compose collections in institutions worried with social memory, as is the case of libraries. The journals that most publish articles on the subject were Encontros Bibli and Journal of Documentation, and the databases that index the most journals that address the topic were BRAPCI and Library and Information Science Abstracts. Conclusion: The book’s materiality theme establishes a bridge between the breadth of the “materiality” concept and a relationship between book and document. The book - when studied based on the multidimensionality of materiality, whether expressed in analog or digital environment - constitutes itself as a symbolic object in addition to being conceived as a mere source of information.

RESUMO Introdução: O livro é um objeto simbólico ou um “semióforo”, o que denota sua condição de estar “para além da informação”, envolvendo, ademais, materialidade e institucionalidade. Objetivo: Mapear autores, obras e temas relativos ou tangentes ao assunto “materialidade do livro” no âmbito da Ciência da Informação. Metodologia: Realizou-se mapeamento da cobertura temática em bases de dados nacionais e internacionais; em seguida, procedeu-se a análise e a visualização dos textos identificados mediante a ferramenta Voyant Tools. Resultados: Foram analisados 100 documentos que cobriram o período entre 1996 e 2020, constatando maior ocorrência de publicações da temática materialidade do livro nos anos 2016, 2017 e 2018. No âmbito terminológico, destacaram-se expressões que levam à compreensão do livro como um suporte documental e simbólico que contém informação, compondo coleções em instituições preocupadas com a memória social, como é o caso das bibliotecas. Os periódicos que mais publicaram artigos sobre o tema foram Encontros Bibli e Journal of Documentation, e as bases de dados que mais indexaram periódicos que abordaram a temática foram a BRAPCI e a Library and Information Science Abstracts. Conclusão: O tema materialidade do livro estabelece uma ponte entre a amplitude do conceito “materialidade” e a relação entre livro e documento. O livro - quando estudado tendo como fundamento a multidimensionalidade da materialidade, seja expressa em meio analógico ou digital - se constitui como um objeto simbólico para além de ser concebido como uma mera fonte de informação.

https://doi.org/10.20396/rdbci.v20i00.8670863

Women engaged in prostitution and COVID-19: why are they excluded from socially vulnerable groups?
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Chiang, Michelle Ishida

; Basile, Maitê Leite

; Souza, Ana Beatriz Pereira de

; Moccagatta, Isabella Dastler

; Vieira, Julia Rabello Guerra

; Lourenço, Thaís Rocha

; Gonçalves, Mariana Langanke

; Pinto, Helena Afférri Fernandes

; Lowenthal, Rosane

; Ferrer, Michele Lacerda Pereira

; Klautau, Giselle Burlamaqui

Revista de Saúde Pública

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2022, Volume 56 elocation 3

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

RESUMO Esta pesquisa analisou a exposição de mulheres em situação de prostituição no centro de São Paulo à covid-19. Este estudo transversal contou com amostra de conveniência selecionada em maio de 2021. Entrevistou-se 219 mulheres majoritariamente negras, de meia idade, pobres e com comorbidades. Dentre essas mulheres, 61 tiveram sintomas de covid-19, 23 com teste positivo,7 foram internadas e 4 relataram complicações pós-covid-19. Somente 26 (30,2%) haviam sido vacinadas. Além das desigualdades de gênero, raça e classe, essas mulheres são expostas a um maior risco de contraírem covid-19, devido às condições de trabalho e por apresentarem doença grave relacionada à idade e falta de vacinação.

ABSTRACT This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.

https://doi.org/10.11606/s1518-8787.2022056004229

Women engaged in prostitution and COVID-19: why are they excluded from socially vulnerable groups?
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Chiang, Michelle Ishida

; Basile, Maitê Leite

; Souza, Ana Beatriz Pereira de

; Moccagatta, Isabella Dastler

; Vieira, Julia Rabello Guerra

; Lourenço, Thaís Rocha

; Gonçalves, Mariana Langanke

; Pinto, Helena Afférri Fernandes

; Lowenthal, Rosane

; Ferrer, Michele Lacerda Pereira

; Klautau, Giselle Burlamaqui

Revista de Saúde Pública

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2022, Volume 56 elocation 3

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

https://doi.org/10.11606/s1518-8787.2022056004229

10.

Manejo de los episodios de neutropenia febril en niños con cáncer. Consenso de la Sociedad Latinoamericana de Infectología Pediátrica 2021
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Santolaya, María E. Contardo, Verónica Torres, Juan P. López-Medina, Eduardo Rosanova, María T. Álvarez, Ana M. Gutiérrez, Valentina Claverie, Ximena Rabello, Marcela Zubieta, Marcela Álvarez-Olmos, Martha I. Camacho, Germán Perez, Pahola Mariño, Cristina Garces, Carlos Coronell, Wilfrido López, Pío Gómez, Sandra Epelbaum, Carolina Ezcurra, Gustavo Fallo, Aurelia Avilés-Robles, Martha Díaz-Cadena, Tanya Martínez-Bustamante, María Elena Nava-Ruíz, Enid Alejandra

Revista chilena de infectología

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dec 2021, Volume 38 N. 6 Pages 857 - 909

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

Abstract The Committee for Infections in Immunocompromised Children of Sociedad Latinoamericana de Infectología Pediátrica, presents this Consensus document, titled “Management of episodes of febrile neutropenia in children with cancer. Consensus of the Sociedad Latinoamericana de Infectología Pediátrica 2021”. The document includes recommendations on prevention, prediction, diagnosis, treatment and prognosis of episodes of fever and neutropenia, including specific recommendations on: Analysis at admission; evaluation, adjustments and duration of antimicrobial therapies; diagnosis and management of invasive fungal infection; analysis of the main clinical source of infections; environmental conditions necessary for hospitals caring for children with cancer and chemoprophylaxis. Special emphasis has been placed on providing the best recommendations to optimize the management of episodes of fever and neutropenia in children with cancer, with equity and excellence through all the centers that treat these patients in Latin America.

Resumen El Comité de Infecciones en el Niño Inmunocomprometido de la Sociedad Latinoamericana de Infectología Pediátrica, entrega este documento de Consenso, llamado “Manejo de los episodios de neutropenia febril en niños con cáncer. Consenso de la Sociedad Latinoamericana de Infectología Pediátrica 2021”. El documento contiene recomendaciones sobre aspectos de prevención, predicción, diagnóstico, tratamiento y pronóstico de los episodios de fiebre y neutropenia, incluyendo recomendaciones específicas sobre: Análisis de ingreso; evaluación, ajustes y duración de terapias antimicrobianas; diagnóstico y manejo de infección fúngica invasora; análisis de los principales focos clínicos de infección; condiciones ambientales necesarias para hospitales que atienden niños con cáncer y quimioprofilaxis. Se ha puesto especial énfasis en entregar las mejores recomendaciones para optimizar el manejo de los episodios de fiebre y neutropenia en niños con cáncer, buscando la equidad y la excelencia a través de todos los centros que atienden estos pacientes en América Latina.

https://doi.org/10.4067/s0716-10182021000600857

11.

Follow-up and outcome of the twelve-year experience in adult patients with acute promyelocytic leukemia
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Steffenello-Durigon, Giovanna

; Bigolin, Alisson

; Moraes, Ana Carolina Rabello de

; Rudolf-Oliveira, Renata Cristina Moral, Joanita Angela Gonzaga Del Santos-Silva, Maria Claudia

Hematology, Transfusion and Cell Therapy

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mar 2021, Volume 43 N. 1 Pages 21 - 27

Abstract: En | Text: En | PDF: En

ABSTRACT Acute promyelocytic leukemia is a subtype of acute myeloid leukemia, characterized by the presence of neoplastic promyelocytes, due to the reciprocal balanced translocation between chromosomes 15 and 17. Currently, with the use of agents that act directly on this molecular change, such as all-trans retinoic acid and arsenic trioxide, APL has shifted from a highly mortal to a curable disease. However, some cases are still at high risk of death, especially early death, and acquiring a better understanding of the clinical and biological factors involving APL is needed to correctly identify and treat such cases. The early suspected diagnosis and prompt initiation of the target therapy are important for better response rates. The follow-up and outcomes, using real-life data from 44 consecutive APL patients, were studied between 2001 and 2013. The overall survival rate was 82.7% and early death was 16%. Almost all patient deaths were due to severe bleeding, which was confirmed by multivariate analysis, as the most important prognostic factor leading to death. A better understanding the pathogenesis of the hemorrhagic complications in APL is needed, as well as the risk factors associated with early death in APL patients, as this has become synonymous with overall mortality.

https://doi.org/10.1016/j.htct.2019.12.001 124 downloads

12.

Individual niche trajectories in nesting green turtles on Rocas Atoll, Brazil: an isotopic tool to assess diet shifts over time
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Agostinho, Karoline Fernanda Ferreira

; Monteiro, Leandro Rabello

; Beneditto, Ana Paula Madeira Di

Biota Neotropica

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2021, Volume 21 N. 1 elocation e20201099

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

Resumo Neste estudo, a análise de isótopos estáveis em múltiplos tecidos (vitelo e carapaça) foi usada para avaliar as trajetórias individuais de nicho isotópico de tartarugas verdes em nidificação no Atol das Rocas, nordeste do Brasil, e para revelar uma mudança de dieta na dimensão temporal. As trajetórias individuais da dieta de tartarugas verdes foram altamente direcionais, com um componente mais forte na direção de valores decrescentes de δ15N da carapaça ao vitelo. Quando as tartarugas verdes estão em seus locais de forrageamento (janela temporal medida pelas amostras de vitelo), elas são mais herbívoras. Por outro lado, em uma janela temporal mais ampla, as tartarugas verdes demonstram uma estratégia carnívora-onívora, representada por valores mais elevados de δ15N na carapaça. Os resultados confirmam uma mudança temporal na dieta. Este é o primeiro estudo que aplica trajetórias de nicho trófico para tartarugas marinhas, adicionando uma nova ferramenta isotópica para entender a ecologia trófica desses animais migrantes.

Abstract In this study, multi-tissue (yolk and carapace) stable isotope analysis was used to assess individual isotopic niche trajectories of nesting green turtles on Rocas Atoll, off northeastern Brazil, and to reveal a diet shift in the temporal dimension. The diet trajectories of individual green turtles were highly directional, with a stronger component towards decreasing values of δ15N from carapace to yolk. When the green turtles are in their foraging sites (temporal window measured by the yolk samples), they are more herbivores. Conversely, in a broader temporal window, the green turtles demonstrate a carnivore-omnivore strategy, such as represented by heavier δ15N values in the carapace. This finding confirms a temporal diet shift. This is the first study that applies trophic niche trajectories for sea turtles, adding a new isotopic tool to understand the trophic ecology of these migrant animals.

https://doi.org/10.1590/1676-0611-bn-2020-1099 711 downloads

13.

Economic evaluations addressing diagnosis and treatment strategies for neglected tropical diseases: an overview
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Assis, Tália Machado de

; Rabello, Ana Cota, Gláucia

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e41

Abstract: En | Text: En | PDF: En

ABSTRACT Neglected tropical diseases (NTDs) are those affecting vulnerable people and causing additional social and economic burden. The aim of this study was to carry out a general overview of the health economic assessments involving the diagnosis and treatment of six NTDs: cutaneous leishmaniasis (CL), Chagas disease, cysticercosis, filariasis, schistosomiasis and visceral leishmaniasis (VL). The literature search was based on two of the main medical literature databases (Medline and SciELO) and identified 46 studies. Twenty-six studies (57%) addressed therapeutic strategies, while other 20 (43%) assessed diagnostic or both diagnostic and therapeutic approaches. The studies were published between 1994 and 2021, and 57% of them (26/46) were carried out in four countries. Cost-effectiveness analyses were conducted in 59% (27/46) of the studies. Economic studies of NTDs have timidly increased in recent years. Despite the improvement of analytical methods, completeness and accuracy of information, there are few new technologies applied to NTDs and public health systems. In addition, economic studies for NTDs are concentrated in a few countries. Thus, this review points out the need for investment in research, development and training of human resources dedicated to the economic analysis in health, especially on NTDs, as a strategy to reduce inequalities by optimizing the use of health resources.

https://doi.org/10.1590/s1678-9946202163041 337 downloads

14.

Mothers of a Child with Cerebral Palsy: Perception on the Diagnosis Moment and the Child’s General and Oral Health
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Rabello, Flavia

; Prado, Heloisa Vieira

; Angelo, Gabriela Lopes

; Martins, Milene Bento

; Carneiro, Natália Cristina Ruy

; Borges-Oliveira, Ana Cristina

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2021, Volume 21 elocation e210007

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To analyze the perception of mothers of children with Cerebral Palsy (CP) on the diagnosis moment and the child’s health. Material and Methods: Research with a qualitative approach, carried out with 19 mothers of children with CP, in a public higher education institution, in the state of Minas Gerais, Brazil. For data collection, the interview was used and for data interpretation, content analysis. Results: Mothers reported that the diagnosis of a child with CP resulted in major changes in the family’s daily life, increasing their responsibility and demands. After the diagnosis, mothers revealed oscillating feelings, with progressively replaced by her motherly ability to take care, reestablishing the psychic balance. The health associated with the absence of disease and curative practices was frequently observed. Mothers reported a great concern with oral hygiene habits and frequent visits to the dentist. Conclusion: The diagnosis of a child with CP led to changes in the family's priorities and routine. After the moment of anguish, uncertainty and fear, the mothers accepted the reality. The biomedical principle significantly influenced the mother´s perception of health, being health perceived as the absence of disease and curative practices. In relation to oral health, practices widely spread and recommended by the media and health services, such as correct tooth brushing, showed an orientation of patients to maintain oral health.

https://doi.org/10.1590/pboci.2021.144 12 downloads

15.

Avaliação da exposição a BTEX em postos de revenda de combustíveis no Rio de Janeiro, Brasil, e os riscos à saúde do trabalhador
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Figueiredo, Victor Oliva

; Carvalho, Leandro Vargas Barreto de

; Borges, Renato Marçullo

; Costa-Amaral, Isabele Campos

; Santos, Marcus Vinicius Corrêa dos

; Rosa, Ana Cristina Simões

; Menezes, Marco Antônio Carneiro de

; Mattos, Rita de Cássia Oliveira da Costa

; Sarcinelli, Paula Novaes

; Alves, Sergio Rabello

; Larentis, Ariane Leites

; Gonçalves, Eline Simões

Cadernos de Saúde Pública

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2021, Volume 37 N. 11 elocation e00351520

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

Gasoline is a complex mixture of substances, including aromatic hydrocarbons such as benzene, toluene, ethylbenzene, and xylenes (BTEX). These compounds are emitted into the air, with the special relevance of benzene since it is provenly carcinogenic. The study aimed to assess BTEX concentrations in filling stations in the city of Rio de Janeiro, Brazil, and to calculate the cancer risk associated with such exposures. Two types of sampling were performed (stationary and mobile), adapted from methodology n. 1,501 (U.S. National Institute for Occupational Safety and Health) for aromatic hydrocarbons, in six filling stations in the West Zone of Rio de Janeiro. Stationary sampling was done near the fuel pumps, while mobile sampling was done in the breathing zone of the workers (station attendants) as they moved around the station. The samples were analyzed with gas chromatography flame ionization detector. The sampling results were used to calculate the health risk, using the indicators Hazard quotient (HQ) and Cancer risk (CR) to assess the possible non-carcinogenic and carcinogenic effects, respectively, in filling station workers. Environmental concentrations for the most of the BTEX compounds were below the recommended limits, except for benzene, a carcinogenic compound, which displayed concentrations far above the limits, leading to high cancer risk values. The results showed that there are health risks for filling station attendants, especially the risk of developing cancer from excessive exposure to benzene.

A gasolina é uma mistura complexa de substâncias, dentre elas estão hidrocarbonetos como o benzeno, tolueno, etilbenzeno e xilenos (BTEX), sendo esses compostos emitidos para a atmosfera, com destaque ao benzeno, por ser comprovadamente carcinogênico. Objetivamos avaliar as concentrações de BTEX no ar de postos de revenda de combustíveis no Município do Rio de Janeiro, Brasil, e calcular o risco de câncer associado a estas exposições. Foram realizados dois tipos de amostragem (fixa e móvel) adaptadas da metodologia nº 1.501 do Instituto Nacional de Segurança e Saúde Ocupacional (Estados Unidos), em seis postos de revenda de combustíveis na Zona Oeste da cidade. A amostragem fixa foi feita próxima às bombas de combustível, enquanto a móvel foi realizada através da coleta do ar na zona respiratória dos trabalhadores (frentistas), conforme estes se deslocavam pelo posto. As amostras foram analisadas por cromatografia gasosa com detecção por ionização em chama. Com os resultados das amostragens foram feitos os cálculos de risco à saúde, usando os indicadores Quociente de perigo (HQ) e Risco de câncer (CR), para avaliar os possíveis efeitos não-carcinogênicos e carcinogênicos, respectivamente, nos trabalhadores dos postos de revenda de combustíveis. As concentrações ambientais para a maioria dos compostos BTEX foram abaixo dos limites preconizados, menos para o benzeno, um composto carcinogênico, que apresentou concentrações muito acima dos limites, levando a altos valores de risco de câncer. Os resultados demonstraram que há riscos à saúde dos trabalhadores de postos de revenda de combustíveis, principalmente o risco de desenvolver câncer, devido à exposição excessiva ao benzeno.

La gasolina es una mezcla compleja de sustancias, entre ellas existen hidrocarburos como el benceno, tolueno, etilbenceno y xilenos (BTEX), emitiéndose estos compuestos a la atmósfera, donde se destaca el benceno, al tratarse de un carcinogénico comprobado. Los objetivos fueron evaluar las concentraciones de BTEX en el aire de puestos de reventa de combustibles, en el municipio de Río de Janeiro, Brasil, así como calcular el riesgo de cáncer asociado a estas exposiciones. Se realizaron dos tipos de muestra (fija y movible), adaptadas de la metodología nº 1.501 del Instituto Nacional de Seguridad y Salud Laboral (EE.UU.), en seis puestos de reventa de combustibles de la zona oeste de la ciudad. La muestra fija se realizó cerca de las bombas de combustible, mientras que la móvil se hizo mediante tomas de aire en la zona respiratoria de los trabajadores (de la gasolinera), a medida que estos se desplazaban por el lugar de trabajo. Las muestras se analizaron por cromatografía gaseosa con detección por ionización en llama. Junto a los resultados de las muestras, se realizaron cálculos de riesgo para la salud, usando los indicadores Cociente de peligro (HQ) y Riesgo de cáncer (CR), con el fin de evaluar los posibles efectos no-carcinogénicos y carcinogénicos, respectivamente, en los trabajadores de los puestos de reventa de combustibles. Las concentraciones ambientales para la mayoría de los compuestos BTEX estuvieron por debajo de los limites preconizados, menos en el caso del benceno, un compuesto carcinogénico, que presentó concentraciones muy por encima de los límites, llevando a altos valores de riesgo de cáncer. Los resultados demostraron que existen riesgos para la salud de los trabajadores de puestos de reventa de combustibles, principalmente, riesgo de desarrollar cáncer, debido a la exposición excesiva al benceno.

https://doi.org/10.1590/0102-311x00351520

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