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au:Raymundo, Carlos Eduardo

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Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
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Traldi, Paula de Carmago

; Magalhães-Barbosa, Maria Clara de

; Raymundo, Carlos Eduardo

; Cunha, Antonio José Ledo Alves da

; Prata-Barbosa, Arnaldo

Jornal de Pediatria

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jul 2022, Volume 98 N. 4 Pages 369 - 375

Abstract: En | Text: En | PDF: En

Abstract Objective: To evaluate the validity of the computerized version of the pediatric triage system CLARIPED. Methods: Prospective, observational study in a tertiary emergency department (ED) from Jan-2018 to Jan-2019. A convenience sample of patients aged 0-18 years who had computerized triage and outcome variables registered. Construct validity was assessed through the association between urgency levels and patient outcomes. Sensitivity, specificity, positive and negative predictive values (PPVand NPV), undertriage, and overtriage rates were assessed. Results: 19,122 of 38,321 visits were analyzed. The urgency levels were: RED (emergency) 0.02%, ORANGE (high urgency) 3.21%, YELLOW (urgency) 35.69%, GREEN (low urgency) 58.46%, and BLUE (no urgency) 2.62%. The following outcomes increased according to the increase in the level of urgency: hospital admission (0.4%, 0.6%, 3.1%, 11.9% and 25%), stay in the ED observation room (2.8%, 4.7%, 15.9%, 40.4%, 50%), ≥ 2 diagnostic or therapeutic resources (7.8%, 16.5%, 33.7%, 60.6%, 75%), and ED length of stay in minutes (18, 24, 67,120, 260). The odds of using ≥ 2 resources or being hospitalized were significantly greater in the most urgent patients (Red, Orange, and Yellow) compared to the least urgent (Green and Blue): OR 7.88 (95%CI: 5.35-11.6) and OR 2.85 (95%CI: 2.63-3.09), respectively. The sensitivity to identify urgency was 0.82 (95%CI: 0.77-0.85); specificity, 0.62 (95%CI: 0.61-0.6; NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 4.28% and undertriage, 18.41%. Conclusion: The computerized version of CLARIPED is a valid and safe pediatric triage system, with a significant correlation with clinical outcomes, good sensitivity, and low undertriage rate.

https://doi.org/10.1016/j.jped.2021.08.004

Improvement of 1st-hour bundle compliance and sepsis mortality in pediatrics after the implementation of the surviving sepsis campaign guidelines
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Rodrigues-Santos, Gustavo

; Magalhães-Barbosa, Maria Clara de

; Raymundo, Carlos Eduardo

; Lima-Setta, Fernanda

; Cunha, Antonio José Ledo Alves da

; Prata-Barbosa, Arnaldo

Jornal de Pediatria

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aug 2021, Volume 97 N. 4 Pages 459 - 467

Abstract: En | Text: En | PDF: En

Abstract Objectives To study the impact of the implementation of the Pediatric Surviving Sepsis Campaign protocol on early recognition of sepsis, 1 -h treatment bundle and mortality. Methods Retrospective, single-center study, before and after the implementation of the sepsis protocol. Outcomes: sepsis recognition, compliance with the 1 -h bundle (fluid resuscitation, blood culture, antibiotics), time interval to fluid resuscitation and antibiotics administration, and mortality. Patients with febrile neutropenia were excluded. The comparisons between the periods were performed using non-parametric tests and odds ratios or relative risk were calculated. Results We studied 84 patients before and 103 after the protocol implementation. There was an increase in sepsis recognition (OR 21.5 [95% CI: 10.1-45.7]), in the compliance with the 1 -h bundle as a whole (62% x 0%), and with its three components: fluid resuscitation (OR 31.1 [95% CI: 3.9−247.2]), blood culture (OR 15.9 [95% CI: 3.9−65.2]), and antibiotics (OR 35.6 [95% CI: 8.9−143.2]). Significant reduction between sepsis recognition to fluid resuscitation (152min × 12min, p < 0.001) and to antibiotics administration (137min × 30min) also occurred. The risk of death before protocol implementation was four times greater (RR 4.1 [95% CI: 1.2-14.4]), and the absolute death risk reduction was 9%. Conclusion Even if we considered the low precision of some estimates, the lower limits of the Confidence Intervals show that the implementation of the Pediatric Surviving Sepsis Campaign guidelines alongside a qualitive assurance initiative has led to improvements in sepsis recognition, compliance with the 1 -h treatment bundle, reduction in the time interval to fluid resuscitation and antibiotics, and reduction in sepsis mortality.

https://doi.org/10.1016/j.jped.2020.09.005

Diabetes and hypertension are associated with lowered cognitive performance among middle-aged Brazilian adults: cross-sectional analyses nested in the longitudinal Pró-Saúde study
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Passos, Valéria Maria de Azeredo

; Raymundo, Carlos Eduardo

; Bezerra, Flávia Fioruci

; Faerstein, Eduardo

Sao Paulo Medical Journal

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feb 2021, Volume 139 N. 1 Pages 46 - 52

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Cardiovascular risk factors are frequently associated with lowered cognitive performance among elderly people, but rarely among middle-aged adults. OBJECTIVES: To investigate associations between cardiovascular risk factors (age, physical inactivity, smoking, alcohol use, hypertension and diabetes) and lower cognitive performance among middle-aged (45-64 years) Brazilian adults. DESIGN AND SETTING: Cross-sectional study nested within the Pró-Saúde cohort. From 2,876 baseline study participants (1999), we randomly selected 488 participants and gave them validated and standardized cognitive tests (2012). METHODS: We used multiple linear and logistic regression analyses to detect associations of cardiovascular risk factors with crude scores in cognitive tests on memory (word test) and executive function (verbal fluency tests), and with overall cognitive performance scores, respectively. RESULTS: All cognitive test scores presented statistically significant inverse associations with age and direct associations with education. There was no association between lower cognitive performance and smoking or alcohol use. In both 1999 and 2012, after adjusting for sex, age and schooling, being physically active was inversely associated with lower performance regarding late memory. For individuals with diabetes in 1999, there was an association with lower performance regarding executive function, while there was a borderline association for those reporting it only in 2012. Having a diagnosis of hypertension since 1999 was associated with lower performance regarding both memory and executive functions, while reporting hypertension in 2012 was associated with lower performance regarding executive function. CONCLUSIONS: Aging, low schooling and cardiovascular risk factors may represent life course disadvantages associated with cognitive decline even among middle-aged Brazilian adults.

https://doi.org/10.1590/1516-3180.2020.0269.r1.30102020

Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study,
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Prata-Barbosa, Arnaldo

; Lima-Setta, Fernanda

; Santos, Gustavo Rodrigues dos

; Lanziotti, Vanessa Soares

; Castro, Roberta Esteves Vieira de

; Souza, Daniela Carla de

; Raymundo, Carlos Eduardo

; Oliveira, Felipe Rezende Caino de

; Lima, Lucio Flavio Peixoto de

; Tonial, Cristian Tedesco

; Colleti Jr., José

; Bellinat, Ana Paula Novaes

; Lorenzo, Vivian Botelho

; Zeitel, Raquel de Seixas

; Pulcheri, Lucas

; Costa, Fernanda Ciuffo Monte da

; La Torre, Fabíola Peixoto Ferreira

; Figueiredo, Elaine Augusta das Neves

; Silva, Thiago Peres da

; Riveiro, Paula Marins

; Mota, Isabele Coelho Fonseca da

; Brandão, Igor Bromonschenkel

; Azevedo, Zina Maria Almeida de

; Gregory, Simone Camera

; Boedo, Fernanda Raquel Oliveira

; Carvalho, Rosana Novais de

; Castro, Natália Almeida de Arnaldo Silva Rodriguez

; Genu, Daniel Hilário Santos

; Foronda, Flavia Andrea Krepel

; Cunha, Antonio José Ledo A.

; Magalhães-Barbosa, Maria Clara de

Jornal de Pediatria

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dec 2020, Volume 96 N. 5 Pages 582 - 592

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

Abstract Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID-19. Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March-May 2020) were included. Demographic, clinical-epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A multivariable logistic regression model was used for predictors of severity. Results: Seventy-nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length-of-stay was five days; there were two deaths (3%) in the non- multisystemic inflammatory syndrome group. Patients with comorbidities were older and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43-21.12; p = 0.01). Conclusions: In Brazilian pediatric intensive care units, COVID-19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of males, but only comorbidities and chronic diseases were independent predictors of severity.

Resumo Objetivo: Descrever as características clínicas de crianças e adolescentes internados em unidade de terapia intensiva com COVID-19 confirmada. Método: Estudo prospectivo, multicêntrico, observacional, em 19 unidades de terapia intensiva pediátrica. Foram incluídos pacientes entre um mês e 19 anos, admitidos consecutivamente (março a maio de 2020). As características demográficas, clínico-epidemiológicas, o tratamento e os resultados foram coletados. Os subgrupos foram comparados de acordo com as comorbidades, idade < 1 ano e necessidade de ventilação mecânica invasiva. Um modelo de regressão logística multivariável foi utilizado para preditores de gravidade. Resultados: Setenta e nove pacientes foram incluídos (10 com síndrome inflamatória multi-ssistêmica). Mediana de idade, quatro anos; 54% eram do sexo masculino (síndrome inflamatória multissistêmica, 80%); 41% tinham comorbidades (síndrome inflamatória multissistêmica, 20%). Febre (76%), tosse (51%) e taquipneia (50%) foram comuns nos dois grupos. Sintomas graves egastrointestinais e marcadores inflamatórios mais elevados foram mais frequentes na presença de síndrome inflamatória multissistêmica. Infiltrados intersticiais pulmonares foram comuns em ambos os grupos, mas o derrame pleural foi mais prevalente no grupo com síndrome inflamatória multissistêmica (43% vs. 14%). A ventilação mecânica invasiva foi utilizada em 18% (mediana 7,5 dias); antibióticos, oseltamivir e corticosteroides foram utilizados em 76%, 43% e 23%, respectivamente, mas não a hidroxicloroquina. A mediana do tempo de permanência na unidade de terapia intensiva pediátrica foi de 5 dias; duas mortes ocorreram (3%) no grupo não- síndrome inflamatória multissistêmica. Os pacientes com comorbidades eram mais velhos, e as comorbidades foram independentemente associadas à necessidade de ventilação mecânica invasiva(OR 5,5; IC95%, 1,43-21,12; P 0,01). Conclusões: Nas unidades de terapia intensiva pediátrica brasileiras, a COVID-19 apresentou baixa mortalidade, a idade inferior a um ano não foi associada a um pior prognóstico, os pacientes com síndrome inflamatória multissistêmica apresentaram sintomas mais graves, biomarcadores inflamatórios mais elevados e uma grande predominância no sexo masculino, mas apenas a presença de comorbidades e doenças crônicas foi um preditor independente de gravidade.

https://doi.org/10.1016/j.jped.2020.07.002

VALIDADE E CONFIABILIDADE DE UM NOVO SISTEMA DE CLASSIFICAÇÃO DE RISCO PARA EMERGÊNCIAS PEDIÁTRICAS: CLARIPED
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Magalhães-Barbosa, Maria Clara de

; Prata-Barbosa, Arnaldo

; Raymundo, Carlos Eduardo

; Cunha, Antonio José Ledo Alves da

; Lopes, Claudia de Souza

Revista Paulista de Pediatria

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dec 2018, Volume 36 N. 4 Pages 398 - 406

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

ABSTRACT Objective: To assess the validity and reliability of a triage system for pediatric emergency care (CLARIPED) developed in Brazil. Methods: Validity phase: prospective observational study with children aged 0 to 15 years who consecutively visited the pediatric emergency department (ED) of a tertiary hospital from July 2 to 18, 2013. We evaluated the association of urgency levels with clinical outcomes (resource utilization, ED admission rate, hospitalization rate, and ED length of stay); and compared the CLARIPED performance to a reference standard. Inter-rater reliability phase: a convenience sample of patients who visited the pediatric ED between April and July 2013 was consecutively and independently double triaged by two nurses, and the quadratic weighted kappa was estimated. Results: In the validity phase, the distribution of urgency levels in 1,416 visits was the following: 0.0% red (emergency); 5.9% orange (high urgency); 40.5% yellow (urgency); 50.6% green (low urgency); and 3.0% blue (no urgency). The percentage of patients who used two or more resources decreased from the orange level to the yellow, green, and blue levels (81%, 49%, 22%, and 2%, respectively, p<0.0001), as did the ED admission rate, ED length of stay, and hospitalization rate. The sensitivity to identify patients with high urgency level was 0.89 (confidence interval of 95% [95%CI] 0.78-0.95), and the undertriage rate was 7.4%. The inter-rater reliability in 191patients classified by two nurses was substantial (kw2=0.75; 95%CI 0.74-0.79). Conclusions: The CLARIPED system showed good validity and substantial reliability for triage in a pediatric emergency department.

RESUMO Objetivo: Avaliar a validade e a confiabilidade de um sistema de classificação de risco para emergências pediátricas (CLARIPED) desenvolvido no Brasil. Métodos: Fase de validade: estudo observacional prospectivo em crianças de 0 a 15anos atendidas consecutivamente no serviço de emergência pediátrica (SEP) de um hospital terciário entre 2 e 18de julho de 2013. Avaliou-se a associação dos níveis de urgência com desfechos clínicos (utilização de recursos, taxa de admissão no SEP, taxa de hospitalização e tempo de permanência no SEP); e comparou-se o desempenho do CLARIPED com um padrão de referência. Fase de confiabilidade interobservadores: uma amostra de conveniência de pacientes atendidos entre abril e julho de 2013 foi submetida a duas classificações de risco consecutivas e independentes, e estimou-se o Kappa ponderado quadrático. Resultados: Em 1.416 atendimentos realizados na fase de validade, a distribuição de níveis de urgência foi: 0,0% vermelho/emergência; 5,9% laranja/muito urgente; 40,5% amarelo/urgente; 50,6% verde/pouco urgente; e 3,0% azul/sem urgência. Ospercentuais de pacientes que usaram dois ou mais recursos diminuíram do nível laranja para o amarelo, verde e azul (81, 49, 22 e 2%, respectivamente, p<0,0001), assim como a taxa de admissão no SEP, o tempo de permanência no SEP e a taxa de admissão hospitalar. Asensibilidade para discriminar pacientes muito urgentes foi de 0,89 (intervalo de confiança de 95%- IC95% 0,78-0,95), e a taxa de subtriagem foi de 7,4%. Aconfiabilidade interobservadores em 191 pacientes classificados por duas enfermeiras foi substancial (kw2=0,75; IC95% 0,74-0,79). Conclusões: O sistema CLARIPED mostrou boa validade e substancial confiabilidade para classificação de risco em um serviço de emergência pediátrica.

https://doi.org/10.1590/1984-0462/;2018;36;4;00017 2164 downloads

Viral detection profile in children with severe acute respiratory infection
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Canela, Luciana Nascimento Pinto

; Magalhães-Barbosa, Maria Clara de

; Raymundo, Carlos Eduardo

; Carney, Sharon

; Siqueira, Marilda Mendonca

; Prata-Barbosa, Arnaldo

; Cunha, Antonio José Ledo Alves da

Brazilian Journal of Infectious Diseases

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oct 2018, Volume 22 N. 5 Pages 402 - 411

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: The role of viral co-detection in children with severe acute respiratory infection is not clear. We described the viral detection profile and its association with clinical characteristics in children admitted to the Pediatric Intensive Care Unit (PICU) during the 2009 influenza A(H1N1) pandemic. Method: Longitudinal observational retrospective study, with patients aged 0–18 years, admitted to 11 PICUs in Rio de Janeiro, with suspected H1N1 infection, from June to November, 2009. The results of respiratory samples which were sent to the Laboratory of Fiocruz/RJ and clinical data extracted from specific forms were analyzed. Results: Of 71 samples, 38% tested positive for H1N1 virus. Of the 63 samples tested for other viruses, 58 were positive: influenza H1N1 (43.1% of positive samples), rhinovirus/enterovirus (41.4%), respiratory syncytial vírus (12.1%), human metapneumovirus (12.1%), adenovirus (6.9%), and bocavirus (3.5%). Viral codetection occured in 22.4% of the cases. H1N1-positive patients were of a higher median age, had higher frequency of fever, cough and tachypnea, and decreased leukometry when compared to H1N1-negative patients. There was no difference in relation to severity outcomes (number of organic dysfunctions, use of mechanical ventilation or amines, hospital/PICU length of stay or death). Comparing the groups with mono-detection and co-dection of any virus, no difference was found regarding the association with any clinical variable. Conclusions: Other viruses can be implicated in SARI in children. The role of viral codetection has not yet been completely elucidated.

https://doi.org/10.1016/j.bjid.2018.09.001 818 downloads

Efecto in vitro en la inhibición del proceso de nucleación en litiasis renal, capacidad de captura de radicales libres, actividad antimicrobiana y tóxica del extracto metanólico de Berberis trifoliata
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Pérez Hernández, Raymundo Alejandro

; Leos Rivas, Catalina

; Oranday Cárdenas, Azucena

; Hernández Luna, Carlos Eduardo

; Sánchez García, Eduardo

; Rivas Morales, Catalina

Revista mexicana de ciencias farmacéuticas

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mar 2015, Volume 46 N. 1 Pages 70 - 76

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

Abstract: In vitro antiurolithic, antimicrobial and free radicals scavenger activities, toxicity, and phytochemical composition of methanolic extract of aerial parts of Berberis trifoliata was evaluated. The studied extract inhibits up to a 93 ± 0.01 % the nucleation of crystals of calcium oxalate at a concentration of 1000 μg/mL and have free radical scavenging activity with a CE50 = 12.84 μg/mL. The extract did not exhibit antimicrobial activity against isolated clinical bacteria that causes urinary infections. In terms of toxicity against Artemia salina, the extract showed a medium lethal concentration value of 925 μ g/mL. It has a diversity of compounds and functional groups like carbohydrates, coumarins, double bonds, flavonoids, carboxyl group, sesquiterpenlactones, alkaloids and tannins.

Resumen: Se evaluaron mediante técnicas in vitro las actividades antiurolítica, antimicrobiana, capacidad de captura de radicales libres, toxicidad y composición fitoquímica del extracto metanólico de las partes aéreas de Berberis trifoliata. El extracto en estudio inhibió en un 93 ± 0.01 % la nucleación de cristales de oxalato de calcio a una concentración de 1000 μg/mL, exhibió capacidad de captura de radicales libres con una CE50 de 12.84 μg/mL. El extracto no presentó actividad antimicrobiana frente a aislados clínicos responsables de infecciones en tracto urinario y se obtuvo mediante el ensayo de Artemia salina una CL50 de 925 μg/mL. En cuanto a su composición fitoquímica se determinó la presencia de compuestos y grupos funcionales tales como: carbohidratos, cumarinas, dobles enlaces, flavonoides, grupos carboxilo, sesquiterpenlactonas, alcaloides y taninos.

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Factores socieconómicos y parasitológicos que limitan la producción del cacao en Chiapas, México
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Hernández-Gómez, Elizabeth

; Hernández-Morales, Javier

; Avendaño-Arrazate, Carlos Hugo

; López-Guillen, Guillermo

; Garrido-Ramírez, Eduardo Raymundo

; Romero-Nápoles, Jesús

; Nava-Díaz, Cristian

Revista mexicana de fitopatología

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2015, Volume 33 N. 2 Pages 232 - 246

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

The main goal of this research was to identify the socioeconomic and parasitological factors that limit cocoa production in Chiapas, Mexico. One hundred and nine cacao-growers were visited and interviewed in the two main cocoa-producing regions. According to results only 14.7 % farmers grow white-almond cacao. The average production unit is 2.6 hectares. Cacao growers are 59 years-old on average and 56 % of them did not finish elementary school. Only 19.3 % of the production units are under woman responsibility. Average yield is 118 kg ha-1 and 60.5 % growers sell cacao to intermediaries. Pests that affect the crop and their occurrence include Moniliophthora roreri(100 %), Phytophthora capsici(67%), Fusariumsp. (10.1 %), Colletotrichum gloeosporioides(3.7 %), Ceratocystis cacaofunesta(0.9 %), Atta sp. (33.9 %), Toxoptera aurantii (11 %), squirrels (7.3 %), Xyleborus ferrugineus, Xylosandrus morigerus, Hypothenemus birmanus, Corthylus minutissimus, Taurodermus sharpi, Hypothenemus interstitialis(5.5 %), Vanduzea segmentata(5.5 %), woodpecker (4.6 %), Selenothrips rubrocintus (3.7 %), Clastoptera laenata (3.7 %) and mole (3.7 %). Moniliophthora is the main factor that affects cacao survival and biodiversity in Chiapas. The disease destroys production, makes control uneconomical and causes growers to abandon their plantations.

El objetivo de la investigación fue identificar los factores socioeconómicos y parasitológicos que limitan la producción del cacao en Chiapas, México. Se llevaron a cabo encuestas y visitas a 109 productores de las dos principales regiones productoras. Entre los resultados más importantes se registró que solamente el 14.7 % de los productores cultiva cacao de almendra blanca. La unidad de producción promedio es de 2.6 ha. Los productores tienen una edad promedio de 59 años y el 56 % de ellos no completó su instrucción primaria. Sólo el 19.3 % de las unidades productivas está bajo la responsabilidad de mujeres. El rendimiento promedio es de 118 kg ha-1 y el 60.5 % de los productores vende el cacao a intermediarios. Las plagas que afectan al cultivo y su frecuencia son: Moniliophthora roreri(100 %), Phytophthora capsici(67 %), Fusariumsp. (10.1 %), Colletotrichum gloeosporioides(3.7 %), Ceratocystis cacaofunesta(0.9 %), Atta sp. (33.9 %), Toxoptera aurantii (11 %), ardillas (7.3 %), Xyleborus ferrugineus, Xylosandrus morigerus, Hypothenemus birmanus, Corthylus minutissimus, Taurodermus sharpi, Hypothenemus interstitialis(5.5 %), Vanduzea segmentata(5.5 %), pájaro carpintero (4.6 %), Selenothrips rubrocintus (3.7 %), Clastoptera laenata (3.7 %) y tuzas (3.7 %). Moniliophthora es el principal factor que afecta la supervivencia del cacao y su biodiversidad en Chiapas. Esta enfermedad destruye la producción, hace su control no rentable e induce a los agricultores a abandonar sus huertas.

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Ocorrência de anticorpos contra o vírus Maedi-Visna em ovinos Santa Inês, no Estado de Sergipe, Brasil
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Mendonça, Carlos Eduardo D'Alencar

; Barros, Sílvia Letícia Bomfim

; Mendonça, Marcus Aurélio D'Alencar

; Guimarães, Vitor Andrade Accioly

; Pinheiro, Raymundo Rizaldo

Arquivos do Instituto Biológico

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sep 2013, Volume 80 N. 3 Pages 346 - 351

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

Small Ruminant Lentiviruses (SRLV) are infectious diseases of viral etiology caused by retroviruses, characterized for being a slowly progressive degenerative disease. The aim of this study was to determine the occcurrence of antibodies against lentivirus in the flock of Santa Inês sheep in Sergipe, Brazil. A minimum number of samples was analyzed by the Astudillo calculation, with an expected prevalence (p) of 10%, error rate (α) of 20% and confidence level of 95% (g = 1.96) obtaining the minimum number of samples (n) of 861. Finally, 941 serum samples were collected, derived from 54 properties and 19 municipalities distributed in three regions of the State, and the number of collected samples was proportional to the sheep flock of each municipality. The serum was placed at -20°C until the Agar Gel Immunodiffusion test (AGID), and results considered as positive or suspicious in AGID were assessed by the Western blotting technique. Out of sampled animals, 194 (20.62%) were male and 747 (79.38%) were female. From the stratification by age, 300 were young sheep (31.88%), aged between six months and one year old, 308 (32.73%) were young adults, aged between 1 and 3 years old, and 333 (35.39%) were estimated to be older than three years old. Results showed that antibodies against the Maedi-Visna virus in the sheep flock occcurred in the State of Sergipe at low frequency (0.11%). Thus, the occcurrence of Maedi-Visna infection in sheep in the State of Sergipe is reported, and emphasizes the participation of the transit of animals in the epidemiology of the disease.

As Lentiviroses de Pequenos Ruminantes (LVPR) são enfermidades infecciosas de etiologia viral causadas por retrovírus, caracterizadas por uma doença de degeneração progressiva e lenta. O objetivo deste estudo foi determinar a ocorrência de anticorpos contra o lentivírus no rebanho ovino Santa Inês, de Sergipe. Para analisar o número mínimo de amostras utilizou-se o cálculo de Astudillo, com prevalência esperada (p) de 10%, margem de erro (α) de 20% e grau de confiança de 95% (g = 1,96), obtendo-se o número mínimo de amostras (n) de 861. Foram colhidas 941 amostras de soro ovino oriundas de 54 propriedades e 19 municípios distribuídos nas três mesorregiões do Estado, sendo o número de amostras proporcional ao efetivo ovino do município. O soro foi acondicionado a -20°C até a realização do teste de Imunodifusão em Gel de Ágar (IDGA). Os resultados considerados positivos ou suspeitos na IDGA foram reavaliados através da técnica de Western blotting. Dos animais amostrados, 194 (20,62%) eram machos e 747 (79,38%) eram fêmeas. Quanto à estratificação por idade, 300 ovinos eram jovens (31,88%), entre seis meses e um ano, 308 (32,73%) eram jovens adultos, entre 1 e 3 anos, e 333 (35,39%) tinham idade estimada superior a 3 anos. Os resultados obtidos demonstraram que anticorpos contra o vírus Maedi-Visna (MVV) ocorrem no rebanho ovino do estado de Sergipe em baixa frequência (0,11%). Assim, relata-se a ocorrência da infecção por Maedi-Visna em ovinos no estado de Sergipe e ressalta-se a participação do trânsito de animais na epidemiologia da doença.

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10.

Morbidade materna extremamente grave a partir dos registros de internação hospitalar do Sistema Único de Saúde: algoritmo para identificação dos casos
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Magalhães, Maria da Consolação

; Raymundo, Carlos Eduardo

; Bustamante-Teixeira, Maria Teresa

Revista Brasileira de Saúde Materno Infantil

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mar 2013, Volume 13 N. 1 Pages 17 - 22

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

OBJECTIVES: to identify codes for constant procedures in the Brazilian National Health System's Hospital Information System (SIH-SUS) deemed to be cases of Extremely Severe Maternal Morbidity (MMEG) and to develop an algorithm to manage/prepare an AIH database, with a view to identifying cases of MMEG in this database. METHODS: the data used were from the SIH-SUS supplied by the Juiz de Fora Health Secretary and refer to admissions to SUS hospitals between 2006 and 2007. The study covered all admissions where the principal diagnosis involved all of Chapter XV of CID10 - complications of pregnancy, miscarriage, delivery and puerperium and/or admissions to hospital involving obstetric procedures. For identification of SIH-SUS procedures deemed to be MMEG, the criteria proposed by the WHO were used. The algorithm was developed using Microsoft Access. RESULTS: 326 cases of MMEG were found among the 8620 women selected, constituting a rate of 37. 8/1000 women. The most frequent procedures were transfusion of blood products, "a longer stay" and severe pre-eclampsia/eclampsia, with a prevalence of 15. 7/1000, 9. 5/1000 and 8. 2/1000, respectively. CONCLUSIONS: the algorithm used may optimize the use of the SIH-SUS for identifying cases of MMEG and generating information for maternal morbidity and mortality surveillance services and the evaluation of obstetric care.

OBJETIVOS: identificar os códigos de procedimentos constantes no Sistema de Informação Hospitalar - Sistema Único de Saúde (SIH-SUS) considerados como Morbidade Materna Extremamente Grave (MMEG) e construir um algoritmo para o manejo/preparação da base de dados de Autorização de Internação Hospitalar visando a captura dos casos de MMEG neste banco de dados. MÉTODOS: utilizaram-se os dados do SIH-SUS fornecidos pela Secretaria de Saúde de Juiz de Fora e referem se as internações ocorridas no SUS no período de 2006-2007. Foram selecionadas todas as internações cujo diagnóstico principal compreendia todo o capítulo XV da Classificação Internacional de Doenças (CID10) - Complicações da gravidez, aborto, parto e puerpério e/ou internações em que procedimentos obstétricos foram realizados. Para identificação dos procedimentos no SIH-SUS, considerados como MMEG, adotaram-se os critérios propostos pela Organização Mundial da Saúde. O algoritmo foi desenvolvido no software Microsoft Access. RESULTADOS: foram capturados 326 casos de MMEG entre as 8620 mulheres selecionadas, perfazendo uma taxa de 37,8/1000 mulheres. Os procedimentos mais frequentes foram transfusão de hemoderivados, "permanência a maior" e pré-eclampsia grave/eclâmpsia, com prevalências de 15,7/1000, 9,5/1000 e 8,2/1000, respectivamente. CONCLUSÕES: o algoritmo utilizado pode otimizar o uso do SIH-SUS para a captação dos casos de MMEG e gerar informações para os serviços de vigilância da morbimortalidade materna e avaliação de cuidados obstétricos.

https://doi.org/10.1590/S1519-38292013000100002 3881 downloads

11.

Hepatite aguda criptogênica: uma entidade heterogênea com possibilidades de complicações
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Codes, Liana

; Schinoni, Maria Isabel

; Freitas, Luiz Antonio Rodrigues

; Rolim, Carlos Eduardo

; Matos, Ludmilla

; Matteoni, Luciana

; Andrade, Zilton

; Paraná, Raymundo

Jornal Brasileiro de Patologia e Medicina Laboratorial

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aug 2006, Volume 42 N. 4 Pages 293 - 298

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

Acute or chronic hepatitis with no defined causes constitute a problem for clinical and gastroenterologists. In spite of sophisticated tests, a substantial proportion of hepatitis remains with no certain cause. They are cryptogenic hepatitis or hepatitis no A-E. Possible aetiologies are suggested: unknown virus, metabolic diseases or auto-immune hepatitis with atypical presentation. Recently, our group demonstrated that, in a reference center for hepatic diseases in Brazil, 17% of cases of acute hepatitis are cryptogenic, with some aspects suggesting viral aetiology. We described four clinical cases of acute cryptogenic hepatitis, demonstrating the heterogeneity of this condition that may be associated with possible complications. This justifies a careful epidemiological and laboratorial investigation, as well as a follow-up of those patients.

Hepatites agudas ou crônicas de causas não definidas constituem um problema na prática de médicos clínicos e gastroenterologistas. Apesar do desenvolvimento de sofisticados testes laboratoriais, uma proporção significativa das hepatites ainda permanece com causa não-determinada. São as chamadas hepatites criptogênicas ou hepatites não A-E. Possíveis etiologias são sugeridas: vírus desconhecido, doenças metabólicas ou hepatite auto-imune de apresentação atípica. Recentemente, nosso grupo demonstrou que, num centro de referência no Brasil, 17% dos casos de hepatites agudas são criptogênicos, com alguns aspectos sugerindo etiologia viral. Nós relatamos quatro casos de hepatite aguda criptogênica, demonstrando a heterogeneidade dessa condição clínica associada à possibilidade de complicações, o que justifica uma criteriosa investigação epidemiológica, clínica e laboratorial, assim como o acompanhamento desses pacientes.

https://doi.org/10.1590/S1676-24442006000400011 12390 downloads Cited 1 time in SciELO

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