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Abstract: Brazil has the second largest number of leprosy cases (a disease with a significant burden) in the world. Despite global and local efforts to eliminate this public health problem, inadequate or late diagnosis contribute to perpetuate its transmission, especially among household contacts. Tests such as the rapid IgM antibody detection (RT) and real-time polymerase chain reaction (RT-PCR) were developed to overcome the challenges of early diagnosis of leprosy. This study aimed to analyze the cost-effectiveness of a new diagnostic algorithm recommended by the Brazilian government to diagnose leprosy in household contacts of confirmed leprosy cases, which includes the RT and RT-PCR tests. A decision tree model was constructed and the perspective of the Brazilian Unified National Health System (SUS) and a 1-year time horizon were adopted. Only direct medical costs related to diagnostic tests were included. Effectiveness was measured as the number of avoided undiagnosed leprosy cases. Different scenarios were analyzed. The sequential use of RT, slit-skin smear (SSS) microscopy, and RT-PCR as recommended by the Brazilian Ministry of Health was compared to a base case (isolated SSS microscopy), yielding an incremental cost-effectiveness ratio of USD 616.46 per avoided undiagnosed leprosy case. Univariate sensitivity analysis showed that the prevalence of leprosy among household contacts was the variable that influenced the model the most. This is the first economic model to analyze a diagnostic algorithm of leprosy. Results may aid managers to define policies and strategies to eradicate leprosy in Brazil.

Resumen: Brasil tiene el segundo mayor número de casos de lepra (enfermedad con carga significativa) del mundo. A pesar de los esfuerzos globales y locales para eliminar ese problema de salud pública, el diagnóstico inadecuado o tardío contribuye a perpetuar su transmisión, sobre todo entre contactos intradomiciliarios. Los exámenes como la prueba rápida de anticuerpos IgM (RT) y la reacción en cadena de la polimerasa en tiempo real (RT-PCR) se desarrollaron para superar las barreras del diagnóstico precoz de la lepra. El objetivo de este estudio fue analizar la relación de costo-efectividad de un nuevo algoritmo de diagnóstico recomendado por el gobierno brasileño para diagnosticar la lepra en contactos domiciliarios de casos confirmados de lepra, que incluye las pruebas RT y RT-PCR. Se construyó un modelo de árbol de decisión y se adoptó la perspectiva del Sistema Único de Salud (SUS) teniendo en cuenta el periodo de un año. Solo se incluyeron los costos médicos directos relacionados con los exámenes diagnósticos. Se midió la efectividad teniendo en cuenta el número de casos de lepra evitados. Se analizaron distintos escenarios. Se comparó el uso secuencial de RT, baciloscopia y RT-PCR, conforme el Ministerio de Salud recomienda, con un caso base (baciloscopia aislada), y se obtuvo un cociente de costo-efectividad incremental de USD 616,46 por cada caso de lepra evitado. El análisis de sensibilidad univariante mostró que la prevalencia de lepra entre contactos intradomiciliarios fue la variable que más influyó el modelo. Este es el primer modelo económico que analiza un algoritmo diagnóstico de lepra. Los resultados podrán ayudar los gestores a definir políticas y estrategias para erradicar la lepra en Brasil.

Resumo: O Brasil tem o segundo maior número de casos de hanseníase (doença com carga significativa) do mundo. Apesar dos esforços globais e locais para eliminar esse problema de saúde pública, o diagnóstico inadequado ou tardio contribui para perpetuar sua transmissão, especialmente entre contatos intradomiciliares. Exames como o teste rápido de anticorpos IgM (RT) e a reação em cadeia da polimerase em tempo real (RT-PCR) foram desenvolvidos para superar as barreiras do diagnóstico precoce da hanseníase. Este estudo teve como objetivo analisar a relação custo-efetividade de um novo algoritmo de diagnóstico recomendado pelo governo brasileiro para diagnosticar a hanseníase em contatos domiciliares de casos confirmados de hanseníase, que inclui os testes RT e RT-PCR. Foi construído um modelo de árvore de decisão e adotada a perspectiva do Sistema Único de Saúde (SUS) considerando o período de um ano. Foram incluídos apenas os custos médicos diretos relacionados aos exames diagnósticos. A efetividade foi medida considerando o número de casos evitados de hanseníase. Diferentes cenários foram analisados. O uso sequencial de RT, baciloscopia e RT-PCR, conforme recomendado pelo Ministério da Saúde, foi comparado a um caso base (baciloscopia isolada), obtendo-se uma razão de custo-efetividade incremental de USD 616,46 por caso evitado de hanseníase. A análise de sensibilidade univariada mostrou que a prevalência de hanseníase entre contatos intradomiciliares foi a variável que mais influenciou o modelo. Este é o primeiro modelo econômico a analisar um algoritmo diagnóstico da hanseníase. Os resultados poderão auxiliar os gestores na definição de políticas e estratégias para a erradicação da hanseníase no Brasil.

https://doi.org/10.1590/0102-311xen038723

A cost-effectiveness analysis of a novel algorithm to sequentially diagnose leprosy based on manufactured tests under the SUS perspective
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Costa, Milene Rangel da

; Magliano, Carlos Alberto da Silva

; Barros, Bruno Monteiro

; Morais, Quenia Cristina Dias

; Braga, Andressa Araujo

; Senna, Kátia Marie Simões e

; Gomes, Ciro Martins

; Macedo, Alexandre Casimiro de

; Santos, Marisa da Silva

Cadernos de Saúde Pública

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2024, Volume 40 N. 1 elocation e00038723

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

https://doi.org/10.1590/0102-311xen038723

Autorização para uso off-label pode ser benéfica para o Sistema Único de Saúde?
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Santos, Marisa da Silva

; Costa, Márcia Gisele Santos da

; Tura, Bernardo Rangel

; Torres, Priscila

; Martins, Sandro José

; Toscas, Fotini Santos

Cadernos de Saúde Pública

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2023, Volume 39 N. 6 elocation e00032623

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/0102-311xpt032623

Depressão, ansiedade, estresse e apoio social: estudo transversal com cuidadores de crianças com deficiência visual no Rio de Janeiro, Brasil - Views-QoL Study
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Moreira, Martha Cristina Nunes

; Steffen, Ricardo Ewbanck

; Zin, Andrea Araujo

; Santos, Marisa da Silva

; Costa, Ana Carolina Carioca da

; Campos, Daniel de Souza

; Barros, Letícia Baptista de Paula

; Moreira, Maria Elisabeth Lopes

; Mendes, Corina Helena Figueira

; Kuper, Hannah

; Pinto, Márcia

Cadernos de Saúde Pública

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2023, Volume 39 N. 11 elocation e00247622

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

Resumen: El objetivo fue identificar los relatos de síntomas de depresión, ansiedad y estrés entre cuidadores de niños sin discapacidad visual, con baja visión y con ceguera y su relación con el grado de apoyo social, emocional, material y afectivo. Estudio transversal y multicéntrico realizado en la ciudad de Río de Janeiro, Brasil, entre el 2019 y el 2020. Se aplicó un cuestionario para obtener datos sociodemográficos y económicos del cuidador. Se utilizaron la Escala de Apoyo Social (The Medical Outcomes Study Social Support Scale - MOS-SSS) y Escala de Depresión, Ansiedad y Estrés (The Depression, Anxiety, and Stress Scale - DASS-21). Al comparar las escalas, se utilizaron pruebas para comparaciones múltiples. Se estimó la razón de prevalencia de síntomas de depresión, ansiedad y estrés. Del total de cuidadores (N = 355), más del 90% eran mujeres madres y la mayor proporción de cuidadores sin escolaridad o con primaria incompleta y con menor ingreso mensual promedio fueron los de niños con discapacidad visual. La mayoría de los cuidadores de niños con ceguera reportó síntomas de depresión, ansiedad y estrés, respectivamente, 66,7%, 73,3% y 80%, mismo comportamiento observado en el grupo de cuidadores de niños con baja visión. Al evaluar la relación entre los resultados de las escalas MOS-SSS y DASS-21, entre los cuidadores de niños sin discapacidad o con menor compromiso visual, se observó mayor apoyo y menores puntajes de relatos de depresión, ansiedad y estrés. Entre los cuidadores de niños ciegos, la mayor prevalencia de tales relatos no dependió del apoyo recibido. Los resultados indican la necesidad de una Política de Cuidado con mecanismos para proteger la salud mental de los cuidadores de niños con discapacidad visual.

Abstract: We aimed to identify the reports of symptoms of depression, anxiety, and stress among caregivers of children without visual impairment, with low vision, and with blindness and their relationship with the degree of social, emotional, material, and affective support. This cross-sectional and multicenter study was conducted in the municipality of Rio de Janeiro, Brazil, from 2019 to 2020. A questionnaire was applied to obtain caregivers’ sociodemographic and economic data. The Medical Outcomes Study Social Support Scale (MOS-SSS) and The Depression, Anxiety, and Stress Scale (DASS-21) were used. Tests were used for multiple comparisons of these scales. The prevalence ratio of symptoms of depression, anxiety, and stress was estimated. Of all caregivers (N = 355), more than 90% were women-mothers. Caregivers of children with visual impairment show the highest proportion of no schooling, incomplete elementary education, or lower average monthly income. Most caregivers of children with blindness reported symptoms of depression, anxiety, and stress (66.7%, 73.3%, and 80%, respectively) as did those of children with low vision. The evaluation of the relationship between MOS-SSS and DASS-21 results shows greater support and lower scores of reports of depression, anxiety, and stress for caregivers of children without disabilities or with less visual impairment. For caregivers of blind children, the highest prevalence of such reports was independent of the received support. Results indicate the need for a care policy with mechanisms to protect the mental health of caregivers of visually impaired children.

Resumo: O objetivo foi identificar os relatos de sintomas de depressão, ansiedade e estresse entre cuidadores de crianças sem deficiência visual, com baixa visão e com cegueira e sua relação com o grau de apoio social, emocional, material e afetivo. Estudo transversal e multicêntrico, realizado no Município do Rio de Janeiro, Brasil, entre 2019 e 2020. Aplicou-se um questionário para obter dados sociodemográficos e econômicos do cuidador. Foram utilizadas a Escala de Apoio Social (The Medical Outcomes Study Social Support Scale - MOS-SSS) e a Escala de Depressão, Ansiedade e Estresse (The Depression, Anxiety, and Stress Scale - DASS-21). Na comparação entre as escalas, foram utilizados testes para comparações múltiplas. Estimou-se a razão de prevalência de sintomas de depressão, ansiedade e estresse. Do total de cuidadores (N = 355), mais de 90% eram mulheres-mães e a maior proporção de cuidadores sem instrução ou Ensino Fundamental incompleto e com menor renda média mensal foi daqueles de crianças com deficiência visual. A maioria dos cuidadores de crianças com cegueira relatou sintomas de depressão, ansiedade e estresse (respectivamente, 66,7%, 73,3% e 80%), mesmo comportamento observado no grupo de cuidadores de crianças com baixa visão. Na avaliação da relação entre os resultados das escalas MOS-SSS e DASS-21, entre os cuidadores de crianças sem deficiência ou com menor comprometimento visual, observou-se maiores apoios e menores escores de relatos de depressão, ansiedade e estresse. Entre os cuidadores de crianças cegas, as maiores prevalências não dependeram dos apoios recebidos. Os resultados indicam a necessidade de uma política de cuidado com mecanismos de proteção à saúde mental dos cuidadores de crianças com deficiência visual.

https://doi.org/10.1590/0102-311xpt247622

Depressão, ansiedade, estresse e apoio social: estudo transversal com cuidadores de crianças com deficiência visual no Rio de Janeiro, Brasil - Views-QoL Study
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Moreira, Martha Cristina Nunes

; Steffen, Ricardo Ewbanck

; Zin, Andrea Araujo

; Santos, Marisa da Silva

; Costa, Ana Carolina Carioca da

; Campos, Daniel de Souza

; Barros, Letícia Baptista de Paula

; Moreira, Maria Elisabeth Lopes

; Mendes, Corina Helena Figueira

; Kuper, Hannah

; Pinto, Márcia

Cadernos de Saúde Pública

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2023, Volume 39 N. 11 elocation e00247622

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

https://doi.org/10.1590/0102-311xpt247622

Autorização para uso off-label pode ser benéfica para o Sistema Único de Saúde? offlabel off label Saúde
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Santos, Marisa da Silva

; Costa, Márcia Gisele Santos da

; Tura, Bernardo Rangel

; Torres, Priscila

; Martins, Sandro José

; Toscas, Fotini Santos

Cadernos de Saúde Pública

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2023, Volume 39 N. 6 elocation e00032623

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/0102-311xpt032623

Association between frailty and depression among hemodialysis patients: a cross-sectional study
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Santos, Diana Gabriela Mendes dos

; Ferreira, Layana Giselly Silva

; Pallone, Joice Marques

; Ottaviani, Ana Carolina

; Santos-Orlandi, Ariene Angelini

; Pavarini, Sofia Cristina Iost

; Zazzetta, Marisa Silvana

; Orlandi, Fabiana de Souza

Sao Paulo Medical Journal

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jun 2022, Volume 140 N. 3 Pages 406 - 411

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. OBJECTIVE: To assess frailty and its relationship with depression among patients with CKD undergoing hemodialysis. DESIGN AND SETTING: Observational and quantitative cross-sectional study conducted in a renal therapy unit, located in the interior of the state of São Paulo, Brazil. METHODS: This investigation took place in 2019, among 80 patients. The following instruments were applied: a sociodemographic, economic and health condition characterization and the Subjective Frailty Assessment (SFA) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: Among the patients, there was higher prevalence of females, individuals with a steady partner and retirees, and their mean age was 59.63 (± 15.14) years. There was high prevalence of physical frailty (73.8%) and depression (93.7%). Depression was associated with frailty, such that patients with depression were 9.8 times more likely to be frail than were patients without depression (odds ratio, OR = 9.80; 95% confidence interval, CI, 1.93-49.79). CONCLUSION: Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.

https://doi.org/10.1590/1516-3180.2021.0556.r1.14092021

Handicap auditivo e fragilidade em idosos da comunidade
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Campos, Ruana Danieli da Silva

; Zazzetta, Marisa Silvana

; Orlandi, Fabiana de Souza

; Pavarini, Sofia Cristina Iost

; Cominetti, Márcia Regina

; Santos-Orlandi, Ariene Angelini dos

; Jesus, Isabela Thaís Machado de

; Gomes, Grace Angélica de Oliveira

; Gratão, Aline Cristina Martins

; Costa-Guarisco, Letícia Pimenta

CoDAS

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2022, Volume 34 N. 4 elocation e20210080

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

RESUMO Objetivo Verificar a relação entre o handicap auditivo e fragilidade em idosos residentes da comunidade. Método Estudo transversal realizado com 238 idosos (idade ≥ 60 anos), no ano de 2018. O questionário Hearing Handicap Inventory for the Elderly - Screening version - HHIE-S, foi aplicado para quantificar o handicap auditivo. A fragilidade foi avaliada segundo o Fenótipo de Fragilidade proposto por Fried e colaboradores, utilizando os 5 critérios: perda de peso não intencional, fadiga relatada, redução da força de preensão, redução da velocidade de caminhada e baixa atividade física. A relação entre o handicap auditivo e a fragilidade foi realizada por meio dos Testes Kruskal-Wallis e Spermann. Resultados Maior percepção do handicap auditivo foi verificado nos indivíduos pré-frágeis e frágeis, comparados aos não frágeis. O handicap auditivo apresentou correlação positiva e estatisticamente significante com maiores níveis de fragilidade. Conclusão O handicap auditivo está relacionado a fragilidade em idosos da comunidade.

ABSTRACT Purpose To verify the relationship between hearing handicap and frailty in community-dwelling older adults. Methods A cross-sectional study was carried out with 238 older adults (aged ≥ 60 years) in 2018. The Hearing Handicap Inventory for the Elderly – Screening version – HHIE-S was applied to assess the hearing handicap. To assess frailty, the Frailty Phenotype proposed for Fried and co-workers was adopted, objectively evaluating 5 criteria: unintentional weight loss, reported fatigue, reduced grip strength, reduced walking speed and low physical activity. It was investigated whether the hearing handicap were related with frailty using Kruskal-Wallis and Spearman test. Results Worse perception of the hearing handicap was found in pre-frail and frail individuals, compared to non-frail individuals. In addition, hearing handicap showed a positive and statistically significant correlation with frailty. Conclusion Hearing handicap is related to frailty in community-dwelling older adults.

https://doi.org/10.1590/2317-1782/20212021080

Relationship between frailty, social support and family functionality of hemodialysis patients: a cross-sectional study
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Santos, Diana Gabriela Mendes dos

; Pallone, Joice Marques

; Manzini, Carlene Souza Silva

; Zazzetta, Marisa Silvana

; Orlandi, Fabiana de Souza

Sao Paulo Medical Journal

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dec 2021, Volume 139 N. 6 Pages 570 - 575

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: The population with chronic kidney disease (CKD) is more predisposed to early development of frailty. Although the concept of frailty is well established from a physical point of view, it is not an exclusively physical syndrome. It can be characterized as an interaction of physical, psychological and social factors. OBJECTIVE: To ascertain the relationship between frailty, social support and family functionality among CKD patients undergoing hemodialysis. DESIGN AND SETTING: Correlational, cross-sectional and quantitative study conducted at a service in the interior of the state of São Paulo. METHODS: This study included 80 patients with CKD who were on hemodialysis. The participants were interviewed individually, with application of the following instruments: sociodemographic and economic characterization, Tilburg Frailty Indicator, Medical Outcomes Study and Family APGAR. Females and white ethnicity predominated among the participants, and their mean age was 59.63 ± 15.14 years. RESULTS: There was high prevalence of frailty (93.8%). Although there was a difference in scores for the dimensions of social support between the frail group and the non-frail group, only family functionality reached a statistically relevant difference. There was a significant correlation between physical frailty, social support and family functionality. CONCLUSIONS: Presence of frailty is related to the social support and family functionality of patients with CKD undergoing hemodialysis.

https://doi.org/10.1590/1516-3180.2021.0089.r1.0904221

10.

Fonoaudiologia, conflitos decisórios e pacientes disfágicos: revisão integrativa
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Moreira, Márcio José da Silva

; Santos, Roberta Nascimento de Oliveira Lemos dos

; Palacios, Marisa

Revista Bioética

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jun 2021, Volume 29 N. 2 Pages 401 - 415

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

Resumo A disfagia tem impactos negativos multidimensionais na vida do paciente disfágico e pode gerar conflitos decisórios relacionados à alimentação. O objetivo deste artigo é revisar a literatura sobre fonoaudiologia, conflitos na tomada de decisão e agentes envolvidos nas deliberações sobre a nutrição desse tipo de paciente. Trata-se de estudo exploratório-descritivo, de revisão integrativa, com análise de conteúdo conforme proposta por Bardin. As bases de dados utilizadas foram: PubMed, Scopus, Web of Science, Cochrane, Embase e Biblioteca Virtual em Saúde. Identificaram-se conflitos envolvendo o fonoaudiólogo, o paciente, a família e a equipe multidisciplinar. Nos artigos selecionados não foi possível identificar uma teoria ou método que fundamentasse a mediação desses conflitos. Não foram encontradas publicações brasileiras que respondessem à pergunta norteadora da revisão.

Abstract Dysphagia presents multidimensional negative impacts on the life of dysphagic patients and may generate decision conflicts related to their diet. This is a review of the literature on speech-language therapy, decision conflicts and the agents involved in the decision making process for deliberations related to the nutrition of this type of patient. This is an exploratory and descriptive study, with content analysis as proposed by Bardin. The databases used were PubMed, Scopus, Web of Science, Cochrane, Embase and Virtual Health Library. Conflicts involving the speech-language therapist, the patient, the family and the multidisciplinary team were identified. In the selected articles, no theory or method was identified to support the mediation of these conflicts. No Brazilian publications that answered the guiding question were found.

Resumen La disfagia tiene impactos negativos multidimensionales en la vida del paciente disfágico y puede generar conflictos de decisión relacionados con su alimentación. El objetivo de este artículo fue revisar la literatura sobre fonoaudiología, los conflictos de decisión y los agentes involucrados en el proceso de toma de decisiones para las deliberaciones relacionadas con la nutrición de este tipo de pacientes. Se trata de un estudio exploratorio y descriptivo, donde se realizó una revisión integradora con análisis de contenido y categorización por Bardin. Las bases de datos utilizadas fueron: PubMed, Scopus, Web of Science, Cochrane, Embase y Biblioteca Virtual en Salud. Se identificaron los conflictos entre fonoaudiólogo, paciente, familia y equipo multidisciplinario. En los artículos seleccionados no se identificó ninguna teoría o método que sustente la mediación de estos conflictos. No hay publicaciones nacionales que respondan a la pregunta orientadora.

https://doi.org/10.1590/1983-80422021292478 222 downloads

11.

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

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

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

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

12.

Foliar application of molybdenum on cover crops and response of common beans in successive cultivation
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Brandelero, Fernanda Daniela

; Kutz, Talita Slota

; Vargas, Thiago de Oliveira

; Modolo, Alcir José

; Cassol, Luís César

; Oliveira, Marisa de Cacia

; Santos, Ricardo Henrique Silva

Revista Ceres

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feb 2020, Volume 67 N. 1 Pages 35 - 41

Abstract: En | Text: En | PDF: En

ABSTRACT The effects of foliar application of Mo and use of N from cover crops (Crotalaria juncea L. and Canavalia ensiformis (L.) DC) on the performance of common beans were investigated in this study. Field experiments were carried out in a succession planting system (cover crops - common beans), and nitrate reductase activities were evaluated in the laboratory. The production of cover crops was done in a 2 x 4 factorial scheme installed in random blocks with four replications. The two cover crops sunn hemp and jack bean composed the first factor and the molibdenum doses (0, 40, 80, and 120 g ha-1) the second. These doses were applied as foliar fertilization using sodium molybdate (Na2MoO4) as Mo source. For bean cultivation, an unfertilized control treatment was evaluated.. Sunn hemp showed a linear positive response to Mo application in terms of shoot dry matter and N accumulation, while jack bean showed a quadratic negative response for shoot dry matter; for N accumulation, there was no adjustment of the regression models. Nitrate reductase activity in the common beans was up to three times higher at the Mo dose of 0 g ha-1 when compared to the treatments with Mo application to both cover crops. Cover crops or Mo doses had no significant effect on bean productivity.

https://doi.org/10.1590/0034-737x202067010006 558 downloads

13.

Perfil da judicialização do Método Therasuit e seu custo direto no âmbito do Estado do Rio de Janeiro
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Moraes, Dominique Souza de

; Teixeira, Roberta da Silva

; Santos, Marisa da Silva

Revista Brasileira de Epidemiologia

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2019, Volume 22 elocation e190006

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

RESUMO: Introdução: O Método Therasuit possui alto custo e não é disponibilizado pelo Sistema Único de Saúde, o que tem ocasionado a judicialização desse tratamento. O estudo visou traçar o perfil dessa judicialização, bem como estimar os custos diretos decorrentes do cumprimento das decisões judiciais deferidas. Método: Foram analisados processos submetidos ao Tribunal de Justiça do Rio de Janeiro entre janeiro de 2013 e janeiro de 2017, no qual foi solicitado o Método Therasuit. Os dados demográficos, clínicos, advocatícios e jurídicos foram extraídos, assim como o tempo da decisão judicial e os orçamentos da tecnologia requerida. Resultados: O total de 11 processos foi analisado. Os autores tinham uma média de idade de 6,8 anos e mediana de 6, sendo a maioria do sexo masculino e residentes na capital do estado. A quadriparesia foi a condição mais relatada. A gratuidade de justiça foi solicitada por todos, e a Defensoria Pública foi utilizada em 9 dos 11 processos analisados. Foram consideradas as decisões judiciais em primeira instância. O tempo da decisão judicial foi em média de 266,5 dias com uma mediana de 35,5. Em todos houve requerimento da ferramenta jurídica tutela antecipada. O índice de deferimento foi de 90%, totalizando um custo direto anual de R$501.894,09. Discussão: A judicialização desse tratamento pode ocasionar um deslocamento não previsto de verba pública, podendo impactar nos princípios da equidade e na integralidade do Sistema Único de Saúde. Conclusão: Constatou-se elevada taxa de processos deferidos, acarretando um alto custo despendido pelo Poder Público para atender a uma pequena parcela de pacientes.

ABSTRACT: Introduction: The lack of availability of the Therasuit Method by the Unified Health System associated with its high cost has led to the prosecution of this treatment. The study aimed to outline the profile of this judicialization, as well as to estimate the direct costs resulting from compliance with the deferred judicial decisions. Method: Weanalyzed the cases submitted to the Court of Justice of Rio de Janeiro between January 2013 and January 2017, in which the Therasuit Method was applied. Demographic, clinical, advocacy and legal data were extracted, as was the timing of the court’s decision and the required technology budgets. Results: Atotal of 11 processes was analyzed. The authors had a mean age of 6.8 years and a median of 6, the majority being male, and resident in thestate capital. Quadriparesis was the most reported condition. The gratuity of justice was requested by all, and the Public Defender’s Officewas used by 9 of the 11 processes. The judicial decisions at first instance were considered. In all of processes there was application of the legal tool called guardianship. The time of the judicial decision was on average of 266.5 days with a median of 35.5. The deferral index was 90%, totaling an annual direct cost of R$501,894.09. Discussion: The judicialization of this treatment can cause an unforeseen displacement of public funds, transgressing the principles of equity and the integrality of Unified Health System. Conclusion: It was observed a high rate of deferred processes, resulting in a high cost spent by the Public Power to attend a small portion of patients.

https://doi.org/10.1590/1980-549720190006

14.

Perfil da judicialização do Método Therasuit e seu custo direto no âmbito do Estado do Rio de Janeiro
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Moraes, Dominique Souza de

; Teixeira, Roberta da Silva

; Santos, Marisa da Silva

Revista Brasileira de Epidemiologia

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2019, Volume 22 elocation e190006

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

https://doi.org/10.1590/1980-549720190006 6114 downloads

15.

Occurrence and predictors of gingivitis and supragingival calculus in a population of Brazilian adults
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Haas, Alex Nogueira

; Prado, Renan

; Rios, Fernando Silva

; Costa, Ricardo dos Santos Araújo

; Angst, Patricia Daniela Melchiors

; Moura, Mauricio dos Santos

; Maltz, Marisa

; Jardim, Juliana Jardim

Brazilian Oral Research

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2019, Volume 33 elocation e036

Abstract: En | Text: En | PDF: En

Abstract: The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.

https://doi.org/10.1590/1807-3107bor-2019.vol33.0036 2153 downloads

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