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Safety of two-dose schedule of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan) and heterologous additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised and immunocompetent individuals
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Miyaji, Karina Takesaki

; Ibrahim, Karim Yaqub

; Infante, Vanessa

; Moreira, Raquel Megale

; Santos, Carolina Ferreira dos Belizário, Juliana de Cássia Pinto, Maria Isabel de Moraes Marinho, Ana Karolina Barreto Berselli Pereira, Juliana Marquezi Mello, Liliane Saraiva de Silva, Vitor Gabriel Lopes da Sato, Paula Keiko Strabelli, Tânia Mara Varejão Ragiotto, Lucas Pacheco, Pedro Henrique Theotonio de Mesquita Braga, Patricia Emilia Loch, Ana Paula Precioso, Alexander Roberto Sartori, Ana Marli Christovam França, João Ítalo Lima, Marcos Alves de Ando, Mauricio Cesar Sampaio Rodrigues, Camila Cristina Martini Song, Alice Tung Wan Lara, Amanda Nazareth Belizário, Ana Cristina Lima, Anna Helena Simões Bortulucci de Zanetti, Ariane Cristina Barboza Paulo, Audrey Rose da Silveira Amancio de Rosa, Barbara Miranda dos Santos Moraes, Bruna Del Guerra de Carvalho Oliveira, Bruna Ribeiro de Picone, Camila de Melo Aranda, Carolina Sanches Troli, Carolinne Paioli Kokron, Cristina M. Terrabuio, Debora Raquel Benedita Abdala, Edson David Neto, Elias Nakanishi, Érika Yoshie Shimoda Lima, Fabiana Mascarenhas Souza Firmino, Fabio Batista Santos, Fernanda Barone Alves dos Bacal, Fernando Fatobene, Giancarlo Santana, Jaqueline Oliveira Kalil, Jorge Barbosa, Julia Gonçalves, Leandro Peres Otuyama, Leonardo Jun Pierrotti, Ligia Camera Compte, Livia Caroline Mariano Marinho, Livia Chaer, Livia Netto Seguro, Luis Fernando Azevedo, Luiz Sergio Ueda, Márcia Aiko Terreri, Maria Teresa Barros, Myrthes Anna Maragna Toledo Grecco, Octávio Sejas, Odeli Nicole Encinas Musqueira, Priscila Tavares Ito, Raquel Keiko de Luca Teixeira, Samia Silveira Souza Fidalgo, Serafim Costa, Silvia Figueiredo Campos, Silvia Vidal Fernandes, Tamiris Hinsching Rocha, Vanderson Geraldo Coelho, Vivian Caso

Revista do Instituto de Medicina Tropical de São Paulo

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2025, Volume 67 elocation e2

Abstract: En | Text: En | PDF: En

ABSTRACT Immunocompromised individuals were considered high-risk for severe disease due to SARS COV-2 infection. This study aimed to describe the safety of two doses of COVID-19 adsorbed inactivated vaccine (CoronaVac; Sinovac/Butantan), followed by additional doses of mRNA BNT162b2 (Pfizer/BioNTech) in immunocompromised (IC) adults, compared to immunocompetent/healthy (H) individuals. This phase 4, multicenter, open label study included solid organ transplant and hematopoietic stem cell transplant recipients, cancer patients and people with inborn errors of immunity with defects in antibody production, rheumatic, end-stage chronic kidney or liver disease, who were enrolled in the IC group. Participants received two doses of CoronaVac and additional doses of mRNA BNT162b2. Adverse reactions (AR) data were collected within seven days after each vaccination. Serious adverse events and of special interest (AESI) were monitored throughout the study. We included 241 immunocompromised and 100 immunocompetent subjects. Arthralgia, fatigue, myalgia, and nausea were more frequent in the IC group after CoronaVac. Following the first additional dose of mRNA BNT162, pain, induration, and tenderness at injection site, fatigue and myalgia were more frequent in the H group. A heart transplant recipient had a graft rejection temporally associated with the second CoronaVac dose, but there was no literature evidence of causal association. Four cases of AESI were considered related to the vaccine: three erythema multiforme after CoronaVac, all in IC participants, and one paresthesia after mRNA, in a H participant. Our findings were comparable to other studies that evaluated the safety of COVID-19 vaccines in different immunocompromised populations. Both vaccines were safe for immunocompromised participants.

https://doi.org/10.1590/s1678-9946202567002

Saturated hydraulic conductivity and steady-state infiltration rate database for Brazilian soils
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Ottoni, Marta Vasconcelos

; Teixeira, Wenceslau Geraldes

; Reis, Aline Mari Huf dos

; Pimentel, Letícia Guimarães

; Souza, Luciana Rodrigues

; Albuquerque, Jackson Adriano

; Melo, Valdinar Ferreira

; Cavalieri-Polizeli, Karina Maria Vieira

; Reichert, José Miguel

; Viana, João Herbert Moreira

; Fontana, Ademir

; Medrado, Lucas de Castro

; Santos, Glenio Guimarães

; Amaral, Luís Gustavo Henriques do

; Anjos, Lúcia Helena Cunha dos

; Araújo Filho, José Coelho de

; Bhering, Silvio Barge

; Brito, Gabrielle Fernandes de

; Valle, Pedro Gomes de Campos do

; Campos, Pablo Nieto

; Costa, Adriana Monteiro da

; Marques, Jean Dalmo de Oliveira

; Martins, Alba Leonor da Silva

; Nascimento, Michele Bruna de Souza do

; Noronha, Norberto Cornejo

; Oliveira, Ricardo Duarte de

; Portela, Jeane Cruz

; Serafim, Milson Evaldo

; Silva, Marlen Barros e

; Rodrigues, Sueli

; Almeida, Wilk Sampaio de

; Moraes, Margareth Lopes de

; Curi, Nilton

Revista Brasileira de Ciência do Solo

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2025, Volume 49 elocation e0240003

Abstract: En | Text: En | PDF: En

ABSTRACT Soil saturated hydraulic conductivity (Ksat) and steady-state infiltration rate (SSIR) are essential and necessary soil properties for different geoscience applications. Values of these hydraulic properties for the Brazilian territory are difficult to access and are dispersed in research efforts carried out around the country. This study developed an easy-to-manipulate, freely accessible database of soil saturated hydraulic conductivity, comprising field and laboratory analyses, and steady-state infiltration rates for Brazilian soils. This database was named Ksat-SSIR-DB. One analysis of the Ksat-SSIR-DB aimed to evaluate its coverage in Brazilian territory and in different soil groups. Average values of these hydraulic properties were also presented for textural classes, with values compared to those reported in international literature, and for other groupings, such as soil class, land use class, and porosity class. The variability of Ksat data in these groupings and in their combinations were also analyzed. The Ksat-SSIR-DB showed broad national coverage, comprising a total of 2,579 records, corresponding to 409 sampling sites, with Ksat and/or SSIR data and other associated soil information. A significant difference was observed between Ksat values for the vast majority of Brazilian clayey and very clayey soils compared to soils from the same textural groups from temperate regions. The two groupings that presented the lowest variability in terms of Ksat standard deviation values were the combination of textural classes with soil classes at the second category level of SiBCS (Brazilian Soil Classification System), and porosity classes with soil classes at the second category level of SiBCS. The Ksat-SSIR-DB has enormous potential for developing and testing Ksat pedotransfer functions in Brazilian soils, serving as a reference source for different geoenvironmental applications and, in particular, for modeling land surface processes. It is open access and can be accessed at https://www.sgb.gov.br/ksat-ssir-dbbase-de-dados-de-condutividade-hidraulica-saturada-e-de-taxa-de-infiltracao-basica-emsolos-brasileiros, which also includes the python script for data analysis.

https://doi.org/10.36783/18069657rbcs20240003

Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies
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Ferreira, Juliana Carvalho

; Vianna, Arthur Oswaldo de Abreu

; Pinheiro, Bruno Valle

; Maia, Israel Silva

; Baldisserotto, Sérgio Vasconcellos

; Isola, Alexandre Marini

; Cavalcanti, Alexandre Biasi Gama, Ana Maria Casati Nogueira da Rocha, Angelo Roncalli Miranda Oliveira, Antonio Gonçalves de Serpa Neto, Ary Farias, Augusto Manoel de Carvalho Orlando, Bianca Rodrigues Esteves, Bruno da Costa Mazza, Bruno Franco Silveira, Camila de Freitas Martins Soares Carvalho, Carlos Roberto Ribeiro de Toufen Junior, Carlos Barbas, Carmen Silvia Valente Teixeira, Cassiano Silveira, Débora Dutra da Medeiros, Denise Machado Parolo, Edino Costa, Eduardo Leite Vieira Caser, Eliana Bernadete Oliveira, Ellen Pierre de Banholzer, Eric Grieger Carvalho, Erich Vidal Amorim, Fabio Ferreira Saddy, Felipe Gonçalves, Fernanda Alves Ferreira Galas, Filomena Regina Barbosa Gomes Zanatta, Giovanna Carolina Gardini Silva, Gisele Sampaio Westphal, Glauco Adrieno Matos, Gustavo Faissol Janot de Souza, João Claudio Emmerich de Silva Junior, João Manoel Valiatti, Jorge Luis dos Santos Nascimento Junior, José Ribamar do Rocco, Jose Rodolfo Hajjar, Ludhmila Abrahão Forgiarini Junior, Luiz Alberto Malbuisson, Luiz Marcelo Sá Holanda, Marcelo Alcantara Amato, Marcelo Britto Passos Park, Marcelo Oliveira, Marco Antonio da Rosa e Reis, Marco Antonio Soares Tavares, Marcos Soares Souza, Mario Henrique Dutra de Damasceno, Marta Cristina Pauleti Lira-Batista, Marta Maria da Silva Pattacini, Max Morais Assunção, Murillo Santucci Cesar de Oliveira, Neymar Elias de Franzosi, Oellen Stuani Rocco, Patricia Rieken Macedo Caruso, Pedro Silva, Pedro Leme Mendes, Pedro Vitale Duarte, Pericles Almeida Delfino Santa Neto, Renato Fabio Alberto Della Rodrigues, Ricardo Goulart Cordioli, Ricardo Luiz Palazzo, Roberta Fittipaldi Goldwasser, Rosane Pinheiro, Sabrina dos Santos Justino, Sandra Regina Nemer, Sergio Nogueira Oliveira, Vanessa Martins de Silva, Vinicius Zacarias Maldaner da Nedel, Wagner Luis Bellissimo-Rodrigues, Wanessa Teixeira Oliveira Filho, Wilson de

Critical Care Science

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2025, Volume 37 elocation e20250242en

Abstract: En | Text: En | PDF: En

ABSTRACT Mechanical ventilation can be a life-saving intervention, but its implementation requires a multidisciplinary approach, with an understanding of its indications and contraindications due to the potential for complications. The management of mechanical ventilation should be part of the curricula during clinical training; however, trainees and practicing professionals frequently report low confidence in managing mechanical ventilation, often seeking additional sources of knowledge. Review articles, consensus statements and clinical practice guidelines have become important sources of guidance in mechanical ventilation, and although clinical practice guidelines offer rigorously developed recommendations, they take a long time to develop and can address only a limited number of clinical questions. The Associação de Medicina Intensiva Brasileira and the Sociedade Brasileira de Pneumologia e Tisiologia sponsored the development of a joint statement addressing all aspects of mechanical ventilation, which was divided into 38 topics. Seventy-five experts from all regions of Brazil worked in pairs to perform scoping reviews, searching for publications on their specific topic of mechanical ventilation in the last 20 years in the highest impact factor journals in the areas of intensive care, pulmonology, and anesthesiology. Each pair produced suggestions and considerations on their topics, which were presented to the entire group in a plenary session for modification when necessary and approval. The result was a comprehensive document encompassing all aspects of mechanical ventilation to provide guidance at the bedside. In this article, we report the methodology used to produce the document and highlight the most important suggestions and considerations of the document, which has been made available to the public in Portuguese.

https://doi.org/10.62675/2965-2774.20250242-en

Inhibiting effect of cholesterol isolated from marine red seaweed Plocamium brasiliense in the Eastern Amazon Region, Brazil
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Fonseca, Rainiomar Raimundo

; Ramos, Carlos Jose Brito

; Filho, Antônio Pedro Souza Teixeira, Valeria Laneuville

Ciência Rural

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2025, Volume 55 N. 1 elocation e20210810

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

ABSTRACT: In general, allelopathy can be defined as a biological process by which an organism produces one or more metabolites that can change the germination, growth, survival, and reproduction of other organisms, and thus influencing the stability of agroecosystems. Cholesterol is a very abundant sterol isolated from the marine red alga Plocamium brasiliense that has been studied regarding its potential inhibitory effects on seed germination, radicle elongation, and hypocotyl development of the weeds Mimosa pudica (malicia) and Senna obtusifolia (mata-pasto). Cholesterol was isolated from a hexane extract by chromatographic methods. Over a 15-day period, germination bioassays were performed at 25 ºC with a 12-h photoperiod. Radicle elongation and hypocotyl development were assayed at 25 ºC with a 24-h photoperiod. Later, Petri dishes 9.0 cm in diameter were coated with filter paper, and 25 seeds were placed in a germination chamber. Six pre-germinated seeds were placed in the Petri dish for 2-3 days. After 10 days, radicle and hypocotyl extensions were measured, and the inhibitory potential of cholesterol was assessed at 5, 10, 15, and 20 ppm. In both herbs, M. pudica and S. obtusifolia, they were significantly affected by the action of cholesterol, achieving higher percentages of inhibition in seed germination (50% and 33%, respectively), radical germination (68% and 60%, respectively), and hypocotyl development (66% and 55%, respectively). The inhibition effects were dose-dependent in all experiments, having more pronounced allelopathic effects at 20ppm.

RESUMO: Em geral, alelopatia pode ser definido como o processo biológico no qual um organismo produz metabolitos que alteram a germinação, o crescimento, a sobrevivência e a reprodução de outros organismos, influenciando a estabilidade de agroecossistemas. O colesterol, o mais abundante esterol isolado da alga vermelha marinha Plocamium brasiliense, foi estudado quanto ao seu potencial efeito inibitório na germinação de sementes, alongamento das radículas e desenvolvimento do hipocótilo das ervas daninhas Mimosa pudica (malicia) e Senna obtusifolia (mata-pasto). Colesterol foi isolado do extrato em Hexano por métodos cromatográficos. Durante 15 dias, os bioensaios de germinação foram realizados a 25 ºC e fotoperíodo de 12 horas, enquanto os bioensaio de alongamento da radícula e do hipocótilo foram realizados a 25 ºC e fotoperíodo de 24 horas. Posteriormente, placas de Petri de 9,0 cm de diâmetro foram revestidas de papelfiltro, e 25 sementes foram mantidas em câmaras de germinação, enquanto seis sementes pré-germinadas foram postas em placas de Petri por 2-3 dias. Após dez dias, a extensão da radícula e do hipocótilo foi medida. O potencial inibitório do colesterol foi avaliado a 5, 10, 15 e 20 ppm. Em ambas as ervas M. pudica e S. obtusifolia, foram afetadas significativamente pela ação do cholesterol alcançando maiores percentuais de inibição na germinação das sementes (50% e 33%, respectivamente), alongamento da radícula (68% e 60%, respectivamente) e desenvolvimento do hipocótilo (66% e 55%, respectivamente). Os efeitos inibitórios foram dose-dependentes em todos os experimentos, tendo efeitos alelopaticos mais acentuados a 20 ppm.

https://doi.org/10.1590/0103-8478cr20210810

Poderão as características clínicas prever a duração do internamento na Neuronite Vestibular?
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Pina, Paulo

; Teixeira, Mónica

; Medeiros, Nuno

; Ferreira, Edite

; Oliveira, Pedro

Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço

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dec 2024, Volume 62 N. 4 Pages 357 - 367

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

Resumo Objetivos: Caracterização epidemiológica e clínica da população com diagnóstico de nevrite vestibular (NV) durante um período de cinco anos, num hospital terciário em Portugal. Avaliar a influência de várias características como fator de risco para internamento prolongado (≥ 8 dias). Desenho do estudo: Retrospetivo. Material e métodos: Revisão dos processos clínicos dos doentes internados para tratamento médico entre janeiro de 2019 e dezembro de 2023 com diagnóstico de NV. Resultados: Foram incluídos 99 doentes. A idade mediana foi 62±14,3 anos, sendo 57,6% mulheres. Apenas 14,1% tinham história de Diabetes Mellitus (DM). O valor mediano de dias de internamento foi 4±3,3dias. À admissão, 70,7% dos doentes apresentavam nistagmo grau III. Conclusões: Os resultados sugerem, a um nível estatisticamente significativo, que idade ≥ 65 anos (p=0,038), história de DM (p=0,017) e grau do nistagmo à admissão (p=0,018) podem representar fatores preditores para internamentos com duração ≥ 8 dias nos doentes com NV.

Abstract Objectives: Epidemiological and clinical characterization of the population diagnosed with vestibular neuritis (VN) over a five-year period at a tertiary hospital in Portugal. Evaluate the influence of various characteristics as risk factors for prolonged hospitalization (≥ 8 days). Study design: Retrospective. Materials and Methods: Review of clinical records of patients hospitalized and treated between January 2019 and December 2023 with a diagnosis of VN. Results: Ninety-nine patients were included. The median age was 62±14.3 years, with 57.6% being women. Only 14.1% had a history of Diabetes Mellitus (DM). The median length of hospital stay was 4±3.3 days. 70.7% of patients presented with grade III nystagmus. Conclusions: The results suggest, at a statistically significant level, that age ≥ 65 years old (p=0.038), history of DM (p=0.017) and grade of nystagmus at admission (p=0.018) may represent predictive factors for hospitalizations lasting ≥ 8 days in patients with VN.

https://doi.org/10.34631/sporl.2211

Lymph node ratio: prognostic value in laryngeal cancer after primary total laryngectomy
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Teixeira, Mónica

; Rebelo, Joana Freitas

; Branco, Elisabete Torres

; Medeiros, Nuno

; Alves, Sandra

; Oliveira, Pedro

Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço

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sep 2024, Volume 62 N. 3 Pages 239 - 245

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

Resumo Objetivo: Avaliar o Rácio de gânglios linfáticos (RGL) como preditor de sobrevida e recidiva de cancro da laringe com metastização cervical (pN+). Desenho do estudo: Estudo retrospetivo, que incluiu doentes submetidos a laringectomia total associada a esvaziamento ganglionar cervical bilateral, entre outubro/2010 e abril/2023. Resultados: Foram incluídos 73 doentes. Entre os doentes pN+ (n=37;50,7%), aqueles com evidência de recidiva tumoral (n=16;43,2%) apresentaram uma mediana de RGL superior (0,159 versus 0.060), p=0,007. Após análise da curva ROC, o RGL>0,063 indicou recidiva tumoral (sensibilidade:87%; especificidade:48%). Para além disso, o RGL>0,063 manteve-se como um preditor independente de recidiva tumoral, após análise multivariada ajustada para potenciais fatores de confundimento (idade, extensão extraganglionar, margem de resseção e estadio patológico T),(HR=6,58; p=0,049). Por último, um RGL elevado (>0,063) esteve associado à morte específica por cancro em doentes pN+ (OR=8,64; p=0,008). Conclusão: Este estudo indica que doentes com RGL>0,063 têm maior probabilidade de doença agressiva. Assim, o RGL é um parâmetro prognóstico relevante, podendo ser útil para complementar o estadiamento TNM no cancro da laringe pN+.

Abstract Objectives: To evaluate Lymph node ratio (LNR) as a predictor for survival and recurrence of laryngeal cancer with metastatic lymph nodes (pN+). Study design: This retrospective study included patients who underwent primary laryngectomy combined with bilateral neck dissection, between October/2010 and April/2023. Results: A total of 73 patients were included. Among pN+ patients (n=37;50.7%), those with disease recurrence (n=16;43.2%) exhibited a higher median LNR (0.159 versus 0.060), p=0.007. ROC curve analysis showed that LNR>0.063 predicted recurrence (sensitivity 87%;specificity 48%). Moreover, multivariate analysis confirmed LNR>0.063 as an independent predictor of disease recurrence, after controlling for potential confounders, namely age, extracapsular spread, resection margin and pathological T category, (HR=6.58; p=0.049). Finally, high LNR (>0.063) was associated with cancer-specific death (OR=8.64; p=0.008) in pN+ patients. Conclusion: Our findings highlight that patients with LNR>0.063 are more likely to have aggressive disease, suggesting LNR as a significant prognostic factor complementing TNM staging in pN+ laryngeal cancer.

https://doi.org/10.34631/sporl.2189

Rinosseptoplastia: satisfação funcional e estética após 1 ano. Um estudo prospetivo
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Teixeira, Mónica

; Aguiar, Cristina

; Pina, Paulo

; Lima, Nuno

; Alves, Sandra

; Oliveira, Pedro

Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço

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sep 2024, Volume 62 N. 3 Pages 206 - 209

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

Resumo Objetivos: Avaliação do grau de satisfação, funcional e estética, 1 ano após rinosseptoplastia. Determinação da variação mínima dos scores (SNOT-22 e ROE), necessária para se refletir numa melhoria subjetiva da qualidade de vida. Métodos: Estudo prospetivo, que incluiu 44 doentes submetidos a rinosseptoplastia no CHVNG/E, que responderam aos questionários SNOT-22 e ROE previamente à cirurgia e 1 ano após. Resultados: Do total da amostra, 79,5% reportou uma melhoria clinicamente importante da qualidade de vida em termos funcionais e 81,8% em termos estéticos. A diferença mínima clinicamente importante no score SNOT-22 foi de 5 pontos e no score ROE 13,7 pontos. A variação do score ROE foi significativamente inferior nos doentes submetidos a revisão de rinosseptoplastia (25,0 vs 51,4)(p=0,04). Conclusões: Verificamos uma elevada percentagem de doentes com uma melhoria clinicamente importante da qualidade de vida após rinosseptoplastia. A história de rinosseptoplastia prévia foi o único fator determinante de menor satisfação pós-cirúrgica.

Abstract Objectives: We aim to evaluate patient functional and aesthetical satisfaction 1 year after rhinoseptoplasty and to determine the minimum clinically important difference (MCID) of SNOT-22 and ROE scores. Study design: A 1-year prospective study of adult patients undergoing rhinoseptoplasty in CHVNG/E was conducted. SNOT-22 and ROE scores were assessed preoperatively and 1 year after surgery. Results: We included 44 patients. 79.5% of our sample reported an improvement in quality-of-life regarding the functional outcome and 81.8% regarding the aesthetical outcome. The MCID of SNOT-22 score was 5 points, whilst the MCID of ROE score was 13.7 points. The mean change in ROE score was significantly lower among patients undergoing revision rhinoplasty (25.0 vs 51.4)(p=0.04). Conclusions: Rhinoseptoplasty improved quality-of-life in most patients. The history of previous rhinoseptoplasty was the only predictor of lower postoperative satisfaction.

https://doi.org/10.34631/sporl.2079

Lump in a child’s toe
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Teixeira, Susana C

; Marinho, Pedro

; Nogueira, Miguel

; Machado, Susana

Nascer e Crescer

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sep 2024, Volume 33 N. 3 Pages 207 - 208

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

Resumo A exostose subungueal (ES) é um crescimento de osso normal, lento e benigno por baixo da unha. A localização mais frequente é o halux. Esta proliferação pode originar distúrbios ungueais, mascarando o verdadeiro problema e levando frequentemente a erros de diagnóstico. A dor provocada pela ES, sobretudo quando ocorre fricção promovida pelo calçado, é relevante e pode interferir com a qualidade de vida dos doentes, pelo que o rápido diagnóstico é importante.

Abstract SE is a slow and benign growth of normal bone under the nail. The most common site is the hallux. This growth can cause nail disorders, masking the true problem and often leading to misdiagnosis. The pain caused by SE, especially with shoe contact, is significant and can affect the patient’s quality of life, so a prompt diagnosis is important.

https://doi.org/10.25753/birthgrowthmj.v33.i3.28344

Direção técnica em ginásios e health clubs: um estudo exploratório sobre a perceção dos profissionais de exercício físico
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Teixeira, Diogo

; Sousa, Ana

; Chaves, César

; Ruivo, Rodrigo

; Dias, Amândio

; Asseiceira, Pedro

; Rodrigues, Filipe

; Monteiro, Diogo

; Cid, Luis

; Bastos, Vasco

; Pedragosa, Vera

; Pereira, Hugo

Motricidade

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jun 2024, Volume 20 N. 2 Pages 157 - 167

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

RESUMO A figura do diretor técnico foi introduzida na lei em 2012, mas pouca investigação foi produzida para compreender como tem desenvolvido a sua ação. Este estudo pretendeu analisar as perceções dos técnicos de exercício físico (TEF) sobre i) a importância das funções dos diretores técnicos (tal como definidas na lei), e ii) a forma como os diretores técnicos cumprem e desenvolvem as suas funções, contrastando os resultados por segmento de mercado. Realizou-se uma análise descritiva e de frequências a uma amostra de 194 profissionais de exercício com uma média de idades de 34.46 anos (DP= 8.78), e com uma média de anos de experiência de 9.04 anos (DP= 6.84), que participaram voluntariamente neste estudo. O presente trabalho evidenciou que os TEF valorizam as funções atribuídas ao diretor técnico expressas na lei. Verificou-se que a regularidade do apoio do diretor técnico é bastante heterogénea, sendo que em quase 50% dos respondentes a classificação atribuída foi de inexistente ou pouco regular. Verificou-se ainda que cerca de 45% dos TEF consideraram a prestação dos diretores técnicos como sendo muito fraca ou fraca. Da análise por segmento de mercado, o low cost apresentou, genericamente, os piores resultados percentuais, e o premium os melhores.

ABSTRACT The position of the technical director was introduced into Portuguese law in 2012, but little research has been produced to understand how it has developed its action since. This study analysed the perceptions of the physical exercise technicians (TEF) regarding i) the importance of the functions of technical directors (as defined in the law) and ii) the way technical directors fulfil and develop their roles, contrasting the results by market segment. A descriptive and frequency analysis was made of a sample of 194 exercise professionals, with a mean age of 34.46 years (SD= 8.78) and a mean years of experience of 9.04 years (SD= 6.84), who voluntarily participated in this study. The present work showed that the TEF value the role attributed to the technical director expressed in the law. The regularity of the technical director's support was found to be quite heterogeneous, with almost 50% of the respondents classifying it as non-existent or not very regular. It was also found that around 45% of the TEF considered the performance of the technical directors to be very weak or weak. From the analysis by market segment, the low cost generally presented the worst percentage results, while the premium segment presented the best results.

https://doi.org/10.6063/motricidade.30748

10.

Comparing Artificial Intelligence AI-Rad Companion Chest CT vs Experts on Emphysema, Lung Nodules, Thoracic Aorta and Thoracic Spine
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Santos, Filipa Marques dos

; Senra, Carlos

; Mota, Cristina

; Antunes, Francisco

; Matos, Inês

; Sousa, Pedro Teixeira

; Marques, Inês Dias

Acta Radiológica Portuguesa

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apr 2024, Volume 36 N. 1 Pages 6 - 11

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

Resumo Introdução: O objetivo do trabalho foi avaliar a acuidade do software AI-Rad Companion (AIRC-cCT)(Siemens Healthineers®) através da análise de TC torácicos e comparação dos resultados com a avaliação por Radiologistas. Métodos: O AIRC-cCT analisou restrospetivamente 348 TC torácicos, avaliando a presença de enfisema, nódulos pulmonares, diâmetro da aorta torácica e vértebras torácicas. Um painel de Radiologistas experientes (Expert Panel) reviu todos os resultados, relatórios e foi considerado para efeitos comparativos. Resultados: O AIRC-cCT apresentou sensibilidade (68,5%) e especificidade (64,7%) adequadas para detetar enfisema. O software falhou na interpretação de outras áreas de baixa densidade que não enfisema, oferecendo contudo a vantagem de permitir quantificar o enfisema. Foram incluídos os 6 maiores nódulos apresentados pela aplicação, num total de 1003 nódulos. O Expert Panel validou 677 (67,5%) como verdadeiros nódulos. 209 nódulos (20,8%) foram considerados não relevantes (125 granulomas, 84 gânglios intra-cisurais, entre outros). O AIRC-cCT detetou 101 exames com dilatação patológica da aorta. Houve elevado grau de concordância entre o AIRC-cCT e o Expert Panel em relação à aorta (Cohen’s kappa = 98,9%, 95% CI 98,1-99,7%; p<0,0001), sendo os resultados adequados para exames de rastreio (sensibilidade = 99,1%, especificidade = 98,7%; p<0,0001). O AIRC-cCT classificou automaticamente 130 (37,4%) colunas dorsais como anormais, mas apenas 18 (13,8%) foram consideradas clinicamente relevantes pelo Expert Panel. Conclusões: Comparativamente com o Expert Panel, o AIRC-cCT detetou e quantificou enfisema e nódulos pulmonares com acuidade adequada, embora com alguns resultados falsos positivos. O software revelou grande exatidão a detetar dilatação da aorta torácica. Foi menos preciso para alterações da coluna dorsal, com muitos resultados falsos positivos.

Abstract Background: The objective was to evaluate the performance of AI-Rad Companion software (AIRC-cCT)(Siemens Healthineers®) by analyzing chest CT scans and comparing the results against Radiologists’ evaluation. Methods : AIRC-cCT retrospectively assessed 348 chest CTs, evaluating emphysema, lung nodules, thoracic aorta diameters and thoracic vertebral spine. An Expert Panel reviewed all results/reportings and was considered the ground truth. Results : AIRC-cCT was adequately sensitive (68.5%) and specific (64.7%) detecting emphysema. The software misinterpreted low density areas as emphysema but offered the advantage of emphysema quantification. The 6 biggest nodules presented by AIRC-cCT were considered, in a total of 1003. Expert Panel validated 677 (67.5%) as real nodules. 209 nodules (20.8%) were regarded as non-relevant (125 granulomas, 84 perifissural nodules, among others). AIRC-cCT detected 101 scans with pathological dilation of the Aorta. Expert Panel and AIRC-cCT strongly agreed about aortic dilation status (Cohen’s kappa = 98.9%, 95% CI 98.1-99.7%; p<0,0001) with excellent screening parameters (sensitivity = 99.1%, specificity = 98.7%; p<0,0001). AIRC-cCT automatically classified 130 (37.4%) thoracic spines as abnormal, but only 18 (13.8%) of them were considered clinically relevant by the Expert Panel. Conclusions : Compared with the Expert Panel, AIRC-cCT detected and quantified emphysema and lung nodules with adequate accuracy, although with some false positive results. The software revealed great exactitude detecting thoracic aorta dilation. It was less precise for thoracic spine changes, with utmost false positive results.

https://doi.org/10.25748/arp.29177

11.

Onicomadese secundária à doença mão-pé-boca: relato de caso
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Teixeira, Sara Pereira

; Sonié, Pedro Neves, Marta Perro Duarte, Ana Rita Almeida, Marta

Revista Portuguesa de Medicina Geral e Familiar

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feb 2024, Volume 40 N. 1 Pages 92 - 94

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

Resumo Introdução: A onicomadese é o descolamento da placa ungueal a partir da prega proximal da unha. Esta alteração ungueal autolimitada foi descrita como uma complicação tardia da doença mão-pé-boca, uma infeção viral comum em crianças. Descrição do caso: Criança do sexo feminino de quatro anos, acompanhada pelo pai (representante legal), recorreu a consulta aberta (CA) com um quadro de febre alta, vesículas e pústulas na mucosa oral, língua, períneo, palmas e plantas das mãos e pés. Foi feito o diagnóstico de doença mão-pé-boca. Após três semanas recorre novamente a CA, com resolução completa do quadro viral, mas com alterações ungueais compatíveis com onicomadese. Comentário: A onicomadese secundária à doença mão-pé-boca é uma manifestação relativamente incomum, mas que causa bastante ansiedade aos pais. O reconhecimento desta associação permite orientar os pais sobre a situação transitória e benigna que pode surgir com esta infeção viral, evitando ansiedade, sobreutilização dos cuidados de saúde e tratamentos desnecessários.

Abstract Introduction: Onychomadesis is the detachment of the nail plate from the proximal crease of the nail. This self-limited nail change has been described as a late complication of hand-foot-and-mouth disease, a common viral infection in children. Case description: A 4-year-old female child, accompanied by her father (legal representative), presented to an urgent appointment with high fever, vesicles, and pustules on the oral mucosa, tongue, perineum, palms, and soles of the hands and feet. The diagnosis of hand-foot-mouth disease was made. After three weeks, she returned to another appointment, with complete resolution of the viral picture, but with nail changes consistent with onychomadesis. Comment: Onychomadesis secondary to hand-foot-and-mouth disease is a relatively uncommon manifestation, but one that causes considerable anxiety to parents. Recognition of this association makes it possible to guide parents on the transient and benign situation that can arise with this viral infection, avoiding anxiety, overuse of health care, and unnecessary treatments.

https://doi.org/10.32385/rpmgf.v40i1.13585

12.

FUNCTIONAL TESTS AND ISOKINETIC KNEE ASSESSMENT IN STREET RUNNER ATHLETES CORRELATION
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Borges, João Pedro

; Duarte, Danilo Teixeira de Barros

; Saad, Marcelo Camargo

; Riberto, Marcelo

Revista Brasileira de Medicina do Esporte

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2024, Volume 30 elocation e2021_0547

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

ABSTRACT Introduction: The assessment of biomechanical changes related to the lower limbs is necessary in clinical practice to measure the potential risks of injury and the influences on existing dysfunction. Biomechanical changes related to previous ankle injuries are known to influence the performance of the entire lower limb. Objective: The aim of this study was to correlate muscle strength tests, performance tests and ankle stability with the Single Hop Test (SHT). Methods: 82 amateur runners were evaluated with isokinetic tests of quadriceps and hamstring muscle strength, as well as Y Balance Test (YBT), Weight-bearing Lung Test (WBLT), and the SHT. Results: The results showed there was a significant correlation between the SHT and the YBT in subjects with hamstring/quadriceps ratio (I/Q ratio) <0.55, and the length of the unilateral SHT with the peak torque of ipsilateral knee extensors. Conclusion: The study was successful in correlating the functional tests in question with the results obtained in isokinetic dynamometry. Level of Evidence V; Cross-Sectional Study.

RESUMO Introdução: A avaliação de alterações biomecânicas relacionadas aos membros inferiores é necessária na prática clínica para mensurar os riscos potenciais de alguma lesão e as influencias sobre uma disfunção existente. As alterações biomecânicas relacionadas a lesões prévias de tornozelo são conhecidas pela influência na performance de todo o membro inferior. Objetivo: Correlacionar testes de força muscular, testes de performance e estabilidade do tornozelo com o teste de salto simples (Single Hop Test - SHT). Métodos: Foram avaliados 82 corredores amadores com testes isocinéticos de força muscular de quadríceps e isquiotibiais, além de testes Y Balance Test (YBT), Weight-bearing Lung Test (WBLT), e o SHT. Resultados: Os resultados demonstraram haver correlação significativa entre o SHT e o YBT nos indivíduos com relação Isquiotibiais/Quadríceps (relação I/Q) <0,55, e o comprimento do SHT unilateral com o pico de torque de extensores de joelho ipsilateral. Conclusão: O estudo foi bem sucedido em correlacionar os testes funcionais em questão com os resultados obtidos na dinamometria isocinética. Nível de Evidência V; Estudo Transversal.

RESUMEN Introducción: La evaluación de los cambios biomecánicos relacionados con las extremidades inferiores es necesaria en la práctica clínica para medir los riesgos potenciales de lesión y las influencias sobre la disfunción existente. Se sabe que los cambios biomecánicos relacionados con lesiones previas de tobillo influyen en el rendimiento de toda la extremidad inferior. Objetivo: Correlacionar las pruebas de fuerza muscular, las pruebas de rendimiento y la estabilidad del tobillo con la prueba de salto simple (Single Hop Test, SHT). Métodos: Se evaluó a 82 corredores aficionados con pruebas isocinéticas de fuerza muscular de cuádriceps e isquiotibiales, además de pruebas como Y Balance Test (YBT), Weight-bearing Lung Test (WBLT) y la prueba SHT. Resultados: Los resultados mostraron que existía una correlación significativa entre el SHT y el YBT en sujetos con ratio isquiotibiales/cuádriceps (ratio I/Q) <0,55, y la longitud del SHT unilateral con el par máximo de los extensores de la rodilla ipsilateral. Conclusión: El estudio logró correlacionar las pruebas funcionales en cuestión con los resultados obtenidos en la dinamometría isocinética. Nivel de Evidencia V; Estudio Transversal.

https://doi.org/10.1590/1517-8692202430022021_0547i

13.

Autoinflammatory diseases: a Latin American multicenter study according to age and sex
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Piotto, Daniela Gerent Petry

; Kozu, Katia

; Aikawa, Nádia Emi

; Carneiro, Pedro Lopes

; Katsicas, María Martha

; Oliveira, Sheila Knupp Feitosa de

; Fernandes, Taciana de Albuquerque Pedrosa

; Magalhães, Claudia Saad

; Cunha, Ana Luiza Garcia

; Bica, Blanca Elena Rios Gomes

; Rabelo Júnior, Carlos Nobre

; Battagliotti, Cristina

; Matos, Erica Naomi Naka

; Santos, Flavia Patrícia Sena Teixeira

; Sztajnbok, Flavio Roberto

; Bezrodnik, Liliana

; Bandeira, Marcia

; Rodrigues, Marta Cristine Felix

; Munittis, Pablo García

; Appenzeller, Simone

; Robazzi, Teresa Cristina Martins

; Clemente, Gleice

; Silva, Clovis Artur

; Terreri, Maria Teresa

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2022184

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

ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença.

https://doi.org/10.1590/1984-0462/2024/42/2022184

14.

Noninvasive mechanical ventilation assistance in amyotrophic lateral sclerosis: a systematic review
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Cunha-Correia, Carolina da

; Gama, Mylana Dandara Pereira

; Fontana, Pedro Nogueira

; Fantini, Francisca Goreth Malheiro Moraes

; Prado, Gilmar Fernandes

; Dourado Júnior, Mário Emílio Teixeira

; Schwingel, Paulo Adriano

Sao Paulo Medical Journal

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2024, Volume 142 N. 1 elocation e2022470

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS. OBJECTIVES: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system. DESIGN AND SETTING: Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies. METHODS: The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis. RESULTS: Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype. CONCLUSIONS: NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds. SYSTEMATIC REVIEW REGISTRATION: PROSPERO database: CRD42021279910 — https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.

https://doi.org/10.1590/1516-3180.2022.0470.r1.100423

15.

Evaluation of Severe Acute Respiratory Syndrome surveillance caused by respiratory viruses in a pediatric unit, 2013 to 2019
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Freitas, Felipe Teixeira de Mello

; Pimentel, Cíntia Costa Pereira

; Bianchini, Pedro Ribeiro

; Carvalho, Rafaela Moreira de

; Serafim, Alexandre Peixoto

; Costa, Cira Ferreira Antunes

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2022215

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

ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses.

RESUMO Objetivo: Avaliar a vigilância da síndrome respiratória aguda grave em uma unidade pediátrica. Métodos: Estudo descritivo dos casos de síndrome respiratória aguda grave, notificados e com a detecção de vírus respiratório em amostra de nasofaringe de pacientes internados entre 2013 e 2019, em um hospital de referência do Distrito Federal. Resultados: Um total de 269 crianças tiveram algum vírus detectado, resultando em 280 vírus, sendo 152 (54%) vírus sincicial respiratório. A detecção do vírus sincicial respiratório foi maior durante o período de outono-inverno. A mediana da idade das crianças foi de 6,9 meses, 156 (58%) eram do sexo masculino, 104 (39%) tinham comorbidade, 197 (73%) necessitaram de ventilação mecânica, 241 (90%) receberam antibióticos e 146 (54%) oseltamivir. Ocorreram 19 (7%) óbitos. A mediana do tempo desde o início dos sintomas até a coleta da amostra foi de 5 dias, e do tempo da coleta até o resultado foi de 6 dias. Conclusões: O sistema necessita reduzir o tempo do resultado final para que seja possível evitar o uso inadequado de antibióticos e antivirais. Ademais, o impacto das pneumonias virais foi relevante e o sistema deve ser flexível suficiente para incluir vírus emergentes, para ser útil na resposta às emergências de saúde pública causada por vírus respiratórios.

https://doi.org/10.1590/1984-0462/2024/42/2022215

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