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; Saad, Carla Goncalves Schahin Marques, Claudia Diniz Lopes Ribeiro, Sandra Lúcia Euzébio Gavi, Maria Bernadete Renoldi de Oliveira Yazbek, Michel Alexandre Marinho, Adriana de Oliveira Menin, Rita de Cássia Ochtrop, Manuella Lima Gomes Soares, Andressa Miozzo Cavalcanti, Nara Gualberto Carneiro, Jamille Nascimento Werner de Castro, Glaucio Ricardo Fernandes, José Mauro Carneiro Souza, Elziane da Cruz Ribeiro E Alvarenga, Corina Quental de Menezes Vieira, Rejane Maria Rodrigues de Abreu Machado, Natalia Pereira Ximenes, Antônio Carlos Gazzeta, Morgana Ohira Albuquerque, Cleandro Pires de Skare, Thelma Larocca Keiserman, Mauro Waldemar Kohem, Charles Lubianca Benacon, Gabriel Sarkis Rocha, Vítor Florêncio Santos Lage, Ricardo da Cruz Malheiro, Olivio Brito Golebiovski, Rywka Tenenbaum Medeiros Oliveira, Thauana Luiza Duque, Ruben Horst Londe, Ana Carolina Pinheiro, Marcelo de Medeiros Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2024, Volume 64 elocation 33

Abstract: En | Text: En | PDF: En

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population.

https://doi.org/10.1186/s42358-024-00372-0

Clinical spectrum of congenital Zika virus infection in Brazil: Update and issues for research development
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Martelli, Celina Maria Turchi

; Cortes, Fanny

; Brandão-Filho, Sinval Pinto

; Turchi, Marilia Dalva

; Souza, Wayner Vieira de

; Araújo, Thalia Velho Barreto de

; Ximenes, Ricardo Arraes de Alencar

; Miranda-Filho, Demócrito de Barros

Revista da Sociedade Brasileira de Medicina Tropical

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2024, Volume 57 elocation e00301-2024

Abstract: En | Text: En | PDF: En

ABSTRACT This review aimed to provide an update on the morphological and/or functional abnormalities related to congenital Zika virus (ZIKV) infection, based on primary data from studies conducted in Brazil since 2015. During the epidemic years (2015-2016), case series and pediatric cohort studies described several birth defects, including severe and/or disproportionate microcephaly, cranial bone overlap, skull collapse, congenital contractures (arthrogryposis and/or clubfoot), and visual and hearing abnormalities, as part of the spectrum of Congenital Zika Syndrome (CZS). Brain imaging abnormalities, mainly cortical atrophy, ventriculomegaly, and calcifications, serve as structural markers of CZS severity. Most case series and cohorts of microcephaly have reported the co-occurrence of epilepsy, dysphagia, orthopedic deformities, motor function impairment, cerebral palsy, and urological impairment. A previous large meta-analysis conducted in Brazil revealed that a confirmed ZIKV infection during pregnancy was associated with a 4% risk of microcephaly. Additionally, one-third of children showed at least one abnormality, predominantly identified in isolation. Studies examining antenatally ZIKV-exposed children without detectable abnormalities at birth reported conflicting neurodevelopmental results. Therefore, long-term follow-up studies involving pediatric cohorts with appropriate control groups are needed to address this knowledge gap. We recognize the crucial role of a national network of scientists collaborating with international research institutions in understanding the lifelong consequences of congenital ZIKV infection. Additionally, we highlight the need to provide sustainable resources for research and development to reduce the risk of future Zika outbreaks.

https://doi.org/10.1590/0037-8682-0153-2024

Curva de Aprendizagem da Mortalidade Hospitalar da Substituição da Válvula Aórtica Transcateter: Insights do Registro Nacional Brasileiro
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Bernardi, Fernando Luiz de Melo

; Abizaid, Alexandre A.

; Brito Jr, Fábio Sândoli de

; Lemos, Pedro A.

; Siqueira, Dimytri Alexandre Alvim de

; Costa, Ricardo Alves

; Leite, Rogério Eduardo Gomes Sarmento

; Mangione, Fernanda Marinho

; Thiago, Luiz Eduardo Koenig São

; Mangione, José A.

; Lima, Valter Correia de

; Oliveira, Adriano Dourado

; Marino, Marcos Antônio

; Cardoso, Carlos José Francisco

; Caramori, Paulo R. A.

; Tumelero, Rogério

; Portela, Antenor Lages Fortes

; Prudente, Mauricio Henriques, Leônidas Alvarenga Souza, Fabio Solano Bezerra, Cristiano Guedes Prado Jr, Guy F. A. Freitas, Leandro Zacaris Figueiredo Nogueira, Ederlon Ferreira Meireles, George César Ximenes Pope, Renato Bastos Guerios, Enio Andrade, Pedro Beraldo de Santos, Luciano de Moura Marchi, Mauricio Felippi de Sá Fundão, Nelson Henrique Fantin Ribeiro, Henrique Barbosa

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e20230622

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

Resumo Fundamento Dados robustos sobre a curva de aprendizagem (LC) da substituição da válvula aórtica transcateter (TAVR) são escassos nos países em desenvolvimento. Objetivo Avaliar a LC da TAVR no Brasil ao longo do tempo. Métodos Analisamos dados do registro brasileiro de TAVR de 2008 a 2023. Pacientes de cada centro foram numerados cronologicamente em número sequencial de caso (NSC). A LC foi realizada usando um spline cúbico restrito ajustado para o EuroSCORE-II e o uso de próteses de nova geração. Ainda, os desfechos hospitalares foram comparados entre grupos definidos de acordo com o nível de experiência, com base no NSC: 1º ao 40º caso (experiência inicial), 41º ao 80º caso (experiência básica), 81º ao 120º caso (experiência intermediária) e 121º caso em diante (experiência alta). Análises adicionais foram conduzidas de acordo com o número de casos tratados antes de 2014 (>40 e ≤40 procedimentos). O nível de significância adotado foi p <0,05. Resultados Foram incluídos 3194 pacientes de 25 centros. A idade média foi 80,7±8,1 anos e o EuroSCORE II médio foi 7±7,1. A análise da LC demonstrou uma queda na mortalidade hospitalar ajustada após o tratamento de 40 pacientes. Um patamar de nivelamento na curva foi observado após o caso 118. A mortalidade hospitalar entre os grupos foi 8,6%, 7,7%, 5,9%, e 3,7% para experiência inicial, básica, intermediária e alta, respectivamente (p<0,001). A experiência alta foi preditora independente de mortalidade mais baixa (OR 0,57, p=0,013 vs. experiência inicial). Centros com baixo volume de casos antes de 2014 não mostraram uma redução significativa na probabilidade de morte com o ganho de experiência, enquanto centros com alto volume de casos antes de 2014 apresentaram uma melhora contínua após o caso de número 10. Conclusão Observou-se um fenômeno de LC para a mortalidade hospitalar do TAVR no Brasil. Esse efeito foi mais pronunciado em centros que trataram seus 40 primeiros casos antes de 2014 que naqueles que o fizeram após 2014.

Abstract Background Robust data on the learning curve (LC) of transcatheter aortic valve replacement (TAVR) are lacking in developing countries. Objective To assess TAVR’s LC in Brazil over time. Methods We analyzed data from the Brazilian TAVR registry from 2008 to 2023. Patients from each center were numbered chronologically in case sequence numbers (CSNs). LC was performed using restricted cubic splines adjusted for EuroSCORE-II and the use of new-generation prostheses. Also, in-hospital outcomes were compared between groups defined according to the level of experience based on the CSN: 1st to 40th (initial-experience), 41st to 80th (early-experience), 81st to 120th (intermediate-experience), and over 121st (high-experience). Additional analysis was performed grouping hospitals according to the number of cases treated before 2014 (>40 and ≤40 procedures). The level of significance adopted was <0.05. Results A total of 3,194 patients from 25 centers were included. Mean age and EuroSCORE II were 80.7±8.1 years and 7±7.1, respectively. LC analysis demonstrated a drop in adjusted in-hospital mortality after treating 40 patients. A leveling off of the curve was observed after case #118. In-hospital mortality across the groups was 8.6%, 7.7%, 5.9%, and 3.7% for initial-, early-, intermediate-, and high-experience, respectively (p<0.001). High experience independently predicted lower mortality (OR 0.57, p=0.013 vs. initial experience). Low-volume centers before 2014 showed no significant decrease in the likelihood of death with gained experience, whereas high-volume centers had a continuous improvement after case #10. Conclusion A TAVR LC phenomenon was observed for in-hospital mortality in Brazil. This effect was more pronounced in centers that treated their first 40 cases before 2014 than those that reached this milestone after 2014.

https://doi.org/10.36660/abc.20230622

Survival and mortality profile among people living with HIV in a cohort in the Northeastern region of Brazil
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Leite, Kaliene Maria Estevão

; Lima, Kledoaldo Oliveira

; Ximenes, Ricardo Arraes de Alencar

; Albuquerque, Maria de Fatima Militão de

; Miranda-Filho, Demócrito de Barros

; Godoi, Emmanuelle Tenório Albuquerque Madruga

; Montarroyos, Ulisses Ramos

; Lacerda, Heloísa Ramos

Revista do Instituto de Medicina Tropical de São Paulo

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2024, Volume 66 elocation e23

Abstract: En | Text: En | PDF: En

ABSTRACT Conditions related to the acquired immune deficiency syndrome (AIDS) are still a significant cause of morbidity and mortality among people living with HIV (PLHIV). Longer survival in this population were reported to increase the risk of developing noncommunicable chronic diseases (NCDs). This study aimed to estimate the survival and causes of death according to age group and sex among PLHIV monitored at two referral centers in the Northeastern Brazil. This is a prospective, retrospective cohort with death records from 2007 to 2018, based on a database that registers causes of death using the International Classification of Disease (ICD-10), which were subsequently coded following the Coding Causes of Death in HIV (CoDe). A total of 2,359 PLHIV participated in the study, with 63.2% being men, with a follow-up period of 13.9 years. Annual mortality rate was 1.46 deaths per 100 PLHIV (95% CI: 1.33 – 1.60) with a frequency of 20.9%. Risk of death for men increased by 49% when compared to women, and the risk of death in PLHIV increased by 51% among those aged 50 years and over at the time of diagnosis. It was observed that 73.5% accounted for AIDS-related deaths, 6.9% for non-AIDS defining cancer, 6.3% for external causes, and 3.2% for cardiovascular diseases. Among the youngest, 97.2% presented an AIDS-related cause of death. Highest frequency of deaths from neoplasms was among women and from external causes among men. There is a need for health services to implement strategies ensuring greater adherence to treatment, especially among men and young people. Moreover, screening for chronic diseases and cancer is essential, including the establishment of easily accessible multidisciplinary care centers that can identify and address habits such as illicit drug use and alcoholism, which are associated with violent deaths.

https://doi.org/10.1590/s1678-9946202466023

NOVAS POSSIBILIDADES HISTÓRICAS PARA A DEMOCRACIA E PARA A EDUCAÇÃO PÚBLICA
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Leher, Roberto

; Pino, Ivany Rodrigues

; Zuin, Antônio Alvaro Soares

; Almeida, Luana Costa

; Silveira, Adriana Aparecida Dragone

; Dalbosco, Claudio Almir

; Moraes, Carmen Sylvia Vidigal

; Mazza, Débora

; Amaral, Nelson Cardoso

; Souza, Sandra Maria Zákia Lian

; Almeida, Ana Maria Fonseca de

; Ferretti, Celso João

; Sisto, Vicente

; Goergen, Pedro

; Ximenes, Salomão

; Lima, Licínio Carlos Viana da Silva

; Trevisan, Anderson Ricardo

; Rambla, Xavier

Educação & Sociedade

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2023, Volume 44 elocation e271371

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/es.271371

Still on the Brazilian Response to the Microcephaly Epidemic: A Meta-analysis of 1,548 Pregnant Women from 13 Cohorts to Evaluate the Risk of Adverse Outcomes Epidemic Metaanalysis Meta analysis 1548 1 548 1,54 154 54 1,5 15 5 1,
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Ximenes, Ricardo Arraes de Alencar

; Miranda-Filho, Demócrito de Barros

; Martinez-Espinoza, Flor Ernestina

; Brasil, Patrícia

Revista Brasileira de Ginecologia e Obstetrícia

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2023, Volume 45 N. 4 Pages 169 - 170

Abstract: En | Text: En | PDF: En

https://doi.org/10.1055/s-0043-1769107

Relationship between Perme ICU Mobility Score and length of stay in patients after cardiac surgery
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Kenji Nawa, Ricardo

; Daros dos Santos, Tamires

; Albiero Real, Amanda

; Corrêa Matheus, Silvana

; Tatsch Ximenes, Mauricio

; Machado Cardoso, Dannuey

; Martins de Albuquerque, Isabella

Colombia Médica

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sep 2022, Volume 53 N. 3 elocation e2005179

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

Resumen Antecedentes: Los pacientes sometidos a cirugía cardiaca pueden experimentar deterioro funcional. Objetivo: Evaluar la influencia del Perme Score en la estancia hospitalaria en la unidad de cuidados intensivos (UCI) en pacientes postoperados de cirugía cardiaca. Como objetivo secundario fue investigar si las variables preoperatorias pueden predecir el estado de movilidad del paciente después de la cirugía. Métodos: Se realizó un estudio observacional prospectivo en la UCI de un hospital universitario. El estado de movilidad (Perme Score) se monitoreó desde el primer día postoperatorio, hasta el alta de la UCI. Se recolectó la evaluación preoperatoria de la fuerza de los músculos respiratorios, la función pulmonar y la fuerza de agarre. Resultados: Fueron incluidos en el estudio 44 pacientes, con edad media de 62.3 años y 28 hombres. Se obruvo una puntuación alta de Perme entre los pacientes que se sometieron a un injerto de derivación de la arteria coronaria a partir del segundo día posoperatorio y al tercer día posoperatorio en tres tipos de intervención (injerto de derivación de la arteria coronaria, reemplazo de válvula o ambos simultáneamente), se asoció con una estancia más corta en la UCI. La función pulmonar preoperatoria fue uno de los principales predictores independientes del estado de movilidad en los tres primeros días de estancia en la UCI, además de la fracción de eyección del ventrículo izquierdo y el tiempo de circulación extracorpórea al primer día, la edad y la fracción de eyección del ventrículo izquierdo al segundo día y presión espiratoria máxima al tercer día. Conclusión: Un aumento en el estado de movilidad (Perme Score), principalmente en el tercer día postoperatorio, redujo la estancia en la UCI, influenciado principalmente por la función pulmonar preoperatoria.

Abstract Background: Patients undergoing cardiac surgery can experience functional impairment. Objective: Assess the influence of Perme Score on the intensive care unit (ICU) length of stay in patients after cardiac surgery. As a secondary objective, investigate if preoperative variables can predict the patient's mobility status after surgery. Methods: A prospective observational study was conducted in ICU in a university hospital. The mobility status (Perme Score) was collected from the first postoperative day until ICU discharge. The preoperative assessment of respiratory muscle strength, pulmonary function, and handgrip strength were collected. Results: A total of 44 patients, mean age of 62.3 years, 28 men were included in the study. A high Perme Score on the second postoperative day among patients who underwent Coronary artery bypass grafting and the third postoperative day on three types of intervention (Coronary artery bypass grafting, valve replacement, or both simultaneously) was associated with shorter ICU length of stay). The preoperative pulmonary function was one of the main independent predictors of mobility status on the first three days of ICU stay, in addition to left ventricular ejection fraction and cardiopulmonary bypass time on the first day, age, and left ventricular ejection fraction on the second day and maximum expiratory pressure on third day Conclusion: An increase in mobility status (Perme Score), mainly on the third postoperative day, reduced the ICU stay, mainly influenced by preoperative pulmonary function.

https://doi.org/10.25100/cm.v53i3.5179

Reconstrução total da cobertura cutânea do pênis com retalho miocutâneo: relato de caso
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PITA, PEDRO CELSO DE CASTRO

; ALMEIDA, AMANDA COÊLHO DE ANDRADE

; ROMÃO, RICARDO FUSANO

; DELARISSA, VINÍCIUS DE OLIVEIRA PALONE

; COUTINHO, LUCAS RIBEIRO

; MORAIS, RAFAEL XIMENES BANDEIRA

Revista Brasileira de Cirurgia Plástica

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apr 2022, Volume 37 N. 2 Pages 256 - 259

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

RESUMO Introdução: O pênis é uma importante estrutura do corpo masculino, sendo sua reconstrução um desafio. Existem diversas doenças e deformidades que acometem este órgão, sendo necessário, em certos casos, a reconstrução total da cobertura cutânea do pênis, tendo já sido descritas na literatura diversas técnicas, tais como o uso de enxertos totais, retalho escrotal, retalhos miocutâneos da fáscia lata e outros. Relato de Caso: Neste relato é apresentada uma reconstrução da cobertura total do pênis por meio do uso de retalho miocutâneo do músculo cremaster com pele da bolsa escrotal, conseguindo prover uma boa vascularização e mantendo a permeabilidade uretral. Conclusão: Tal técnica não foi encontrada em nenhuma das bases de dados pesquisadas no trabalho, apenas semelhantes, e mostrouse como uma boa opção para a reconstrução total da cobertura cutânea peniana.

ABSTRACT Introduction: The penis is an important structure of the male body, and its reconstruction is a challenge. Several diseases and deformities affect this organ, being necessary, in certain cases, for the total reconstruction of the cutaneous coverage of the penis, having already been described in the literature several techniques, such as the use of total grafts, scrotal flap, myocutaneous flaps of the fasciae latae and others. Case Report: In this report, a reconstruction of the total coverage of the penis is presented using a myocutaneous flap of the cremaster muscle with skin from the scrotum, achieving good vascularization and maintaining urethral permeability. Conclusion: This technique was not found in any of the databases researched in this study, only similar ones, and it proved to be a good option for the total reconstruction of penile skin coverage.

https://doi.org/10.5935/2177-1235.2022rbcp0041

10.

REFORMA DO ENSINO MÉDIO: A INSTITUCIONALIZAÇÃO DO APARTHEID SOCIAL NA EDUCAÇÃO
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Moraes, Carmen Sylvia Vidigal

; Ferretti, Celso João

; Pino, Ivany Rodrigues

; Leher, Roberto

; Almeida, Luana Costa

; Ximenes, Salomão Barros

; Dalbosco, Claudio Almir

; Souza, Sandra Maria Zákia Lian

; Zuin, Antônio Alvaro Soares

; Silveira, Adriana Aparecida Dragone

; Almeida, Ana Maria Fonseca de

; Trevisan, Anderson Ricardo

; Mazza, Débora

; Lima, Licínio Carlos Viana da Silva

; Amaral, Nelson Cardoso

; Goergen, Pedro

; Rambla, Xavier

; Sisto, Vicente

Educação & Sociedade

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2022, Volume 43 elocation e261875

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/es.261875

11.

Protective effect of exclusive breastfeeding and effectiveness of maternal vaccination in reducing pertussis-like illness
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Nascimento, Renata Medeiros do

; Baptista, Paulo Neves

; Lopes, Katiuscia Araújo de Miranda

; Pimentel, Analíria Moraes

; Cruz, Fábia da Silva Pereira

; Ximenes, Ricardo Arraes de Alencar

Jornal de Pediatria

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oct 2021, Volume 97 N. 5 Pages 500 - 507

Abstract: En | Text: En | PDF: En

Abstract Objective: To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness. Method: This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date. Results: Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; −34% a 60%). Conclusions: Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.

https://doi.org/10.1016/j.jped.2020.10.018 28 downloads

12.

[SciELO Preprints] - Strengthening the surveillance and information activities is urgent and essential to reduce the transmission force of SARS-CoV-2
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Teixeira, Maria Glória Kerr, Ligia Regina Franco Sansigolo Ximenes, Ricardo Arraes de Alencar Almeida, Rosa Lívia Freitas de Ichihara, Maria Yury Albuquerque, Maria de Fátima Militão de Aquino, Estela M L Werneck, Guilherme Carmo, Eduardo Hage Medronho, Roberto Andrade Oliveira, Wanderson Kleber de Henriques, Claudio Maierovitch Pessanha Kendall, Carl Silva, Antônio Augusto Moura da Almeida-Filho, Naomar M. Souza, Wayner Vieira de Veras , Maria Amelia de Sousa Mascena Penna, Gerson Oliveira Silva , Gulnar Azevedo e Brandão Filho, Sinval Pinto Barreto, Maurício L.

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Publication date: 2021-08-17

Abstract: En Pt

N/A

https://doi.org/10.1590/1980-549720210049

13.

Covid-19 no nordeste do Brasil: entre o lockdown e o relaxamento das medidas de distanciamento social
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Ximenes, Ricardo Arraes de Alencar

; Albuquerque, Maria de Fatima Pessoa Militão de

; Martelli, Celina Maria Turchi

; Araújo, Thália Velho Barreto de

; Miranda Filho, Demócrito de Barros

; Souza, Wayner Vieira de

; Ichihara, Maria Yury Travassos

; Lira, Pedro Israel Cabral de

; Kerr, Ligia Regina Franco Sansigolo

; Aquino, Estela ML

; Silva, Antônio Augusto Moura da

; Almeida, Rosa Lívia Freitas de

; Kendall, Carl

; Pescarini, Julia M

; Brandão Filho, Sinval Pinto

; Almeida-Filho, Naomar

; Oliveira, Juliane Fonseca de

; Teles, Carlos

; Jorge, Daniel Cardoso Pereira

; Santana, Guilherme

; Gabrielli, Ligia

; Rodrigues, Moreno MS

; Silva, Natanael Jesus da

; Souza, Rafael Felipe da Silva

; Silva, Vivian Alessandra Ferreira da

; Barreto, Maurício Lima

Ciência & Saúde Coletiva

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apr 2021, Volume 26 N. 4 Pages 1441 - 1456

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

Resumo Mesmo no período em que a pandemia de Covid-19 encontrava-se em crescimento no Nordeste do Brasil, iniciou-se a adoção de medidas de flexibilização do distanciamento social. O objetivo do estudo é o de avaliar a pertinência das propostas de flexibilização, tomando-se em conta a situação da pandemia em cada local e o momento em que foram adotadas. Tendo como referência as diretrizes da OMS, foram construídos e analisados indicadores operacionais para cada diretriz, no contexto da região Nordeste. Para análise do comportamento da epidemia, conforme indicadores selecionados, foram usadas técnicas de Joinpoint Trend Analysis, mapas de calor, razão de taxas e comparação da tendência temporal entre capitais e interior dos estados. O pico do crescimento semanal ocorreu em maio-julho/2020 (semanas epidemiológicas 19 a 31). Na maioria das capitais não se observou tendência decrescente simultânea do número de casos e óbitos nos 14 dias prévios à flexibilização. Em todos os estados o quantitativo de testes realizados foi insuficiente. Na semana epidemiológica 24 os percentuais estaduais de ocupação de leitos de UTI/Covid-19 foram próximos ou superiores 70%. A situação epidemiológica das nove capitais dos estados do Nordeste, no momento em que a decisão de flexibilização foi tomada, mostra que nenhuma delas atendia aos critérios e parâmetros recomendados pela OMS.

Abstract Even in the period when the Covid-19 pandemic was on the rise in the Northeast of Brazil, the relaxation of social distancing measures was introduced. The scope of the study is to assess, in the light of the epidemiological-sanitary situation in the region, the suitability of relaxation of social distancing measures. Based on the WHO guidelines for relaxation of social distancing, operational indicators were created and analyzed for each guideline in the context of the Northeast. To analyze the behavior of the epidemic, according to selected indicators, Joinpoint trend analysis techniques, heat maps, rate ratios and time trends between capitals and the state interior were compared. The weekly growth peak of the epidemic occurred in May-July 2020 (epidemiological weeks 19 to 31). In most capitals, there was no simultaneous downward trend in the number of cases and deaths in the 14 days prior to flexibilization. In all states the number of tests performed was insufficient. In epidemiological week 24, the state percentages of ICU/Covid-19 bed occupancy were close to or above 70%. The epidemiological situation of the nine Northeastern state capitals analyzed here did not meet criteria and parameters recommended by the World Health Organization for the relaxation of social distancing measures.

https://doi.org/10.1590/1413-81232021264.39422020 2043 downloads

14.

Prevalence of hepatitis A in the capitals of the States of North, Southeast and South regions of Brazil: decrease in prevalence and some consequences
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Pereira, Leila M. M. B.

; Stein, Airton T.

; Figueiredo, Gerusa Maria

; Coral, Gabriela Perdomo

; Montarroyos, Ulisses R.

; Cardoso, Maria Regina Alves

; Braga, Maria Cynthia

; Moreira, Regina Celia

; Santos, Alex A. dos

; Ximenes, Ricardo Alencar

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e34

Abstract: En | Text: En | PDF: En

ABSTRACT Hepatitis A virus (HAV) infection has been considered one of the leading causes of acute hepatitis. The aim of the present study was to estimate the prevalence of HAV among children and adolescents in a population-based study in the capitals of the States of the North, Southeast and South of Brazil and identify predictive factors for the infection. A multi-stage sampling was used to select subjects aged between 5-9 and 10-19 years. Individual and household levels aside from the level of variables in the areas were collected. The outcome was the total IgG antibodies to HAV levels detected using a commercial Enzyme Immuno Assay (EIA). The associations between HAV and the independent variables were assessed using the odds ratio. A multilevel analysis was performed by GLLAMM using the Stata software. The prevalence of HAV infection in the 5-9 and 10-19 age groups was 28.7% and 67.5%, respectively for the North, 20.6% and 37.7%, for the Southeast and 18.9% and 34.5% for the South Region. The prevalence of HAV increased according to age in all sites. Variables related to education at the individual level (North and South), family and area level (South and Southeast) and family income level (Southeast and South) were independently associated with HAV infection. This emphasizes the need for individualized strategies to prevent the infection.

https://doi.org/10.1590/s1678-9946202163034 358 downloads

15.

Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis
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Lage, Ricardo da Cruz

; Marques, Claudia Diniz Lopes Oliveira, Thauana Luiza Resende, Gustavo Gomes Kohem, Charles Lubianca Saad, Carla Gonçalves Ximenes, Antônio Carlos Gonçalves, Célio Roberto Bianchi, Washington Alves Meirelles, Eduardo de Souza Keiserman, Mauro Waldemar Chiereghin, Adriano Campanholo, Cristiano Barbosa Lyrio, André Marun Schainberg, Cláudia Goldenstein Pieruccetti, Lenise Brandao Yazbek, Michel Alexandre Palominos, Penelope Esther Goncalves, Rafaela Silva Guimarães Assad, Rodrigo Luppino Bonfiglioli, Rubens Lima, Sônia Maria Alvarenga Anti Loduca Carneiro, Sueli Azevedo, Valderílio Feijó Albuquerque, Cleandro Pires Bernardo, Wanderley Marques Sampaio-Barros, Percival Degrava Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 4

Abstract: En | Text: En | PDF: En

Abstract Spondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

https://doi.org/10.1186/s42358-020-00160-6 505 downloads

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