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Resumen Objetivo Identificar la prevalencia de la alfabetización funcional en salud y analizar la asociación entre los niveles de alfabetización funcional en salud y las variables clínicas y sociodemográficas en pacientes renales crónicos no dializados. Métodos Estudio transversal realizado con 167 pacientes renales crónicos con seguimiento en consultorios externos de nefrología de un municipio de gran porte del estado de Minas Gerais, Brasil. Para las entrevistas se utilizó un cuestionario sociodemográfico y clínico y la versión brasileña del Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para medir la alfabetización funcional en salud. Se realizó estadística descriptiva para variables sociodemográficas y clínicas, pruebas de correlación y modelos de regresión lineales para asociación con alfabetización funcional en salud. Resultados La mayoría de los participantes eran personas mayores de 68 años de mediana de edad, el 33,3 % (56 pacientes) se encontraba en la etapa 3B de la enfermedad renal crónica y el 53,9 % (90 pacientes) presentó alfabetización funcional en salud inadecuada. No hubo asociación entre los niveles de alfabetización funcional en salud y las variables clínicas. La mayoría relató que no usaba internet y la etapa más avanzada de la enfermedad renal crónica presentó menor puntaje de alfabetización. Se identificaron peores puntajes de alfabetización funcional en salud en aquellos con menores ingresos. Conclusión La mayoría de los participantes presentó alfabetización funcional en salud inadecuada. Las variables clínicas no fueron predictoras de los puntajes de alfabetización. Sin embargo, se identificaron puntajes más bajos de alfabetización en salud en aquellos en etapa más avanzada de la enfermedad renal, con menores ingresos y menor uso de internet. dializados 16 Gerais Brasil SAHLPA18, SAHLPA18 SAHLPA 18, 18 SAHLPA-18 6 edad 333 33 3 33, 56 (5 B 539 53 9 53, 90 (9 inadecuada embargo 1 SAHLPA1 SAHLPA-1 5 ( SAHLPA-

Abstract Objective To identify the prevalence of functional health literacy and analyze the association between functional health literacy levels and clinical and sociodemographic variables in non-dialysis chronic kidney disease patients. Methods This is a cross-sectional study carried out with 167 chronic kidney disease patients being monitored at the nephrology outpatient clinic of a large city in the state of Minas Gerais, Brazil. For the interviews, a sociodemographic and clinical questionnaire and the Brazilian version of the Short Assessment of Health Literacy for Portuguese Speaking Adults (SAHLPA-18) were used to measure functional health literacy. Descriptive statistics were performed for sociodemographic and clinical variables, and correlation tests and linear regression models for association with functional health literacy. Results Most participants were older adults with a median age of 68 years, 33.3% (56 patients) were in stage 3B of chronic kidney disease and 53.9% (90 patients) had inadequate functional health literacy. There was no association between functional health literacy levels and clinical variables. The majority reported not using the internet and the more advanced stage of chronic kidney disease had lower literacy scores. Worse functional health literacy scores were also identified in those with lower income. Conclusion Most participants had inadequate functional health literacy. Clinical variables were not predictors of literacy scores. However, lower health literacy scores were identified in those with more advanced stage kidney disease, lower income and less internet use. nondialysis non dialysis crosssectional cross sectional 16 Gerais Brazil interviews SAHLPA18 SAHLPA 18 (SAHLPA-18 6 years 333 33 3 33.3 56 (5 B 539 53 9 53.9 90 (9 However use 1 SAHLPA1 (SAHLPA-1 33. 5 ( 53. (SAHLPA- (SAHLPA

Resumo Objetivo Identificar a prevalência de letramento funcional em saúde e analisar a associação entre os níveis de letramento funcional em saúde e as variáveis clínicas e sociodemográficas em pacientes renais crônicos não dialíticos. Métodos Estudo transversal realizado com 167 renais crônicos em acompanhamento no ambulatório de nefrologia de um município de grande porte do estado de Minas Gerais, Brasil. Para as entrevistas foram utilizados questionário sociodemográfico e clínico e a versão brasileira do Short Assessment of Health Literacy for Portuguese Speaking Adults - SAHLPA-18, para mensurar o letramento funcional em saúde. Realizado estatística descritiva para variáveis sociodemográficas e clínicas; testes de correlação e modelos de regressão lineares para associação com letramento funcional em saúde. Resultados A maior parte dos participantes era idosa com mediana de idade de 68 anos, 33,3% (56 pacientes) se encontravam no estágio 3B da doença renal crônica e 53,9% (90 pacientes) apresentaram letramento funcional em saúde inadequado. Não houve associação entre os níveis de letramento funcional em saúde e as variáveis clínicas. A maioria referiu não usar internet e o estágio mais avançado da doença renal crônica apresentou menores escores de letramento. Piores escores de letramento funcional em saúde também foi identificado naqueles com menor renda. Conclusão A maioria dos participantes apresentou letramento funcional em saúde inadequado. As variaveis clínicas não foram preditoras dos ecores de letramento. No entanto, escores mais baixos de letramento em saúde foram identificados naqueles em estágio mais avancado da doença renal, menor renda e menor uso da internet. dialíticos 16 Gerais Brasil SAHLPA18, SAHLPA18 SAHLPA 18, 18 SAHLPA-18 6 anos 333 33 3 33,3 56 (5 B 539 53 9 53,9 90 (9 inadequado entanto 1 SAHLPA1 SAHLPA-1 33, 5 ( 53, SAHLPA-

https://doi.org/10.37689/acta-ape/2024ao00007111

A Comparative Analysis of Three Online Drug-Drug Interaction Checkers: A Short Communication DrugDrug Drug Checkers
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Aguilar, Diego Rodrigues de

; Cruz, Alex Junio Silva

; Martins, Maria Auxiliadora Parreiras

; Abreu, Mauro Henrique Nogueira Guimarães

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2024, Volume 24 elocation e230193

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To assess the agreement among three different online drug-drug interaction (DDI) checkers for the detection of psychotropic drug interactions among dental patients in the state of Minas Gerais, Brazil. Material and Methods: Between January and December 2017, a cross-sectional study was conducted in Minas Gerais with data on pharmaceutical claims of psychotropic drugs prescribed by dental practitioners. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The occurrence of DDI was determined by entering the name of the drugs taken by each patient into Merative Micromedex®, Medscape®, and DrugBank. The degree of agreement among the three DDI online checkers was analyzed using the Fleiss' kappa test. Results: Overall, 797 dental patients were found to be taking some psychotropic medication with other drugs simultaneously. The number of patients with DDI varied according to Micromedex® (n= 366), Medscape® (n= 473), and DrugBank (n= 736). The agreement between the DDI checkers was poor (Fleiss' kappa: 0.165; p<0.001). Conclusion: The online DDI checkers assessed in this study showed variations in their ability to detect interactions and poor agreement among them. Objective drugdrug (DDI Brazil Methods 2017 crosssectional cross sectional practitioners use Micromedex Medscape Fleiss test Results Overall 79 simultaneously n= n (n 366, 366 , 366) 473, 473 473) 736. 736 . 736) (Fleiss 0.165 0165 0 165 p<0.001. p0001 p p<0.001 001 p<0.001) Conclusion them 201 7 36 47 73 0.16 016 16 p000 p<0.00 00 20 3 4 0.1 01 1 p00 p<0.0 2 0. p0 p<0. p<0 p<

https://doi.org/10.1590/pboci.2024.044

Factors Associated with Variation in Time in Therapeutic Range in Two Anticoagulation Clinics in Brazil
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Costa, Josiane Moreira da

; Marcolino, Milena S.

; Machado, Carla Jorge

; Cintra, Leandro Pinheiro

; Siqueira, Izabella Fernanda Bastos

; Ribeiro, Daniel Dias

; Martins, Maria Auxiliadora Parreiras

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20230172

Resumo: En | Texto: En | PDF: En

Abstract Background Time in therapeutic range (TTR) plays an important role in the effectiveness of anticoagulant therapy with vitamin K antagonists. Objective To identify factors associated with variation in TTR. Methods The study sites were anticoagulation clinics at two university hospitals in Minas Gerais, with a total of 1357 patients studied. TTR was calculated using the Rosendaal method. Binary logistic regressions were carried out with the study variables, followed by multiple regression with those that were significant for the model, adopting a significance level of 5%. Results The outpatient clinics presented different values in mean TTR; one corresponded to the expected percentage, while the other did not. Multiple regression identified the variable male sex as a protective factor in relation to TTR < 60% (odds ratio [OR]: 0.42; p = 0). Conclusion The identification of variables associated with inadequate TTR contributes to identifying weaknesses in the care process and implementing improvement actions in the hospitals studied. (TTR antagonists Gerais 135 studied method model 5 5% percentage not 60 odds OR [OR] 0.42 042 0 42 0. . 0) 13 6 [OR 0.4 04 4 1

https://doi.org/10.36660/ijcs.20230172

The Challenges of Implementing a Text Message Intervention to Promote Behavioral Change in Primary Care Patients With Hypertension and Diabetes
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Oliveira, João Antonio de Queiroz

; Cimini, Christiane

; Almeida, Vania

; Maia, Junia Xavier

; Resende, Raissa Eda

; Gualberto, Leticia Alves

; Santos, Pedro Henrique Lauar

; Gomes, Paulo R.

; Bonisson, Leonardo

; Paixão, Maria Cristina

; Costa, Janaina Moutinho

; Cardoso, Clareci Silva

; Santo, Karla

; Ribeiro, Antonio

; Martins, Maria Auxiliadora

; Marcolino, Milena S.

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220050

Resumo: En | Texto: En | PDF: En

Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program’s long-term effects on clinical outcomes. solutions lowincome low income selfreported self 20 activity adherence motivation Mucuri MG diseases months 13 11 86.0% 860 86 0 (86.0% 86.3%, 863 86.3% , 3 (86.3%) 90.6%, 906 90.6% 90 (90.6%) 65.0% 650 65 (65.0%) 846 84 84.6 healthier 85.5%, 855 85.5% 85 (85.5%) 65.8%, 658 65.8% (65.8%) 56.4%. 564 56.4% . 56 4 (56.4%) 60.7% 607 60 7 (60.7% acquaintances 89.7% 897 89 (89.7% 95.7%. 957 95.7% 95 (95.7%) lowresource resource settings programs s longterm long term outcomes 2 1 86.0 (86.0 86.3 (86.3% 90.6 9 (90.6% 65.0 (65.0% 84. 85.5 (85.5% 65.8 (65.8% 56.4 (56.4% 60.7 (60.7 89.7 (89.7 95.7 (95.7% 86. (86. (86.3 90. (90.6 65. (65.0 85. (85.5 (65.8 56. (56.4 60. (60. 89. (89. 95. (95.7 (86 (90. (65. (85. (56. (60 (89 (95. (8 (90 (65 (85 (56 (6 (95 ( (9 (5

https://doi.org/10.36660/ijcs.20220050

E-learning as a strategy in dentistry in the context of COVID-19: a path to follow? Elearning E learning COVID19 COVID 19 COVID-19 follow COVID1 1 COVID-1 COVID-
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MARQUES-MEDEIROS, Ana Carolina

; MARTINS, Renata Castro

; SOUZA, Leandro Napier de

; GOMEZ, Ricardo Santiago

; SILVA, Maria Elisa de Souza e

; MARTINS, Maria Auxiliadora Parreiras

; ABREU, Mauro Henrique Nogueira Guimarães de

Brazilian Oral Research

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2023, Volume 37 elocation e060

Resumo: En | Texto: En | PDF: En

Abstract The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff’s knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended. elearning e COVID19 COVID 19 COVID-1 Brazil quasiexperimental quasi experimental structured pretested pre tested questionnaire format performed 54 phases 269 26 9 26.9% stage gloves goggles masks staffs s 100 improved guidelines Therefore recommended COVID1 1 COVID- 5 2 26.9 10 26.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0060

A completeness indicator of gestational and congenital syphilis information in Brazil
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Oliveira, Guilherme Lopes de

; Ferreira, Andrêa JF

; Santana, José Guilherme

; Lana, Raquel Martins

; Cardoso, Andrey Moreira

; Teles, Carlos

; Fiaccone, Rosemeire L.

; Aquino, Rosana

; Soares, Maria Auxiliadora Santos

; Paixao, Enny S.

; Santos, Idália Oliveira

; Salvi, Leonardo

; Barreto, Maurício L.

; Ichihara, Maria Yury

Revista de Saúde Pública

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2023, Volume 57 elocation 42

Resumo: En | Texto: En | PDF: En

ABSTRACT OBJECTIVE To evaluate the quality of information on gestational syphilis (GS) and congenital syphilis (CS) on the Sistema de Informação de Agravos de Notificação (SINAN-Syphilis Brazil – Notifiable Diseases Information System) by compiling and validating completeness indicators between 2007 and 2018. METHODS Overall, care, and socioeconomic completeness scores were compiled based on selected variables, by using ad hoc weights assigned by experts. The completeness scores were analysed, considering the region and area of residence, the pregnant woman’s race/colour, and the year of case notification. Pearson’s correlation coefficients were used to validate the scores obtained by the weighted average method, compared with the values obtained by principal component analysis (PCA). RESULTS Most selected variables presented a good or excellent degree of completeness for GS and CS, except for clinical classification, pregnant woman’s level of education, partner’s treatment, and child’s race/colour, which were classified as poor or very poor. The overall (89.93% versus 89.69%) and socioeconomic (88.71% versus 88.24%) completeness scores for GS and CS, respectively, were classified as regular, whereas the care score (GS-90.88%, and CS-90.72%) was good, despite improvements over time. Differences in the overall, care and socioeconomic completeness scores according to region, area of residence, and ethnic-racial groups were reported for syphilis notifications. The completeness scores estimated by the weighted average method and PCA showed a strong linear correlation (> 0.90). CONCLUSION The completeness of GS and CS notifications has been improving in recent years, highlighting the variables that form the care score, compared with the socioeconomic scores, despite differences between regions, area of residence, and ethnic-racial groups. The weighted average was a viable methodological alternative easily operationalised to estimate data completeness scores, allowing routine monitoring of the completeness of gestational and congenital syphilis records. (GS (CS SINANSyphilis SINAN Syphilis System 200 2018 Overall experts analysed residence womans woman s racecolour race colour race/colour notification Pearsons Pearson PCA. . (PCA) classification education partners partner treatment childs child 89.93% 8993 89 93 (89.93 89.69% 8969 69 88.71% 8871 88 71 (88.71 88.24% 8824 24 respectively regular GS90.88%, GS9088 90.88%, 90 (GS-90.88% CS90.72% CS9072 90.72% 72 CS-90.72% time ethnicracial ethnic racial > ( 0.90. 090 0.90 0 0.90) years regions records 20 201 (PCA 89.93 899 8 9 (89.9 89.69 896 6 88.71 887 7 (88.7 88.24 882 2 GS90 GS90.88% GS908 9088 90.88% (GS-90.88 CS90 CS90.72 CS907 9072 90.72 CS-90.72 09 0.9 89.9 (89. 89.6 88.7 (88. 88.2 GS9 GS90.88 908 90.88 (GS-90.8 CS9 CS90.7 907 90.7 CS-90.7 0. 89. (89 88. (88 GS90.8 90.8 (GS-90. CS90. 90. CS-90. (8 GS90. (GS-90 CS-90 (GS-9 CS-9 (GS- CS-

https://doi.org/10.11606/s1518-8787.2023057004789

Health Literacy, Patient Knowledge and Adherence to Oral Anticoagulation in Primary Care Literacy
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Marcolino, Milena Soriano

; Sales, Thaís Lorenna Souza

; Oliveira, João Antônio de

; Rios, Danyelle Romana Alves

; Pedroso, Thaís Marques

; Sá, Laura Caetano de

; Martins, Maria Auxiliadora

; Ribeiro, Antonio Luiz Pinho

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220158

Resumo: En | Texto: En | PDF: En

Abstract Background Warfarin is the only oral anticoagulant available in the Brazilian public health system. Health knowledge and treatment are essential to achieving the desirable therapeutic effect. However, data on these aspects among primary care patients are still lacking. Objective To assess health literacy, patient knowledge, and adherence to oral anticoagulation with warfarin, as well as the medication regimen complexity in primary health units in the municipality of Divinópolis, Minas Gerais, Brazil. Methods This cross-sectional study included patients using warfarin from primary care settings. Sociodemographic and clinical data were collected from medical records. Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18), Oral Anticoagulation Knowledge (OAK), adaptation of the Measure of Adherence to Treatment (MAT-adapted) to oral anticoagulation, and Medication Regimen Complexity Index (MRCI) were applied, and the time in therapeutic range (TTR) was calculated. Patients were stratified in two groups (TTR < 60% and TTR ≥ 60%) and compared using Fisher's exact test at a significance level of p < 0.050. Results Analysis included 162 patients (64.8 ± 12.7 years old, 55.6% women). Nonvalvular atrial fibrillation (26.5%) and venous thromboembolism (24.1%) were the main indications for warfarin, and 67.9%, 88.3%, and 16.7% of the patients had inadequate health literacy, insufficient knowledge regarding anticoagulant therapy, and non-adherence to warfarin therapy, respectively. There was no significant association of these parameters in relation to TTR. MRCI showed high pharmacotherapy complexity between the drug prescriptions. Conclusion This study showed alarming insufficient knowledge about warfarin therapy and low health literacy in primary care patients. system effect However lacking Divinópolis Gerais Brazil crosssectional cross sectional settings records PortugueseSpeaking Portuguese Speaking SAHLPA18, SAHLPA18 SAHLPA 18 , (SAHLPA-18) OAK, OAK (OAK) MATadapted MAT adapted (MAT-adapted (MRCI applied calculated 60 Fishers Fisher s 0050 0 050 0.050 16 64.8 648 64 8 (64. 127 12 7 12. old 556 55 6 55.6 women. women . women) 26.5% 265 26 5 (26.5% 24.1% 241 24 1 (24.1% 679 67 9 67.9% 883 88 3 88.3% 167 16.7 nonadherence non respectively prescriptions SAHLPA1 (SAHLPA-18 (OAK 005 05 0.05 64. (64 55. 26.5 2 (26.5 24.1 (24.1 67.9 88.3 16. (SAHLPA-1 00 0.0 (6 26. (26. 24. (24. 67. 88. (SAHLPA- 0. ( (26 (24 (SAHLPA (2

https://doi.org/10.36660/ijcs.20220158

Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina
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Barbosa, Hannah Cardoso

; Torres, Heloisa de Carvalho

; Oliveira, João Antônio de Queiroz

; Santos, Rebeca Priscila de Melo

; Costa, Josiane Moreira da

; Miranda, Leonardo Gonçalves

; Pagano, Adriana Silvina

; Praxedes, Marcus Fernando da Silva

; Martins, Maria Auxiliadora Parreiras

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 6 elocation e20220576

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Background Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy. Objective The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients. Methods The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population. Results Relevance, adequacy, clarity, and internal reliability of the instrument’s items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96. Conclusion EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings. thromboembolism events anticoagulation selfcare, selfcare self care, care self-care therapy objectives validity pretest pre test Relevance adequacy instruments s JC (JC Esurv E surv platform 091 0 91 ≥0.91 096 96 0.96 outcomes settings 09 9 ≥0.9 0.9 ≥0. 0. ≥0 ≥

Resumo Fundamento A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia. Objetivo Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina. Métodos As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo. Resultados Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96. Conclusão O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde. tromboembolismo adversos farmacoterapia objetivos préteste pré teste alvo Relevância adequação Esurv, Esurv E surv, surv E-surv obtendose obtendo 091 0 91 ≥0,91 populaçãoalvo 096 96 0,96 clínicos saúde 09 9 ≥0,9 0,9 ≥0, 0, ≥0 ≥

https://doi.org/10.36660/abc.20220576

Lesão Miocárdica e Prognóstico em Pacientes Hospitalizados com COVID-19 no Brasil: Resultados do Registro Nacional de COVID-19 COVID19 COVID 19 COVID-1 Brasil COVID1 1 COVID-
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Barbosa, Hannah Cardoso

; Martins, Maria Auxiliadora Parreiras

; Jesus, Jordana Cristina de

; Meira, Karina Cardoso

; Passaglia, Luiz Guilherme

; Sacioto, Manuela Furtado

; Bezerra, Adriana Falangola Benjamin

; Schwarzbold, Alexandre Vargas

; Maurílio, Amanda de Oliveira

; Farace, Barbara Lopes

; Silva, Carla Thais Cândida Alves da

; Cimini, Christiane Corrêa Rodrigues

; Silveira, Daniel Vitorio

; Carazai, Daniela do Reis

; Ponce, Daniela

; Costa, Emanuel Victor Alves

; Manenti, Euler Roberto Fernandes

; Cenci, Evelin Paola de Almeida

; Bartolazzi, Frederico

; Madeira, Glícia Cristina de Castro

; Nascimento, Guilherme Fagundes

; Velloso, Isabela Vasconcellos Pires

; Batista, Joanna d’Arc Lyra

; Morais, Júlia Drumond Parreiras de

; Carvalho, Juliana da Silva Nogueira

; Ruschel, Karen Brasil

; Martins, Karina Paula Medeiros Prado

; Zandoná, Liege Barella

; Menezes, Luanna Silva Monteiro

; Kopittke, Luciane

; Castro, Luís César de

; Nasi, Luiz Antônio

; Floriani, Maiara Anschau

; Souza, Maíra Dias

; Carneiro, Marcelo

; Bicalho, Maria Aparecida Camargos

; Lima, Maria Clara Pontello Barbosa

; Godoy, Mariana Frizzo de

; Guimarães-Júnior, Milton Henriques

; Mendes, Paulo Mascarenhas

; Delfino-Pereira, Polianna

; Ribeiro, Raquel Jaqueline Eder

; Finger, Renan Goulart

; Menezes, Rochele Mosmann

; Francisco, Saionara Cristina

; Araújo, Silvia Ferreira

; Oliveira, Talita Fischer

; Oliveira, Thainara Conceição de

; Polanczyk, Carisi Anne

; Marcolino, Milena Soriano

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 2 elocation e20220151

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Background Cardiovascular complications of COVID-19 are important aspects of the disease’s pathogenesis and prognosis. Evidence on the prognostic role of troponin and myocardial injury in Latin American hospitalized COVID-19 patients is still scarce. Objectives To evaluate myocardial injury as independent predictor of in-hospital mortality and invasive mechanical ventilation support in hospitalized patients, from the Brazilian COVID-19 Registry. Methods This cohort study is a substudy of the Brazilian COVID-19 Registry, conducted in 31 Brazilian hospitals of 17 cities, March-September 2020. Primary outcomes included in-hospital mortality and invasive mechanical ventilation support. Models for the primary outcomes were estimated by Poisson regression with robust variance, with statistical significance of p<0.05. Results Of 2,925 patients (median age of 60 years [48-71], 57.1% men), 27.3% presented myocardial injury. The proportion of patients with comorbidities was higher among patients with cardiac injury (median 2 [1-2] vs. 1 [0-2]). Patients with myocardial injury had higher median levels of brain natriuretic peptide, lactate dehydrogenase, creatine phosphokinase, N-terminal pro-brain natriuretic peptide, and C-reactive protein than patients without myocardial injury. As independent predictors, C-reactive protein and platelet counts were related to the risk of death, and neutrophils and platelet counts were related to the risk of invasive mechanical ventilation support. Patients with high troponin levels presented a higher risk of death (RR 2.03, 95% CI 1.60-2.58) and invasive mechanical ventilation support (RR 1.87, 95% CI 1.57-2.23), when compared to those with normal troponin levels. Conclusion Cardiac injury was an independent predictor of in-hospital mortality and the need for invasive mechanical ventilation support in hospitalized COVID-19 patients. COVID19 COVID 19 COVID-1 diseases disease s prognosis scarce inhospital hospital Registry 3 cities MarchSeptember March September 2020 variance p005 p 0 05 p<0.05 2925 925 2,92 6 4871, 4871 48 71 , [48-71] 571 57 57.1 men, men men) 273 27 27.3 12 [1-2 vs 02. 02 . [0-2]) peptide dehydrogenase phosphokinase Nterminal N terminal probrain pro Creactive C reactive predictors RR 203 03 2.03 95 1.602.58 160258 1.60 2.58 58 1.60-2.58 187 87 1.87 1.572.23, 157223 1.57 2.23 23 1.57-2.23) COVID1 COVID- 202 p00 p<0.0 292 92 2,9 487 4 7 [48-71 5 57. 27. [1- [0-2] 20 2.0 9 602 1.602.5 16025 160 1.6 258 2.5 1.60-2.5 18 8 1.8 572 1.572.23 15722 157 1.5 223 2.2 1.57-2.23 p0 p<0. 29 2, [48-7 [1 [0-2 2. 1.602. 1602 16 1. 25 1.60-2. 1.572.2 1572 15 22 1.57-2.2 p<0 [48- [ [0- 1.602 1.60-2 1.572. 1.57-2. p< [48 [0 1.60- 1.572 1.57-2 [4 1.57-

Resumo Fundamento As complicações cardiovasculares da COVID-19 são aspectos importantes da patogênese e do prognóstico da doença. Evidências do papel prognóstico da troponina e da lesão miocárdica em pacientes hospitalizados com COVID-19 na América Latina são ainda escassos. Objetivos Avaliar a lesão miocárdica como preditor independente de mortalidade hospitalar e suporte ventilatório mecânico em pacientes hospitalizados, do registro brasileiro de COVID-19. Métodos Este estudo coorte é um subestudo do registro brasileiro de COVID-19, conduzido em 31 hospitais brasileiros de 17 cidades, de março a setembro de 2020. Os desfechos primários incluíram mortalidade hospitalar e suporte ventilatório mecânico invasivo. Os modelos para os desfechos primários foram estimados por regressão de Poisson com variância robusta, com significância estatística de p<0,05. Resultados Dos 2925 pacientes [idade mediana de 60 anos (48-71), 57,1%], 27,3% apresentaram lesão miocárdica. A proporção de pacientes com comorbidades foi maior nos pacientes com lesão miocárdica [mediana 2 (1-2) vs. 1 (0-20)]. Os pacientes com lesão miocárdica apresentaram maiores valores medianos de peptídeo natriurético cerebral, lactato desidrogenase, creatina fosfoquinase, N-terminal do pró-peptídeo natriurético tipo B e proteína C reativa em comparação a pacientes sem lesão miocárdica. Como fatores independentes, proteína C reativa e contagem de plaquetas foram relacionados com o risco de morte, e neutrófilos e contagem de plaquetas foram relacionados ao risco de suporte ventilatório mecânico invasivo. Os pacientes com níveis elevados de troponina apresentaram um maior risco de morte (RR 2,03, IC95% 1,60-2,58) e suporte ventilatório mecânico (RR 1,87;IC95% 1,57-2,23), em comparação àqueles com níveis de troponina normais. Conclusão Lesão cardíaca foi um preditor independente de mortalidade hospitalar e necessidade de suporte ventilatório mecânico em pacientes hospitalizados com COVID-19. COVID19 COVID 19 COVID-1 doença escassos COVID19. 19. COVID19, 19, 3 cidades 2020 invasivo robusta p005 p 0 05 p<0,05 292 idade 6 4871, 4871 48 71 , (48-71) 57,1%, 571 57,1% 57 57,1%] 273 27 27,3 12 (1-2 vs 020. 020 20 . (0-20)] cerebral desidrogenase fosfoquinase Nterminal N terminal própeptídeo pró independentes RR 203 03 2,03 IC95 IC 1,602,58 160258 1,60 2,58 58 1,60-2,58 1,87IC95% 187IC95 1,87 87 1,87;IC95 1,572,23, 157223 1,57 2,23 23 1,57-2,23) normais COVID1 COVID- 202 p00 p<0,0 29 487 4 7 (48-71 57,1 5 27, (1- 02 (0-20) 2,0 IC9 602 1,602,5 16025 160 1,6 258 2,5 1,60-2,5 87IC95 1,87IC95 187IC9 187 1,8 8 1,87;IC9 572 1,572,23 15722 157 1,5 223 2,2 1,57-2,23 p0 p<0, (48-7 57, (1 (0-20 2, 1,602, 1602 16 1, 25 1,60-2, 87IC9 1,87IC9 187IC 18 1,87;IC 1,572,2 1572 15 22 1,57-2,2 p<0 (48- ( (0-2 1,602 1,60-2 87IC 1,87IC 1,572, 1,57-2, p< (48 (0- 1,60- 1,572 1,57-2 (4 (0 1,57-

https://doi.org/10.36660/abc.20220151

10.

A completeness indicator of gestational and congenital syphilis information in Brazil
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Oliveira, Guilherme Lopes de

; Ferreira, Andrêa JF

; Santana, José Guilherme

; Lana, Raquel Martins

; Cardoso, Andrey Moreira

; Teles, Carlos

; Fiaccone, Rosemeire L.

; Aquino, Rosana

; Soares, Maria Auxiliadora Santos

; Paixao, Enny S.

; Santos, Idália Oliveira

; Salvi, Leonardo

; Barreto, Maurício L.

; Ichihara, Maria Yury

Revista de Saúde Pública

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2023, Volume 57 elocation 42

Resumo: En | Texto: En | PDF: En

https://doi.org/10.11606/s1518-8787.2023057004789

11.

Factors associated with the development of leprosy in Brazilian contacts: a systematic review
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Alecrin, Edilamar Silva de

; Oliveira, Ana Laura Grossi de

; Guimarães, Nathália Sernizon

; Lyon, Sandra

; Martins, Maria Auxiliadora Parreiras

; Rocha, Manoel Otávio da Costa

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e55

Resumo: En | Texto: En | PDF: En

ABSTRACT People who interact with leprosy patients in their environment, neighborhood, family, or social relationships are at risk to develop the disease. This systematic review investigated the risk and protective factors associated with the development of leprosy in Brazilian contacts. The studies were found in Cochrane Library, PubMed (MEDLINE), Embase, Virtual Health Library, grey literature and hand search until July 2021. The study selection, data extraction and quality assessment were independently performed by two investigators. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). This review was registered in PROSPERO (CRD42020160680). Seventeen articles fulfilled the inclusion criteria (n=544). The immunological and molecular factors, such as Anti-phenolic Glycolipid Antibodies (Anti-PGL-1) seropositivity, negative Mitsuda test, absence of Bacillus Calmette-Guérin (BCG) scar, positive Polymerase Chain Reaction (PCR) in blood; age and race; conviviality, education, contact time and type of contact, as well as elements related to the index case (bacilloscopic index; genetic conditions, family relationships), and some combined factors were shown to be relevant risk factors associated with the development of the disease in Brazilian leprosy contacts. The protective factors reported were the presence of one or more BCG scars, positive Mitsuda test, and education level. All selected studies were considered of high quality according to NOS. The knowledge of disease-related risk and protective factors provides the scientific basis for decision-making in the management of the disease in leprosy contacts.

https://doi.org/10.1590/s1678-9946202264055

12.

Staff Knowledge and Attitudes Towards COVID-19 New Biosafety Practices at a Brazilian Dental School
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Marques-Medeiros, Ana Carolina

; Martins, Renata Castro

; Silva, Maria Elisa Souza e

; Vilaça, Ênio Lacerda

; Souza, Leandro Napier de

; Martins, Maria Auxiliadora Parreiras

; Gomez, Ricardo Santiago

; Guimarães de Abreu, Mauro Henrique Nogueira

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2022, Volume 22 elocation e210139

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective To evaluate knowledge and attitudes towards biosafety recommendations during the COVID-19 pandemic at a Brazilian dental school. Material and Methods A cross-sectional study was performed in 2020 with the clinical staff of a Brazilian dental school. The whole clinical staff was sent pre-tested self-administered online questionnaires about knowledge and attitudes towards the recommendations for biosafety in dental settings in the context of the COVID-19 pandemic. Descriptive statistical analyses were carried out for proportion calculation. Results Disposable head covering caps, isolation gowns, and gloves were the most frequently reported personal protective equipment (PPE). The rates ranged from 52.9% to 88.5% for N95 respirators, from 68.6% to 92.6% for face shields, from 47.4% to 67.5% for conventional eye protection shields, and 45.1% to 77.4% for eye protection with solid side shields. Chlorhexidine gluconate was the most frequent mouthwash indicated before clinical dental care. The percentage of agreement to provide clinical care to patients with suspected COVID-19 varied from 23.5% to 50.0%. The percentage of respondents who agreed that bioaerosol-generating procedures should be avoided was higher than 74.5%. Less than 50% knew the correct sequence for doffing of PPE. Conclusion This study revealed important gaps in knowledge and attitudes towards prevention and control measures against infection in dental environments in the context of COVID-19, indicating the need for improvements.

https://doi.org/10.1590/pboci.2022.007

13.

Características e Tendências na Mortalidade em Diferentes Fenótipos de Insuficiência Cardíaca na Atenção Primária
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Jorge, Antonio José Lagoeiro

; Barbetta, Leticia Mara dos Santos

; Correia, Eduardo Thadeu de Oliveira

; Martins, Wolney de Andrade

; Leite, Adson Renato

; Saad, Maria Auxiliadora Nogueira

; Santos, Márcia Maria Sales dos

; Correia, Dayse Mary

; Rosa, Maria Luiza Garcia

; Chermont, Sérgio

; Santos, Cárita Cunha dos

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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Ago 2021, Volume 117 Nº 2 Páginas 300 - 306

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A classificação da insuficiência cardíaca (IC) por fenótipos possui grande relevância na prática clínica. Objetivo: O estudo visou analisar a prevalência, as características clínicas e os desfechos entre os fenótipos de IC no contexto da atenção primária. Métodos: Trata-se de uma análise de um estudo de coorte que incluiu 560 indivíduos, com idade ≥ 45 anos, que foram selecionados aleatoriamente em um programa de atenção primária. Todos os participantes foram submetidos a avaliações clínicas, dosagem do peptídeo natriurético tipo B (BNP), eletrocardiograma e ecocardiografia em um único dia. A IC com fração de ejeção do ventrículo esquerdo (FEVE) < 40% foi classificado como IC com fração de ejeção reduzida (ICFEr), FEVE de 40% a 49% como IC com fração de ejeção intermediária (ICFEi) e FEVE ≥ 50% como IC com fração de ejeção preservada (ICFEp). Após 5 anos, os pacientes foram reavaliados quanto à ocorrência do desfecho composto de óbito por qualquer causa ou internação por doença cardiovascular. Resultados: Dos 560 pacientes incluídos, 51 pacientes tinham IC (9,1%), 11 dos quais tinham ICFEr (21,6%), 10 tinham ICFEi (19,6%) e 30 tinham ICFEp (58,8%). A ICFEi foi semelhante à ICFEp nos níveis de BNP (p < 0,001), índice de massa do ventrículo esquerdo (p = 0,037) e índice de volume do átrio esquerdo (p < 0,001). O fenótipo de ICFEi foi semelhante ao de ICFEr em relação à doença arterial coronariana (p = 0,009). Após 5 anos, os pacientes com ICFEi apresentaram melhor prognóstico quando comparados aos pacientes com ICFEp e ICFEr (p < 0,001). Conclusão: A prevalência de ICFEI foi semelhante ao observado em estudos anteriores. A ICFEI apresentou características semelhantes a ICFEP neste estudo. Nossos dados mostram que a ICFEi teve melhor prognóstico em comparação com os outros dois fenótipos.

Abstract Background: The classification of heart failure (HF) by phenotypes has a great relevance in clinical practice. Objective: The study aimed to analyze the prevalence, clinical characteristics, and outcomes between HF phenotypes in the primary care setting. Methods: This is an analysis of a cohort study including 560 individuals, aged ≥ 45 years, who were randomly selected in a primary care program. All participants underwent clinical evaluations, b-type natriuretic peptide (BNP) measurements, electrocardiogram, and echocardiography in a single day. HF with left ventricular ejection fraction (LVEF) < 40% was classified as HF with reduced ejection fraction (HFrEF), LVEF 40% to 49% as HF with mid-range ejection fraction (HFmrEF) and LVEF ≥ 50% as HF with preserved ejection fraction (HFpEF). After 5 years, the patients were reassessed as to the occurrence of the composite outcome of death from any cause or hospitalization for cardiovascular disease. Results: Of the 560 patients included, 51 patients had HF (9.1%), 11 of whom had HFrEF (21.6%), 10 had HFmrEF (19.6%) and 30 had HFpEF (58.8%). HFmrEF was similar to HFpEF in BNP levels (p < 0.001), left ventricular mass index (p = 0.037), and left atrial volume index (p < 0.001). The HFmrEF phenotype was similar to HFrEF regarding coronary artery disease (p = 0.009). After 5 years, patients with HFmrEF had a better prognosis when compared to patients with HFpEF and HFrEF (p < 0.001). Conclusion: The prevalence of ICFEI was similar to that observed in previous studies. ICFEI presented characteristics similar to ICFEP in this study. Our data show that ICFEi had a better prognosis compared to the other two phenotypes.

https://doi.org/10.36660/abc.20190912 165 downloads

14.

Primary cutaneous histoplasmosis difficult to treat in immunocompetent patient: case report and literature review
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Batista, Jéssica Mauricio

; Martins, Maria Auxiliadora Parreiras

; Bertollo, Caryne Margotto

einstein (São Paulo)

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2021, Volume 19 elocation eRC5488

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO A histoplasmose é uma infecção causada pelo fungo dimórfico Histoplasma capsulatum. A doença é endêmica em diversas regiões de clima tropical e temperado. O fungo apresenta comportamento oportunístico, causando infecção disseminada em pacientes imunocomprometidos, resultante da complicação da infecção pulmonar primária, por reinfecção exógena ou reativação de um foco quiescente. Em indivíduos imunocompetentes, cerca de 95% das infecções pulmonares são assintomáticas. No entanto, a exposição prolongada à quantidade elevada de esporos pode levar à infecção pulmonar aguda ou crônica. Devido à baixa quantidade de inóculo, a histoplasmose cutânea primária causada por implantação traumática é extremamente rara e efetivamente tratada com triazóis. Assim, o presente estudo tem como objetivos relatar um caso de histoplasmose cutânea primária de difícil tratamento em paciente imunocompetente, e revisar a literatura a respeito da incidência de cepas de Histoplasma capsulatum resistentes aos fármacos utilizados na prática clínica.

ABSTRACT Histoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum. The disease is endemic in several regions of tropical and temperate climate. The fungus presents opportunistic behavior, causing widespread infection in immunocompromised patients, resulting from complication of primary pulmonary infection, due to exogenous reinfection or reactivation of a quiescent source. In immunocompetent individuals, approximately 95% of pulmonary infections are asymptomatic. However, prolonged exposure to high amount spores may lead to acute or chronic lung infection. Due to the low amount of inoculum, primary cutaneous histoplasmosis caused by traumatic implantation is extremely rare and effectively treated with triazoles. Thus, the present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice.

https://doi.org/10.31744/einstein_journal/2021rc5488 153 downloads

15.

New drugs registered in Brazil from 2003 to 2013: analysis from the perspective of child health
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Castro, Jaqueline Cristina da Silveira Xavier e

; Botelho, Stephanie Ferreira

; Martins, Maria Auxiliadora Parreiras

; Vieira, Liliana Batista

; Reis, Adriano Max Moreira

Brazilian Journal of Pharmaceutical Sciences

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2021, Volume 57 elocation e19087

Resumo: En | Texto: En | PDF: En

This study aims to analyze the new drugs registered in Brazil from 2003 to 2013 from the perspective of childcare needs, drug safety and considering the disease burden of the country. This is a retrospective cohort study including new drugs registered in Brazil between 2003 and 2013. Drug indications were related to the Disability-Adjusted Life Year (DALY) of the 2015 Global Burden of Disease Study. Association between the number of new drugs and DALY was determined by Spearman’s coefficient. Post-marketing safety alerts specific to the pediatric population have been identified in the WHO Drug Information Bulletin and on websites of drug regulatory agencies. A total of 134 new drugs were included in the cohort and 46 (34.3%) had a pediatric indication. There was no evidence of an association between the disease burden in children in Brazil and the number of pediatric drugs. The safety alert data associated with the pediatric population published after registration of the new drugs were scarce. The number of new drugs launched in Brazil with a pediatric indication was small, reflecting the international challenges of developing effective and safe medicines for children. No association was found between the number of new drugs and the disease burden.

https://doi.org/10.1590/s2175-97902020000419087 83 downloads

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