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[SciELO Preprints] - THE ROLE OF OBESITY (AND WEIGHT LOSS THROUGH BARIATRIC SURGERY) IN AUTOIMMUNE DISEASES
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Beckhauser , Ana Paula Nisihara , Renato Mitsunori Tonial , Alessandro Ferroni Nassif, Paulo Afonso Nunes Santos , Carlos Eduardo Oliveira dos Lages Neto , Manoel Skare , Thelma Larocca

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Data de publicação: 2024-05-07

Resumo: Pt En

Introdução : A obesidade tem sido associada ao aparecimento ou piora de doenças autoimunes. Objetivo : Revisar a presença de autoanticorpos em obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura efetuada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica” . Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : Foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positiva na população obesa e candidata à cirurgia bariátrica que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com o fator reumatóide, anticorpos do perfil ENA e anti-ds DNA, anticorpos anticardiolipina IgG e IgM, e anticorpos anti-endomísio. Nenhuma variável clínica ou antropométrica pôde estar ligada à presença de autoanticorpos, salvo níveis de vitamina D que foram significativamente menores nos indivíduos no pré-operatório e FAN positivos.

Introdução : A obesidade tem sido associada ao aparecimento ou agravamento de doenças autoimunes. Objetivo : Rever a presença de autoanticorpos em pacientes obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura realizada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica ”. Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positivo na população obesa e candidata à cirurgia bariátrica, que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com fator reumatoide, anticorpos ENA e anti-ds DNA, anticorpos IgG e IgM anticardiolipina e anticorpos antiendomísio. Nenhuma variável clínica ou antropométrica pôde ser associada à presença de autoanticorpos, exceto os níveis de vitamina D, que foram significativamente mais baixos nos indivíduos pré-operatórios e ANA-positivos.

https://doi.org/10.1590/SciELOPreprints.8878

Extended half-life recombinant factor VIII treatment of hemophilia A in Brazil: an expert consensus statement halflife half life Brazil
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Ozelo, Margareth Castro

; Antunes, Sandra Vallin

; Villaca, Paula Ribeiro

; Oliveira, Luciana Correa

; Pinto, Ieda Solange

; Lorenzato, Claúdia Santos

; Prezotti, Alessandra Nunes Loureiro

; Picoli, Renato Mantelli

Hematology, Transfusion and Cell Therapy

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Mar 2024, Volume 46 Nº 1 Páginas 36 - 41

Resumo: En | Texto: En | PDF: En

Introduction Treatment of hemophilia A in Brazil is offered to all patients at no cost. However, several unmet medical needs exist. Method In this study, we applied the Delphi method to discuss with seven hemophilia A specialists the challenges that patients and the health system face regarding hemophilia A treatment and opportunities for improvement. Results A consensus was obtained regarding the number of weekly infusions and patient adherence to treatment. The bleeding profile, unfavourable pharmacokinetics (PKs), low adherence and high daily activity were patient profiles that would benefit from using the extended half-life (EHL) recombinant factor VIII (rFVIII). The advantages of treatment with the EHL rFVIII were the lower number of infusions per week, which could increase patient adherence and decrease the risk of bleeds, due to a more constant plasma level, a lower value. Additionally, the EHL rFVIII could improve quality of life, especially in patients with high daily activity, such as adolescents and young adults. The panelists mentioned that EHL rFVIII, if available, could be offered first to the priority group (adolescents between 12 and 19 years old), followed by adults (20 to 64 years old) and elderly people (over 65 years old). Conclusion In summary, the EHL rFVIII offers the optimal prophylaxis by decreasing the dose frequency, increasing the treatment adherence and improving the QoL, without compromising safety and efficacy. cost However exist study improvement profile PKs, PKs , (PKs) halflife half life (EHL rFVIII. . (rFVIII) week bleeds level value Additionally available 1 old, old 20 (2 6 over old. summary frequency QoL efficacy (PKs (rFVIII 2 (

https://doi.org/10.1016/j.htct.2022.11.008

Revisão de escopo da aplicação do Postgraduate Hospital Educational Environment Measure (PHEEM) na residência médica PHEEM (PHEEM
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Gonçalves, Patrícia Lofêgo

; Marçal, Ana Paula Moscon

; França, Renata de Almeida

; Nogueira, Vania dos Santos Nunes

Revista Brasileira de Educação Médica

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2024, Volume 48 Nº 1 elocation e024

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

Resumo Introdução: O Postgraduate Hospital Educational Environment Measure (PHEEM) é um instrumento validado e confiável para avaliar o ambiente educacional nos programas de residência médica. Objetivo: Este estudo teve como objetivos mapear a aplicação do questionário PHEEM na residência médica e avaliar os resultados, os aspectos positivos e negativos e os pontos passíveis de melhoria. Método: Trata-se de uma revisão de escopo de acordo com a metodologia do Instituto Joanna Briggs de revisões de escopo. Foram incluídos estudos seguindo a estrutura PCC: P (participantes) = médicos residentes de qualquer especialidade; C (conceito) = o PHEEM é um instrumento utilizado para avaliar o ambiente educacional na residência médica, por meio de um questionário de 40 itens divididos em três subescalas que incluem percepção de autonomia, ensino e suporte social; C (cenário) = pesquisas sobre o PHEEM na residência médica de qualquer especialidade. As bases eletrônicas pesquisadas foram: PubMed, Embase e Biblioteca Virtual em Saúde (BVS). Resultado: As estratégias de busca rodadas resultaram em 1.588 estudos, 50 foram lidos na íntegra, e incluíram-se 36. Os estudos foram realizados em 22 países, e a maioria revelou um ambiente educacional mais positivo que negativo, entretanto com espaço para melhorias. Nas subescalas, a percepção de autonomia se mostrou mais positiva que negativa, e a percepção de ensino revelou que a maioria dos programas está caminhando na direção certa. Entretanto, na avaliação do suporte social, os resultados foram divididos entre um ambiente não agradável e um ambiente com mais prós do que contras. Os principais pontos positivos destacados foram baixa discriminação racial e sexual, possibilidade de trabalhar em equipe, nível adequado de responsabilidades, professores acessíveis e com boas habilidades de ensino, oportunidades de aprendizado e participação em eventos educacionais. Os principais pontos negativos foram falta de alimentação e acomodação adequadas durante o plantão, carga horária excessiva, falta de feedback por parte dos preceptores, falta de tempo protegido para estudo e cultura de culpar o residente. Conclusão: A aplicação do PHEEM revelou que, na maioria dos programas de residência médica, o ambiente educacional se mostrou mais positivo que negativo, entretanto com espaço para melhorias. São necessários esforços para a melhoria do ambiente educacional, especialmente do suporte social, nos programas de residência médica. Introdução (PHEEM Objetivo Método Tratase Trata PCC participantes (participantes especialidade conceito (conceito 4 social cenário (cenário PubMed BVS. BVS . (BVS) Resultado 1588 1 588 1.58 5 íntegra incluíramse incluíram 36 2 países negativo melhorias negativa certa Entretanto contras sexual equipe responsabilidades educacionais plantão excessiva preceptores residente Conclusão (BVS 158 58 1.5 3 15 1.

Abstract Introduction: The PHEEM (postgraduate hospital educational environment measure) is a validated and reliable instrument to assess the educational environment in medical residency programs. Objective: To map the application of the PHEEM questionnaire in medical residency, evaluate the results found, positive and negative aspects and points for improvement. Method: We performed a scoping review according to the Joanna Briggs institution’s methodology. Studies that followed the PCC structure were included, as follows: P (participants) = resident physicians of any specialty; C (concept) = The PHEEM is an instrument used to assess the educational environment in medical residency, through a 40-item questionnaire divided into 3 subscales that include perception of autonomy, teaching and social support. C (context)= studies on PHEEM in medical residency of any specialty. PubMed, EMBASE and the Virtual Health Library databases were the data sources. Results: We identified 1588 references, and after reading the title and abstract, 50 references were selected for full reading, and 36 studies were included. The studies were carried out in 22 countries, and most revealed a more positive than negative educational environment, albeit with room for improvement. In the subscales, the perception of autonomy was more positive than negative, and the perception of teaching revealed that most programs are moving in the right direction. However, when evaluating social support, the results were divided between an unpleasant environment and an environment with more pros than cons. The main highlighted positive points were low racial and sexual discrimination, possibility of working in a team, adequate level of responsibilities, accessible teachers with good teaching skills, learning opportunities and participation in educational events. The main negative points were lack of adequate food and accommodation during the shifts, excessive workload, lack of feedback from preceptors and lack of protected time for study and the culture of blaming the resident. Conclusion: The application of PHEEM revealed that in most medical residency programs the educational environment was more positive than negative, albeit with room for improvement. Efforts are needed to improve the educational environment, especially social support, in medical residency programs. Introduction postgraduate measure Objective found improvement Method institutions institution s methodology included follows participants (participants specialty concept (concept 40item item 40 support context= context (context) PubMed sources Results 158 abstract 5 2 countries direction However cons discrimination team responsibilities skills events shifts workload Conclusion 4 (context 15 1

https://doi.org/10.1590/1981-5271v48.1-2023-0048

Treatment of hyperprolactinemia in women: A Position Statement from the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and the Brazilian Society of Endocrinology and Metabolism (SBEM) women Febrasgo (Febrasgo SBEM (SBEM
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Benetti-Pinto, Cristina Laguna

; Nácul, Andrea Prestes

; Rosa-e-Silva, Ana Carolina Japur de Sá

; Maciel, Gustavo Arantes Rosa

; Nogueira, Vania dos Santos Nunes

; Elias, Paula Condé Lamparelli

; Martins, Manoel

; Kasuki, Leandro

; Garmes, Heraldo Mendes

; Glezer, Andrea

Archives of Endocrinology and Metabolism

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2024, Volume 68 elocation e230504

Resumo: En | Texto: En | PDF: En

ABSTRACT Dopamine agonists are the first line of treatment for patients with symptomatic hyperprolactinemia due to prolactinomas and in those with idiopathic hyperprolactinemia. Treatment with these agents is effective in 80%-90% of the cases. Infertility treatment of patients with hyperprolactinemia is also carried out with dopamine agonists, aiming for the normalization of prolactin levels. The risk of symptomatic growth of prolactinomas during pregnancy is dependent on the tumor's size, duration of previous treatments, and prolactin levels. Notably, the corresponding risk is relatively low in cases of microprolactinomas (<5%). Remission of hyperprolactinemia occurs in about 30% of the patients after drug treatment and may also occur after pregnancy and menopause. The use of some drugs, such as antidepressants and antipsychotics, is a frequent cause of hyperprolactinemia, and managing this occurrence involves unique considerations. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Society of Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and drug-induced hyperprolactinemia in women. 80%90% 8090 80% 90% 80 90 80%-90 tumors tumor s size treatments Notably <5%. 5 <5% . (<5%) 30 menopause drugs antipsychotics considerations Febrasgo (Febrasgo SBEM (SBEM druginduced induced women 80%90 809 8 9 80%-9 <5 (<5% 3 80%9 80%- < (<5 (< (

https://doi.org/10.20945/2359-4292-2023-0504

Diagnosis of hyperprolactinemia in women: A Position Statement from the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and the Brazilian Society of Endocrinology and Metabolism (SBEM) women Febrasgo (Febrasgo SBEM (SBEM
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Glezer, Andrea

; Garmes, Heraldo Mendes

; Kasuki, Leandro

; Martins, Manoel

; Elias, Paula Condé Lamparelli

; Nogueira, Vania dos Santos Nunes

; Rosa-e-Silva, Ana Carolina Japur de Sá

; Maciel, Gustavo Arantes Rosa

; Benetti-Pinto, Cristina Laguna

; Nácul, Andrea Prestes

Archives of Endocrinology and Metabolism

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2024, Volume 68 elocation e230502

Resumo: En | Texto: En | PDF: En

ABSTRACT Hyperprolactinemia is a frequent cause of menstrual irregularity, galactorrhea, hypogonadism, and infertility. The most common etiologies of hyperprolactinemia can be classified as physiological, pharmacological, and pathological. Among pathological conditions, it is essential to distinguish prolactinomas from other tumors and pituitary lesions presenting with hyperprolactinemia due to pituitary stalk disconnection. Proper investigation considering clinical data, laboratory tests, and, if necessary, imaging evaluation, is important to identify the correct cause of hyperprolactinemia and manage the patient properly. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Society of Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and medication-induced hyperprolactinemia in women. irregularity galactorrhea hypogonadism infertility physiological pharmacological conditions disconnection data tests necessary evaluation properly Febrasgo (Febrasgo SBEM (SBEM medicationinduced medication induced women

https://doi.org/10.20945/2359-4292-2023-0502

Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis disease metaanalysis meta analysis
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Aguiar, Francisco José Nunes

; Menezes, Fabrício dos Santos

; Fagundes, Marcela de Araújo

; Fernandes, Gisele Aparecida

; Alves, Fabio de Abreu

; Goncalves Filho, João

; Curado, Maria Paula

Clinics

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2024, Volume 79 elocation 100321

Resumo: En | Texto: En | PDF: En

Abstract Background The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). Methods The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). Results There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). Conclusions The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists. tract (PD . (GAC) metaanalysis meta analysis 196 2022 criteria studies NewcastleOttawa Newcastle Ottawa casecontrol case control andor or RR 9 (9 CI. CI) 63 3 ( casecontrols cohorts. cohorts cohorts) Overall 1253 1 253 1,25 2501 2 501 2,50 1631 631 1,63 RR=1.17 RR117 (RR=1.17 1.03‒1.32, 103132 1.03‒1.32 , 03 32 1.03‒1.32) ie i e i.e. 1.19 119 19 1.14‒1.24 114124 14 24 selfreport self report 1.34 134 34 1.06‒1.69. 106169 1.06‒1.69 06 69 1.06‒1.69) Moreover 1.00‒1.36 100136 00 36 1.18 118 18 0.84‒1.66. 084166 0.84‒1.66 0 84 66 0.84‒1.66) infectiousinflammatory infectious inflammatory development oralgastric out dentists (GAC 202 125 25 1,2 250 50 2,5 163 1,6 RR=1.1 RR11 (RR=1.1 10313 1.03‒1.3 i.e 1.1 11 1.14‒1.2 11412 1.3 13 10616 1.06‒1.6 1.00‒1.3 10013 08416 0.84‒1.6 8 20 12 1, 5 2, 16 RR=1. RR1 (RR=1. 1031 1.03‒1. 1. 1.14‒1. 1141 1061 1.06‒1. 1.00‒1. 1001 0841 0.84‒1. RR=1 (RR=1 103 1.03‒1 1.14‒1 114 106 1.06‒1 1.00‒1 100 084 0.84‒1 RR= (RR= 10 1.03‒ 1.14‒ 1.06‒ 1.00‒ 08 0.84‒ 1.03 1.14 1.06 1.00 0.84 1.0 0.8 0.

https://doi.org/10.1016/j.clinsp.2023.100321

Hyperprolactinemia in women: treatment women
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Benetti-Pinto, Cristina Laguna

; Nácul, Andrea Prestes

; Rosa e Silva, Ana Carolina Japur

; Maciel, Gustavo Arantes Rosa

; dos Santos Nunes Nogueira, Vania

; Elias, Paula Condé Lamparelli

; Martins, Manoel

; Kasuki, Leandro

; Garmes, Heraldo Mendes

; Glezer, Andrea

Revista Brasileira de Ginecologia e Obstetrícia

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2024, Volume 46 elocation e-FPS05

Resumo: En | Texto: En | PDF: En

https://doi.org/10.61622/rbgo/2024fps05

Hyperprolactinemia in women: diagnostic approach women
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Glezer, Andrea

; Garmes, Heraldo Mendes

; Kasuki, Leandro

; Martins, Manoel

; Elias, Paula Condé Lamparelli

; Nogueira, Vania dos Santos Nunes

; Rosa-e-Silva, Ana Carolina Japur de Sá

; Maciel, Gustavo Arantes Rosa

; Benetti-Pinto, Cristina Laguna

; Nácul, Andrea Prestes

Revista Brasileira de Ginecologia e Obstetrícia

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2024, Volume 46 elocation e-FPS04

Resumo: En | Texto: En | PDF: En

https://doi.org/10.61622/rbgo/2024fps04

Bacillus-based probiotics on broiler chicken performance under coccidiosis and Clostridium perfringens challenge
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Berto, Rafaela

; Rohloff Junior, Nilton

; dos Santos Andrade, Thiago

; Kaufmann, Cristine

; Sartor, Heloisa

; Costa, Ana Paula Guimarães Cruz

; Comin, Gabriel Natã

; Toniazzo, Gabrielli

; de Queiroz Teixeira, Vinicius

; Naranjo, Victor Daniel

; Eyng, Cinthia

; Nunes, Ricardo Vianna

South African Journal of Animal Science

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2024, Volume 54 Nº 4 Páginas 509 - 523

Resumo: En | Texto: En | PDF: En

The study analyzed the impacts of two probiotics (Ecobiol® and GutCare®) on growth performance, carcass and cut yields, intestinal morphometry and lesion score, biochemical parameters, and short-chain fatty acid concentration in chickens using a challenge model combining coccidiosis vaccine and Clostridium perfringens. A total of 880 one-day-old male broilers (Cobb 500) were randomly assigned to four treatments with 10 replicates and 22 birds per experimental unit (EU). The treatments consisted of: PC: positive control with the inclusion of 80 g ton-1 of Enramax® (8% enramycin) until 35 d of age; NC: negative control without the inclusion of growth-promoting probiotic; BA: NC with the inclusion of 1000 g ton-1 of Ecobiol® (Bacillus amyloliquefaciens - CECT 5940); BS: NC with the inclusion of 500 g ton-1 of GutCare® (Bacillus subtilis - DSM 32315). Diets used maize-soybean meal in a three-phase plan. Broiler chickens on the BA and BS diets had higher feed consumption, body weight gain, and improved feed conversion efficiency at 28 and 42 d when compared to the birds in the negative control. Broiler chickens fed PC, BA, and BS diets had a higher villus height and absorption area in the jejunum at 28 d, compared to the birds in the negative control. There was more butyric acid production by the intestinal microbiota at 28 d of age in broilers on the BA diet. Supplementing with 1000 g/ton of BA and 500 g/ton of BS effectively substituted the 8% enramycin antibiotic, enhancing broiler growth during an induced intestinal challenge.

https://doi.org/10.4314/sajas.v54i4.04

10.

Occurrence of avian reovirus and picobirnavirus in wild birds from an environmental protection area in the Brazilian Amazon
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PEREIRA, Diego

; SOUTO, Lizandra Caroline dos Santos

; GUERRA, Sylvia de Fátima dos Santos

; PENHA-JÚNIOR, Edvaldo Tavares da

; LOBO, Patrícia dos Santos

; SOARES, Luana da Silva

; PINHEIRO, Helder Henrique Costa

; CHAGAS, Elaine Hellen Nunes

; GUIMARÃES, Ricardo José de Paula Souza e

; RAMOS, Bruna Alves

; CHAGAS, Liliane Leal das

; FREITAS, Maria Nazaré Oliveira

; FURTADO, Erilene Cristina da Silva

; RODRIGUES, Jéssica Cecília Pinheiro

; CASSEB, Alexandre do Rosário

; MARTINS, Lívia Caricio

; MASCARENHAS, Joana D’Arc Pereira

Acta Amazonica

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2024, Volume 54 Nº 1 elocation e54hs23012

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

RESUMO As aves silvestres têm grande destaque na transmissão de doenças ao homem, principalmente pela facilidade de acesso à população humana, levantando preocupações sobre o potencial impacto dessa proximidade no contexto da saúde pública. O presente estudo relata a ocorrência de ARV e PBV em aves silvestres de uma área de proteção ambiental no bioma Amazônico. Obtivemos 155 espécimes fecais de 47 espécies de aves silvestres, que foram submetidos a extração de RNA, detecção de ARV e PBV por técnicas moleculares, sequenciamento nucleotídico e análise filogenética. A prevalência de infecção por ARV foi 0,6% (1/155), sendo positivo em um indivíduo de Myrmotherula longipennis, e a prevalência de PBV foi 1,29% (2/155), afetando dois insdivíduos de Guira guira. A análise filogenética agrupou as cepas de PBV no genogrupo I, mostrando intensa relação filogenética com cepas isoladas de outras regiões geográficas. A cepa de ARV esteve mais relacionada filogeneticamente a cepas previamente circulantes na mesma região. Este é o primeiro estudo sobre detecção de ARV em aves silvestres no Brasil e o primeiro relato sobre a ocorrência de PBV em Guira guira. A circulação de ARV e PBV nesse ambiente demonstra que os ciclos desses agentes estão ocorrendo de forma natural no ecossistema silvestre, o que pode desencadear possíveis eventos de transmissão entre as espécies aviárias e humanos. Estudos adicionais são necessários para determinar a epidemiologia, origem, evolução e surgimento de novos vírus potencialmente patogênicos na Amazônia. homem humana pública Amazônico 15 4 RNA moleculares 06 0 6 0,6 1/155, 1155 1/155 , 1 (1/155) longipennis 129 29 1,29 2/155, 2155 2/155 2 (2/155) guira I geográficas região silvestre humanos epidemiologia origem Amazônia 0, 115 1/15 (1/155 12 1,2 215 2/15 (2/155 11 1/1 (1/15 1, 21 2/1 (2/15 1/ (1/1 2/ (2/1 (1/ (2/ (1 (2 (

ABSTRACT Wild birds have great prominence in the transmission of diseases to humans, mainly due to their ease of access to human populations, raising concerns about the potential impact of that proximity on public health. The present study reports ARV and PBV occurrence in wild birds from an environmental protection area in the Amazon biome, in Pará state, Brazil. We obtained 155 fecal specimens from 47 species of wild birds for RNA extraction, ARV and PBV detection utilizing molecular methods, nucleotide sequencing, and phylogenetic analysis. ARV prevalence was 0.6% (1/155), being positive in an individual of Myrmotherula longipennis, and PBV prevalence was 1.29% (2/155), affecting two individuals of Guira guira. The PBV strains were assigned to genogroup I based on phylogenetic analysis, and they shared a strong phylogenetic link with strains isolated from different geographic locations. The ARV strain was more closely related to strains that had previously circulated in the same region. The presence of ARV and PBV in this habitat suggests that infection cycles of these agents occur naturally in the wild ecosystem, potentially triggering transmission events between bird species and humans. This is the first study on ARV detection in wild birds in Brazil and the first report on the occurrence of PBV in wild Guira guira. Additional studies are required to determine the epidemiology, origin, evolution, and emergence of new potentially pathogenic viruses in the Amazon. humans populations health biome state 15 4 extraction methods sequencing analysis 06 0 6 0.6 1/155, 1155 1/155 , 1 (1/155) longipennis 129 29 1.29 2/155, 2155 2/155 2 (2/155) guira locations region ecosystem epidemiology origin evolution 0. 115 1/15 (1/155 12 1.2 215 2/15 (2/155 11 1/1 (1/15 1. 21 2/1 (2/15 1/ (1/1 2/ (2/1 (1/ (2/ (1 (2 (

https://doi.org/10.1590/1809-4392202300120

11.

IMPACT OF TRANSITION OF CARE ON CLINICAL OUTCOMES: HISTORICAL COHORT OUTCOMES
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Gheno, Jociele

; Ulbrich, Ana Helena Dias Pereira dos Santos

; Andreatta, Ana Paula Fabbris

; Fish, Patrícia

; Petry, Roberta Cristina

; Nunes, Thaise da Silva

; Weis, Alisia Helena

Texto & Contexto - Enfermagem

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2024, Volume 33 elocation e20230231

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

RESUMO Objetivo: verificar o impacto da transição de cuidado nas reinternações e nos óbitos em 30 dias após a alta dos pacientes adultos e idosos. Método: estudo de coorte histórica realizado em um hospital de nível terciário do sul do Brasil. Foram incluídos todos os pacientes para os quais foi realizado contato com os serviços da rede de atenção à saúde para transição de cuidado no momento da alta, no ano de 2019. Os dados foram analisados por meio do software Statistical Package for the Social Sciences (SPSS), versão 20.0. Resultado: foram realizados 705 contatos com os serviços da rede de atenção para as transições do cuidado de pacientes no momento da alta. Ocorreram 3% de perdas de seguimento, sendo assim, 684 pacientes foram considerados para a avaliação da reinternação e óbito em 30 dias após a alta. Dos acompanhamentos pactuados com os serviços da rede no momento da alta, 73,5% deles foram realizados. Quando comparados ao grupo de pacientes que tiveram acompanhamento realizado com o grupo que não recebeu acompanhamento após a alta, o primeiro grupo teve menores taxas de reinternação e óbito em 30 dias após a alta (para reinternação: 19,7% vs. 28,7%; p=0,001 e para óbito: 5,8 % vs. 13,8 %; p=0,012). Conclusão: os resultados do estudo reforçam o impacto que a transição de cuidado tem nas reinternações e nos óbitos após a alta, reafirmam a importância da articulação e da comunicação entre os serviços de saúde na qualificação e segurança das transições. Objetivo 3 idosos Método Brasil 2019 SPSS, SPSS , (SPSS) 200 20 0 20.0 Resultado 70 seguimento assim 68 735 73 5 73,5 197 19 7 19,7 vs 28,7% 287 28 p0001 p 001 p=0,00 58 8 5, 138 13 13, p=0,012. p0012 p=0,012 . 012 p=0,012) Conclusão 201 (SPSS 2 20. 6 73, 1 19, 28,7 p000 00 p=0,0 p001 p=0,01 01 28, p00 p=0, p0 p=0 p=

ABSTRACT Objective to verify the impact of transition of care on readmissions and deaths within 30 days after discharge of adult and elderly patients. Method this is a historical cohort study conducted in a tertiary hospital in southern Brazil. All patients for whom contact was made with the healthcare network services for transition of care at discharge in 2019 were included. Data were analyzed using the Statistical Package for the Social Sciences version 20.0. Result a total of 705 contacts were made with care network services for patient transitions of care at discharge. There were 3% losses to follow-up. Therefore, 684 patients were considered for readmission assessment and death within 30 days after discharge. Of the follow-ups agreed with the network services at discharge, 73.5% of them were carried out. When compared to the group of patients who had follow-up performed with the group that did not receive follow-up after discharge, the first group had lower rates of readmission and death within 30 days after discharge (for readmission: 19.7% vs. 28.7%; p=0.001 and for death: 5.8% vs. 13.8%; p=0.012). Conclusion the results of this study reinforce the impact that transition of care has on readmissions and deaths after discharge, reaffirming the importance of coordination and communication between healthcare services in transition qualification and safety. 3 Brazil 201 included 200 20 0 20.0 70 followup. followup follow up. up Therefore 68 followups ups 735 73 5 73.5 out 197 19 7 19.7 vs 28.7% 287 28 p0001 p 001 p=0.00 58 8 5.8 13.8% 138 13 p=0.012. p0012 p=0.012 . 012 p=0.012) safety 2 20. 6 73. 1 19. 28.7 p000 00 p=0.0 5. 13.8 p001 p=0.01 01 28. p00 p=0. 13. p0 p=0 p=

RESUMEN Objetivo verificar el impacto de la transición de la atención en los reingresos y las muertes dentro de los 30 días posteriores al alta de pacientes adultos y ancianos. Método: estudio de cohorte histórica realizado en un hospital terciario del sur de Brasil. Se incluyeron todos los pacientes que tuvieron contacto con servicios de la red de atención de salud para transición de atención en el momento del alta en 2019. Los datos fueron analizados mediante el software Statistical Package for the Social Sciences (SPSS), versión 20.0. Resultado se realizaron 705 contactos con los servicios de la red asistencial para las transiciones de atención del paciente al momento del alta. Hubo pérdidas del 3% durante el seguimiento. Por lo tanto, se consideraron 684 pacientes para la evaluación de reingreso y muerte dentro de los 30 días posteriores al alta. De los seguimientos acordados con los servicios de la red en el momento del alta, se realizaron el 73,5% de los mismos. En comparación con el grupo de pacientes a los que se les realizó seguimiento con el grupo que no recibió seguimiento después del alta, el primer grupo tuvo tasas más bajas de reingreso y muerte dentro de los 30 días posteriores al alta (para reingreso: 19,7% vs. 28,7 %; p=0,001 y para muerte: 5,8 % vs. 13,8 %; p=0,012). Conclusión los resultados del estudio refuerzan el impacto que la transición de la atención tiene en los reingresos y muertes después del alta, reafirmando la importancia de la coordinación y comunicación entre los servicios de salud en la calificación y seguridad de las transiciones. 3 ancianos Método Brasil 2019 SPSS, SPSS , (SPSS) 200 20 0 20.0 70 tanto 68 735 73 5 73,5 mismos 197 19 7 19,7 vs 287 28 28, p0001 p 001 p=0,00 58 8 5, 138 13 13, p=0,012. p0012 p=0,012 . 012 p=0,012) 201 (SPSS 2 20. 6 73, 1 19, p000 00 p=0,0 p001 p=0,01 01 p00 p=0, p0 p=0 p=

https://doi.org/10.1590/1980-265x-tce-2023-0231en

12.

Uma experiência de pesquisa/intervenção da terapia ocupacional social para um cuidado ativo e democrático a jovens estudantes no contexto pós-pandêmico pesquisaintervenção pesquisa intervenção póspandêmico pós pandêmico
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Lopes, Roseli Esquerdo

; Pereira, Beatriz Prado

; Pan, Lívia Celegati

; Barreiro, Rafael Garcia

; Silva, Marina Jorge da

; Malfitano, Ana Paula Serrata

; Farias, Magno Nunes

; Braga, Iara Falleiros

; Ito, Gisele Gonsalez

; Reis, Stéphany Conceição Correia Alves Guedes

; Reis, Bruna Carolina Silva dos

; Santos, Edna Diniz dos

; Borba, Patrícia Leme de Oliveira

Cadernos Brasileiros de Terapia Ocupacional

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2024, Volume 32 elocation e3748

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

Resumo A pandemia de CoVID-19 agravou muitas problemáticas não suficientemente enfrentadas pelas políticas públicas sociais do Brasil. A evasão escolar é uma delas e afeta desproporcionalmente jovens das classes populares, em especial aqueles que são pobres, negros e periféricos, demandando corresponsabilidade de diferentes setores e atores sociais. A experiência da pesquisa/intervenção da qual decorre este texto voltou-se para as matrizes explicativas que incidiram e permanecem incidindo na ocorrência da evasão e/ou desistência escolar, além da compreensão e busca da superação dos motivos impeditivos do retorno ou da permanência do jovem à/na escola. Uma equipe interinstitucional formada por pesquisadores vinculados à Rede Metuia – Terapia Ocupacional Social, composta também por jovens universitários e jovens estudantes do Ensino Médio, vem desenvolvendo esta pesquisa/intervenção nas cidades de São Carlos e Santos (SP), João Pessoa (PB), Petrolina (PE), Brasília/Ceilândia (DF) e Simão Dias (SE). Para tanto, tendo como base a pesquisa-participante e a terapia ocupacional social, jovens universitários e jovens pesquisadores em suas escolas e/ou comunidades têm acompanhado, de forma singular e territorial, outros jovens que estão fora da escola. Agregando-se outras estratégias metodológicas, tais como questionários, photovoice, entrevistas, painel de especialistas, seminários locais e internacionais, bem como ampliando-se a ideia da “busca ativa”, que tem sido exigida dos profissionais da educação, pretende-se um cuidado ativo e democrático, corresponsabilizando todos que compõem a rede social de suporte dos jovens em seus territórios. Trata-se aqui de compartilhar essa experiência desde sua construção aos questionamentos decorrentes dos seus dois primeiros anos. CoVID19 CoVID 19 CoVID-1 Brasil populares pobres periféricos pesquisaintervenção pesquisa intervenção voltouse voltou se eou àna escola Social Médio SP, SP , (SP) PB, PB (PB) PE, PE (PE) BrasíliaCeilândia Brasília Ceilândia DF (DF SE. SE . (SE) tanto pesquisaparticipante participante acompanhado territorial Agregandose Agregando metodológicas questionários photovoice entrevistas especialistas internacionais ampliandose ampliando ativa, ativa ativa” educação pretendese pretende democrático territórios Tratase Trata anos CoVID1 1 CoVID- (SP (PB (PE (SE

Abstract The CoVID-19 pandemic exacerbated many issues insufficiently addressed by Brazil’s social public policies. School dropout is one such issue, disproportionately affecting young people from working-class backgrounds, especially those who are the poor, Black, and peripheral populations, requiring the shared responsibility of various sectors and social actors. The research/intervention experience focused on the explanatory frameworks contributing to the occurrence and persistence of school dropout and/or withdrawal, as well as understanding and seeking to overcome the obstacles preventing young people from returning to or staying in school. An interinstitutional team, comprising researchers affiliated with the Metuia Network – Social Occupational Therapy, along with young university and high-school students, has been conducting this research/intervention in the cities of São Carlos and Santos (SP), João Pessoa (PB), Petrolina (PE), Brasília/Ceilândia (DF), and Simão Dias (SE). Based on participatory action research and social occupational therapy, young university students and young researchers in their schools and/or communities have been individually and territorially following up other young people who are out of school. By incorporating additional methodological strategies, such as questionnaires, photovoice, interviews, expert panels, domestic and international seminars, and expanding the concept of “active search,” which has been required of education professionals, the aim is to provide active and democratic care, ensuring shared responsibility among all those who form the social support network for young people in their territories. This text aims to share this experience, from its inception to the questions arising from its first two years. CoVID19 CoVID 19 CoVID-1 Brazils Brazil s policies issue workingclass working class backgrounds poor Black populations actors researchintervention intervention andor withdrawal team Therapy highschool high SP, SP , (SP) PB, PB (PB) PE, PE (PE) BrasíliaCeilândia Brasília Ceilândia DF, DF (DF) SE. SE . (SE) therapy strategies questionnaires photovoice interviews panels seminars search, search professionals care territories years CoVID1 1 CoVID- (SP (PB (PE (DF (SE

https://doi.org/10.1590/2526-8910.ctore288637481

13.

Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials COVID19 COVID 19 COVID-19 metaanalysis meta analysis COVID1 1 COVID-1 COVID-
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Almeida, Paula Ribeiro Lopes

; Person, Osmar Clayton

; Puga, Maria Eduarda dos Santos

; Giusti, Maria Fernanda

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira

; Atallah, Álvaro Nagib

Sao Paulo Medical Journal

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Abr 2023, Volume 141 Nº 2 Páginas 168 - 176

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Tocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus on its efficacy for the treatment of COVID-19. OBJECTIVE: To evaluate the effectiveness and safety of tocilizumab for treating COVID-19. DESIGN AND SETTING: Systematic Review of randomized controlled trials (RCTs), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. METHODS: We searched MEDLINE via PubMed, EMBASE, CENTRAL, and IBECS for RCTs published up to March 2021. Two authors selected studies and assessed the risk of bias and the certainty of the evidence following Cochrane Recommendations. RESULTS: Eight RCTs with 6,139 participants were included. We were not able to find differences between using tocilizumab compared to standard care on mortality in hospitalized patients with COVID-19 (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.84 to 1.13; 8 trials; 5,950 participants; low-certainty evidence). However, hospitalized patients under tocilizumab plus standard care treatment seemed to present a significantly lower risk of needing mechanical ventilation (risk ratio = 0.78; 95% CI 0.64−0.94 moderate-certainty of evidence). CONCLUSIONS: To date, the best evidence available shows no difference between using tocilizumab plus standard care compared to standard care alone for reducing mortality in patients with COVID-19. However, as a finding with a practical implication, the use of tocilizumab in association to standard care probably reduces the risk of progressing to mechanical ventilation in those patients. REGISTRATION: osf.io/qe4fs. BACKGROUND antihuman anti human 201 COVID19. COVID19 COVID 19 . (COVID-19) However 19. OBJECTIVE SETTING RCTs, , (RCTs) UNIFESP, UNIFESP (UNIFESP) SP, SP (SP) Brazil METHODS PubMed EMBASE CENTRAL 2021 Recommendations RESULTS 6139 139 6,13 included COVID-1 RR (RR 097 0 97 0.97 95 (CI 084 84 0.8 1.13 113 1 13 5950 5 950 5,95 lowcertainty low evidence. evidence) 0.78 078 78 064094 64 94 0.64−0.9 moderatecertainty moderate CONCLUSIONS date implication REGISTRATION osfioqe4fs osfioqefs osf io qe4fs qe fs osf.io/qe4fs 20 COVID1 (COVID-19 (RCTs (UNIFESP (SP 202 613 6,1 COVID- 09 9 0.9 08 0. 1.1 11 595 5,9 0.7 07 7 06409 0.64−0. osfioqe qefs 2 (COVID-1 61 6, 1. 59 5, 0640 0.64−0 (COVID- 064 0.64− (COVID 06 0.64 0.6

https://doi.org/10.1590/1516-3180.2022.0170.r1.01072022

14.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System. (OMPLs SCC. . (SCC) crosssectional cross sectional North, North (North Northeast CentralWest, CentralWest Central West, West Central-West South. South South) 201 120010 120 010 120,01 20102019, 20102019 , (2010-2019) 69 6 9 6.9 8,321 8321 8 321 (8,32 0.8%, 08 0 (0.8% 95 cases, 4.9%, 49 4 (4.9% 5971 5 971 5,97 1.2%, 12 1 2 (1.2% 1399 399 1,39 Brazils s 64.5%, 645 64.5% 64 (64.5%) located men years level consumption group nonCaucasian non formercurrent former users Institute 99 9.9 Therefore System (SCC 20 12001 01 120,0 2010201 (2010-2019 6. 8,32 832 32 (8,3 0.8% (0.8 4.9% (4.9 597 97 5,9 1.2% (1.2 139 39 1,3 64.5 (64.5% 9. 1200 120, 201020 (2010-201 8,3 83 3 (8, 0.8 (0. 4.9 (4. 59 5, 1.2 (1. 13 1, 64. (64.5 20102 (2010-20 8, (8 0. (0 4. (4 1. (1 (64. (2010-2 ( (64 (2010- (6 (2010 (201 (20 (2

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

15.

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak selflimited self limited 20172019 2017 2019 (2017-2019 202 2017201 201 (2017-201 20 201720 (2017-20 2 20172 (2017-2 (2017- (2017 (201 (20 (2 (
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Resumo: En | Texto: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk. mosquitoborne mosquito borne 2014 Brazil AsianCaribbean Asian Caribbean AC (AC EastCentralSouthAfrican East Central South African (ECSA states RS, , (RS) 2016 (CHIKF 20172021. 20172021 2017 2021. 2021 2017-2021 period 2020 limited Then lineage population 1 risk 201 (RS 2017202 202 2017-202 20 201720 2017-20 2 20172 2017-2 2017-

https://doi.org/10.1590/0074-02760220259

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