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[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães
Barroso, Weimar Kunz Sebba
Mion Júnior, Décio
Nobre, Fernando
Mota-Gomes, Marco Antonio
Jardim, Paulo Cesar Brandão Veiga
Amodeo, Celso
Camargo, Adriana
Alessi, Alexandre
Sousa, Ana Luiza Lima
Brandão, Andréa Araujo
Pio-Abreu, Andrea
Sposito, Andrei Carvalho
Pierin, Angela Maria Geraldo
Paiva, Annelise Machado Gomes de
Spinelli, Antonio Carlos de Souza
Machado, Carlos Alberto
Poli-de-Figueiredo, Carlos Eduardo
Rodrigues, Cibele Isaac Saad
Forjaz, Cláudia Lúcia de Moraes
Sampaio, Diogo Pereira Santos
Barbosa, Eduardo Costa Duarte
Freitas, Elizabete Viana de
Cestário , Elizabeth do Espírito Santo
Muxfeldt, Elizabeth Silaid
Lima Júnior, Emilton
Campana, Erika Maria Gonçalves
Feitosa, Fabiana Gomes Aragão Magalhães
Consolim-Colombo, Fernanda Marciano
Almeida, Fernando Antônio de
Silva, Giovanio Vieira da
Moreno Júnior, Heitor
Finimundi, Helius Carlos
Guimarães, Isabel Cristina Britto
Gemelli, João Roberto
Barreto Filho, José Augusto Soares
Vilela-Martin, José Fernando
Ribeiro, José Marcio
Yugar-Toledo, Juan Carlos
Magalhães, Lucélia Batista Neves Cunha
Drager, Luciano Ferreira
Bortolotto, Luiz Aparecido
Alves, Marco Antonio de Melo
Malachias, Marcus Vinícius Bolívar
Neves, Mario Fritsch Toros
Santos, Mayara Cedrim
Dinamarco, Nelson
Moreira Filho, Osni
Passarelli Júnior, Oswaldo
Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira
Miranda, Roberto Dischinger
Bezerra, Rodrigo
Pedrosa, Rodrigo Pinto
Paula, Rogério Baumgratz de
Okawa, Rogério Toshiro Passos
Póvoa, Rui Manuel dos Santos
Fuchs, Sandra C.
Inuzuka, Sayuri
Ferreira-Filho, Sebastião R.
Paffer Fillho, Silvio Hock de
Jardim, Thiago de Souza Veiga
Guimarães Neto, Vanildo da Silva
Koch, Vera Hermina
Gusmão, Waléria Dantas Pereira
Oigman, Wille
Nadruz, Wilson
Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population.
Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care.
It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations.
Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced.
Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM).
Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance.
Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.
La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial.
La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización.
Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones.
Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA.
La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA).
Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia.
Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.
A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial.
A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização.
Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações.
Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA.
A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA).
Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz).
Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.
2.
Validation HPLC-DAD Method for Quantification of Gallic and Ellagic Acid from Eugenia punicifolia Leaves, Extracts and Fractions
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Silva, Liliane S.
; Oliveira, Matheus G. de
; Martins, Christiane F.
; Borges, Leonardo L.
; Fiuza, Tatiana S.
; Conceição, Edemilson C. da
; Paula, José R. de
.
Journal of the Brazilian Chemical Society
- Métricas do periódico
Eugenia punicifolia (Kunth) DC, known as “pedra ume-caá” or “pitanguinha do cerrado”, is popularly used to treat infectious diseases like inflammation, and diabetes. Therefore, this study aimed to develop and validate an analytical method by high-performance liquid chromatography with diode array detector (HPLC-DAD) for the seasonal quantification of gallic acid (GA) and ellagic acid (EA), and to co-validate the method for quantification from the ethanol extract and fractions of the E. punicifolia leaves. Chromatographic separations were performed with a mobile phase gradient of acetonitrile/methanol/water acidified with 0.2% formic acid, a flow of 0.8 mL min 1, detection at 254 nm, and a C18 column (250 × 4.6 mm, 5 µm). Method validation parameters were determined following Brazilian legislation. The HPLC-DAD analytical method developed for the quantification of GA and EA was validated and demonstrated to be selective, linear, precise, accurate, robust, and without matrix effect. Accordingly, it is helpful for the analysis of these tannins in crude ethanol extracts and fractions from E. punicifoila leaves. Thus, our results may be of great help for quality control assessment and standardization of raw materials containing Eugenia punicifolia.
3.
Hepatozoon Miller, 1908 parasites in the Colubridae snakes Clelia clelia (Daudin, 1803) and Drymarchon corais (Boie, 1827) from the Eastern Amazonia
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PICELLI, AMANDA MARIA
; SILVA, MARIA REGINA L.
; CORREA, JAMILLE KARINA C.
; PAIVA, GLEICIERLE R.
; PAULA, FABIANE R.
; HERNÁNDEZ-RUZ, EMIL JOSÉ
; OLIVEIRA, ELCIOMAR A.
; VIANA, LÚCIO ANDRÉ
.
Anais da Academia Brasileira de Ciências
- Métricas do periódico
Abstract Based on the genetic, morphological, and morphometric data of blood gamonts, we identified Hepatozoon parasites in colubrid snakes sampled in the Eastern Amazon region. Hepatozoon trigeminum was detected in the mussurana snake Clelia clelia and exhibited wide and elongated gamonts (mean dimensions: 14.25±0.65 × 4.31±0.43 μm) with an evident parasitophorous vacuole. Hepatozoon odwyerae sp. nov. was described in the indigo snake Drymarchon corais, whose gamonts have elongated and thin bodies (mean dimensions: 13.41±0.79 × 3.72±0.35 μm) with one end more tapered than the other. Phylogenetic analyses, based on the amplification of a 441 bp fragment of the 18S rRNA gene, revealed that the novel sequences of Hepatozoon spp. from our study were closely related to hemogregarine lineages found in lizards and snakes from Brazil, forming a well-supported monophyletic clade with them. The present study provides the first species description of Hepatoozon in D. corais and a new record of a host species for C. clelia using the integrated taxonomic data. We also highlight the importance of further investigations into the diversity of Hepatozoon in snakes, a rich but underestimated group of parasites, especially in the Amazonian biome.
4.
Effects of herbal choline as a replacement for choline chloride on myopathy, locomotor system, and hepatic health of broilers
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Dias, Allan Gabriel Ferreira
; Santin, Ana Paula Iglesias
; Brasileiro, Júlio César Lopes
; Leite, Carla Daniela Suguimoto
; Stringhini, José Henrique
; Gouveia, Alison Batista Vieira Silva
; Silva, Júlia Marixara Sousa da
; Café, Marcos Barcellos
.
ABSTRACT The objective of this study was to evaluate the effects of replacing choline chloride with a plant source of choline on the locomotor system, liver health, and development of breast myopathies in broilers aged 1-42 days of age. We allocated 1,120 one-day-old Cobb broilers to four treatment groups and fed them commercial diets based on corn and soybean meal. The treatments included choline in the form of 1,800.00 mg/kg choline chloride; 1,350.00 mg/kg choline chloride + 450.00 mg/kg herbal choline; 900.00 mg/kg choline chloride + 900.00 mg/kg herbal choline; and 1,000.00 mg/kg herbal choline. Each treatment group had eight replications. Throughout the experiment, gait score, footpad dermatitis, hock burn, and leg deformities (valgus and varus) were evaluated in the birds at 28 and 35 days of age. After slaughter, parameters such as breast myopathies, tibial dyschondroplasia score, and histological slides of the pectoral muscle, liver, and proximal tibial epiphysis were assessed. The results demonstrated good hepatic and locomotor health in the broilers, as no classical signs of choline deficiency were observed. Statistical analyses indicated no significant differences between treatments in terms of liver and locomotor health, suggesting that broilers fed diets supplemented with the plant source did not experience choline deficiency. Additionally, no statistically significant differences were found between treatments regarding breast myopathies. Overall, the tested choline plant source can effectively replace choline chloride in broiler diets.
5.
GENETIC PARAMETERS AND DIVERSITY, AND CORRELATIONS IN ONION STRAINS
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SEGUNDO, VANESSA CLÁUDIA VASCONCELOS
; INNECCO, RENATO
; FREITAS, JOELSON ANDRÉ
; LIMA, EVELINE NOGUEIRA
; NOGUEIRA, ANA PAULA OLIVEIRA
; LUZ, JOSÉ MAGNO QUEIROZ
.
RESUMO Os programas de melhoramento vegetal têm investido no desenvolvimento de cebolas com alto padrão comercial e para tal dependem dos recursos genéticos disponíveis para a obtenção de híbridos comerciais. O objetivo deste estudo foi avaliar parâmetros genéticos, diversidade genética e as correlações fenotípicas e genotípicas de caracteres relacionados à produção de cebola. O experimento foi realizado em Uberlândia - Minas Gerais, Brasil. Foram avaliadas 53 linhagens de cebola. Foi utilizado o delineamento em blocos ao acaso. Foram avaliadas 13 características de planta e bulbo. As análises estatísticas foram realizadas no programa Genes e R. Observou-se a existência de variabilidade genética entre os genótipos para a maioria dos caracteres ao nível de 1% pelo teste F. A herdabilidade da maioria dos caracteres apresentou valores moderados a altos (≥ 70%) e relação CVg/CVe alta (≥1). O método UPGMA possibilitou separar os genótipos em 20 grupos e de forma semelhante o método de Tocher separou os mesmos em 19 grupos. Os grupos que mais se destacaram foram V, XIV, XV, XVI, XVII, XVIII, XIX e XX. Houve seis correlações fenotípicas significativas pelo teste t com grau de associação baixo a moderado, e as correlações genotípicas, em sua maioria, mostraram-se superiores às fenotípicas e apresentaram o mesmo sinal. A partir dos parâmetros genéticos estudados existe alta possibilidade de ganhos na seleção. Há ampla variabilidade genética para os caracteres estudados o que permitiu a separação de grupos de genitores divergentes. Adicionalmente, as correlações fenotípicas e genotípicas mostraram inviabilidade para seleção indireta.
ABSTRACT Plant breeding programs have been investing in the development of high commercial standard onions; thus, they depend on the genetic resources available for obtaining commercial hybrids. The objective of this study was to evaluate genetic parameters and diversity, and phenotypic and genotypic correlations of characters related to onion production. The experiment was conducted in Uberlândia, Minas Gerais, Brazil. Fifty-three onion strains were evaluated, and a randomized block design was used. The number of plant and bulb characteristics evaluated was 13. The statistical analyses were performed using Genes and R software. A genetic variability among the genotypes was found for most of the characters at 1% level of significance in the F test. The heritability of most characters presented moderate to high values (≥ 70%) and high CVg/CVe ratio (≥ 1). The UPGMA method separated the genotypes into 20 groups, while the Tocher method separated them into 19 groups. The groups that stood out were V, XIV, XV, XV, XVI, XVII, XVIII, XIX, and XX. The results of t-test showed six significant phenotypic correlations with low to moderate degree of association, and the genotypic correlations, in most cases, were higher than the phenotypic ones and showed the same sign. From the genetic parameters studied, the possibility of gains in the selection is high. The separation of groups of divergent genitors was possible due to the wide genetic variability for the studied characters. Moreover, the phenotypic and genotypic correlations showed that indirect selection is not feasible.
6.
Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic
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Pilz, Luísa K.
; Couto Pereira, Natividade S.
; Francisco, Ana Paula
; Carissimi, Alicia
; Constantino, Débora B.
; Caus, Letícia B.
; Abreu, Ana Carolina O.
; Amando, Guilherme R.
; Bonatto, Fernanda S.
; Carvalho, Paula V.V.
; Cipolla-Neto, José
; Harb, Ana
; Lazzarotto, Gabriela
; Marafiga, Joseane Righes
; Minuzzi, Luciano
; Montagner, Francisco
; Nishino, Fernanda A.
; Oliveira, Melissa A.B.
; dos Santos, Bruno G.T.
; Steibel, Eduardo G.
; Tavares, Patrice S.
; Tonon, André C.
; Xavier, Nicóli B.
; Zanona, Querusche Klippel
; Amaral, Fernanda G.
; Calcagnotto, Maria Elisa
; Frey, Benicio N.
; Hidalgo, Maria Paz
; Idiart, Marco
; Russomano, Thais
.
Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.
7.
Insuficiencia cardíaca crónica en Argentina. OFFICE IC AR, un registro conjunto de la Sociedad Argentina de Cardiología y de la Federación Argentina de Cardiología
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THIERER, JORGE
; PERNA, EDUARDO R.
; MARINO, JAVIER
; CORONEL, MARÍA LORENA
; BARISANI, JOSÉ LUIS
; GARCÍA BRASCA, DANIELA
; PEREZ TERNS, PAULA
; CÍMBARO CANELLA, JUAN PABLO
; PEREIRO GONZÁLEZ, STELLA MARIS
.
ABSTRACT Background: Several Argentine registries on chronic heart failure (CHF) have been generated over the past 25 years, either individually by the Argentine Society of Cardiology (SAC) or the Argentine Federation of Cardiology (FAC), with different representativeness. The last known data are from 2013. The OFFICE IC AR registry was jointly undertaken by the SAC and FAC to know the reality of CHF in Argentina. Objective: The aim of this registry was to extensively and comprehensively describe the outstanding characteristics of CHF in Argentina, including patient characteristics, use of diagnostic and therapeutic resources, adherence to practice guidelines and mid-and long-term prognosis. Methods: This was a prospective cohort study of patients with at least 6-month evolution CHF and not hospitalized for at least the past 3 months. Clinical and paraclinical data were collected. Patients were categorized according to left ventricular ejection fraction (LVEF), into HF with reduced EF, HFrEF (≤40 %), HF with midrange EF, now termed HF with mildly reduced EF, HFmrEF (41%-49%), and HF with preserved EF, HFpEF (≥50%). The incidence of hospitalization for HF (HHF), cardiovascular mortality (CVM) and all-cause mortality (ACM) was recorded for at least 1-year follow-up. Results: Between November 2017 and January 2020, 100 cardiologists from all over the country included 1004 patients with CHF. Mean age was 65.8 ± 12.4 years, 74.6% were men, and 93.8% had known LVEF. In 68.4% of cases, patients had HFrEF, 16% HFmrEF and 15.6% HFpEF. A high prevalence of comorbidities was found, including diabetes and anemia in 30% of cases, and chronic renal failure in 22%. There was high use of neurohormonal antagonists (NHA): 89.5% betablockers, 57.3% renin-angiotensin system inhibitors or antagonists, 28.9% sacubitril-valsartan and 78.6% aldosterone antagonists. Triple therapy was used in 69% of patients, with higher prescription in HFrEF, but elevated even on HFpEF. At a median follow-up of 1.7 years, the annual incidence of CVM/HHF was 12.8%, CVM 6.6% and ACM 8.4%, without statistical differences between the different LVEF categories. Conclusions: This first SAC-FAC joint CHF registry verified a high prevalence of HFrEF, a high prevalence of comorbidities, frequent use of NHA and prognosis according to international registries.
RESUMEN Introducción: Diferentes registros argentinos de insuficiencia cardíaca crónica (ICC) fueron generados en los últimos 25 años, en forma individual por la Sociedad Argentina de Cardiología (SAC) y la Federación Argentina de Cardiología (FAC), con diversa representatividad. Los últimos datos conocidos datan de 2013. El Registro OFFICE IC AR fue encarado en forma conjunta por la SAC y la FAC para conocer la realidad de la ICC en Argentina. Objetivos: Describir en forma amplia y comprensiva las características salientes de la ICC en Argentina, incluyendo las características de los pacientes, el uso de recursos diagnósticos y terapéuticos, la adherencia a las guías de práctica y el pronóstico a mediano y largo plazo. Material y Métodos: Estudio prospectivo de cohorte, de pacientes con ICC de al menos 6 meses de evolución, alejados de una internación por al menos 3 meses. Se recabaron datos clínicos y paraclínicos. Los pacientes fueron categorizados, de acuerdo a la fracción de eyección ventricular izquierda (FEVI), en IC con FE reducida, ICFER (≤40%); IC con FE en el rango medio, ICFErm, ahora denominada IC con FE levemente reducida, ICFElr (41%-49%), e IC con FE preservada, ICFEP (≥50%). En seguimiento de al menos 1 año se registró la incidencia de hospitalización por insuficiencia cardíaca (HIC), muerte cardiovascular (MCV) y muerte de todas las causas (MTC) Resultados: Entre noviembre de 2017 y enero de 2020, 100 cardiólogos de todo el país incluyeron 1004 pacientes con ICC; edad media 65,8 ± 12,4 años, 74,6% hombres, FEVI conocida en el 93,8%. El 68,4% tenía ICFER, el 16% ICFElr y el 15,6% ICFEP. Hubo alta prevalencia de comorbilidades, incluyendo diabetes y anemia en el 30%, e insuficiencia renal crónica en el 22%. Fue elevada la utilización de antagonistas neurohormonales (ANH): 89,5% betabloqueantes; 57,3% inhibidores o antagonistas del sistema renina angiotensina, 28,9% sacubitril valsartán y 78,6% antialdosterónicos. En 69% se utilizó triple terapia. Su empleo fue mayor en la ICFER, pero elevado incluso en la ICFEP. En una mediana de seguimiento de 1,7 años la incidencia anual de MCV/HIC fue 12,8%, la de MCV 6,6% y la de MTC 8,4%, sin diferencia entre las distintas categorías de FEVI. Conclusiones: En el primer registro conjunto de ICC SAC-FAC se verificó elevada prevalencia de ICFER, alta prevalencia de comorbilidades, uso frecuente de ANH y pronóstico acorde a los registros internacionales.
https://doi.org/10.7775/rac.es.v90.i1.20480
15 downloads
8.
Nocturnal and crepuscular pollination of Passiflora morifolia (Passifloraceae): breeding system, floral biology and pollinators
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Abstract Barbosa, J. F.; P. R. Moraes, A. Silvério & L. A. Souza. 2022. Nocturnal and crepuscular pollination of Passiflora morifolia (Passifloraceae): breeding system, floral biology and pollinators. Darwiniana, nueva serie 10(1): 228-240. The study of interactions between plants and animals is important for detecting the degree of vulnerability of species under the current scenario of forest fragmentation. The genus Passiflora (Passifloraceae) is widely distributed in forest formations in Brazil with about 157 species. Here we studied the pollination biology of Passiflora morifolia, a native species of Brazil that is widely distributed in the American continent. Floral biology observations, controlled pollination tests and the recording of floral visitors were carried out in an area of natural occurrence, a fragment of Araucaria Moist Forest, located in the state of Paraná, Brazil. The results showed that the species is self-compatible, with flowers that open at night and remain open and receptive in the morning. The greatest volume of secreted nectar was observed at the beginning of anthesis, when the flower released an intense sweet odor and received visits from nocturnal and crepuscular bees. The bees Megommation insigne and Ptiloglossa willinki were the first visitors to the opened flowers and also the main pollinators.
Resumen Barbosa, J. F.; P. R. Moraes, A. Silvério & L. A. Souza. 2022. Polinización nocturna y crepuscular de Passiflora morifolia (Passifloraceae): sistema reproductivo, biología floral y polinizadores. Darwiniana, nueva serie 10(1): 228-240. El estudio de las interacciones entre plantas y animales es importante para detectar el grado de vulnerabilidad de las especies en el escenario actual de fragmentación de bosques. El género Passiflora (Passifloraceae), se encuentra en prácticamente todas las formaciones boscosas de Brasil, con aproximadamente 157 especies. Estudiamos la biología de la polinización de Passiflora morifolia, nativa de Brasil y ampliamente distribuida en el continente americano. Se realizaron observaciones de biología floral, pruebas de polinización controlada y registro de visitantes florales de la especie en un área de ocurrencia natural, un fragmento de Bosque Húmedo de Araucaria, ubicado en el estado de Paraná, Brasil. Los resultados mostraron que la especie es autocompatible, con flores que se abren por la noche y permanecen abiertas y receptivas por la mañana. La secreción de néctar es mayor al inicio de la antesis, cuando la flor libera un olor dulce intenso y recibe visitas de abejas nocturnas y crepusculares. Las abejas Megommation insigne y Ptiloglossa willinki fueron las primeras visitantes de las flores abiertas y también las principales polinizadoras.
9.
Antinociceptive and anti-inflammatory effects of extract of Celtis iguanaea (Jacq.) Sargent leaves in mice
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MORAES, WEULLER FILHO DE
; SILVA, DAIANY PRISCILLA B. DA
; FLORENTINO, IZIARA F.
; ALMEIDA, DIONYS S.
; MOREIRA, LORRANE KELLE S.
; NASCIMENTO, MARCUS VINÍCIUS M.
; CARVALHO, PABLINNY M.G. DE
; COUTO, RENÊ O. DO
; PAULA, JOSÉ R. DE
; COSTA, ELSON A.
.
Abstract The antinociceptive and anti-inflammatory activities of crude ethanolic extract of Celtis iguanaea leaves and their active fractions are reported. The oral treatment with crude ethanolic extract (CEE; 100, 300 or 1000 mg/Kg) inhibited the number of writhings in a dose-dependent manner. The intermediate dose also inhibited formalin-induced nociception in both phases. The oral treatment with dichloromethane fraction (DF; 9 mg/Kg) produced antinociceptive effect in both phases of formalin test; however, the treatment with ethyl acetate fraction (EAF; 16 mg/Kg) reduced pain only in the second phase of this test. The oral treatments with CEE (300 mg/Kg) or DF (9 mg/Kg) reduced the nociception induced by capsaicin and pre-treatment with naloxone did not change these effects. The oral administration of CEE (300 mg/Kg), DF (9 mg/Kg) or ethyl EAF (16 mg/Kg) reduced ear edema, leukocytes migration and myeloperoxidase activity. Furthermore, the oral treatment with CEE (300 mg/Kg) or EAF (16 mg/Kg) reduced the level of Tumor Necrosis Factor - Alpha (TNF-α) in the pleurisy test. In conclusion, the DF showed antinociceptive activity that involves the vanilloid system as well as anti-inflammatory effect and the EAF showed anti-inflammatory activity involving the reduction of TNF-α cytokine.
10.
Mammals in São Paulo State: diversity, distribution, ecology, and conservation
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Galetti, Mauro
; Carmignotto, Ana Paula
; Percequillo, Alexandre R.
; Santos, Marcos C. de O.
; Ferraz, Katia Maria P. M. de Barros
; Lima, Fernando
; Vancine, Maurício H.
; Muylaert, Renata L.
; Bonfim, Fernando César Gonçalves
; Magioli, Marcelo
; Abra, Fernanda D.
; Chiarello, Adriano G.
; Duarte, José Maurício Barbanti
; Morato, Ronaldo
; de Mello Beisiegel, Beatriz
; Olmos, Fábio
; Galetti Jr., Pedro Manoel
; Ribeiro, Milton Cezar
.
Resumo Os mamíferos são organismos carismáticos que desempenham um papel fundamental na função ecológica e nos serviços ecossistêmicos, como polinização, dispersão de sementes, ciclagem de nutrientes e controle de pragas. O Estado de São Paulo representa apenas 3% do território brasileiro, mas detém 33% da diversidade de mamíferos. A maior parte de seu território é dominado pela agricultura, pastagens e áreas urbanas que afetam diretamente a diversidade e a persistência dos mamíferos na paisagem. Além disso, São Paulo possui o maior porto da América Latina e o maior reservatório de petróleo costeiro do Brasil, com 600 km de extensão de litoral com diversas espécies de mamíferos marinhos. Essas infraestruturas afetam a diversidade, distribuição, ecologia e o futuro dos mamíferos no estado. Aqui, respondemos cinco perguntas principais: 1) Qual é a diversidade de mamíferos silvestres no Estado de São Paulo? 2) Onde eles ocorrem? 3) Qual é o seu impacto positivo e negativo no bem-estar humano? 4) Como os mamíferos persistem em paisagens modificadas pelo homem? 5) Qual é o futuro dos mamíferos no estado? O estado de São Paulo possui 255 espécies de mamíferos nativos, com quatro espécies endêmicas, duas delas globalmente ameaçadas de extinção. Pelo menos seis espécies (dois marsupiais, ariranha, veado-campeiro, veado-cambuta e tatu-canastra) foram extirpadas do estado devido à caça e perda de habitat. O intenso uso humano da terra no estado forçou muitas espécies de mamíferos a mudar sua dieta para lidar com a intensa fragmentação e agricultura. A monocultura em larga escala facilitou a invasão de espécies exóticas, como porcos selvagens (javaporco) e a lebre europeia. Várias espécies de áreas abertas estão expandindo suas áreas de distribuição (lobo-guará, veado-catingueiro) sobre áreas desmatadas e provavelmente refletem mudanças em direção a um clima mais seco. Como o estado possui o maior sistema rodoviário do Brasil, cerca de 40 mil mamíferos de 33 espécies são mortos por ano em colisões, causando um prejuízo econômico de 12 milhões de dólares/ano. A diversidade de mamíferos está concentrada nos maiores remanescentes florestais da Serra do Mar e no interior do Estado, principalmente nas regiões de Ribeirão Preto e Jundiaí. As lacunas amostrais estão concentradas em todo o interior do estado, principalmente na região noroeste. Os mamíferos silvestres desempenham um papel fundamental em muitos serviços ecossistêmicos, mas também podem ser uma preocupação em trazer novas doenças emergentes para as populações humanas. Embora a taxonomia de mamíferos pareça ser bem conhecida, mostramos que novas espécies estão sendo continuamente descobertas no estado. Portanto, pesquisas usando tecnologias tradicionais e novas (eDNA, iDNA, drones), monitoramento populacional de longo prazo, a investigação da interface do conflito homem-vida selvagem e a compreensão do papel único no ecossistema desempenhado pelos mamíferos são um caminho futuro para promover uma paisagem verde sustentável aliada ao bem-estar humano no estado. O plantio de corredores florestais ou de cerrado, principalmente junto aos principais sistemas fluviais, no planalto, o controle da caça ilegal nas áreas costeiras, o manejo dos regimes de fogo no Cerrado e a mitigação dos atropelamentos devem ser uma prioridade para proteger essa notável diversidade de mamíferos.
Abstract Mammals are charismatic organisms that play a fundamental role in ecological functions and ecosystem services, such as pollination, seed dispersal, nutrient cycling, and pest control. The state of São Paulo represents only 3% of the Brazilian territory but holds 33% of its mammalian diversity. Most of its territory is dominated by agriculture, pastures, and urban areas which directly affect the diversity and persistence of mammals in the landscape. In addition, São Paulo has the largest port in Latin America and the largest offshore oil reservoir in Brazil, with a 600 km stretch of coastline with several marine mammal species. These human-made infrastructures affect the diversity, distribution, ecology, and the future of mammals in the state. Here, we answer five main questions: 1) What is the diversity of wild mammals in São Paulo state? 2) Where are they? 3) What is their positive and negative impact on human well-being? 4) How do mammals thrive in human-modified landscapes? 5) What is the future of mammals in the state? The state of São Paulo holds 255 species of native mammals, with four endemic species, two of them globally endangered. At least six species (two marsupials, Giant otter, Pampas deer, Brazilian dwarf brocket deer, and Giant armadillo) were extirpated from the state due to hunting and habitat loss. The intense human land use in the state forced many mammalian species to change their diet to cope with the intense fragmentation and agriculture. Large-scale monoculture has facilitated the invasion of exotic species such as wild boars (javali) and the European hare. Several “savanna-dwelling” species are expanding their ranges (Maned wolf, Brocket deer) over deforested areas and probably reflect changes towards a drier climate. Because the state has the largest road system, about 40,000 mammals from 33 species are killed per year in collisions causing an economic loss of 12 million dollars/year. The diversity of mammals is concentrated in the largest forest remnants of Serra do Mar and in the interior of the State, mainly in the regions of Ribeirão Preto and Jundiaí. Sampling gaps are concentrated throughout the interior of the state, particularly in the northwest region. Wild mammals play a fundamental role in many ecosystem services, but they can also be a concern in bringing new emergent diseases to humans. Although the taxonomy of mammals seems to be well known, we show that new species are continuously being discovered in the state. Therefore, continuous surveys using traditional and new technologies (eDNA, iDNA, drones), long-term population monitoring, investigation of the interface of human-wildlife conflict, and understanding of the unique ecosystem role played by mammals are future avenues for promoting sustainable green landscapes allied to human well-being in the state. The planting of forest or savanna corridors, particularly along with major river systems, in the plateau, controlling illegal hunting in the coastal areas, managing fire regimes in the Cerrado, and mitigating roadkill must be prioritized to protect this outstanding mammal diversity.
11.
Cordyceps cateniannulata and Cordyceps javanica: first report of pathogenicity to Glycaspis brimblecombei (Hemiptera: Aphalaridae)
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DOMINGUES, MAURÍCIO M.
; SANTOS, PAULA L.
; GÊA, BIANCA C.C.
; CARVALHO, VANESSA R.
; OLIVEIRA, FABRICIO N.
; SOLIMAN, EVERTON P.
; PEREIRA, FABRICIO F.
; ZANUNCIO, JOSÉ C.
; WILCKEN, CARLOS F.
.
Abstract Cultivation of species of the genus Eucalyptus is important for the Brazilian economy, with 6.97 million hectares planted. Glycaspis brimblecombei Moore (Hemiptera: Aphalaridae), detected in Brazil in 2003, has dispersed and now damages Eucalyptus crops in all regions of this country. The location and identification of entomopathogenic fungi isolates may increase the options for integrated pest management. The objective of this research was to evaluate the pathogenicity of Cordyceps cateniannulata and Cordyceps javanica isolates to G. brimblecombei. Ten nymphs of G. brimblecombei, with or without lerps, were placed per Eucalyptus leaf cut with one of its edges on hydroretentive gel inside Petri dishes. The fungi isolates were suspended in a solution of Tween 80 (0.1%) at the concentration of 1.0 x 108 conidia mL-1 and sprayed on the G. brimblecombei nymphs. The mortality of this insect was evaluated daily for seven days, and the dead individuals were transferred to humid chambers. The conidia viability of the isolates was greater than 93%. The mortality of G. brimblecombei nymphs, seven days after the application of the fungi, was 100%. This is the first report of the pathogenicity of C. cateniannulata and C. javanica isolates, occurring naturally in the field, to G. brimblecombei.
12.
Atualização da Diretriz Brasileira de Hipercolesterolemia Familiar – 2021
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Izar, Maria Cristina de Oliveira
; Giraldez, Viviane Zorzanelli Rocha
; Bertolami, Adriana
; Santos Filho, Raul Dias dos
; Lottenberg, Ana Maria
; Assad, Marcelo Heitor Vieira
; Saraiva, José Francisco Kerr
; Chacra, Ana Paula M.
; Martinez, Tania L. R.
; Bahia, Luciana Ribeiro
; Fonseca, Francisco Antonio Helfenstein
; Faludi, Andre Arpad
; Sposito, Andrei C.
; Chagas, Antônio Carlos Palandri
; Jannes, Cinthia Elim
; Amaral, Cristiane Kovacs
; Araújo, Daniel Branco de
; Cintra, Dennys Esper
; Coutinho, Elaine dos Reis
; Cesena, Fernando
; Xavier, Hermes Toros
; Mota, Isabela Cardoso Pimentel
; Giuliano, Isabela de Carlos Back
; Faria Neto, José Rocha
; Kato, Juliana Tieko
; Bertolami, Marcelo Chiara
; Miname, Marcio Hiroshi
; Castelo, Maria Helane Costa Gurgel
; Lavrador, Maria Sílvia Ferrari
; Machado, Roberta Marcondes
; Souza, Patrícia Guedes de
; Alves, Renato Jorge
; Machado, Valeria Arruda
; Salgado Filho, Wilson
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
https://doi.org/10.36660/abc.20210788
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13.
Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba
; Rodrigues, Cibele Isaac Saad
; Bortolotto, Luiz Aparecido
; Mota-Gomes, Marco Antônio
; Brandão, Andréa Araujo
; Feitosa, Audes Diógenes de Magalhães
; Machado, Carlos Alberto
; Poli-de-Figueiredo, Carlos Eduardo
; Amodeo, Celso
; Mion Júnior, Décio
; Barbosa, Eduardo Costa Duarte
; Nobre, Fernando
; Guimarães, Isabel Cristina Britto
; Vilela-Martin, José Fernando
; Yugar-Toledo, Juan Carlos
; Magalhães, Maria Eliane Campos
; Neves, Mário Fritsch Toros
; Jardim, Paulo César Brandão Veiga
; Miranda, Roberto Dischinger
; Póvoa, Rui Manuel dos Santos
; Fuchs, Sandra C
; Alessi, Alexandre
; Lucena, Alexandre Jorge Gomes de
; Avezum, Alvaro
; Sousa, Ana Luiza Lima
; Pio-Abreu, Andrea
; Sposito, Andrei Carvalho
; Pierin, Angela Maria Geraldo
; Paiva, Annelise Machado Gomes de
; Spinelli, Antonio Carlos de Souza
; Nogueira, Armando da Rocha
; Dinamarco, Nelson
; Eibel, Bruna
; Forjaz, Cláudia Lúcia de Moraes
; Zanini, Claudia Regina de Oliveira
; Souza, Cristiane Bueno de
; Souza, Dilma do Socorro Moraes de
; Nilson, Eduardo Augusto Fernandes
; Costa, Elisa Franco de Assis
; Freitas, Elizabete Viana de
; Duarte, Elizabeth da Rosa
; Muxfeldt, Elizabeth Silaid
; Lima Júnior, Emilton
; Campana, Erika Maria Gonçalves
; Cesarino, Evandro José
; Marques, Fabiana
; Argenta, Fábio
; Consolim-Colombo, Fernanda Marciano
; Baptista, Fernanda Spadotto
; Almeida, Fernando Antonio de
; Borelli, Flávio Antonio de Oliveira
; Fuchs, Flávio Danni
; Plavnik, Frida Liane
; Salles, Gil Fernando
; Feitosa, Gilson Soares
; Silva, Giovanio Vieira da
; Guerra, Grazia Maria
; Moreno Júnior, Heitor
; Finimundi, Helius Carlos
; Back, Isabela de Carlos
; Oliveira Filho, João Bosco de
; Gemelli, João Roberto
; Mill, José Geraldo
; Ribeiro, José Marcio
; Lotaif, Leda A. Daud
; Costa, Lilian Soares da
; Magalhães, Lucélia Batista Neves Cunha
; Drager, Luciano Ferreira
; Martin, Luis Cuadrado
; Scala, Luiz César Nazário
; Almeida, Madson Q.
; Gowdak, Marcia Maria Godoy
; Klein, Marcia Regina Simas Torres
; Malachias, Marcus Vinícius Bolívar
; Kuschnir, Maria Cristina Caetano
; Pinheiro, Maria Eliete
; Borba, Mario Henrique Elesbão de
; Moreira Filho, Osni
; Passarelli Júnior, Oswaldo
; Coelho, Otavio Rizzi
; Vitorino, Priscila Valverde de Oliveira
; Ribeiro Junior, Renault Mattos
; Esporcatte, Roberto
; Franco, Roberto
; Pedrosa, Rodrigo
; Mulinari, Rogerio Andrade
; Paula, Rogério Baumgratz de
; Okawa, Rogério Toshiro Passos
; Rosa, Ronaldo Fernandes
; Amaral, Sandra Lia do
; Ferreira-Filho, Sebastião R.
; Kaiser, Sergio Emanuel
; Jardim, Thiago de Souza Veiga
; Guimarães, Vanildo
; Koch, Vera H.
; Oigman, Wille
; Nadruz, Wilson
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
https://doi.org/10.36660/abc.20201238
10948 downloads
14.
Consenso de hemofilia en México
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López-Arroyo, José L.
; Pérez-Zúñiga, Juan M.
; Merino-Pasaye, Laura E.
; Saavedra-González, Azucena
; Alcivar-Cedeño, Luisa María
; Álvarez-Vera, José Luis
; Anaya-Cuellar, Irene
; Arana-Luna, Luara L.
; Ávila-Castro, David
; Bates-Martín, Ramón A.
; Cesarman-Maus, Gabriela
; Chávez-Aguilar, Lénica A.
; Peña-Celaya, José A. de la
; Espitia-Ríos, María E.
; Estrada-Domínguez, Patricia
; Fermín-Caminero, Denisse
; Flores-Patricio, Willy
; García Chávez, Jaime
; García-Lee, María T.
; González-Pérez, María del Carmen
; González-Rubio, María del Carmen
; González-Villareal, María Guadalupe
; Ramírez-Moreno, Fabiola
; Hernández-Colin, Ana K.
; Hernández-Ruiz, Eleazar
; Herrera-Olivares, Wilfrido
; Leyto-Cruz, Faustino
; Loera-Fragoso, Sergio
; Martínez-Ríos, Annel
; Miranda-Madrazo, María R.
; Morales-Hernández, Alba
; Nava-Villegas, Lorena
; Orellana-Garibay, Juan J.
; Palma-Moreno, Orlando G.
; Paredes-Lozano, Eugenia P.
; Peña-Alcántara, Paula
; Pérez-Lozano, Uendy
; Pichardo-Cepín, Yayra M.
; Reynoso-Pérez, Ana Carolina
; Rodríguez-Serna, Mishel
; Rojas-Castillejos, Flavio
; Romero-Rodelo, Hilda
; Ruíz-Contreras, Josué I.
; Segura-García, Adela
; Silva-Vera, Karina
; Soto-Cisneros, Paulina M.
; Tapia-Enríquez, Ana L.
; Tavera-Rodríguez, Martha G.
; Teomitzi-Sánchez, Óscar
; Tepepa-Flores, Fredy
; Valencia-Rivas, María D.
; Valle-Cárdenas, Teresa
; Varela-Constantino, Ana
; Javier-Morales, Adrián
; Martínez-Ramírez, Mario A.
; Tena-Cano, Sergio
; Terrazas-Marín, Ricardo
; Vilchis-González, Shendel P.
; Villela-Peña, Atenas
; Mena-Zepeda, Verónica
; Alvarado Ibarra, Martha
.
Abstract Hemophilia is a hemorrhagic disorder with a sex-linked inherited pattern, characterized by an inability to amplify coagulation due to a deficiency in coagulation factor VIII (hemophilia A or classic) or factor IX (hemophilia B). Sequencing of the genes involved in hemophilia has provided a description and record of the main mutations, as well as a correlation with the various degrees of severity. Hemorrhagic manifestations are related to levels of circulating factor, mainly affecting the musculoskeletal system and specifically the large joints (knees, ankles and elbows). This document is a review and consensus of the main genetic aspects of hemophilia, from the inheritance pattern to the concept of women carriers, physiopathology and classification of the disorder, the basic and confirmation studies when hemophilia is suspected, the various treatment regimens based on infusion of the deficient coagulation factor as well as innovative factor-free therapies and recommendations for the management of complications associated with treatment (development of inhibitors and/or transfusion transmitted infections) or secondary to articular hemorrhagic events (hemophilic arthropathy). Finally, relevant reviews of clinical and treatment aspects of hemorrhagic pathology charachterized by acquired deficiency of FVIII secondary to neutralized antibodies named acquired hemophilia.
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https://doi.org/10.24875/gmm.m20000451
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Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.
; Marques, Heloisa H.S.
; Gualano, Bruno
; Lindoso, Livia
; Bain, Vera
; Astley, Camilla
; Martins, Fernanda
; Matheus, Denise
; Matsuo, Olivia M.
; Suguita, Priscila
; Trindade, Vitor
; Paula, Camila S.Y.
; Farhat, Sylvia C.L.
; Palmeira, Patricia
; Leal, Gabriela N.
; Suzuki, Lisa
; Odone Filho, Vicente
; Carneiro-Sampaio, Magda
; Duarte, Alberto José S.
; Antonangelo, Leila
; Batisttella, Linamara R.
; Polanczyk, Guilherme V.
; Pereira, Rosa Maria R.
; Carvalho, Carlos Roberto R.
; Buchpiguel, Carlos A.
; Latronico, Ana Claudia
; Seelaender, Marilia
; Silva, Clovis Artur
; Pereira, Maria Fernanda B.
; Sallum, Adriana M. E.
; Brentani, Alexandra V. M.
; Neto, Álvaro José S.
; Ihara, Amanda
; Santos, Andrea R.
; Canton, Ana Pinheiro M.
; Watanabe, Andreia
; Santos, Angélica C. dos
; Pastorino, Antonio C.
; Franco, Bernadette D. G. M.
; Caruzo, Bruna
; Ceneviva, Carina
; Martins, Carolina C. M. F.
; Prado, Danilo
; Abellan, Deipara M.
; Benatti, Fabiana B.
; Smaria, Fabiana
; Gonçalves, Fernanda T.
; Penteado, Fernando D.
; Castro, Gabriela S. F. de
; Gonçalves, Guilherme S.
; Roschel, Hamilton
; Disi, Ilana R.
; Marques, Isabela G.
; Castro, Inar A.
; Buscatti, Izabel M.
; Faiad, Jaline Z.
; Fiamoncini, Jarlei
; Rodrigues, Joaquim C.
; Carneiro, Jorge D. A.
; Paz, Jose A.
; Ferreira, Juliana C.
; Ferreira, Juliana C. O.
; Silva, Katia R.
; Bastos, Karina L. M.
; Kozu, Katia
; Cristofani, Lilian M.
; Souza, Lucas V. B.
; Campos, Lucia M. A.
; Silva Filho, Luiz Vicente R. F.
; Sapienza, Marcelo T.
; Lima, Marcos S.
; Garanito, Marlene P.
; Santos, Márcia F. A.
; Dorna, Mayra B.
; Aikawa, Nadia E.
; Litvinov, Nadia
; Sakita, Neusa K.
; Gaiolla, Paula V. V.
; Pasqualucci, Paula
; Toma, Ricardo K.
; Correa-Silva, Simone
; Sieczkowska, Sofia M.
; Imamura, Marta
; Forsait, Silvana
; Santos, Vera A.
; Zheng, Yingying
.
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
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