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Elevated serum IL-6 levels predict treatment interruption in patients with moderate to severe psoriasis: a 6-year real-world cohort study IL6 IL 6 IL- psoriasis 6year year realworld real world
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Alves, Natália Ribeiro de Magalhães
; Kurizky, Patrícia Shu
; Mota, Licia Maria Henrique da
; Albuquerque, Cleandro Pires de
; Esper, Juliana Tomaz
; Campos, Aridne Souza Costa
; Reis, Vitoria Pereira
; Ferro, Henrique Metzker
; Gil-Jaramillo, Natalia
; Brito-de-Sousa, Joaquim Pedro
; Leal, Luana Cabral Leão
; Nóbrega, Otávio de Toledo
; Araújo, Carla Nunes de
; Santos Júnior, Agenor de Castro Moreira dos
; Martins, Gladys Aires
; Martins Filho, Olindo Assis
; Gomes, Ciro Martins
.
Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response. Background Realworld, Realworld Real world, world Real-world scarce Objective Th1Th17 ThTh Th1 Th17 Th Th1/Th1 Methods years interferonα, interferonα interferon α, α interferon-α factorα, factorα factor factor-α interleukin inter leukin IL2, IL2 IL 2, 2 (IL)-2 IL4, IL4 4, 4 IL-4 IL6, IL6 6, IL10, IL10 10, 10 IL-10 IL17A ILA 17A A array assessed HRs (HRs model Results 26 biologics HR 1.04 104 1 04 95 1.01–1.07 101107 01 07 0.012 0012 0 012 IL- 1.99 199 99 1.29–3.08 129308 29 3 08 0.002 0002 002 limitations evaluation Conclusions environment response Th1Th1 Th1/Th (IL)- IL1 IL-1 1.0 9 1.01–1.0 10110 0.01 001 1.9 19 1.29–3.0 12930 0.00 000 00 Th1Th (IL) 1. 1.01–1. 1011 0.0 1.29–3. 1293 (IL 1.01–1 101 0. 1.29–3 129 1.01– 1.29– 12 1.01 1.29 1.2
2.
To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis B B2 positive outcomes
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Resende, Gustavo Gomes
; Saad, Carla Goncalves Schahin
; Marques, Claudia Diniz Lopes
; Ribeiro, Sandra Lúcia Euzébio
; Gavi, Maria Bernadete Renoldi de Oliveira
; Yazbek, Michel Alexandre
; Marinho, Adriana de Oliveira
; Menin, Rita de Cássia
; Ochtrop, Manuella Lima Gomes
; Soares, Andressa Miozzo
; Cavalcanti, Nara Gualberto
; Carneiro, Jamille Nascimento
; Werner de Castro, Glaucio Ricardo
; Fernandes, José Mauro Carneiro
; Souza, Elziane da Cruz Ribeiro E
; Alvarenga, Corina Quental de Menezes
; Vieira, Rejane Maria Rodrigues de Abreu
; Machado, Natalia Pereira
; Ximenes, Antônio Carlos
; Gazzeta, Morgana Ohira
; Albuquerque, Cleandro Pires de
; Skare, Thelma Larocca
; Keiserman, Mauro Waldemar
; Kohem, Charles Lubianca
; Benacon, Gabriel Sarkis
; Rocha, Vítor Florêncio Santos
; Lage, Ricardo da Cruz
; Malheiro, Olivio Brito
; Golebiovski, Rywka Tenenbaum Medeiros
; Oliveira, Thauana Luiza
; Duque, Ruben Horst
; Londe, Ana Carolina
; Pinheiro, Marcelo de Medeiros
; Sampaio-Barros, Percival Degrava
.
Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±
3.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
; Jesuíno, Isabella de Andrade
; Reis, Luiz Fernando Lima
; Mattos, Renata Rodrigues de
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Spadoni, Clayse Carla da Silva
; Moro, Elisângela Emilene
; Bueno, Flávia Regina
; Sampaio, Camila Santana Justo Cintra
; Silva, Débora Patrício
; Baldassare, Franca Pellison
; Silva, Ana Cecilia Alcantara
; Veiga, Thabata
; Barbante, Leticia
; Lambauer, Marianne
; Campos, Viviane Bezerra
; Santos, Elton
; Santos, Renato Hideo Nakawaga
; Laranjeiras, Ligia Nasi
; Valeis, Nanci
; Santucci, Eliana
; Miranda, Tamiris Abait
; Patrocínio, Ana Cristina Lagoeiro do
; Carvalho, Andréa de
; Sousa, Eduvirgens Maria Couto de
; Sousa, Ancelmo Honorato Ferraz de
; Malheiro, Daniel Tavares
; Bezerra, Isabella Lott
; Rodrigues, Mirian Batista
; Malicia, Julliana Chicuta
; Silva, Sabrina Souza da
; Gimenes, Bruna dos Passos
; Sesin, Guilhermo Prates
; Zavascki, Alexandre Prehn
; Sganzerla, Daniel
; Medeiros, Gregory Saraiva
; Santos, Rosa da Rosa Minho dos
; Silva, Fernanda Kelly Romeiro
; Cheno, Maysa Yukari
; Abrahão, Carolinne Ferreira
; Oliveira Junior, Haliton Alves de
; Rocha, Leonardo Lima
; Nunes Neto, Pedro Aniceto
; Pereira, Valéria Chagas
; Paciência, Luis Eduardo Miranda
; Bueno, Elaine Silva
; Caser, Eliana Bernadete
; Ribeiro, Larissa Zuqui
; Fernandes, Caio Cesar Ferreira
; Garcia, Juliana Mazzei
; Silva, Vanildes de Fátima Fernandes
; Santos, Alisson Junior dos
; Machado, Flávia Ribeiro
; Souza, Maria Aparecida de
; Ferronato, Bianca Ramos
; Urbano, Hugo Corrêa de Andrade
; Moreira, Danielle Conceição Aparecida
; Souza-Dantas, Vicente Cés de
; Duarte, Diego Meireles
; Coelho, Juliana
; Figueiredo, Rodrigo Cruvinel
; Foreque, Fernanda
; Romano, Thiago Gomes
; Cubos, Daniel
; Spirale, Vladimir Miguel
; Nogueira, Roberta Schiavon
; Maia, Israel Silva
; Zandonai, Cassio Luis
; Lovato, Wilson José
; Cerantola, Rodrigo Barbosa
; Toledo, Tatiana Gozzi Pancev
; Tomba, Pablo Oscar
; Almeida, Joyce Ramos de
; Sanches, Luciana Coelho
; Pierini, Leticia
; Cunha, Mariana
; Sousa, Michelle Tereza
; Azevedo, Bruna
; Dal-Pizzol, Felipe
; Damasio, Danusa de Castro
; Bainy, Marina Peres
; Beduhn, Dagoberta Alves Vieira
; Jatobá, Joana D’Arc Vila Nova
; Moura, Maria Tereza Farias de
; Rego, Leila Rezegue de Moraes
; Silva, Adria Vanessa da
; Oliveira, Luana Pontes
; Sodré Filho, Eliene Sá
; Santos, Silvana Soares dos
; Neves, Itallo de Lima
; Leão, Vanessa Cristina de Aquino
; Paes, João Lucidio Lobato
; Silva, Marielle Cristina Mendes
; Oliveira, Cláudio Dornas de
; Santiago, Raquel Caldeira Brant
; Paranhos, Jorge Luiz da Rocha
; Wiermann, Iany Grinezia da Silva
; Pedroso, Durval Ferreira Fonseca
; Sawada, Priscilla Yoshiko
; Prestes, Rejane Martins
; Nascimento, Glícia Cardoso
; Grion, Cintia Magalhães Carvalho
; Carrilho, Claudia Maria Dantas de Maio
; Dantas, Roberta Lacerda Almeida de Miranda
; Silva, Eliane Pereira
; Silva, Antônio Carlos da
; Oliveira, Sheila Mara Bezerra de
; Golin, Nicole Alberti
; Tregnago, Rogerio
; Lima, Valéria Paes
; Silva, Kamilla Grasielle Nunes da
; Boschi, Emerson
; Buffon, Viviane
; Machado, André Sant’Ana
; Capeletti, Leticia
; Foernges, Rafael Botelho
; Carvalho, Andréia Schubert de
; Oliveira Junior, Lúcio Couto de
; Oliveira, Daniela Cunha de
; Silva, Everton Macêdo
; Ribeiro, Julival
; Pereira, Francielle Constantino
; Salgado, Fernanda Borges
; Deutschendorf, Caroline
; Silva, Cristofer Farias da
; Gobatto, Andre Luiz Nunes
; Oliveira, Carolaine Bomfim de
; Dracoulakis, Marianna Deway Andrade
; Alvaia, Natália Oliveira Santos
; Souza, Roberta Machado de
; Araújo, Larissa Liz Cardoso de
; Melo, Rodrigo Morel Vieira de
; Passos, Luiz Carlos Santana
; Vidal, Claudia Fernanda de Lacerda
; Rodrigues, Fernanda Lopes de Albuquerque
; Kurtz, Pedro
; Shinotsuka, Cássia Righy
; Tavares, Maria Brandão
; Santana, Igor das Virgens
; Gavinho, Luciana Macedo da Silva
; Nascimento, Alaís Brito
; Pereira, Adriano J
; Cavalcanti, Alexandre Biasi
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
4.
Association between demographic factors, anxiety and depression in smokers
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Gouveia, Tamara dos Santos
; Pontes, Natália de Souza
; Lima, Mariana Belon Previatto de
; Santos, Caroline Pereira
; Ramos, Ercy Mara Cipulo
; Christofaro, Diego Giulliano Destro
; Ramos, Dionei
.
Abstract Background Smoking is one of the leading causes of death, although there are several strategies for quitting smoking. Anxiety and depression can hinder this process. Objective To assess levels of anxiety and depression in smokers, adjusting the values for possible confounding variables such as sex, age, schooling, and socioeconomic status. Method Cross-sectional study, the sample included 444 subjects were assessed for smoking history, anxiety levels and depression by the Hospital Anxiety and Depression Scale and characterized according to the socioeconomic profile. Results An association was found between smoking and anxiety (p=0.003) and between smoking and depression (p≤ 0.001) even after adjustments for confounding factors (Smoking and anxiety: OR Sex: 2.01; OR Age: 2.56; OR Schooling: 2.25; OR Socioeconomic level: 2.26; Smoking and Depression: OR Sex: 4.80; OR Age: 3.13; OR Schooling: 1.82; OR Socioeconomic level: 1.81). Conclusion The study showed that smokers present high anxiety and depression.
Resumo Introdução O tabagismo é uma das principais causas de morte, e embora existam várias estratégias para parar de fumar, a ansiedade e a depressão podem prejudicar este processo. Objetivo Avaliar os níveis de ansiedade e depressão em tabagistas, ajustando os valores para possíveis variáveis de confusão, como sexo, idade, escolaridade e nível socioeconômico. Método Estudo transversal, amostra de 444 indivíduos avaliados em relação ao histórico de tabagismo, níveis de ansiedade e depressão pela Escala Hospitalar de Ansiedade e Depressão e caracterizados conforme o perfil socioeconômico. Resultados Encontrou-se uma associação entre tabagismo e ansiedade (p = 0,003) e entre tabagismo e depressão (p <0,001) mesmo após ajustes para fatores de confusão (tabagismo e ansiedade: OR sexo: 2,01; OR idade: 2,56; OR escolaridade: 2,25; OR nível socioeconômico: 2,26; tabagismo e depressão: OR sexo: 4,80; OR idade: 3,13; OR escolaridade: 1,82; OR nível socioeconômico: 1,81). Conclusão O estudo mostrou que tabagistas apresentam altos níveis de ansiedade e depressão.
5.
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions
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Viana, Stéphanie de Souza Costa
; Souza, Natália Pereira dos Santos
; Aliberti, Márlon Juliano Romero
; Jacob-Filho, Wilson
.
ABSTRACT Objective To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible.
6.
Association between demographic factors, anxiety and depression in smokers
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Gouveia, Tamara dos Santos
; Pontes, Natália de Souza
; Lima, Mariana Belon Previatto de
; Santos, Caroline Pereira
; Ramos, Ercy Mara Cipulo
; Christofaro, Diego Giulliano Destro
; Ramos, Dionei
.
Abstract Background Smoking is one of the leading causes of death, although there are several strategies for quitting smoking. Anxiety and depression can hinder this process. Objective To assess levels of anxiety and depression in smokers, adjusting the values for possible confounding variables such as sex, age, schooling, and socioeconomic status. Method Cross-sectional study, the sample included 444 subjects were assessed for smoking history, anxiety levels and depression by the Hospital Anxiety and Depression Scale and characterized according to the socioeconomic profile. Results An association was found between smoking and anxiety (p=0.003) and between smoking and depression (p≤ 0.001) even after adjustments for confounding factors (Smoking and anxiety: OR Sex: 2.01; OR Age: 2.56; OR Schooling: 2.25; OR Socioeconomic level: 2.26; Smoking and Depression: OR Sex: 4.80; OR Age: 3.13; OR Schooling: 1.82; OR Socioeconomic level: 1.81). Conclusion The study showed that smokers present high anxiety and depression.
Resumo Introdução O tabagismo é uma das principais causas de morte, e embora existam várias estratégias para parar de fumar, a ansiedade e a depressão podem prejudicar este processo. Objetivo Avaliar os níveis de ansiedade e depressão em tabagistas, ajustando os valores para possíveis variáveis de confusão, como sexo, idade, escolaridade e nível socioeconômico. Método Estudo transversal, amostra de 444 indivíduos avaliados em relação ao histórico de tabagismo, níveis de ansiedade e depressão pela Escala Hospitalar de Ansiedade e Depressão e caracterizados conforme o perfil socioeconômico. Resultados Encontrou-se uma associação entre tabagismo e ansiedade (p = 0,003) e entre tabagismo e depressão (p <0,001) mesmo após ajustes para fatores de confusão (tabagismo e ansiedade: OR sexo: 2,01; OR idade: 2,56; OR escolaridade: 2,25; OR nível socioeconômico: 2,26; tabagismo e depressão: OR sexo: 4,80; OR idade: 3,13; OR escolaridade: 1,82; OR nível socioeconômico: 1,81). Conclusão O estudo mostrou que tabagistas apresentam altos níveis de ansiedade e depressão.
7.
Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa
; Pereira, Maria Fernanda Badue
; Santos, Angélica Carreira dos
; Fink, Thais Toledo
; Paula, Camila Sanson Yoshino de
; Litvinov, Nadia
; Schvartsman, Claudio
; Delgado, Artur Figueiredo
; Gibelli, Maria Augusta Bento Cicaroni
; Carvalho, Werther Brunow de
; Odone Filho, Vicente
; Tannuri, Uenis
; Carneiro-Sampaio, Magda
; Grisi, Sandra
; Duarte, Alberto José da Silva
; Antonangelo, Leila
; Francisco, Rossana Pucineli Vieira
; Okay, Thelma Suely
; Batisttella, Linamara Rizzo
; Carvalho, Carlos Roberto Ribeiro de
; Brentani, Alexandra Valéria Maria
; Silva, Clovis Artur
; Eisencraft, Adriana Pasmanik
; Rossi Junior, Alfio
; Fante, Alice Lima
; Cora, Aline Pivetta
; Reis, Amelia Gorete A. de Costa
; Ferrer, Ana Paula Scoleze
; Andrade, Anarella Penha Meirelles de
; Watanabe, Andreia
; Gonçalves, Angelina Maria Freire
; Waetge, Aurora Rosaria Pagliara
; Silva, Camila Altenfelder
; Ceneviva, Carina
; Lazari, Carolina dos Santos
; Abellan, Deipara Monteiro
; Santos, Emilly Henrique dos
; Sabino, Ester Cerdeira
; Bianchini, Fabíola Roberta Marim
; Alcantara, Flávio Ferraz de Paes
; Ramos, Gabriel Frizzo
; Leal, Gabriela Nunes
; Rodriguez, Isadora Souza
; Pinho, João Renato Rebello
; Carneiro, Jorge David Avaizoglou
; Paz, Jose Albino
; Ferreira, Juliana Carvalho
; Ferranti, Juliana Ferreira
; Ferreira, Juliana de Oliveira Achili
; Framil, Juliana Valéria de Souza
; Silva, Katia Regina da
; Kanunfre, Kelly Aparecida
; Bastos, Karina Lucio de Medeiros
; Galleti, Karine Vusberg
; Cristofani, Lilian Maria
; Suzuki, Lisa
; Campos, Lucia Maria Arruda
; Perondi, Maria Beatriz de Moliterno
; Diniz, Maria de Fatima Rodrigues
; Fonseca, Maria Fernanda Mota
; Cordon, Mariana Nutti de Almeida
; Pissolato, Mariana
; Peres, Marina Silva
; Garanito, Marlene Pereira
; Imamura, Marta
; Dorna, Mayra de Barros
; Luglio, Michele
; Rocha, Mussya Cisotto
; Aikawa, Nadia Emi
; Degaspare, Natalia Viu
; Sakita, Neusa Keico
; Udsen, Nicole Lee
; Scudeller, Paula Gobi
; Gaiolla, Paula Vieira de Vincenzi
; Severini, Rafael da Silva Giannasi
; Rodrigues, Regina Maria
; Toma, Ricardo Katsuya
; Paula, Ricardo Iunis Citrangulo de
; Palmeira, Patricia
; Forsait, Silvana
; Farhat, Sylvia Costa Lima
; Sakano, Tânia Miyuki Shimoda
; Koch, Vera Hermina Kalika
; Cobello Junior, Vilson
.
OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
8.
Are Patients' Blood Pressure Levels Being Routinely Measured in Medical Offices?
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Maynarde, Israel Guilharde
; Jardim, Thiago Veiga
; Souza, Weimar Kunz Sebba Barroso de
; Sousa, Ana Luiza Lima
; Rocca, Andrey Rocha
; Lin, Bruna Yana de Carvalho
; Santos, Natália Mirelle Carrijo dos
; Sampaio, Diogo Pereira Santos
; Serafim, Xênia Larissa Motta
; Jardim, Paulo Cesar Brandao Veiga
.
International Journal of Cardiovascular Sciences
- Métricas do periódico
Resumo Fundamentos: A medida da pressão arterial é recomendada em toda avaliação médica, independente da especialidade. É um procedimento simples e de fácil realização, mas frequentemente negligenciado e realizado de forma incorreta. Objetivo: Avaliar se a medida da pressão arterial estava sendo realizada rotineiramente e comparar os valores encontrados por medida rotineira em consulta ambulatorial às medidas realizadas, seguindo a técnica adequada. Métodos: Estudo transversal e observacional que incluiu pacientes adultos (> 18 anos) atendidos nos ambulatórios de especialidades clínicas e cirúrgicas de um hospital universitário. Os sujeitos responderam a questionário específico e, em seguida, foram submetidos a três medidas de pressão arterial, seguindo as recomendações das diretrizes vigentes, por equipe treinada. Seguiram para o atendimento ambulatorial e após o término, foi verificado em prontuário se a pressão arterial foi aferida e, em caso positivo, anotou-se o valor desta aferição. Resultados: Foram selecionados consecutivamente 129 pacientes com idade média de 53 anos (± 15,92) e predomínio do sexo feminino (61,2%). A maioria foi atendida em especialidades clínicas (70,5%) e 49,6% referiram diagnóstico prévio de hipertensão arterial sistêmica. A pressão arterial não foi aferida em 38,8% dos atendimentos, sendo mais frequente nas especialidades cirúrgicas (72,5% vs. 27,5%; p < 0,001). O diagnóstico prévio de hipertensão arterial sistêmica não influenciou na chance de um paciente ter sua pressão aferida (p = 0,082). Não houve diferença entre a pressão arterial aferida pelos pesquisadores e aquelas realizadas em consulta (118 mmHg vs. 117 mmHg; p = 0,651; 72 mmHg vs. 75 mmHg; p = 0,055). Conclusões: A pressão arterial dos pacientes não foi aferida em um grande número de atendimentos, principalmente nos ambulatórios de especialidades cirúrgicas.
Abstract Background: Blood pressure measurement is recommended in all medical evaluations, regardless of the specialty. It is a simple and easy-to-do procedure, but usually neglected or performed incorrectly. Objectives: To assess if blood pressure is being measured routinely and compare the values obtained in the usual ambulatory consultations to those obtained when following the adequate techniques. Methods: Cross-sectional and observational study that included adult (age >18 years) outpatients treated in clinical and surgical specialties of a teaching hospital. Subjects answered a specific questionnaire and then three blood pressure measurements were performed according to the current guidelines by trained research staff. After that, the patients had their appointments and at the end, the medical charts were checked to see if blood pressure was measured and, if so, the observed value was recorded. Results: We included 129 consecutive patients with a mean age of 53 years (± 15.92) predominantly females (61.2%). Most of the appointments occurred in clinical specialties (70.5%) and 49.6% reported themselves as hypertensive. Blood pressure was not measured in 38.8% of the patients, more frequently in surgical specialties (72,5% vs. 27,5%; p < 0,001). The previous diagnosis of hypertension did not influence the chance of a patient having his blood pressure measured (p = 0,082). There were no differences between the blood pressure measured by the researchers and those recorded at the medical charts (118 mmHg vs. 117 mmHg; p = 0,651; 72 mmHg vs. 75 mmHg; p = 0,055). Conclusions: The patients' blood pressure levels were not measured in many of the medical appointments, especially at outpatient clinics of surgical specialties.
https://doi.org/10.5935/2359-4802.20170055
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