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Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials
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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.

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

Economic burden of respiratory syncytial and parainfluenza viruses in children of upper-middle-income countries: a systematic review
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Rocha Filho, César Ramos

; Ramalho, Gabriel Sodré

; Martins, Johnny Wallef Leite

; Lucchetta, Rosa Camila

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira da

; Trevisani, Giulia Fernandes Moça

; Reis, Felipe Sebastião de Assis

; Ferla, Laura Jantsch

; Mastroianni, Patrícia de Carvalho

; Correa, Luci

; Saconato, Humberto

; Trevisani, Virgínia Fernandes Moça

Jornal de Pediatria

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2023, Volume 99 Nº 6 Páginas 537 - 545

Resumo: En | Texto: En | PDF: En

Abstract Objective: To identify and assess the current evidence available about the costs of managing hospitalized pediatric patients diagnosed with Respiratory Syncytial Virus (RSV) and Parainfluenza Virus Type 3 (PIV3) in upper-middle-income countries. Methods: The authors conducted a systematic review across seven key databases from database inception to July 2022. Costs extracted were converted into 2022 International Dollars using the Purchasing Power Parity-adjusted. PROSPERO identifier: CRD42020225757. Results: No eligible study for PIV3 was recovered. For RSV, cost analysis and COI studies were performed for populations in Colombia, China, Malaysia, and Mexico. Comparing the total economic impact, the lowest cost per patient at the pediatric ward was observed in Malaysia ($ 347.60), while the highest was in Colombia ($ 709.66). On the other hand, at pediatric ICU, the lowest cost was observed in China ($ 1068.26), while the highest was in Mexico ($ 3815.56). Although there is no consensus on the major cost driver, all included studies described that the medications (treatment) consumed over 30% of the total cost. A high rate of inappropriate prescription drugs was observed. Conclusion: The present study highlighted how RSV infection represents a substantial economic burden to health care systems and to society. The findings of the included studies suggest a possible association between baseline risk status and expenditures. Moreover, it was observed that an important amount of the cost is destinated to treatments that have no evidence or support in most clinical practice guidelines.

https://doi.org/10.1016/j.jped.2023.05.003

Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study
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Araújo, Fabrícia Coelho de

; Silva, Karoline Sampaio da

; Ohara, Daniela Gonçalves

; Matos, Areolino Pena

; Pinto, Ana Carolina Pereira Nunes

; Pegorari, Maycon Sousa

Ciência & Saúde Coletiva

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Fev 2022, Volume 27 Nº 2 Páginas 761 - 769

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

Resumo O objetivo deste artigo é identificar a prevalência e os fatores associados à obesidade abdominal dinapênica (OAD) em idosos de uma cidade da região Norte do Brasil. Estudo transversal realizado com 382 idosos comunitários residentes em Macapá, Amapá, Brasil. As informações socioeconômicas, clínicas e de saúde foram coletadas por meio de um formulário estruturado. A OAD foi definida pela combinação de dinapenia (força de preensão manual < 26 kgf para homens e < 16 kgf para mulheres) e obesidade abdominal (circunferência abdominal > 102 cm para homens e > 88 cm para mulheres). As análises descritivas e inferenciais foram realizadas utilizando os testes qui-quadrado, t de Student e regressão de Poisson. A prevalência de OAD foi de 10,73%. Na análise bivariada preliminar, as variáveis faixa etária, estado conjugal, número de doenças, incapacidade funcional para atividades básicas e instrumentais de vida diária, velocidade da marcha e nível de atividade física atenderam ao critério estabelecido. O modelo final indicou que apenas a velocidade da marcha foi um preditor para a OAD em idosos. A OAD afeta quase 11% dos idosos residentes nessa comunidade do Norte do Brasil; e a velocidade de marcha é um preditor que pode ser uma ferramenta útil para gerenciar e monitorar a saúde desta população.

Abstract This article aims to identify the prevalence of and factors associated with dynapenic abdominal obesity (DAO) in older adults in a city in the northern region of Brazil. A cross-sectional study was conducted with 382 community-dwelling older adults in Macapa, Amapa, Brazil. Socioeconomic, clinical, and health information were collected using a structured form. DAO was defined as a combination of dynapenia (handgrip strength of < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). Descriptive and inferential analyses were performed using chi-squared tests, Student’s t-tests, and a Poisson regression. The prevalence of DAO was 10.73%. In the preliminary bivariate analysis, the variables of age range, marital status, number of diseases, functional disability for basic and instrumental activities of daily living, gait speed, and level of physical activity met the established criterion. The final model indicated that only gait speed was a predictor of DAO in older adults. DAO affects nearly 11% of community-dwelling older adults from northern Brazil; gait speed was a predictor of DAO and could be a useful tool for managing and monitoring this population’s health.

https://doi.org/10.1590/1413-81232022272.01122021

Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study
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Araújo, Fabrícia Coelho de

; Silva, Karoline Sampaio da

; Ohara, Daniela Gonçalves

; Matos, Areolino Pena

; Pinto, Ana Carolina Pereira Nunes

; Pegorari, Maycon Sousa

Ciência & Saúde Coletiva

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2022, Volume 27 Nº 2 Páginas 761 - 769

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

https://doi.org/10.1590/1413-81232022272.01122021

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary sjogren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian Society of Rheumatology (articular, pulmonary and renal)
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Trevisani, Virginia Fernandes Moça

; Pugliesi, Alisson

; Pasoto, Sandra Gofinet

; Lopes, Maria Lucia Lemos

; Guedes, Lissiane Karine Noronha

; Miyamoto, Samira Tatiyama

; Fernandes, Marilena Leal Mesquita Silvestre

; Fialho, Sonia Cristina de Magalhães Souza

; Pinheiro, Aysa César

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lúcia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório-Kimura, Tatiana Nayara

; Santos, Maria Carmen Lopes Ferreira Silva

; Cantali, Diego Ustárroz

; Gennari, Juliana D’Agostino

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha-Filho, César Ramos

; Oliveira, Fabiola Reis

; Rocha, Aline Pereira da

; Valim, Valeria

Advances in Rheumatology

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2022, Volume 62 elocation 18

Resumo: En | Texto: En | PDF: En

Abstract Sjogren’s Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.

https://doi.org/10.1186/s42358-022-00248-1

Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials
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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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2022, Nº ahead

Resumo: En | Texto: En | PDF: En

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

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)
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Trevisani, Virginia Fernandes Moça

; Pinheiro, Aysa César

; Fialho, Sonia Cristina de Magalhães Souza

; Fernandes, Marilena Leal Mesquita Silvestre

; Pugliesi, Alisson

; Pasoto, Sandra Gofinet

; Lopes, Maria Lucia Lemos

; Guedes, Lissiane Karine Noronha

; Miyamoto, Samira Tatiyama

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lúcia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório-Kimura, Tatiana Nayara

; Santos, Maria Carmen Lopes Ferreira Silva

; Cantali, Diego Ustárroz

; Gennari, Juliana D.’Agostino

; Capobianco, Karina Gatz

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira da

; Rocha Filho, César Ramos

; Oliveira, Fabiola Reis

; Valim, Valeria

Advances in Rheumatology

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2022, Volume 62 elocation 35

Resumo: En | Texto: En | PDF: En

Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.

https://doi.org/10.1186/s42358-022-00267-y

Association between frailty syndrome and sedentary behavior among community-dwelling older adults in the Amazon region: a cross-sectional study
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Santos, Izabelle Santos dos

; Silva, Caroline de Fátima Ribeiro

; Ohara, Daniela Gonçalves

; Matos, Areolino Pena

; Pinto, Ana Carolina Pereira Nunes

; Pegorari, Maycon Sousa

Sao Paulo Medical Journal

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Jun 2021, Volume 139 Nº 3 Páginas 226 - 233

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Existence of an association between sedentary behavior and frailty among older adults has been suggested. However, there is a lack of studies conducted in Brazil, especially in areas of the Amazon region. OBJECTIVE: To analyze the association between frailty syndrome and sedentary behavior among community-dwelling older adults. DESIGN AND SETTING: Cross-sectional study carried out in Macapá, state of Amapá, Brazil. METHODS: Frailty status was assessed using Fried's frailty phenotype, and sedentary behavior was evaluated using two questions concerning time spent in a seated position, from the International Physical Activity Questionnaire (IPAQ). A multinomial logistic regression model was used to verify the association between frailty syndrome and sedentary behavior. RESULTS: The final study sample was made up of 411 older adults with a mean age of 70.14 ± 7.25 years and an average daily duration of sedentary behavior of 2.86 ± 2.53 hours. The prevalence of non-frailty was 28.7%, prevalence of pre-frailty was 58.4% and prevalence of frailty was 12.9%. The adjusted analysis showed that there were independent associations between sedentary behavior and pre-frailty (odds ratio, OR = 1.18; 95% confidence interval, CI: 1.03-1.34) and between sedentary behavior and frailty (OR = 1.20; 95% CI: 1.02-1.40). CONCLUSION: Frailty and pre-frailty status were associated with sedentary behavior among community-dwelling older adults.

https://doi.org/10.1590/1516-3180.2020.0546.r1.14122020 161 downloads

2021 recommendations of the Brazilian Society of Rheumatology for the gynecological and obstetric care of patients with Sjogren’s syndrome
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Oliveira, Fabiola Reis

; Valim, Valeria

; Pasoto, Sandra Gofinet

; Fernandes, Marilena Leal Mesquita Silvestre

; Lopes, Maria Lucia Lemos

; Souza Fialho, Sonia Cristina de Magalhães

; Pinheiro, Aysa César

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Fidelix, Tania

; Ribeiro, Sandra Lucia Euzébio

; Brito, Danielle Christinne Soares Egypto de

; Libório, Tatiana

; Santos, Maria Carmen Lopes Ferreira Silva

; Tanure, Leandro

; Gennari, Juliana DAgostino

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha Filho, César Ramos

; Miyamoto, Samira Tatiyama

; Guedes, Lissiane Karine Noronha

; Pugliesi, Alisson

; Trevisani, Virginia Fernandes Moça

Advances in Rheumatology

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2021, Volume 61 elocation 54

Resumo: En | Texto: En | PDF: En

Abstract Sjogren’s syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.

https://doi.org/10.1186/s42358-021-00208-1 54 downloads

10.

Barreiras e facilitadores da mobilização precoce na unidade de terapia intensiva pediátrica: revisão sistemática
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Daloia, Lígia Maria Tezo

; Pinto, Ana Carolina Pereira Nunes

; Silva, Élida Pereira da

Fisioterapia e Pesquisa

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2021, Volume 28 Nº 3 Páginas 299 - 307

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

RESUMO O objetivo desta revisão sistemática foi identificar as barreiras e facilitadores para a implementação da mobilização precoce em unidades de terapia intensiva pediátrica. Realizou-se uma busca sistemática baseada em estudos que abordassem barreiras e/ou facilitadores para mobilização precoce em crianças e adolescentes. Foram incluídos estudos publicados até junho de 2019 nas bases de dados MEDLINE®, Physiotherapy Evidence Database, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cochrane Library, Scientific Electronic Library Online. A seleção e a avaliação da qualidade metodológica foram realizadas por dois revisores independentes. Dados que pudessem ser identificados como barreiras e/ou facilitadores foram extraídos para análise. Foram encontrados 358 registros nas bases de dados, dos quais foram incluídos 13 artigos. Foram citadas 18 barreiras, sendo as mais citadas o número insuficiente de profissionais, e insegurança da equipe. Dos 11 facilitadores citados, os mais frequentes foram treinamento/educação da equipe multidisciplinar e a instituição de diretriz/consenso. Existem muitas barreiras a serem quebradas para que a mobilização precoce seja efetiva, porém alguns facilitadores já são conhecidos e podem ser implementados, tornando viável a sua implementação para a população pediátrica.

ABSTRACT This systematic review aimed to identify barriers and facilitators for the implementation of early mobilization in pediatric intensive care units. A systematic search was carried out based on studies that addressed barriers and/or facilitators for early mobilization in children and adolescents. Studies published until June 2019 in the MEDLINE®, Physiotherapy Evidence Database, Latin American & Caribbean Health Sciences Literature, Cochrane Library, and Scientific Electronic Library Online databases were included. Selection and assessment of methodological quality were performed by two independent reviewers. Data that could be identified as barriers and/or facilitators were extracted for analysis. 358 records were found in the databases, of which 13 articles were included. 18 barriers were cited; the most cited ones were the insufficient number of professionals and team’s insecurity. Of the 11 mentioned facilitators, the most frequent were training/education of the multidisciplinary team and the establishment of guidelines/consensus. There are many barriers to be broken for early mobilization to be effective, but some facilitators are already known and can be implemented, making their implementation feasible for the pediatric population.

RESUMEN El propósito de esta revisión sistemática fue identificar barreras y facilitadores para aplicar la movilización temprana en las unidades de cuidados intensivos pediátrica. Se realizó una búsqueda sistemática de estudios que abordaron barreras y/o facilitadores para la movilización temprana en niños y adolescentes. Se incluyeron estudios publicados hasta junio de 2019 en las bases de datos MEDLINE®, Physiotherapy Evidence Database, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Cochrane Library y Scientific Electronic Library Online. La selección y evaluación de la calidad metodológica fue realizada por dos revisores independientes. Los datos que se han identificado como barreras y/o facilitadores se extrajeron para su análisis. De los 358 registros encontrados en las bases de datos, se incluyeron 13 artículos. Se mencionaron 18 barreras, y las más citadas fueron el número insuficiente de profesionales y la inseguridad del equipo. De los 11 facilitadores mencionados, los más frecuentes fueron la formación/educación del equipo multidisciplinario y el establecimiento de lineamientos/consensos. Hay muchas barreras que romper para que la movilización temprana sea efectiva, pero algunos facilitadores ya son conocidos y pueden ser aplicados, haciendo su aplicación factible a la población pediátrica.

https://doi.org/10.1590/1809-2950/20026728032021 1 downloads

11.

Associação entre sarcopenia e qualidade de vida relacionada à saúde em idosos comunitários
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Chagas, Camila Santos

; Ohara, Daniela Gonçalves

; Matos, Areolino Pena

; Oliveira, Mônica Silvia Rodrigues de

; Lopes, Manoela Gomes Reis

; Marmo, Flavia Aparecida Dias

; Pinto, Ana Carolina Pereira Nunes

; Pegorari, Maycon Sousa

Acta Paulista de Enfermagem

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2021, Volume 34 elocation eAPE002125

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

Resumo Objetivo O objetivo deste estudo foi comparar a qualidade de vida entre idosos sarcopênicos e não sarcopênicos e verificar a associação entre sarcopenia e qualidade de vida em idosos residentes na comunidade. Métodos Estudo transversal conduzido com idosos residentes na comunidade (n = 378) de Macapá, Amapá, Brasil. A qualidade de vida foi avaliada por meio do Short Form (36) Health Survey. O algoritmo proposto pelo Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas (EWGSOP) foi usado para avaliar a sarcopenia. Foram realizadas análises descritivas, inferenciais e modelo de regressão linear. Resultados Os idosos sarcopênicos apresentaram escores de qualidade de vida significativamente mais baixos nos domínios função física, dor corporal, estado geral de saúde e função social. Após o ajuste, a sarcopenia associou-se inversamente ao funcionamento físico (β = -0,125; p = 0,010) e ao estado geral de saúde (β = -0,112; p = 0,028). Conclusão Os resultados deste estudo sugerem um provável declínio na qualidade de vida em idosos sarcopênicos, principalmente nos domínios funcionamento físico e estado geral de saúde.

Abstract Objective This study aimed to compare quality of life between sarcopenic and non-sarcopenic older adults and to verify the association of sarcopenia and quality of life in community-dwelling older adults. Methods This was a cross-sectional study conducted in community-dwelling older adults (n = 378) from Macapá, Amapá, Brazil. Quality of life was assessed using the Short Form (36) Health Survey. The algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) was used to assess sarcopenia. Descriptive, inferential analyses and linear regression model were performed. Results Sarcopenic older adults presented significantly lower quality of life scores in the domains of physical functioning, bodily pain, general health status, and social functioning. After adjustment, sarcopenia was inversely associated with physical functioning (β = -0.125; p = 0.010) and general health status (β = -0.112; p = 0.028). Conclusion The results of this study suggest a probable decline in the quality of life in sarcopenic older adults, especially in the physical functioning and general health status domains.

Resumen Objetivo El objetivo de este estudio fue comparar la calidad de vida entre adultos mayores con sarcopenia y sin sarcopenia y verificar la relación entre sarcopenia y calidad de vida en adultos mayores residentes de la comunidad. Métodos Estudio transversal llevado a cabo con adultos mayores residentes de la comunidad (n = 378) de Macapá, estado de Amapá, Brasil. La calidad de vida fue evaluada mediante el Short Form (36) Health Survey. El algoritmo propuesto por el Grupo Europeo de Trabajo sobre la Sarcopenia en Personas de Edad Avanzada (EWGSOP) fue utilizado para evaluar la sarcopenia. Se realizaron análisis descriptivos, inferenciales y modelo de regresión lineal. Resultados Los adultos mayores con sarcopenia presentaron una puntuación de calidad de vida significativamente más baja en los dominios función física, dolor corporal, estado general de salud y función social. Luego del ajuste, la sarcopenia se relacionó inversamente con el funcionamiento físico (β = -0,125; p = 0,010) y con el estado general de salud (β = -0,112; p = 0,028). Conclusión Los resultados de este estudio sugieren un probable deterioro en la calidad de vida de adultos mayores con sarcopenia, principalmente en los dominios funcionamiento físico y estado general de salud.

https://doi.org/10.37689/acta-ape/2021ao002125 1 downloads

12.

Factors associated with social isolation and loneliness in community-dwelling older adults during pandemic times: a cross-sectional study
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Pegorari, Maycon Sousa

; Silva, Caroline de Fátima Ribeiro

; Araújo, Fabrícia Coelho de

; Silva, Juliana de Souza da

; Ohara, Daniela Gonçalves

; Matos, Alessandro Pena

; Matos, Areolino Pena

; Pinto, Ana Carolina Pereira Nunes

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0195-2020

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Psychosocial aspects need to be discussed in the context of the Covid-19 pandemic. Currently, no studies have investigated the factors associated with social isolation and loneliness among community-dwelling older adults. Therefore, this study analyzed the association of social isolation and loneliness with socioeconomic, clinical, and health characteristics, and Covid-19-related variables, among community-dwelling older adults during the pandemic. METHODS: A cross-sectional study was conducted via a telephone survey of community-dwelling older adults aged ≥60 years in Macapa, Amapa, Brazil. A structured form was used to collect data. Descriptive and inferential analyses were performed using Pearson's correlation test and a linear regression model. RESULTS: Participants comprised 86 community-dwelling older adults with a mean age of 71.78+6.98 years. Among them, 9.3% were diagnosed with Covid-19, of whom 3.5% were hospitalized. Most participants reported no difficulty obtaining food, medicines, or attending routine medical appointments during the pandemic. Furthermore, 23.3% (n=20) were socially isolated, and 20.9% (n=18) reported feelings of loneliness. The mean values for fear, anxiety, and obsession were 19.01±7.25, 1.01±1.90, and 2.84±3.28, respectively. A moderate positive correlation was identified between loneliness and the number of diseases, and a weak positive correlation between loneliness and the number of medications and depressive symptoms and risk for sarcopenia. The linear regression model indicated that higher loneliness scores were associated with a greater number of diseases (β=0.288; p=0.007). CONCLUSIONS: The findings suggest a probable resilience of the older population to Covid-19, despite the association of loneliness with many diseases in times of a pandemic.

https://doi.org/10.1590/0037-8682-0195-2020 239 downloads

13.

SARS-CoV-2 and arbovirus infection: a rapid systematic review
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Milby, Keilla Martins

; Atallah, Alvaro Nagib

; Rocha-Filho, César Ramos

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira da

; Reis, Felipe Sebastião de Assis

; Carvas Junior, Nelson

; Civile, Vinicius Tassoni

; Santos, Rodolfo Rodrigo Pereira

; Ferla, Laura Jantsch

; Trevisani, Giulia Fernandes Moça

; Ramalho, Gabriel Sodré

; Puga, Maria Eduarda dos Santos

; Trevisani, Virgínia Fernandes Moça

Sao Paulo Medical Journal

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Dez 2020, Volume 138 Nº 6 Páginas 498 - 504

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: The numbers of cases of arboviral diseases have increased in tropical and subtropical regions while the coronavirus disease (COVID-19) pandemic overwhelms healthcare systems worldwide. The clinical manifestations of arboviral diseases, especially dengue fever, can be very similar to COVID-19, and misdiagnoses are still a reality. In the meantime, outcomes for patients and healthcare systems in situations of possible syndemic have not yet been clarified. OBJECTIVE: We set out to conduct a systematic review to understand and summarize the evidence relating to clinical manifestations, disease severity and prognoses among patients coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses. METHODS: We conducted a rapid systematic review with meta-analysis, on prospective and retrospective cohorts, case-control studies and case series of patients with confirmed diagnoses of SARS-CoV-2 and arboviral infection. We followed the Cochrane Handbook recommendations. We searched EMBASE, MEDLINE, Cochrane Library, LILACS, Scopus and Web of Science to identify published, ongoing and unpublished studies. We planned to extract data and assess the risk of bias and the certainty of evidence of the studies included, using the Quality in Prognosis Studies tool and the Grading of Recommendations Assessment. RESULTS: We were able to retrieve 2,407 citations using the search strategy, but none of the studies fulfilled the inclusion criteria. CONCLUSION: The clinical presentations, disease severity and prognoses of patients coinfected with SARS-CoV-2 and arboviruses remain unclear. Further prospective studies are necessary in order to provide useful information for clinical decision-making processes. Protocol registration number in the PROSPERO database: CRD42020183460

https://doi.org/10.1590/1516-3180.2020.0422.08092020 1325 downloads

14.

COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review
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Rocha, Aline Pereira da

; Atallah, Álvaro Nagib

; Pinto, Ana Carolina Pereira Nunes

; Rocha-Filho, César Ramos

; Milby, Keilla Martins

; Civile, Vinicius Tassoni

; Carvas Junior, Nelson

; Reis, Felipe Sebastião de Assis

; Ferla, Laura Jantsch

; Ramalho, Gabriel Sodré

; Trevisani, Giulia Fernandes Moça

; Puga, Maria Eduarda dos Santos

; Trevisani, Virgínia Fernandes Moça

Sao Paulo Medical Journal

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Dez 2020, Volume 138 Nº 6 Páginas 515 - 520

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Patients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection. OBJECTIVE: To assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19. DESIGN AND SETTING: Rapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil. METHODS: We searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations. RESULTS: We identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups: hospitalization: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate: OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD: OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence). CONCLUSION: Patients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.

https://doi.org/10.1590/1516-3180.2020.0421.r2.10092020 1116 downloads

15.

Covid-19: perspectives and initiatives in older adults health context in Brazil
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Pegorari, Maycon Sousa

; Ohara, Daniela Gonçalves

; Matos, Areolino Pena

; Pinto, Ana Carolina Pereira Nunes

Ciência & Saúde Coletiva

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Set 2020, Volume 25 Nº 9 Páginas 3459 - 3464

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

Resumo Este artigo fornece informações sobre a COVID-19, contextualizando o cenário nacional e internacional, com ênfase na saúde do idoso. São apresentadas perspectivas e iniciativas voltadas para esse grupo de risco, reforçando a necessidade de considerar o processo de envelhecimento e não apenas a idade como o principal marcador na abordagem dessa população.

Abstract This article provides information about COVID-19, contextualizing the national and international scenario, with an emphasis on the health of the elderly. Perspectives and initiatives for this risk group are presented, reinforcing the need to consider the aging process and not just age as the main marker in the approach of this population.

https://doi.org/10.1590/1413-81232020259.21622020 2333 downloads

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