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ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença.

https://doi.org/10.1590/1984-0462/2024/42/2022184

A multimodal strategy to improve health care for pediatric patients with cancer and fever in Peru
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Mendieta, Ana

; Rios Lopez, Ligia

; Vargas Arteaga, Maria

; Maradiegue, Essy

; Delgadillo Arone, Walter

; Rueda Bazalar, Carlos

; Holguin, Alexis

; Santillan Salas, Carlos

; Maza, Ivan

; Homsi, Maysam

; Farias Barrios, Frankly

; Assayag, Claudia

; Vásquez, Liliana

; Pascual, Claudia

; Caniza, Miguela

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e140

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

RESUMEN Objetivo. El proyecto DoTT (Disminuyendo el tiempo a la terapia, sigla en inglés) busca minimizar el intervalo entre el inicio de la fiebre y las intervenciones médicas en la población infantil con neutropenia febril. El objetivo de este estudio fue determinar el efecto de la implementación del proyecto DoTT sobre el tiempo transcurrido desde el inicio de la fiebre hasta la llegada del paciente (TLP) al hospital y el tiempo transcurrido en el hospital hasta la administración del antibiótico (TAA) en niños con neutropenia febril ingresados en el servicio de urgencias. Métodos. El proyecto DoTT se puso en marcha en un hospital peruano, según el modelo de estrategia multimodal de mejora de la Organización Mundial de la Salud (OMS). Entre sus componentes se encontraban crear un conjunto de servicios de atención de salud y de algoritmos para la selección de antibióticos; capacitar a los usuarios en la utilización del conjunto de servicios y de los algoritmos; realizar un seguimiento de los resultados de los pacientes y recabar la opinión de los usuarios; fomentar el uso del nuevo sistema; y promover la integración del proyecto en la cultura institucional. Se capacitó al personal de la sala de urgencias en la atención de pacientes pediátricos con cáncer y fiebre, y en el uso del conjunto de servicios y de los algoritmos. Se informó sobre el proyecto DoTT mediante folletos y carteles, con vistas a institucionalizar el concepto y difundirlo a otros servicios hospitalarios. Resultados. Se analizaron los datos de ingreso de 129 pacientes de nuestro registro que cumplían con los requisitos. Se compararon el TAA y el TLP al hospital antes y después de la intervención con las pautas del proyecto DoTT. La mediana del TAA fue de 146 minutos (intervalo intercuartílico [II]: 97-265 minutos) en 99 pacientes antes de la intervención y de 69 minutos (II: 50-120 minutos) en 30 pacientes después de ella (p <0,01). La mediana del TLP disminuyó de 1 483 minutos en el momento de la evaluación inicial a 660 minutos después de la intervención (p <0,01). Conclusiones. La aplicación del modelo de estrategia multimodal de mejora de la OMS a la atención de la población infantil con neutropenia febril que acude al hospital tuvo un efecto positivo sobre el TLP y el TAA, lo que podría aumentar la supervivencia de estos pacientes.

ABSTRACT Objective. The DoTT (Decreasing Time to Therapy) project aimed to minimize the interval between fever onset and medical interventions for children with febrile neutropenia. The objective of this study was to determine the effect of implementing the DoTT project on the hospital time to antibiotic (TTA) and patient time to arrival (PTA) at the hospital in children with febrile neutropenia admitted to the emergency department. Methods. The DoTT project was implemented at a Peruvian hospital and followed the World Health Organization (WHO) multimodal improvement strategy model. Components included creating a healthcare delivery bundle and antibiotic selection pathways, training users of the bundle and pathways, monitoring patient outcomes and obtaining user feedback, encouraging use of the new system, and promoting the integration of DoTT into the institutional culture. Emergency room providers were trained in the care delivery for children with cancer and fever and taught to use the bundle and pathways. DoTT was promoted via pamphlets and posters, with a view to institutionalizing the concept and disseminating it to other hospital services. Results. Admission data for 129 eligible patients in our registry were analyzed. The TTA and PTA were compared before and after the DoTT intervention. The median TTA was 146 minutes (interquartile range [IQR] 97–265 minutes) before the intervention in 99 patients, and 69 minutes (IQR 50–120 minutes) afterwards in 30 patients (p < 0.01). The median PTA was reduced from 1 483 minutes at baseline to 660 minutes after the intervention (p < 0.01). Conclusions. Applying the WHO multimodal improvement strategy model to the care of children with febrile neutropenia arriving at the hospital had a positive impact on the PTA and TTA, thus potentially increasing the survival of these patients.

RESUMO Objetivo. O projeto DoTT (Redução do Tempo para o Tratamento, na sigla em inglês) tem como objetivo reduzir ao máximo o intervalo entre o início da febre e as intervenções médicas em crianças com neutropenia febril. O objetivo deste estudo foi determinar o efeito da implementação do projeto DoTT no tempo desde o início da febre até a chegada do paciente (TCP) ao hospital e no tempo no hospital até a administração de antibióticos (TAA) em crianças com neutropenia febril admitidas no departamento de emergência. Métodos. O projeto DoTT foi implementado em um hospital do Peru e seguiu o modelo de estratégia de melhoria multimodal da Organização Mundial da Saúde (OMS). Os componentes incluíram a criação de um pacote de prestação de serviços de saúde e de protocolos de seleção de antibióticos, o treinamento de usuários no pacote e nos protocolos de seleção, o monitoramento da evolução dos pacientes e obtenção de feedback dos usuários, o incentivo ao uso do novo sistema e a promoção da integração do DoTT à cultura institucional. Os profissionais do pronto-socorro foram capacitados na prestação de cuidados a crianças com câncer e febre e no uso do pacote e dos protocolos de seleção. O DoTT foi divulgado por meio de panfletos e pôsteres, com o objetivo de institucionalizar o conceito e disseminá-lo para outros serviços hospitalares. Resultados. Foram analisados os dados de internação de 129 pacientes elegíveis em nosso registro. O TAA e o TCP foram comparados antes e depois da intervenção DoTT. O TAA mediano era de 146 minutos (intervalo interquartil: 97-265 minutos) antes da intervenção em 99 pacientes e de 69 minutos (intervalo interquartil: 50-120 minutos) depois da intervenção em 30 pacientes (p < 0,01). O TCP mediano diminuiu de 1483 minutos na linha de base para 660 minutos após a intervenção (p < 0,01). Conclusão. A aplicação do modelo de estratégia multimodal de melhoria da OMS ao atendimento de crianças com neutropenia febril que chegam ao hospital teve um impacto positivo no TCP e no TAA, potencialmente aumentando a sobrevida desses pacientes.

https://doi.org/10.26633/rpsp.2023.140

Multi-level toxicity assessment of the antidepressant venlafaxine in embryos/larvae and adults of zebrafish (Danio rerio)
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Oliveira, Ana Clara

; Fascineli, Maria Luiza

; Oliveira, Paula Martins de

; Gelfuso, Guilherme Martins

; Villacis, Rolando André Rios

; Grisolia, Cesar Koppe

Genetics and Molecular Biology

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2023, Volume 46 Nº 3 elocation e20220377

Resumo: En | Texto: En | PDF: En

Abstract The toxic effects of venlafaxine (VLX) on aquatic organisms have already been verified and therefore are a proven matter of concern. Herein, we evaluated zebrafish embryos/adults after acute exposure to VLX. Embryos/larvae were exposed to different concentrations of VLX (100-1000 mg/L; 1.33 as a dilution factor), to evaluate mortality/developmental changos and to analyze biomarkers (0.002-100 mg/L). For adults, mortality, genotoxicity, and biomarkers were assessed in five different concentrations of VLX (1-100 mg/L). The median lethal concentration (LC50-168h) was 274.1 mg/L for embryos/larvae, and >100 mg/L for adults (LC50-96h). VLX decreased the heart rate frequency and caused premature hatching and lack of equilibrium in embryos/larvae exposed to different concentrations ranging from 100 to 562.5 mg/L. The activity of acetylcholinesterase (AChE) was inhibited in larvae exposed to 1, 25 and 100 mg/L. Glutathione-S-transferase (GST) activity was reduced in both larvae and adults after exposure to different concentrations, mainly at 25 mg/L. For both larvae and adults, lactate dehydrogenase (LDH) activity increased after 100 mg/L of VLX exposure. No DNA damage was observed in peripheral erythrocytes. Exposure to VLX may cause adverse effects on zebrafish in their early and adult life stages, interfering with embryo-larval development, and can induce physiological disturbances in adults.

https://doi.org/10.1590/1678-4685-gmb-2022-0377

Acquired enamel pellicle protects gastroesophageal reflux disease patients against erosive tooth wear
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MARTINI, Tatiana

; RIOS, Daniela

; DIONIZIO, Aline

; CASSIANO, Luiza de Paula Silva

; SILVA, Cíntia Maria de Souza e

; TAIRA, Even Akemi

; VENTURA, Talita Mendes Oliveira

; CÂMARA, João Victor Frazão

; Araujo, Tamara Teodoro

; MAGALHÃES, Ana Carolina

; CARVALHO, Thiago Saads

; BAUMANN, Tommy

; LUSSI, Adrian

; OLIVEIRA, Ricardo Brandt de

; PALMA-DIBB, Regina Guenka

; BUZALAF, Marília Afonso Rabelo

Brazilian Oral Research

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2023, Volume 37 elocation e085

Resumo: En | Texto: En | PDF: En

Abstract The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calcium-binding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0085

Cross-cultural invariance of the Spanish version of the COVID-19 Assessment Scorecard to measure the perception of government actions against COVID-19 in Latin America
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Caycho-Rodríguez, Tomás

; Valencia, Pablo D.

; Ventura-León, José

; Carbajal-León, Carlos

; Vilca, Lindsey W.

; Reyes-Bossio, Mario

; Delgado-Campusano, Mariel

; Yupanqui-Lorenzo, Daniel E.

; Paredes-Angeles, Rubí

; Rojas-Jara, Claudio

; Gallegos, Miguel

; Cervigni, Mauricio

; Martino, Pablo

; Polanco-Carrasco, Roberto

; Palacios, Diego Alejandro

; Moreta-Herrera, Rodrigo

; Samaniego-Pinho, Antonio

; Rivera, Marlon Elías Lobos

; Figares, Andrés Buschiazzo

; Puerta-Cortés, Diana Ximena

; Corrales-Reyes, Ibraín Enrique

; Calderón, Raymundo

; Gallegos, Walter L. Arias

; Petzold, Olimpia

; Camargo, Andrés

; Torales, Julio

; Blanco, J. Arkangel Monge

; González, Pedronel

; Smith-Castro, Vanessa

; Rivera, Wendy Yamilet Matute

; Ferrufino-Borja, Daniela

; Ceballos-Vásquez, Paula

; Muñoz-del-Carpio-Toia, Agueda

; Palacios, Jorge

; Burgos-Videla, Carmen

; León, Ana María Eduviges Florez

; Vergara, Ibeth

; Vega, Diego

; Barria-Asenjo, Nicol A.

; Schulmeyer, Marion K.

; Rios, Hassell Tatiana Urrutia

; Lira, Arelly Esther Lira

Psicologia: Reflexão e Crítica

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2023, Volume 36 elocation 34

Resumo: En | Texto: En | PDF: En

Abstract Objectives The present study aimed to evaluate the measurement invariance of a general measure of the perception of governmental responses to COVID-|19 (COVID-SCORE-10) in the general population of 13 Latin American countries. Methods A total of 5780 individuals from 13 Latin American and Caribbean countries selected by non-probabilistic snowball sampling participated. A confirmatory factor analysis was performed and the alignment method was used to evaluate invariance. Additionally, a graded response model was used for the assessment of item characteristics. Results The results indicate that there is approximate measurement invariance of the COVID-SCORE-10 among the participating countries. Furthermore, IRT results suggest that the COVID-SCORE-10 measures with good psychometric ability a broad spectrum of the construct assessed, especially around average levels. Comparison of COVID-SCORE-10 scores indicated that participants from Cuba, Uruguay and El Salvador had the most positive perceptions of government actions to address the pandemic. Thus, the underlying construct of perception of government actions was equivalent in all countries. Conclusion The results show the importance of initially establishing the fundamental measurement properties and MI before inferring the cross-cultural universality of the construct to be measured.

https://doi.org/10.1186/s41155-023-00277-9

O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos
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Pereira, Rui Antunes

; Sousa, Marta

; Cidade, José Pedro

; Melo, Luís

; Lopes, Diogo

; Ventura, Sara

; Aragão, Irene

; Lima Neto, Raul Miguel de Freitas

; Molinos, Elena

; Marques, Ana

; Cardoso, Nelson

; Marino, Flávio

; Monteiro, Filipa Brás

; Oliveira, Ana Pinho

; Silva, Rogério C

; Real, André Miguel Neto

; Banheiro, Bruno Sarmento

; Reis, Renato

; Adão-Serrano, Maria

; Cracium, Ana

; Valadas, Ana

; Ribeiro, João Miguel

; Póvoa, Pedro

; Tapadinhas, Camila

; Mendes, Vítor

; Coelho, Luís

; Maia, Raquel

; Freitas, Paulo Telles

; Ferreira, Isabel Amorim

; Ramires, Tiago

; Val-Flores, Luís Silva

; Cascão, Mariana

; Alves, Rita

; Rodeia, Simão C

; Barrigoto, Cleide

; Cardiga, Rosa

; Silva, Maria João Ferreira da

; Vale, Bruno

; Fonseca, Tatiana

; Rios, Ana Lúcia

; Camões, João

; Pérez, Danay

; Cabral, Susana

; Ribeiro, Maria Inês

; Mendes, João João

; Gouveia, João

; Fernandes, Susana Mendes

Revista Brasileira de Terapia Intensiva

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Dez 2022, Volume 34 Nº 4 Páginas 433 - 442

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

ABSTRACT Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave.

RESUMO Objetivo: Analisar e comparar as características de pacientes críticos com a COVID-19, a abordagem clínica e os resultados entre os períodos de pico e de platô na primeira onda pandêmica em Portugal. Métodos: Este foi um estudo de coorte multicêntrico ambispectivo, que incluiu pacientes consecutivos com a forma grave da COVID-19 entre março e agosto de 2020 de 16 unidades de terapia intensiva portuguesas. Definiram-se as semanas 10 - 16 e 17 - 34 como os períodos de pico e platô. Resultados: Incluíram-se 541 pacientes adultos com mediana de idade de 65 [57 - 74] anos, a maioria do sexo masculino (71,2%). Não houve diferenças significativas na mediana de idade (p = 0,3), no Simplified Acute Physiology Score II (40 versus 39; p = 0,8), na pressão parcial de oxigênio/fração inspirada de oxigênio (139 versus 136; p = 0,6), na terapia com antibióticos na admissão (57% versus 64%; p = 0,2) ou na mortalidade aos 28 dias (24,4% versus 22,8%; p = 0,7) entre o período de pico e platô. Durante o período de pico, os pacientes tiveram menos comorbidades (1 [0 - 3] versus 2 [0 - 5]; p = 0,002); fizeram mais uso de vasopressores (47% versus 36%; p < 0,001) e ventilação mecânica invasiva na admissão (58,1% versus 49,2%; p < 0,001), e tiveram mais prescrição de hidroxicloroquina (59% versus 10%; p < 0,001), lopinavir/ritonavir (41% versus 10%; p < 0,001) e posição prona (45% versus 36%; p = 0,04). Entretanto, durante o platô, observou-se maior uso de cânulas nasais de alto fluxo (5% versus 16%; p < 0,001) na admissão, remdesivir (0,3% versus 15%; p < 0,001) e corticosteroides (29% versus 52%; p < 0,001), além de menor tempo de internação na unidade de terapia intensiva (12 versus 8 dias; p < 0,001). Conclusão: Houve mudanças significativas nas comorbidades dos pacientes, nos tratamentos da unidade de terapia intensiva e no tempo de internação entre os períodos de pico e platô na primeira onda da COVID-19.

https://doi.org/10.5935/0103-507x.20210037-pt

Performance and reference intervals of thrombin generation test: results from the Brazilian longitudinal study of adult health (ELSA-Brasil). A cross-sectional study
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Rios, Danyelle Romana Alves

; Barreto, Sandhi Maria

; Ferreira, Letícia Gonçalves Resende

; Batista, Thaís Resende

; Silva, Ana Paula Ferreira

; de Oliveira Júnior, Wander Valadares

; Maluf, Chams Bicalho

; Carvalho, Maria das Graças

; Figueiredo, Roberta Carvalho

Sao Paulo Medical Journal

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Jun 2022, Volume 140 Nº 3 Páginas 474 - 485

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: The thrombin generation test (TGT) has shown promise for investigation of hemorrhagic and thrombotic diseases. However, despite its potential, it still needs standardization. Moreover, few studies have established reference values for TGT parameters. In Brazil, these values have not yet been established. OBJECTIVE: To determine TGT performance and reference intervals for TGT parameters in healthy individuals. DESIGN AND SETTING: Cross-sectional study conducted among participants in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). METHODS: The reference sample consisted of 620 healthy individuals. The calibrated automated thrombogram (CAT) method, under low and high tissue factor (TF) conditions, was used to assess thrombin generation. Test performance was analyzed using intra and interassay coefficients of variation (CV) and reference intervals were calculated using the nonparametric method proposed by the International Federation of Clinical Chemistry and the Clinical and Laboratory Standards Institute. RESULTS: The intraassay CV ranged from 1.4% to 2.2% and the interassay CV, 6.8% to 14.7%. The reference intervals for TGT parameters under low and high TF conditions were, respectively: lagtime: 3.0-10.3 and 1.4-3.7 min; endogenous thrombin potential (ETP): 1134.6-2517.9 and 1413.6-2658.0 nM.min; normalized ETP: 0.6-1.3 and 0.7-1.4; peak: 103.2-397.7 and 256.4-479.0 nM; normalized peak: 0.3-1.3 and 0.7-1.2; and time-to-peak: 5.6-16.0 and 3.4-6.7 min. These parameters were categorized relative to sex. Conclusion: TGT performance was adequate and the proposed reference intervals were similar to those of other studies. Our findings may be useful for consolidating the TGT, through contributing to its standardization and validation.

https://doi.org/10.1590/1516-3180.2021.0425.r1.07102021

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes

; Melo, Ana Karla Guedes de

; Cruz, Vítor Alves

; Souza, Viviane Angelina de

; Carvalho, Joana Starling de

; Machado, Ketty Lysie Libardi Lira

; Valadares, Lilian David de Azevedo

; Reis Neto, Edgard Torres dos

; Rezende, Rodrigo Poubel Vieira de

; Guimarães, Maria Fernanda Brandão de Resende

; Ferreira, Gilda Aparecida

; Braz, Alessandra de Sousa

; Vieira, Rejane Maria Rodrigues de Abreu

; Pinheiro, Marcelo de Medeiros

; Ribeiro, Sandra Lúcia Euzébio

; Bica, Blanca Elena Gomes Rios

; Baptista, Kátia Lino

; Costa, Izaias Pereira da

; Marques, Claudia Diniz Lopes

; Lopes, Maria Lúcia Lemos

; Martinez, José Eduardo

; Giorgi, Rina Dalva Neubarth

; Mota, Lícia Maria Henrique da

; Loures, Marcos Antônio Araújo da Rocha

; Paiva, Eduardo dos Santos

; Monticielo, Odirlei André

; Xavier, Ricardo Machado

; Kakehasi, Adriana Maria

; Pileggi, Gecilmara Cristina Salviato

Advances in Rheumatology

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2022, Volume 62 elocation 3

Resumo: En | Texto: En | PDF: En

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

https://doi.org/10.1186/s42358-022-00234-7

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil
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Pacheco-Silva, Ana Beatriz

; Martins, Ezequias Batista

; López, Angie Jeannine Rios

; Detepo, Paula João Tomas

; Mamani, Roxana Flores

; Japiassú, André Miguel

; Lupi, Otilia

; Mendes, Tulio Vieira

; Pina-Costa, Anielle de

; Calvet, Guilherme Amaral

; Bressan, Clarisse da Silveira

; Silva, Michele Fernanda Borges da

; Ogino, Liana Lumi

; Assis, Matheus Ribeiro da Silva

; Marques, Amanda Meneleu

; Dias, Cristina Maria Giordano

; Borchert, Juliana Mildward

; Lemos, Elba Regina Sampaio de

; Brasil, Patrícia

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e77

Resumo: En | Texto: En | PDF: En

ABSTRACT Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

https://doi.org/10.1590/s1678-9946202264077

10.

Óleo e azeite de coco babaçu (Orbignya speciosa Mart.) como matériasprimas para produção de biodiesel
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Ferreira da Silva Neto, João

; Silva Machado, Jose

; Mendes, Fernando

; de Sousa Rios, Maria Alexsandra

; da Costa Assunção, João Carlos

; Maia da Silva, Francisco Felipe

; Mathias Macêdo, Ana Angélica

; Volken de Souza, Claucia Fernanda

Revista ION

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Dez 2021, Volume 34 Nº 2 Páginas 95 - 104

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

Resumen El uso de fuentes de energía renovable, como los aceites vegetales, aceite de coco babasú (Orbignya speciosa Mart.) extraído industrialmente y manualmente, tiene ventajas económicas y ambientales. En este escenario, el presente trabajo presenta la producción y caracterización del aceite de coco babasú extraído industrialmente y manualmente y el biodiésel. Los biocombustibles se obtuvieron por transesterificación alcalina, utilizando hidróxido de potasio y metanol. La caracterización se realizó mediante infrarrojo con transformada de Fourier (FTIR), viscosidad cinemática, densidad, cenizas sulfatadas, índice de acidez, punto de fluidez, punto de inflamación y cromatografía de gases. Según los resultados, los espectros FTIR mostraron una absorción característica del éster, los estiramientos de enlace C=O (1704 cm-1 y 1742 cm-1) y C-O (1112 cm-1 y 1111 cm-1). Los resultados de las pruebas de viscosidad cinemática, densidad, índice de acidez, punto de fluidez y punto de inflamación se ajustaron a los límites establecidos por la ANP, Resolución nº 45/2014. La cromatografía de gases mostró el predominio de ésteres metílicos derivados de los ácidos láurico (C12:0), mirístico (C14:0) y palmítico (C16:0). Así, el aceite de coco y el aceite de coco babasú extraído industrialmente y manualmente resultaron viables para la producción de biodiésel, presentándose como una potencial materia prima para el sector de biocombustibles, dado el volumen expresivo de las plantaciones de babasú en el estado de Maranhão.

Abstract The use of renewable energy sources, such as vegetable oils like babassu coconut (Orbignya speciosa Mart.) oil extracted industrially and manually, has economic and environmental advantages. In this scenario, the present work presents the production and characterization biodiesel of babassu coconut oil extracted industrially and manually. Biofuels were obtained by alkaline transesterification, using potassium hydroxide and methanol. The characterization was performed by infrared with Fourier transform (FTIR), kinematic viscosity, density, sulphated ash, acidity index, pour point, flash point and gas chromatography. According to the results, the Fourier-transform infrared spectroscopy FTIR spectra showed characteristic absorption of esters, the C=O bond stretches (1704 cm-1 and 1742 cm-1) and C-O (1112 cm-1 and 1111 cm-1). The results of the kinematic viscosity, density, acidity index, pour point and flash point tests were in compliance with the limits established by the ANP, Resolution no. 45/2014. The gas chromatography showed the predominance of methyl esters derived from lauric (C12:0), miristic (C14:0) and palmitic (C16:0) acids. Thus, babassu coconut oil extracted industrially and manually proved to be viable for the production of biodiesel, presenting itself as a potential raw material for the biofuel sector, given the significant volume of babassu plantations in the state of Maranhão.

Resumo A utilização de fontes renováveis de energia, como os óleos vegetais, a exemplo o óleo e azeite de coco babaçu (Orbignya speciosa Mart.), apresentam vantagens econômicas e ambientais. Neste cenário, o presente trabalho apresenta a produção e caracterização do biodiesel de óleo e azeite de coco babaçu. Os biocombustíveis foram obtidos por transesterificação alcalina, utilizando-se hidróxido de potássio e metanol. A caracterização foi realizada por infravermelho com transformada de Fourier (FTIR), viscosidade cinemática, densidade, cinzas sulfatadas, índice de acidez, ponto de fluidez e ponto de fulgor e cromatografia gasosa. De acordo com os resultados, os espectros de FTIR apresentaram absorções características de ésteres, os estiramentos da ligação C=O (1704 cm-1 e 1742 cm-1) e C-O (1112 cm-1 e 1111 cm-1). Os resultados dos ensaios de viscosidade cinemática, densidade, índice de acidez, ponto de fluidez e ponto de fulgor apresentaram conformidade com os limites estabelecidos pela ANP, Resolução nº 45/2014. A cromatografia gasosa apontou a predominância de ésteres metílicos derivados dos ácidos láurico (C12:0), mirístico (C14:0) e palmítico (C16:0). Desta forma, o óleo e o aceite de coco babaçu se mostraram viáveis para a produção de biodiesel, apresentando-se como potencial matéria-prima para o setor de biocombustíveis, dado o volume expressivo das plantações de babaçuais do estado do Maranhão.

https://doi.org/10.18273/revion.v34n2-2021009 37 downloads

11.

Interiorização da COVID-19 no Oeste da Bahia: perfil epidemiológico e análise espacial dos óbitos e casos confirmados
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Gomes, Daiene Rosa

; Souza, Raiane Costa

; Oliveira, Uldérico Rios

; Mattos, Mússio Pirajá

; Aleluia, Ítalo Ricardo Santos

; Mapeli, Ana Maria

Ciência & Saúde Coletiva

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Out 2021, Volume 26 Nº 10 Páginas 4665 - 4680

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

Resumo O objetivo deste artigo é descrever o perfil epidemiológico e a distribuição espacial dos óbitos e casos confirmados da COVID-19 na macrorregião de saúde Oeste da Bahia. Estudo ecológico sobre a interiorização do SARS-CoV-2, entre 21 de março de 2020 e 31 de março de 2021, considerando o coeficiente de incidência e de mortalidade, letalidade, densidade de casos e média móvel de casos e óbitos. Foram registrados 37.036 casos e 536 óbitos confirmados. Dos casos, 94,5% estão recuperados e 4,0% ativos. O coeficiente de incidência foi 3.884,1/100 mil habitantes, o coeficiente de mortalidade, 56,2/100 mil habitantes, e a letalidade, 1,4%. Identificou-se a predominância de intensidade muito alta e alta da ocorrência da COVID-19 na macrorregião, com a média móvel evidenciando uma tendência de crescimento. Os achados descrevem alto risco de infecção e morte na macrorregião, além de apresentar uma tendência de crescimento dos casos acumulados, confirmando a interiorização da doença.

Abstract This article aims to describe the epidemiological profile and the spatial distribution of deaths and confirmed cases of COVID-19 in the health macroregion of Western Bahia. An ecological study on the inland expansion of SARS-CoV-2 was performed from March 21, 2020 to March 31, 2021 considering incidence and mortality rate, case fatality rate, case density and moving average of cases and deaths. 37,036 cases and 536 confirmed deaths were registered. Of all cases, 94.5% recovered and 4.0% remained active. The incidence rate was 3884.1/100,000 inhabitants, the mortality rate 56.2/100,000 inhabitants and the fatality rate was 1.4% A predominance of very high and high intensity of the occurrence of COVID-19 in the macroregion was identified and moving average revealed an increasing trend. Findings show a high risk of infection and death in the macroregion, in addition to a growing trend in accumulated cases, confirming the inland expansion of the disease.

https://doi.org/10.1590/1413-812320212610.11262021 140 downloads

12.

The influence of sensory attributes on overall liking by a gamma regression model: an analysis of Cerrado mixed fruits jams
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PEREIRA, Patrícia Aparecida Pimenta

; SOUZA, Vanessa Rios de

; SCHIASSI, Maria Cecília Evangelista Vasconcelos

; DIAS, Ana Clara Costa

; QUEIROZ, Fabiana

; PINHEIRO, Ana Carla Marques

; BORGES, Soraia Vilela

; CIRILLO, Marcelo Ângelo

Food Science and Technology

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Set 2021, Volume 41 Nº 3 Páginas 702 - 707

Resumo: En | Texto: En | PDF: En

Abstract Factors that influence the acceptability and preferences of consumers have been perceived as sensory attributes, such as color, appearance, flavor, and texture. Understanding which attributes are most important for overall liking would be helpful to establish meaningful criteria for product grading. Thus, in addition to the overall chemical and sensory qualities, it is important to appreciate which sensory attributes make a product pleasant or unpleasant to a consumer. In this context, the aim of this study was to evaluate the sensory attribute that contributes most to the overall liking by a gamma regression model using different formulations of mixed fruit jams made with Brazilian Cerrado fruits. Based on the proposed model, we concluded that appearance was the most important predictor of the overall liking of the assessors.

https://doi.org/10.1590/fst.17920 135 downloads

13.

Interiorização da COVID-19 no Oeste da Bahia: perfil epidemiológico e análise espacial dos óbitos e casos confirmados
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Gomes, Daiene Rosa

; Souza, Raiane Costa

; Oliveira, Uldérico Rios

; Mattos, Mússio Pirajá

; Aleluia, Ítalo Ricardo Santos

; Mapeli, Ana Maria

Ciência & Saúde Coletiva

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2021, Volume 26 Nº 10 Páginas 4665 - 4680

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

https://doi.org/10.1590/1413-812320212610.11262021

14.

Variables hemodinámicas de la rigidez arterial en embarazadas y su relación con bajo peso para la edad gestacional
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Flórez-Rios, Ana María

; Alzate-Giraldo, Juliana

; Zuleta-Tobón, John Jairo

; Gallego-Vélez, Liliana Isabel

; Ascuntar-Tello, Johana

; Jaimes-Barragán, Fabián Alberto

Ginecología y obstetricia de México

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2021, Volume 89 Nº 1 Páginas 34 - 42

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

Abstract: OBJECTIVE: To identify a maternal variable of arterial stiffness and a cut-off point that identifies neonates with low weight for gestational age, with a sensitivity> 75%. MATERIALS AND METHODS: Prospective cohort study, in a health institution in Medellín (Colombia) between April 2017 and February 2019. Patients >15 years of age, with gestation ≤17 weeks were included. Pregnant women with chronic arterial hypertension, a fetus with malformations incompatible with life, multiple gestation, refusal to participate, or the development of a hypertensive disorder associated with pregnancy were excluded. The aortic enlargement index, pulse wave velocity, and central aortic systolic pressure were measured during pregnancy and their relationship with the presence of low weight for gestational age at birth was evaluated. The discrimination of the variables with respect to the outcome was carried out by means of the area under the curve (AUC ROC), in addition the model of generalized estimable equations was used for the difference between the “rate of change” of the variables. RESULTS: After a loss of 6.4% of the pregnant women, the follow-up of 1661 patients was completed, of which 18.1% corresponded to pregnant women with neonates with low weight for gestational age. When evaluating the AUC-ROC of the arterial stiffness variables, none of the cut-off points evaluated for each of the variables reached the expected sensitivity. CONCLUSION: The variables of arterial stiffness evaluated seem not to be a useful tool to predict the risk of fetal growth deficit.

Resumen: OBJETIVO: Encontrar una variable materna de rigidez arterial y un punto de corte, con una sensibilidad mayor de 75% para los neonatos con bajo peso para la edad gestacional. MATERIALES Y MÉTODOS: Estudio de cohorte, prospectivo, efectuado en una institución de salud de Medellín, Colombia, entre abril de 2017 y febrero de 2019. Criterios de inclusión: pacientes mayores de 15 años, con embarazo ≤ 17 semanas. Criterios de exclusión: embarazadas con hipertensión arterial crónica, feto con malformaciones incompatibles con la vida, embarazo múltiple, negativa para participar o coexistencia de algún trastorno hipertensivo asociado con el embarazo. Se midieron: el índice de aumento aórtico, velocidad de onda de pulso y presión sistólica aórtica central durante el embarazo. Se evaluó su relación con el bajo peso para la edad gestacional al nacer. La discriminación de las variables con respecto al desenlace se hizo mediante el área bajo la curva (AUC-ROC); además, se utilizó el modelo de ecuaciones estimables generalizadas para la diferencia entre la “tasa de cambio” de las variables. RESULTADOS: Se dio seguimiento a 1661 pacientes, de las que 18.1% correspondieron a embarazadas con neonatos con bajo peso para la edad gestacional. Al evaluar el área bajo la curva ROC de las variables de rigidez arterial, ninguno de los puntos de corte evaluados para cada una de las variables alcanzó la sensibilidad esperada. CONCLUSIONES: Al parecer, las variables de rigidez arterial evaluadas no son una herramienta útil para predecir el riesgo de déficit de crecimiento fetal.

https://doi.org/10.24245/gom.v89i1.4471 11 downloads

15.

Implantación y gestión de la plataforma “TELEA” en el seguimiento de pacientes Covid-19 positivos
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Rodríguez Feijóo, Ana Belén

; Salgado Cotilla, Benita

; Rivera Rios, Concepción

; Quintana Jambrina, María Isabel

; Civeira Pérez, Verónica

; Rodríguez Araujo, Josefa

; Cabanelas González, Beatriz

Index de Enfermería

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Dez 2020, Volume 29 Nº 4 Páginas 244 - 248

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

Abstract Telemedicine is presented as an alternative in the monitoring of Covid-19 patients in a home confinement situation. Galician Health Service through the home care platform TELEA, managed by nurses belonging to the Shared Monitoring Team for Hospital Care (ESCAH), has provided a home control to all those patients in the Ourense Province (Spain). General: to evaluate of the implementation and management of the home care platform TELEA as a tool of controlling the Covid-19 patient’s evolution with nursing service as a guide. Methodology: sequential explanatory quantitative-qualitative study (QUAN → QUAL). Study population: Covid-19 patients included in the TELEA home care program with a incorporation period to the platform between 03/17/2020 and 04/30/2020. Results: Data resulting from the quantitative study show a proactive patient, low number of admissions and attention in emergencies during the stay of the patients in TELEA-ESCAH as well as, a high capacity of nurse resolution. The qualitative study shows a patient satisfaction with the platform and with the comprehensive care provided by nursing service. Conclusions: TELEA platform is presented as a useful tool for the control of Covid-19 patients in a home confinement situation. Nursing care is essential in the success of telecare with TELEA.

Resumen La telemedicina se presenta como una alternativa en el seguimiento de los pacientes con Covid-19 en situación de aislamiento domiciliario. En la provincia de Ourense (España), el Servicio Gallego de Salud, mediante la plataforma de asistencia domiciliaria TELEA, gestionada por enfermeras pertenecientes al Equipo de Seguimiento Compartido de Atención Hospitalaria (ESCAH), aporta un control domiciliario a todos aquellos pacientes que así lo requieren. Objetivo: evaluar la implantación y gestión de la plataforma de asistencia domiciliaria TELEA, como herramienta de control en la evolución de los pacientes diagnosticados como Covid-19 positivos, con la enfermería como guía. Metodología: estudio cuanti-cualitativo explicativo secuencial (QUAN → QUAL). Población a estudio: pacientes Covid-19 positivos incluidos en el programa de atención domiciliaria TELEA, con periodo de incorporación a la plataforma, entre el 17/03/2020 y el 30/04/2020. Resultados: Los datos del estudio cuantitativo muestran un paciente proactivo, cifras bajas de ingresos y atención en urgencias durante su estancia en TELEA-ESCAH y una alta capacidad de resolución enfermera. El estudio cualitativo muestra la satisfacción de los pacientes con la plataforma y con el cuidado integral proporcionado por las enfermeras. Conclusiones: TELEA se presenta como una buena herramienta para el control de los pacientes con Covid-19 en aislamiento domiciliario. La atención enfermera es básica en el éxito de la teleasistencia con TELEA.

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