au:Rodrigues, Izabel R. C.
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1. Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
Gonçalves, Fabio Augusto Rodrigues ; Besen, Bruno Adler Maccagnan Pinheiro ; Lima, Clarice Antunes de ; Corá, Aline Pivetta ; Pereira, Antônio José Rodrigues ; Perazzio, Sandro Félix ; Gouvea, Christiane Pereira ; Fonseca, Luiz Augusto Marcondes ; Trindade, Evelinda Marramon ; Sumita, Nairo Massakazu ; Duarte, Alberto José da Silva ; Lichtenstein, Arnaldo ; Bonfa, Eloisa ; Utiyama, Edivaldo M. ; Segurado, Aluisio C. ; Perondi, Beatriz ; Miethke-Morais, Anna ; Montal, Amanda C. ; Harima, Leila ; Fusco, Solange R. G. ; Silva, Marjorie F. ; Rocha, Marcelo C. ; Marcilio, Izabel ; Rios, Izabel Cristina ; Kawano, Fabiane Yumi Ogihara ; Jesus, Maria Amélia de ; Kallas, Ésper George ; Carmo, Carolina ; Tanaka, Clarice ; Souza, Heraldo Possolo de ; Marchini, Julio F. M. ; Carvalho, Carlos ; Ferreira, Juliana C. ; Levin, Anna Sara Shafferman ; Oliveira, Maura Salaroli ; Guimarães, Thaís ; Lázari, Carolina dos Santos ; Sabino, Ester ; Magri, Marcello M. C. ; Barros-Filho, Tarcisio E. P. ; Francisco, Maria Cristina Peres Braido ; Costa, Silvia F. .
OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.
2. COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
Fukuti, Pedro ; Uchôa, Caroline Louise Mesquita ; Mazzoco, Marina Flaborea ; Cruz, Isabella D'Andrea Garcia da ; Echegaray, Mariana V.F. ; Humes, Eduardo de Castro ; Silveira, Júlia Belizário ; Santi, Talita Di ; Miguel, Euripedes Constantino ; Corchs, Felipe ; Fatori, Daniel ; Campello, Guilherme ; Oliveira, Gabriel M. de ; Argolo, Felipe C. ; Ferreira, Felipe de M. ; Machado, Gustavo ; Argeu, Adriana ; Oliveira, Graça Maria Ramos de ; Serafim, Antônio de Pádua ; Siqueira, Luciana de Lima ; Rossi, Luciane de ; Rios, Izabel Cristina ; Oliveira, Talita Rodrigues de ; Antoniazzi, Leilane C. K. ; Gagliotti, Daniel Augusto Mori ; Abelama Neto, Emílio ; Oliveira Junior, Paulo Novais de ; Correia, Aline Villalobo ; Gonçalves, Luca Schilling ; Tortato, Liana Silva ; Busato, Wagner Machado Moraes ; Guimarães-Fernandes, Flávio ; Alves, Marcos ; Leite Netto, Oswaldo Ferreira ; Schoueri, Patrícia de Campos Lindenberg ; Roque, Márcio de Assis ; Merlin, Silvia Stahl ; Boer, Giovana Cardoso Machado ; Sallet, Paulo Clemente ; Malbergier, André ; Spedo, Mariana Abrahão ; Kamitsuji, Carla Satie ; Faria, Elizabeth de ; Moreira, Moacyr Vergara de Godoy ; Kaufman, Arthur ; Abdo, Carmita ; Scanavino, Marco de Tubino ; Lancman, Selma ; Tavares, Hermano ; Polanczyk, Guilherme ; Brunoni, André R. ; Forlenza, Orestes V. ; Barros-Filho, Tarcísio Eloy Pessoa de .
OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.
3. Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
Fink, Thais T. ; Marques, Heloisa H.S. ; Gualano, Bruno ; Lindoso, Livia ; Bain, Vera ; Astley, Camilla ; Martins, Fernanda ; Matheus, Denise ; Matsuo, Olivia M. ; Suguita, Priscila ; Trindade, Vitor ; Paula, Camila S.Y. ; Farhat, Sylvia C.L. ; Palmeira, Patricia ; Leal, Gabriela N. ; Suzuki, Lisa ; Odone Filho, Vicente ; Carneiro-Sampaio, Magda ; Duarte, Alberto José S. ; Antonangelo, Leila ; Batisttella, Linamara R. ; Polanczyk, Guilherme V. ; Pereira, Rosa Maria R. ; Carvalho, Carlos Roberto R. ; Buchpiguel, Carlos A. ; Xavier, Ana Claudia L. ; Seelaender, Marilia ; Silva, Clovis Artur ; Pereira, Maria Fernanda B. ; Sallum, Adriana M. E. ; Brentani, Alexandra V. M. ; Neto, Álvaro José S. ; Ihara, Amanda ; Santos, Andrea R. ; Canton, Ana Pinheiro M. ; Watanabe, Andreia ; Santos, Angélica C. dos ; Pastorino, Antonio C. ; Franco, Bernadette D. G. M. ; Caruzo, Bruna ; Ceneviva, Carina ; Martins, Carolina C. M. F. ; Prado, Danilo ; Abellan, Deipara M. ; Benatti, Fabiana B. ; Smaria, Fabiana ; Gonçalves, Fernanda T. ; Penteado, Fernando D. ; Castro, Gabriela S. F. de ; Gonçalves, Guilherme S. ; Roschel, Hamilton ; Disi, Ilana R. ; Marques, Isabela G. ; Castro, Inar A. ; Buscatti, Izabel M. ; Faiad, Jaline Z. ; Fiamoncini, Jarlei ; Rodrigues, Joaquim C. ; Carneiro, Jorge D. A. ; Paz, Jose A. ; Ferreira, Juliana C. ; Ferreira, Juliana C. O. ; Silva, Katia R. ; Bastos, Karina L. M. ; Kozu, Katia ; Cristofani, Lilian M. ; Souza, Lucas V. B. ; Campos, Lucia M. A. ; Silva Filho, Luiz Vicente R. F. ; Sapienza, Marcelo T. ; Lima, Marcos S. ; Garanito, Marlene P. ; Santos, Márcia F. A. ; Dorna, Mayra B. ; Aikawa, Nadia E. ; Litvinov, Nadia ; Sakita, Neusa K. ; Gaiolla, Paula V. V. ; Pasqualucci, Paula ; Toma, Ricardo K. ; Correa-Silva, Simone ; Sieczkowska, Sofia M. ; Imamura, Marta ; Forsait, Silvana ; Santos, Vera A. ; Zheng, Yingying .
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
4. Novel immunoassay for TSH measurement in rats
Alves, Thalita G. ; Melo, Maria Clara de C. ; Kasamatsu, Teresa S. ; Oliveira, Kelen C. ; Souza, Janaina Sena de ; Conceição, Rodrigo Rodrigues da ; Giannocco, Gisele ; Dias-da-Silva, Magnus R. ; Chiamolera, Maria Izabel ; Vieira, José Gilberto .
Archives of Endocrinology and Metabolism Set 2017, Volume 61 Nº 5 Páginas 460 - 463
ABSTRACT Measuring thyroid hormones is an important aspect for the study of metabolism and for monitoring diseases in both human and animal models. The traditional method for hormone measurement in rats is the radioimmunoassay (RIA). However, the RIA is associated with some practical disadvantages, including the use of radioactive material, the need for specialized equipment and expert staff, the short shelf-life of kits according to the half-life of the radioisotope and high costs. The objective of this study was to develop a new cost-effective method for measuring TSH levels in rats that avoids the use of radioactive material. We developed an in-house competitive immunoassay using a reference standard, polyclonal antibody produced in rabbits and biotinylated antigen. This method was tested in 64 Wistar rats that were divided into a control group (n = 41) and a group with hypothyroidism (n = 23). Our assay demonstrated an analytical sensitivity of 0.24 ng/mL (n = 12) and an intra-assay coefficient of variation (CV) of 8.9% for sera with TSH levels of 1.5 ng/mL and 13.2% for sera with TSH levels of 17.5 ng/mL (n = 14). The inter-assay CV was 13.5% for sera with TSH levels of 1.4 ng/mL and 14.5% for TSH levels of 18.2 ng/mL (n = 5). The analysis of mean TSH levels in control rats (5.06 ± 0.5701) and hypothyroid rats (51.09 ± 5.136) revealed a statistically significant difference (p < 0.001) between the groups. This method showed good sensitivity, can be automated and is low-cost compared with RIA. Our method offers a viable alternative for TSH measurement in rats.
5. HIV-1 Reverse Transcriptase: a potential target for marine products
Miceli, Leonardo A. ; Souza, Alessandra M. T. de ; Rodrigues, Carlos R. ; Paixão, Izabel C. N. P. ; Teixeira, Valéria L. ; Castro, Helena C. .
Revista Brasileira de Farmacognosia Ago 2012, Volume 22 Nº 4 Páginas 881 - 888
HIV-1 reverse transcriptase (HIV-1 RT) is a therapeutic target for the treatment of HIV-positive individuals or those already showing AIDS symptoms. In this perspective, the identification of new inhibitors for this enzyme is of great importance in view of the growing viral resistance to the existing treatments. This resistance has compromised the quality of life of those infected with multidrug-resistant strains, whose treatment options are already limited, putting at risk these individuals lives. The literature has recognized marine organisms and their products as natural sources for the identification of new therapeutic options for different pathologies. In this brief review, we consider the structure of HIV-1 RT and its most common inhibitors, as well as some marine diterpenes originally reported as HIV-1 RT inhibitors to encourage the identification and development of new marine antiviral prototypes.
6. Sobre o isolamento de uma cepa humana de Schistosoma mansoni, Sambon, 1907
Memórias do Instituto Oswaldo Cruz 1987, Volume 82 Supl. 4 Páginas 355 - 358
In this paper the authors briefly describe a human Schistosoma mansoni strain from Pará State, Brazil. The CIRENE'S strain was capable of infecting 71.4% of the snail vector Biomphalaria glabrata (Telegrafo's strain) provided by the "Evando Chagas" Institute, Belém. The cycle was completed by the infection of six mice. The thoracic and abdominal organs were examined microscopically which demonstrated the passage of the worm into the liver and lungs. The authors discuss the importance of these results in the epidemiology of schistosomiasis in Pará.
https://doi.org/10.1590/S0074-02761987000800069 871 downloads
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