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1.
[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio
Simões, Marcus V.
Correia, Edileide de Barros
Marcondes-Braga, Fabiana G.
Coelho-Filho, Otavio Rizzi
Mesquita, Cláudio Tinoco
Mathias-Junior, Wilson
Rochitte, Carlos Eduardo
Ramires, Felix José Alvarez
Alves, Silvia Marinho Martins
Montera, Marcelo Westerlund
Lopes, Renato Delascio
Oliveira-Junior, Mucio Tavares
Scolari, Fernando L.
Avila, Walkiria Samuel
Canesin, Manoel Fernandes
Bacal, Fernando
Bocchi, Edimar Alcides
Moura, Lídia Ana Zytynski
Saad, Eduardo Benchimol
Scanavacca, Mauricio I.
Valdigem, Bruno Pereira
Cano , Manuel Nicolas
Abizaid , Alexandre
Ribeiro, Henrique Barbosa
Lemos-Neto, Pedro Alves
Ribeiro, Gustavo Calado de Aguiar
Jatene, Fabio Biscegli
Dias, Ricardo Ribeiro
Beck-da-Silva, Luis
Rohde, Luis Eduardo P.
Bittencourt, Marcelo Imbroinise
Pereira, Alexandre
Krieger, José Eduardo
Villacorta, Humberto
Martins, Wolney de Andrade
Figueiredo-Neto, José Albuquerque de
Cardoso , Juliano Novaes
Pastore, Carlos Alberto
Jatene, Ieda Biscegli
Tanaka, Ana Cristina Sayuri
Hotta, Viviane Tiemi
Romano, Minna Moreira Dias
Albuquerque, Denilson Campos de
Mourilhe-Rocha, Ricardo
Hajjar, Ludhmila Abrahão
Brito, Fabio Sandoli de
Caramelli , Bruno
Calderaro, Daniela
Farsky, Pedro Silvio
Colafranceschi , Alexandre Siciliano
Pinto, Ibraim Masciarelli
Vieira , Marcelo Luiz Campos
Danzmann, Luiz Claudio
Barberato , Silvio Henrique
Mady, Charles
Martinelli-Filho, Martino
Torbey , Ana Flavia Malheiros
Schwartzmann, Pedro Vellosa
Macedo, Ariane Vieira Scarlatelli
Ferreira , Silvia Moreira Ayub
Schmidt, Andre
Melo , Marcelo Dantas Tavares de
Lima-Filho, Moysés Oliveira
Sposito, Andrei C.
Brito, Flavio de Souza
Biolo, Andreia
Madrini-Junior, Vagner
Rizk, Stéphanie Itala
Mesquita, Evandro Tinoco
A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE. Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).
La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).
Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.
2.
Repeatability estimates in longitudinal data on guava trees
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Silva, Flavia Alves da
; Viana, Alexandre Pio
; Corrêa, Caio Cezar Guedes
; Leal, Lucas Souza da Silva
; Glória, Leonardo Siqueira
.
ABSTRACT The use of longitudinal measurements is an essential practice both in Psidium guajava L. breeding and in other perennial crops in which covariance structures can be introduced to explain the form of dependence between measurements. Hence, this study aimed to analyze six covariance structures to identify one that best described the correlation between the repeated measurements in time in traits of guava full-sib families. The repeatability coefficient for each trait was estimated and the minimum number of evaluations required for estimates representing the population was determined. The work was performed based on average data of three yield-related variables from nine harvests of a guava tree population evaluated from 2011 to 2018. The best model was chosen based on the Akaike and Schwarz Bayesian information criterion. The autoregressive covariance structure best represented the dependencies among families between crops for all traits. The number of variables of fruits and total yield per plant presented repeatability estimates higher than 0.5 and may be essential traits for indirect selection of others, such as fruit mass, which had an estimated repeatability of 0.24, proving low regularity in the repetition of the character from one cycle to another. It was also possible to define four harvests as the minimum acceptable number of observations necessary on the same individual for these traits; therefore, the repetitions represented the individuals.
3.
N-Methyl-(2S,4R)-trans-4-hydroxy-L-proline isolated Sideroxylon obtusifolium attenuates TPA-induced irritant contact dermatitis in mice
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NUNES, PAULO IURY G.
; VIANA, ANA FLÁVIA S.C.
; SASAHARA, GREYCE L.
; SANTOS, SABRINA M. DOS
; ALVES, ANA PAULA N.N.
; SILVEIRA, EDILBERTO R.
; SANTOS, FLÁVIA A.
.
Abstract Dermatitis is defined as a set of inflammatory diseases that affect the skin, with varied causes. Among the different types of dermatitis, contact dermatitis is the most prevalent. Although the current therapy is often effective, it is associated with adverse effects and the possibility of drug tolerance. N-Methyl-(2S, 4R)-trans-4-hydroxy-L-proline is a L-proline amino acid derivative found in the leaves of Sideroxylon obtusifolium, a species traditionally used to treat inflammatory diseases. The aim of this study was to investigate the topical anti-inflammatory effect of N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline (NMP) in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced irritant contact dermatitis in mice. Topically administered NMP, at doses of 0.03 − 0.50 mg/ear, reduced TPA-induced ear edema and neutrophil migration, as evidenced by low tissue myeloperoxidase activity and verified by histological examination. In addition, NMP (0.06 mg/ear) reduced tissue levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β, INF-γ and MCP-1) and of the anti-inflammatory cytokine IL-10, and reduced gene expression of TNF-α, IL-6 and IL-1β increased by TPA. The data suggest that N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline acts as a topical anti-inflammatory agent that decreases the expression of inflammatory cytokines, making it useful for the treatment of skin inflammation. Further investigations are necessary for its development as a therapeutic agent.
4.
Racial and economic segregation in Brazil: a nationwide analysis of socioeconomic and socio-spatial inequalities
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Sousa Filho, José Firmino de
; Pedeira, Sara Costa
; Santos, Gervásio F. dos
; Guimarães, Joanna M. N.
; Ferreira, Andrêa J. F.
; Alves, Flávia Jôse O.
; Nascimento, Gabrielle R.
; Paiva, Aureliano S. S.
; Andrade, Roberto F. S.
; Góes, Emanuelle F.
; Barreto, Maurício L.
; Aquino, Estela M. L.
.
Abstract This article aims to analyze residential segregation by race (racial segregation) and income (economic segregation) in Brazil and explore its relationship with socioeconomic and socio-spatial factors. Residential segregation was assessed using the dissimilarity index based on the 2010 demographic census and considering urban census tracts since segregation is sociologically considered an urban problem. The results for racial segregation showed that it is more evident in cities in the South and Southeast of Brazil and mainly affects the self-declared black population. The approach used to calculate economic segregation involved examining the income level of different low-income groups. Therefore, we consider families that earned between 0 and 1 minimum wage as the group with the greatest social vulnerability. We did not find significant correlations between racial and income segregation indices with aspects such as urbanization (urban population size). Finally, we present the racial segregation indices stratifying families by income thresholds for the 27 Brazilian capitals and conclude that per capita household income is a preponderant factor for the segregation of the poorest, especially in families whose residents self-identify as black.
Resumen Este artículo tiene como objetivo analizar la segregación residencial por raza (segregación racial) y renta (segregación económica) en Brasil y explorar su relación con factores socioeconómicos y socioespaciales. La segregación residencial se evaluó utilizando el índice de disimilitud con base en el censo demográfico de 2010 y considerando las secciones censales urbanas ya que la segregación es considerada sociológicamente como un problema urbano. Los resultados para la segregación racial mostraron que esta es más evidente en ciudades del sur y del sudeste de Brasil y que afecta principalmente a la población autodeclarada negra. El enfoque usado para calcular la segregación económica implicó examinar el nivel de ingresos de diferentes grupos de bajos ingresos. Por lo tanto, consideramos que las familias que ganaban entre cero y un salario mínimo son el grupo con mayor vulnerabilidad social. No encontramos correlaciones significativas entre los índices de segregación racial y los de ingresos con factores como la urbanización (tamaño de la población urbana). Finalmente, presentamos los índices de segregación racial estratificando a las familias por umbrales de renta para las 27 capitales brasileñas y concluimos que la renta per cápita de los hogares es un factor preponderante para la segregación de los más pobres, en especial en las familias cuyos habitantes se autodeclaran negros.
Resumo Este artigo tem como objetivo analisar a segregação residencial por raça (segregação racial) e renda (segregação econômica) no Brasil e explorar sua relação com fatores socioeconômicos e socioespaciais. A segregação residencial foi avaliada pelo índice de dissimilaridade baseado no Censo Demográfico de 2010 e considerando setores censitários urbanos, uma vez que a segregação é entendida sociologicamente como um problema urbano. Os resultados mostram que a segregação racial é mais evidente nas cidades do Sul e Sudeste do Brasil, atingindo principalmente a população autodeclarada preta. A abordagem utilizada para calcular a segregação econômica envolveu examinar o nível de renda de diferentes grupos de baixa renda. Portanto, consideramos as famílias que ganham entre 0 e 1 salário mínimo - o grupo de maior vulnerabilidade social. Não encontramos correlações significativas entre os índices de segregação racial e de renda com fatores como a urbanização (tamanho da população urbana). Por fim, apresentamos os índices de segregação racial estratificando as famílias por faixas de renda para as 27 capitais brasileiras e concluímos que a renda domiciliar per capita é fator preponderante para a segregação dos mais pobres, principalmente nas famílias cujos moradores se autodeclaram pretos.
5.
Adaptations to the drought season and impacts on the yield of ‘Híbrido de Timor’ coffee tree in the Minas Gerais State Cerrado (Brazilian Savanna)
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Santos, Cyntia Stephânia dos
; Freitas, Ana Flávia de
; Silva, Glauber Henrique Barbosa da
; Carvalho, Milene Alves de Figueiredo
; Santos, Meline de Oliveira
; Carvalho, Gladyston Rodrigues
; Silva, Vânia Aparecida
.
RESUMO As mudanças climáticas ameaçam a sobrevivência das culturas comercias com sua base genética estreita. Uma das alternativas é a identificação de plantas com potencial para a tolerância a estresses abióticos. Objetivou-se verificar as adaptações fisiológicas e anatômicas ao período seco e os impactos sobre a produtividade de acessos de cafeeiro Híbrido de Timor. O delineamento experimental foi em blocos casualizados, em esquema fatorial 7 x 2, sendo sete genótipos (UFV 377-21, UFV 377-21, UFV 442-42, BE 5 Wush-Wush x UFV 366-08, UFV 428-02, UFV 376-31 e UFV 427-55) e dois períodos sazonais (seco e chuvoso), com duas repetições. Foram avaliados a condutância estomática; potencial hídrico na antemanhã; níveis de peróxido de hidrogênio e malondialdeído; atividade das enzimas catalase, superóxido dismutase e ascorbato peroxidase; conteúdo de ascorbato; espessura da cutícula da face adaxial e limbo foliar; densidade estomática; relação entre diâmetro polar e equatorial; área do floema; área, diâmetro e frequência de vasos do xilema; condutividade hidráulica relativa; índice de vulnerabilidade; e produtividade. Observaram-se aclimatações dos acessos ao período seco, sendo que alguns mantiveram maiores valores de potencial hídrico na antemanhã; indução do sistema antioxidante com o aumento da atividade da enzima superóxido dismutase e de níveis de ascorbato; aumento da espessura da cutícula e do limbo foliar; e maior relação entre diâmetro polar e equatorial. A maioria dos acessos avaliados apresentou bom desempenho produtivo, com destaque para UFV 377-21, UFV 442-42 e UFV 376-31, com adaptações ao período seco e potencial produtivo.
ABSTRACT Climate change threatens the survival of commercial crops due to their narrow genetic base. One of the alternatives is the identification of plants with potential for abiotic stress tolerance. This study aimed to verify the physiological and anatomical adaptations to the drought period and the impacts on the yield of ‘Híbrido de Timor’ coffee tree accessions. The experimental design was randomized blocks, in a 7 x 2 factorial arrangement, being seven genotypes (UFV 377-21, UFV 377-21, UFV 442-42, BE 5 Wush-Wush x UFV 366-08, UFV 428-02, UFV 376-31 and UFV 427-55) and two seasonal periods (dry and rainy), with two replications. The stomatal conductance; predawn water potential; levels of hydrogen peroxide and malondialdehyde; activity of the enzymes catalase, superoxide dismutase and ascorbate oxidase; ascorbate content; cuticle thickness of the adaxial surface and leaf lamina; stomatal density; ratio between polar and equatorial diameter; phloem area; area, diameter and frequency of xylem vessels; relative hydraulic conductivity; vulnerability index; and yield were evaluated. The results showed acclimatization of the accessions to the dry period, with some of them maintaining higher water potential values in the predawn; induction of the antioxidant system with the increase in the activity of the superoxide dismutase enzyme and ascorbate levels; increase in the cuticle and leaf lamina thickness; and a higher ratio between polar and equatorial diameters. Most of the evaluated accessions showed a good productive performance, especially the ‘UFV 377-21’, ‘UFV 442-42’ and ‘UFV 376-31’, with adaptations to the dry period and yield potential.
6.
Multi-trait selection of tomato introgression lines under drought-induced conditions at germination and seedling stages
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Pessoa, Herika Paula
; Rocha, João Romero do Amaral Santos de Carvalho
; Alves, Flávia Maria
; Copati, Mariane Gonçalves Ferreira
; Dariva, Françoise Dalprá
; Silva, Laércio Junio da
; Carneiro, Pedro Crescêncio
; Gomes, Carlos Nick
.
ABSTRACT. To be considered drought-tolerant, a tomato cultivar is required to present some level of tolerance at all developmental stages of plant growth. Since drought tolerance is a stage-specific phenomenon, genotype assessment must be performed separately at all developmental stages. In this study, we used a multi-trait index based on factor analysis and genotype-ideotype distance (FAI-BLUP index) to properly rank 49 tomato genotypes according to their tolerance to drought stress conditions at germination and seedling stages. Seeds of 47 introgression lines, which cultivar M82 is considered drought-sensitive, and the Solanum pennellii wild accession LA 716, which is considered drought-tolerant, were subjected to a control condition, where seeds were soaked in distilled water, and a drought condition, where seeds were soaked in a polyethylene glycol (PEG) solution (-0.3 MPa). Drought stress, induced by PEG, had a significant impact on all nine germination and growth performance-related traits; there was a reduction in shoot length (SL), total length (TL), initial germination percentage (IGP), final germination percentage (FGP), germination velocity index (GVI), and germination rate (GR). In contrast, the root-to-shoot ratio (R/S) and time to reach 50% germination (T50) increased under drought stress. Root length (RL) was less affected by drought, and in some genotypes, it was even increased. As expected, LA 716 ranked closest to the drought tolerance ideotype. IL 1-4-18, IL 2-3, IL 1-2, IL 9-2, and IL 10-1 were the most drought-tolerant at the germination stage. These results will serve as guidance for breeders who are aiming at developing drought-resistant tomato cultivars.
7.
Differentials in death count records by databases in Brazil in 2010
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Diógenes, Victor Hugo Dias
; Pinto Júnior, Elzo Pereira
; Gonzaga, Marcos Roberto
; Queiroz, Bernardo Lanza
; Lima, Everton E. C.
; Costa, Lilia Carolina C. da
; Rocha, Aline S.
; Ferreira, Andrêa J. F.
; Teixeira, Camila S. S.
; Alves, Flávia Jôse O.
; Rameh, Leila
; Flores-Ortiz, Renzo
; Leyland, Alastair
; Dundas, Ruth
; Barreto, Maurício L.
; Ichihara, Maria Yury Travassos
.
ABSTRACT OBJECTIVE To compare the death counts from three sources of information on mortality available in Brazil in 2010, the Mortality Information System (SIM - Sistema de Informações sobre Mortalidade ), Civil Registration Statistic System (RC - Sistema de Estatísticas de Resgistro Civil ), and the 2010 Demographic Census at various geographical levels, and to confirm the association between municipal socioeconomic characteristics and the source which showed the highest death count. METHODS This is a descriptive and comparative study of raw data on deaths in the SIM, RC and 2010 Census databases, the latter held in Brazilian states and municipalities between August 2009 and July 2010. The percentage of municipalities was confirmed by the database showing the highest death count. The association between the source of the highest death count and socioeconomic indicators - the Índice de Privação Brasileiro (IBP – Brazilian Deprivation Index) and Índice de Desenvolvimento Humano Municipal (IHDM – Municipal Human Development Index) - was performed by bivariate choropleth and Moran Local Index of Spatial Association (LISA) cluster maps. RESULTS Confirmed that the SIM is the database with the highest number of deaths counted for all Brazilian macroregions, except the North, in which the highest coverage was from the 2010 Census. Based on the indicators proposed, in general, the Census showed a higher coverage of deaths than the SIM and the RC in the most deprived (highest IBP values) and less developed municipalities (lowest IDHM values) in the country. CONCLUSION The results highlight regional inequalities in how the databases chosen for this study cover death records, and the importance of maintaining the issue of mortality on the basic census questionnaire.
8.
Differentials in death count records by databases in Brazil in 2010
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Diógenes, Victor Hugo Dias
; Pinto Júnior, Elzo Pereira
; Gonzaga, Marcos Roberto
; Queiroz, Bernardo Lanza
; Lima, Everton E. C.
; Costa, Lilia Carolina C. da
; Rocha, Aline S.
; Ferreira, Andrêa J. F.
; Teixeira, Camila S. S.
; Alves, Flávia Jôse O.
; Rameh, Leila
; Flores-Ortiz, Renzo
; Leyland, Alastair
; Dundas, Ruth
; Barreto, Maurício L.
; Ichihara, Maria Yury Travassos
.
ABSTRACT OBJECTIVE To compare the death counts from three sources of information on mortality available in Brazil in 2010, the Mortality Information System (SIM - Sistema de Informações sobre Mortalidade ), Civil Registration Statistic System (RC - Sistema de Estatísticas de Resgistro Civil ), and the 2010 Demographic Census at various geographical levels, and to confirm the association between municipal socioeconomic characteristics and the source which showed the highest death count. METHODS This is a descriptive and comparative study of raw data on deaths in the SIM, RC and 2010 Census databases, the latter held in Brazilian states and municipalities between August 2009 and July 2010. The percentage of municipalities was confirmed by the database showing the highest death count. The association between the source of the highest death count and socioeconomic indicators - the Índice de Privação Brasileiro (IBP – Brazilian Deprivation Index) and Índice de Desenvolvimento Humano Municipal (IHDM – Municipal Human Development Index) - was performed by bivariate choropleth and Moran Local Index of Spatial Association (LISA) cluster maps. RESULTS Confirmed that the SIM is the database with the highest number of deaths counted for all Brazilian macroregions, except the North, in which the highest coverage was from the 2010 Census. Based on the indicators proposed, in general, the Census showed a higher coverage of deaths than the SIM and the RC in the most deprived (highest IBP values) and less developed municipalities (lowest IDHM values) in the country. CONCLUSION The results highlight regional inequalities in how the databases chosen for this study cover death records, and the importance of maintaining the issue of mortality on the basic census questionnaire.
9.
Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review
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Ichihara, Maria Yury
; Ferreira, Andrêa J.F.
; Teixeira, Camila S. S.
; Alves, Flávia Jôse O.
; Rocha, Aline Santos
; Diógenes, Victor Hugo Dias
; Ramos, Dandara Oliveira
; Pinto Júnior, Elzo Pereira
; Flores-Ortiz, Renzo
; Rameh, Leila
; Costa, Lilia Carolina C. da
; Gonzaga, Marcos Roberto
; Lima, Everton E. C.
; Dundas, Ruth
; Leyland, Alastair
; Barreto, Maurício L.
.
ABSTRACT OBJECTIVE Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. METHODS This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. RESULTS Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. CONCLUSIONS Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis.
10.
Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review
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Ichihara, Maria Yury
; Ferreira, Andrêa J.F.
; Teixeira, Camila S. S.
; Alves, Flávia Jôse O.
; Rocha, Aline Santos
; Diógenes, Victor Hugo Dias
; Ramos, Dandara Oliveira
; Pinto Júnior, Elzo Pereira
; Flores-Ortiz, Renzo
; Rameh, Leila
; Costa, Lilia Carolina C. da
; Gonzaga, Marcos Roberto
; Lima, Everton E. C.
; Dundas, Ruth
; Leyland, Alastair
; Barreto, Maurício L.
.
ABSTRACT OBJECTIVE Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. METHODS This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. RESULTS Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. CONCLUSIONS Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis.
11.
Métodos para avaliação da efetividade de vacinas para COVID-19 com ênfase em abordagens quase-experimentais
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Pescarini, Julia Moreira
; Teixeira, Camila Silveira Silva
; Cruz, Enny Paixão
; Ortelan, Naia
; Pinto, Priscila Fernanda Porto Scaff
; Ferreira, Andrêa Jacqueline Fortes
; Alves, Flavia Jôse Oliveira
; Pinto Junior, Elzo Pereira
; Falcão, Ila Rocha
; Rocha, Aline dos Santos
; Silva, Nivea Bispo da
; Ortiz, Renzo Flores
; Saavedra, Ramon da Costa
; Oliveira, Vinicius de Araújo
; Ribeiro-Silva, Rita de Cássia
; Ichihara, Maria Yury Travassos
; Boaventura, Viviane
; Barral Netto, Manoel
; Kerr, Ligia Regina Franco Sansigolo
; Werneck, Guilherme Loureiro
; Barreto, Mauricio L.
.
Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.
Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.
12.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
13.
Métodos para avaliação da efetividade de vacinas para COVID-19 com ênfase em abordagens quase-experimentais
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Pescarini, Julia Moreira
; Teixeira, Camila Silveira Silva
; Cruz, Enny Paixão
; Ortelan, Naia
; Pinto, Priscila Fernanda Porto Scaff
; Ferreira, Andrêa Jacqueline Fortes
; Alves, Flavia Jôse Oliveira
; Pinto Junior, Elzo Pereira
; Falcão, Ila Rocha
; Rocha, Aline dos Santos
; Silva, Nivea Bispo da
; Ortiz, Renzo Flores
; Saavedra, Ramon da Costa
; Oliveira, Vinicius de Araújo
; Ribeiro-Silva, Rita de Cássia
; Ichihara, Maria Yury Travassos
; Boaventura, Viviane
; Barral Netto, Manoel
; Kerr, Ligia Regina Franco Sansigolo
; Werneck, Guilherme Loureiro
; Barreto, Mauricio L.
.
Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.
Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.
14.
EXTRAÇÃO ASSISTIDA POR ULTRASSOM PARA DETERMINAÇÃO DE LIPÍDEOS EM ALIMENTOS: UM EXPERIMENTO DE LABORATÓRIO
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Ferreira, Bruno L.
; Beik, Junior V.
; Alves, Salvino J. Z.
; Henrique, Flavia A.
; Sauer, Elenise
; Chornobai, Cesar A.
; Bowles, Simone
; Chaves, Eduardo S.
.
The ultrasound-assisted extraction (UAE) is an alternative approach for the total lipid content determination in food samples. The high extraction efficiency, being less time-consuming and with the possibility of using less toxic solvents are the main advantages of UAE. It is, thus, an excellent alternative to be applied as a laboratory experiment for undergraduate students. The UAE procedure was optimized and the extraction parameters, such as extractor solvent, time and frequency of the ultrasound, were evaluated. The accuracy of the UAE procedure was evaluated by comparing the obtained results with those found by the traditional lipids extraction approach. The results showed that the lipids content found in the analyzed samples by using UAE were in agreement with the results obtained by the traditional lipids extraction. Therefore, the optimized UAE procedure was proposed as a laboratory experiment to 15 groups of undergraduate students to introduce the subjects of an alternative approach for total lipids determination in food samples. The results obtained showed that 80% of the student groups found results for total lipid contents in agreement with those found by traditional lipids extraction method. The proposed UAE procedure as a laboratory experiment proved to be simple and easy to be applied to undergraduate students.
https://doi.org/10.21577/0100-4042.20170592
848 downloads
15.
Medidas de distanciamento social no controle da pandemia de COVID-19: potenciais impactos e desafios no Brasil
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Aquino, Estela M. L.
; Silveira, Ismael Henrique
; Pescarini, Julia Moreira
; Aquino, Rosana
; Souza-Filho, Jaime Almeida de
; Rocha, Aline dos Santos
; Ferreira, Andrea
; Victor, Audêncio
; Teixeira, Camila
; Machado, Daiane Borges
; Paixão, Enny
; Alves, Flávia Jôse Oliveira
; Pilecco, Flávia
; Menezes, Greice
; Gabrielli, Ligia
; Leite, Luciana
; Almeida, Maria da Conceição Chagas de
; Ortelan, Naiá
; Fernandes, Qeren Hapuk R. Ferreira
; Ortiz, Renzo Joel Flores
; Palmeira, Raquel Nunes
; Pinto Junior, Elzo Pereira
; Aragão, Erika
; Souza, Luis Eugenio Portela Fernandes de
; Barral Netto, Manoel
; Teixeira, Maria Glória
; Barreto, Mauricio Lima
; Ichihara, Maria Yury
; Lima, Raíza Tourinho dos Reis Silva
.
Resumo A pandemia de COVID-19 tem desafiado pesquisadores e gestores a encontrar medidas de saúde pública que evitem o colapso dos sistemas de saúde e reduzam os óbitos. Esta revisão narrativa buscou sistematizar as evidências sobre o impacto das medidas de distanciamento social na epidemia de COVID-19 e discutir sua implementação no Brasil. Foram triados artigos sobre o efeito do distanciamento social na COVID-19 no PubMed, medRXiv e bioRvix, e analisados atos do poder público nos níveis federal e estadual para sumarizar as estratégias implementadas no Brasil. Os achados sugerem que o distanciamento social adotado por população é efetivo, especialmente quando combinado ao isolamento de casos e à quarentena dos contatos. Recomenda-se a implementação de medidas de distanciamento social e de políticas de proteção social para garantir a sustentabilidade dessas medidas. Para o controle da COVID-19 no Brasil, é imprescindível que essas medidas estejam aliadas ao fortalecimento do sistema de vigilância nos três níveis do SUS, que inclui a avaliação e uso de indicadores adicionais para monitorar a evolução da pandemia e o efeito das medidas de controle, a ampliação da capacidade de testagem, e divulgação ampla e transparente das notificações e de testagem desagregadas.
Abstract The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available.
https://doi.org/10.1590/1413-81232020256.1.10502020
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