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au:CUNHA, ANA PAULA ALVES DA

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Citopatológico do colo uterino e adequabilidade da amostra: ensaio clínico randomizado controlado
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Freitas, Vívien Cunha Alves de

; Soares, Paula Renata Amorim Lessa

; Nicolau, Ana Izabel Oliveira

; Lima, Thaís Marques

; Pinheiro, Ana Karina Bezerra

Acta Paulista de Enfermagem

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2023, Volume 36 elocation eAPE00972

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract Objective To assess two cervicovaginal collection techniques to sample suitability and the other findings of Pap smear. Methods The study was conducted from September 2018 to July 2019, in a school health center located in the city of Fortaleza - Ceará. The sample consisted of 365 women randomly divided, with 184 participants in the Control Group (technique in which the ectocervix smear was placed on the slide before endocervical material was collected) and 181 in the Comparison Group (in which the vaginal ectocervix smear was placed on the slide only after collecting the material from the endocervix). An instrument containing sociodemographic, clinical, sexual, reproductive and findings in cytopathological report was used. Women aged between 18 and 64 years, who had already started their sexual life and who underwent the cervical cancer prevention test during the data collection period, were included. Chi-square, Fisher and Kruskal-Wallis tests were used. Results There was no statistical association between cytopathological sample suitability for the two cervicovaginal collection techniques used and for the other clinical, sexual, reproductive and other variables related to the other findings in cytopathological report, obtaining a value of p>5% in all associations performed. Conclusion The two techniques for collecting cervical cells described in official manuals did not differ for obtaining an adequate cell sample, being equally effective and providing the guarantee of an accurate and timely Pap smear. Brazilian Clinical Trial Registry (ReBEC): RBR-2H4MPN.

Resumen Objetivo Evaluar dos técnicas de toma de muestra cervicovaginal con la adecuación de la muestra y con los demás resultados del informe colpocitológico. Métodos El estudio fue realizado durante el período de septiembre de 2018 a julio de 2019, en un centro de salud-escuela, ubicado en el municipio de Fortaleza, estado de Ceará. La muestra estaba compuesta por 365 mujeres divididas aleatoriamente, de las cuales 184 participantes estaban en el Grupo Control (técnica por la que el frotis del ectocérvix fue colocado en la lámina antes de la toma del material del endocérvix) y 181 en el Grupo Comparación (en el que el frotis del ectocérvix vaginal fue colocado sobre la lámina únicamente después de la toma del material del endocérvix). Se utilizó un instrumento con variables sociodemográficas, clínicas, sexuales, reproductivas y relativas a los resultados del informe citológico. Fueron incluidas mujeres del grupo de edad de 18 a 64 años, que ya habían empezado su vida sexual y que realizaron la prueba de prevención de cáncer de cuello uterino durante el período de la recopilación de datos. Se utilizaron las pruebas χ2 de Pearson, Fisher y Kruskal-Wallis. Resultados No hubo asociación estadística entre la adecuación de la muestra citológica con las dos técnicas de toma cervicovaginal utilizadas y con las demás variables clínicas, sexuales, reproductivas y referentes a los demás resultados del informe citológico, y se obtuvo un valor de p>5 % en todas las asociaciones realizadas. Conclusión Las dos técnicas de toma de células cervicales que se describen en manuales oficiales no difirieron en la obtención de una muestra celular adecuada y son igualmente eficaces y favorecen la garantía de un informe colpocitológico preciso y oportuno.

Resumo Objetivo Avaliar duas técnicas de coleta cervicovaginal à adequabilidade da amostra e aos demais achados do laudo colpocitopatológico. Métodos O estudo foi realizado no período de setembro de 2018 a julho de 2019, em um centro de saúde-escola, localizado no município de Fortaleza - Ceará. A amostra foi composta por 365 mulheres divididas aleatoriamente, sendo 184 participantes no Grupo Controle (técnica na qual o esfregaço da ectocérvice foi disposto na lâmina antes da coleta do material da endocérvice) e 181 no Grupo Comparação (no qual o esfregaço da ectocérvice vaginal foi disposto na lâmina apenas após a coleta do material da endocérvice). Utilizou-se um instrumento contendo variáveis sociodemográficas, clínicas, sexuais, reprodutivas e referentes aos achados no laudo citopatológico. Incluíram-se mulheres na faixa etária de 18 a 64 anos, que já tinham iniciado vida sexual e que realizaram o exame de prevenção do câncer de colo uterino no período da coleta de dados. Os testes do qui-quadrado, Fisher e Kruskal-Wallis foram utilizados. Resultados Não houve associação estatística entre a adequabilidade da amostra citopatológica às duas técnicas de coleta cervicovaginal empregadas e às demais variáveis clínicas, sexuais, reprodutivas e referentes aos demais achados no laudo citopatológico, obtendo-se valor de p>5% em todas as associações realizadas. Conclusão As duas técnicas de coleta de células cervicais descritas em manuais oficiais não diferiram para a obtenção de uma amostra celular adequada, sendo igualmente eficazes e propiciando a garantia de um laudo colpocitopatológico preciso e oportuno. Registro Brasileiro de Ensaios Clínicos (ReBEC): RBR-2H4MPN.

https://doi.org/10.37689/acta-ape/2023ao00972

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Abstract: En | Text: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.

https://doi.org/10.1590/0074-02760220259

Decreasing delays in the diagnosis and treatment of rheumatoid arthritis in Brazil: a nationwide multicenter observational study
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Albuquerque, Cleandro Pires de

; Reis, Ana Paula Monteiro Gomides

; Santos, Ana Beatriz Vargas

; Bértolo, Manoel Barros

; Louzada Júnior, Paulo

; Giorgi, Rina Dalva Neubarth

; Radominski, Sebastião Cezar

; Guimarães, Maria Fernanda B. Resende

; Bonfiglioli, Karina Rossi

; Sauma, Maria de Fátima L. da Cunha

; Pereira, Ivânio Alves

; Brenol, Claiton Viegas

; Mota, Licia Maria Henrique da

; Santos Neto, Leopoldo

; Pinheiro, Geraldo R. Castelar

Advances in Rheumatology

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2023, Volume 63 elocation 3

Abstract: En | Text: En | PDF: En

Abstract Background Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil. Methods Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann–Kendall trend test, chi-squared tests with Cramer’s V effect sizes and analysis of variance were conducted. Results We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = - 0.677, p < 0.001) and treatment (tau = - 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011–2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4–12) and 11 (5–17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window. Conclusion The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.

https://doi.org/10.1186/s42358-022-00265-0

Do it fast! Early access to specialized care improved long-term outcomes in rheumatoid arthritis: data from the REAL multicenter observational study
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Albuquerque, Cleandro Pires

; Reis, Ana Paula Monteiro Gomides

; Santos, Ana Beatriz Vargas

; Bértolo, Manoel Barros

; Louzada Júnior, Paulo

; Giorgi, Rina Dalva Neubarth

; Radominski, Sebastião Cezar

; Guimarães, Maria Fernanda B. Resende

; Bonfiglioli, Karina Rossi

; Sauma, Maria de Fátima L Cunha

; Pereira, Ivânio Alves

; Brenol, Claiton Viegas

; Mota, Licia Maria Henrique

; Santos Neto, Leopoldo

; Pinheiro, Geraldo Rocha Castelar

Advances in Rheumatology

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2023, Volume 63 elocation 17

Abstract: En | Text: En | PDF: En

Abstract Background Early rheumatoid arthritis (RA) offers an opportunity for better treatment outcomes. In real-life settings, grasping this opportunity might depend on access to specialized care. We evaluated the effects of early versus late assessment by the rheumatologist on the diagnosis, treatment initiation and long-term outcomes of RA under real-life conditions. Methods Adults meeting the ACR/EULAR (2010) or ARA (1987) criteria for RA were included. Structured interviews were conducted. The specialized assessment was deemed “early” when the rheumatologist was the first or second physician consulted after symptoms onset, and “late” when performed afterwards. Delays in RA diagnosis and treatment were inquired. Disease activity (DAS28-CRP) and physical function (HAQ-DI) were evaluated. Student's t, Mann-Whitney U, chi-squared and correlation tests, and multiple linear regression were performed. For sensitivity analysis, a propensity score-matched subsample of early- vs. late-assessed participants was derived based on logistic regression. The study received ethical approval; all participants signed informed consent. Results We included 1057 participants (89.4% female, 56.5% white); mean (SD) age: 56.9 (11.5) years; disease duration: 173.1 (114.5) months. Median (IQR) delays from symptoms onset to both RA diagnosis and initial treatment coincided: 12 (6–36) months, with no significant delay between diagnosis and treatment. Most participants (64.6%) first sought a general practitioner. Notwithstanding, 80.7% had the diagnosis established only by the rheumatologist. Only a minority (28.7%) attained early RA treatment (≤ 6 months of symptoms). Diagnostic and treatment delays were strongly correlated (rho 0.816; p < 0.001). The chances of missing early treatment more than doubled when the assessment by the rheumatologist was belated (OR 2.77; 95% CI: 1.93, 3.97). After long disease duration, late-assessed participants still presented lower chances of remission/low disease activity (OR 0.74; 95% CI: 0.55, 0.99), while the early-assessed ones showed better DAS28-CRP and HAQ-DI scores (difference in means [95% CI]: −0.25 [−0.46, −0.04] and − 0.196 [−0.306, −0.087] respectively). The results in the propensity-score matched subsample confirmed those observed in the original (whole) sample. Conclusions Early diagnosis and treatment initiation in patients with RA was critically dependent on early access to the rheumatologist; late specialized assessment was associated with worse long-term clinical outcomes.

https://doi.org/10.1186/s42358-023-00301-7

Profile of volatile compounds released by Waitea circinata against Magnaporthe oryzae under different periods and temperatures
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Cruz, Luiza Vieira da

; Santos, Marcos Henrique Faleiros

; Gama, Bryna Tamilla Alves Falcão

; Araújo, Leila Garcês de

; Terezan, Ana Paula

; Oliveira Neto, Jerônimo Raimundo de

; Cunha, Luiz Carlos da

; Oliveira, Anselmo Elcana de

; Silva, Márcia Matos da

; Coelho, Carla Thaís Pereira

; Severino, Vanessa Gisele Pasqualotto

Pesquisa Agropecuária Tropical

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2023, Volume 53 elocation e75038

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A brusone causada pelo patógeno Magnaporthe oryzae é a principal doença do arroz, e pode causar perdas devastadoras. Objetivou-se investigar o perfil de compostos voláteis da micorriza Waitea circinata no antagonismo a M. oryzae, em diferentes períodos e temperaturas, utilizando-se delineamento inteiramente casualizado. Compostos orgânicos voláteis foram extraídos por micro extração em fase sólida, no modo headspace, e analisados por cromatografia gasosa acoplada a espectrometria de massas, enquanto o escalonamento multidimensional foi usado para comparar os compostos orgânicos voláteis produzidos. Os principais compostos responsáveis pelo antagonismo a M. oryzae foram longifoleno, trans-β-farneseno, (Z)-α-bisaboleno e δ-amorfeno, que podem ser usados como biofungicidas e incorporados às estratégias de manejo da brusone do arroz. arroz devastadoras Objetivouse Objetivou se M temperaturas utilizandose utilizando casualizado sólida headspace massas produzidos longifoleno transβfarneseno, transβfarneseno trans β farneseno, farneseno trans-β-farneseno Zαbisaboleno Z α bisaboleno δamorfeno, δamorfeno δ amorfeno, amorfeno δ-amorfeno

ABSTRACT Rice blast caused by the Magnaporthe oryzae pathogen is a major disease in this crop, and may cause devastating losses. This study aimed to investigate the profile of Waitea circinata mycorrhiza volatile compounds in antagonism to M. oryzae, under different growth periods and temperatures, using a completely randomized design. Volatile organic compounds were extracted by headspace solid phase microextraction and analyzed by gas chromatography mass spectrometry, while multidimensional scaling was used to compare the produced volatile organic compounds. The main compounds responsible by the antagonism to M. oryzae were longifolene, trans-β-farnesene, (Z)-α-bisabolene and δ-amorphene, which can be used as biofungicides and incorporated into rice blast management strategies. crop losses M temperatures design spectrometry longifolene transβfarnesene, transβfarnesene trans β farnesene, farnesene trans-β-farnesene Zαbisabolene Z α bisabolene δamorphene, δamorphene δ amorphene, amorphene δ-amorphene strategies

https://doi.org/10.1590/1983-40632023v5375038

Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real- life study
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Vicente, Gustavo Nogueira Schincariol

; Pereira, Ivânio Alves

; Castro, Gláucio Ricardo Werner de

; Mota, Licia Maria Henrique da

; Carnieletto, Ana Paula

; Souza, Dhara Giovanna Santin de

; Gama, Fabiana Oenning da

; Santos, Ana Beatriz Vargas

; Albuquerque, Cleandro Pires de

; Bértolo, Manoel Barros

; Louzada Júnior, Paulo

; Giorgi, Rina Dalva Neubarth

; Radominski, Sebastião Cezar

; Guimarães, Maria Fernanda Brandão Resende

; Bonfiglioli, Karina Rossi

; Sauma, Maria de Fátima Lobato da Cunha

; Brenol, Claiton Viegas

; Pinheiro, Geraldo da Rocha Castelar

Advances in Rheumatology

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2021, Volume 61 elocation 38

Abstract: En | Text: En | PDF: En

Abstract Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs. Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher’s Exact tests. Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003). Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.

https://doi.org/10.1186/s42358-021-00186-4 82 downloads

Climbing plants of Porto Ferreira State Park, southeastern Brazil
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Vargas, Betânia da Cunha

; Oliveira, Ana Paula Caldeira

; Udulutsch, Renata Giassi

; Marcusso, Gabriel Mendes

; Sabino, Gabriel Pavan

; Melo, Pablo Hendrigo Alves de

; Grillo, Roberta Marotti Martelletti

; Kamimura, Vitor de Andrade

; Assis, Marco Antonio

Biota Neotropica

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2018, Volume 18 N. 2 elocation e20170346

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O levantamento florístico das trepadeiras foi realizado em um ecótono de Floresta Estacional Semidecidual (FES) e Cerradão (CER), no Parque Estadual de Porto Ferreira, Sudeste do Brasil. Realizamos coletas mensais dos espécimes reprodutivos ao longo de dois períodos, março 2010 a setembro 2011, abril e julho 2015. Os levantamentos foram realizados por meio do método de caminhada e os indivíduos amostrados foram classificados quanto ao hábito, mecanismo de ascensão e síndrome de dispersão. No geral, foram registradas 109 espécies, pertencentes a 67 gêneros e 29 famílias. Dentre essas, 49 espécies ocorrem nos dois tipos de vegetação, sendo que 29 e 31 espécies são exclusivas de FES e CER, respectivamente. Bignoniaceae e Malpighiaceae foram as famílias mais ricas com 17 espécies, seguidas por Sapindaceae (12 espécies), Asteraceae e Apocynaceae (8 espécies cada) e Fabaceae (6). A maioria das espécies de trepadeiras são lianas, volúveis e anemocóricas, correspondendo a 70%, 47% e 66% de toda a amostra, respectivamente. Neste trabalho, acrescentamos uma nova família e 14 espécies para a lista de trepadeiras do Cerrado paulista e 10 espécies para a lista brasileira de trepadeiras em Floresta Estacional Semidecidual. Portanto, contribuímos para o conhecimento da diversidade de trepadeiras em tipos vegetacionais pouco estudados para este grupo de planta, destacando o Cerradão, no qual encontramos novos registros para um grande número de espécies.

Abstract A floristic survey of climbing plants was carried out in an ecotone area of seasonal semideciduous forest (SSF) and forested savanna (CER), in Porto Ferreira State Park (PFSP), Southeastern Brazil. We sampled the reproductive specimens every month during two periods, March 2010 to September 2011 and April and July 2015. The surveys were performed by the walking method, and the sampled individuals were classified by habit, climbing mechanism and dispersal mode. Overall, 109 species, belonging to 67 genera and 29 families, were recorded; 49 species occurred in both, 29 and 31 were exclusive to SSF and CER, respectively. Bignoniaceae and Malpighiaceae were the richest families, with 17 species, followed by Sapindaceae (12 species), Asteraceae and Apocynaceae (8 species each) and Fabaceae (6). The majority of climbers were lianas, twining and anemochoric species, corresponding to 70%, 47% and 66% of all samples, respectively. In this work, we added one new family and 14 species to the Cerrado’s list of climbing plants from São Paulo state, and 10 species to the Brazilian seasonal semideciduous forest’s list. Therefore, we contributed to the understanding of diversity of climbing plants in vegetation types poorly studied for this plant group, mainly in the Cerradão, wherein we found new records for several species.

https://doi.org/10.1590/1676-0611-bn-2017-0346 1463 downloads

Avaliação de coberturas vacinais de crianças em uma cidade de médio porte (Brasil) utilizando registro informatizado de imunização
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Ferreira, Vinicius Leati de Rossi

; Waldman, Eliseu Alves

; Rodrigues, Laura Cunha

; Martineli, Edmar

; Costa, Ângela Aparecida

; Inenami, Marta

; Sato, Ana Paula Sayuri

Cadernos de Saúde Pública

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2018, Volume 34 N. 9 elocation e00184317

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Dados administrativos mostram altas coberturas vacinais no Brasil, porém não há avaliação da validade e oportunidade de aplicação das doses, nem se o esquema vacinal está completo. Este estudo avaliou as coberturas oportunas e atualizadas de crianças de 12 a 24 meses de idade. Estudo longitudinal de base populacional em Araraquara, São Paulo, uma cidade de médio porte predominantemente urbana, utilizando dados do Sistema Juarez, um registro informatizado de imunização (RII). As coberturas foram avaliadas para 49.741 crianças nascidas entre 1998 e 2013, período com cinco calendários de vacinação diferentes. As tendências foram estimadas pelo método de regressão linear Prais-Winsten. A cobertura atualizada do esquema completo variou entre 79,5% e 91,3%, aos 12 meses, e entre 75,8% e 86,9%, aos 24 meses. A cobertura oportuna (todas as doses aplicadas na idade recomendada, sem atraso) variou entre 53,3% e 74%, aos 12 meses, e entre 36,7% e 53,8%, aos 24 meses. Houve tendência crescente para a cobertura atualizada aos 24 meses. Os atrasos em relação à idade recomendada se acentuam em doses a partir dos seis meses e parecem estar mais relacionados à idade do que ao número de doses do esquema. A proporção de doses inválidas e atrasadas foi menor do que em outros estudos. Apesar do aumento do número de doses no calendário vacinal, foram alcançadas altas coberturas atualizadas e coberturas oportunas maiores do que as encontradas na literatura nacional e internacional, porém são necessários mais esforços para o aumento da oportunidade. O RII mostrou-se relevante para avaliação e monitoramento de coberturas vacinais, com análises mais acuradas.

Administrative data show high vaccination coverage rates in Brazil, but there is no assessment of the validity and timeliness of dose administration, or whether the vaccination schedule is complete. This study assessed timely and updated coverage rates in children 12 to 24 months of age. This was a longitudinal population-based study in Araraquara, São Paulo State, a predominantly urban medium-sized municipality, using the Juarez System, an electronic immunization registry (EIR). Coverage rates were assessed in 49,741 children born from 1998 to 2013, a period in which five different vaccination schedules were used. Trends were estimated with the Prais-Winsten linear regression method. Updated coverage of the complete schedule varied from 79.5% to 91.3% at 12 months and from 75.8% to 86.9%, at 24 months. Timely coverage (all doses applied at the recommended ages, with no delays) ranged from 53.3% to 74% at 12 months and from 36.7% to 53.8% at 24 months. There was an upward trend in updated coverage at 24 months. The delays in relation to recommended age increased starting at six months and appeared to relate more to age than to the number of doses in the schedule. The proportion of invalid and late doses was lower than in other studies. Despite the increase in the number of doses in the vaccination schedule, the study showed high updated coverage rates and higher timely coverage than reported in the national and international literature; however, more effort is needed to increase timeliness. EIR proved relevant for assessing and monitoring vaccination coverage with more accurate analyses.

Los datos administrativos muestran altas coberturas de vacunación en Brasil, sin embargo, no existe una evaluación de la validez y oportunidad de aplicación de las dosis, ni si la cartilla de vacunación ha sido completada. Este estudio evalúo las coberturas necesarias y actualizadas en niños de 12 a 24 meses de edad. Se trata de un estudio longitudinal con base poblacional en Araraquara, São Paulo, una ciudad media, predominantemente urbana, utilizando datos del Sistema Juarez, un registro informatizado de inmunización (RII). Las coberturas se evaluaron en 49.741 niños, nacidos entre 1998 y 2013, durante un período con cinco calendarios de vacunación diferentes. Las tendencias se estimaron mediante el método de regresión lineal Prais-Winsten. La cobertura actualizada del esquema completo varió entre 79,5% y 91,3%, a los 12 meses, y entre 75,8% y 86,9%, a los 24 meses. La cobertura necesaria (todas las dosis aplicadas a la edad recomendada, sin atrasos) varió entre 53,3% y 74%, a los 12 meses, y entre 36,7% y 53,8% a los 24 meses. Hubo una tendencia creciente en la cobertura actualizada a los 24 meses. Los atrasos, en relación con la edad recomendada, se acentúan en dosis a partir de los seis meses y parecen estar más relacionados con la edad que con el número de dosis del esquema. La proporción de dosis inválidas y atrasadas fue menor que en otros estudios. A pesar del aumento del número de dosis en el calendario de vacunas, se alcanzaron altas coberturas actualizadas y coberturas oportunas mayores que las encontradas en la literatura nacional e internacional, sin embargo, se necesitan más esfuerzos para el aumento de la oportunidad. El RII se mostró relevante en la evaluación y supervisión de coberturas de vacunación con análisis más exactos.

https://doi.org/10.1590/0102-311x00184317 37 downloads

Avaliação de coberturas vacinais de crianças em uma cidade de médio porte (Brasil) utilizando registro informatizado de imunização
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Ferreira, Vinicius Leati de Rossi

; Waldman, Eliseu Alves

; Rodrigues, Laura Cunha

; Martineli, Edmar

; Costa, Ângela Aparecida

; Inenami, Marta

; Sato, Ana Paula Sayuri

Cadernos de Saúde Pública

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2018, Volume 34 N. 9 elocation e00184317

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311x00184317 4092 downloads

10.

Use of electronic immunization registry in the surveillance of adverse events following immunization
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Sato, Ana Paula Sayuri

; Ferreira, Vinícius Leati de Rossi

; Tauil, Márcia de Cantuária

; Rodrigues, Laura Cunha

; Barros, Mariana Bernardes

; Martineli, Edmar

; Costa, Ângela Aparecida

; Inenami, Marta

; Waldman, Eliseu Alves

Revista de Saúde Pública

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2018, Volume 52 elocation 4

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Descrever os eventos adversos pós-vacina ocorridos em crianças com até dois anos de idade e analisar a tendência desses eventos, entre 2000 e 2013, em Araraquara, SP, Brasil. MÉTODOS Estudo descritivo com dados da vigilância passiva de eventos adversos pós-vacina, disponíveis no registro informatizado de imunização do prontuário eletrônico do serviço municipal de saúde (Sistema Juarez). As variáveis de estudo foram: idade, sexo, vacina, dose, manifestações clínicas e hospitalização. As taxas foram estimadas tomando-se os casos de eventos adversos pós-vacina como numerador e as doses aplicadas, como denominador. Estimou-se a sensibilidade da vigilância de eventos adversos pós-vacina aplicando-se o método proposto pelo Centers for Disease Control and Prevention. Para análise de tendência utilizou-se a regressão de Prais-Winsten, considerando o nível de significância de 5,0%. RESULTADOS A taxa anual média de eventos adversos pós-vacina foi de 11,3/10.000 doses aplicadas, porém, sem tendência no período estudado (p = 0,491). Houve predomínio de casos após a primeira dose (41,7%) e entre menores de um ano de idade (72,6%). As vacinas com componente pertussis, de febre amarela e de sarampo-caxumba-rubéola foram as mais reatogênicas. Destacou-se a frequência de episódio hipotônico hiporresponsivo e convulsão, com taxas de 4,1/10.000 e 1,5/10.000 doses de vacinas com componente pertussis, respectivamente, mais elevadas na primeira dose; 60,0% dos casos apresentaram sintomas nas primeiras 24 horas após a vacinação e 18,6% apresentaram-se após 96 horas. A sensibilidade da vigilância foi estimada em 71,9% e 78,9% para episódio hipotônico hiporresponsivo e convulsão, respectivamente. CONCLUSÕES O sistema de vigilância de eventos adversos pós-vacina com base no registro informatizado de imunização mostrou-se útil e dotado de elevada sensibilidade para descrever o perfil de segurança das vacinas em um município de médio porte. Adicionalmente, a expressiva ampliação, na última década, das vacinas incluídas no esquema básico de vacinação na infância não alterou o elevado padrão de segurança do Programa Nacional de Imunizações.

ABSTRACT OBJECTIVE To describe adverse events following vaccination (AEFV) of children under two years old and analyze trend of this events from 2000 to 2013, in the city of Araraquara (SP), Brazil. METHODS This is a descriptive study conducted with data of the passive surveillance system of AEFV that is available in the electronic immunization registry (EIR) of the computerized medical record of the municipal health service (Juarez System). The study variables were: age, gender, vaccine, dose, clinical manifestations and hospitalization. We estimated rates using AEFV as numerator and administered doses of vaccines as denominator. The surveillance sensitivity was estimated by applying the method proposed by the Centers for Disease Control and Prevention. We used Prais-Winsten regression with a significance level of 5.0%. RESULTS The average annual rate of AEFV was 11.3/10,000 administered doses, however without a trend in the study period (p=0.491). Most cases occurred after the first dose (41.7%) and among children under one year of age (72.6%). Vaccines with pertussis component, yellow fever and measles-mumps-rubella were the most reactogenic. We highlighted the rates of hypotonic-hyporesponsive episodes and convulsion that were 4.1/10,000 and 1.5/10,000 doses of vaccines with pertussis component, respectively, most frequently in the first dose; 60,0% of cases presented symptoms in the first 24 hours after vaccination, however, 18.6% showed after 96 hours. The sensitivity of surveillance was 71.9% and 78.9% for hypotonic-hyporesponsive episodes and convulsion, respectively. CONCLUSIONS The EIR-based AEFV surveillance system proved to be useful and highly sensitive to describe the safety profile of vaccines in a medium-sized city. It was also shown that the significant increase of the vaccines included in the basic vaccination schedule in childhood in the last decade did not alter the high safety standard of the National Immunization Program.

https://doi.org/10.11606/s1518-8787.2018052000295 3709 downloads

11.

Use of electronic immunization registry in the surveillance of adverse events following immunization
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Sato, Ana Paula Sayuri

; Ferreira, Vinícius Leati de Rossi

; Tauil, Márcia de Cantuária

; Rodrigues, Laura Cunha

; Barros, Mariana Bernardes

; Martineli, Edmar

; Costa, Ângela Aparecida

; Inenami, Marta

; Waldman, Eliseu Alves

Revista de Saúde Pública

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2018, Volume 52 elocation 4

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2018052000295 178 downloads

12.

Stunting in children under five years old is still a health problem in the Western Brazilian Amazon: a population-based study in Assis Brasil, Acre, Brazil
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Mantovani, Saulo Augusto Silva

; Ramalho, Alanderson Alves

; Pereira, Thasciany Moraes

; Branco, Fernando Luiz Cunha Castelo

; Oliart-Guzmán, Humberto

; Delfino, Breno Matos

; Braña, Athos Muniz

; Martins, Antonio Camargo

; Filgueira-Júnior, José Alcântara

; Santos, Ana Paula

; Campos, Rhanderson Gardinali

; Guimarães, Andréia Silva

; Araújo, Thiago Santos de

; Oliveira, Cristieli Sérgio de Menezes

; Codeço, Cláudia Torres

; Silva-Nunes, Mônica da

Ciência & Saúde Coletiva

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jul 2016, Volume 21 N. 7 Pages 2257 - 2266

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Apesar do processo de transição nutricional no Brasil, em alguns lugares, como a região amazônica, o nanismo ainda é um importante problema de saúde pública. Identificou-se a prevalência e fatores associados ao déficit de crescimento em crianças menores de cinco anos de idade residentes na área urbana de Assis Brasil. Um inquérito foi realizado utilizando instrumento semiestruturado sobre características socioeconômicas, maternas e das crianças, e foram aferidas medidas antropométricas. As crianças com índice de estatura para idade inferior a -2 escores-Z foram consideradas com déficit de crescimento, de acordo com os critérios da Organização Mundial da Saúde. Quatrocentos e vinte e oito crianças foram avaliadas. Destas, 62 apresentaram déficit de crescimento. Os fatores associados à baixa estatura, de acordo com modelos ajustados, foram: presença de esgoto a céu aberto, índice de riqueza para as famílias, recebimento de ajuda financeira governamental, altura materna, idade e escolaridade maternas. Portanto, observou-se que as características familiares e da mãe, bem como fatores ambientais e socioeconômicos estavam intimamente relacionados com a ocorrência de déficit de crescimento na população estudada, e que a desnutrição ainda é um problema de saúde na Amazônia brasileira.

Abstract Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and children’s conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mother’s height, age and education. Therefore, it was observed that family and the mother’s characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.

https://doi.org/10.1590/1413-81232015217.18602014 668 downloads

13.

Stunting in children under five years old is still a health problem in the Western Brazilian Amazon: a population-based study in Assis Brasil, Acre, Brazil
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Mantovani, Saulo Augusto Silva

; Ramalho, Alanderson Alves

; Pereira, Thasciany Moraes

; Branco, Fernando Luiz Cunha Castelo

; Oliart-Guzmán, Humberto

; Delfino, Breno Matos

; Braña, Athos Muniz

; Martins, Antonio Camargo

; Filgueira-Júnior, José Alcântara

; Santos, Ana Paula

; Campos, Rhanderson Gardinali

; Guimarães, Andréia Silva

; Araújo, Thiago Santos de

; Oliveira, Cristieli Sérgio de Menezes

; Codeço, Cláudia Torres

; Silva-Nunes, Mônica da

Ciência & Saúde Coletiva

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jul 2016, Volume 21 N. 7 Pages 2257 - 2266

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232015217.18602014 2438 downloads

14.

USO DE RECEPTORES GPS DE 100 HZ NA DETECÇÃO DE DEFLEXÕES VERTICAIS MILIMÉTRICAS DE PONTES DE CONCRETO DE PEQUENO PORTE
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LAROCCA, ANA PAULA CAMARGO

; ARAÚJO NETO, JOÃO OLYMPIO DE

; TRABANCO, JORGE LUIZ ALVES

; BARBOSA, AUGUSTO CÉSAR BARROS

; CUNHA, ANDRÉ LUIZ BARBOSA NUNES DA

; SCHAAL, RICARDO ERNESTO

Boletim de Ciências Geodésicas

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jun 2015, Volume 21 N. 2 Pages 290 - 307

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

As últimas quatro décadas foram importantes para o desenvolvimento da malha rodoviária brasileira. O país recebeu incentivos financeiros para a sua expansão e diversas soluções estruturais para pontes e viadutos foram criadas. Em paralelo a este desenvolvimento, houve nos últimos anos um crescimento significativo dessas estruturas em estágio avançado de deterioração devido à ausência de programas de manutenção preventiva. Dessa maneira, este trabalho propõe o uso de receptores GPS num plano de monitoramento de curta duração para acompanhar o comportamento estrutural de uma ponte rodoviária curva de concreto armado já em serviço. E apresenta os primeiros resultados da pesquisa com a portadora L1 do sistema GPS e dados gravados com taxa de 100 Hz, no monitoramento do vão central de ponte de concreto de pequeno porte situada sobre o Rio Jaguari, na cidade de Extrema, divisa entre os Estados de Minas Gerais e São Paulo. O desafio reside no fato de que estruturas como estas - pontes de concreto de pequeno e médio porte - respondem pela grande maioria das obras de arte da malha rodoviária brasileira e por serem estruturas rígidas, apresentam deflexões verticais pequenas, de até 5mm. O experimento foi realizado por meio de sessões de observações com receptores GPS sobre a ponte, no vão instrumentado por equipamentos convencionais para posterior confrontação de resultados entre os receptores GPS e os métodos clássicos de monitoramento. A ferramenta de filtragem Continuos Wavelet Transform (CWT) foi utilizada para analisar as frequências de resposta da ponte a partir dos resíduos da dupla diferença de fase da portadora L1. A análise do espectro de energia da CWT gerado a partir dos dados coletados com os receptores GPS indicou alta concentração de energia nas mesmas faixas de frequência - de resposta do tabuleiro da ponte - apontadas pela Modelagem por Elementos Finitos e pela prova de carga dinâmica.

The last four decades were important for the Brazilian highway system. Financial investments were made so it could expand and many structural solutions for bridges and viaducts were developed. In parallel whit this development, there was a significant raise of pathologies in these structures, due to lack of maintenance procedures. Thus, this paper purposes the use of GPS to create a short-term monitoring plan in order to check the structural behavior of a curved highway concrete bridge in current use. And it present the first results of the research with the L1 GPS carrier frequency and recorded data at a rate of 100 Hz, at the monitoring center span of small concrete bridge located on the Jaguari River, in the city of Extreme which borders Minas Gerais and São Paulo states. The challenge lies in the fact that such structures, small and medium-sized concrete bridges, account for the vast majority of art works of Brazilian highways and, as they are rigid structures, small present up to 5 mm vertical deflections. This experiment was carried out through observations sessions with GPS receivers over the bridge at the span instrumented by conventional structural equipment for further confrontation of results between GPS receivers and classic methods of monitoring. The Continuous Wavelet Transform (CWT) was used to analyze the frequency of the response of the bridge from the residues of double difference carrier phase L1.The analysis of the CWT energy spectrum generated from the data collected with GPS receivers indicated a high concentration of energy in the same frequency bands - of the bridge deck response identified by the Finite Element Modeling and the dynamic load test.

https://doi.org/10.1590/S1982-21702015000200017 1868 downloads

15.

Crescimento e acúmulo de macronutrientes na cultura do melão em Baraúna - RN e Petrolina - PE
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Aguiar Neto, Pedro

; Grangeiro, Leilson Costa

; Mendes, Alessandra Monteiro Salviano

; Costa, Nivaldo Duarte

; Cunha, Ana paula Alves da

Revista Brasileira de Fruticultura

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sep 2014, Volume 36 N. 3 Pages 556 - 567

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Com o objetivo de avaliar o crescimento e o acúmulo de nutrientes por híbridos de melão desenvolveram-se experimentos em área comercial no município de Baraúna-RN, e na estação experimental de Bebedouro (Petrolina-PE) da Embrapa Semiárido. Em Baraúna-RN, o experimento foi desenvolvido de setembro a novembro de 2010, e em Petrolina-PE, de agosto a outubro de 2010. O delineamento experimental foi em blocos casualizados completos, com quatro repetições, em esquema fatorial 2 x 5. Os tratamentos resultaram da combinação de dois híbridos de melão (Iracema e Gran Prix) e cinco épocas de coletas de plantas (15; 25; 35; 45 e 55 dias após o transplante, DAT). Para se fazer um programa de adubação na cultura do meloeiro, tanto do grupo Amarelo como do grupo Pele-de-Sapo, observou-se um crescimento lento no início, maior incremento da parte aérea de 35 a 45 DAT e maior exigência da planta para o estádio de frutificação de 35 a 45 DAT para 'Iracema' e 45 a 55 DAT para 'Gran Prix' Quanto ao acúmulo, para os dois materiais e nos dois locais, observou-se a seguinte ordem: K>N>P>Ca>Mg.

Aiming to evaluate the growth and nutrient accumulation by hybrid melon experiments were developed in commercial area in the city of Baraúna - RN and in the experimental station Embrapa Semi-Arid (Petrolina - PE). In Baraúna - RN, the experiment was conducted from September to November 2010 and in Petrolina - PE from August to October 2010. The experimental design was a completely randomized design with four replications in a factorial 2 x 5. Treatments resulted from the combination of two melon hybrids (Iracema and Gran Prix) and five periods of the gathering of samples plants (15, 25, 35, 45 and 55 days after transplanting 'DAT'). To make a fertilization program in the melon, such as the Yellow Group as the Group of Skin Frog, there was a slow growth in the beginning, the greater increase in aerial parts was from 35 to 45 DAT, and the requirement for the fruiting stage from 35 to 45 DAT for Iracema and 45 to 55 DAT for Grand Prix; was observed the following order: K > N > P > Ca > Mg for the accumulation of nutrients in the two samples of the two cities.

https://doi.org/10.1590/0100-2945-192/13 19248 downloads

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