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

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

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

Effects of neuromodulation on executive functions and food desires in individuals with obesity: a systematic review
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da Silva-Lira-Batista, Marta Maria

; Lima-Silagi, Marcela

; Freire-Lima, Gleydyson Wesley

; Moreira-da Silva, Jaynara Keylla

; Carvalho-Silva, Maria Rita

; Dantas-de França, Laureni

; Galhardoni, Ricardo

; Pereira-da Silva, Janyerson Dannys

; Mendes-Benigno, Maria Ivone

; de Moura-Filho, Oseas Florêncio

; de Carvalho-e Martins, Maria do Carmo

Nutrición Hospitalaria

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feb 2023, Volume 40 N. 1 Pages 177 - 185

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

Resumen Objetivo: describir los efectos de la neuromodulación en el desempeño de funciones ejecutivas en pacientes con sobrepeso y/o obesidad. Métodos: se seleccionaron artículos publicados en las bases de datos PubMed, ScienceDirect, BIREME y Web of Science utilizando la siguiente combinación de descriptores: (“resolución de problemas” O “función ejecutiva” O memoria) Y (tDCS O TMS) Y obesidad. Después de aplicar los criterios de selección, 08 artículos fueron incluidos para el análisis. Resultados: los artículos incluidos tuvieron un promedio de 30,1 participantes por estudio, con un mínimo de 12 y un máximo de 76. El estado nutricional general osciló entre bajo peso y obesidad grado 3, y el índice de masa corporal promedio general fue de 28,1 kg/m2. En cuanto a los instrumentos utilizados para evaluar las funciones ejecutivas, los más frecuentes fueron: paradigma del flanqueador; rivalidad binocular para la supresión continua de flash (bCFS/NoCFS); tarea de Stroop; Tarea Go/No-Go; y tarea N-back. Los resultados primarios dependieron del sitio objetivo de la neuromodulación. Se observó una reducción del antojo de alimentos y un mejor rendimiento en el grupo activo debido a la disminución del tiempo de respuesta y al aumento de la precisión en las tareas cognitivas. Conclusión: la neuromodulación puede generar cambios en las funciones ejecutivas, reduciendo el antojo de alimentos en personas con sobrepeso y obesidad.

Abstract Objective: to describe the effects of neuromodulation on the performance of executive functions in overweight and/or individuals with obesity. Methods: articles published in PubMed, ScienceDirect, BIREME, and Web of Science databases were selected using the following combination of descriptors: (“problem solving” OR “executive function” OR memory) AND (tDCS OR TMS) AND obesity. After applying the selection criteria, 08 articles were included for analysis. Results: the articles included had an average of 30.1 participants per study, with a minimum of 12 and a maximum of 76. The overall nutritional status ranged from underweight to grade 3 obesity, and the general mean body mass index was 28,1 kg/m2. Regarding the instruments used to assess executive functions, the most frequent were: the flanker paradigm; binocular rivalry for Continuous Flash Suppression (bCFS/NoCFS); Stroop task; Go/No-Go task; and N-back task. The primary outcomes were dependent on the neuromodulation target site. Reduced food craving and improved performance in the active group were observed from decreased response time and increased precision in cognitive tasks. Conclusion: neuromodulation can generate changes in executive functions, reducing food cravings in overweight and individuals with obesity.

https://doi.org/10.20960/nh.04100

Clinical Aspects Of Hypertensive Patients With COVID-19 Hospitalized In A Campaign Hospital In Northeast Brazil
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Xavier, Luan George

; Mello Neto, Renato Sampaio

; Morais, Marcos Henrique de Oliveira

; Cronemberger, Pedro Jorge

; Martins, Maria do Carmo Carvalho

; Rosal, Marta

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220033

Abstract: En | Text: En | PDF: En

Abstract Background In view of the absence of effective therapy for COVID-19, many studies have been conducted seeking to identify determining factors for the development of severe forms, aiming to direct efforts to avoid the worst outcomes in patients susceptible to severe conditions. One of the main comorbidities associated with complicated forms of the disease is systemic arterial hypertension (SAH). Objective To assess aspects of the clinical, demographic, laboratory, and radiological characteristics of hypertensive patients with COVID-19 to contribute to the knowledge of the relationship between the presence of this comorbidity and the severity of the disease. Methods A total of 380 patients with a diagnosis of acute SARS-CoV-2 infection hospitalized between June and August 2020 were included. Patients were divided into two groups according to the presence or absence of a previous diagnosis of hypertension. For comparison between groups, a significant difference was established if p < 0.05. Results Of the total of 380 patients, 202 (53.16%) had a clinical diagnosis of SAH. Hypertensive patients were significantly older (p < 0.01) and had more comorbidities (p < 0.01) than the non-hypertensive group. In laboratory tests, hypertensive patients had higher levels of blood glucose (p = 0.014), creatinine (p = 0.002), and urea (p = 0.003), while values for alanine aminotransferase (ALT) (p < 0.01), aspartate aminotransferase (AST) (p = 0.006), and sodium (p = 0.024) were lower. There was no difference between groups in radiographic parameters. Conclusions This study showed that, although the hypertensive group had some laboratory alterations that elicited severe disease, these patients did not have worse outcomes.

https://doi.org/10.36660/ijcs.20220033

Subclinical signs of podocyte injury associated with Circulating Anodic Antigen (CAA) in Schistosoma mansoni-infected patients in Brazil
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Sousa, Mariana Silva

; Meneses, Gdayllon Cavalcante

; Dam, Govert Jan van

; Corstjens, Paul Leo Albert Maria

; Galvão, Rosangela Lima de Freitas

; Pinheiro, Marta Cristhiany Cunha

; Martins, Alice Maria Costa

; Daher, Elizabeth de Francesco

; Bezerra, Fernando Schemelzer de Moraes

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0341-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: The long-term effects of schistosomiasis on the glomerulus may contribute to the development of chronic kidney disease. This study aimed to investigate baseline Schistosoma mansoni-Circulating Anodic Antigen (CAA) levels and their association with kidney biomarkers related to podocyte injury and inflammation in long-term follow-up after praziquantel (PZQ) treatment. Methods: Schistosoma infection was diagnosed by detecting CAA in urine using a quantitative assay based on lateral flow using luminescent up-converting phosphor reporter particles. A cutoff threshold of 0.1 pg/mL CAA was used to diagnose Schistosoma infection (baseline) in a low-prevalence area in Ceará, Northeast, Brazil. Two groups were included: CAA-positive and CAA-negative individuals, both of which received a single dose of PZQ at baseline. Urinary samples from 55 individuals were evaluated before (baseline) and at 1, 2, and 3 years after PZQ treatment. At all time points, kidney biomarkers were quantified in urine and adjusted for urinary creatinine levels. Results: CAA-positive patients had increased baseline albuminuria and proteinuria and showed greater associations between kidney biomarkers. CAA levels correlated only with Vascular Endothelial Growth Factor (VEGF) (podocyte injury) levels. Increasing trends were observed for malondialdehyde (oxidative stress), monocyte chemoattractant protein-1 (inflammation marker), and VEGF. In the follow-up analysis, no relevant differences were observed in kidney biomarkers between the groups and different periods. Conclusions: S. mansoni-infected individuals presented subclinical signs of glomerular damage that may reflect podocyte injury. However, no causal effect on long-term renal function was observed after PZQ treatment.

https://doi.org/10.1590/0037-8682-0341-2022

A brazilian nationwide multicenter study on deficiency of deaminase-2 (DADA2)
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Melo, Adriana

; Carvalho, Luciana Martins de

; Ferriani, Virginia Paes Leme

; Cavalcanti, André

; Appenzeller, Simone

; Oliveira, Valéria Rossato

; Chong Neto, Herberto

; Rosário, Nelson Augusto

; Poswar, Fabiano de Oliveira

; Guimaraes, Matheus Xavier

; Kokron, Cristina Maria

; Maia, Rayana Elias

; Silva, Guilherme Diogo

; Keller, Gabriel

; Ferreira, Mauricio Domingues

; Vasconcelos, Dewton Moraes

; Toledo-Barros, Myrthes Anna Maragna

; Barros, Samar Freschi

; Rosa Neto, Nilton Salles

; Krieger, Marta Helena

; Kalil, Jorge

; Mendonça, Leonardo Oliveira

Advances in Rheumatology

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2023, Volume 63 elocation 23

Abstract: En | Text: En | PDF: En

Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t).

https://doi.org/10.1186/s42358-023-00303-5

Separation and quantification of milk proteins with the addition of cheese whey by lab-on-a-chip
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Santos, Alessa Siqueira de Oliveira dos

; Pereira, Hyago Passe

; Fogaça, Gisele Nogueira

; Meurer, Vaneida Maria

; Furtado, Marco Antônio Moreira

; Borges, Cristiano Amâncio Vieira

; Weller, Mayara Morena Del Cambre Amaral

; Martins, Marta Fonseca

Pesquisa Agropecuária Brasileira

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2023, Volume 58 elocation e03099

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

Abstract The objective of this work was to evaluate microfluidic chip electrophoresis, known as lab-on-a-chip technique, for the detection of milk adulteration using cheese whey in comparison with SDS-PAGE. Raw, pasteurized, processed at an ultra-high temperature (UHT), and powdered milk samples received increasing concentrations of cheese whey (0, 1, 2.5, 5, 10, 20, 30, 50, and 100% v/v), and were subjected to lab-on-a-chip electrophoresis and SDS-PAGE to detect their mixtures. The lab-on-a-chip methodology was able to separate and quantify milk proteins. In addition, the tested technique is easy, rapid, sensitive, and can detect the addition of cheese whey in milk from the lowest level tested (1%) for milk proteins α-casein and β-casein.

Resumo O objetivo deste trabalho foi avaliar a eletroforese com dispositivo de microfluidos, conhecida como técnica lab-on-a-chip, para detecção de adulteração de leite com soro de queijo, em comparação ao SDS-PAGE. Amostras de leite cru, pasteurizado, processado em temperatura ultra-alta (UHT) e em pó receberam adição de soro de queijo em concentrações crescentes (0, 1, 2,5, 5, 10, 20, 30, 50 e 100% v/v) e foram submetidas a eletroforese lab-on-a-chip e SDS-PAGE para detectar suas misturas. A metodologia lab-on-a-chip foi capaz de separar e quantificar as proteínas do leite. Além disso, a técnica lab-on-a-chip é fácil, rápida, sensível e pode detectar adição de soro de queijo no leite do nível mais baixo testado (1%) para as proteínas do leite α-caseína e β-caseína.

https://doi.org/10.1590/s1678-3921.pab2023.v58.03099

Nosocomial Infections. COVID-19: A Friend or Foe?
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Moreira, Laura Bonito

; Martins-dos-Santos, Gonçalo

; Ilharco, Marta

; Vieira, Marta Mello

; Midões, Carolina

; Rocha, Inês

; Soares, Leonor

; Fevereiro, Maria do Carmo

Medicina Interna

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mar 2022, Volume 29 N. 1 Pages 13 - 19

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

Abstract: Introduction: Nosocomial Infections constitute a public health problem and bring excess avoidable costs associated with hospital admissions. Over the COVID-19 pandemics there was a shift in policies focusing on infection prevention and control programs. Methods: We postulate that such shift may have an indirect effect in the occurrence of nosocomial infections. We performed a retrospective study aiming to compare the differences in nosocomial infection prevalence between a COVID-19 period and a non-COVID-19 period, in a free-COVID-19 Internal Medicine ward from a central hospital in Lisbon. We included 393 patients, 192 patients being from the non-COVID-19 period and 201 patients from the COVID-19 period. Results: We found a statistically significant reduction in the occurrence of nosocomial infections in the COVID-19 period from 16.1% (n = 31) to 5.5% (n = 11) (p = 0.001; OR 0.301; 95% CI: 0.146-0.617). We also found a statistically significant reduction in antibiotic usage (n = 31; 16.1% vs n = 11; 5.5%; p = 0.001) and in the occurrence of multidrug resistant organism infection (n = 9; 29.0% vs n = 1; 9.1%; p = 0.009) in the COVID-19 period. Conclusion: Our results confirm that after implementation of systematic infection control protocols there was a reduction in nosocomial infections. We suggest further investigation to validate the data obtained and a cost-benefit analysis to clarify whether the universal implementation of infection prevention and control measures will add value to the treatment of patients.

Resumo: Introdução: As infeções nosocomiais constituem um problema de saúde pública e trazem custos excessivos evitáveis associados aos internamentos hospitalares. Durante a pandemia da COVID-19, houve uma mudança nas políticas com foco em programas de prevenção e controlo de infeção. Métodos: Postulamos que tal mudança pode ter um efeito indireto na ocorrência de Infeções nosocomiais. Realizámos um estudo retrospetivo com o objetivo de comparar as diferenças na prevalência de infeção hospitalar entre um período COVID-19 e um período não COVID-19, numa enfermaria de Medicina Interna de um hospital central de Lisboa, sem doen-tes com COVID-19. Foram incluídos 393 pacientes, sendo 192 do período não COVID-19 e 201 do período COVID-19. Resultados: Encontramos uma redução estatisticamente significativa na ocorrência de infeções nosocomiais no período COVID-19 de 16,1% (n = 31) para 5,5% (n = 11) (p = 0,001; OR 0,301; IC 95%: 0,146-0,617). Também encontramos uma redução estatisticamente significativa no uso de antibióticos (n = 31; 16,1% vs n = 11; 5,5%; p = 0,001) e na ocorrência de infeção por organismos multirresistentes (n = 9; 29,0% vs n = 1; 9,1%; p = 0,009) no período COVID-19. Conclusão: Estes resultados confirmam que, após a implementação de protocolos sistemáticos de controlo de infeção, houve uma redução nas infeções nosocomiais. Sugerimos uma investigação mais aprofundada para validar os dados obtidos e uma análise custo-benefício para esclarecer se a implementação universal das medidas de prevenção e controlo de infeção constituirão uma mais-valia para o tratamento dos doentes.

https://doi.org/10.24950/rspmi.2022.01.292 8 downloads

Development and Characterization of a Hydrogel Containing Silver Sulfadiazine for Antimicrobial Topical Applications. Part II: Stability, Cytotoxicity and Silver Release Patterns
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Vaz, Lilian Vieira

; Balcão, Victor Manuel

; Oliveira Jr, José Martins

; Tubino, Matthieu

; Jozala, Angela

; Yoshida, Valquíria Miwa Hanai

; Vila, Marta Maria Duarte Carvalho

Brazilian Journal of Pharmaceutical Sciences

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2022, Volume 58 elocation e18688

Abstract: En | Text: En | PDF: En

Abstract Hydrogels are interesting for use in the treatment of topical wounds due to their virtually zero toxicity, and capacity for extended release of pharmaceuticals. Silver sulfadiazine (SSDZ) is the drug of choice in the treatment of skin burns. The aim of the study was to determine cytotoxicity, antimicrobial activity and stability of a PVA hydrogel with integrated silver sulfadiazine. SSDZ-hydrogels were prepared using 10% (w/w) PVA (either 89% or 99% hydrolyzed) and 1% (w/w) silver sulfadiazine. Cellular viability was assessed via MTS assays, antimicrobial activity via disk-diffusion and accelerated stability tests were carried out with analysis at 0, 30, 60, 90 and 180 days of storage at 40 ± 2 °C and a relative humidity of 75 ± 5%. The parameters evaluated included organoleptic characteristics, moisture, swelling ability, mechanical strength, FTIR, XRD, TGA and DSC, and silver release patterns via XRD and potentiometry. Cell viability tests indicated some cytotoxicity, although within acceptable levels. After 90 days of storage, SSDZ hydrogel samples exhibited a brown coloration, probably due to the formation of Ag or Ag2O nanoparticles. The SSDZ-loaded hydrogels suffered visual and physical changes; however, these changes did not compromise its use as occlusive wound dressings or its antimicrobial properties.

https://doi.org/10.1590/s2175-97902022e18688

Influence of eCG and reproductive management in the resynchronization of ovulation in dairy goats
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Cosentino, Isabel Oliveira

; Balaro, Mário Felipe Alvares

; Silva, Polyanne Martins da

; Taira, Augusto Ryonosuke

; Santos, Juliana Dantas Rodrigues

; Ribeiro, Ana Clara Sarzedas

; Figueiredo, Bruna Ramalho Rigaud de

; Costa, Marta Maria Campos Pereira da

; Vieira, Bruno Ribeiro

; Brandão, Felipe Zandonadi

Animal Reproduction

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2022, Volume 19 N. 3 elocation e20210112

Abstract: En | Text: En | PDF: En

Abstract Resynchronization protocols have been proposed as a way of shortening females’ unproductive time in the flock, with good results in cattle and sheep. In goats, initial studies have shown that a second progestogen device inserted before luteolysis and pregnancy diagnosis does not interfere with the corpus luteum lifespan or functionality. This study aimed to evaluate the follicular growth, ovulation pattern and pregnancy rate after insertion of a second and new progestogen device for resynchronizing, with or without equine Chorionic Gonadotrophin (eCG), submitted to natural mating (NM) or artificial insemination (AI) to propose a viable resynchronization protocol for dairy goats. A total of 38 multiparous Saanen goats underwent a short-term progesterone protocol [six days exposed to medroxyprogesterone acetate (MAP) intravaginal sponges + 200 IU eCG and 0.12 mg of cloprostenol sodium on the 5th day + 0.025 mg of lecirelin 34 hours after sponge withdrawal] and, on day 16th after the ovulation, received a new MAP device which was retained until day 21. At this moment females were split into four groups: GeCG+NM – 100 IU eCG with NM; GSal+NM – saline solution with NM; GeCG+AI – 100 IU eCG with AI; and GSal+AI – saline solution with AI. Ultrasound scans were performed every 12 h from sponge withdrawal (day 21) until 108 h after sponge withdrawal (day 25) for follicular dynamics evaluation, at 240 h (day 31) for assessing the presence of active corpus luteum, and on day 60 for pregnancy diagnosis. No differences were found regarding ovulation time, synchronization and follicle size. However, GeCG+NM presented a greater estrus manifestation rate (100%) and pregnancy rate (62.5%) when compared to GSal+AI. In conclusion, resynchronization protocols in dairy goats may present satisfactory results.

https://doi.org/10.1590/1984-3143-ar2021-0112

10.

ENFERMAGEM DE REABILITAÇÃO EM TRANSPLANTE CARDÍACO (ERTXC) - APRESENTAÇÃO DE PROJETO DE INTERVENÇÃO
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Loureiro, Maria

; Costa, Marta

; Sola, Emília

; Coutinho, Gonçalo

; Martins, Maria Manuela

; Novo, André

Revista Portuguesa de Enfermagem de Reabilitação

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jun 2021, Volume 4 N. 1 Pages 37 - 46

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

Resumen Introducción: La rehabilitación cardíaca (RC) es una intervención multifactorial, generalmente compuesta por ejercicio físico estructurado, apoyo psicológico y educación para la salud. La estructuración en las diferentes fases de la RC para esta población específica no ha sido profundamente estudiada, y existen lagunas en la evidencia científica sobre los beneficios en salud resultantes de los programas de RC. La literatura sobre cuidadores / familiares también es escasa. El objetivo de este estudio es identificar en qué dominios pueden intervenir las enfermeras especializadas en rehabilitación para desarrollar beneficios para la salud de los receptores de trasplantes de corazón y sus cuidadores / familiares. Método: Para hacer operativa esta intervención, se utilizará el Modelo de Resultados de Calidad en Salud de Doran, en el componente de resultados sensibles al cuidado de enfermería. Se realizarán dos estudios de forma simultánea, uno dirigido a la rehabilitación cardíaca del trasplantado (fases 1, 2 y 3) y el otro centrado en la rehabilitación cardíaca del cuidador / familia. Las metodologías utilizadas serán la revisión de alcance, el caso clínico, el estudio exploratorio y el estudio clínico aleatorizado (con grupo de intervención y grupo de control). Discusión/Resultados esperados: El Programa de Enfermería de Rehabilitación en Trasplante Cardíaco (ERtxC) se construirá e implementará, en sus diferentes fases, durante los años 2021 y 2022. Se estima que el programa puede ser accedido por 150 pacientes trasplantados cardíacos y sus respectivos familias / cuidador. Conclusión: Para fines del año 2022, se estima haber llegado al final de este programa, con la respectiva evaluación de los logros en salud. Una vez validado este programa, se intentará crear de forma permanente esta oferta de forma sistemática para todas las personas sometidas a trasplante de corazón, en Portugal.

Resumo Introdução: A Reabilitação Cardíaca (RC) é uma intervenção multifactorial, geralmente composta por exercício físico estruturado, apoio psicológico e educação para a saúde. A estruturação nas diferentes fases de RC para esta população específica não está profundamente estudada, existindo lacunas na evidência científica relativamente aos ganhos em saúde decorrentes de programas de RC. A literatura relativa ao cuidador/família é também escassa. O objetivo deste estudo é identificar em que domínios é que os enfermeiros especialistas de reabilitação poderão intervir de forma a desenvolver ganhos em saúde de pessoas transplantadas cardíacas e seu cuidador/família. Método: Para a operacionalização desta intervenção será utilizado oThe Quality Health Outcomes Model, de Doran, na componente de resultados sensíveis aos cuidados de enfermagem. Serão efetuados de forma concorrente 2 estudos, um direcionado à reabilitação cardíaca da pessoa transplantada (fases 1, 2 e 3) e outro com enfoque na reabilitação cardíaca do cuidador/família. As metodologias utilizadas serão ascoping review, o relato de caso, o estudo exploratório e o estudo clínico randomizado (com grupo de intervenção e grupo de controlo). Discussão/Resultados Esperados: Será construído e implementado o programa Enfermagem de Reabilitação em Transplante Cardíaco (ERtxC), nas suas diferentes fases, durante os anos de 2021 e 2022. Estima-se que o programa possa ser acedido por 150 pessoas transplantadas cardíacas e respetivas famílias/cuidador. Conclusão: No final do ano de 2022 estima-se ter chegado ao final deste programa, com respetiva avaliação dos ganhos em saúde. Após validação deste programa, tentar-se-á criar em definitivo esta oferta de forma sistemática para todas pessoas submetidas a transplante cardíaco, em Portugal.

Abstract Introduction: Cardiac Rehabilitation (CR) is a multifactorial intervention, usually composed of structured physical exercise, psychological support and health education. The structuring in the different phases of CR for this specific population has not been deeply studied, with gaps in the scientific evidence regarding health gains resulting from CR programs. The caregiver / family literature is also scarce. The aim of this study is to identify in which domains rehabilitation nurses can intervene in order to develop health gains in heart transplant recipients and their caregivers/family. Method: To make this intervention operational, Doran's The Quality Health Outcomes Model will be used, in the component of results sensitive to nursing care. Two studies will be carried out concurrently, one aimed at the cardiac rehabilitation of the transplanted person (phases 1, 2 and 3) and the other focusing on the cardiac rehabilitation of the caregiver / family. The methodologies used will be thescoping review, the case report, the exploratory study and the randomized clinical study (with intervention group and control group). Discussion/Expected Results: The Rehabilitation Nursing in Cardiac Transplant Program (ERtxC) will be built and implemented, in its different phases, during the years 2021 and 2022. It is estimated that the program can be accessed by 150 heart transplant patients and their respective families / caregiver. Conclusion: At the end of the year 2022, it is estimated to have reached the end of this program, with the respective assessment of health gains. After validation of this program, an attempt will be made to permanently create this offer in a systematic way for all people undergoing heart transplantation in Portugal.

https://doi.org/10.33194/rper.2021.v4.n1.160 52 downloads

11.

The Program for Biodiversity Research in Brazil: The role of regional networks for biodiversity knowledge, dissemination, and conservation
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ROSA, CLARISSA

; BACCARO, FABRICIO

; CRONEMBERGER, CECILIA

; HIPÓLITO, JULIANA

; BARROS, CLAUDIA FRANCA

; RODRIGUES, DOMINGOS DE JESUS

; NECKEL-OLIVEIRA, SELVINO

; OVERBECK, GERHARD E.

; DRECHSLER-SANTOS, ELISANDRO RICARDO

; ANJOS, MARCELO RODRIGUES DOS

; FERREGUETTI, ÁTILLA C.

; AKAMA, ALBERTO

; MARTINS, MARLÚCIA BONIFÁCIO

; TOMAS, WALFRIDO MORAES

; SANTOS, SANDRA APARECIDA

; FERREIRA, VANDA LÚCIA

; CUNHA, CATIA NUNES DA

; PENHA, JERRY

; PINHO, JOÃO BATISTA DE

; SALIS, SUZANA MARIA

; DORIA, CAROLINA RODRIGUES DA COSTA

; PILLAR, VALÉRIO D.

; PODGAISKI, LUCIANA R.

; MENIN, MARCELO

; BÍGIO, NARCÍSIO COSTA

; ARAGÓN, SUSAN

; MANZATTO, ANGELO GILBERTO

; VÉLEZ-MARTIN, EDUARDO

; SILVA, ANA CAROLINA BORGES LINS E

; IZZO, THIAGO JUNQUEIRA

; MORTATI, AMANDA FREDERICO

; GIACOMIN, LEANDRO LACERDA

; ALMEIDA, THAÍS ELIAS

; ANDRÉ, THIAGO

; SILVEIRA, MARIA AUREA PINHEIRO DE ALMEIDA

; SILVEIRA, ANTÔNIO LAFFAYETE PIRES DA

; MESSIAS, MARILUCE REZENDE

; MARQUES, MARCIA C.M.

; PADIAL, ANDRE ANDRIAN

; MARQUES, RENATO

; BITAR, YOUSZEF O.C.

; SILVEIRA, MARCOS

; MORATO, ELDER FERREIRA

; PAGOTTO, RUBIANI DE CÁSSIA

; STRUSSMANN, CHRISTINE

; MACHADO, RICARDO BOMFIM

; AGUIAR, LUDMILLA MOURA DE SOUZA

; FERNANDES, GERALDO WILSON

; OKI, YUMI

; NOVAIS, SAMUEL

; FERREIRA, GUILHERME BRAGA

; BARBOSA, FLÁVIA RODRIGUES

; OCHOA, ANA C.

; MANGIONE, ANTONIO M.

; GATICA, AILIN

; CARRIZO, MARÍA CELINA

; RETTA, LUCÍA MARTINEZ

; JOFRÉ, LAURA E.

; CASTILLO, LUCIANA L.

; NEME, ANDREA M.

; RUEDA, CARLA

; TOLEDO, JOSÉ JULIO DE

; GRELLE, CARLOS EDUARDO VIVEIROS

; VALE, MARIANA M.

; VIEIRA, MARCUS VINICIUS

; CERQUEIRA, RUI

; HIGASHIKAWA, EMÍLIO MANABU

; MENDONÇA, FERNANDO PEREIRA DE

; GUERREIRO, QUÊZIA LEANDRO DE MOURA

; BANHOS, AUREO

; HERO, JEAN-MARC

; KOBLITZ, RODRIGO

; COLLEVATTI, ROSANE GARCIA

; SILVEIRA, LUÍS FÁBIO

; VASCONCELOS, HERALDO L.

; VIEIRA, CECÍLIA RODRIGUES

; COLLI, GUARINO RINALDI

; CECHIN, SONIA ZANINI

; SANTOS, TIAGO GOMES DOS

; FONTANA, CARLA S.

; JARENKOW, JOÃO A.

; MALABARBA, LUIZ R.

; RUEDA, MARTA P.

; ARAUJO, PUBLIO A.

; PALOMO, LUCAS

; ITURRE, MARTA C.

; BERGALLO, HELENA GODOY

; MAGNUSSON, WILLIAM E.

Anais da Academia Brasileira de Ciências

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2021, Volume 93 N. 2 elocation e20201604

Abstract: En | Text: En | PDF: En

Abstract The Program for Biodiversity Research (PPBio) is an innovative program designed to integrate all biodiversity research stakeholders. Operating since 2004, it has installed long-term ecological research sites throughout Brazil and its logic has been applied in some other southern-hemisphere countries. The program supports all aspects of research necessary to understand biodiversity and the processes that affect it. There are presently 161 sampling sites (see some of them at Supplementary Appendix), most of which use a standardized methodology that allows comparisons across biomes and through time. To date, there are about 1200 publications associated with PPBio that cover topics ranging from natural history to genetics and species distributions. Most of the field data and metadata are available through PPBio web sites or DataONE. Metadata is available for researchers that intend to explore the different faces of Brazilian biodiversity spatio-temporal variation, as well as for managers intending to improve conservation strategies. The Program also fostered, directly and indirectly, local technical capacity building, and supported the training of hundreds of undergraduate and graduate students. The main challenge is maintaining the long-term funding necessary to understand biodiversity patterns and processes under pressure from global environmental changes.

https://doi.org/10.1590/0001-3765202120201604 1034 downloads

12.

Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
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Fink, Thais T.

; Marques, Heloisa H.S.

; Gualano, Bruno

; Lindoso, Livia

; Bain, Vera

; Astley, Camilla

; Martins, Fernanda

; Matheus, Denise

; Matsuo, Olivia M.

; Suguita, Priscila

; Trindade, Vitor

; Paula, Camila S.Y.

; Farhat, Sylvia C.L.

; Palmeira, Patricia

; Leal, Gabriela N.

; Suzuki, Lisa

; Odone Filho, Vicente

; Carneiro-Sampaio, Magda

; Duarte, Alberto José S.

; Antonangelo, Leila

; Batisttella, Linamara R.

; Polanczyk, Guilherme V.

; Pereira, Rosa Maria R.

; Carvalho, Carlos Roberto R.

; Buchpiguel, Carlos A.

; Latronico, Ana Claudia

; Seelaender, Marilia

; Silva, Clovis Artur

; Pereira, Maria Fernanda B.

; Sallum, Adriana M. E.

; Brentani, Alexandra V. M.

; Neto, Álvaro José S.

; Ihara, Amanda

; Santos, Andrea R.

; Canton, Ana Pinheiro M.

; Watanabe, Andreia

; Santos, Angélica C. dos

; Pastorino, Antonio C.

; Franco, Bernadette D. G. M.

; Caruzo, Bruna

; Ceneviva, Carina

; Martins, Carolina C. M. F.

; Prado, Danilo

; Abellan, Deipara M.

; Benatti, Fabiana B.

; Smaria, Fabiana

; Gonçalves, Fernanda T.

; Penteado, Fernando D.

; Castro, Gabriela S. F. de

; Gonçalves, Guilherme S.

; Roschel, Hamilton

; Disi, Ilana R.

; Marques, Isabela G.

; Castro, Inar A.

; Buscatti, Izabel M.

; Faiad, Jaline Z.

; Fiamoncini, Jarlei

; Rodrigues, Joaquim C.

; Carneiro, Jorge D. A.

; Paz, Jose A.

; Ferreira, Juliana C.

; Ferreira, Juliana C. O.

; Silva, Katia R.

; Bastos, Karina L. M.

; Kozu, Katia

; Cristofani, Lilian M.

; Souza, Lucas V. B.

; Campos, Lucia M. A.

; Silva Filho, Luiz Vicente R. F.

; Sapienza, Marcelo T.

; Lima, Marcos S.

; Garanito, Marlene P.

; Santos, Márcia F. A.

; Dorna, Mayra B.

; Aikawa, Nadia E.

; Litvinov, Nadia

; Sakita, Neusa K.

; Gaiolla, Paula V. V.

; Pasqualucci, Paula

; Toma, Ricardo K.

; Correa-Silva, Simone

; Sieczkowska, Sofia M.

; Imamura, Marta

; Forsait, Silvana

; Santos, Vera A.

; Zheng, Yingying

Clinics

Journal Metrics
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2021, Volume 76 elocation e3511

Abstract: En | Text: En | PDF: En

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.

https://doi.org/10.6061/clinics/2021/e3511

13.

Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
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Jácome, Cristina

; Amaral, Rita

; Almeida, Rute

; Pereira, Ana Margarida

; Couto, Mariana

; Araújo, Luís

; Alves-Correia, Magna

; Pereira, Mariana

; Ferreira-Magalhães, Manuel

; Loureiro, Cláudia Chaves

; Catarata, Maria Joana

; Santos, Lília Maia

; Cabral, Sara

; Pereira, João

; Ramos, Bárbara

; Lopes, Cristina

; Mendes, Ana

; Lopes, Anabela

; Rodrigues, José Carlos Cidrais

; Oliveira, Georgeta

; Aguiar, Ana Paula

; Afonso, Ivete

; Carvalho, Joana

; Arrobas, Ana Maria

; Costa, José

; Valério, Margarida

; Pereira, Marta

; Almeida, Teresa

; Dias, Joana

; Bom, Ana Todo

; Azevedo, João

; Ribeiro, Carmelita

; Alves, Marta

; Pinto, Paula Leiria

; Neuparth, Nuno

; Neves, Ana Castro

; Palhinha, Ana

; Marques, João Gaspar

; Martins, Pedro

; Trincão, David Pina

; Todo-Bom, Filipa

; Santos, Maria Alvarenga

; Branco, Joana

; Costa, Alberto

; Neto, Armandina Silva

; Santalha, Marta

; Lozoya, Carlos

; Santos, Natacha

; Silva, Diana

; Vasconcelos, Maria João

; Barata, Luís Taborda

; Teixeira, Maria Fernanda

; Pinto, Diana

; Alves, Rodrigo Rodrigues

; Moreira, Ana Sofia

; Pinto, Cláudia Sofia

; Silva, Pedro Morais

; Alves, Carlos

; Câmara, Raquel

; Coelho, Didina

; Bordalo, Diana

; Carvalho, Fernanda

; Fernandes, Ricardo

; Ferreira, Rosário

; Oliveira, José Ferraz de

; Menezes, Fernando

; Gomes, Ricardo

; Calix, Maria José

; Marques, Ana

; Cardoso, João

; Emiliano, Madalena

; Gerardo, Rita

; Nunes, Carlos

; Ferreira, José Alberto

; Lopes, Inês

; Alves, Adelaide

; Fonseca, João Almeida

Revista Portuguesa de Imunoalergologia

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dec 2020, Volume 28 N. 4 Pages 231 - 240

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

Objetivos: Identificar clusters de controlo da asma baseados no Teste de Controlo da Asma e Rinite Alérgica (CARAT) e comparar as características dos doentes nos diferentes clusters. Métodos: Adultos e adolescentes (≥13 anos) com asma persistente foram recrutados em 29 centros no contexto de 2 estudos observacionais do projeto INSPIRERS. Foram recolhidos dados relativos a características demográficas e clínicas, adesão ao inalador, crenças sobre a medicação, sintomas de ansiedade e depressão, qualidade de vida e controlo da asma (CARAT, >24 bom controlo). Foi efetuada uma análise hierárquica de clusters usando a pontuação total do CARAT (CARAT-T).Resultados: Foram analisados 410 doentes (68% adultos), com uma idade mediana (percentil 25-percentil 75) de 28 (16-46) anos. Foram identificados três clusters [média CARAT-T(min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] e cluster 3 [10(2-13)]. Os doentes no cluster 1 (34%) apresentavam melhor controlo da asma, melhor qualidade de vida, maior adesão aos inaladores e usavam um único inalador. Os doentes nos clusters 2 (50%) e 3 (16%) tinham a asma não controlada, menor adesão aos inaladores, mais sintomas de ansiedade e depressão e mais de metade reportavam pelo menos uma exacerbação no último ano. Adicionalmente, os doentes no cluster 3 eram predominantemente mulheres, tinham mais consultas médicas não agendadas, apresentavam mais sintomas de ansiedade, percebiam uma maior necessidade dos inaladores, mas também uma maior preocupação associada ao seu uso. Não se verificaram diferenças na idade, índice de massa corporal, função pulmonar, hábitos tabágicos, hospitalizações ou tempo de seguimento pelo médico especialista. Conclusões: Um método não supervisionado baseado no CARAT-T, identificou 3 clusters de doentes com diferentes características clínicas. O cluster com melhor controlo apresenta um ponto de corte semelhante ao estabelecido no estudo de validação do CARAT. Este estudo sugere ainda a existência de um ponto de corte adicional para distinguir doença mais grave. Mais investigação é necessária para validar os clusters identificados

Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25-percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT-T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.

https://doi.org/10.32932/rpia.2020.12.046 633 downloads

14.

Tendências e perceções dos Ginecologistas Portugueses sobre contraceção hormonal intrauterina: o estudo DIOGIN
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Brito, Marta

; Costa, Ana Rosa

; Pacheco, Amália

; Rebelo, Cláudio

; Castro, Maria Geraldina

; Martins, Isabel

; Palma, Fátima

Acta Obstétrica e Ginecológica Portuguesa

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jun 2020, Volume 14 N. 2 Pages 74 - 82

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

Overview and Aims: Intrauterine systems (IUS) are one of the most effective forms of long acting reversible birth control, with low failure rates and high continuity and satisfaction rates. Still, they account for a small proportion of contraception use, which may be due to several myths and misperceptions. With this study, we aimed to assess Portuguese experts’ perceptions on potential benefits and fears that may limit women’s contraception choice and to identify current trends in clinical practice. Methods and Population: We performed an observational, descriptive and analytical study in which gynecologists/obstetricians were invited to answer an anonymous questionnaire by call or email made of multiple-choice questions on IUS use. Results: A total of 482 Portuguese Gynecologists answered the survey, of which 97.1% revealed that the insertion of IUS is a common procedure in their current clinical practice. More than 95% considered the insertion of IUS an easy procedure and a safe contraceptive method. Cost-efficacy and the fact that this method doesn’t rely on women´s action to be effective were the top benefits for IUS users, perceived by the physicians. On the other hand, concern about having a foreign object inside the body and fear of insertion pain were perceived by the physicians as the top barriers to IUS use. Female gynecologists perceived a higher degree of pain associated with IUS insertion (p=0.021). Overall, gynecology experts’ opinions were conservative regarding IUS recommendations to women. Conclusions: The results of this study provide a general insight towards Portuguese gynecologists’ perceptions, opinions and attitudes on the use of IUS. Most of the experts consider IUS a safe contraception method but, on the other hand, there is still concern about its use in particular female conditions which may in part contribute to the low rate of IUS use in Portuguese women.

588 downloads

15.

40 years of immunization in Mozambique: a narrative review of literature, accomplishments, and perspectives
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Cassocera, Marta

; Chissaque, Assucênio

; Martins, Maria R. O.

; Deus, Nilsa de

Cadernos de Saúde Pública

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2020, Volume 36 Suppl. 2 elocation e00038320

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

Em Moçambique, o Programa Alargado de Vacinação (PAV) foi implementado em 1979 com o compromisso de reduzir a morbimortalidade na população infantil através dos serviços de imunização. O presente estudo tem como objetivo descrever as características do PAV e revisar as informações disponíveis relacionadas aos serviços de imunização em Moçambique, os avanços e perspectivas. Foi realizada uma revisão narrativa da literatura, e as bases de dados acessadas foram BVS, Google Scholar e PubMed, entre 1979 e 2019, usando descritores relacionados ao tema. A revisão acessou um total de 28 artigos científicos, além de outras fontes relevantes. A cobertura nacional de vacinação em Moçambique entre 1997 (47%) e 2015 (66%) aumentou 19 pontos percentuais, e a cobertura de vacinação em crianças abaixo de 12 meses de idade aumentou de 44,3% (1997) para 57% (2015). De acordo com os dados de 2015, das 11 províncias, apenas as do Sul e a de Cabo Delgado atingiram a meta de cobertura recomendada de 80%. As províncias de Zambézia, Nampula e Tete mostraram baixas coberturas ao longo dos anos, enquanto Cabo Delgado mostrou oscilação na cobertura. As vacinas BCG, DPT3, Polio 3 e sarampo atingiram a meta de cobertura de 80% entre 1997 e 2015. Nossa análise mostrou avanços importantes na vacinação nacional, caracterizados por um aumento geral nas coberturas nacional e provinciais e uma queda no número de crianças que não receberam nenhuma vacina. Apesar desses avanços, algumas províncias tiveram coberturas aquém das metas, o que reforça a necessidade de entender os determinantes do abandono da imunização nas crianças, para retê-las e assegurar a imunização oportuna e completa.

In Mozambique, the Expanded Program on Immunization (EPI) was implemented in 1979 with the objective of reducing child mortality and morbidity through the provision of immunization services. This study aims to describe the characteristics of the EPI and review the available information related to immunization service in Mozambique, its accomplishments and perspectives. A narrative review of the literature was carried out and the electronic databases accessed were VHL, Google Scholar, and PubMed between 1979 and 2019, using descriptors related to the theme. A total of 28 articles and other relevant sources have been consulted for the review. The national immunization coverage in Mozambique between 1997 (47%) and 2015 (66%) improved 19 percentual points; also immunization coverage of children under 12 months has increased from 44.3% (1997) to 57% (2015). The 2015 survey showed that out of the 11 provinces, only the southern and Cabo Delgado province could reach the 80% recommended goal at the provincial level. Zambézia, Nampula, and Tete provinces have been reporting low coverage over the years and Cabo Delgado presents coverage oscillation. The BCG, DPT3, Polio 3, and measles have reached 80% of coverage goal from 1997 to 2015. Our analysis have shown important improvements in national immunization, characterized by an overall increase in the national and provincial coverage and a decrease in the number of children that did not receive any vaccine. Despite these improvements, some provinces have lower coverages than expected and it is necessary to understand the determinants of dropout in children to retain them and provide timely and full immunization.

En Mozambique, el Programa de Inmunización Expandido (EPI por sus siglas en inglés) fue implementado en 1979, con el compromiso de reducir la mortalidad infantil y la morbilidad a través de la provisión de servicios de inmunización. El objetivo del presente estudio es describir las características del EPI y revisar la información disponible, relacionada con el servicio de inmunización en Mozambique, así como sus logros y perspectivas. Se llevó a cabo una revisión narrativa de la literatura y se accedió a las siguientes bases de datos electrónicas: BVS, Google Scholar y PubMed para el período de 1979 a 2019, usando descriptores relacionados con el tema. Se tuvo acceso a un total de 28 artículos y otras fuentes relevantes para la revisión. La cobertura nacional de inmunización en Mozambique de 1997 (47%) a 2015 (66%) mejoró 19 puntos porcentuales y la cobertura de inmunización de los niños con menos de 12 meses se incrementó de un 44,3% (1997) a un 57% (2015). La encuesta de 2015 mostró que, de las 11 provincias, solamente la provincia del sur y la provincia de Cabo Delgado podrían alcanzar el 80% de la meta recomendada a nivel provincial. Las provincias de Zambézia, Nampula, y Tete han estado informando de baja cobertura a largo de estos años y Cabo Delgado tiene oscilaciones en la cobertura. BCG, DPT3, Polio 3 y sarampión han alcanzado un 80% de la meta de la cobertura de 1997-2015. Nuestro análisis ha mostrado importantes mejoras en la inmunización nacional, caracterizada por un aumento en general en la cobertura nacional y provincial, así como un decremento en el número de niños que no recibieron ninguna vacuna. A pesar de estas mejoras, algunas provincias tienen coberturas más bajas que las esperadas y existe una necesidad para entender los determinantes del abandono en niños para retenerlos y proporcionarles a tiempo una completa inmunización.

https://doi.org/10.1590/0102-311x00038320

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