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Resumo Introdução: As dificuldades alimentares na primeira infância estão entre as principais queixas dos pais e podem refletir características intrínsecas da criança ou um problema relacional. Estas dificuldades estão associadas a problemas subsequentes no desenvolvimento da criança, como problemas comportamentais, défices cognitivos e perturbações do comportamento alimentar. Materiais e Métodos: Foi realizada uma análise retrospetiva e descritiva dos dados sociodemográficos e clínicos de crianças com menos de seis anos de idade avaliadas em primeira consulta de Pedopsiquiatria de um hospital terciário por dificuldades alimentares entre janeiro de 2019 e maio de 2021. Crianças com diagnóstico ou suspeita de perturbação do espetro do autismo foram excluídas. Resultados: De um total de 647 crianças avaliadas, 57 (8,81%) foram classificadas como tendo dificuldades ou problemas alimentares. A mediana de idades foi de 24,5 meses. A seletividade alimentar foi o problema alimentar mais comum (45,6%), seguida de dificuldades na autorregulação durante as refeições (43,9%) e apetite reduzido (33,3%). Vinte e um por cento das mães apresentava antecedentes de perturbação depressiva e 7% apresentava antecedentes de perturbação de ansiedade. Quarenta e nove por cento das crianças incluídas no estudo apresentava padrões de interação com o cuidador principal preocupantes ou perturbados. Em 54% das crianças, a orientação terapêutica mais comum foi psicoterapia criança-cuidador. Conclusões: É necessária deteção e intervenção precoce para crianças com dificuldades alimentares. As perturbações alimentares são comuns na primeira infância e deve ser sempre considerada uma abordagem multidisciplinar das mesmas, uma vez que podem ter impacto em vários domínios do desenvolvimento e saúde da criança.

Abstract Introduction: Feeding difficulties in early childhood are among the most common problems reported by parents and may reflect the child’s own characteristics or a relational problem. They are associated with problems in later life, such as behavioral disorders, cognitive deficits, and eating disorders. Materials and Methods: This study was a retrospective, descriptive analysis of sociodemographic and clinical data of children under six years of age with feeding or eating problems evaluated at a first consultation in a child psychiatry unit of a tertiary hospital between January 2019 and May 2021. Children with a diagnosis or suspected diagnosis of autism spectrum disorder were excluded. Results: Of a total of 647 children evaluated, 57 (8.81%) were classified as having feeding difficulties. Their median age was 24.5 months. Food selectivity was the most frequently reported problem (45.6%), followed by difficulties in self-regulation at mealtimes (43.9%) and decreased appetite (33.3%). Among the mothers, 21% had a history of depressive disorders and 7% had a history of anxiety disorders. Forty-nine percent of children had patterns of interaction with their primary caregiver that were considered worrisome or disruptive. Fifty-four percent of the therapeutic interventions provided were child-parent psychotherapy. Conclusions: Early identification and intervention are needed for children with feeding problems. Feeding problems are common in early childhood and a multidisciplinary approach must always be considered as they can affect several domains of the child’s health and development.

https://doi.org/10.25753/birthgrowthmj.v32.i3.26966

Nonalcoholic fatty liver disease in adolescents with phenylketonuria
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Silveira, Adriana Márcia

; Lima, Poliane Lopes

; Alves, Michelle Rosa Andrade

; Jesus, Rosângela Passos de

; Pinto-Silva, Rogério Augusto

; Rodrigues, Valéria de Melo

; Starling, Ana Lúcia Pimenta

; Norton, Rocksane de Carvalho

; Aguiar, Marcos José Burle de

Jornal de Pediatria

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apr 2023, Volume 99 N. 2 Pages 174 - 180

Abstract: En | Text: En | PDF: En

Abstract Objective: This study aimed to investigate non-alcoholic fatty liver disease (NAFLD) occurrence and factors associated with the disease in phenylketonuria (PKU) patients undergoing exclusive dietary treatment. Method: This cross-sectional study included 101 adolescents 10 to < 20 years of age with PKU, who were undergoing exclusive dietary treatment and monitored since early diagnosis at a single reference service. Anthropometric and biochemical assessments were performed and food intake was documented, and an ultrasound diagnosis of NAFLD was established. Data were evaluated using the Student’s t-test for continuous variables, the chi-square for categorical variables, and logistic regression using the Wald chi-squared test; differences with p < 0.05 were considered to be statistically significant. Results: NAFLD was detected in 26 (25.7%) teenagers. There was no difference in prevalence between the sexes or nutritional status. The final logistic regression model revealed low sensitivity (26.1%) and high specificity (94.7%). The specificity suggested a lower likelihood of NAFLD in older adolescents, in the presence of normal or high levels of alkaline phosphatase, lower carbohydrate intake, and adequate protein and lipid intake. Conclusions: The prevalence of NAFLD in adolescents with PKU was higher than that found in healthy Brazilian adolescents and similar to that found in obese Brazilian children, suggesting a higher risk for NAFLD in patients with PKU treated exclusively by dietary modification.

https://doi.org/10.1016/j.jped.2022.08.003

“Tratamento precoce”, antivacinação e negacionismo: quem são os Médicos pela Vida no contexto da pandemia de COVID-19 no Brasil?
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Ferrari, Isaura Wayhs

; Grisotti, Márcia

; Amorim, Lucas de Carvalho de

; Rodrigues, Larissa Zancan

; Ribas, Marcella Trindade

; Silva, Cristiane Uflacker da

Ciência & Saúde Coletiva

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nov 2022, Volume 27 N. 11 Pages 4213 - 4213

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

Resumo O artigo pretende identificar quem são os “Médicos pela Vida” (MPV), suas informações acadêmicas e profissionais, quais as premissas utilizadas para a defesa do “tratamento precoce” e da negação das vacinas contra COVID-19 e qual a representatividade de seus discursos no contexto da prática médica no Brasil. A análise baseia-se na lista de 276 profissionais médicos catalogados no site dos MPV e em informações acadêmicas e profissionais coletadas nos sites do Conselho Federal de Medicina e da Plataforma Lattes, do Conselho Nacional de Desenvolvimento Científico e Tecnológico. A análise do conteúdo aponta para a centralidade das especialidades da Homeopatia e Acupuntura na população de MPV quando comparada ao conjunto dos especialistas do Brasil. A adesão significativa de homeopatas e acupunturistas ao movimento dos MPV pode iluminar a compreensão sobre racionalidades médicas específicas, permitindo distinguir quais categorias e ideias acerca dos processos de saúde e doença estão em disputa. Conclui-se que, para além de descrever a problemática, é preciso estabelecer suas correlações com um conjunto de acontecimentos, práticas, decisões políticas, encadeamentos econômicos, compartilhamento de crenças e uma corrente de processos que configuram seu caráter inegavelmente social.

Abstract The article aims to identify who the “Doctors for Life” are, their academic and professional information, which assumptions have been mobilized for the defense of “early treatment” and the denial of vaccines for COVID-19, and the representativeness of their discourses in the medical practice context in Brazil. The analysis is based on a list of 276 doctors’ names, cataloged from their website, and on academic and professional information obtained through research on the Federal Medical Conseil website and the Scientific and Technological Development Nacional Council platform. The content analysis points to the centrality of the medical specialties of homeopathy and acupuncture in the population of Doctors for Life when compared to the set of specialist doctors in Brazil. The significant accession of homeopaths and acupuncturists to the Doctors for Life movement can clarify the understanding of specific medical rationalities, allowing us to distinguish which categories and ideas about the health-disease process are in dispute. It is concluded that, more than describing the problem, it is needed to establish its correlations with a group of events, practices, political decisions, economic linkages, shared beliefs, and a chain of processes that configure its undeniably social characteristics.

https://doi.org/10.1590/1413-812320222711.09282022

“Tratamento precoce”, antivacinação e negacionismo: quem são os Médicos pela Vida no contexto da pandemia de COVID-19 no Brasil?
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Ferrari, Isaura Wayhs

; Grisotti, Márcia

; Amorim, Lucas de Carvalho de

; Rodrigues, Larissa Zancan

; Ribas, Marcella Trindade

; Silva, Cristiane Uflacker da

Ciência & Saúde Coletiva

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nov 2022, Volume 27 N. 11 Pages 4213 - 4213

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

https://doi.org/10.1590/1413-812320222711.09282022

Overweight/obesity in adolescents with phenylketonuria: protective and predisposing factors
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Silveira, Adriana Márcia

; Lima, Poliane Lopes

; Alves, Michelle Rosa Andrade

; Soares, Rosângelis Del Lama

; Kanufre, Viviane de Cássia

; Rodrigues, Valéria de Melo

; Starling, Ana Lúcia Pimenta

; Norton, Rocksane de Carvalho

; Aguiar, Marcos José Burle de

Jornal de Pediatria

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feb 2022, Volume 98 N. 1 Pages 104 - 110

Abstract: En | Text: En | PDF: En

Abstract Objective: To estimate the prevalence and factors associated with overweight/obesity development in adolescents with early diagnosed phenylketonuria treated exclusively by diet. Methodology: In this cross-sectional study anthropometric measurements, serum phenylalanine levels, and 10 metabolites associated with lipid and carbohydrate metabolism were analyzed in 101 adolescents aged 10–20 years. Adolescents were categorized into overweight/obesity and eutrophic/low body mass index groups. These patients were compared using Student’s t-test, Pearson’s chi-square test, Wald’s chi-square test for multivariate analysis. Further, to verify whether the prevalence of overweight/obesity found in the study population was similar to that in the general population, the authors compared the nutritional status of 46 patients aged 13–17 years with that of healthy students of the same age from the National School Health Survey using the chi-square test for adherence. The significance threshold was p < 0.5. Results: The prevalence of overweight/obesity in adolescents was 27.7%. There was no difference in prevalence between sexes. Older age was a protective factor and Increased Homeostasis Model Assessment Insulin Resistance index and high phenylalanine and low-density lipoprotein cholesterol levels were predictive factors for overweight/obesity. The equality hypothesis was not rejected in the comparison of nutritional states of 46 patients aged 13–17 years and healthy students of the same age. Conclusion: The prevalence of overweight/obesity in phenylketonuria adolescents was similar to what is found in healthy adolescents.

https://doi.org/10.1016/j.jped.2021.04.009

Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Barroso, Weimar Kunz Sebba

; Rodrigues, Cibele Isaac Saad

; Bortolotto, Luiz Aparecido

; Mota-Gomes, Marco Antônio

; Brandão, Andréa Araujo

; Feitosa, Audes Diógenes de Magalhães

; Machado, Carlos Alberto

; Poli-de-Figueiredo, Carlos Eduardo

; Amodeo, Celso

; Mion Júnior, Décio

; Barbosa, Eduardo Costa Duarte

; Nobre, Fernando

; Guimarães, Isabel Cristina Britto

; Vilela-Martin, José Fernando

; Yugar-Toledo, Juan Carlos

; Magalhães, Maria Eliane Campos

; Neves, Mário Fritsch Toros

; Jardim, Paulo César Brandão Veiga

; Miranda, Roberto Dischinger

; Póvoa, Rui Manuel dos Santos

; Fuchs, Sandra C

; Alessi, Alexandre

; Lucena, Alexandre Jorge Gomes de

; Avezum, Alvaro

; Sousa, Ana Luiza Lima

; Pio-Abreu, Andrea

; Sposito, Andrei Carvalho

; Pierin, Angela Maria Geraldo

; Paiva, Annelise Machado Gomes de

; Spinelli, Antonio Carlos de Souza

; Nogueira, Armando da Rocha

; Dinamarco, Nelson

; Eibel, Bruna

; Forjaz, Cláudia Lúcia de Moraes

; Zanini, Claudia Regina de Oliveira

; Souza, Cristiane Bueno de

; Souza, Dilma do Socorro Moraes de

; Nilson, Eduardo Augusto Fernandes

; Costa, Elisa Franco de Assis

; Freitas, Elizabete Viana de

; Duarte, Elizabeth da Rosa

; Muxfeldt, Elizabeth Silaid

; Lima Júnior, Emilton

; Campana, Erika Maria Gonçalves

; Cesarino, Evandro José

; Marques, Fabiana

; Argenta, Fábio

; Consolim-Colombo, Fernanda Marciano

; Baptista, Fernanda Spadotto

; Almeida, Fernando Antonio de

; Borelli, Flávio Antonio de Oliveira

; Fuchs, Flávio Danni

; Plavnik, Frida Liane

; Salles, Gil Fernando

; Feitosa, Gilson Soares

; Silva, Giovanio Vieira da

; Guerra, Grazia Maria

; Moreno Júnior, Heitor

; Finimundi, Helius Carlos

; Back, Isabela de Carlos

; Oliveira Filho, João Bosco de

; Gemelli, João Roberto

; Mill, José Geraldo

; Ribeiro, José Marcio

; Lotaif, Leda A. Daud

; Costa, Lilian Soares da

; Magalhães, Lucélia Batista Neves Cunha

; Drager, Luciano Ferreira

; Martin, Luis Cuadrado

; Scala, Luiz César Nazário

; Almeida, Madson Q.

; Gowdak, Marcia Maria Godoy

; Klein, Marcia Regina Simas Torres

; Malachias, Marcus Vinícius Bolívar

; Kuschnir, Maria Cristina Caetano

; Pinheiro, Maria Eliete

; Borba, Mario Henrique Elesbão de

; Moreira Filho, Osni

; Passarelli Júnior, Oswaldo

; Coelho, Otavio Rizzi

; Vitorino, Priscila Valverde de Oliveira

; Ribeiro Junior, Renault Mattos

; Esporcatte, Roberto

; Franco, Roberto

; Pedrosa, Rodrigo

; Mulinari, Rogerio Andrade

; Paula, Rogério Baumgratz de

; Okawa, Rogério Toshiro Passos

; Rosa, Ronaldo Fernandes

; Amaral, Sandra Lia do

; Ferreira-Filho, Sebastião R.

; Kaiser, Sergio Emanuel

; Jardim, Thiago de Souza Veiga

; Guimarães, Vanildo

; Koch, Vera H.

; Oigman, Wille

; Nadruz, Wilson

Arquivos Brasileiros de Cardiologia

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mar 2021, Volume 116 N. 3 Pages 516 - 658

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

https://doi.org/10.36660/abc.20201238 10948 downloads

Emotional labor of nurses in the front line against the COVID-19 pandemic
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Diogo, Paula Manuela Jorge

; Sousa, Maria Odete Carvalho Lemos e

; Rodrigues, Joana Rita Guarda da Venda

; Silva, Tânia Alexandra de Almeida Martins de Almeida e

; Santos, Márcia Leandra Ferreira

Revista Brasileira de Enfermagem

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2021, Volume 74 Suppl. 1 elocation e20200660

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

RESUMO Objetivo: Analisar as experiências de enfermeiros da linha de frente do combate à pandemia de COVID-19 quanto ao desempenho do trabalho emocional (TE) visando à sua caracterização e identificação de estratégias de suporte e oportunidades de desenvolvimento dos enfermeiros e das práticas. Métodos: Estudo qualitativo, descritivo e exploratório, com análise de conteúdo de 11 narrativas escritas e relatos de um grupo focal composto por enfermeiros com experiência de cuidados a pacientes com COVID 19, de diferentes Centros Hospitalares de Lisboa, Portugal. Resultados: Extraíram-se cinco temas: 1) Desafios vividos pelos enfermeiros na linha de frente; 2) Emoções experienciadas por enfermeiros na prestação de cuidados; 3) Respostas emocionais de enfermeiros e pacientes: impacto nos cuidados; 4) Trabalho Emocional de enfermeiros no processo de cuidados ao paciente; 5) Oportunidades de desenvolvimento face ao desafio emocional exigido dos enfermeiros no combate à COVID-19. Considerações finais: Os enfermeiros demonstraram capacidade de transformar positivamente esta experiência profundamente emocional.

ABSTRACT Objective: To analyze nurses’ experiences in the front line of the fight against the COVID-19 pandemic regarding the performance of emotional labor (EL), aiming at its characterization and identification of support strategies and development opportunities of nurses and practices. Methods: Qualitative, descriptive, and exploratory study, with content analysis of eleven written narratives and reports from a focus group composed of nurses with experience in caring for patients with COVID-19 from different Hospital Centers in Lisbon, Portugal. Results: Five themes were extracted: 1) Challenges experienced by nurses in the frontline; 2) Emotions experienced by nurses in service care; 3) Emotional responses of nurses and patients: impact on care; 4) EL of nurses in the patient care process; 5) Opportunities for development in the face of the emotional challenge required of nurses in combating COVID-19. Final considerations: The nurses demonstrated the ability to transform this profoundly emotional experience positively.

RESUMEN Objetivo: Analizar las experiencias de enfermeros de primera línea frente a la pandemia de COVID-19 cuanto al desempeño del trabajo emocional (TE) visando su caracterización e identificación de estrategias de suporte y oportunidades de desarrollo de enfermeros y de prácticas. Métodos: Estudio cualitativo, descriptivo y exploratorio, con análisis de contenido de 11 narrativas escritas y relatos de un grupo focal compuesto por enfermeros con experiencia de cuidados a pacientes con COVID-19, de diferentes Centros Hospitalarios de Lisboa, Portugal. Resultados: Extrajeron cinco temas: 1) Desafíos vividos por enfermeros en primera línea; 2) Emociones experienciadas por enfermeros en la prestación de cuidados; 3) Respuestas emocionales de enfermeros y pacientes: impacto en los cuidados; 4) TE de enfermeros en el proceso de cuidados al paciente; 5) Oportunidades de desarrollo delante desafío emocional exigido de los enfermeros frente a la COVID-19. Consideraciones finales Los enfermeros demostraron capacidad de transformar positivamente esta experiencia profundamente emocional.

https://doi.org/10.1590/0034-7167-2020-0660 1680 downloads

COVID-19: The question of genetic diversity and therapeutic intervention approaches
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Figueiredo, David Livingstone Alves

; Ximenez, João Paulo Bianchi

; Seiva, Fábio Rodrigues Ferreira

; Panis, Carolina

; Bezerra, Rafael dos Santos

; Ferrasa, Adriano

; Cecchini, Alessandra Lourenço

; Medeiros, Alexandra Ivo de

; Almeida, Ana Marisa Fusco

; Ramão, Anelisa

; Boldt, Angelica Beate Winter

; Moya, Carla Fredrichsen

; Chin, Chung Man

; Paula, Daniel de

; Rech, Daniel

; Gradia, Daniela Fiori

; Malheiros, Danielle

; Venturini, Danielle

; Tavares, Eliandro Reis

; Carraro, Emerson

; Ribeiro, Enilze Maria de Souza Fonseca

; Pereira, Evani Marques

; Tuon, Felipe Francisco

; Follador, Franciele Aní Caovilla

; Fernandes, Glaura Scantamburlo Alves

; Volpato, Hélito

; Cólus, Ilce Mara de Syllos

; Oliveira, Jaqueline Carvalho de

; Rodrigues, Jean Henrique da Silva

; Santos, Jean Leandro dos

; Visentainer, Jeane Eliete Laguila

; Brandi, Juliana Cristina

; Serpeloni, Juliana Mara

; Bonini, Juliana Sartori

; Oliveira, Karen Brajão de

; Fiorentin, Karine

; Lucio, Léia Carolina

; Faccin-Galhardi, Ligia Carla

; Ferreto, Lirane Elize Defante

; Lioni, Lucy Megumi Yamauchi

; Consolaro, Marcia Edilaine Lopes

; Vicari, Marcelo Ricardo

; Arbex, Marcos Abdo

; Pileggi, Marcos

; Watanabe, Maria Angelica Ehara

; Costa, Maria Antônia Ramos

; Giannini, Maria José S. Mendes

; Amarante, Marla Karine

; Khalil, Najeh Maissar

; Lima Neto, Quirino Alves de

; Herai, Roberto H.

; Guembarovski, Roberta Losi

; Shinsato, Rogério N.

; Mainardes, Rubiana Mara

; Giuliatti, Silvana

; Yamada-Ogatta, Sueli Fumie

; Gerber, Viviane Knuppel de Quadros

; Pavanelli, Wander Rogério

; Silva, Weber Claudio da

; Petzl-Erler, Maria Luiza

; Valente, Valeria

; Soares, Christiane Pienna

; Cavalli, Luciane Regina

; Silva Jr, Wilson Araujo

Genetics and Molecular Biology

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2021, Volume 44 N. 1 elocation e20200452

Abstract: En | Text: En | PDF: En

Abstract Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China’s Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients’ overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.

https://doi.org/10.1590/1678-4685-gmb-2020-0452

Prevalence of virological and serological markers of SARS-CoV-2 infection in the population of Ribeirão Preto, Southeast Brazil: an epidemiological survey
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Martinez, Edson Zangiacomi

; Passos, Afonso Dinis Costa

; Fabbro, Amaury Lelis Dal

; Silva, Anderson Soares da

; Escarso, Andreia Cássia

; Pazin-Filho, Antônio

; Fonseca, Benedito Antônio Lopes da

; Maciel, Benedito Carlos

; Araújo, Daniel Cardoso de Almeida e

; Clé, Diego Villa

; Gaspar, Gilberto Gambero

; Santos, Jair Lício Ferreira dos

; Ferreira, Janise Braga Barros

; Souza, João Paulo

; Mello, Luane Marques de

; Santos, Luciane Loures dos

; Passos, Luzia Márcia Romanholi

; Siconelli, Márcio Junio Lima

; Cavalli, Ricardo de Carvalho

; Santana, Rodrigo de Carvalho

; Calado, Rodrigo do Tocantins

; Scarpelini, Sandro

; Bollela, Valdes Roberto

; Floriano, Vitor Gonçalves

; Bellissimo-Rodrigues, Fernando

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0210-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: This epidemiological household survey aimed to estimate the prevalence of the current and past SARS-CoV-2 infections in Ribeirão Preto, a municipality of southeast Brazil. METHODS: The survey was conducted in two phases using a clustered sampling scheme. The first phase spanned May 1-3 and involved 709 participants. The second phase spanned June 11-14, 2020, and involved 646 participants. RESULTS: During the first phase, RT-PCR performed on nasopharyngeal swabs was positive at 0.14%. The serological tests were positive in 1.27% of the patients during the first phase and 2.79% during the second phase. People living in households with more than five members had a prevalence of 10.83% (95%CI: 1.58-74.27) higher than those living alone or with someone other. Considering the proportion of the positive serological test results with sex and age adjustments, approximately 2.37% (95%CI: 1.32-3.42) of the population had been cumulatively infected by mid-June 2020, which is equivalent to 16,670 people (95%CI: 9,267-24,074). Considering that 68 deaths from the disease in the residents of the city had been confirmed as at the date of the second phase of the survey, the infection fatality rate was estimated to be 0.41% (95%CI: 0.28-0.73). Our results suggest that approximately 88% of the cases of SARS-CoV-2 infection at the time of the survey were not reported to the local epidemiological surveillance service. CONCLUSIONS: The findings of this study provide in-depth knowledge of the COVID-19 pandemic in Brazil and are helpful for the preventive and decision-making policies of public managers.

https://doi.org/10.1590/0037-8682-0210-2021 117 downloads

10.

Predominance of Giardia duodenalis AII sub-assemblage in young children from Salvador, Bahia, Brazil
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Figueiredo Pacheco, Flávia Thamiris

; Rodrigues Silva, Renata Kelly Novaes

; Souza de Carvalho, Silvia

; Carvalho Rocha, Felipe

; Trindade das Chagas, Gisele Maria

; Chagas Gomes, Daisy

; da Costa-Ribeiro Junior, Hugo

; Medrado Ribeiro, Tereza Cristina

; Mattos, Ângela Peixoto de

; Kalabric Silva, Luciano

; Soares, Neci Matos

; Aquino Teixeira, Márcia Cristina

Biomédica

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sep 2020, Volume 40 N. 3 Pages 557 - 568

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

Resumen Introducción. Giardia duodenalis es un protozoo intestinal de gran prevalencia en los niños de los países en desarrollo. En estudios moleculares se ha evidenciado la gran diversidad genética de G. duodenalis y se han identificado los conjuntos A y B, principalmente en humanos. A pesar de su importancia, el conocimiento de la epidemiología molecular de la giardiasis humana aún es limitado en Brasil. Objetivo. Caracterizar los aislamientos moleculares de G. duodenalis de muestras tomadas a niños de Salvador, Bahía, Brasil. Materiales y métodos. Las muestras fecales positivas para G. duodenalis se obtuvieron de 71 niños de dos guarderías y de 39 usuarios de un laboratorio de análisis clínicos. Las muestras se analizaron mediante PCR-RFLP de los genes gdh y beta-giardin, y secuenciación de beta-giardin. Resultados. De las 110 muestras de G. duodenalis, en 80 (72,7 %) se amplificaron uno o ambos genes. De estos, 62 (77,5 %) se identificaron como pertenecientes al conjunto A y 18 (22,5 %) al B. El subconjunto AII se identificó en el 58,8 % (n=47) de los aislamientos, seguido del AI en el 18,8% (n=15), el BIV en el 11,2% (n=9) y el BIII en el 5,0% (n=4). El subconjunto AII fue el más frecuente en los niños de ambas guarderías, en tanto que el AI solo se encontró en el grupo atendido en el laboratorio clínico. El subconjunto AII predominó en los niños menores de dos años. Conclusiones. La mayor frecuencia del subconjunto AII sugiere que la transmisión antroponótica es más común en Salvador, pero también existen vías de transmisión zoonóticas, y que pueden ocurrir cambios en la sensibilidad frente a diferentes patrones moleculares de Giardia durante el crecimiento infantil.

Abstract Introduction. Giardia duodenalis is an intestinal protozoan with a high prevalence in children of developing countries. Molecular studies revealed a great genetic diversity of G. duodenalis, with assemblages A and B found mainly in humans. Despite its importance, the information on the molecular epidemiology of human giardiasis is still limited in Brazil. Objective. To characterize G. duodenalis molecular isolates in children from Salvador, Bahia, Brazil. Materials and methods. Giardia duodenalis positive fecal samples were obtained from 71 children from two day care centers and 39 users of a clinical analysis laboratory. Samples were analyzed by PCR-RFLP of the glutamate dehydrogenase (gdh) and beta-giardin genes and by the sequencing of beta-giardin. Results. Of the 110 G. duodenalis samples, 80 (72.7%) amplified one or both target genes. Of these, 62 (77.5 %) were identified as assemblage A and 18 (22.5%) as assemblage B. The subassemblage AII was identified in 58.8% (n=47) of isolates followed by the sub-assemblage AI (18.8%, n=15), BIV (11.2%, n=9), and BIII (5.0%, n=4). The AII sub-assemblage was the most frequent in children of both day care centers whereas AI was found only in the group attended at the clinical laboratory. Sub-assemblage AII predominated in children under two years. Conclusions. The higher frequency of AII sub-assemblage suggests that anthroponotic transmission is more common in Salvador, but that zoonotic transmission pathways are also present and a change in susceptibility to different molecular patterns of Giardia may occur during child growth.

https://doi.org/10.7705/biomedica.5161 296 downloads

11.

How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation
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Perini, Guilherme Fleury

; Fischer, Thais

; Gaiolla, Rafael Dezen

; Rocha, Talita Bueno

; Bellesso, Marcelo

; Teixeira, Larissa Lane Cardoso

; Delamain, Marcia Torresan

; Scheliga, Adriana Alves de Souza

; Ribeiro, Glaciano Nogueira

; Vaz Neto, Jorge

; Baiocchi, Otávio Cesar Carvalho Guimaraes

; Abdo, André Neder Ramires

; Arrais-Rodrigues, Celso

; Fogliatto, Laura M.

; Bigni, Ricardo de Sá

; Schaffel, Rony

; Biasoli, Irene

; Pereira, Juliana

; Nabhan, Samir Kanaan

; Souza, Cármino Antônio de

; Chiattone, Carlos Sérgio

Hematology, Transfusion and Cell Therapy

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jun 2020, Volume 42 N. 2 Pages 103 - 110

Abstract: En | Text: En | PDF: En

ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.

https://doi.org/10.1016/j.htct.2020.04.002 435 downloads

12.

Primary Health Care attributes in the context of indigenous health
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Rocha, Esron Soares Carvalho

; Toledo, Noeli das Neves

; Pina, Rizioléia Marina Pinheiro

; Fausto, Márcia Cristina Rodrigues

; D’Viana, Ana Luiza

; Lacerda, Rúbia Aparecida

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 5 elocation e20190641

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

RESUMO Objetivos: avaliar os atributos da Atenção Primária à Saúde, na perspectiva dos profissionais de saúde, comparando os serviços no Distrito Sanitário Especial Indígena e nas Secretarias Municipais de Saúde. Métodos: trata-se de um estudo transversal, na região do Alto Rio Negro, Amazonas, com 116 profissionais. Os dados foram coletados por meio do Primary Care Assessment Tool. Fez-se a categorização dos escores (≥ 6,6) - forte orientação e (< 6,6) - baixa orientação. O Teste Qui-Quadrado e de máxima verossimilhança para análise dos cruzamentos. A comparação entre os profissionais o Teste de Kruskal-Wallis. Resultados: foi observado escore geral maior no Distrito Sanitário Indígena (7,2). A mesma tendência foi observada individualmente nos atributos essenciais e derivados. Conclusões: este trabalho poderá subsidiar estratégias que impactem positivamente no modelo de gestão e processos de trabalho na perspectiva do fortalecimento da Atenção Primária ofertada à população rionegrina.

ABSTRACT Objectives: to assess the attributes of Primary Health Care from the perspective of health professionals, comparing services in the Special Indigenous Health District and the Municipal Health Offices. Methods: a cross-sectional study in the Upper Rio Negro region, State of Amazonas, with 116 professionals. The data were collected through the Primary Care Assessment Tool. Scores were categorized (≥ 6.6) - strong orientation and (<6.6) - low orientation. The chi-square and maximum likelihood test for crossover analysis. The comparison between professionals the Kruskal-Wallis Test. Results: a higher overall score was observed in the Indigenous Health District (7.2). The same trend was observed individually in the essential and derived attributes. Conclusions: this work may support strategies that positively impact the management model and work processes from the perspective of strengthening the primary care offered to the population from Rio Negro.

RESUMEN Objetivos: evaluarlos atributos de la Atención Primaria de Salud, desde la perspectiva de los profesionales de la salud, comparando servicios en el Distrito Especial de Salud Indígena y los Departamentos Municipales de Salud. Métodos: este es un estudio transversal en la región del Alto Rio Negro, Amazonas, con 116 profesionales. Los datos fueron recolectados a través de la Primary Care Assessment Tool. Las puntuaciones se clasificaron (≥ 6.6) - orientación fuerte y (<6.6) - orientación baja. La prueba de chi-cuadrado y de máxima verosimilitud para el análisis cruzado. La comparación entre profesionales de la prueba de Kruskal-Wallis. Resultados: se observó una puntuación general más alta en el Distrito de Salud Indígena (7,2). La misma tendencia se observó individualmente en los atributos esenciales y derivados. Conclusiones: este trabajo puede apoyar estrategias que impacten positivamente el modelo de gestión y los procesos de trabajo desde la perspectiva del fortalecimiento de la Atención Primaria ofrecida a la población de Río Negro.

https://doi.org/10.1590/0034-7167-2019-0641 869 downloads

13.

Primary Health Care attributes in the context of indigenous health
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Rocha, Esron Soares Carvalho

; Toledo, Noeli das Neves

; Pina, Rizioléia Marina Pinheiro

; Fausto, Márcia Cristina Rodrigues

; D’Viana, Ana Luiza

; Lacerda, Rúbia Aparecida

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 5 elocation e20190641

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

https://doi.org/10.1590/0034-7167-2019-0641 49 downloads

14.

Care coordination and longitudinality in primary health care in the Brazilian Amazon
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Rabelo, Amanda Lia Rebelo

; Lacerda, Rúbia Aparecida

; Rocha, Esron Soares Carvalho

; Gagno, Juliana

; Fausto, Marcia Cristina Rodrigues

; Gonçalves, Maria Jacirema Ferreira

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2020, Volume 73 N. 3 elocation e20180841

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

RESUMO Objetivos: avaliar os atributos da atenção básica, longitudinalidade e coordenação do cuidar, a partir da percepção do profissional e dos pacientes no estado do Amazonas, Brasil. Métodos: pesquisa avaliativa quantitativa em que foi utilizado um instrumento de avaliação externa com 469 profissionais e 1.888 pacientes de 367 unidades básicas de saúde, que aderiram ao Programa de Melhoria de Acesso e Qualidade da Atenção Primária à Saúde padronizados pelo Ministério da Saúde do Brasil. Os dados foram agrupados por análise multivariada de cluster para encontrar uma classificação da atenção primária à saúde sob o ponto de vista de profissionais e pacientes. Resultados: os atributos de coordenação e longitudinalidade ainda são expressos de forma fraca e pouco desenvolvida no cenário da Amazônia brasileira. Conclusões: é necessário reconhecer as barreiras organizacionais e o que pode promover condições para que as equipes de atenção primária à saúde atuem sob a perspectiva de um cuidado contínuo, integral e coordenado.

ABSTRACT Objectives: to evaluate the attributes of primary health care, care coordination and longitudinality, from the perception of the professional and patients in the state of Amazonas, Brazil. Methods: quantitative evaluative study, in which was used an external evaluation instrument with 469 professionals and 1,888 patients from 367 primary health care facilities that adhered to the Program for Improving Access and Quality of primary health care (Portuguese acronym: PMAQ) standardized by the Ministry of Health. Data were grouped by multivariate cluster analysis in order to find a classification of primary health care from the perspective of professionals and patients. Results: the attributes of coordination and longitudinality are still expressed in a weak and undeveloped way in the Brazilian Amazon scenario. Conclusions: it is necessary to recognize the organizational barriers and what could promote conditions for the performance of health care teams in the perspective of a continuous, integral and coordinated care.

RESUMEN Objetivos: evaluar los atributos de atención primaria de salud, longitudinalidad y coordinación del cuidado, a partir de la percepción del profesional y los pacientes en el estado de Amazonas, Brasil. Métodos: investigación evaluativa cuantitativa en la que se utilizó un instrumento de evaluación externa con 469 profesionales y 1.888 pacientes de 367 centros de atención primaria de salud, que se adhirieron al Programa de Mejora del Acceso y Calidad de la atención primaria de salud estandarizado por el Ministerio de Salud de Brasil. Los datos se agruparon por análisis de grupos multivariados de cluster para encontrar una clasificación de la atención primaria de salud desde el punto de vista de profesionales y pacientes. Resultados: los atributos de coordinación y longitudinalidad todavía se expresan de manera débil y poco desarrollado en el escenario de la Amazonia brasileña. Conclusiones: es necesario reconocer las barreras organizativas y lo que puede promover las condiciones para que los equipos de atención primaria de salud actúen desde la perspectiva de una atención continua, integral y coordenada.

https://doi.org/10.1590/0034-7167-2018-0841 871 downloads

15.

Care coordination and longitudinality in primary health care in the Brazilian Amazon
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Rabelo, Amanda Lia Rebelo

; Lacerda, Rúbia Aparecida

; Rocha, Esron Soares Carvalho

; Gagno, Juliana

; Fausto, Marcia Cristina Rodrigues

; Gonçalves, Maria Jacirema Ferreira

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 3 elocation e20180841

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

https://doi.org/10.1590/0034-7167-2018-0841 40 downloads

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