rtabnetsp: pacote R para extração de indicadores de saúde do estado de São Paulo

Health status indicators constitute an important tool in the context of evaluating public health interventions, understanding health trends and determining priority regions for resource allocation. In order to increase the feasibility of handling and analysing health indicators data, an R package was developed. The rtabnetsp package performs requests to TabNet servers from São Paulo State Department of Health, retrieving and preprocessing such data for user manipulation. This article introduces the packet and its functions, installation and use, and also exemplifies its functionalities, which involve listing and searching among available indicators, selecting desired content and obtaining aggregated data by regionalization level in a data frame form, granting agility in tasks regarding public health management in the state of São Paulo.Indicadores de saúde representam uma importante ferramenta de acompanhamento de desempenho de ações em Saúde Pública, permitindo a avaliação de intervenções realizadas, bem como a identificação de tendências e regiões prioritárias para alocação de recursos. Com o objetivo de aumentar a praticidade nas tarefas de análise e manipulação de dados desses indicadores, foi criado um pacote R. O pacote rtabnetsp realiza requisições aos servidores TabNet da página eletrônica da Secretaria de Estado da Saúde de São Paulo, recuperando e tratando tais dados para utilização do usuário. Este artigo apresenta o pacote rtabnetsp e suas funções, modo de instalação e uso; além de exemplos de suas funcionalidades, que permitem a visualização, busca e seleção, entre uma lista de indicadores, do conteúdo desejado, além da obtenção dos dados agregados pelo nível de regionalização disponível na matriz de dados, conferindo maior agilidade a tarefas de gestão em saúde do estado de São Paulo

O uso de fontes não-tradicionais para a vigilância em saúde: atendimentos de urgência para detecção precoce de eventos

Preparation and response to Public Health emergencies involve efforts in developing systems for early detection, alert and response. Models for dealing with notification delay and diversification of data sources are some of the commonly used strategies for faster information and action. In this paper, we present the strategy implemented in Rio de Janeiro municipality, where data from urgency and emergency visits were acquired and modeled, in order to detect trend shifts and generate alerts. From the ICD-10 field in electronic records, time series representing events of interest were created. A GAM model was fitted for smoothing, slope determination in each point, and alert generation. The results obtained are displayed in a dashboard, monitored daily. From 2023, multiple events of interest were identified through the dashboard, some of which lead to coordinated communication and actions in the territory. We draw attention to the potentials in the use of these type of data on identifying events of interest in a timely manner, approaching the concepts of a modern surveillance.A preparação e resposta às emergências em Saúde Pública envolve o investimento em sistemas de detecção precoce, alerta e resposta. Modelos de correção de atraso de notificação e a diversificação de fontes de dados utilizadas são algumas abordagens comumente utilizadas para geração de informação e ação mais oportunos. Neste artigo é apresentada a estratégia implementada no município do Rio de Janeiro de utilização de dados de atendimentos de urgência e emergência unida à aplicação de modelos de detecção de tendências para geração automatizada de alertas. A partir de CIDs marcados nos prontuários eletrônicos de atendimentos, monitoram-se séries temporais de eventos de interesse no município. Um modelo GAM é ajustado às séries para suavização, determinação da inclinação e geração dos alertas. Os resultados são exibidos em painel e monitorados diariamente. Desde 2023, múltiplos eventos de interesse foram identificados através do painel e resultaram em comunicação coordenada e ações no território. Os resultados exaltam a potencialidade no uso desses dados na identificação de eventos de interesse em tempo oportuno, alinhando-se a conceitos de uma vigilância moderna

Improved serological detection of rheumatoid arthritis: a highly antigenic mimotope of carbonic anhydrase III selected in a murine model by phage display

© 2015 Araujo et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects around 1% of the human population worldwide. RA diagnosis can be difficult as there is no definitive test for its detection. Therefore, the aim of this study was to identify biomarkers that could be used for RA diagnosis. Methods: Sera from a collagen-induced arthritis mouse model were used to select potential biomarkers for RA diagnosis by phage display technology. In silico and in vitro analyses were performed to characterize and validate the selected peptides. Samples were classified into three groups: RA; two other immune-mediated rheumatic diseases (systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS)); and healthy controls (HC). Enzyme-linked immunosorbent assay (ELISA) was carried out to determine antibody levels, and diagnostic parameters were determined by constructing receiver operating characteristic curves. Mass spectrometry and Western blot were performed to identify the putative autoantigen that was mimicked by a highly reactive mimotope. Results: After three rounds of selection, 14 clones were obtained and tested for immunoreactivity analysis against sera from RA and HC groups. The phage-fused peptide with the highest immunoreactivity (M12) was synthesized, and was able to efficiently discriminate RA patients from SLE, AS and HCs (p < 0.0001) by ELISA. The specificity and sensitivity of anti-M12 antibodies for RA diagnosis were 91 % and 84.3 %, respectively. The M12 peptide was identified as one that mimics a predicted antigenic site of the carbonic anhydrase III (CAIII) protein, a ubiquitous biomarker that has been identified in patients with other diseases. Conclusion: M12 is the first peptide associated with the CAIII protein that may be used as an antigen for antibody detection to aid in RA diagnosis with high sensitivity and specificity.This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Foundation, Ministry of Education of Brazil (CSF SDW-2027/13-5) and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).info:eu-repo/semantics/publishedVersio

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

What are the engagement strategies for people with leprosy? A scoping review

The protocol for scoping review of the engagement strategies for people with lepros