UTILIZAÇÃO DE TECNOLOGIAS EM SAÚDE NA CONSULTA PUERPERAL NO CONTEXTO DA PANDEMIA DE COVID-19

Objective: to describe the experience of developing computerized and educational technologies in health in a family clinic located in the city of Rio de Janeiro, to improve the quality of care for postpartum women in the context of the covid-19 pandemic. Method: This is an experience report with the application of an intervention project based on the problem tree methodology. Results: virtual health technologies were developed, such as Infographic, to support the conduct of care to postpartum women, application of virtual forms and teleconsultation through video platforms. Final considerations: It is expected that the results of this study contribute to the construction of care mediated by technologies, equipping professionals to meet the needs of women in the puerperal period.Objetivo: describir la experiencia de desarrollo de tecnologías informatizadas y educativas en salud en una clínica familiar ubicada en la ciudad de Río de Janeiro, para mejorar la calidad de la atención a mujeres posparto en el contexto de la pandemia de covid-19. Método: Se trata de un relato de experiencia con la aplicación de un proyecto de intervención basado en la metodología del árbol de problemas. Resultados: se desarrollaron tecnologías de salud virtual, como Infografía, para apoyar la conducción de la atención a las mujeres posparto, la aplicación de formularios virtuales y la teleconsulta a través de plataformas de video. Consideraciones finales: Se espera que los resultados de este estudio contribuyan a la construcción de un cuidado mediado por tecnologías, equipando a los profesionales para atender las necesidades de las mujeres en el puerperio.Objetivo: descrever a experiência do desenvolvimento de tecnologias informatizadas e educacionais em saúde em uma clínica da família localizada no município do Rio de Janeiro, para a melhoria da qualidade de assistência as puérperas no contexto da pandemia de covid-19. Método: Trata-se de um relato de experiência com a aplicação de um projeto de intervenção pautado na metodologia de árvore de problemas. Resultados: foram elaboradas tecnologias virtuais em saúde, como Infográfico, para apoio a condução dos atendimentos às puérperas, aplicação de formulários virtuais e teleconsulta por plataformas de vídeo. Considerações finais: Espera-se que os resultados deste estudo contribuam na construção do cuidado mediado pelas tecnologias, instrumentalizando os profissionais no atendimento às necessidades da mulher no período puerpera

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Estudo da variabilidade genética do parvovírus humano B19 circulante em Niterói

A infecção pelo parvovirus humano (B19V) tem distribuição mundial, sendo geralmente aguda e auto-limitada em pessoas imunocompetentesque desenvolvem o eritema infeccioso (EI). No entanto indivíduos imunocomprometidos, como os infectados pelo HIV, podem desenvolver uma infecção persistente resultando em anemia crônica. Por causa da diversidade genética, hojeo B19V é classificado em três genótipos distintos (1, 2 e 3), sendo que os genótipos 1 e 3 são subdivididos em 1a (B19V) e 1b, 3a (V9) e 3b (D91.1). Como o Serviço de Infectologia do Hospital Universitário Antônio Pedro (HUAP/UFF) possui uma soroteca com amostras coletadas de pacientes com EI e de pacientes infectados pelo HIV, este trabalho teve como objetivo realizar a caracterização molecular dos genótipos do B19V circulantes em Niterói/ RJ entre 1996 e 2006, período em que dois surtos (1999-2000 e 2004-2005) de EI foram observados.Para isto, 131 soros de pacientes com EI e cinco soros de pacientes infectados pelo HIV com confirmação laboratorial para o B19V foram selecionados. Para a pesquisa do genoma do B19V nas amostras dos indivíduos infectados pelo HIV foram utilizados iniciadores (E1987F e E1905R)que amplificam um fragmento de 102pb da região do genoma que codifica para a proteína NS1.Para as amostras de pacientes com EI foram utilizados iniciadores (P12 e P16). que amplificam um fragmento de 563pb, da região do genoma que codifica para a proteína do capsídeo viral, VP1/VP2. Para o sequenciamento, foram utilizados os produtos da snPCR (476pb) dos iniciadores P12/P16 e P13/P16. Dentre as 56/131 amostras dos pacientes de EI em que o genoma do B19V foi detectado, em 27 foi possível o sequenciamento.As amostras sequenciadas de pacientes de EI e 4/5 de pacientes infectados pelo HIV foram classificados como G1a caracterizando sua circulação nos surtos de 1999-2000 e de 2004-2005, enquanto que uma amostra de um paciente infectado pelo HIV, caracterizada como G3b foi identificada no surto de 2004-2005. Entretanto nenhuma relação entre genótipo e sintoma clínico ou ano e local do isolamento da amostra pode ser estabelecidaO presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES)The infection with human parvovirus (B19V) has worldwide distribution and is usually acute and self-limited in immunocompetent persons who develop erythema infectiosum (EI). However immunocompromised individuals such as those infected with HIV may develop a persistent infection resulting in chronic anemia. Because of the genetic diversity, today B19V is classified into three distinct genotypes (1, 2 and 3). Genotypes 1 and 3 are subdivided into 1a (B19V) and 1b, 3a (V9) and 3b (D91.1). As the Service of Infectious Diseases, Hospital Universitário Antônio Pedro (HUAP / UFF) has a serum bank with samples collected from patients with EI and HIV-infected patients, this study aimed to perform molecular characterization of circulating genotypes of B19V in Niterói / RJ between 1996 and 2006, during which two outbreaks (1999-2000 and 2004-2005) of EI were observed. For this purpose, 131 sera from patients with EI and five sera from HIV-infected confirmed for B19V infedtion were selected.. For the research of the B19V genome in samples of individuals infected by HIV primers (E1987F/E1905R) that amplify a fragment of 102bp region of the genome encoding the NS1 protein were used. For samples from patients with EI primers (P12/P16) which amplify a fragment of 563bp, the region of the genome encoding the viral capsid protein, VP1 / VP2 were used. For sequencing, the products of nPCR (476pb) with primers P12 / P16 and P13 / P16 were used. Among the 56/131 patients samples of EI the B19V genome was detected and in 27 was possible sequencing. The samples sequenced of EI patients and 4/5 of HIV-infected patients were classified as G1a featuring its circulation in outbreaks of 1999-2000 and 2004-2005, while a sample of HIV-infected patient, characterized G3b was identified in the outbreak of 2004-2005. However, no relationship between genotype and clinical symptoms, or year and local isolation of the sample may be determined.99f

Emergence of methicillin-resistant Staphylococcus aureus from clonal complex 398 with no livestock association in Brazil

<div><p>CC398 is a livestock-associated Staphylococcus aureus. However, it has also been isolated from humans with no previous contact with livestock. A surveillance of methicillin-resistant S. aureus colonisation among children attending public day care centres and hospitals in Niterói and Rio de Janeiro, Brazil, between 2011 and 2013, resulted in the isolation of six cases of CC398 from individuals with no previous exposure to livestock. These isolates showed a high frequency of the erm(C) gene (4/6, 66.7%) with induced resistance to clindamycin, and a relatively high frequency of SEs and lukS/lukF genes. These results suggest the emergence of a non-LA-CC398 in Brazil.</p></div

The relationship between birth weight and insulin resistance in childhood

Chronic diseases that are typical of adulthood may originate in intra-uterine life through inadequate fetal development. The present epidemiological cohort study of 506 healthy children aged 5\20138 years evaluated the relationship between birth weight and insulin resistance in an age group that has been assessed in few similar studies. Insulin concentration was determined by chemiluminescence and insulin resistance by the homeostasis model assessment (HOMA). Blood glucose, total cholesterol and fractions (LDL cholesterol and HDL cholesterol) and TAG concentrations were determined by automated enzymatic methods. Linear regression analysis investigated the relationship between birth weight (assessed as a continuous variable and in three categories: small for gestational age, SGA; adequate for gestational age and large for gestational age) and the HOMA index, using backward stepwise selection and biological models to explain the causal pathway of the relationship. There were negativeassociations between birth weight (P < 0·001), SGA (P = 0·027) and the HOMA index, and a positive association between waist circumference (P < 0·001) and the HOMA index. Considering the significant associations between birth weight and waist circumference (P < 0·001) and waist circumference and insulin resistance (P < 0·001), we can probably suspect that lower birth weight is a common cause of higher waist circumference and insulin resistance. In summary, the results of the present study showed increased insulin resistance in apparently healthy, young children, who had lower weight at birth and higher measurements of waist circumference. There is a need to develop public health policies that adopt preventive measures to promote adequate maternal-fetal and child development and enable early diagnosis of metabolic abnormalitiesFAPESP n. 04/04109-