Einstein-Sao Paulo最新文献

{"title":"Analysis of signs and symptoms in confirmed cases of severe dengue among children aged 0 to 10 years old.","authors":"Álvaro Silvério Avelino da Silva, Francisco Leal Carvalho, Giovanna Araújo Pinto, Laís Silva Rios Saad, Mariana Oliveira Curado, Thais Caroline Dallabona Dombroski, Hugo Dias Hoffmann-Santos, Rosa Maria Elias","doi":"10.31744/einstein_journal/2024AO0546","DOIUrl":"10.31744/einstein_journal/2024AO0546","url":null,"abstract":"<p><strong>Objective: </strong>The prevalent symptoms of severe dengue in pediatric patients are divided into three subgroups: severe plasma leakage, severe bleeding, and severe organ damage. In addition, the seasonal patterns of the disease and the outcomes of cure or death from dengue were evaluated.</p><p><strong>Methods: </strong>An epidemiological, observational, analytical, cross-sectional study was conducted with data from the Notifiable Disease Information System (SINAN - Sistema de Informação de Agravos de Notificação and DATASUS - Departamento de Informática do Sistema Único de Saúde) of the Ministry of Health from 2019 to 2020.</p><p><strong>Results: </strong>During the study period, 1,857 cases of severe dengue were observed in the pediatric age group, with the most common symptoms being respiratory failure, melena, hematemesis, and altered level of consciousness. The total proportion of patients hospitalized for severe dengue was 89.6%, and 51.2% of these patients died, corroborating the importance of early detection of the disease.</p><p><strong>Conclusion: </strong>Severe dengue is more prevalent during the seasonal period, with hot and humid characteristics owing to the mechanism involved in the viral cycle. The most prevalent symptoms of severe dengue in pediatric patients were respiratory failure alone, gastrointestinal bleeding, and altered level of consciousness. It is important to identify signs of severity for early intervention and a better prognosis, considering that death is closely related to a delayed diagnosis.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a biocellulose-based repair of fetal open spina bifida on the need to untether the cord: is it time to unify techniques for prenatal repair?","authors":"Denise Araújo Lapa, Gustavo Yano Callado, Giulia Catissi, Lucas Trigo, Fernanda Faig-Leite, Ana Paola Arthaud Berthet Sevilla","doi":"10.31744/einstein_journal/2024AO0557","DOIUrl":"10.31744/einstein_journal/2024AO0557","url":null,"abstract":"<p><strong>Objective: </strong>To report the need for cord untethering after prenatal repair of open spina bifida using a unique biocellulose-based technique performed at a later gestational age.</p><p><strong>Methods: </strong>An observational cohort study was conducted to determine the incidence of tethered cord syndrome. Between May 2013 and May 2022, we performed 172 procedures using the percutaneous fetoscopic approach in fetuses at 26-28 weeks of gestation. After placode dissection, a biocellulose patch was placed to cover the placode, a myofascial flap (when possible) was dissected, and the skin was closed. Owing to death or loss to follow-up, 23 cases were excluded. Cord tethering syndrome was defined as symptoms of medullary stretching, and the infants were evaluated and operated on by local neurosurgeons after an magnetic resonance imaging examination. Infants over 30-month had ambulation and neurodevelopment evaluations (PEDI scale).</p><p><strong>Results: </strong>Among 172 cases operated at a median gestational age of 26.7 weeks and delivered at 33.2 weeks, 149 cases were available for postnatal follow-up, and cord untethering was needed in 4.4% of cases (6/136; excluding 13 cases younger than 12 months). Cerebrospinal fluid diversion and bladder catheterization were needed in 38% and 36% of cases, respectively. Of the 78 cases evaluated at 30 months, 49% were ambulating independently, and 94% had normal social function.</p><p><strong>Conclusion: </strong>The biocellulose-based technique was associated with a low rate of cord tethering, wich may be attributed to the lack of the duramater suture during prenatal repair, the formation of a neoduramater and/or later gestational age of surgery.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slide tracheoplasty for congenital tracheal stenosis with involvement of the carina and bronchi: a case report.","authors":"Fabio Eiti Nishibe Minamoto, Mariana Rodrigues Cremonese, Eduardo de Campos Werebe, Victor Nudelman, Helio Minamoto","doi":"10.31744/einstein_journal/2024RC0659","DOIUrl":"10.31744/einstein_journal/2024RC0659","url":null,"abstract":"<p><p>A female newborn presented with respiratory distress at birth and was diagnosed with congenital tracheal stenosis. The stenosis was positioned at the distal trachea and compromised the carina and the right and left bronchi. She underwent surgical treatment using circulatory life support with veno-arterial peripheral extracorporeal membrane oxygenation, and the airway was reconstructed using the slide tracheoplasty technique to build a neocarina. The patient had an excellent postoperative course, was successfully weaned from extracorporeal membrane oxygenation and invasive ventilation, and was discharged.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet use by pregnant women during prenatal care.","authors":"Carolina Fernandes Giacometti, Giulia Siqueira Galfano, Denis Schapira Wajman, Eduardo Cordioli, Ana Paula Avritscher Beck, Sérgio Podgaec","doi":"10.31744/einstein_journal/2024AO0447","DOIUrl":"10.31744/einstein_journal/2024AO0447","url":null,"abstract":"<p><strong>Objective: </strong>The search for medical information on the internet is a part of people's daily lives. Exponential volumes of data are available through various media and platforms. There are several problems related to the ease of creating and accessing medical information on the internet, as evidenced by the quantity of false content and increasing anxiety due to the consumption of these data. In light of this accessibility, it is necessary to understand how people use internet-based medical information and its impact on specific populations. This prospective study aimed to analyze pregnant women's behavior when searching for health-related information on the internet, and how they were influenced by the information.</p><p><strong>Methods: </strong>Questionnaires were administered to the participants during their immediate puerperium, and their answers were tabulated.</p><p><strong>Results: </strong>Three hundred and two patients answered the questionnaires. We observed that internet use was frequent, and most patients discussed the findings with their physicians. However, this did not affect the delivery routes.</p><p><strong>Conclusion: </strong>The search for health information by pregnant women is very prevalent but does not interfere with the delivery route.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torsades de pointes and myocardial infarction following reversal of supraventricular tachycardia with adenosine: a case report.","authors":"Milena Ribeiro Paixão, Fernando Faglioni Ribas, Tarso Augusto Duenhas Accorsi, Karine De Amicis, José Leão de Souza","doi":"10.31744/einstein_journal/2024RC0522","DOIUrl":"10.31744/einstein_journal/2024RC0522","url":null,"abstract":"<p><p>Adenosine is an antiarrhythmic drug that slows conduction through the atrioventricular node and acts as a coronary blood vessel dilator. This case report highlights two unusual life-threatening events following the use of adenosine to revert supraventricular tachycardia in a structurally normal heart: non-sustained polymorphic ventricular tachycardia and myocardial infarction. A 46-year-old woman presented to the emergency department with a two-hour history of palpitations and was diagnosed with supraventricular tachycardia. Vagal maneuvers were ineffective, and after intravenous adenosine administration, the patient presented with chest pain and hypotension. The rhythm degenerated into non-sustained polymorphic ventricular tachycardia and spontaneously reverted to sinus rhythm with ST elevation in lead aVR and ST depression in the inferior and anterolateral leads. The patient spontaneously recovered within a few minutes. Despite successful arrhythmia reversal, the patient was admitted to the intensive care unit because of an infarction without obstructive atherosclerosis. This report aims to alert emergency physicians about the potential complications associated with supraventricular tachycardia and its reversal with adenosine.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal and spatial analysis of over 7,000 measles cases outbreak from 2018 to 2019 in the Brazilian Amazon.","authors":"Felipe de Mello Martins, Alessandra Pinheiro Vidal, Jeevan Giddaluru, Bernardo Maia da Silva, Eva K Lee, Peijue Zhang, Lucas Esteves Cardozo, Carlos Augusto Prete Junior, Helves Humberto Domingues, Ester Cerdeira Sabino, Vanderson de Souza Sampaio, Wuelton Marcelo Monteiro, Helder I Nakaya","doi":"10.31744/einstein_journal/2024AO0931","DOIUrl":"10.31744/einstein_journal/2024AO0931","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present a temporal and spatial analysis of the 2018 measles outbreak in Brazil, particularly in the metropolitan city of Manaus in the Amazon region, and further introduce a new tool for spatial analysis.</p><p><strong>Methods: </strong>We analyzed the geographical data of the residences of over 7,000 individuals with measles in Manaus during 2018 and 2019. Spatial and temporal analyses were conducted to characterize various aspects of the outbreak, including the onset and prevalence of symptoms, demographics, and vaccination status. A visualization tool was also constructed to display the geographical and temporal distribution of the reported measles cases.</p><p><strong>Results: </strong>Approximately 95% of the included participants had not received vaccination within the past decade. Heterogeneity was observed across all facets of the outbreak, including variations in the incubation period and symptom presentation. Age distribution exhibited two peaks, occurring at one year and 18 years of age, and the potential implications of this distribution on predictive analysis were discussed. Additionally, spatial analysis revealed that areas with the highest case densities tended to have the lowest standard of living.</p><p><strong>Conclusion: </strong>Understanding the spatial and temporal spread of measles outbreaks provides insights for decision-making regarding measures to mitigate future epidemics.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcoid-like reaction induced by neoadjuvant immunotherapy in Stage III non-small cell lung cancer.","authors":"Leonardo Chaves Machado, Eduardo Kaiser Ururahy Nunes Fonseca, Genival Viana de Oliveira Júnior, Gustavo Schvartsman, Rodrigo Caruso Chate","doi":"10.31744/einstein_journal/2024AI0810","DOIUrl":"10.31744/einstein_journal/2024AI0810","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life of women who underwent breast cancer treatment relative to sociodemographic, behavioral, and clinical factors.","authors":"Angélica Atala Lombelo Campos, Maria Teresa Bustamante-Teixeira, Rafaela Russi Ervilha, Vivian Assis Fayer, Jane Rocha Duarte Cintra, Renata Mendes de Freitas, Daniela Pereira de Almeida, Maximiliano Ribeiro Guerra","doi":"10.31744/einstein_journal/2024AO0585","DOIUrl":"10.31744/einstein_journal/2024AO0585","url":null,"abstract":"<p><strong>Objective: </strong>Patients with cancer often undergo multiple extended treatments that decrease their quality of life. However, the quality of life of women with breast cancer after they undergo treatment remains underexplored in Brazil. Therefore, this study determined sociodemographic, behavioral, and clinical factors related to the post-treatment quality of life of women with breast cancer.</p><p><strong>Methods: </strong>This cross-sectional study involved 101 women diagnosed with breast cancer between 2014 and 2016 and treated at a Brazilian Oncology Reference Service. Data were collected from them using face-to-face surveys. Quality of life was evaluated using the European Organization for the Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) and EORTC Breast Cancer-specific Quality of Life questionnaire (EORTC QLQ-BR23). The data collected were analyzed using Student's t-test and Mann-Whitney U test.</p><p><strong>Results: </strong>The median score on the global health, functional, and symptom scales of the EORTC QLQ-C30 was 75.00 (Interquartile range=33.33), 75.99 (Standard deviation [SD]=19.26), and 19.67 (SD=16.91), respectively. The mean score on the functional and symptom scales of the EORTC QLQ-BR23 was 61.89 (SD=17.21) and 20.12 (SD=16.94), respectively. Furthermore, higher post-treatment quality of life was found to be associated with being aged 50 or more, being Black, having eight or more years of education, having a partner, having a paying job, receiving treatment from the private healthcare system, having a higher income, living in the municipality where healthcare services are availed, engaging in physical activity, not smoking, being more religious, having more social support, not being overweight, having no comorbidities, and undergoing lumpectomy.</p><p><strong>Conclusion: </strong>Sociodemographic, behavioral, and clinical factors significantly impact the quality of life of women who undergo breast cancer treatment. Implementing interventions that improve health and reducing inequalities in the access to healthcare services can improve the quality of life of these patients.</p><p><strong>Background: </strong>Sociodemographic, clinical, and lifestyle factors impact the quality of life of breast cancer survivors.</p><p><strong>Background: </strong>Breast cancer therapy may affect future perspectives and emotional, cognitive, and sexual function.</p><p><strong>Background: </strong>Some aspects of quality of life still require attention from health professionals.</p><p><strong>Background: </strong>Higher post-treatment quality of life of women with breast cancer is linked to being aged 50 or more, being Black, having 8 or more years of education, having a partner, having a paying job, receiving care from private healthcare, having a high per capita income, residing in the municipality where the service is availed, engaging in physical activity, not smoking, greater religiosity, h","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ringing a bell in healthcare: harnessing benefits, overcoming implementation challenges, and bridging knowledge gaps of Closed-Loop Oxygen Control systems (CLOCs).","authors":"Caroline Gomes Mól, Aléxia Gabriela da Silva Vieira, Raquel Afonso Caserta Eid, Ary Serpa Neto, Marcus J Schultz, Ricardo Kenji Nawa","doi":"10.31744/einstein_journal/2024CE0910","DOIUrl":"10.31744/einstein_journal/2024CE0910","url":null,"abstract":"","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New immunological aspects of peri-implantitis.","authors":"Bárbara Bellocchio Bertoldo, Guilherme Oliveira Paulo, Taíssa Cássia de Souza Furtado, Thiago Lima Pereira, Virmondes Rodrigues Junior, Denise Bertulucci Rocha Rodrigues, Juliana Barbosa de Faria, Rodrigo César Rosa, Sanívia Aparecida de Lima Pereira","doi":"10.31744/einstein_journal/2024AO0396","DOIUrl":"10.31744/einstein_journal/2024AO0396","url":null,"abstract":"<p><strong>Background: </strong>The authors compared the levels of HIF1-α, VEGF, TNF-α, and IL-10 in peri-implant crevicular fluid between patients with or without peri-implantitis. HIF-1α levels were significantly high in the peri-implantitis possibly due to hypoxia triggered by persistent inflammation.</p><p><strong>Objective: </strong>This study aimed to compare the levels of HIF1-α, VEGF, TNF-α, and IL-10 in the peri-implant crevicular fluid of patients with and without peri-implantitis.</p><p><strong>Methods: </strong>Forty patients, comprising 16 with and 24 without peri-implantitis were selected.</p><p><strong>Results: </strong>Patients with peri-implantitis exhibited significantly higher HIF-1α levels than those without peri-implantitis (p=0.0005). TNF-α revealed significant positive correlations with IL-10 (p=0.0008) and VEGF (p=0.0246), whereas HIF-1α and IL-10 levels (p=0.0041) demonstrated a negative and significative correlation in the peri-implantitis group.</p><p><strong>Conclusion: </strong>This study, for the first time demonstrates the balance of HIF-1α, TNFα, IL-10, and VEGF in peri-implantitis. It shows an elevated HIF-1α levels in patients with peri-implantitis, which could have stemmed from persistent inflammation- triggered hypoxia. Furthermore, the positive correlation between TNF-α and VEGF suggests intensified proinflammatory activity in peri-implantitis. Nevertheless, further studies are essential to understand these immune dynamics in peri-implantitis.</p><p><strong>Background: </strong>Higher levels of HIF-1α in patients with peri-implantitis occurred possibly due to persistent hypoxia triggered by inflammation.</p><p><strong>Background: </strong>Tissue hypoxia in peri-implantitis induced increase in HIF-1α consequently increased VEGF and angiogenesis, contributing to the persistence of inflammation.</p>","PeriodicalId":47359,"journal":{"name":"Einstein-Sao Paulo","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}