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Physico-chemical characterization of acid base disorders in patients with COVID-19:A cohort study

World Journal of Nephrology 2024年第2期13卷 16-23页

作者： Sergio Pinto de Souza Juliana R Caldas marcelo Barreto Lopes marcelo augusto duarte silveira Fernanda Oliveira Coelho Igor Oliveira Queiroz Pedro Domingues Cury Rogério da Hora Passos Department of Nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of Nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： COVID-19 Physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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Acute kidney injury and electrolyte disorders in COVID-19

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World Journal of Virology 2022年第5期11卷 283-292页

作者： Gabriel Martins Nogueira Noel Lucas Oliveira Rodrigues Silva Ana Flávia Moura marcelo augusto duarte silveira JoséA Moura-Neto Department of Medicine Bahiana School of Medicine and Public HealthSalvador 40290-000BahiaBrazil Department of Nephrology D’Or Institute for Research and EducationHospital São RafaelSalvador 41253900BahiaBrazil

Acute kidney injury(AKI)and electrolyte disorders are important complications of hospitalized coronavirus disease 2019(COVID-19)*** is thought to occur due to multiple pathophysiological mechanisms,such as multiple organ dysfunction(mainly cardiac and respiratory),direct viral entry in the renal tubules,and cytokine release *** is present in approximately one in every ten hospitalized COVID-19 *** incidence rates of AKI increase in patients who are admitted to the intensive care unit(ICU),with levels higher than 50%.Additionally,renal replacement therapy(RRT)is used in 7%of all AKI cases,but in nearly 20%of patients admitted to an ***-19 patients with AKI are considered moderate-to-severe cases and are managed with multiple interdisciplinary *** acts as a risk factor for mortality in severe acute respiratory syndrome coronavirus 2 infection,especially when RRT is *** disorders are also common manifestations in hospitalized COVID-19 patients,mainly hyponatremia,hypokalemia,and *** occurs due to a combination of syndrome of inappropriate secretion of antidiuretic hormone and gastrointestinal fluid loss from vomiting and *** it comes to hypokalemia,its mechanism is not fully understood but may derive from hyperaldosteronism due to renin angiotensin aldosterone system overstimulation and gastrointestinal fluid loss as *** clinical features of hypokalemia in COVID-19 are similar to those in other *** is the most common electrolyte disorder in COVID-19 and seems to occur because of vitamin D deficiency and parathyroid *** is also highly associated with longer hospital and ICU stay.

关键词： COVID-19 SARS-CoV-2 Acute kidney injury Electrolyte disorders Renal dialysis

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Rabies outbreak in Brazil: first case series in children from an indigenous village

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Infectious Diseases of Poverty 2023年第4期12卷 103-103页

作者： Dilceu silveira Tolentino Júnior Maryana Santos Vasconcelos Marques Amanda Krummenauer Magda Machado Saraiva duarte Silene Manrique Rocha Mariana Gontijo de Brito Ludmila Ferraz de Santana Roberto Carlos de Oliveira Eliseu Miranda de Assis Kellyn Kessiene de Sousa Cavalcante Carlos Henrique Alencar Postgraduate Program in Technology Environment and SocietyFederal University of the Jequitinhonha e Mucuri ValleysTeófilo OtoniMGBrazil Special Indigenous Health District of Minas Gerais and Espírito Santo Ministry of HealthGovernador ValadaresMGBrazil Brazil Field Epidemiology Training Program Ministry of HealthHealth and Environment Surveillance SecretariatBrasíliaDFBrazil Health Surveillance Secretariat Ministry of HealthBrasíliaDFBrazil State Department of Health of Minas Gerais Coordination of ZoonosesBelo HorizonteMGBrazil Postgraduate Program in Integrated Territory Management Vale do Rio Doce UniversityGovernador ValadaresMGBrazil Federal Institute of Bahia EunápolisBABrazil Postgraduate Program in Public Health Federal University of CearáFortalezaCEBrazil

BackgroundHuman rabies outbreak transmitted by bats continues to be a relevant public health problem not only in the Amazon region. The disease has affected one of the areas with the greatest poverty in southeastern Brazil, a region inhabited by the Maxakali indigenous *** presentationWe describe four cases of rabies among indigenous children that occurred in the indigenous village of Pradinho, municipality of Bertópolis, Minas Gerais, Brazil. Cases were notified between April and May 2022, all of whom died on average eight days after the first symptoms. All cases were observed in rural residents under 12 years of age. The probable form of exposure was through bat bites. The predominant symptoms were prostration, fever, dyspnea, sialorrhea, tachycardia, and altered level of consciousness. Half of the cases underwent late and/or incomplete post-exposure rabies prophylaxis, however, the other half underwent pre-exposure rabies prophylaxis, with only one case completing the scheme and another undergoing the adapted Milwaukee Protocol (Recife Protocol). All cases ended in *** was the first rabies outbreak among indigenous people in Brazil. Among the manifested clinical forms in the series, there was a disease atypical presentation in at least one case. We suggest active surveillance and an intercultural educational campaign to prevent new cases.

关键词： Rabies Outbreak Indigenous population Low income Brazil

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Historical Case Report: 45 Years of the First Plastic Surgery in Morbid Obese in Brazil and Their Weight Loss

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Modern Plastic Surgery 2020年第3期10卷 82-92页

作者： José Humberto Cardoso Resende Cristine Mara Fragoso Dos Santos Oliveira Heitor Dos Santos Leã o Bruno Viana Martins Brenda Martins Fernandes Valentina Ruvieri silveira Juliana Araújo Naves Ítalo Julierme Barros duarte Emídio Silva Falcã o Brasileiro UNIFAN Coordinator of the Work Aparecida de Goi&#226 nia Brazil UNIFAN Academics of Medicine Aparecida de Goi&#226 nia Brazil UNIFAN Coordinator of Research Aparecida de Goi&#226 nia Brazil

Before the 70s, in Brazil, each city had its morbidly obese, considered as the “excessive fats”, in very small numbers if we compare it with the current percentage. There was no classification of the degree of obesity by the body mass index (BMI) as we have today. By chance, on a Saturday in June 1975, at the Outpatient Clinic of the 23rd Infirmary of Santa Casa da Misericórdia Hospital in Rio de Janeiro, arrived the patient I. S., 41 years old, 1.70 m tall, supported by her two children, weighing 210 kg in weight body. Knowing that bariatric surgery only appeared in the 1980s, before that, patients with morbid obesity were left to their own devices, with hypertension and diabetes. The patient I. S. was hospitalized for 3 years in our Plastic Surgery Service, having received nutritional monitoring, had sporadic discharges and undergone 9 reparative plastic surgeries. She was discharged weighing 71 kg, with self-esteem recovered and happy to start a new life, without hypertension and diabetes.

关键词： Obesity Hypertension Diabetes Plastic Surgery Slimming

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