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Resolutive Results with Oral Corticosteroids for Patients with COVID-19 in Pulmonary Inflammatory Phase. Successful Outpatient Experience during the Collapse of Belem Do Para Health System—Brazil

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Health 2021年第8期13卷 830-838页

作者： Roberto S. Zeballos Luciana N. L. Cruz Vânia C. R. Brilhante Adriana V. Lima Carlliane L. L. P. Martins Karla N. A. Lima Michele C. G. L. Leão Belinete L. Cruz Alessandra B. Dysarz Paulo C. B. Lobato Erika S. Almeida Rute A. P. Costa Klevison C. Araújo Augusto C. C. Almeida Leônidas B. D. Junior Kathia O. Harada Rita H. V. S. Araújo Elaine X. Prestes Ivete M. S. Souza Avany M. P. Pereira Antônio B. M. A. Rocha Iracema A. Estevão Fagnei I. C. Carvalho Paulo M. P. Melo clinical Care Sao Paulo Brazil Instituto de Ciencias da saude Faculdade de Medicina Universidade Federal do Para Belem Brazil Fundacao Publica Estadual Hospital de clinicas Gaspar Vianna Belem Brazil Hospital da Policia Militar do Para Belem Brazil Imunoclinic Belem Brazil Universidade Estadual do Para Fundacao Santa Casa de Misericordia do Para Belem Brazil clinica Barros Cirurgia Plastica Belem Brazil secretaria de Estado de saude Publica Castanhal Brazil Centro de Tratamento Oncologico Belem Brazil Sociedade Brasileira de Valorizaç ã o das Sociedades Medicas—SOBEMED S&#227 o Paulo Brazil clinica de Nutrologia Sao Luiz Brazil Hospital Nipo Brasileiro de Olhos Belem Brazil Centro de Ciencias Biologicas e da saude Universidade do Estado do Para Belem Brazil Hospital Regional do Baixo Amazonas Santarem Brazil clinica vallinoto secretaria de saude de barcarena Barcarena Brazil Estrategia saude da Familia secretaria Municipal de saude de Ananindeua Centro Universitario do Estado do Para Belem Brazil A. M. P. Endocrinologia Belem Brazil Instituto Avertano Rocha Belem Brazil departamento de Neurocirurgia Hospital Militar de Area De Sao Paulo Sao Paulo Brazil

In the face of new diseases, medicine needs to reinvent itself in order to contain and control epidemics, such as the one we have recently faced, COVID-19, a disease with a wide spectrum of clinical severity. A new moment has been established, since the application of well-known, effective and safe medications for other diseases, has shown high success rates in the treatment of COVID-19. Thereunto, studies with early intervention are needed, which can change the unfavorable outcome of patients. In this article, we report the successful experience using an oral strategy during the collapse of Belem (Para, Brazil) Health System. Two hundred and ten patients were diagnosed with respiratory failure due to COVID-19, with no option of hospital treatment due to lack of beds and resources. These patients were then started on therapeutic regimen consisting of 40 mg prednisolone, 40 mg enoxaparin and macrolides (500 mg clarithromycin, 500 mg axetylcefuroxime) associated and followed in outpatient facilities. Two hundred and eight patients had an excellent therapeutic response and there were only two fatalities. These results push research boundaries, valuing outpatient treatment with early use of prednisolone in the initial pulmonary phase, preventing severe COVID-19 pneumonitis. Adoption of the proposed treatment intends to reduce the need for hospitalization, as well as lethality, with social robust benefits and incalculable economic savings since involves the use of accessible, safe and not expensive medications.

关键词： COVID-19 Corticosteroids Pulmonary Inflammatory Phase Collapse Brazil

Microcephaly prevalence after the 2015 to 2016 Zika outbreak in Tangará da Serra, Brazil: a population-based study

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Reproductive and developmental Medicine 2022年第2期6卷 98-103页

作者： Juliana Herrero da Silva Ana Claudia Pereira Tercas-Trettel Juliano Andre Boquett Giovanny Vinicius Araujo Franca Augusto Cesar Cardoso-dos-Santos Marina Atanaka Marcelo Zagonel Oliveira Anna Pires Terra Viviane Karoline Vivi Lucia Andreia Nunes de Oliveira Lucia Schaedler Ronaldo Fernandes Santos Alves Lavinia Schuler-Faccini Prefeitura Municipal de Tangara da Serra Secretaria de SaudeVigilancia EpidemiologicaTangara da SerraBrazil Programa de Pos-Graduacao em Genetica e Biologia Molecular Universidade Federal do Rio Grande do SulPorto AlegreBrazil Universidade do Estado de Mato Grosso Tangara da SerraBrazil Programa de Pos-Graduagcao em saude Coletiva Universidade Federal de Mato GrossoCuiabaBrazil Instituto Nacional de Genetica Medica Populacional-INaGeMP Servico de Genetica MedicaHospital de Clinicas de Porto Alegre(HCPA)Porto AlegreBrazil Programa de Pos-Graduacao em saude da Crianga e do Adolescente Universidade Federal do Rio Grande do SulPorto AlegreBrazil secretaria de Vigilancia em saude Ministerio da SaudeBrasiliaBrazil Laboratorio de Visualizacao Avangada e Geoinformatica(VIZLab) Programa de Pos-Graduacao em Computacao AplicadaUniversidade do Vale do Rio dos SinosSao LeopoldoBrazil Programa de Pos-Graduacao em Ciencia da Informacao Universidade Federal do Rio Grande do SulPorto AlegreBrazil clinica Santa Luzia Tangara da SerraBrazil

Objective::Prenatal infection with the Zika virus (ZIKV) can lead to congenital Zika syndrome (CZS), characterized by microcephaly and brain injury. However, there are questions regarding the prevalence of microcephaly/CZS after the ZIKV outbreak in defined geographic areas. This study aimed to identify adverse outcomes in live births of fetuses exposed in utero to the ZIKV, compared to unexposed births, as well as maternal sociodemographic, delivery, and birth ***::Here, we conducted a cross-sectional observational study to investigate the characteristics of all live births in the city of Tangará da Serra, Mato Grosso, Brazil, in 2016, after the outbreak of ZIKV infection in late 2015. All live births of children to women residing in the municipality of Tangará da Serra between January 1 and december 31, 2016, were evaluated, and head circumference was measured at birth and after 24 hours. Children born with microcephaly or a maternal history of confirmed or suspected prenatal ZIKV infection were evaluated by a multidisciplinary team. The outcomes of the exposed and non-exposed children were compared. Prevalence ratios and their respective 95% confidence intervals were calculated for sociodemographic, delivery, and live birth ***::Of 1,441 live births, 106 (7.3%) were from mothers with confirmed or highly probable exposure to ZIKV. The prevalence of severe congenital microcephaly (41.7/10,000) in Tangará da Serra in 2016 was ten-fold higher than that in Latin America before ***::This study may serve as a model to investigate possible outbreaks of infections in a defined geographical space in the future.

关键词： Epidemiology Live births Microcephaly Zika virus

Oficina das Letras： Practical Approach to Writing in a Psychiatric Hospital

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Psychology Research 2018年第8期8卷 367-374页

作者： Barbara de Caldas Melo Leila Akemi Evangelista Kusano Rosiberton Pereira da Cruz Michelle Andreza Falcao Rodrigues Centro Universitario UDF Brasilia (DF) Brasil secretaria de Estado de saude do Distrito Federal Brasilia (DF) Brasil

Schistosomiasis Mansoni in the Amazon Region:Malacological Surveys of Intermediate Hosts for the Identification of Disease Transmission Areas in Belem,Para,Brazil

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Journal of Pharmacy and Pharmacology 2019年第2期7卷 51-60页

作者： Christiane de Oliveira Goveia Ricardo Jose de Paula Souza e Guimaraes Marcio Roberto Teixeira Nunes Isabelle Helena Lima Dias Martin Johannes Enk Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da Saude-IEC/SVS/MS-Secao de ParasitologiaLaboratario de Parasitoses IntestinaisEsquistossomose e MalacologiaAnanindeuaParaBrasil Programa de Pos-Graduacao em Biologia Parasitaria na Amazonia Universidade do Estado do Para-UEPABelemParaBrasil Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da SaudeLaboratorio de Geoprocessamento-LABGEO/IEC/SVS/MSAnanindeuaParaBrasil Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da SaudeCentro de Inovacoes Tecnologicas-CIT/IEC/SVS/MSAnanindeuaParaBrasil

In Brazil,schistosomiasis occurrence is related to the presence of the etiological agent Schistosoma *** presence of mollusks for Biomphalaria genus is a necessary condition for development of the parasite *** Parástate,the species ***,***,*** and *** have already been identified,with reports of the last two occurring in Belé*** aim of this study was to determine the spatial distribution of Biomphalaria species in Belém,Pará,Brazil,identifying risk areas for schistosomiasis *** malacological surveys were carried out between September 2013 and October 2017 in 35 neighborhoods of Belé*** collection points were georeferenced using a Global Positioning System(GPS)receiver and the Kernel density Estimation(Kde)was used to the spatial *** mollusks,after measurement,were exposed to light to verify the presence of *** ***,mollusks were sacrificed and fixed for dissection and morphological identification of *** surveys resulted in a total of 10,803 mollusks collected,of which 9,367(86.70%)specimens were *** the analyzed mollusks,5,820(62.14%)were identified as *** and 3,547(37.86%)as *** presence of the parasite was observed in 208(2.22%)specimens,all *** mollusks were found in six neighborhoods:Guamá(51 mollusks/24.5%),Sacramenta(47 mollusks/22.6%),Telégrafo(47 mollusks/22.6%),Terra Firme(36 mollusks/17.3%),Condor(20 mollusks/9.6%)and Barreiro(7 mollusks/3.4%).This study confirms that *** species actively participates as intermediate host in the disease maintenance in Belé*** Kde allowed to analyze the spatial distribution of collection sites and consequently to determine possible risk areas of schistosomiasis transmission in *** development of maps identifying sites with schistosomiasis positive snails may support efforts of this municipality by directing activities related to endemic disease control.

关键词： Biomphalaria spp. Schistosoma mansoni intermediate hosts schistosomiasis spatial analysis

2015年巴西寨卡病毒感染与小头畸形之间可能存在的关联

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上海预防医学 2017年第1期29卷 82-84页

作者： Lavinia Schuler-Faccini Erlane M.Ribeiro Ian M.L.Feitosa Dafne D.G.Horovitz denise P.Cavalcanti AndréPessoa Maria Juliana R.Doriqui Joao Ivanildo Neri Joao Monteiro de Pina Neto Hector Y.C.Wanderley Mirlene Cernach Antonette S.El-Husny Marcos V.S.Pone Cassio L.C.Serao Maria Teresa V.Sanseverino 朱秋丽(译) 陆仁敏(校) Universidade Federal do Rio Grande do Sul Brazil Hospital Infantil Albert Sabin FortalezaCEBrazil Universidade Federal de Pernambuco Brazil Fundaqao Oswaldo Cruz Rio de JaneiroBrazil University of Campinas Sao PauloBrazil Hospital Infantil Juvencio Mattos MaranhaoBrazil Universidade Potiguar Rio Grande do NorteBrazil University of Sao Paulo Ribeirao PretoBrazil secretaria de Estado da saude do Espirito Santo Brazil Universidade Federal de Sao Paulo Brazil Centro Universitario do Estado do Para Brazil Universidade do Estado do Rio de Janeiro Brazil Hospital de clinicas de Porto Alegre Brazil Brazilian Medical Genetics Society-Zika Embryopathy Task Force 不详

2015年初,通过伊蚊传播的寨卡病毒在登革热病毒流行地区巴西的东北部暴发,该病毒属于黄病毒属。2015年9月,寨卡病毒流行地区开始出现关于小头畸形患儿的报道,且报道数量呈现增加的趋势。与此同时,有2名妇女产前超声检查发现有胎儿畸形,... 详细信息

2015年初,通过伊蚊传播的寨卡病毒在登革热病毒流行地区巴西的东北部暴发,该病毒属于黄病毒属。2015年9月,寨卡病毒流行地区开始出现关于小头畸形患儿的报道,且报道数量呈现增加的趋势。与此同时,有2名妇女产前超声检查发现有胎儿畸形,在她们的羊水中也检测出寨卡病毒RNA。

关键词：小头畸形病毒感染报道数量登革热病毒产前超声检查胎儿畸形西寨黄病毒属病毒流行先天性异常