1039 Nocturnal Awakening With Headache In The Sao Paulo City, Brazil In The Follow-up Study (2015) And Relationship With Insomnia

Abstract Introduction The complaint of nocturnal awakening with headache (NAH), was prevalent (8.4%) in the São Paulo population and was associated with sleep disturbances, as demonstrated in a study conducted in 2007 (EPISONO). Indeed, this relationship between sleep and headache is well documented in the literature. Objective: To assess the incidence and evolution of NAH and to associate sleep-related variables in an eight-year prospective study. Methods From 1042 volunteers enrolled in the baseline, 712 agreed to participate in the follow-up. Questionnaires and scales were applied and polysomnography and actigraphy performed. The complaint of NAH was analyzed according to a frequency questionnaire and separated into frequent or occasional. Results At follow-up, 110 volunteers reported NAH, of which 82 were the same as those from the baseline, but only 38 had frequent complaints. Comparing with volunteers whose headache has become occasional, we have as a difference the insomnia severity index which is significantly higher in the group with frequent NAH (8.40 ± 5.10 vs 11.20±6.40 p:0.03) and worse sleep quality as measured by the Pittsburgh questionnaire (7.25±3.60 vs 10.25±4.60 p:0.002). In addition, these volunteers had higher anxiety (10.40±9.30 vs 12.00± 10:00 p: 0.008) and depression (10.60±9.90 vs 12:00±9.90 p:0.005) from Beck’s questionnaires and greater fatigue (4.85±3.10 vs 9.75±5.55 p:0.001). The associations of NAH with insomnia, nightmares, and bruxism observed in the baseline continued, but no difference was observed between those who had frequent or occasional complaints at follow-up. Conclusion Our study showed that NAH was highly prevalent in the Sao Paulo population in both the baseline and follow-up studies, but this frequency had a reduction in follow-up. Volunteers who persisted with the frequent complaint showed greater severity of insomnia, higher anxiety and depression and greater fatigue. Support Associação Fundo de Incentivo à Pesquisa (AFIP) and São Paulo Research Foundation (FAPESP)

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Determinants of healthy aging: Follow-up study of elderly residents in Sao Paulo Brazil

Journal of Clinical Epidemiology ◽

10.1016/0895-4356(96)89225-0 ◽

1996 ◽

Vol 49 ◽

pp. S20

Author(s):

Luiz R. Ramos ◽

Clovis Peres ◽

Simone Schenkman

Keyword(s):

Healthy Aging ◽

Sao Paulo ◽

São Paulo ◽

Follow Up Study

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Follow-up of the air pollution and the human male-to-female ratio analysis in São Paulo, Brazil: a times series study

BMJ Open ◽

10.1136/bmjopen-2013-002552 ◽

2013 ◽

Vol 3 (7) ◽

pp. e002552 ◽

Cited By ~ 8

Author(s):

Simone Georges El Khouri Miraglia ◽

Mariana Matera Veras ◽

Luis Fernando Amato-Lourenço ◽

Fernando Rodrigues-Silva ◽

Paulo Hilário Nascimento Saldiva

Keyword(s):

Air Pollution ◽

Sao Paulo ◽

Ratio Analysis ◽

São Paulo ◽

Female Ratio ◽

Times Series ◽

Human Male ◽

Male To Female ◽

Series Study

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A new computational tool for the follow up of mechanized excavation of tunnels: the case study of the subway line 5-LILAC in São Paulo, Brazil

REM - International Engineering Journal ◽

10.1590/0370-44672018710022 ◽

2018 ◽

Vol 71 (4) ◽

pp. 521-529 ◽

Cited By ~ 1

Author(s):

Marcos Eduardo Hartwig ◽

Cesar Augusto Moreira

Keyword(s):

Sao Paulo ◽

São Paulo ◽

Computational Tool

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Reanatomização do sorriso com uso de resina composta: relato de caso

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v8i9.3233 ◽

2020 ◽

Vol 8 (9) ◽

Author(s):

Martha Gerusa da Silva Lima ◽

Fabíola Gabriellen Barros Brito ◽

José Henrique de Araújo Cruz ◽

Luanna Abílio Diniz Melquíades Medeiros ◽

Elizandra Silva da Penha ◽

...

Keyword(s):

Minimally Invasive ◽

Multidisciplinary Approach ◽

Sao Paulo ◽

Resin Composites ◽

São Paulo ◽

Fernando Pessoa ◽

Tooth Structure ◽

Smile Aesthetics ◽

Tooth Colour

Introdução: Os pacientes têm exigido cada vez mais da odontologia estética para solucionar casos de desarmonia do sorriso, como alterações de cor, forma e tamanho. Com o avanço dos materiais dentários e aperfeiçoamento das técnicas é possível tratar casos estéticos com mínimos desgastes dentários e ter resultados excelentes. Cabe ao cirurgião-dentista optar por um tratamento que devolva saúde e função além da estética. Objetivo: Realizar reanatomização do sorriso por meio de facetas diretas em resina composta, como também mostrar que é possível alcançar sucesso clínico usando um material mais barato como a resina composta. Relato do caso: Paciente sexo feminino, 22 anos, apresentou-se à Clínica Escola de Odontologia da UFCG buscando melhorar a estética do seu sorriso. O material de escolhido foi resina composto por ser mais viável financeiramente em relação às cerâmicas, ter execução mais simples, necessitar de pouco ou nenhum desgaste e também ser reversível. A técnica usada foi Facetas diretas em resina composta; para realiza-lo foram imprescindíveis etapas pré-operatórias de gengivectomia, clareamento dental, enceramento diagnóstico para posteriormente realizar-se os desgastes. Utilizou-se guia de silicone para nortear os aumentos incisais, condicionamento ácido com ácido fosfórico a 37%, aplicação do sistema adesivo e realização dos incrementos de compósitos com posterior acabamento e polimento. Conclusão: A colaboração da paciente, um bom planejamento do caso, execução adequada da técnica e controle e manutenção periódica, proporcionaram uma estética dentária dentro dos padrões tão valorizados atualmente e aumento da sua autoestima.Descritores: Estética Dentária; Facetas Dentárias; Resinas Compostas.ReferênciasMarcondes R, Pires HCS, Bocutti JH. Lâmina cerâmica unitária sobre substrato escurecido: protocolo clinicolaboratorial com estratifcação em duas camadas. Rev Dental Press Estét. 2012;9(4):28-44.Sakamoto Junior AS, Higashi C, Gomes JC. Substituição de coroas totais metalocerâmicas em incisivos laterais conoides vitais: relato de caso clínico. Rev Dental Press Estét. 2015;12(3):71-83.Pontons-Melo JC. Harmonização do sorriso por meio de procedimentos minimamente invasivos. FGM News. 2013;132-37.Mondelli J. Estética e cosmética: em clínica integrada restauradora. São Paulo: Quintessence; 2003.Baratieri LN. Soluções clínicas: fundamentos e técnicas. Florianópolis: Ponto; 2008.Silva SB. Facetas diretas de resina composta versus facetas indiretas em porcelana [monografia] Florianópolis: ABO-SC; 2005.Queiroga RB. Laminados cerâmicos minimamente invasivos: novas possibilidades. Rev Dental Press Estét. 2012;9(1):34-47.Soares PV, Faria NFB, Cardoso IO, Moura GF, Pereira AG. Multidisciplinary approach for rehabilitation of smile aesthetics with minimally invasive ceramic veneers. J Clin Dent Res. 2017;14(1):68-88.Joiner A, Luo W. Tooth colour and whiteness: A review. J Dent. 2017; 67S:S3-S10.Nash RW. Resurfacing tooth structure with ceramic laminates. Dent Today. 2014; 33(8):68-71. Dietschi D. Optimizing smile composition and esthetics with resin composites and other conservative esthetic procedures. Eur J Esthet Dent. 2008;3(1):14-29.Almeida RR, Garib D.G, Almeida-Pedrin RR, Almeida MR, Pinzan A, Junqueira MHZ. Diastemas interincisivos centrais superiores: quando e como intervir?. R Dental Press Ortodon Ortop Facial. 2004;9(3):137-56.Lima RBW, Leite JT, França RM, Brito MCT, Uchôa RC, Andrade AKM. Reabilitação estética anterior pela técnica do facetamento – relato de caso. Rev bras ciênc saúde 2013; 17(4):363-70.Frese C, Schiller P, Staehle HJ, Wolff D. Recontouring teeth and closing diastemas with direct composite buildups: A 5-year follow-up. J Dent. 2013;41(11):979-85.Souza SJB, Magalhães D, Silva GR, Soares CJ, Soares PFB, Santos-Filho PCF. Cirurgia plástica periodontal para correção de sorriso gengival associada a restaurações em resina composta: relato de caso clínico. Rev Odontol Bras Central. 2010;19(51):362-66.Ferreira CLB. Fraturas dentárias no sector anterior abordagem estética através de restaurações diretas a resina composta [dissertação]. Porto: Faculdade de Ciências da Saúde Universidade Fernando Pessoa; 2013.Okida RC, Rahal V, Okida DSS. A associação entre dentística e periodontia no tratamento estético com lentes de contato: relato de caso. Rev Odontol Araçatuba. 2015;36(1):59-64.Cruz JHA, Silva RLB, Andrade-Júnior FP, Guênes GMT, Almeida MSC, Medeiros LADM et al. A importância da anatomia e escultura dental para prática de procedimentos clínicos odontológicos. RSC online, 2018;7(1):76-85.Sousa LX, Cruz JHA, Melo WOS, Freire SCP, Ribeiro ED, Freire JCP. Abfração dentária: um enfoque sobre a etiologia e o tratamento restaurador. Arch Health Invest. 2018; 7(2):51-53.

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“É som de preto, de favelado”: o funk como forma de (r)existência para crianças e adolescentes em acolhimento/“Its black marginalized music”: funk as a way of (r)existence for children and young's in foster

Revista Interinstitucional Brasileira de Terapia Ocupacional - REVISBRATO ◽

10.47222/2526-3544.rbto41463 ◽

2021 ◽

Vol 5 (4) ◽

pp. 632-638

Author(s):

Paula Fernanda De Andrade Leite Fernandes ◽

Alice Fernandes De Andrade ◽

Leticia Ambrosio ◽

Clau Fragelli

Keyword(s):

Occupational Therapy ◽

Cultural Identity ◽

Professional Practice ◽

Black People ◽

Life Experience ◽

Sao Paulo ◽

São Paulo ◽

Critical Perspective ◽

Identidad Cultural

Contextualização: O artigo analisa a prática profissional terapêutica ocupacional em um Serviço de Acolhimento Institucional Infantojuvenil, em uma cidade no interior de São Paulo. Processo de intervenção: Compreendendo a raça como um marcador social de estereótipos e estigmas na vivência cotidiana dos corpos negros e a racialização das infâncias institucionalizadas, analisamos as experiências infantojuvenis nos processos de institucionalização. Análise crítica da prática: A partir de uma perspectiva decolonial e crítica da Terapia Ocupacional e de uma proposta contra hegemônica de atuação, discutimos a respeito de ações interventivas para valorização e reconhecimento da identidade cultural negra dentro do serviço, como uma possibilidade de prática afrorreferenciada e antirracista na/para Terapia Ocupacional.Palavras-chave: terapia Ocupacional. Prática Profissional. Criança Acolhida. Popoluação Negra AbstractContextualization: This article analyzes the professional practice of occupational therapist in an Institutional Childcare Service in a city of São Paulo state, in Brazil. Intervention / Follow-up process: We analyze children's experiences in institutionalization processes understanding race as a social marker. Critical analysis of the practice: The racialization of institutionalized childhoods causes stereotypes and stigmas in the day life experience of black kids. From a decolonial and critical perspective of Occupational Therapy and a counter-hegemonic proposal of action, we discuss interventional actions for valuing and recognizing black cultural identity within the service as a possibility of afro-referenced and anti-racist practice in/for Occupational Therapy.Keywords: Occupational Therapy. Professional Practice. Foster Child. Black People ResumenContextualización: El artículo analiza la práctica profesional terapéutica ocupacional en un Servicio de Acogida Institucional Infantil en una ciudad del interior de estado de São Paulo, en Brasil. Intervención / Proceso de seguimiento: Entendiendo la raza como un marcador social de estereotipos y estigmas en la vida cotidiana de los cuerpos negros y la racialización de la niñez institucionalizada, analizamos las experiencias de los niños en los procesos de institucionalización. Análisis crítico de la práctica: Desde una perspectiva decolonial y crítica de la Terapia Ocupacional y una propuesta de acción contrahegemónica, discutimos las acciones intervencionistas para la valoración y reconocimiento de la identidad cultural negra dentro del servicio como una posibilidad de práctica afro-referenciada y antirracista en/para la Terapia Ocupacional.Palabras clave: Terapia Ocupacional. Práctica Profesional. Ninõ acogido. Población Negra

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Clinical, Laboratory, and Genetic Features of Erdheim-Chester Disease Patients from Two Reference Centers in a Developing Country

Blood ◽

10.1182/blood-2020-142617 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 22-23

Author(s):

Antonio Adolfo Guerra Soares Brandão ◽

Giancarlo Fatobene ◽

Andre Abdo ◽

Luis Alberto de Padua Covas Lage ◽

Israel Bendit ◽

...

Keyword(s):

Median Time ◽

Latin American ◽

Braf Mutation ◽

Sao Paulo ◽

São Paulo ◽

First Line ◽

Erdheim Chester Disease ◽

Erdheim Chester ◽

Chester Disease

INTRODUCTION: Erdheim-Chester Disease (ECD) is a rare histiocytic neoplasm with a heterogenous clinical course with asymptomatic localized course or systemic compromise involving multiples organs causing significant morbidity and mortality. There are few cohorts published however mainly from North America and Europe. Given the scarcity of data on ECD in Latin America, we have established a local registry in the city of São Paulo to collect clinical and biological material of ECD patients. METHODS: We retrospectively collected clinical data on biopsy-proven ECD patients diagnosed and treated at two reference centers for histiocytic disorders (Hospital das Clínicas da Universidade de São Paulo e Hospital Sírio-Libanês, Brazil) from January 2006 to February 2020. RESULTS: Sixteen patients with confirmed diagnosis of ECD were included with median age of 53 years. 75% were males and a median follow-up time of 50 months (7-163). Median time from onset of symptoms to diagnosis was 13 months (0.1-142). Immunohistochemistry (IHC) findings showed positivity for CD68 in 15/16 (94%) and for S100 in 3/16 (19%) patients, no case had CD1a positivity. The most frequent organs involved were: bone (75%), skin (44%), central nervous system (CNS) (44%), lymph nodes (31%), lung (13%), liver (6%), spleen (6%), and gastrointestinal tract (6%) of cases. CNS lesions involvement occurred mostly in the pituitary gland (86%). Twelve of 16 (75%) patients presented disease in more than one organ. Xanthelasma and xanthoma were the most common skin lesions (44%). The most frequent histiocytosis-related clinical manifestations were bone pain (44%) and diabetes insipidus (38%). The most frequent radiologic findings were osteosclerosis in 12/16 (75%) patients, retroperitoneal fibrosis around the kidneys in 6/16 (38%), the coated aorta sign and orbital infiltration were found in 4/16 (25%) of cases. 18FDG/PET-CT was performed in all patients, of whom 13 (81%) had hypermetabolic lesions. BRAF status at diagnosis was available in 13/16 patients using the technique of Sanger in 5/13, pyrosequencing in 3/13, IHC in 3/13 and polymerase chain reaction (PCR) in 2/13. Mutations were detected in only 3/16 (19%) cases. All patients received treatment due to symptomatic disease with a median of two lines of therapy (1-7). Median time between diagnosis and the first treatment was one month. First-line treatments were interferon in 12/16 patients, steroids in 5/16, and each one of thalidomide, vemurafenib and tumoral resection in one patient. Beyond first-line therapy, the most conventional chemotherapy regimens used were cladribine (4/16 patients) and LCH-like etoposide-containing vinblastine, methotrexate and mercaptopurine (2/16 patients). Other treatments included radiotherapy (4/16 patients) and a single patient used cobimetinib, imatinib and infliximab. Median progression free survival (PFS) after the first line treatment was 7.5 months (95% CI 5-10), and median overall survival (OS) was not reached to this date. Time to next treatment was 9 months in patients who did not achieved at least partial response after first line, and 15 months in those who attained it. PFS at 2 years was 45% (95% CI 0.17-0.71), and OS at 2 years was 100%. One patient died due to infection complication after the first cycle of cladribine after 50 months of follow-up. CONCLUSION: To our knowledge, despite the low number of patients, this is the largest Latin American cohort of patients with ECD reported to date. Our findings resemble demographic characteristics, sites of involvement and treatment choices reported by other groups. However, it is noteworthy that the proportion of ECD patients bearing a BRAF mutation (18.8%) was pretty lower than previously reported (approximately 50%). This needs to be taken cautiously due to the small number of subjects and due to technical issues, since all samples analyzed by PCR or Sanger were negative for BRAF mutation. A national registry of histiocytosis is needed to confirm these preliminary data. Disclosures No relevant conflicts of interest to declare.

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PP151 Comparison Of Patients Undergoing New Technology For Prostate Cancer

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318002805 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 125-126

Author(s):

Deyvid Silva ◽

Letícia Lazarini ◽

Araujo Aline ◽

Evelinda Trindade ◽

Otavio Becker ◽

...

Keyword(s):

Intensive Care ◽

Operating Room ◽

Gleason Score ◽

Open Surgery ◽

Sao Paulo ◽

High Intensity Focused Ultrasound ◽

Disease Stage ◽

Consecutive Series ◽

São Paulo

Introduction:Prostate neoplasia affects more than one million people worldwide. Surgical treatments have evolved from open or video prostatectomy, up to the High Intensity Focused Ultrasound (HIFU) technique. HIFU studies cite less costs and better quality of life during the first year of follow-up. The objective of this study is to describe a consecutive series of eligible patients, with Gleason score 6 and 7, and compare resources used along those three treatment techniques.Methods:A comparative and retrospective study was conducted during the first 2017 semester, at Hospital de Transplantes de São Paulo, São Paulo city, Brazil. Consecutive eligible patients were matched by age, disease stage and profile and Gleason score 6 or 7. Resources used were assessed through medical records review and in- and out-patient visit interviews.Results:A total of 152 patients were followed: 50 underwent open surgery prostatectomy, 50 underwent video prostatectomy and 52 underwent HIFU. Mean age did not differ between groups (66.6, 64.1 and 65.6 years, respectively). All patients were followed for at least three months. The average operating room time was 4.7, 4.1 and 2.3 hours, and the average anesthetic recovery time was 2.0, 1.9 and 2.0 hours, respectively. Average inpatient length of stay was 2.5, 2.7 and 1.5 days, respectively. Postoperatively, nine (18 percent) open surgery patients, and 14 (28 percent) video-prostatectomy patients required an average of one full day of intensive care, compared to only one (2 percent) HIFU patient. During follow-up, the same effectiveness was observed between the groups, none required re-intervention. Thus, considering the 50 percent economy in hours of operating room and of days of hospital stay, as well as 10 times less use of intensive care unit days when the HIFU technique was compared to conventional surgeries, it is estimated the HIFU program allowed 30 percent cost savings.Conclusions:The HIFU program presented effectiveness and savings. The hospital can increase access to care for prostate neoplasia patients.

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Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil

Pathogens ◽

10.3390/pathogens9010025 ◽

2019 ◽

Vol 9 (1) ◽

pp. 25 ◽

Cited By ~ 1

Author(s):

Rosa Maria N. Marcusso ◽

Johan Van Weyenbergh ◽

João Victor Luisi de Moura ◽

Flávia Esper Dahy ◽

Aline de Moura Brasil Matos ◽

...

Keyword(s):

T Cell ◽

Cause Of Death ◽

Clinical Care ◽

Laboratory Data ◽

Sao Paulo ◽

São Paulo ◽

T Cell Leukemia ◽

Cell Leukemia ◽

Associated Diseases

Background: Despite its relatively low incidence of associated diseases, Human T-cell Leukemia Virus-1 (HTLV-1) infection was reported to carry a significant risk of mortality in several endemic areas. HTLV-1-associated diseases, adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraperesis (HAM/TSP), as well as frequent coinfections with human immunodeficiency virus (HIV), hepatitis C virus (HCV), and Strongyloides stercoralis were associated to increased morbidity and mortality of HTLV-1 infection. Objective: To determine the mortality rate and its associated variables from an open cohort started in July 1997 at the HTLV Clinic, Emilio Ribas Institute (IIER), a major infectious disease hospital in São Paulo, Brazil. Methods: Since inception up to September 2018, we admitted 727 HTLV-1-infected individuals, with a rate of 30–50 new admissions per year. All patient data, including clinical and laboratory data, were regularly updated throughout the 21-year period, using a dedicated REDCap database. The Ethical Board of IIER approved the protocol. Results: During 21 years of clinical care to people living with HTLV-1 in the São Paulo region, we recruited 479 asymptomatic HTLV-1-infected individuals and 248 HAM/TSP patients, of which 632 remained under active follow-up. During a total of 3800 person-years of follow-up (maximum follow-up 21.5 years, mean follow-up 6.0 years), 27 individuals died (median age of 51.5 years), of which 12 were asymptomatic, one ATLL patient and 14 HAM/TSP patients. HAM/TSP diagnosis (but neither age nor gender) was a significant predictor of increased mortality by univariate and multivariate (hazard ratio (HR) 5.03, 95% CI [1.96–12.91], p = 0.001) Cox regression models. Coinfection with HIV/HCV was an independent predictor of increased mortality (HR 15.08; 95% CI [5.50–41.32]; p < 0.001), with AIDS-related infections as a more frequent cause of death in asymptomatics (6/13; p = 0.033). HIV/HCV-negative fatal HAM/TSP cases were all female, with urinary tract infection and decubitus ulcer-associated sepsis as the main cause of death (8/14, p = 0.002). Conclusions: All-cause mortality among people living with HTLV-1 in São Paulo differs between asymptomatic (2.9%) and HAM/TSP patients (7.3%), independent of age and gender. We observe a dichotomy in fatal cases, with HAM/TSP and HIV/HCV coinfection as independent risk factors for death. Our findings reveal an urgent need for public health actions, as the major causes of death, infections secondary to decubitus ulcers, and immune deficiency syndrome (AIDS)-related infections, can be targeted by preventive measures.

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