scholarly journals Management and Clinical Characteristics in Children with SARS-CoV-2 Infection: Experience in a highly complex public hospital in the city of São Paulo

2020 ◽  
Author(s):  
Rafael Santos Rodrigues Vieira ◽  
Erisson Linhares de Aguiar ◽  
Nara Michelle de Araújo Evangelista ◽  
Sergio Antonio Bastos Sarrubbo ◽  
Helmar Abreu Rocha Verlangieri ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
Pediatric Hospital ◽  
Multiprofessional Team ◽  
The City

AbstractIn February 2020, the World Health Organization designated the disease COVID-19, which means Coronavirus disease 2019. The virus that causes COVID-19 is designated as severe acute respiratory syndrome by Coronavirus 2 (SARS-CoV-2). The virus tends to determine clinical manifestations more frequently in adults and, especially, in the elderly, with high mortality in the population with chronic diseases. Most studies confirm the trend towards less severe disease in pediatric patients, and few studies describe the behavior of the virus in children. In late February 2020, a public pediatric hospital in the city of São Paulo, in the face of the announced epidemic, through its multiprofessional team, prepared itself to the care of patients with SARS-CoV-2 infection, determing certain clinical protocols defining the flow of care and therapeutic procedures to patients. This study intends to present the clinical characteristics and evolution of the disease by SARS-CoV-2 in pediatric patients seen in a public pediatric hospital of high complexity, evaluating the effectiveness and acceptance of the measures adopted. As a result, a good evolution of the disease was observed in the affected children, even in those with comorbidities. There was a trend towards a greater number of days of hospitalization and the need for ICU in patients with comorbidities and progression with clinical worsening after initial improvement. The protocols adopted and the flow instituted allowed good adherence by the multidisciplinary team.

scholarly journals Evaluating the effects of re-opening plans on dynamics of COVID-19 in São Paulo, Brazil1

2021 ◽  
Author(s):  
F.A. Rubio ◽  
T.N. Vilches
Keyword(s):  
Virus Transmission ◽  
Sao Paulo ◽  
World Health ◽  
Local Health ◽  
São Paulo ◽  
The Government ◽  
Health Organization ◽  
Five Phases ◽  
Local Health System ◽  
The City

AbstractCoronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in early March 2020. In Brazil, São Paulo is the most affected state, comprising about 20% of the country’s cases. With no vaccine available to date, distancing measures have been taken to reduce virus transmission. To reduce the pandemic’s effect on the economy, the government of São Paulo has proposed a plan consisting of five phases of the gradual re-opening of activities. In this context, we have developed a mathematical model to simulate the gradual re-opening plan on the transmission dynamics of COVID-19, in the city of São Paulo. The model shows that a precipitous reopening can cause a higher peak of the disease, which may compromise the local health system. Waiting for the reduction in the incidence of infected individuals for at least 15 days to phase transition is the most efficient strategy compared to the fixed-period scenario at each phase of the re-opening plan.

scholarly journals Expected impact of COVID-19 outbreak in a major metropolitan area in Brazil

2020 ◽  
Author(s):  
Tarcísio M. Rocha Filho ◽  
Fabiana Sherine Ganem dos Santos ◽  
Victor Bertollo Gomes ◽  
Thiago Augusto Hernandes Rocha ◽  
Julio Henrique Rosa Croda ◽  
...  
Keyword(s):  
Public Health ◽  
Older People ◽  
Metropolitan Area ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
The World ◽  
Health Organization ◽  
The Impact ◽  
The City

AbstractIn January 2020 China reported to the World Health Organization an outbreak of pneumonia of undetermined origin in the city of Wuhan, Hubei. In January 30, 2020, the World Health Organization declared the outbreak of COVID-19 as a Public Health Emergency of International Interest (PHEI).ObjectivesThe aim of this study is to assess the impact of a COVID-19 epidemic in the metropolitan region of São Paulo, Brazil.MethodsWe used a generalized SEIR (Susceptibles, Exposed, Infectious, Recovered) model, with additional Hospitalized variables (SEIHR model) and age-stratified structure to analyze the expected time evolution during the onset of the epidemic in the metropolitan area of São Paulo. The model allows to determine the evolution of the number of cases, the number of patients admitted to hospitals and deaths caused by COVID-19. In order to investigate the sensibility of our results with respect to parameter estimation errors we performed Monte Carlo analysis with 100 000 simulations by sampling parameter values from an uniform distribution in the confidence interval.ResultsWe estimate 1 368 (IQR: 880, 2 407) cases, 301 (22%) in older people (≥60 years), 81 (50, 143) hospitalizations, and 14 (9, 26) deaths in the first 30 days, and 38 583 (IQR: 16 698, 113, 163) cases, 8 427 (21.8%) in older people (≥60 years), 2181 (914, 6392) hospitalizations, and 397(166, 1205) deaths in the first 60 days.LimitationsWe supposed a constant transmission probability Pc among different age-groups, and that every severe and critic case will be hospitalized, as well as that the detection capacity in all the primary healthcare services does not change during the outbreak.ConclusionSupposing the reported parameters in the literature apply in the city of São Paulo, our study shows that it is expected that the impact of a COVID-19 outbreak will be important, requiring special planning from the authorities. This is the first study for a major metropolitan center in the south hemisphere, and we believe it can provide policy makers with a prognosis of the burden of the pandemic not only in Brazil, but also in other tropical zones, allowing to estimate total cases, hospitalization and deaths, in support to the management of the public health emergence caused by COVID-19.

scholarly journals PLATINO, a nine-year follow-up study of COPD in the city of São Paulo, Brazil: the problem of underdiagnosis

2014 ◽  
Vol 40 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Graciane Laender Moreira ◽  
Beatriz Martins Manzano ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Rogelio Perez-Padilla ◽  
...  
Keyword(s):  
Latin American ◽  
Initial Phase ◽  
Severe Disease ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Chi Square Test ◽  
Study Population ◽  
The City

OBJECTIVE: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. METHODS: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. RESULTS: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. CONCLUSIONS: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention.

scholarly journals Analysis of quality of life and associated factors in a group of elderly persons with supplemental health plans in the city of São Paulo, Brazil

2019 ◽  
Vol 22 (4) ◽  
Author(s):  
Maria Elisa Gonzalez Manso ◽  
Leandro Tadeu Prazeres Maresti ◽  
Henrique Souza Barros de Oliveira
Keyword(s):  
Quality Of Life ◽  
Health Plan ◽  
Associated Factors ◽  
The Elderly ◽  
Sao Paulo ◽  
World Health ◽  
Elderly Persons ◽  
São Paulo ◽  
The City

Abstract Objective: To measure the Quality of Life (QoL) and associated factors in a group of elderly persons receiving care through a health plan operator in the city of São Paulo, Brazil. Method: A cross-sectional study was carried out with 169 elderly persons enrolled in a health plan and who were participants in a program to promote health and prevent risks and diseases. The Bref and Old versions of the World Health Organization Quality of Life (WHOQOL) instruments were adopted for the evaluation of the QoL of the elderly. After descriptive analysis, a comparative analysis was performed through the Student’s t-tests and ANOVA. The Brown-Forsythe test was applied for situations in which no homogeneity was found and the Tukey test for multiple comparisons was applied. Results: The highest mean QoL values were found in the Psychological [72.1 (±14.3)] and Environment [68 (±15.4)] and Intimacy [72.5 (±20.8)] domains, while the worst results were found in the Physical [64.3 (±18)] domain and in the Death and Dying facet [61.2 (±23.2)]. In this group, factors such as obesity, neoplasia and previous hospitalizations were negatively associated with QoL, whereas young elderly, female, widows, carriers of chronic non-communicable diseases and those limited to two morbidities, who practiced physical activity and had clinical care provided by a reference physician had a positive influence. Conclusion: The findings of this research showed high levels of satisfaction with health and QoL, in addition to raising relevant discussions about predictors that influence the QoL of the elderly receiving care from the supplementary sector. It also emphasizes the need for new strategies of action to ensure improvements in the health care of the elderly.

scholarly journals Environmental contamination by Toxocara sp. eggs in Ribeirão Preto, São Paulo State, Brazil

2005 ◽  
Vol 47 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Divani Maria Capuano ◽  
Gutemberg de Melo Rocha
Keyword(s):  
Zinc Sulphate ◽  
Clinical Manifestations ◽  
Central Area ◽  
Toxocara Canis ◽  
Asymptomatic Infection ◽  
Sao Paulo ◽  
Larva Migrans ◽  
São Paulo ◽  
Protection Measures ◽  
The City

Toxocariasis is a zoonosis mainly caused by Toxocara canis, an intestinal nematode of dogs. Man acquires the infection through accidental ingestion of viable eggs, and the toxocariasis clinical manifestations may vary from an asymptomatic infection up to the Visceral Larva Migrans syndrome. Seventy eight public squares of Ribeirão Preto, São Paulo, Brazil, including Bonfim Paulista district were visited aiming to evaluate the soil contamination by Toxocara eggs. The squares were divided in five different areas corresponding to the Sanitary Districts of the city. From May to December 2003, soil samples weighting about 250 g each were collected from five distinct sites of each public square. The laboratorial analysis was done by centrifugal-flotation techniques in magnesium sulphate solutions with 5% of potassium iodide (d = 1.33) and zinc sulphate (d = 1.20), and by the sedimentation- flotation in conic chalices with zinc sulphate (d = 1.20). Toxocara sp. eggs were found on 16 (20.5%) squares, with the lowest prevalence (12%) at the central area. From these results, it is expected that the legal authority will adopt protection measures for the city public areas, reducing thus the contamination risk by Toxocara sp. eggs.

scholarly journals Dermatophyte agents in the city of São Paulo, from 1992 to 2002

2003 ◽  
Vol 45 (5) ◽  
pp. 259-263 ◽  
Author(s):  
Patricia Augusta Vianna Chimelli ◽  
Alexandre de Abreu Sofiatti ◽  
Ricardo Spina Nunes ◽  
Jose Eduardo da Costa Martins
Keyword(s):  
Clinical Manifestations ◽  
Trichophyton Mentagrophytes ◽  
Sao Paulo ◽  
Microsporum Canis ◽  
Microsporum Gypseum ◽  
São Paulo ◽  
Epidermophyton Floccosum ◽  
Etiologic Agents ◽  
Clinical Variants ◽  
The City

Dermatophytosis are superficial mycoses caused by fungi that can invade stratum corneum and keratinized tissues. In order to study the frequency of dermatophytes species and the clinical manifestations caused by these fungi, in São Paulo, SP, Brazil, the authors analyzed cultures isolated at the Mycology Laboratory from a selected population (15,300 out-patients of the Hospital das Clínicas, Department of Dermatology, Faculty of Medicine of University of São Paulo) from January 1992 to June 2002. The most prevalent dermatophyte was Trichophyton rubrum (48.7%), followed by Microsporum canis (20.9%), Trichophyton tonsurans (13.8%), Trichophyton mentagrophytes (9.7%), Epidermophyton floccosum (4.1%), and Microsporum gypseum (2.5%). These agents determined more than one clinical manifestation, i.e., tinea corporis (31.5%), tinea capitis (27.5%), tinea unguium (14.8%), tinea cruris (13.9%), tinea pedis (9.9%), and tinea manuum (1.9%). Clinical variants of dermatophytosis and their relationship to the etiologic agents were studied and the results were compared to those obtained in previous studies in other regions of Brazil and in other countries.

Dietary habits in a group of patients with multiple sclerosis are similar to those of healthy control subjects

2020 ◽  
Vol 78 (10) ◽  
pp. 638-641
Author(s):  
Stella Boreggio MACHADO ◽  
Raquel CABRAL ◽  
Nadya MURADE ◽  
Nayara Cavalcanti ARES ◽  
Claudio SCORCINE ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dietary Habits ◽  
Salt Intake ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
Control Subjects ◽  
Healthy Control ◽  
Inflammatory Profile ◽  
The City

ABSTRACT Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. Over time, patients with MS accumulate neurological disabilities. MS typically affects young adults and is associated with an inflammatory profile of cytokines and lymphocytes. If a patient were to consume a potentially inflammatory diet, it is possible that the evolution of MS in that individual would be more aggressive. Objective: To investigate whether patients with MS living in and around the city of Santos, São Paulo, Brazil, had a profile of inflammatory diet. Methods: Patients with MS and healthy control subjects were individually interviewed, and the 24-hour Diet Recall and the Bristol Stool Form Scale were applied. Salt intake was calculated using the WebDiet 2.0 software. Results: There were no remarkable differences in dietary habits between healthy control subjects (n=34) and patients with MS (n=66), except for higher consumption of carbohydrates by patients. Both patients with MS and control subjects had higher protein and lower carbohydrate intake than the World Health Organization’s recommended daily amounts. There was no correlation between food intake and neurological disability in patients with MS. Conclusion: The dietary patterns of patients with MS and healthy controls were similar in the city of Santos, São Paulo, Brazil, and surrounding towns, except for higher intake of carbohydrates by patients. No profile of pro-inflammatory diets was identified among the patients with MS enrolled in this study.

scholarly journals Impact of the bitewing radiography exam inclusion on the prevalence of dental caries in 12-year-old students in the city of Franca, São Paulo, Brazil

2006 ◽  
Vol 14 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Soraya Fernandes Mestriner ◽  
Luiz Carlos Pardini ◽  
Wilson Júnior Mestriner
Keyword(s):  
Dental Caries ◽  
Epidemiological Survey ◽  
Sao Paulo ◽  
World Health ◽  
Clinical Aspects ◽  
São Paulo ◽  
Cross Sectional ◽  
Permanent Molar ◽  
Carious Lesions ◽  
The City

INTRODUCTION: The pattern of development of carious lesions has changed. The carious lesion has been progressive and reaches the dentin without showing alterations in the clinical aspects. OBJECTIVES: To determine the prevalence of caries in 12-year-old students in the city of Franca - São Paulo, Brazil, during the year of 2003, and to evaluate the additional value of bitewing radiograph to detect hidden carious lesions in permanent molar dentin. MATERIALS AND METHODS: A probabilistic sample composed of two hundred and fifty six (256) students, from public and private schools, was submitted to a cross-sectional study through examination by a calibrated examiner, in order to detect the caries prevalence, using the methodology recommended by the World Health Organization (WHO). For 66% of the sample, bitewing radiographs of the permanent molar region were obtained. The images were analyzed by a calibrated examiner, who established the presence of hidden caries in teeth with radiolucency in dentin, yet considered healthy in the epidemiological survey. RESULTS: The prevalence of dental caries in epidemiological exam without (WHO) and with (WHO/R) the inclusion of hidden caries lesion was 54% and 64%, and the DMFT index was 1.73 and 1.92 respectively. CONCLUSION: Utilization of the method of bitewing radiographic diagnosis significantly increased (p<0.001) the prevalence of caries in the studied population.

Seasonal Variation of Suicide in the City of São Paulo, Brazil, 1996–2010

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Daniel Hideki Bando ◽  
Fernando Madalena Volpe
Keyword(s):  
Seasonal Pattern ◽  
Total Sample ◽  
Sao Paulo ◽  
Seasonal Patterns ◽  
São Paulo ◽  
Health Statistics ◽  
Males And Females ◽  
June July ◽  
The City ◽  
Over Time

Background: In light of the few reports from intertropical latitudes and their conflicting results, we aimed to replicate and update the investigation of seasonal patterns of suicide occurrences in the city of São Paulo, Brazil. Methods: Data relating to male and female suicides were extracted from the Mortality Information Enhancement Program (PRO-AIM), the official health statistics of the municipality of São Paulo. Seasonality was assessed by studying distribution of suicides over time using cosinor analyses. Results: There were 6,916 registered suicides (76.7% men), with an average of 39.0 ± 7.0 observed suicides per month. For the total sample and for both sexes, cosinor analysis estimated a significant seasonal pattern. For the total sample and for males suicide peaked in November (late spring) with a trough in May–June (late autumn). For females, the estimated peak occurred in January, and the trough in June–July. Conclusions: A seasonal pattern of suicides was found for both males and females, peaking in spring/summer and dipping in fall/winter. The scarcity of reports from intertropical latitudes warrants promoting more studies in this area.

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