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

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.

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

10.1101/2020.06.22.20136994 ◽

2020 ◽

Cited By ~ 1

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.

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

10.1101/2021.01.14.21249809 ◽

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.

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The prevalence of multiple sclerosis in the city of São Paulo, Brazil, 1997

Acta Neurologica Scandinavica ◽

10.1034/j.1600-0404.2001.00372.x ◽

2001 ◽

Vol 104 (4) ◽

pp. 208-213 ◽

Cited By ~ 62

Author(s):

D. Callegaro ◽

M. Goldbaum ◽

L. Morais ◽

C. P. Tilbery ◽

M. A. Moreira ◽

...

Keyword(s):

Multiple Sclerosis ◽

Sao Paulo ◽

São Paulo ◽

The City

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Study of oligoclonal bands restricted to the cerebrospinal fluid in multiple sclerosis patients in the city of São Paulo

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000600011 ◽

2009 ◽

Vol 67 (4) ◽

pp. 1017-1022 ◽

Cited By ~ 12

Author(s):

Paulo Diniz da Gama ◽

Luís dos Ramos Machado ◽

José Antonio Livramento ◽

Hélio Rodrigues Gomes ◽

Tarso Adoni ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cerebrospinal Fluid ◽

Sao Paulo ◽

Oligoclonal Bands ◽

Control Group ◽

São Paulo ◽

The Central Nervous System ◽

Different Populations ◽

Multiple Sclerosis Patients ◽

The City

The frequency of oligoclonal bands (OCB) restricted to the cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) varies widely in different populations. The objective of this study was to determine the frequency of these OCB in a group of MS patients in the city of São Paulo. Techniques used to detect OCB consisted of isoelectric focusing followed by immunoblotting. Oligoclonal bands were found in 49 (54.4%) out of 90 patients with clinically definite MS; in (31.2%) of the 16 patients with clinically isolated syndrome; in 7 (17.9%) of 39 patients with inflammatory disorders of the central nervous system (IDCNS), and in none of the individuals with no neurological condition (control group). The specificity of the method was 100% when compared to the control group and 82.1% when compared to the IDCNS group. These results suggest that the frequency of CSF OCB is much lower in Brazilian MS patients from São Paulo city than that reported in MS series from Caucasian populations.

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

10.1101/2020.03.14.20035873 ◽

2020 ◽

Cited By ~ 8

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.

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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

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562019022.190013 ◽

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.

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Prevalence of Multiple Sclerosis in the City of São Paulo, Brazil, in 1990

Neuroepidemiology ◽

10.1159/000110901 ◽

1992 ◽

Vol 11 (1) ◽

pp. 11-14 ◽

Cited By ~ 32

Author(s):

Dagoberto Callegaro ◽

Cecília Amaro de Lolio ◽

João Radvany ◽

Charles P. Tilbery ◽

Renato A. Mendonça ◽

...

Keyword(s):

Multiple Sclerosis ◽

Sao Paulo ◽

São Paulo ◽

The City

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Prevalence of multiple sclerosis in the city of Santos, SP

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2007000400005 ◽

2007 ◽

Vol 10 (4) ◽

pp. 479-482 ◽

Cited By ~ 18

Author(s):

Yara Dadalti Fragoso ◽

Maristela Peres

Keyword(s):

Multiple Sclerosis ◽

Coastal Region ◽

Sao Paulo ◽

The State ◽

City Council ◽

Initial Symptom ◽

São Paulo ◽

Data Collection And Analysis ◽

Evaluation Of Data ◽

The City

OBJECTIVE: To assess the prevalence of multiple sclerosis (MS) in the city of Santos, SP. METHOD: Evaluation of data from the Reference Center for MS of the coastal region of the State of São Paulo, from the Regional Association of Patients with MS (APEMBS), with active participation of all neurologists and neurosurgeons of the city, data from IBGE, from the city council, and from EMPLASA. The protocol proposed by the BCTRIMS (already used in other similar studies) was used for data collection and analysis, June 30th 2005 being established as the prevalence day. RESULTS: Santos has an area of 280.3 km², with 418,316 inhabitants (1.49 inhabitant per km²). A total of 65 patients were identified, attaining the prevalence of 15.54/100.000. The most frequent initial symptom of the disease was optical neuritis (28.8%). CONCLUSION: data from the city of Santos are similar to those already observed, but as yet not published, in other cities of the State of São Paulo and of Brazil.

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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

Journal of Applied Oral Science ◽

10.1590/s1678-77572006000300004 ◽

2006 ◽

Vol 14 (3) ◽

pp. 167-171 ◽

Cited By ~ 5

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.

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Description and characteristics of 81 patients attending the Reference Center for Multiple Sclerosis of the coastal region of the state of São Paulo - Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000500003 ◽

2005 ◽

Vol 63 (3b) ◽

pp. 741-744 ◽

Cited By ~ 8

Author(s):

Yara Dadalti Fragoso ◽

Ana Patricia Perez Fiore

Keyword(s):

Multiple Sclerosis ◽

Coastal Region ◽

Sao Paulo ◽

The State ◽

São Paulo ◽

Individual Interviews ◽

Disability Status ◽

Relapsing Remitting ◽

To Come ◽

The City

OBJETIVE: to register multiple sclerosis (MS) patients residing in the coastal region of the State of São Paulo (CEREM Litoral Paulista). METHOD: Individual interviews with identified cases of MS. RESULTS: 81 individuals with diagnosis of MS agreed to come for registration (62 females [76.5%], 19 males [23.5%]). 65% of all patients were residents of the city of Santos. The mean age of these patients was 43 years (14 to 74 years), and the Expanded Disability Status Scale (EDSS) was < 5.5 in 76.5% of the cases. 82.7% of the assessed patients presented the relapsing/remitting form of MS. 81.5% of all patients were undergoing treatment with immunomodulators. CONCLUSION: Due to their clinical profile, patients seem to come to CEREM Litoral Paulista for prescription of immunomodulators. There is a clear need to identify other cases in the region and to allow other forms of treatment to be put into practice.

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