Tiago Dahrug Barros

Fundação Hospitalar do Estado de Minas Gerais

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Gláucio Mosimann

Ministério da Saúde

Victor Bertollo Gomes Pôrto

Hospital de Base

Paula Pezzuto

University of Bologna

Flor Ernestina Martínez-Espinosa

Fundação de Medicina Tropical

Geraldo Duarte

Universidade de São Paulo

Michel E. Haziot

Instituto de Infectologia Emílio Ribas

Cecília Roteli-Martins

Faculdade de Medicina do ABC

Luciana Marques Sansão Borges

Instituto de Infectologia Emílio Ribas

Ruan Fernandes

Hospital Israelita Albert Einstein

Madeleine Verhovsek

McMaster University

Cooperative Institutions

Instituto de Infectologia Emílio Ribas

Universidade Federal de Minas Gerais

Ministério da Saúde

Fundação Oswaldo Cruz

Universidade de São Paulo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Instituto de Tecnologia e Pesquisa

Ministério da Saúde

Universidade Estadual do Oeste do Paraná

Universidade Federal do Rio de Janeiro

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Neurological manifestations in people living with HIV/AIDS in the late cART era: a prospective observational study at a tertiary healthcare center in São Paulo, Brazil

HIV Research & Clinical Practice (2021)

João Paulo Telles Ruan Fernandes Tiago Dahrug Barros Alvino Maestri Thiago Vitoriano

Background:The aim of this study was to evaluate the frequency, spectrum, in-hospital mortality rate, and factors associated with death in people living with HIV/AIDS (PLWHA) presenting with neurological diseases from a middle-income country, as well as estimate its one-year global death rate.Methods:This prospective observational cohort study was conducted at a Brazilian tertiary health center between January and July 2017. HIV-infected patients above 18 years of age who were admitted due to neurological complaints were consecutively included. A standardized neurological examination and patient and/or medical assistant interviews were performed weekly until the patient's discharge or death. The diagnostic and therapeutic management of the included cases followed institutional routines.Results:A total of 105 (13.2%) patients were included among the 791 hospitalized PLWHA. The median age was 42.8 [34-51] years, and 61% were men. The median CD4+ lymphocyte cell count was 70 (27-160) cells/mm3, and 90% of patients were experienced in combined antiretroviral therapy. The main diseases were cerebral toxoplasmosis (36%), cryptococcal meningitis (14%), and tuberculous meningitis (8%). Cytomegalovirus causing encephalitis, polyradiculopathy, and/or retinitis was the third most frequent pathogen (12%). Moreover, concomitant neurological infections occurred in 14% of the patients, and immune reconstitution inflammatory syndrome-related diseases occurred in 6% of them. In-hospital mortality rate was 12%, and multivariate analysis showed that altered level of consciousness (P = 0.04; OR: 22.7, CI 95%: 2.6-195.1) and intensive care unit (ICU) admission (P = 0.014; OR: 6.2, CI 95%: 1.4-26.7) were associated with death. The one-year global mortality rate was 31%.Conclusion:In this study, opportunistic neurological diseases were predominant. Cytomegalovirus was a frequent etiological agent, and neurological concomitant diseases were common. ICU admission and altered levels of consciousness were associated with death. Although in-hospital mortality was relatively low, the one-year global death rate was higher.

Tertiary referral hospital

10.1080/25787489.2021.1975609

Cite

Citations (11)

Authors' reply

Revista Brasileira Ginecologia e Obstetrícia (2022)

Carla Dinamerica Kobayashi Victor Bertollo Gomes Pôrto Martha Elizabeth Brasil da Nóbrega Cibelle Mendes Cabral Tiago Dahrug Barros

Spontaneous abortion is the most frequent adverse outcome in pregnancy, with a rate of 10% to 20% of all pregnancies. In Brazil, the rate of abortion before the COVID-19 pandemic was of 3.5%. In our study, we observed 24 miscarriages after 678,025 doses of COVID-19 vaccines had been administered in pregnant women in Brazil, which corresponds to an incidence of 3.5 cases per 100,000 doses.[1] Such incidence is lower than the postvaccination rate of abortion related to COVID-19 vaccines described by Trostle et al.[2] and much lower than the historical 3.5% expected rate in Brazil.

10.1055/s-0042-1757970

Cite

Citations (0)

Urine-based ELISA using a recombinant chimeric protein for the diagnosis of paucibacillary and multibacillary leprosy

Tuberculosis (2025)

Raquel S B Câmara Isabela A.G. Pereira Gisele Espíndola Daniela P. Lage Ana Luísa Silva

10.1016/j.tube.2025.102613

Cite

Citations (0)

Nefrolitíase em pacientes pediátricos: investigação metabólica e anatômica

Brazilian Journal of Nephrology (2011)

Luís Alberto Batista Peres Sarah Sella Langer Raysa Cristina Schmidt Roberto Arthur Bavaresco Nacke Paulo Victor Muller Francescon

Desordens metabólicas são frequentes em pacientes com nefrolitíase pediátrica. OBJETIVOS: Estudar as alterações metabólicas e anatômicas e a análise química dos cálculos encontrados em pacientes da nossa região. MÉTODOS: Este é um estudo retrospectivo em 158 crianças com evidência de formação recente de cálculos, destes apenas 109 concluíram a investigação metabólica. A investigação laboratorial consistiu de duas amostras de urina de 24 horas com dosagem de cálcio, ácido úrico, citrato, oxalato, sódio e creatinina, cistinúria qualitativa, pH urinário seguido de 12 horas de jejum e restrição hídrica, cultura da urina e análise química quando os cálculos foram disponíveis. As técnicas de imagem incluíram ultrassonografia do trato urinário e urografia excretora. RESULTADOS: Em 96,3% das crianças alguma causa foi detectada. A principal alteração metabólica encontrada foi a hipercalciúria (73,4%). Análise química dos cálculos mostrou oxalato de cálcio em 90,9% dos casos. Alterações anatômicas foram encontradas em 18,0% dos pacientes investigados, e a mais frequente foi a duplicação pieloureteral (28,6%). CONCLUSÕES:Hipercalciúria foi a desordem mais encontrada, a alteração anatômica mais comum foi a duplicação pieloureteral e oxalato de cálcio foi o constituinte químico mais frequente. Este trabalho serviu para o conhecimento das características dos pacientes pediátricos portadores de nefrolitíase em nossa região.

10.1590/s0101-28002011000100007

Cite

Citations (10)

Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis

Epidemiologia e Serviços de Saúde (2021)

Geraldo Duarte Paula Pezzuto Tiago Dahrug Barros Gláucio Mosimann Flor Ernestina Martínez-Espinosa

This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B and C viruses also present different forms of transmission, whether parenteral, sexual, vertical or oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an important perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.

Viral Hepatitis

Hepatitis B

Hepatitis C

Sexual transmission

Source

Cite

Citations (3)

Severe fetal and neonatal hemolytic anemia due to a 198 kb deletion removing the complete β‐globin gene cluster

Pediatric Blood & Cancer (2012)

Madeleine Verhovsek Nirmish Shah Ibifiri Wilcox Sara C. Koenig Tiago Dahrug Barros

Fetal and neonatal hemolytic anemia can be caused by (γδβ)(0)-thalassemia deletions of the β-globin gene cluster. Many of these deletions have not been well characterized, and diagnostic tests are not readily available, thus hampering carrier detection, family counseling, and antenatal diagnosis. We report and define a 198 kb deletion removing the entire β-globin gene cluster, which was found in members of a multigeneration family of Irish/Scottish descent. The proband had life-threatening fetal and neonatal hemolytic anemia which subsided by 1 year of age.

Proband

Gene cluster

10.1002/pbc.24094

Cite

Citations (14)

Adverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil

Revista Brasileira Ginecologia e Obstetrícia (2022)

Carla Dinamerica Kobayashi Victor Bertollo Gomes Pôrto Martha Elizabeth Brasil da Nóbrega Cibelle Mendes Cabral Tiago Dahrug Barros

Regulations for the vaccination of pregnant women in Brazil occurred in March 2021. Despite the absence of robust data in the literature on the coronavirus disease 2019 (COVID-19) vaccinations in pregnant women, it is understood that the benefit-risk ratio tends to be favorable when considering the pandemic and the high burden of the disease. However, it is still important to monitor for Events Supposedly Attributable to Vaccination or Immunization (ESAVI) and to draw safety profiles of the different platforms used in pregnant and postpartum women. The present study aims to describe the main characteristics of ESAVIs related to COVID-19 vaccines occurring in pregnant women in the first months of the vaccination campaign in Brazil. During the evaluation period, 1,674 notifications of ESAVIs in pregnant women were recorded, and 582 notifications were included for the analysis. Of the 582 ESAVIs identified, 481 (82%) were classified as non-serious adverse events and 101 (17%) as serious adverse events. Ten deaths were identified, including one death which was considered to be causally related to the vaccine. The other nine maternal deaths had causality C, that is, without causal relationship with the vaccine, and most were due to complications inherent to pregnancy, such as pregnancy-specific hypertensive disorder (PSHD) in 4 cases and 3 due to COVID-19. Despite some limitations in our study, we believe it brings new insights into COVID-19 vaccines in this group and will add to the available evidence.As determinações vacinação nas gestantes foram estabelecidas em março de 2021, no Brasil. Apesar da ausência de dados robustos na literatura da vacinação contra coronavirus disease 2019 (COVID-19) nesse grupo, entende-se que a relação de benefício versus risco tende a ser favorável considerando a situação pandêmica e a elevada carga de doença, tendo justificado o uso dessas vacinas em ampla escala nas gestantes de todo o mundo. Entretanto, o monitoramento dos eventos adversos pós vacinação (EAPVs) torna-se ainda mais importante para traçar um perfil de segurança das diferentes plataformas nas gestantes e puérperas. O presente estudo tem como objetivo descrever as principais características dos EAPVs contra COVID-19 ocorridos nas gestantes nos primeiros meses de campanha da vacinação no Brasil. Foram identificadas 1.674 notificações em gestantes, com a inclusão de 582 EAPVs analisados. Dos 582 EAPVs identificados, 481 (82%) foram classificados como eventos adversos não-graves e 101 (17%) como eventos adversos graves, sendo 10 (9,9%) destes referentes aos óbitos. Apenas um caso de óbito materno teve relação causal com a vacinação comprovada (causalidade A1), e foi secundário à síndrome trombocitopênica trombótica (TTS) após a vacina AstraZeneca/Fiocruz. Os outros nove óbitos maternos tiveram causalidade C, ou seja, sem relação causal com a vacina, e a maioria por complicações inerentes à gravidez, como a doença hipertensiva específica da gestação (DHEG) e COVID-19. Apesar de algumas limitações em nosso estudo, acreditamos que ele traz dados importantes sobre as vacinas COVID-19 neste grupo aumentando as evidências disponíveis.

Pandemic

Causality

10.1055/s-0042-1755461

Cite

Citations (11)

Vaccine-induced immune thrombotic thrombocytopenia after COVID-19 vaccination: Description of a series of 39 cases in Brazil

Vaccine (2022)

Patrícia Mouta Nunes de Oliveira Daniela P. Mendes-de-Almeida Victor Bertollo Gomes Pôrto Catherine Crespo Cordeiro Gabriellen Vitiello Teixeira

Describe a case series of vaccine-induced immune thrombotic thrombocytopenia (VITT) after COVID-19 vaccination in Brazil that included ChAdOx1 nCoV-19, Ad26.COV2.S and BNT162b2 vaccines, describing their clinical and laboratory characteristics.Descriptive case series study using Bio-Manguinhos/Fiocruz/AstraZeneca Brazil and National Immunization Program/Ministry of Health (NIP/MoH) data on COVID-19 AEFI surveillance. We obtained patient-level data from pharmacovigilance for AEFI surveillance and used both the NIP/MoH and Bio-Manguinhos/Fiocruz pharmacovigilance databases to create the study database. Thirty-nine cases of suspect VITT were included, 36 after ChAdOx1 nCoV-19, one after BNT162b2 and two after Ad26.COV2.S vaccine. All cases were based on meeting the Brighton Collaboration criteria for VITT. The primary outcomes were clinical and laboratory features, site of thrombosis, and anti-PF4 ELISA, when available.Thirty-nine cases met the criteria, 38 of which were classified as level 1 and one as level 3 according to Brighton Collaboration. Most cases had the central nervous system (CNS) as the main site of thrombosis (21/39) and happened after the vaccine first dose (34/39). The median age of the cases was 41 years old (23 to 86 yo). Most of the cases (61.5%) occurred in women. The median interval between vaccination and onset of symptoms was 8 days (0-37 days). The platelet count and D-dimer count had median values of 34,000/µL and 19,235 µg FEU/L, respectively. The ELISA anti-PF4 antibody was positive in 18 samples. The overall mortality rate was 51% and was higher in cases of CNS thrombosis with intracerebral bleeding.Our case series shows that Brazilian VITT cases have similar clinical and laboratory profiles as demonstrated in the literature. Brazil has administered more than 300 million doses of COVID-19 vaccines (more than 110 million from ChAdOx1 nCoV-19). VITT seems to be a very rare but serious adverse event following COVID-19 immunization, especially adenoviral vector immunization.

10.1016/j.vaccine.2022.06.014

Cite

Citations (17)

PDG13 CURRENT PRESCRIPTION PROFILE OF RIBAVIRIN FOR HEPATITIS C IN BRAZIL AND THE BUDGET IMPACT ANALYSIS ON UPDATED RECOMMENDATIONS FOR ITS USE BETWEEN 2020 AND 2024 IN THE BRAZILIAN PUBLIC HEALTH SYSTEM

Value in Health (2020)

Karen Cristine Tonini B. Pinheiro dos Santos Tiago Dahrug Barros Marcello Tonini Gláucio Mosimann

Christian ministry

Hepatitis C

10.1016/j.jval.2020.04.303

Cite

Citations (0)

Asymptomatic cryptococcal antigen prevalence detected by lateral flow assay in hospitalised HIV‐infected patients in São Paulo, Brazil

Tropical Medicine & International Health (2016)

J Vidal C Zenatti Adriana Paulino Arnaldo Lopes Colombo Marilena dos Anjos Martins

To determine the prevalence of asymptomatic cryptococcal antigen (CRAG) using lateral flow assay (LFA) in hospitalised HIV-infected patients with CD4 counts <200 cells/μl.Hospitalised HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the São Paulo State, Brazil. All patients were >18 years old without prior cryptococcal meningitis, without clinical suspicion of cryptococcal meningitis, regardless of antiretroviral (ART) status, and with CD4 counts <200 cells/μl. Serum CRAG was tested by LFA in all patients, and whole blood CRAG was tested by LFA in positive cases.We enrolled 163 participants of whom 61% were men. The duration of HIV diagnosis was a median of 8 (range, 1-29) years. 26% were antiretroviral (ART)-naïve, and 74% were ART-experienced. The median CD4 cell count was 25 (range, 1-192) cells/μl. Five patients (3.1%; 95%CI, 1.0-7.0%) were asymptomatic CRAG-positive. Positive results cases were cross-verified by performing LFA in whole blood.3.1% of HIV-infected inpatients with CD4 <200 cells/μl without symptomatic meningitis had cryptococcal antigenemia in São Paulo, suggesting that routine CRAG screening may be beneficial in similar settings in South America. Our study reveals another targeted population for CRAG screening: hospitalised HIV-infected patients with CD4 <200 cells/μl, regardless of ART status. Whole blood CRAG LFA screening seems to be a simple strategy to prevention of symptomatic meningitis.

10.1111/tmi.12790

Cite

Citations (33)