FI

Fabíola Isabel Suano de Souza

Universidade Federal de São Paulo

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Roseli Oselka Saccardo Sarni

Faculdade de Medicina do ABC

Fernando Luiz Affonso Fonseca

Faculdade de Medicina do ABC

Sônia Hix

Faculdade de Medicina do ABC

Maria Wany Louzada Strufaldi

Universidade Federal de São Paulo

João Carlos Pina Faria

Faculdade de Medicina do ABC

Thaís Tobaruela Ortiz

Fundação de Apoio à Universidade Federal de São Paulo

Michelle Cavalcante Caetano

Universidade Federal de São Paulo

Dirceu Solé

Universidade Federal de São Paulo

Rosana Fiorini Puccini

Universidade Federal de São Paulo

Itana Gomes Alves Andrade

Universidade Federal de São Paulo

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Universidade Federal de São Paulo

Faculdade de Medicina do ABC

Fundação de Apoio à Universidade Federal de São Paulo

Universidade de São Paulo

Union des Industries Ferroviaires Européennes

Fundação do ABC

Universidade Estadual de Campinas (UNICAMP)

Weatherford College

Instituto de Saúde

Hospital São Paulo

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Perinatal outcomes in new-borns of pregnant women with COVID-19: a case-control study

Research Square (Research Square) (2024)

Letícia Veríssimo Dutra Giovana Gonçalves Mariliza Henrique da Silva Cibele Wolf Lebrão Fernando Luiz Affonso-Fonseca

Abstract Background The incidence of COVID-19 vertical transmission is approximately 20%, and a shorter interval and greater maternal infection severity increase the risk of mother-to-child transmission. Objective This study aims to describe the frequency of COVID-19 positivity and clinical symptoms in newborns of pregnant women who have had COVID-19. Methods A case‒control study was carried out with unvaccinated women who had COVID-19 during pregnancy and their newborns. The 23 newborns that tested positive for COVID-19 (RT‒PCR for SARS-CoV-2) in the first 48 hours of life were matched (2:1) by day of birth and sex, with 46 other newborns that tested negative for COVID-19. The following data were collected: time and severity of maternal infection, gestational age, anthropometry, and clinical symptoms of the newborns. Results The mean age of the pregnant women was 28.50 ± 6.39 years, and the median time between COVID-19 infection and delivery was 86.0 days (26.5,179). The mean gestational age and birth weight of the newborns were 38.2 ± 1.7 weeks and 2994.2 ± 464.5 grams, respectively. Fifteen (21.7%) of the newborns experienced clinical complications during hospitalization, and the most common complications were early respiratory distress (10.1%), hypotonia/hypoactivity (13.0%), hypoglycemia (1.4%), and vomiting (1.4%). Newborns with positive RT‒PCR results for SARS-CoV-2 had a greater risk of respiratory symptoms (OR = 21.31; 95% CI 2.24 to 201.68; p = 0.008), and the likelihood of positivity in newborns increased by 0.07% (OR = 1.007; 95% CI 1.001 to 1.014; p = 0.026) for each day of COVID‒19 infection during pregnancy closer to birth. Conclusions Newborns who tested positive for SARS-CoV-2 were at greater risk of respiratory disorders, and maternal infection closer to birth increased the likelihood of positivity in newborns. There was no association between infection with COVID-19 in newborns and the severity of maternal infection, prematurity, or birth weight.

2019-20 coronavirus outbreak

10.21203/rs.3.rs-4854531/v1

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Ultra-processed food intake and food allergy in children and adolescents

International Journal of Food Sciences and Nutrition (2024)

Elaine Cristina de Almeida Kotchetkoff Fabíola Isabel Suano de Souza Daniela Neri Gama de Almeida Talita Lemos Neves Barreto Raquel de Deus Mendonça

This study aimed to describe the dietary intake of ultra-processed foods (UPF) by children and adolescents with food allergy (FA) and to verify a possible association between the UPF intake with clinical characteristics and nutritional status in this group. This cross-sectional study included 110 children and adolescents with single or multiple FA IgE and non-IgE mediated. We evaluated food intake using the NOVA classification through the three 24-h recalls. The average contribution of UPF to total energy intake (calories) ranges from 21% in the first quartile to 43% in the last quartile (mean UPF intake 33.9 ± 14.9%). After binary logistic regression, an association was verified between dietary intake of UPF (>4th quartile) as a percentage of total energy intake and having multiple food allergies (OR 4.102; 95% CI − 1.331 to 12.643; p = .014). We concluded that children and adolescents with FA consumed a higher amount of UPF.

Quartile

Calorie

Food group

10.1080/09637486.2024.2306296

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Selenium levels and glutathione peroxidase activity in patients with ataxia-telangiectasia: association with oxidative stress and lipid status biomarkers

Orphanet Journal of Rare Diseases (2021)

Itana Gomes Alves Andrade Fabíola Isabel Suano de Souza Fernando Luiz Affonso Fonseca Carolina Sanchez Aranda Lago Roseli Oselka Saccardo Sarni

Abstract Introduction Ataxia-Telangiectasia (A-T) is a multi-system disorder that may be associated with endocrine changes, oxidative stress in addition to inflammation. Studies suggest that selenium is a trace element related to protection against damage caused by oxidative stress. Objective To describe the plasma levels of selenium and erythrocyte glutathione peroxidase activity in A-T patients and to relate them to oxidative stress and lipid status biomarkers. Methods This is a cross-sectional and controlled study evaluating 22 A-T patients (age median, 12.2 years old) matched by gender and age with 18 healthy controls. We evaluated: nutritional status, food intake, plasma selenium levels, erythrocyte glutathione peroxidase activity, lipid status, inflammation and oxidative stress biomarkers. Results Adequate levels of selenium were observed in 24/36 (66.7%) in this evaluated population. There was no statistically significant difference between the groups in selenium levels [47.6 μg/L (43.2–57.0) vs 54.6 (45.2–62.6) μg/dL, p = 0.242]. Nine of A-T patients (41%) had selenium levels below the reference value. The A-T group presented higher levels of LDL-c, non-HDL-c, oxidized LDL, Apo B, Apo-B/Apo-A-I1, LDL-c/HDL-c ratio, malondialdehyde [3.8 µg/L vs 2.8 µg/L, p = 0.029] and lower Apo-A-I1/HDL-c and glutathione peroxidase activity [7300 U/L vs 8686 U/L, p = 0.005]. Selenium levels were influenced, in both groups, independently, by the concentrations of oxidized LDL, malonaldehyde and non-HDL-c. The oxidized LDL (AUC = 0.849) and ALT (AUC = 0.854) were the variables that showed the greatest discriminatory power between groups. Conclusion In conclusion, we observed the presence of selenium below the reference value in nearly 40% and low GPx activity in A-T patients. There was a significant, inverse and independent association between selenium concentrations and oxidative stress biomarkers. Those data reinforce the importance of assessing the nutritional status of selenium in those patients.

Malondialdehyde

10.1186/s13023-021-01732-5

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Analysis of an instrument for primary health care monitoring

Acta Paulista de Enfermagem (2022)

Paulo de Tarso Puccini Ana Estela Haddad Fabíola Isabel Suano de Souza Rejane Calixto Gonçalves Cássia Liberato Muniz Ribeiro

Objective: To analyze an instrument for monitoring primary care.Methods Qualitative, descriptive, and analytic research that consisted in the application of the instrument in 442 Basic Health Units - PCC from São Paulo city with the participation of local managers in its elaboration; the instrument is composed of 47 aspects that contemplated indicators of Structure, Process, and Result and we organized them in six thematic blocks: I - welcoming technical reception – WTR (reception); II - nursing work; III - medical work; IV - assistance organization and team integration; V - vaccination and program coverage; VI - management and participation. For the statistical analysis, we utilized the SPSS 25.0 program.Results The average and median scores obtained by the 414 evaluated Primary Care Centers (total of 470 possible points) were 356 and 380, respectively. Through the multivariate modeling, nine aspects of Structure and Processes stood out, when analyzed concerning the aspects of the Result, presenting statistical association (p<0.05): WTR carried out in every period of Primary Care Centers; specific training for the care in WTR; nurse clinical performance; systematized medical rearguard for WTR; complete oral health team; reserved time for team meeting; group appointment carried out systematically; health promotion actions; adequate physical accommodations.Conclusion The instrument presented the capacity to capture different stages of the organization and the results of the participant units of this study, and, besides a global evaluation, it revealed critical questions of the services related to the intended changes. As an evaluative tool for the services, it may contribute to the monitoring and the support to the everyday techno-management decision making.

Primary (astronomy)

10.37689/acta-ape/2022ao0203666

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Avaliação neurológica pelo método Dubowitz em recém-nascidos prematuros com idade corrigida de termo comparada a de nascidos a termo

Revista Paulista de Pediatria (2009)

Marina Ortega Golin Fabíola Isabel Suano de Souza Roseli Oselka Saccardo Sarni

OBJETIVO: Comparar a avaliação neurológica de recém-nascidos pré-termo em idade de termo com a de recém-nascidos a termo e verificar a presença de associação entre alterações na avaliação neurológica e características e intercorrências clínicas nos prematuros. MÉTODO: Estudo transversal de 60 nascidos a termo e 30 prematuros do Hospital Estadual Mário Covas, em Santo André (SP), avaliados pelo método Dubowitz. Os pontos de corte da pontuação total foram 30,5 e 26 para comparar recém-nascidos pré-termo e a termo, respectivamente. Os prematuros foram avaliados com idade correspondente ao termo, na 37ª semana, e os do grupo controle, 48 horas após o nascimento. Todos os neonatos foram avaliados pela mesma examinadora, entre as mamadas, nos estágios 4 e 5 de sono e vigília. Para análise estatística, utilizaram-se testes de associação. RESULTADOS: 90% dos nascidos pré-termo não atingiram a pontuação esperada para a idade de termo (p<0,0001), com alterações mais evidentes nas dimensões: tônus, tipo de tônus e movimentos. Dentre os prematuros, 57% não atingiram pontuação total igual ou superior a 26. A sepse neonatal foi a única intercorrência associada de maneira significante, com pontuações abaixo da normalidade em recém-nascidos pré-termo (p=0,009). CONCLUSÃO: Os recém-nascidos pré-termo avaliados com 37 semanas de idade corrigida, quando comparados aos nascidos a termo, apresentaram menor pontuação no exame neurológico e apenas a sepse se associou a alterações neurológicas.

10.1590/s0103-05822009000400009

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Selenium levels and glutathione peroxidase activity in patients with ataxia-telangiectasia: association with oxidative stress and lipid status biomarkers

Research Square (Research Square) (2021)

Itana Gomes Alves Andrade Fabíola Isabel Suano de Souza Fernando Luiz Affonso Fonseca Carolina Sanchez Aranda Lago Roseli Oselka Saccardo Sarni

Abstract Introduction: Ataxia-Telangiectasia (A-T) is a multi-system disorder that may be associated with endocrine changes, oxidative stress in addition to inflammation. Studies suggest that selenium is a trace element related to protection against damage caused by oxidative stress. Objective: To describe the plasma levels of selenium and erythrocyte glutathione peroxidase activity in A-T patients and to relate them to oxidative stress and lipid status biomarkers. Methods : This is a cross-sectional and contolled study evaluating 22 A-T patients (age median, 12.2 years old) matched by gender and age with 18 healthy controls. We evaluated: nutritional status, food intake, plasma selenium levels, erythrocyte glutathione peroxidase activity, lipid status, inflammation and oxidative stress biomarkers. Results: Adequate levels of selenium were observed in 24/36 (66.7%) in this evaluated population. There was no statistically significant difference between the groups in selenium levels [47.6 ug/L (43.2-57.0) vs 54.6 (45.2-62.6) ug/dL, p = 0.242]. Nine/22 (41%) of A-T patients had selenium levels below the reference value. The A-T group presented higher levels of LDL-c, non-HDL-c, oxidized LDL, Apo B, Apo-B/Apo-A-I, LDL-c/HDL-c ratio, malondialdehyde [3.8 µg/L vs 2.8 µg/L, p=0.029] and lower Apo-A-I/HDL-c and glutathione peroxidase activity [7300 U/L vs 8686 U/L, p=0.005]. Selenium levels were influenced, in both groups, independently, only by the concentrations of oxidized LDL, malonaldehyde and non-HDL-c. The oxidized LDL (AUC=0.849) and ALT (AUC=0.854) were the variables that showed the greatest discriminatory power between groups. Conclusion: In conclusion, we observed the presence of selenium below the reference value in nearly 40% and low GPx activity in A-T patients. There was a significant, inverse and independent association between selenium concentrations and oxidative stress biomarkers. Those data reinforce the importance of assessing the nutritional status of selenium in those patients.

Malondialdehyde

10.21203/rs.3.rs-71382/v2

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Frequency of ambulatory care adverse events in Latin American countries: the AMBEAS/PAHO cohort study

International Journal for Quality in Health Care (2015)

Dolors Montserrat-Capella M L Buelga Suarez Lidia Ortíz José Joaquín Mira Hernando Gaitán-Duarte

Determine the frequency and preventability of adverse events (AEs) from available information sources in selected ambulatory care (AC) sites in Latin America (LA). Multinational observational cohort was conducted to determine the period prevalence (retrospective focus) and the cumulative incidence (prospective focus) of AEs. Outpatient clinics in Mexico, Peru, Brazil and Colombia. A random selection of 2080 patients. The existence of AE was decided based on trigger information provided by the patient and crossing the data with each patient's medical history. AE occurrences 6 months prior (prevalence) and 42 days after (incidence) the patient receiving AC were identified. AE type and preventability were also described. Two thousand eighty patients participated in the study. AEs prevalence was 5.2% (108/2080) [95% confidence interval (CI) 4.2–6.1%], and cumulative incidence was 2.4% (42/1757) (95% CI 1.7–3.1%). AEs considered preventable were 44% (55/108) of prevalence period, and 52.4% (22/42) of incidence period. Preventability was associated with patient socioeconomic status (OR 3.5, 95% CI 1.4–8.8), medication error (OR 0.1, 95% CI 0.0–0.4), diagnostic error (OR 0.1, 95% CI 0.0–0.8) and a minor impact on the patient (OR 0.2 95% CI 0.1–0.9). The frequency of AE in ambulatory settings in LA is in the high-frequency range of research focused on the prevalence of AEs. Fifty percent was preventable. This study provides an approach for assessing the frequency and preventability of AE in order to enhance patient safety in LA.

10.1093/intqhc/mzu100

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Association Between Low Vitamin D Levels and the Greater Impact of Fibromyalgia

Journal of Clinical Medicine Research (2020)

Susyane Ribeiro Beserra Fabíola Isabel Suano de Souza Roseli Oselka Saccardo Sarni Myllena Maria de Morais Pereira

Background: Fibromyalgia (FM) is a clinical syndrome mainly characterized by generalized chronic pain, fatigue, sleep and cognition disorders. The role played by vitamin D in the pathophysiology of painful syndromes is poorly known. Studies assessing the association between vitamin D and FM have presented conflicting results. The aims of the current study were to assess vitamin D levels in FM patients, by comparing them to healthy controls, as well as to analyze their impact on this disease. Methods: This was a cross-sectional study comprising 43 FM patients (ACR 2010 criteria) and 40 healthy individuals. All participants had their vitamin D levels measured, and FM patients also had their total calcium, albumin, phosphorus and parathyroid hormone (PTH) measured. Clinical variables capable of affecting the results were evaluated and the fibromyalgia impact questionnaire (FIQ) was applied. Results: There was not statistically significant difference in global mean values of vitamin D between groups. In the total sample, only 4.8% of the individuals had vitamin D deficiency, which corresponded to the deficiency found in the group of patients; in the control, no one had vitamin deficiency; 39.8% had insufficient levels and 55.4% with sufficient levels. The mean serum vitamin D values were similar between the FM and control groups (34.8 ± 12 and 34.7 ± 12.3 ng/mL, respectively; P = 0.806). However, a significant negative correlation was found between vitamin D concentration and FIQ values, that is, patients with the greatest impact of the disease had lower concentrations of vitamin D (P = 0.018). Conclusion: FM patients did not present higher prevalence of vitamin D deficiency or insufficiency than healthy individuals, although low vitamin D concentrations could indicate more severe disease impacts. J Clin Med Res. 2020;12(7):436-442 doi: https://doi.org/10.14740/jocmr4136

Fibromyalgia syndrome

10.14740/jocmr4136

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Relationship between body mass index and waist-to-height ratio in childhood

Revista da Associação Médica Brasileira (2021)

João Carlos Pina Faria Camila Augusta Victorino Luciana Satiko Sawamura Stephanie Ramos Coelho Fabíola Isabel Suano de Souza

SUMMARY OBJECTIVE: To evaluate whether there is an association between the body mass index z-score and waist-to-height ratio of children and adolescents. METHODS: This was a cross-sectional study conducted in a school in Santo André, SP, between June and August 2019. Body mass index was measured for all participants, adopting the z-score cutoff of +2 recommended by the World Health Organization. The waist-to-height ratio was determined in children over two years of age and considered abnormal when ≥0.5. The qualitative variables are presented as absolute numbers and percentages. To compare qualitative data, we used the χ2 test or Fisher's exact test. Pearson's test was applied to assess the correlation between BMI and waist-to-height ratio. The level of significance adopted was 5%. RESULTS: The body mass index was calculated for 518 children and the waist-to-height ratio for 473 children. Regarding body mass index, 60.6% of the participants had normal weight, 3.1% were underweight, and 36.3% were overweight. overweight (24.7%) and obesity (22.7%) were more prevalent in adolescents. The waist-to-height ratio was abnormal in 50.5% of the sample. There was an increasing association between body mass index and waist-to-height ratio with age, according to the Pearson correlation coefficients for the age groups <5 years (r=0.459; p<0.001), 5 to 10 years (r=0.687; p<0.001) and >10 years (r=0.805; p<0.001). CONCLUSION: There was a significant correlation between body mass index and waist-to-height ratio. This association was higher in adolescents. The waist-to-height ratio is easy to apply and may be useful as a predictor of cardiometabolic risk.

Waist-to-height ratio

Underweight

Body volume index

10.1590/1806-9282.20201057

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RAZÕES NEUTRÓFILOS/LINFÓCITOS E PLAQUETAS/LINFÓCITOS E O ÍNDICE IMUNO INFLAMATÓRIO SISTÊMICO: ASSOCIAÇÃO COM PROTEÍNA C REATIVA E MIELOPEROXIDASE EM CRIANÇAS NASCIDAS PREMATURAMENTE.

Blucher Medical Proceedings (2022)

SIMONE HOLZER DE MORAES Denise de Oliveira Schoeps Henrique Holzer de Moraes Fabíola Isabel Suano de Souza Roseli Oselka Saccardo Sarni

JustificativaAproximadamente um terço dos recém nascidos pré-termo (RNPT) terão, aos 20 anos de idade, ao menos um problema crônico de saúde, em especial os relacionados à inflamação crônica (Chermont, 2012). Além dos marcadores inflamatórios clássicos como a proteína C reativa ultrassensível (PCRus) outros têm sido estudados como a Mieloperoxidase (MPO) (Ndrepep, 2019) as razões Neutrófilos/Linfócitos (RNL), Plaquetas/Linfócitos (RPL) e o Índice imuno inflamatório sistêmico IIS (Song,2021) também associados ao risco cardiovascular. Objetivo(s)Verificar a associação das NLR, PLR e SII com a MPO e PCRus em crianças pré- púberes nascidas prematuramenteMétodo(s)Estudo transversal e controlado, com crianças, entre 5 e 10 anos, nascidas prematuramente com Muito Baixo Peso (grupo MBP; n=40) pareadas com crianças saudáveis, nascidas a termo, de mesmo sexo e idade (grupo controle; n=30). Foram avaliados: peso, altura, circunferência abdominal; hemograma, PCR-us e MPO. Análise estatística: Mann-Whitney e correlação de Spearman; Resultado(s)No grupo MBP 43,2% eram do sexo masculino, a média do peso ao nascer e da idade gestacional foram de 1157±242 gramas e 30,0±2,3 semanas, respectivamente. Os grupos não diferiram quanto ao escore z do índice de massa corporal, razão cintura/altura, RNL, RPL, IIS e PCRus. A mediana de MPO do grupo MBP foi superior à do grupo controle(p<0,001). Houve correlação significante e direta entre RNL (rho=0.25; p=0.03) e IIS (rho=0.27; p=0.02) com a MPO Conclusão(ões)A correlação significante entre as razões derivadas do hemograma e a MPO apontam para um possível papel destas na identificação do risco cardiovascular.

10.5151/sabara2022-1342

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