Carem Luana Machado Lessa

Universidade Federal de Ciências da Saúde de Porto Alegre

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Liane Nanci Rotta

Universidade Federal de Ciências da Saúde de Porto Alegre

Amanda de Menezes Mayer

Universidade Federal do Rio Grande do Sul

Andressa Barreto Glaeser

Universidade Federal de Ciências da Saúde de Porto Alegre

Paulo Ricardo Gazzola Zen

Universidade Federal de Ciências da Saúde de Porto Alegre

Andressa Schneiders Santos

Universidade Federal do Rio de Janeiro

Claudia Elizabeth Thompson

Universidade Federal de Ciências da Saúde de Porto Alegre

Vinícius Bonetti Franceschi

Imperial College London

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Álvaro Vigo

Universidade Federal do Rio Grande do Sul

Julia Gonçalves Küchle

Universidade Federal de Ciências da Saúde de Porto Alegre

Ana Trindade Winck

Universidade Federal de Ciências da Saúde de Porto Alegre

Cooperative Institutions

Universidade Federal de Ciências da Saúde de Porto Alegre

Universidade Federal do Rio Grande do Sul

Hospital de Clínicas de Porto Alegre

Pontifícia Universidade Católica do Rio Grande do Sul

Santa Casa de Misericórdia de Marília

Hospital Moinhos de Vento

Universidade Luterana do Brasil

Irmandade da Santa Casa de Misericórdia de São Paulo

United Food and Commercial Workers

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Advanced clinical parameters: A complementary hydroxyurea adherence evaluation in sickle cell anemia treatment

European Journal Of Haematology (2022)

Isabela Delfino Moreira Carem Luana Machado Lessa Gueverson Leonardo Gonçalves Rocha Laura Dewes Schmitz Viviane Schmitt Jahnke

Given the complex pathology of sickle cell anemia (SCA) and low adherence to hydroxyurea (HU) treatment, there is a need to seek parameters that identify recent changes in patient status. The advanced clinical parameters (ACPs) allow an early analysis of hematopoiesis. We aimed to draw the demographic profile of non-adherent SCA patients and to verify the use of ACPs as a measure of HU treatment adherence.In a cross-sectional study, we divided 83 SCA subjects treated with HU into Children (<12 years old) and adolescents/adults (≥12 years old). Their hemogram with the ACPs, electronic medical charts and pharmacy claim data were analyzed.Non-adherent ≥12 years old patients had significantly increased WBC, absolute neutrophil, lymphocyte, monocyte, and basophil counts, RBC, RET, RDW, and PLT, and significantly decreased MCV and MCH. Subjects in the adolescent/adult group with IG† ≥0.035 cells/mm3 had the RR for non-adherence increased by 4.6 times (p = .014), and the systemic immune inflammation index (SII) of non-adherent patients was also significantly higher (p = .042).IG† presents clinical utility in early identification of non-adherence to HU, especially when combined with other parameters, suggesting the evaluation of ACPs in laboratory routine, as they can be easily implemented.

10.1111/ejh.13860

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Comparison of Sepsis-1, 2 and 3 for Predicting Mortality in Septic Patients of a Middle-Income Country: A Retrospective Observational Cohort Study

Journal of Intensive Care Medicine (2023)

Carem Luana Machado Lessa Gisele Branchini Isabela Delfino M. Voos Cassiano Teixeira

Introduction The diagnosis of sepsis is based on expert consensus and does not yet have a “gold standard.” With the aim of improving and standardizing diagnostic methods, there have already been three major consensuses on the subject. However, there are still few studies in middle-income countries comparing the methods. This study describes the characteristics of patients diagnosed with sepsis and evaluates and compares the performance of Sepsis-1, 2, and 3 criteria in predicting 28 days, and in-hospital mortality. Patients and Methods A retrospective observational cohort study was conducted in the intensive care unit of a tertiary hospital. All admissions between January 1, 2018, and December 31, 2019, were reviewed. Patients diagnosed with sepsis were included. Results During the study period, 653 patients diagnosed with sepsis (by any of the studied criteria) were included in the study. The 28 days mortality rate was 45.8%, and the in-hospital mortality rate was 59.7%. We observed that 72.1% of patients met the minimum criteria for diagnosing sepsis according to the three protocols, and this group also had the highest mortality rate. Age and comorbidities such as cancer and liver cirrhosis were significantly associated with in-hospital mortality. The most common microorganisms were Escherichia coli, Klebsiella spp., and Staphylococcus spp. Conclusions The study found that most patients met the diagnostic criteria for sepsis using the three methods. Sepsis-2 showed greater sensitivity to predict mortality, while Sequential Organ Failure Assessment showed low accuracy, but was the only significant one. Furthermore, quick Sequential Organ Failure Assessment (qSOFA) had the highest specificity for mortality. Overall, these findings suggest that, although all three methods contribute to the diagnosis and prognosis of sepsis, Sepsis-2 is particularly sensitive in predicting mortality. Sepsis-3 shows some accuracy but requires improvement, and qSOFA exhibits the highest specificity. More research is needed to improve predictive capabilities and patient outcomes.

Gold standard (test)

10.1177/08850666231208368

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Population-based prevalence surveys during the COVID-19 pandemic: a systematic review

medRxiv (Cold Spring Harbor Laboratory) (2020)

Vinícius Bonetti Franceschi Andressa Schneiders Santos Andressa Barreto Glaeser Janini Cristina Paiz Gabriel Dickin Caldana

Abstract Population-based prevalence surveys of COVID-19 contribute to establish the burden and epidemiology of infection, the role of asymptomatic and mild infections in transmission, and allow more precise decisions about reopen policies. We performed a systematic review to evaluate qualitative aspects of these studies, their reliability, and biases. The available data described 37 surveys from 19 countries, mostly from Europe and America and using antibody testing. They reached highly heterogeneous sample sizes and prevalence estimates. Disproportional prevalence was observed in minority communities. Important risk of bias was detected in four domains: sample size, data analysis with sufficient coverage, measurements in standard way, and response rate. The correspondence analysis showed few consistent patterns for high risk of bias. Intermediate risk of bias was related to American and European studies, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, RT-PCR tests and prevalence <1%. One sentence summary Population-based prevalence surveys of COVID-19 until September 2020 were mostly conducted in Europe and Americas, used antibody testing, and had important risks of bias.

Pandemic

Prevalence

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10.1101/2020.10.20.20216259

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Population‐based prevalence surveys during the Covid‐19 pandemic: A systematic review

Reviews in Medical Virology (2020)

Vinícius Bonetti Franceschi Andressa Schneiders Santos Andressa Barreto Glaeser Janini Cristina Paiz Gabriel Dickin Caldana

Summary Population‐based prevalence surveys of Covid‐19 contribute to establish the burden of infection, the role of asymptomatic and mild infections in transmission, and allow more precise decisions about reopen policies. We performed a systematic review to evaluate qualitative aspects of these studies, assessing their reliability and compiling practices that can influence the methodological quality. We searched MEDLINE, EMBASE, bioRxiv and medRxiv, and included cross‐sectional studies using molecular and/or serological tests to estimate the prevalence of Covid‐19 in the general population. Survey quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A correspondence analysis correlated methodological parameters of each study to identify patterns related to higher, intermediate and lower risks of bias. The available data described 37 surveys from 19 countries. The majority were from Europe and America, used antibody testing, and reached highly heterogeneous sample sizes and prevalence estimates. Minority communities were disproportionately affected by Covid‐19. Important risk of bias was detected in four domains: sample size, data analysis with sufficient coverage, measurements in standard way and response rate. The correspondence analysis showed few consistent patterns for high risk of bias. Intermediate risk of bias was related to American and European studies, municipal and regional initiatives, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, nationwide initiatives, reverse‐transcriptase polymerase chain reaction tests and prevalence <1%. We identified methodological standards applied worldwide in Covid‐19 prevalence surveys, which may assist researchers with the planning, execution and reporting of future population‐based surveys.

Pandemic

10.1002/rmv.2200

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Citations (47)