Papers by Fabiana Schuelter-trevisol
Background and objectives: Laryngoscopy and orotracheal intubation are invasive procedures that c... more Background and objectives: Laryngoscopy and orotracheal intubation are invasive procedures that can generate tachycardia, arterial hypertension and arrhythmias. This study compares the effects of esmolol, magnesium sulfate and placebo on this potential hemodynamic response. Method: A randomized clinical trial, double-blind, that evaluated patients between 18 and 65 years old, ASA I or II, requiring general anesthesia and orotracheal intubation to undergo elective surgery. The subjects were divided into three groups, the E group received 1.5 mg/kg of esmolol intravenous (IV), the M group 30 mg/kg of magnesium sulfate IV and the C receiving none of the adjuvants prior to anesthetic induction. Values of blood pressure and heart rate (HR) were recorded in five times (T) related to drug administration and intubation. Results: A total of 45 participants were studied. Group E was the only one that maintained stable HR in relation to baseline at all times. Group M had the highest mean systo...
Brazilian Journal of Nephrology, 2019
Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a pre... more Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a prevalence of about 25% during hemodialysis sessions, causing increased morbidity and mortality. Objective: To study the effects of sertraline to prevent IDH in hemodialysis patients. Methods: This was a double-blind, crossover clinical trial comparing the use of sertraline versus placebo to reduce intradialytic hypotension. Results: Sixteen patients completed the two phases of the study during a 12-week period. The IDH prevalence was 32%. A comparison between intradialytic interventions, intradialytic symptoms, and IDH episodes revealed no statistical difference in the reduction of IDH episodes (p = 0.207) between the two intervention groups. However, the risk of IDH interventions was 60% higher in the placebo group compared to the sertraline group, and the risk of IDH symptoms was 40% higher in the placebo group compared to the sertraline group. Survival analysis using Kaplan-Meier estima...
Nutrition Research
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Hospital Pharmacy
Introduction: Pharmacological interactions are frequently observed in patients with chronic disea... more Introduction: Pharmacological interactions are frequently observed in patients with chronic diseases, and their occurrence is proportional to the amount of medication used daily. Patients undergoing chemotherapy treatment commonly have comorbidities, which favor a greater prevalence of polypharmacy, increasing the risk of drug interactions. Therefore, the aim of this study was to estimate the prevalence of drug interactions in patients undergoing intravenous chemotherapy treated at a hospital oncology service in southern Brazil. Methods: This was an observational study with a cross-sectional design that was carried out with the analysis of secondary data obtained through the review of medical records. The population assessed consisted of all cancer patients who received intravenous chemotherapy from October to December 2020. Results: Out of the 297 patients included in the study, 231 (77.8%) had at least 1 potential pharmacological interaction. In total, 1044 drug interactions were ...
Jornal Brasileiro de Doenças Sexualmente Transmissíveis
Introduction: People living with the human immunodeficiency virus (HIV) are generally overweight ... more Introduction: People living with the human immunodeficiency virus (HIV) are generally overweight or have an altered body composition as compared to healthy individuals, showing a change in nutritional profile over time. Objective: The aim of the study was to characterize the nutritional status, estimate the prevalence of lipodystrophy, and examine the association between lipohypertrophy and lipid profile alterations, and other clinical data of HIV-infected individuals. Methods: This was a cross-sectional study on male and female subjects living with HIV, treated at a specialized outpatient clinic, aged 18 years old and over, whether using the antiretroviral therapy or not. Results: The sample consisted of 420 people with a mean age of 43.8 years (standard deviation 11.7). The length of time of the HIV infection averaged 74.6 months, and 91% of the respondents were on antiretroviral therapy. Lipodystrophy prevalence was 35.7%. Of these, 82 (54.7%) presented lipohypertrophy, 61 (40.7%...
Additional file 2. Checklist for measuring study quality (Downs & Black).
Pediatric Exercise Science, 2021
Purpose: This study evaluated the effects of 12 weeks of karate training on cardiometabolic param... more Purpose: This study evaluated the effects of 12 weeks of karate training on cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. Method: Seventy adolescents were randomized into 2 groups: control received nutritional and psychological interventions once a week for 12 weeks, and treatment received nutritional and psychological interventions once a week, plus 3 karate sessions per week, for 12 weeks. The main outcome measure was improvement in cardiometabolic parameters, oxidative stress, and inflammation. Results: After the intervention period, the treatment group showed a reduction in resting heart rate (77.86 [10.89]), high-density lipoprotein cholesterol (40.86 [8.31]), and triglycerides (75.18 [32.29]) and an increase in low-density lipoprotein cholesterol (95.64 [42.53]) in relation to pretraining. Regarding oxidative stress markers, there was a reduction in protein carbonylation (0.07 [0.06]) and nitric oxide (1.39 [1.11]) a...
Purpose: To compare different approaches to analyzing accelerometer-based measurement of physical... more Purpose: To compare different approaches to analyzing accelerometer-based measurement of physical activity among HIV-infected patients, and to verify whether the days of the week chosen to wear the equipment affect the classification of the subjects as physically active. Methods: Cross-sectional study of HIV-infected adults. Patients were interviewed using a standardized questionnaire during the routine visit for HIV treatment and used ActiGraph accelerometer during two weekdays and two weekend days. Sedentary activities resulted in less than 100 counts recorded, and moderate to vigorous activities in 1952 counts. Participants were categorized as active by doing ≥ 150 minutes of moderate or vigorous activities per week or its equivalent for less than seven days recorded. Mean comparison of the level of activity was determined using Generalized Estimation Equations, with sequential Bonferroni analysis. Results: In the total, 216 patients were studied; mean age was 39.9 ± 9.6 years; 57.4% were women. Within the weekdays, Friday presented the highest average time in minutes of moderate to vigorous activity. The lowest time spent doing moderate to vigorous physical activity was on Sundays, considered a leisure-time day, statistically different from Saturdays. Conclusion: The choice of accelerometer wearing days interfered with the analysis of data and, consequently, the results. Even so, there was no statistical difference between the categorization of subjects according to their level of physical activity, which allowed reducing the number of accelerometer wearing days, without impairing the quality information.
Apesar de haver rigorosas determinacoes para avaliacao pre-anestesica do paciente cirurgico, cuid... more Apesar de haver rigorosas determinacoes para avaliacao pre-anestesica do paciente cirurgico, cuidados no transoperatorio e no pos-operatorio, ainda se encontram relatos de complicacoes pos-operatorias. O presente estudo foi realizado a fim de identificar complicacoes pos-operatorias ocorridas na Sala de Recuperacao Pos-Anestesica (SRPA) em um Hospital Geral do Sul de Santa Catarina. Foram incluidos no estudo 350 pacientes que se submeteram a Anestesia Geral em cirurgias eletivas e de urgencia. Atraves de questionario aplicado na forma de entrevista, bem como pelas analises dos monitores cardiacos a beira leito dos pacientes, evidenciou-se 74,0% de complicacoes pos-operatorias. A complicacao mais comum encontrada foi dor no local cirurgico (56,9%), seguido de tontura (21,4%). A maioria dos pacientes apresentou apenas uma complicao (47,9%), sendo que apenas um paciente (0,4%) apresentou seis complicacoes. Houve tendencia de associacao entre o tipo de cirurgia e a ocorrencia complicaco...
Jornal Brasileiro de Patologia e Medicina Laboratorial, 2019
Introduction: Fetal death is defined as the death of the product of conception, regardless of ges... more Introduction: Fetal death is defined as the death of the product of conception, regardless of gestational age. Objectives: The objective of this study was to investigate the maternal (obstetrical and placental) risk factors and the necropsy findings associated with fetal death, based on data obtained from the
Apresenta-se o relato de experiência da integração entre serviços de saúde públicos e privados, g... more Apresenta-se o relato de experiência da integração entre serviços de saúde públicos e privados, gestores e universidade, para a vigilância e controle da epidemia de covid-19 em Tubarão, SC, Brasil. A cidade, universitária, cenário de grande fluxo de pessoas de diferentes locais do país, foi um dos primeiros municípios do estado catarinense com transmissão comunitária do SARS-CoV-2. São detalhadas as medidas adotadas com a criação do Comitê de Monitoramento da Covid-19, do Centro de Operações de Emergências Municipais em Saúde, e do Plano de Contingência da Doença. Passados 100 dias de pandemia, foram 5.979 casos notificados e 431 (7,2%) confirmados, dos quais 5 (1,2%) idos a óbito. Decisões precocessuspensão imediata das atividades de comércio e eventos com aglomeraçãopodem ter limitado a propagação do vírus. As parcerias estabelecidas trazem inovação e subsidiam a gestão pública nas tomadas de decisão pautadas em evidências científicas.
Ciência & Saúde Coletiva, 2019
Colorectal Disease, 2016
Background. Enhanced recovery after surgery (ERAS) programs have gained widespread acceptance in ... more Background. Enhanced recovery after surgery (ERAS) programs have gained widespread acceptance in different fields of major surgery. However, most elements of perioperative care in ERAS are based on practices that originated from colorectal surgery. This study investigated compliance with the main elements of ERAS for patients undergoing gastrectomy for gastric carcinoma. Methods. This phase 2 study enrolled 168 patients undergoing elective gastrectomy for gastric carcinoma. An ERAS program consisting of 18 main elements was implemented, and compliance with each element was evaluated (ClinicalTrials.gov, NCT01653496). Results. Distal gastrectomy was performed for 142 patients (84.5%) and total gastrectomy for 26 patients (10.1%). Laparoscopic surgery was performed for 141 patients (86%). The postoperative morbidity rate was 9.5%, and the mortality rate was 0%. The rates of compliance with the 18 main elements of ERAS ranged from 88.1 to 100%. The lowest compliance rate was observed in the restriction of intravenous fluid element (88.1%). Overall, all ERAS elements were successfully applied for 122 patients (72.6%). In the multivariate analysis, the significant factors that adversely affected compliance with ERAS were surgery during the early study period [odds ratio (OR) 0.39; p = 0.038], open surgery (OR 0.15; p \0.001), and postoperative morbidity (OR 0.16; p = 0.003). Conclusions. Most elements of ERAS can be successfully applied for patients undergoing gastrectomy for gastric carcinoma. Multimodal collaboration between providers is essential to achieve proper application of ERAS. The enhanced recovery after surgery (ERAS) program aims to reduce surgical stress and enhance postoperative recovery using evidence-based multimodal practices. 1 Since its introduction in the early 1990s, ERAS has been adopted for different major operations, most notably colorectal surgery. Several randomized trials and metaanalyses have demonstrated accelerated bowel recovery, reduced morbidity and mortality, and earlier hospital discharge with ERAS for colorectal surgery. 2 Despite the advances in surgical techniques and perioperative care, the morbidity rate for gastric cancer surgery is 10-28%, and the mortality rate is 0.8-2.2%. 3-5 In East Asia, where the incidence of gastric cancer is high, operative principles and surgical techniques are standardized. 6 However, perioperative management such as fluid management, prophylactic antibiotics, postoperative oral nutrition, use of a nasogastric tube or abdominal drainage, and pain management varies widely. 7 Recently, investigators have used ERAS for perioperative management of patients undergoing gastrectomy for gastric carcinoma. 8-10 Most have reported the short-term outcomes of ERAS for a small number of patients. However, slightly different ERAS protocols were used in each study. In addition, no previous studies investigated patient compliance with the different practices of ERAS, which is essential for its proper and safe application. Therefore, this
Archives of Pediatric Infectious Diseases, 2015
Background: The incidence rate of acute diarrheal disease in children is a health indicator, and ... more Background: The incidence rate of acute diarrheal disease in children is a health indicator, and the estimation of these data can help guide public health policies. Objectives: The aim of this study was to estimate the incidence and risk factors for acute diarrheal disease in children aged 0-1 year. Patients and Methods: An observational prospective cohort study was conducted on 210 children recruited at Hospital Nossa Senhora da Conceicao, in Tubarao, state of Santa Catarina, Brazil. Children born between July and September 2012 were followed up for 12 months. The presence of three or more liquid or loose stools during a 24-hour period was considered acute diarrhea. The categories of variables evaluated were comprised of sociodemographic characteristics (per capita income, maternal education, maternal age, access to medical care [public or private], and housing and living conditions [sanitation and hygiene, water supply, daycare attendance, and domestic animal]) and characteristics of the child (gender, birth weight, and breastfeeding). Results: The incidence of acute diarrhea among the 0-1-year-old children was 26.7 cases per 1,000 children per month. Independent risk factors for the occurrence of diarrhea were maternal age under 20 years and health care services provided by the Brazilian National Health System (SUS). Conclusions: The high incidence density of diarrhea among the children recruited in this study indicates the need for educational programs directed at people who are involved in this issue.
Revista Paulista de Pediatria
BMC Research Notes, 2014
Background: Oral health problems can generate considerable negative effects on the quality of lif... more Background: Oral health problems can generate considerable negative effects on the quality of life of individuals living with HIV. The aim of this study was investigate the oral health status and its impact on the quality of life of 1 to 18 years-old living with HIV-1 under follow-up at referral centers in Southern Brazil. Methods: A cross-sectional study involving individuals under follow-up (n = 36) was carried out. The individuals living with HIV-1 and their guardians underwent individual interviews using validated questionnaires for assessing oral health-related quality of life according to age group. Clinical oral examinations were performed to establish oral health status, in terms of caries and treatment need, HIV-1-related gingival as well as stomatological changes. Medical records were reviewed searching for clinical history of the infection and the presence of HIV-1-related diseases. Association studies between frequent/very frequent oral health-related impact on quality of life and independent variables were performed using Fisher's exact test. Results: The prevalence of frequent/very frequent oral health-related impact on quality of life was 69.0%. The prevalence of caries was 75.9%. Gingival changes were present in 20.7% of the individuals. Dental treatment was needed in 72.4% of the patients. HIV-1-related disease was present in 55.2%. The variables significantly associated with the prevalence of frequent/very frequent impact on oral health-related quality of life were dental treatment need (p = 0.037) and being more than 12 years of age (p = 0.041). Conclusions: Individuals living with HIV-1 with need for dental treatment and those over 12-years of age reported a statistically higher frequency of frequent/very frequent oral health-related impact on quality of life.
Revista da AMRIGS, 2010
RESUMO Introdução: O acesso à informação técnico-científica, principalmente por meio da Internet,... more RESUMO Introdução: O acesso à informação técnico-científica, principalmente por meio da Internet, aliado ao aumento do nível educacional das populações, tem feito surgir um paciente que busca informações sobre sua doença, sintomas, medicamentos e custos de ...
Expert Review of Endocrinology & Metabolism, 2022
ABSTRACT Introduction Obesity, a multifactorial disease caused by the interaction between genetic... more ABSTRACT Introduction Obesity, a multifactorial disease caused by the interaction between genetic characteristics, metabolism, lifestyle, and environmental factors, is a major global health problem and is currently defined as a pandemic phenomenon. This disease is determined by an interaction of several factors, but the imbalance between energy consumption and expenditure seems to be the crucial point. In some cases, there is no linearity between exposure to those factors that cause the onset of obesity. A striking example of the occurrence of obesity despite no obvious risk factors is that of obesity induced by viral infections. The most important of such viruses appears to be human adenovirus 36 (Adv36). Areas covered This review covers the relation between obesity and infection by Adv36 in humans. Also, discussed are the opportunities of prevention or treatment for the effects of Adv36 in human body. Expert opinion The role of Ad36 in the development of obesity has already been established. Future research should focus on the development of vaccines against this agent, drug discovery for infected individuals, and effective therapeutic uses of E4orf1 gene protein for diabetes and other diseases in clinical practice.
AIDS, 2008
Objective: To assess the performance of WHO clinical and CD4 cell count criteria for antiretrovir... more Objective: To assess the performance of WHO clinical and CD4 cell count criteria for antiretroviral treatment (ART) failure among HIV-infected adults in a workplace HIV care programme in South Africa. Design: Cohort study. Methods: We included initially ART-naive participants who remained on first-line therapy and had an evaluable HIV viral load result at the 12-month visit. WHO-defined clinical and CD4 cell count criteria for ART failure were compared against a gold standard of virological failure. Results: Among 324 individuals (97.5% men, median age 40.2, median starting CD4 cell count and viral load 154 cells/ml and 47 503 copies/ml, respectively), 33 (10.2%) had definite or probable virological failure at 12 months, compared with 19 (6.0%) and 40 (12.5%) with WHO-defined CD4 and clinical failure, respectively. CD4 criteria had a sensitivity of 21.2% and a specificity of 95.8% in detecting virological failure, and clinical criteria had sensitivity of 15.2% and specificity of 88.1%. The positive predictive value of CD4 and clinical criteria in detecting virological failure were 36.8 and 12.8%, respectively. Exclusion of weight loss or tuberculosis failed to improve the performance of clinical criteria. Conclusion: WHO clinical and CD4 criteria have poor sensitivity and specificity in detecting virological failure. The low specificities and positive predictive values mean that individuals with adequate virological suppression risk being incorrectly classified as having treatment failure and unnecessarily switched to second-line therapy. Virological failure should be confirmed before switching to second-line therapy.
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Papers by Fabiana Schuelter-trevisol