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Miyake MM, Valera FCP, Martins RB, Compagnoni IM, Fantucci MZ, Murashima AAB, da Silva LECM, de Lima TM, de Souza MVO, Melo SR, Dolci RLL, Floriano CG, de Campos CAC, Nakanishi M, Freire GSM, Valente AL, Fornazieri MA, da Silva JLB, Anzolin LK, Issa MJA, Souza TV, Lima BA, SantAnna GD, Abreu CB, Sakano E, Cassettari AJ, Avelino MAG, Goncalves MC, de Camargo LA, Romano FR, Alves RD, Roithmann R, Redeker NK, Filho LLB, Dassi CS, Meurer ATO, Garcia DM, Aragon DC, Tepedino MS, Succar ACS, Vianna PM, Dos Santos MCJ, Filho RHR, Kosugi EM, Villa JF, Gregorio LL, Piltcher OB, Meotti CD, Tamashiro E, Arruda E, Anselmo Lima WT. Smell loss associated with SARS-CoV-2 is not clinically different from other viruses: a multicenter cohort study. Rhinology 2024; 62:55-62. [PMID: 37772802 DOI: 10.4193/rhin23.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.
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Affiliation(s)
- M M Miyake
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil and Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - F C P Valera
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R B Martins
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - I M Compagnoni
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M Z Fantucci
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - A A B Murashima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - L E C M da Silva
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - T M de Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M V O de Souza
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - S R Melo
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R L L Dolci
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C G Floriano
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C A C de Campos
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - M Nakanishi
- University of Brasilia, Brasilia, DF, Brazil
| | | | - A L Valente
- University of Brasilia, Brasilia, DF, Brazil
| | | | | | - L K Anzolin
- State University of Londrina, Londrina, PR, Brazil
| | - M J A Issa
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - T V Souza
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - B A Lima
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - G D SantAnna
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - C B Abreu
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - E Sakano
- State University of Campinas. Campinas, SP, Brazil
| | | | | | | | | | | | - R D Alves
- Hospital Moriah, Sao Paulo, SP, Brazil
| | - R Roithmann
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - N K Redeker
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - L L B Filho
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - C S Dassi
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - A T O Meurer
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - D M Garcia
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - D C Aragon
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M S Tepedino
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - A C S Succar
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P M Vianna
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - E M Kosugi
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - J F Villa
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - L L Gregorio
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - C D Meotti
- Hospital de Clinicas Porto Alegre, RS, Brazil
| | - E Tamashiro
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - E Arruda
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - W T Anselmo Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
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Canesin WC, Volpe FAP, Gonçalves-Ferri WA, Manso PH, Aragon DC, Sbragia L. Primary peritoneal drainage in neonates with necrotizing enterocolitis associated with congenital heart disease: a single experience in a Brazilian tertiary center. ACTA ACUST UNITED AC 2021; 54:e10220. [PMID: 34076139 PMCID: PMC8186373 DOI: 10.1590/1414-431x2020e10220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
Necrotizing enterocolitis (NEC) is a common condition in preterm infants. The risk factors that contribute to NEC include asphyxia, apnea, hypotension, sepsis, and congenital heart diseases (CHD). The objective of this study was to evaluate the association between the treatment (surgery or drainage) and unfavorable outcomes in neonates with NEC and congenital heart diseases (NEC+CHD). A 19-year retrospective cohort study was conducted (2000-2019). Inclusion criterion was NEC Bell II stage. Exclusion criteria were associated malformation or genetic syndrome and those who did not undergo echocardiography or had a Bell I diagnosis. We included 100 neonates: NEC (n=52) and NEC+CHD (n=48). The groups were subdivided into NEC patients undergoing surgery (NECS, n=31), NEC patients undergoing peritoneal drainage (NECD, n=19), NEC+CHD patients undergoing surgery (NECCAS, n=21), and NEC+CHD patients who were drained (NECCAD, n=29). Multivariate analysis was performed to estimate the relative risk of death and the length of stay. Covariates were birth weight and gestational age. The group characteristics were similar. The adjusted relative risk of death was higher in the drainage groups [NECD (Adj RR=2.70 (95%CI: 1.47; 4.97) and NECCAD (Adj RR=1.97 (95%CI: 1.08; 3.61)], and they had the shortest time to death: NECD=8.72 (95%CI: 3.10; 24.54) and NECCAD=5.32 (95%CI: 1.95; 14.44). We concluded that performing primary peritoneal drainage in neonates with or without CHD did not improve the number of days of life, did not decrease the risk of death, and was associated with a higher mortality in newborns with NEC and clinical instability.
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Affiliation(s)
- W C Canesin
- Laboratório de Cirurgia Experimental Fetal "Michael Harrison", Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anantomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F A P Volpe
- Laboratório de Cirurgia Experimental Fetal "Michael Harrison", Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anantomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - W A Gonçalves-Ferri
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P H Manso
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - D C Aragon
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L Sbragia
- Laboratório de Cirurgia Experimental Fetal "Michael Harrison", Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anantomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Gonçalves-Ferri WA, Jauregui A, Martins-Celini FP, Sansano I, Fabro AT, Sacramento EMF, Aragon DC, Ochoa JM. Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study. ACTA ACUST UNITED AC 2019; 52:e8585. [PMID: 31314854 PMCID: PMC6644527 DOI: 10.1590/1414-431x20198585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/24/2019] [Indexed: 11/22/2022]
Abstract
Atelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in the study. The animals were divided into 3 groups according to the level of PEEP used: low (2 cmH2O), moderate (5 cmH2O), and high (10 cmH2O). Animals were ventilated with a tidal volume of 6 mL/kg. Before lung removal, the lungs were inspected for the presence of atelectasis. When atelectasis was detected, alveolar recruitment maneuvers were performed. Blood gasometric analysis was performed immediately. Finally, the lungs were retrieved, weighed, and submitted to histological analysis. The animals submitted to higher PEEP showed higher levels of oxygenation with the same tidal volumes PO2=262.14 (PEEP 2), 382.4 (PEEP 5), and 477.0 (PEEP 10). The occurrence of atelectasis was rare in animals with a PEEP of 10 cmH2O, which therefore required less frequent recruitment maneuvers (need for recruitment: PEEP 2=100%, PEEP 5 =100%, and PEEP 10=14.3%). There was no change in hemodynamic stability, occurrence of pulmonary edema, or other histological injuries with the use of high PEEP. The use of high PEEP (10 cmH2O) was feasible and probably a beneficial strategy for the prevention of atelectasis and the optimization of oxygenation during lung retrieval. Clinical studies should be performed to confirm this hypothesis.
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Affiliation(s)
- W A Gonçalves-Ferri
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A Jauregui
- Department of Thoracic Surgery, Hospital Vall d'Hebron, Barcelona, Spain
| | - F P Martins-Celini
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - I Sansano
- Department of Pathology, Hospital Vall d'Hebron, Barcelona, Spain
| | - A T Fabro
- Departamento de Patologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E M F Sacramento
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - D C Aragon
- Departamento de Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J M Ochoa
- Department of Thoracic Surgery, Hospital Vall d'Hebron, Barcelona, Spain
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Martins-Celini FP, Gonçalves-Ferri WA, Aragon DC, Bernichi JP, Calixto C, Sacramento EMF, Santos MA, Martinez FE. Association between type of feeding at discharge from the hospital and nutritional status of very low birth weight preterm infants. Braz J Med Biol Res 2018. [PMID: 29513880 PMCID: PMC5912099 DOI: 10.1590/1414-431x20176540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The ideal feeding for premature babies has been the source of extensive debate. The aim of this study was to assess the association between type of feeding at discharge and the nutritional status of very low birth weight infants. This was a retrospective cohort of preterm babies with birth weight ≤1500 g, born between January 2006 and December 2013. The infants were divided into 3 groups according to type of feeding at discharge: exclusive breast milk (group 1), mixed feeding (group 2) and exclusive artificial formula (group 3). Frequencies of each group were calculated, as well as mean Z-score differences in weight, length and head circumference. Six hundred and forty-nine newborns were included. The mean weight of groups 1, 2, and 3 was 1338.7, 1104.0, and 1254.7 g, respectively, and their mean gestational age was 31.9, 30, and 31.2 weeks, respectively. The Z-score differences (means±SD) for groups 1, 2, and 3 were: −0.84±0.68, −1.02±0.75, and −0.86±0.71 for weight, −0.21±1.23, −0.52±1.64 and −0.08±1.34 for head circumference, and −1.10±1.18, −1.54±1.37, and −0.97±1.21 for length. A significant difference was observed between groups 2 and 3 in the adjusted Z-score model for length, with no significant differences in anthropometric measurements for the other comparative analyses. Because of its many advantages, breastfeeding should be stimulated within neonatal units since nutritional status was not influenced by the different types of feeding.
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