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1. Clinical, epidemiological, and molecular characteristics of SARS-CoV-2 Infections among healthcare workers at a research center in the amazon region of BRAZIL from 2020 to 2022

Author

Cordovil, Darciane Coelho, Bezerra, Delana Andreza Melo, Bedran, Rayssa Layna Silva, Junior, Edvaldo Tavares Penha, Teixeira, Dielle Monteiro, Lobo, Patricia Santos, Siqueira, Jones Anderson Monteiro, Ramos, Adinaura Gama, Silva, Amanda Mendes, Pinheiro, Kenny Costa, Ferreira, Jedson Cardoso, Junior, Wanderley Dias Chagas, Barbagelata, Luana Soares, Tavares, Fernando Neto, Santos, Mirleide Cordeiro, and Soares, Luana Silva

Published
2024
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5. A multicomponent personalized prevention program in the primary care setting: a randomized clinical trial in older people with noncommunicable chronic diseases (Primacare_P3 study)

Author

Pilotto, Alberto, Barbagelata, Marina, Lacorte, Eleonora, Custodero, Carlo, Veronese, Nicola, Maione, Valentina, Morganti, Wanda, Seminerio, Emanuele, Piscopo, Paola, Fabrizi, Elisa, Lorenzini, Patrizia, Carbone, Elena, Lora Aprile, Pierangelo, Solfrizzi, Vincenzo, Barbagallo, Mario, and Vanacore, Nicola

Published
2024
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6. A transitional care program in a technologically monitored in‐hospital facility reduces the length of hospital stay and improves multidimensional frailty in older patients: a Randomized Clinical Trial

Author

Pilotto, Alberto, Morganti, Wanda, Barbagelata, Marina, Seminerio, Emanuele, Morelli, Simona, Custureri, Romina, Dini, Simone, Senesi, Barbara, Prete, Camilla, Puleo, Gianluca, Berutti Bergotto, Carlo, Vallone, Francesco, Custodero, Carlo, and Camurri, Antonio

Published
2024
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8. Technological monitoring of motor parameters to assess multidimensional frailty of older people in the PRO-HOME project

Author

Emanuele Seminerio, Wanda Morganti, Marina Barbagelata, Sanket Rajeev Sabharwal, Simone Ghisio, Camilla Prete, Barbara Senesi, Simone Dini, Romina Custureri, Simonetta Galliani, Simona Morelli, Gianluca Puleo, Carlo Berutti-Bergotto, Antonio Camurri, Alberto Pilotto, and PRO-HOME Project Investigators Group

Subjects
Multidimensional frailty, Comprehensive geriatric assessment, Older people, Technological monitoring, Medicine, Science
Abstract

Abstract An interconnected system employing Kinect Azure and Fitbit Sense for continuous and non-intrusive data collection was used in the PRO-HOME protected discharge program, aiming at monitoring functional and clinical parameters in hospitalized older patients at different risks of frailty. The present study shows the findings on 30 older patients included in the PRO-HOME project. The Fitbit Sense recorded the mean daily and hourly number of steps, mean daily walked distance, and time spent inactive. Moreover, Kinect infrared camera captured gait speed and daily mean latero-lateral (body sway) and antero-posterior oscillations (lean-in). Patients underwent a standard Comprehensive Geriatric Assessment (CGA) to compute the Multidimensional Prognostic Index (MPI), including basic and instrumental activities of daily living (ADL, IADL), cognition (Short Portable Mental Status Questionnaire, SPMSQ) and nutrition, risk of pressure sores (Exton-Smith Scale, ESS), comorbidity, number of drugs and cohabitation status. Significant correlations between the mean hourly number of steps and MPI (p = 0.022), IADL (p = 0.013), SPMSQ (p = 0.006), ESS (p = 0.009), and both mean and maximum automated gait speed (p = 0.046 and p = 0.048) were found. Automated gait speed was also correlated with mean walked distance per day (p = 0.007) and lean-in (p = 0.047). Domotic technological monitoring through Fitbit Sense and Kinect Azure provides information on multidimensional frailty, including mobility and cognitive and functional status, in older people.

Published
2024
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10. A multicomponent personalized prevention program in the primary care setting: a randomized clinical trial in older people with noncommunicable chronic diseases (Primacare_P3 study)

Author

Alberto Pilotto, Marina Barbagelata, Eleonora Lacorte, Carlo Custodero, Nicola Veronese, Valentina Maione, Wanda Morganti, Emanuele Seminerio, Paola Piscopo, Elisa Fabrizi, Patrizia Lorenzini, Elena Carbone, Pierangelo Lora Aprile, Vincenzo Solfrizzi, Mario Barbagallo, Nicola Vanacore, and PrimaCare_P3 study group

Subjects
Primary care setting, Non-communicable chronic diseases, Personalized prevention program, Multicomponent interventions, Comprehensive geriatric assessment, Older people, Medicine (General), R5-920
Abstract

Abstract Background Multicomponent interventions based on a comprehensive geriatric assessment (CGA) could promote active aging and improve health status in older people with Noncommunicable Chronic Diseases (NCDs), but conflicting evidences are available. Aim To evaluate the efficacy of a CGA-based multicomponent personalized preventive program (PPP) in reducing unplanned hospitalization rates during 12-month follow-up in community-dwelling older people with NCDs. Materials and methods In this randomized clinical trial (RCT), 1216 older adults recruited by 33 general practitioners (GPs) will be randomly allocated to intervention group (IG) or usual care control group (CG). The IG will receive a multicomponent PPP developed on the findings of the CGA-based Multidimensional Prognostic Index short-form (Brief-MPI), including structured interventions to improve functional, physical, cognitive, and nutritional status, to monitor NCDs and vaccinations, and to prevent social isolation. Participants in the CG will receive usual care. Brief-MPI, resilience, and health-related quality of life will be assessed after 6 and 12 months. Moreover, saliva samples will be collected at baseline in IG to measure biomarkers of oxidative stress, inflammatory cytokines, and oral microbiome. Expected results The CGA-based PPP might reduce unplanned hospitalization rates and potentially institutionalization rates, emergency department (ED) and unplanned GP visits, and mortality. Further outcomes explored in the IG will be the adherence to PPP, resilience, health-related quality of life, and multidimensional frailty as assessed by the Brief-MPI. Conclusions Results will suggest whether the CGA-based multicomponent PPP is able to improve specific outcomes in a primary care setting. Trial registration ClinicalTrials.gov; identifier: NCT06224556 ; Registered January 25, 2024.

Published
2024
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11. Assessment of bleeding events in patients receiving DOACs with or without statins to treat venous thromboembolism: insights from the RIETE registry

Author

Dominique Farge-bancel, R Marqués, M Ortiz, Paolo Prandoni, J Roa, Manuel Monreal, F Couturaud, J Gutierrez, J Pagan, Peter Verhamme, A Aujayeb, Laurent Bertoletti, P Verhamme, M Monreal, S Fonseca, S Pinto, S Soler, A Lorenzo, R Lecumberri, R Otero, P DI MICCO, F Rivera-Cívico, A Molino, P Suchon, C Grange, JA Caprini, J Osorio, Henri Bounameaux, R Valle, F Negro, A Tufano, Remedios Otero, Aitor Ballaz, G Kenet, I Francisco, F Uresandi, G Barillari, Marijan Bosevski, F García-Bragado, E Grau, D Jiménez, A Maestre, A Visonà, J Criado, R Chopard, I Weinberg, M Lumbierres, B Leclercq, H Bounameaux, Farid Rashidi, Abílio Reis, Lucia Mazzolai, P Llamas, MJ Núñez-Fernández, F Dentali, O Espitia, C Siniscalchi, Rosaria Del Giorno, Sanjiv Keller, Carmine Siniscalchi, Luciano Lopez-Jimenez, Ana Cristina Montenegro, Benjamin Brenner, Raquel Barb, Pierpaolo Di Micco, Sebastian Schellong, Inna Tzoran, Radovan Malý, Joseph A. Caprini, Hanh My Bui, MD Adarraga, A Alberich-Conesa, J Aibar, A Alda-Lozano, J Alfonso, C Amado, M Angelina-García, JI Arcelus, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, F Beddar-Chaib, A Blanco-Molina, JC Caballero, J Carrillo-Alonso, G Castellanos, L Chasco, C De Ancos, J Del Toro, P Demelo-Rodríguez, C De Juana-Izquierdo, MC Díaz-Pedroche, JA Díaz-Peromingo, A Dubois-Silva, JC Escribano, C Falgá, AI Farfán-Sedano, C Fernández-Aracil, C Fernández-Capitán, B Fernández-Jiménez, JL Fernández-Reyes, MA Fidalgo, C Gabara, F Galeano-Valle, C García-González, A García-Ortega, O Gavín-Sebastián, MA Gil-De Gómez, A Gil-Díaz, C Gómez-Cuervo, A González-Munera, L Guirado, L Hernández-Blasco, L Jara-Palomares, MJ Jaras, I Jou, MD Joya, JL Lobo, L López-Jiménez, P López-Miguel, H López-Brull, JJ López-Núñez, A López-Ruiz, JB LópezSáez, O Madridano, PJ Marchena, M Marcos, M Martín del Pozo, F Martín-Martos, R Martínez-Prado, JM Maza, E Mena, MI Mercado, J Moisés, MV Morales, MS Navas, JA Nieto, M Olid, L Ordieres-Ortega, S Otálora, N Pacheco-Gómez, AC Palomeque, E Paredes, P Parra-Caballero, P Parra-Rosado, JM Pedrajas, C Pérez-Ductor, M Pérez-Pinar, MA Pérez-Jacoiste, ML Peris, ML Pesce, JA Porras, R Puchades, A Rodríguez-Cobo, M Romero-Brugera, P Ruiz-Artacho, N Ruiz-Giménez, J Ruiz-Ruiz, G Salgueiro, T Sancho, V Sendín, P Sigüenza, A Steinherr, S Suárez-Fernández, R Tirado, A TorrentsVilar, MI Torres, J Trujillo-Santos, JF Varona, A Villalobos, P Villares, C Ay, S Nopp, I Pabinger, C Van Edom, A Verstraete, Yoo HHB, AC Montenegro, SN Morales, J Hirmerova, R Malý, L Bertoletti, A BuraRiviere, J Catella, R Le Mao, I Mahé, F Moustafa, L Plaisance, G Sarlon-Bartoli, E Versini, S Schellong, B Brenner, I Tzoran, P Sadeghipour, F Rashidi, A Abenante, M Basaglia, M Bertoni, F Bilora, B Brandolin, M Ciammaichella, D Colaizzo, E Grandone, E Imbalzano, R Pesavento, A Poz, P Prandoni, B Taflaj, B Zalunardo, A Skride, D Kigitovica, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, and HM Bui

Subjects
Medicine
Abstract

Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.

Published
2024
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13. Anti-inflammatory effect of semaglutide: updated systematic review and meta-analysis

Author

Walter Masson, Martín Lobo, Juan Patricio Nogueira, Alfredo Matias Rodriguez-Granillo, Leandro Ezequiel Barbagelata, and Daniel Siniawski

Subjects
semaglutide, inflammation, C-reactive protein, glucagon-like peptide-1 receptor agonists, meta-analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

BackgroundThe anti-inflammatory effect could be one of the mechanisms by which semaglutide reduces cardiovascular risk in patients with type 2 diabetes mellitus (T2DM) and/or obesity. Determining the anti-inflammatory effect of semaglutide was the objective of this systematic review and meta-analysis.MethodsThis meta-analysis was performed according to the PRISMA guidelines. A literature search was performed to detect randomised clinical trials that have quantified the effect of semaglutide on C-reactive protein (CRP) levels compared to placebo or a control group (other glucose-lowering drugs). The primary outcome was CRP index (final CRP/basal CRP). A random-effects model was used.ResultsThirteen randomised clinical trials were considered eligible (n = 26,131). Overall, semaglutide therapy was associated with lower CRP index values compared to the placebo group (SMD −0.56; 95% CI −0.69 to −0.43, I2 92%) or the control group (SMD −0.45; 95% CI −0.68 to −0.23, I2 82%).Such an association was similarly observed when different treatment regimens (subcutaneous vs. oral) or different populations (patients with or without T2DM) were analysed. The sensitivity analysis showed that the results were robust.ConclusionThe present meta-analysis demonstrated that the use of semaglutide was associated with a reduction in inflammation irrespective of the population evaluated or the treatment regimen used. These findings would explain one of the mechanisms by which semaglutide reduces cardiovascular events.Systematic Review RegistrationPROSPERO [CRD42024500551].

Published
2024
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14. Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort studyResearch in context

Author

Luis Jara-Palomares, Behnood Bikdeli, David Jiménez, Alfonso Muriel, Pablo Demelo-Rodríguez, Farès Moustafa, Aurora Villalobos, Patricia López-Miguel, Luciano López-Jiménez, Sonia Otálora, María Luisa Peris, Cristina Amado, Romain Chopard, Francisco Rivera-Cívico, Manuel Monreal, María Dolores Adarraga, Ana Alberich Conesa, Jesús Aibar, Alicia Alda Lozano, Joaquín Alfonso, Jesús Alonso Carrillo, María Angelina García, Juan Ignacio Arcelus, Aitor Ballaz, Raquel Barba, María Barca Hernando, Cristina Barbagelata, Manuel Barrón, Belén Barrón Andrés, Fahd Beddar Chaib, María Ángeles Blanco Molina, Juan Carlos Caballero, Gonzalo Castellanos, Leyre Chasco, Juan Criado, Cristina de Ancos, Jorge del Toro, Pablo Demelo Rodríguez, Cristina de Juana Izquierdo, Ana María Díaz Brasero, José Antonio Díaz Peromingo, Álvaro Dubois Silva, Juan Carlos Escribano, Concepción Falgá, Ana Isabel Farfán Sedano, Cleofe Fernández Aracil, Carmen Fernández Capitán, Begoña Fernández Jiménez, José Luis Fernández Reyes, María Ángeles Fidalgo, Iria Francisco, Cristina Gabara, Francisco Galeano Valle, Francisco García Bragado, Alberto García Ortega, Olga Gavín Sebastián, María Allende Gil de Gómez, Aída Gil Díaz, Covadonga Gómez Cuervo, Adriana González Munera, Enric Grau, Leticia Guirado, Javier Gutiérrez, Luis Hernández Blasco, Luis Jara Palomares, María Jesús Jaras, Rafael Jiménez, Inés Jou, María Dolores Joya, Sara Lainez Justo, Antonio Lalueza, Ramón Lecumberri, José Manuel León Ramírez, Pilar Llamas, José Luis Lobo, Luciano López Jiménez, Patricia López Miguel, Juan José López Núñez, Antonio López Ruiz, Juan Bosco López Sáez, Alicia Lorenzo, Marina Lumbierres, Olga Madridano, Ana Maestre, Pablo Javier Marchena, María Marcos, Mar Martín del Pozo, Francisco Martín Martos, Jorge Manuel Maza, Elisabeth Mena, Maria Isabel Mercado, Jorge Moisés, María del Valle Morales, Maria Sierra Navas, José Antonio Nieto, Manuel Jesús Núñez Fernández, Mónica Olid, Lucía Ordieres Ortega, María Ortiz, Jeisson Osorio, Remedios Otero, Nazaret Pacheco Gómez, Javier Pagán, Andrea Catalina Palomeque, Ezequiel Paredes, Pedro Parra Caballero, José María Pedrajas, Cristina Pérez Ductor, Montserrat Pérez Pinar, María Lourdes Pesce, José Antonio Porras, Ramón Puchades, Francisco Rivera Cívico, Ana Rodríguez Cobo, Vladimir Rosa, Marta Romero Brugera, Pedro Ruiz Artacho, Nuria Ruiz Giménez, Justo Ruiz Ruiz, Georgina Salgueiro, Teresa Sancho, Vanesa Sendín, Patricia Sigüenza, Silvia Soler, Susana Suárez Fernández, Raimundo Tirado, Ana Torrents Vilar, María Isabel Torres, Javier Trujillo Santos, Fernando Uresandi, Reina Valle, José Felipe Varona, Paula Villares, Cihan Ay, Stephan Nopp, Ingrid Pabinger, Matthias Engelen, Thomas Vanassche, Peter Verhamme, Hugo Hyung Bok Yoo, Ana Cristina Montenegro, Silvia Natalia Morales, Jairo Roa, Jana Hirmerova, Radovan Malý, Laurent Bertoletti, Alessandra Bura-Riviere, Judith Catella, Francis Couturaud, Olivier Espitia, Claire Grange, Barbara Leclercq, Raphael Le Mao, Isabelle Mahé, Ludovic Plaisance, Gabrielle Sarlon Bartoli, Pierre Suchon, Edouard Versini, Sebastian Schellong, Benjamin Brenner, Najib Dally, Inna Tzoran, Parham Sadeghipour, Fahrid Rashidi, Alessia Abenante, Giovanni Barillari, Manuela Basaglia, Franca Bilora, Daniele Bissacco, Cristiano Bortoluzzi, Barbara Brandolin, Renato Casana, Maurizio Ciammaichella, Donatella Colaizzo, Francesco Dentali, Pierpaolo Di Micco, Elvira Grandone, Egidio Imbalzano, Daniela Lambertenghi Deliliers, Federica Negro, Raffaele Pesavento, Alessandra Poz, Paolo Prandoni, Paolo Scarinzi, Carmine Siniscalchi, Beldisa Taflaj, Antonella Tufano, Adriana Visonà, Ngoc Vo Hong, Beniamino Zalunardo, Andris Skride, Dana Kigitovica, Samuel Fonseca, Rafael Marques, José Meireles, Sara Barbosa Pinto, Marijan Bosevsky, Aleksandra Eftimova, Marijan Zdraveska, Henri Bounameaux, Lucia Mazzolai, Avinash Aujayeb, Joseph Caprini, Ido Weinberg, and Hanh My Bui

Subjects
Pulmonary embolism, Venous thromboembolism, Anticoagulation, COVID-19, SARS-CoV-2, Medicine (General), R5-920
Abstract

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

Published
2024
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17. Enfermedad tromboembólica en pacientes ingresados en Neurocirugía: características y manejo de la anticoagulación en un hospital terciario

Author

Alicia Alonso Alvarez, Cristina Barbagelata López, Olaya Alonso Juarros, Ana Padín Trigo, Diego Llinares García, and Patricia Piñeiro Parga

Subjects
enfermedad tromboembólica, tromboembolismo pulmonar, trombosis venosa profunda, sangrado intracraneal, tumor intracraneal, Medicine, Internal medicine, RC31-1245
Abstract

Resumen Introducción y objetivos: Los pacientes neuroquirúrgicos tienen un elevado riesgo de enfermedad tromboembólica (ETV); sin embargo, su manejo es difícil dado el alto riesgo de sangrado grave. Analizamos características, evolución y tratamiento de los pacientes con ETV en Neurocirugía en nuestro centro. Material y métodos: revisión retrospectiva de historias clínicas de pacientes ingresados en Neurocirugía entre el 01/01/2017 y el 31/12/2021 con ETV. Resultados: Entre el 01/01/2017 y el 31/12/2021 13 pacientes ingresados en Neurocirugía recibieron el diagnóstico de ETV (77% varones, mediana de 66 años). La mayoría ingresaron para cirugía de tumor de SNC o hemorragia intracraneal. El 61% tenían tromboembolismo pulmonar (TEP), 23% trombosis venosa profunda (TVP) y 15% ambos. En 7 de los 13 pacientes la ETV se produjo tras la cirugía (mediana, 13 días después), y 4 pacientes el diagnóstico de ETV era previo (mediana, 26 días antes). La anticoagulación se inició una mediana de 12 días tras la cirugía con heparina de bajo peso molecular (HBPM), y en la mayoría a dosis infraterapéutica, que se fue aumentando progresivamente hasta alcanzar dosis plenas una mediana de 13 días tras la intervención. No se registró ninguna complicación hemorrágica. Dos pacientes fallecieron por su enfermedad de base. Conclusiones: los pacientes neuroquirúrgicos presentan varios factores de riesgo para ETV, que es particularmente difícil de manejar por el alto riesgo de sangrado. En nuestra muestra la mayoría recibieron inicialmente dosis infraterapéuticas de HBPM sin que se registraran hemorragias. Se precisan más estudios para guiar la anticoagulación en esta población. Abstract Introduction and objectives: The neurosurgical patients have a high risk of venous thromboembolism (VTE). However, the management is complex due to high risk of serious bleeding. We herein analyse characteristics, treatment and outcome of the neurosurgical patients with VTE in our centre Methods: retrospective analysis of medical records from the patients admitted to the Neurosurgery ward and with VTE from 01/01/22017 to 12/31/2021 Results: From 01/01/2017 to 12/31/2021, 13 patients admitted to Neurosurgery ward were diagnosed of VTE (77% male, median age 66 years-old). Most of them were admitted because of CNS tumour or intracranial bleeding. 61% had pulmonary embolism (PE) 23% deep venous thrombosis (DVT) and 15% both. In 7 out of 13 patients ETV occurred after surgery (median, 13 days after) and 4 has a previous diagnosis of VTE (median, 26 days before). Anticoagulation was initiated a median of 12 days after surgery with low molecular weight heparin (LMWH), in most of the cases with an infra-therapeutic dose which was progressively increased to maximum doses a median of 13 days after surgery. No bleeding complication was recorded. Two patients died due to their previous illness Conclusions: the neurosurgical patients have several risk factors for VTE, which is especially difficult to manage due to the high bleeding risk. In our centre most patients received initially infra-therapeutic doses of LMWH, and no bleeding events occurred. More studies are needed to guide anticoagulation in this population.

Published
2024
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19. Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia

Author

Adarraga, MD, Alberich-Conesa, A, Aibar, J, Alda-Lozano, A, Alfonso, J, Amado, C, Angelina-García, M, Arcelus, JI, Ballaz, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andrés, B, Beddar-Chaib, F, Blanco-Molina, A, Caballero, JC, Castellanos, G, Criado, J, De Ancos, C, Del Toro, J, Demelo-Rodríguez, P, De Juana-Izquierdo, C, Díaz-Peromingo, JA, Dubois-Silva, A, Escribano, JC, Falgá, C, Farfán-Sedano, AI, Fernández-Aracil, C, Fernández-Capitán, C, Fernández-Jiménez, B, Fernández-Reyes, JL, Fidalgo, MA, Francisco, I, Gabara, C, Galeano-Valle, F, García-Bragado, F, García-Ortega, A, Gavín-Sebastián, O, Gil-Díaz, A, Gómez-Cuervo, C, González-García, C, González-Munera, A, Grau, E, Guirado, L, Gutiérrez-Guisado, J, Hernández-Blasco, L, Herreros, M, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Jou, I, Joya, MD, Lecumberri, R, Llamas, P, Lobo, JL, López-Jiménez, L, López-Miguel, P, López-Brull, H, López-Núñez, JJ, López-Ruiz, A, López-Sáez, JB, Lorenzo, A, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, Marcos, M, Martín del Pozo, M, Martín-Martos, F, Martínez-Prado, R, Maza, JM, Mena, E, Mercado, MI, Moisés, J, Molino, A, Monreal, M, Morales, MV, Navas, MS, Nieto, JA, Núñez-Fernández, MJ, Olid, M, Ordieres-Ortega, L, Ortiz, M, Osorio, J, Otálora, S, Otero, R, Pacheco-Gómez, N, Pagán, J, Palomeque, AC, Paredes, E, Parra-Caballero, P, Pedrajas, JM, Pérez-Ductor, C, Pérez-Pinar, M, Peris, ML, Pesce, ML, Porras, JA, Puchades, R, Rivera-Cívico, F, Rodríguez-Cobo, A, Romero-Brugera, M, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Ruiz, J, Salgueiro, G, Sancho, T, Sendín, V, Sigüenza, P, Soler, S, Steinherr, A, Suárez-Fernández, S, Tirado, R, Torrents-Vilar, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Varona, JF, Villalobos, A, Villares, P, Ay, C, Nopp, S, Pabinger, I, Vanassche, T, Verhamme, P, Verstraete, A, Yoo, HHB, Montenegro, AC, Morales, SN, Roa, J, Hirmerova, J, Malý, R, Bertoletti, L, Bura-Riviere, A, Catella, J, Chopard, R, Couturaud, F, Espitia, O, Grange, C, Le Mao, R, Leclercq, B, Mahé, I, Morange, P, Moustafa, F, Plaisance, L, Sarlon-Bartoli, G, Suchon, P, Versini, E, Schellong, S, Brenner, B, Dally, N, Kenet, G, Tzoran, I, Sadeghipour, P, Rashidi, F, Abenante, A, Barillari, G, Basaglia, M, Bertoni, M, Bilora, F, Brandolin, B, Ciammaichella, M, Colaizzo, D, Dentali, F, Di Micco, P, Grandone, E, Imbalzano, E, Negro, F, Pesavento, R, Poz, A, Prandoni, P, Siniscalchi, C, Taflaj, B, Tufano, A, Visonà, A, Zalunardo, B, Skride, A, Kigitovica, D, Zicans, M, Fonseca, S, Marques, R, Meireles, J, Pinto, S, Bosevski, M, Trajkova, M, Zdraveska, M, Bounameaux, H, Mazzolai, L, Aujayeb, A, Caprini, JA, Weinberg, I, Bui, HM, Cohen, Omri, Waldman Radinsky, Liat, Kenet, Gili, Mahé, Isabelle, Barillari, Giovanni, Soler, Silvia, Sigüenza, Patricia, Del Valle Morales, María, Villares, Paula, and Monreal, Manuel

Published
2024
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21. Clinical outcomes after discontinuing anticoagulant therapy in patients with first unprovoked venous thromboembolism

Author

Agudo, P., Aibar, J., Alberich-Conesa, A., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barreiro, B., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Beddar-Chaib, F., Blanco-Molina, A., Caballero, J.C., Cañas, I., Castellanos, G., Chasco, L., Claver, G., Criado, J., De Juana-Izquierdo, C., Del Toro, J., Demelo-Rodríguez, P., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Falgá, C., Fernández-Aracil, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Reyes, J.L., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil-Díaz, A., Gómez-Cuervo, C., González-Munera, A., Grau, E., Guirado, L., Gutiérrez-Guisado, J., Hernández-Blasco, L., Hernández-Molina, A., Hernández-Vidal, M.J., Jara-Palomares, L., Jiménez, D., Jou, I., Joya, M.D., Lalueza, A., Lecumberri, R., Llamas, P., Lobo, J.L., López-Brull, H., López-De la Fuente, M., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P.J., Marcos, M., Martín del Pozo, M., Martín-Martos, F., Martínez-Prado, R., Maza, J.M., Mercado, M.I., Moisés, J., Molino, A., Monreal, M., Monzón, L., Morales, M.V., Muñoz-Gamito, G., Navas, M.S., Nieto, J.A., Núñez-Fernández, M.J., Olid, M., Ordieres-Ortega, L., Ortiz, M., Osorio, J., Otálora, S., Otero, R., Pacheco-Gómez, N., Pagán, J., Palomeque, A.C., Paredes, E., Parra-Rosado, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Pinar, M., Peris, M.L., Pesce, M.L., Porras, J.A., Puchades, R., Rivas, A., Rivera-Cívico, F., Rivera-Gallego, A., Rodríguez-Cobo, A., Romero-Bruguera, M., Ruiz-Artacho, P., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Steinherr, A., Suárez-Fernández, S., Tirado, R., Torrents-Vilar, A., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J.F., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Verhamme, P., Verstraete, A., Yoo, H.H.B., Montenegro, A.C., Morales, S.N., Roa, J., Hirmerova, J., Malý, R., Varhaník, F., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Le Mao, R., Leclerq, B., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Brenner, B., Dally, N., Kenet, G., Tzoran, I., Rashidi, F., Sadeghipour, P., Tahmasbi, F., Abenante, A., Barillari, G., Bilora, F., Bissacco, D., Brandolin, B., Casana, R., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lambertenghi-Deliliers, D., Martini, R., Meschi, T., Negro, F., Poz, A., Prandoni, P., Simioni, P., Siniscalchi, C., Taflaj, B., Ticinesi, A., Tufano, A., Visonà, A., Zalunardo, B., Kalnina, P., Kigitovica, D., Skride, A., Zicans, M., Nishimoto, Y., Yamashita, Y., Tazi-Mezalek, Z., Fonseca, S., Marques, R., Meireles, J., Pinto, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Bikdeli, B., Caprini, J.A., Khalil, A., Tafur, J., Weinberg, I., Bui, H.M., Nguyen, S.T., Pham, K.Q., Tran, G.B., Gabara, Cristina, Aibar, Jesus, Nishimoto, Yuji, Yamashita, Yugo, Prandoni, Paolo, Barnes, Geoffrey D., Bikdeli, Behnood, Jiménez, David, Demelo-Rodríguez, Pablo, Peris, Ma Luisa, Nguyen, Son Truong, and Monreal, Manuel

Published
2024
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22. Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort study

Author

Adarraga, María Dolores, Conesa, Ana Alberich, Aibar, Jesús, Lozano, Alicia Alda, Alfonso, Joaquín, Carrillo, Jesús Alonso, Amado, Cristina, García, María Angelina, Arcelus, Juan Ignacio, Ballaz, Aitor, Barba, Raquel, Hernando, María Barca, Barbagelata, Cristina, Barrón, Manuel, Andrés, Belén Barrón, Chaib, Fahd Beddar, Blanco Molina, María Ángeles, Caballero, Juan Carlos, Castellanos, Gonzalo, Chasco, Leyre, Criado, Juan, de Ancos, Cristina, Toro, Jorge del, Rodríguez, Pablo Demelo, de Juana Izquierdo, Cristina, Díaz Brasero, Ana María, Díaz Peromingo, José Antonio, Silva, Álvaro Dubois, Escribano, Juan Carlos, Falgá, Concepción, Farfán Sedano, Ana Isabel, Aracil, Cleofe Fernández, Capitán, Carmen Fernández, Jiménez, Begoña Fernández, Fernández Reyes, José Luis, Fidalgo, María Ángeles, Francisco, Iria, Gabara, Cristina, Valle, Francisco Galeano, Bragado, Francisco García, Ortega, Alberto García, Sebastián, Olga Gavín, Gil de Gómez, María Allende, Díaz, Aída Gil, Cuervo, Covadonga Gómez, Munera, Adriana González, Grau, Enric, Guirado, Leticia, Gutiérrez, Javier, Blasco, Luis Hernández, Palomares, Luis Jara, Jaras, María Jesús, Jiménez, David, Jiménez, Rafael, Jou, Inés, Joya, María Dolores, Justo, Sara Lainez, Lalueza, Antonio, Lecumberri, Ramón, León Ramírez, José Manuel, Llamas, Pilar, Lobo, José Luis, Jiménez, Luciano López, Miguel, Patricia López, López Núñez, Juan José, Ruiz, Antonio López, López Sáez, Juan Bosco, Lorenzo, Alicia, Lumbierres, Marina, Madridano, Olga, Maestre, Ana, Marchena, Pablo Javier, Marcos, María, Martín del Pozo, Mar, Martos, Francisco Martín, Maza, Jorge Manuel, Mena, Elisabeth, Mercado, Maria Isabel, Moisés, Jorge, Monreal, Manuel, Morales, María del Valle, Navas, Maria Sierra, Nieto, José Antonio, Núñez Fernández, Manuel Jesús, Olid, Mónica, Ortega, Lucía Ordieres, Ortiz, María, Osorio, Jeisson, Otálora, Sonia, Otero, Remedios, Gómez, Nazaret Pacheco, Pagán, Javier, Palomeque, Andrea Catalina, Paredes, Ezequiel, Caballero, Pedro Parra, Pedrajas, José María, Ductor, Cristina Pérez, Pinar, Montserrat Pérez, Peris, María Luisa, Pesce, María Lourdes, Porras, José Antonio, Puchades, Ramón, Cívico, Francisco Rivera, Cobo, Ana Rodríguez, Rosa, Vladimir, Brugera, Marta Romero, Artacho, Pedro Ruiz, Giménez, Nuria Ruiz, Ruiz, Justo Ruiz, Salgueiro, Georgina, Sancho, Teresa, Sendín, Vanesa, Sigüenza, Patricia, Soler, Silvia, Fernández, Susana Suárez, Tirado, Raimundo, Vilar, Ana Torrents, Torres, María Isabel, Santos, Javier Trujillo, Uresandi, Fernando, Valle, Reina, Varona, José Felipe, Villalobos, Aurora, Villares, Paula, Ay, Cihan, Nopp, Stephan, Pabinger, Ingrid, Engelen, Matthias, Vanassche, Thomas, Verhamme, Peter, Bok Yoo, Hugo Hyung, Montenegro, Ana Cristina, Morales, Silvia Natalia, Roa, Jairo, Hirmerova, Jana, Malý, Radovan, Bertoletti, Laurent, Bura-Riviere, Alessandra, Catella, Judith, Chopard, Romain, Couturaud, Francis, Espitia, Olivier, Grange, Claire, Leclercq, Barbara, Le Mao, Raphael, Mahé, Isabelle, Moustafa, Farès, Plaisance, Ludovic, Bartoli, Gabrielle Sarlon, Suchon, Pierre, Versini, Edouard, Schellong, Sebastian, Brenner, Benjamin, Dally, Najib, Tzoran, Inna, Sadeghipour, Parham, Rashidi, Fahrid, Abenante, Alessia, Barillari, Giovanni, Basaglia, Manuela, Bilora, Franca, Bissacco, Daniele, Bortoluzzi, Cristiano, Brandolin, Barbara, Casana, Renato, Ciammaichella, Maurizio, Colaizzo, Donatella, Dentali, Francesco, Di Micco, Pierpaolo, Grandone, Elvira, Imbalzano, Egidio, Deliliers, Daniela Lambertenghi, Negro, Federica, Pesavento, Raffaele, Poz, Alessandra, Prandoni, Paolo, Scarinzi, Paolo, Siniscalchi, Carmine, Taflaj, Beldisa, Tufano, Antonella, Visonà, Adriana, Hong, Ngoc Vo, Zalunardo, Beniamino, Skride, Andris, Kigitovica, Dana, Fonseca, Samuel, Marques, Rafael, Meireles, José, Pinto, Sara Barbosa, Bosevsky, Marijan, Eftimova, Aleksandra, Zdraveska, Marijan, Bounameaux, Henri, Mazzolai, Lucia, Aujayeb, Avinash, Bikdeli, Behnood, Caprini, Joseph, Weinberg, Ido, Bui, Hanh My, Jara-Palomares, Luis, Muriel, Alfonso, Demelo-Rodríguez, Pablo, López-Miguel, Patricia, López-Jiménez, Luciano, and Rivera-Cívico, Francisco

Published
2024
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25. Equal Maintenance of Anti-SARS-CoV-2 Antibody Levels Induced by Heterologous and Homologous Regimens of the BNT162b2, ChAdOx1, CoronaVac and Ad26.COV2.S Vaccines: A Longitudinal Study Up to the 4th Dose of Booster

Author

Tatiana A. do Nascimento, Patricia Y. Nogami, Camille F. de Oliveira, Walter F. F. Neto, Carla P. da Silva, Ana Claudia S. Ribeiro, Alana W. de Sousa, Maria N. O. Freitas, Jannifer O. Chiang, Franko A. Silva, Liliane L. das Chagas, Valéria L. Carvalho, Raimunda S. S. Azevedo, Pedro F. C. Vasconcelos, Igor B. Costa, Iran B. Costa, Luana S. Barbagelata, Wanderley D. das Chagas Junior, Edvaldo T. da Penha Junior, Luana S. Soares, Giselle M. R. Viana, Alberto A. Amarilla, Naphak Modhiran, Daniel Watterson, Lívia M. N. Casseb, Lívia C. Martins, and Daniele F. Henriques

Subjects
COVID-19, neutralizing antibodies, anti-RBD antibodies, vaccine effectiveness, study longitudinal, ChAdOx1-S, Medicine
Abstract

Several technological approaches have been used to develop vaccines against COVID-19, including those based on inactivated viruses, viral vectors, and mRNA. This study aimed to monitor the maintenance of anti-SARS-CoV-2 antibodies in individuals from Brazil according to the primary vaccination regimen, as follows: BNT162b2 (group 1; 22) and ChAdOx1 (group 2; 18). Everyone received BNT162b2 in the first booster while in the second booster CoronaVac, Ad26.COV2.S, or BNT162b2. Blood samples were collected from 2021 to 2023 to analyze specific RBD (ELISA) and neutralizing antibodies (PRNT50). We observed a progressive increase in anti-RBD and neutralizing antibodies in each subsequent dose, remaining at high titers until the end of follow-up. Group 1 had higher anti-RBD antibody titers than group 2 after beginning the primary regimen, with significant differences after the 2nd and 3rd doses. Group 2 showed a more expressive increase after the first booster with BNT162B2 (heterologous booster). Group 2 also presented high levels of neutralizing antibodies against the Gamma and Delta variants until five months after the second booster. In conclusion, the circulating levels of anti-RBD and neutralizing antibodies against the two variants of SARS-CoV-2 were durable even five months after the 4th dose, suggesting that periodic booster vaccinations (homologous or heterologous) induced long-lasting immunity.

Published
2024
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31. Age-Related Differences in the Presentation, Management, and Clinical Outcomes of 100,000 Patients With Venous Thromboembolism in the RIETE Registry

Author

Adarraga, M.D., Alberich-Conesa, A., Aibar, J., Alda-Lozano, A., Alfonso, J., Amado, C., Angelina-García, M., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Beddar-Chaib, F., Blanco-Molina, A., Caballero, J.C., Castellanos, G., Chasco, L., Criado, J., De Ancos, C., Del Toro, J., Demelo-Rodríguez, P., De Juana-Izquierdo, C., Díaz-Brasero, A.M., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Falgá, C., Farfán-Sedano, A.I., Fernández-Aracil, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Reyes, J.L., Fidalgo, M.A., Francisco, I., Gabara, C., Galeano-Valle, F., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil De Gómez, M.A., Gil-Díaz, A., Gómez-Cuervo, C., González-Munera, A., Grau, E., Guirado, L., Gutiérrez, J., Hernández-Blasco, L., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, R., Jou, I., Joya, M.D., Lainez-Justo, S., Lecumberri, R., León-Ramírez, J.M., Llamas, P., Lobo, J.L., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P.J., Marcos, M., Martín del Pozo, M., Martín-Martos, F., Maza, J.M., Mena, E., Mercado, M.I., Moisés, J., Monreal, M., Morales, M.V., Navas, M.S., Nieto, J.A., Núñez-Fernández, M.J., Olid, M., Ordieres-Ortega, L., Ortiz, M., Osorio, J., Otálora, S., Otero, R., Pacheco-Gómez, N., Pagán, J., Palomeque, A.C., Paredes, E., Parra-Caballero, P., Parra-Rosado, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Pinar, M., Peris, M.L., Pesce, M.L., Porras, J.A., Puchades, R., Rivera-Cívico, F., Rodríguez-Cobo, A., Rosa, V., Romero-Brugera, M., Ruiz-Artacho, P., Ruiz-Giménez, N., Ruiz-Ruiz, J., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suárez-Fernández, S., Tirado, R., Torrents-Vilar, A., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J.F., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Verhamme, P., Verstraete, A., Yoo, H.H.B., Montenegro, A.C., Morales, S.N., Roa, J., Hirmerova, J., Malý, R., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Grange, C., Leclercq, B., Le Mao, R., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Brenner, B., Dally, N., Tzoran, I., Sadeghipour, P., Rashidi, F., Abenante, A., Barillari, G., Basaglia, M., Bilora, F., Bissacco, D., Bortoluzzi, C., Brandolin, B., Casana, R., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Grandone, E., Imbalzano, E., Lambertenghi-Deliliers, D., Negro, F., Pesavento, R., Poz, A., Prandoni, P., Scarinzi, P., Siniscalchi, C., Taflaj, B., Tufano, A., Visonà, A., Vo Hong, N., Zalunardo, B., Paluga, R., Skride, A., Kigitovica, D., Fonseca, S., Marques, R., Meireles, J., Pinto, S., Bosevski, M., Trajkova, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Caprini, J.A., Weinberg, I., Bui, H.M., Ortega, Alberto García, Jiménez, David, Pedro-Tudela, Ana, Pérez-Ductor, Cristina, Fernández-Capitán, Carmen, Falgá, Conxita, Skride, Andris, Siniscalchi, Carmine, Weinberg, Ido, and Monreal, Manuel

Published
2024
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37. 3D Printing for Left Ventricular Assist Device Exchange

Author

Juliana Giorgi, MD, Alejandro Barbagelata, MD, Gracia Luoma-Overstreet, BS, Edgardo Kaplinsky, MD, Sergio do Carmo Jorge, MD, Mauricio Scanavacca, PhD, Paulo Rogério Scordamaglio, PhD, and Robert John Mentz, MD

Subjects
biotechnology, cardiac assist device, heart failure, three-dimensional printing, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Left ventricular assist devices (LVADs) are used in end-stage heart failure. Inadequate positioning of the inflow cannula may necessitate replacement of the LVAD. We present the successful use of a three-dimensional printed model used to optimize surgical planning and allow for simulation and training for the LVAD exchange procedure.

Published
2024
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38. The PRO‐HOME Project. A multicomponent intervention for the protected discharge from the hospital of multimorbid and polytreated older individuals by using innovative technologies: A pilot study

Author

Alberto Pilotto, Erica Volta, Marina Barbagelata, Alessandra Argusti, Antonio Camurri, Niccolò Casiddu, Carlo Berutti‐Bergotto, Carlo Custodero, and Alberto Cella

Subjects
aging, domotics, gerontechnology, multicomponent intervention, Multidimensional Prognostic Index, PRO‐HOME, Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Abstract Backgroud Discharge planning from the hospital of frail older patients is an important step to avoid inappropriate long‐stay hospitalizations and to prevent the risks related to the prolonged hospitalization. In this frame, we developed an experimental trial—‘PRO‐HOME’, a multicomponent programme of interventions for multimorbid and polytreated hospitalized older patients. Aim The main aim of the study was to develop a protected discharge facility using a mini apartment equipped with advanced architectural and technological components to reduce the length of hospital stay of older participants (aged 65+ years old) admitted to the hospital for an acute event, deemed stable and dischargeable. Materials and Methods This is a pilot randomized controlled study, comparing 30 hospitalized participants included in a multidimensional, transitional care programme based on information and communication technologies to 30 patients in standard usual care until hospital discharge. Results We presented the study design of the PRO‐HOME programme, including architectural and technological components, the enrolment procedures, the components of the intervention that is physical activity, cognitive training and life‐style education and the evaluation method of the intervention based on the Comprehensive Geriatric Assessment to explore the changes in the individual domains that are target of the multicomponent intervention. Conclusions The final results will suggest whether the PRO‐HOME programme represents a useful and feasible intervention to reduce the length of hospital stay of multimorbid and polytreated hospitalized older patients and improve their physical and cognitive performances and overall quality of life. Patient or Public Contribution Due to the characteristics of the population of interest of the PRO‐HOME study, we involved in the study design and programme of the activities the participants enrolled in a previous smart home‐based project named MoDiPro carried‐out during a 3‐year period. The elderly participants from the local population involved were asked, by means of focus groups, for feedback on their experience in MoDiPro, and their suggestions were integrated into the design phase of the current PRO‐HOME project. The focus groups included open group interviews with a qualitative collection of the patients' feedback so that the participants could interact with each other.

Published
2024
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39. Development and validation of an art-inspired multimodal interactive technology system for a multi-component intervention for older people: a pilot study

Author

Antonio Camurri, Emanuele Seminerio, Wanda Morganti, Corrado Canepa, Nicola Ferrari, Simone Ghisio, Andrea Cera, Paolo Coletta, Marina Barbagelata, Gianluca Puleo, Ilaria Nolasco, Claudio Costantini, Barbara Senesi, and Alberto Pilotto

Subjects
older people, multidimensional frailty, multimodal systems, motion capture, sonification, cultural welfare, Electronic computers. Computer science, QA75.5-76.95
Abstract

IntroductionThe World Health Organization (WHO) acknowledges the presence of a significant body of research on the positive effects of the arts on health, considering a variety of factors including physical well-being, quality of life, and social and community impact. The model that underlies cultural welfare puts the performing arts, visual arts, and cultural heritage at the service of people personal and societal well-being. The potential connections between movements of the body and artistic content have been extensively studied over time, considering movement as a non-verbal language with a universal character.MethodsThis pilot study presents the results of the validation of an innovative multimodal system, the DanzArTe-Emotional Wellbeing Technology, designed to support active and participative experience of older people providing physical and cognitive activation through a full-body physical interaction with a traditional visual work of art of religious subject. DanzArTe supports a replicable treatment protocol for multidimensional frailty, administered through a low cost and scalable technological platform capable of generating real-time visual and auditory feedback (interactive sonification) from the automated analysis of individual as well as joint movement expressive qualities. The study involved 45 participants, 23 of whom participated in the DanzArTe program and 22 who were included in the control group.ResultsThe two groups were similar in terms of age (p = 0.465) and gender (p = 0.683). The results showed that the DanzArTe program had a positive impact on participants' self-perceived psychological health and well-being (Mean Psychological General Well-Being Index—Short T1 = 19.6 ± 4.3 Vs. T2 = 20.8 ± 4.9; p = 0.029). The same trend was not observed in the control group (p = 0.389).DiscussionThe findings suggest that such programs may have a significant impact particularly on the mental and social well-being of older adults and could be a valuable tool for promoting healthy aging and improving quality of life.

Published
2024
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40. A prognostic score to identify women at increased risk for abnormal uterine bleeding during anticoagulation for venous thromboembolism

Author

Monreal, Manuel, Prandoni, Paolo, Brenner, Benjamin, Farge-Bancel, Dominique, Barba, Raquel, Di Micco, Pierpaolo, Bertoletti, Laurent, Schellong, Sebastian, Tzoran, Inna, Reis, Abilio, Bosevski, Marijan, Bounameaux, Henri, Malý, Radovan, Verhamme, Peter, Caprini, Joseph A., Bui, Hanh My, Adarraga, M.D., Agudo, P., Amado, C., Arcelus, J.I., Ballaz, A., Bascuñana, J., Barba, R., Barbagelata, C., Barrón, M., Barrón-Andrés, B., Blanco-Molina, A., Beddar Chaib, F., Botella, E., Cañas, I., Carrero-Arribas, R., Casado, I., Cerdá, P., Chasco, L., Criado, J., de Ancos, C., de Miguel, J., del Toro, J., Demelo-Rodríguez, P., Díaz-Brasero, A.M., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Domínguez, I.M., Dubois-Silva, A., Escribano, J.C., Espósito, F., Farfán-Sedano, A.I., Falgá, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Muixi, J., Fernández-Reyes, J.L., Font, C., Francisco, I., Galeano-Valle, F., García, M.A., García-Bragado, F., García de Herreros, M., Gavín-Blanco, O., Gil-Díaz, A., Gómez-Cuervo, C., Gómez-Mosquera, A.M., Gonzalez-Moreno, M., Grau, E., Guirado, L., Gutiérrez, J., Hernández-Blasco, L., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jou, I., Joya, M.D., Lacruz, B., Lainez-Justo, S., A, Latorre, J, Lima, Jl, Lobo, López-De la Fuente, M., López-Jiménez, L., López-Meseguer, M., López-Miguel, P., López-Núñez, J.J., López-Reyes, R., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P.J., Martín-Guerra, J.M., Martín-Martos, F., Mellado, M., Mena, E., Moisés, J., Mercado, M.I., Monreal, M., Muñoz-Blanco, A., Muñoz-Gamito, G., Morales, M.V., Nieto, J.A., Noguera-Gras, E., Núñez-Fernández, M.J., Olid-Velilla, M., Osorio, J., Otalora, S., Otero, R., Paredes-Ruiz, D., Parra, P., Parra, V., Pedrajas, J.M., Pérez-López, M., Peris, M.L., Pesce, M.L., Porras, J.A., Poyo-Molina, J., Puchades, R., Riera-Mestre, A., Rivera-Civico, F., Rivera-Gallego, A., Roca, M., Rosa, V., Rodríguez-Cobo, A., Rodríguez-Matute, C., Ruiz-Artacho, P., Ruiz-Giménez, N., Ruiz-Ruiz, J., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suárez-Rodríguez, B., Suriñach, J.M., Tiberio, G., Torres, M.I., Torres-Sánchez, A., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Varona, J.F., Vela, L., Vela, J.R., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Engelen, M.M., Martens, C., Verhamme, P., Yoo, H.H.B., Arguello, J.D., Montenegro, A.C., Roa, J., Hirmerova, J., Malý, R., Accassat, S., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., El Harake, S., Le Mao, R., Mahé, I., Moustafa, F., Plaisance, L., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Braester, A., Brenner, B., Kenet, G., Tzoran, I., Sadeghipour, P., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., De Angelis, A., Dentali, F., Di Micco, P., Imbalzano, E., Merla, S., Pesavento, R., Prandoni, P., Siniscalchi, C., Tufano, A., Visonà, A., Vo Hong, N., Zalunardo, B., Kigitovica, D., Rusa, E., Skride, A., Fonseca, S., Manuel, M., Meireles, J., Bosevski, M., Eftimova, A., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Caprini, J.A., Weinberg, I., Bui, H.M., Sarlon-Bartoli, Gabrielle, Criado, Juan, Middeldorp, Saskia, Nieto, José Antonio, Díaz-Pedroche, María del Carmen, Moustafa, Farès, Ruiz-Giménez, Nuria, and DI Micco, Pierpaolo

Published
2023
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42. COVID-19–associated venous thromboembolism: risk of recurrence and major bleeding

Author

Adarraga, M.D., Alberich-Conesa, A., Amado, C., Amorós, S., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barrón, M., Barrón-Andrés, B., Blanco-Molina, A., Botella, E., Carrero, R., Casado, I., Criado, J., del Toro, J., De Ancos, C., De Juana-Izquierdo, C., Demelo-Rodríguez, P., Díaz-Brasero, A.M., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Espósito, F., Falgá, C., Farfán-Sedano, A.I., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Muixi, J., Fernández-Reyes, J.L., Font, C., Francisco, I., Galeano-Valle, F., García, M.A., García de Herreros, M., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil-Díaz, A., Gil-Hernández, A., Gómez-Cuervo, C., Gómez-Mosquera, A.M., González-Martínez, J., Grau, E., Guirado, L., Gutiérrez, J., Hernández-Blasco, L., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jou, I., Joya, M.D., Lacruz, B., Lalueza, A., Lainez-Justo, S., Lecumberri, R., León-Ramírez, J.M., Lobo, J.L., López-De la Fuente, M., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Reyes, R., López-Ruiz, A., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Mas-Maresma, L., Marcos, M., Martín-Guerra, J.M., Martín-Martos, F., Mellado, M., Mena, E., Mercado, M.I., Moisés, J., Monreal, M., Muñoz-Blanco, A., Muñoz-Gamito, G., Nieto, J.A., Núñez-Fernández, M.J., Osorio, J., Otalora, S., Pacheco-Gómez, N., Paredes-Ruiz, D., Parra, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Jacoiste, A., Pérez-Pérez, J.L., Peris, M.L., Pesce, M.L., Porras, J.A., Poyo-Molina, J., Puchades, R., Riera-Mestre, A., Rivera-Civico, F., Rivera-Gallego, A., Roca, M., Rubio, C.M., Rosa, V., Rodríguez-Cobo, A., Ruiz-Giménez, N., Ruiz-Ruiz, J., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suriñach, J.M., Tiberio, G., Tolosa, C., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Varona, J.F., Vela, J.R., Vela, L., Vidal, G., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Engelen, M., Martens, C., Verhamme, P., Yoo, H.H.B., Arguello, J.D., Montenegro, A.C., Roa, J., Hirmerova, J., Malý, R., Accassat, S., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Grange, C., Leclercq, B., Le Mao, R., Mahé, I., Moustafa, F., Plaisance, L., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Braester, A., Brenner, B., Kenet, G., Najib, D., Tzoran, I., Farrashi, M., Sadeghipour, P., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Grandone, E., Imbalzano, E., Merla, S., Pesavento, R., Prandoni, P., Scarinzi, P., Siniscalchi, C., Taflaj, B., Tufano, A., Visonà, A., Vo Hong, N., Zalunardo, B., Fonseca, S., Manuel, M., Meireles, J., Bosevski, M., Eftimova, A., Zdraveska, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Caprini, J.A., Weinberg, I., Bui, H.M., Demelo-Rodriguez, Pablo, Alonso-Beato, Rubén, Jara-Palomares, Luis, Galeano-Valle, Francisco, Bura-Riviere, Alessandra, Visonà, Adriana, Francisco, Iria, Vidal, Gemma, López-Ruiz, Antonio, and Monreal, Manuel

Published
2023
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43. Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

Author

Monreal, Manuel, Prandoni, Paolo, Brenner, Benjamin, Farge-Bancel, Dominique, Barba, Raquel, Di Micco, Pierpaolo, Bertoletti, Laurent, Schellong, Sebastian, Tzoran, Inna, Reis, Abilio, Bosevski, Marijan, Bounameaux, Henri, Malý, Radovan, Verhamme, Peter, Caprini, Joseph A., Bui, Hanh My, Adarraga, M.D., Alberich-Conesa, A., Alonso-Carrillo, J., Amado, C., Amorós, S., Arcelus, J.I., Ballaz, A., Barba, R., Barbagelata, C., Barrón, M., Barrón-Andrés, B., Blanco-Molina, A., Botella, E., Casado, I., Chasco, L., Cerdà, P., Criado, J., del Toro, J., De Juana-Izquierdo, C., Demelo-Rodríguez, P., Díaz-Brasero, A.M., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Dubois-Silva, A., Escribano, J.C., Espósito, F., Falgá, C., Fernández-Capitán, C., Fernández-Jiménez, B., Fernández-Muixi, J., Fernández-Reyes, J.L., Fidalgo, M.A., Font, C., Francisco, I., Galeano-Valle, F., García, M.A., García de Herreros, M., García-Bragado, F., García-Ortega, A., Gavín-Sebastián, O., Gil-Díaz, A., Gómez-Cuervo, C., Gómez-Mosquera, A.M., González-Martínez, J., González-Moreno, M., Grau, E., Guirado, L., Gutiérrez, J., Hernández-Blasco, L., Jaras, M.J., Jiménez, D., Jou, I., Joya, M.D., Lacruz, B., Lainez-Justo, S., Lalueza, A., Latorre, A., Lecumberri, R., Lobo, J.L., López-De la Fuente, M., López-Jiménez, L., López-Miguel, P., López-Núñez, J.J., López-Ruiz, A., López-Sáez, J.B., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marcos, M., Martín-Martos, F., Mellado, M., Mena, E., Mercado, M.I., Moisés, J., Monreal, M., Muñoz-Blanco, A., Muñoz-Gamito, G., Morales, M.V., Nieto, J.A., Noguera-Gras, E., Núñez-Fernández, M.J., Osorio, J., Otalora, S., Pacheco-Gómez, N., Paredes-Ruiz, D., Parra, P., Pedrajas, J.M., Pérez-Ductor, C., Pérez-Jacoiste, M.A., Pérez-Pérez, J.L., Peris, M.L., Porras, J.A., Poyo-Molina, J., Puchades, R., Riera-Mestre, A., Rivera-Civico, F., Rivera-Gallego, A., Roca, M., Rosa, V., Rodríguez-Cobo, A., Ruiz-Giménez, N., Salgueiro, G., Sancho, T., Sendín, V., Sigüenza, P., Soler, S., Suriñach, J.M., Tiberio, G., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Varona, J.F., Vela, L., Vela, J.R., Villalobos, A., Villares, P., Ay, C., Nopp, S., Pabinger, I., Engelen, M.M., Martens, C., Verhamme, P., Yoo, H.H.B., Arguello, J.D., Montenegro, A.C., Roa, J., Hirmerova, J., Malý, R., Accassat, S., Bertoletti, L., Bura-Riviere, A., Catella, J., Chopard, R., Couturaud, F., Espitia, O., Leclercq, B., Le Mao, R., Mahé, I., Moustafa, F., Plaisance, L., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Versini, E., Schellong, S., Braester, A., Brenner, B., Kenet, G., Tzoran, I., Sadeghipour, P., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., De Angelis, A., Dentali, F., Di Micco, P., Grandone, E., Imbalzano, E., Merla, S., Pesavento, R., Prandoni, P., Scarinzi, P., Siniscalchi, C., Tufano, A., Visonà, A., Vo Hong, N., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Fonseca, S., Manuel, M., Meireles, J., Bosevski, M., Bounameaux, H., Mazzolai, L., Aujayeb, A., Caprini, J.A., Weinberg, I., Bui, H.M., Cohen, Omri, Barg, Assaf A., Nowak-Göttl, Ulrike, Amado-Fernández, Cristina, Mazzolai, Lucia, Tiberio, Gregorio, Skride, Andris, Morales, María del Valle, and Kenet, Gili

Published
2023
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45. A prognostic score to identify women at increased risk for abnormal uterine bleeding during anticoagulation for venous thromboembolism

Author

Gabrielle Sarlon-Bartoli, Juan Criado, Saskia Middeldorp, José Antonio Nieto, María del Carmen Díaz-Pedroche, Farès Moustafa, Nuria Ruiz-Giménez, Benjamin Brenner, Manuel Monreal, Pierpaolo DI Micco, Paolo Prandoni, Dominique Farge-Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Peter Verhamme, Joseph A. Caprini, Hanh My Bui, M.D. Adarraga, P. Agudo, C. Amado, J.I. Arcelus, A. Ballaz, J. Bascuñana, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, A. Blanco-Molina, F. Beddar Chaib, E. Botella, I. Cañas, R. Carrero-Arribas, I. Casado, P. Cerdá, L. Chasco, J. Criado, C. de Ancos, J. de Miguel, J. del Toro, P. Demelo-Rodríguez, A.M. Díaz-Brasero, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, I.M. Domínguez, A. Dubois-Silva, J.C. Escribano, F. Espósito, A.I. Farfán-Sedano, C. Falgá, C. Fernández-Capitán, B. Fernández-Jiménez, J. Fernández-Muixi, J.L. Fernández-Reyes, C. Font, I. Francisco, F. Galeano-Valle, M.A. García, F. García-Bragado, M. García de Herreros, O. Gavín-Blanco, A. Gil-Díaz, C. Gómez-Cuervo, A.M. Gómez-Mosquera, M. Gonzalez-Moreno, E. Grau, L. Guirado, J. Gutiérrez, L. Hernández-Blasco, L. Jara-Palomares, M.J. Jaras, D. Jiménez, I. Jou, M.D. Joya, B. Lacruz, S. Lainez-Justo, Latorre A, Lima J, Lobo Jl, M. López-De la Fuente, L. López-Jiménez, M. López-Meseguer, P. López-Miguel, J.J. López-Núñez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P.J. Marchena, J.M. Martín-Guerra, F. Martín-Martos, M. Mellado, E. Mena, J. Moisés, M.I. Mercado, M. Monreal, A. Muñoz-Blanco, G. Muñoz-Gamito, M.V. Morales, J.A. Nieto, E. Noguera-Gras, M.J. Núñez-Fernández, M. Olid-Velilla, J. Osorio, S. Otalora, R. Otero, D. Paredes-Ruiz, P. Parra, V. Parra, J.M. Pedrajas, M. Pérez-López, M.L. Peris, M.L. Pesce, J.A. Porras, J. Poyo-Molina, R. Puchades, A. Riera-Mestre, F. Rivera-Civico, A. Rivera-Gallego, M. Roca, V. Rosa, A. Rodríguez-Cobo, C. Rodríguez-Matute, P. Ruiz-Artacho, N. Ruiz-Giménez, J. Ruiz-Ruiz, G. Salgueiro, T. Sancho, V. Sendín, P. Sigüenza, S. Soler, B. Suárez-Rodríguez, J.M. Suriñach, G. Tiberio, M.I. Torres, A. Torres-Sánchez, J. Trujillo-Santos, F. Uresandi, E. Usandizaga, R. Valle, J.F. Varona, L. Vela, J.R. Vela, A. Villalobos, P. Villares, C. Ay, S. Nopp, I. Pabinger, M.M. Engelen, C. Martens, P. Verhamme, H.H.B. Yoo, J.D. Arguello, A.C. Montenegro, J. Roa, J. Hirmerova, R. Malý, S. Accassat, L. Bertoletti, A. Bura-Riviere, J. Catella, R. Chopard, F. Couturaud, O. Espitia, S. El Harake, R. Le Mao, I. Mahé, F. Moustafa, L. Plaisance, G. Sarlon-Bartoli, P. Suchon, E. Versini, S. Schellong, A. Braester, B. Brenner, G. Kenet, I. Tzoran, P. Sadeghipour, M. Basaglia, F. Bilora, C. Bortoluzzi, B. Brandolin, M. Ciammaichella, A. De Angelis, F. Dentali, P. Di Micco, E. Imbalzano, S. Merla, R. Pesavento, P. Prandoni, C. Siniscalchi, A. Tufano, A. Visonà, N. Vo Hong, B. Zalunardo, D. Kigitovica, E. Rusa, A. Skride, S. Fonseca, M. Manuel, J. Meireles, M. Bosevski, A. Eftimova, M. Zdraveska, H. Bounameaux, L. Mazzolai, A. Aujayeb, J.A. Caprini, I. Weinberg, and H.M. Bui

Subjects
Anticoagulants, Venous thromboembolism, Uterine bleeding, Prognostic score, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction: Little is known about the clinical characteristics of women at increased risk for abnormal uterine bleeding (UB) during anticoagulation for venous thromboembolism (VTE). Methods: We used the RIETE registry to identify the baseline characteristics of women developing abnormal UB during anticoagulation. We used logistic regression analysis to identify independent predictors for abnormal UB. Then, we built a prognostic score to identify at-risk women. Results: From March 2001 through October 2022, there were 54,372 women with VTE. During anticoagulation (median, 181 days), 318 (0.6%) developed abnormal UB (major bleeding = 88, clinically relevant non-major (CRNM) = 230). On multivariable analysis, women aged 70 kg, with uterine cancer, recent UB, anemia, estrogen-related VTE, or receiving rivaroxaban or apixaban were at increased risk for abnormal UB. Using the prognostic score, 42,273 women (78%) were at low-risk, 8,828 (16%) intermediate-, and 3,271 (6.1%) at high-risk for abnormal UB. Their rates of abnormal UB were: 0.28 (95%CI: 0.23–0.35), 1.32 (95%CI: 1.07–1.61) and 7.12 (95%CI: 5.98–8.41) bleeds per 100 patient-years, respectively. The c-statistic was 0.80 (95%CI: 0.77–0.83). The rates of major UB were: 0.06 (95%CI: 0.04–0.09), 0.43 (95%CI: 0.30–0.60) and 1.85 (95%CI: 1.31–2.53) per 100 patient-years, respectively (c-statistic: 0.84; 95%CI: 0.80–0.89). The rates of CRNM uterine bleeding were: 0.21 (95%CI: 0.17–0.26), 0.85 (95%CI: 0.65–1.08), and 5.02 (95%CI: 4.09–6.10) bleeds per 100 patient-years, respectively (c-statistic: 0.78; 95%CI: 0.75–0.82). Conclusions: Using 7 variables easily available at admission, we built a prognostic score that reliably identified women with VTE at increased risk for abnormal UB during anticoagulation.

Published
2023
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46. DIVERSIDADE GENÉTICA DAS CEPAS DE VÍRUS INFLUENZA A CIRCULANTES NA REGIÃO AMAZÔNICA NOS ANOS DE 2021 A 2023: UMA ANÁLISE DA COMPATIBILIDADE VACINAL

Author

Amanda Mendes Silva Cruz, Edivaldo Costa Sousa Júnior, Luana Soares Barbagelata, Wanderley Dias das Chagas Júnior, Delana Andreza Melo Bezerra, Ágatha Monike Silva Nunes, Walter André Júnior, Kátia Cristina de Lima Furtado, Francy Anny Ribeiro Monteiro Mariscal, Andreia Santos Costa, Luisa Tajuja Rocha, Fernando Tavares, and Mirleide Cordeiro dos Santos

Subjects
Vírus influenza A Caracterização genética Vacina Região Amazônica, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Introdução/Objetivo: Anualmente a Organização Mundial da Saúde (OMS), verifica a necessidade de atualização da composição da vacina antigripal, devido à alta variabilidade dos vírus influenza, baseando-se nos dados capitados pela Rede Global de Vigilância de Influenza. Nesse contexto, objetivamos por meio da caracterização genética, investigar compatibilidade das cepas de vírus influenza A circulantes na região Amazônica no período de janeiro de 2021 a maio de 2023 com as cepas vacinais preconizadas neste período. Metodologia: Foram selecionadas 354 amostras positivas, de modo que houvesse representatividade geográfica e temporal, para realização do sequenciamento de genoma completo por amplicons utilizando a plataforma MiSeq illumina. As sequências de nucleotídeos obtidas foram comparadas com as sequencias das cepas vacinais preconizadas para os Hemisférios Norte e Sul dos anos de 2021-2023. Resultados: Dentre os 354 genomas de influenza A analisados, 194 (55%) foram do subtipo A/H1N1pdm09 e 160 (45%) A/H3N2. Quanto as cepas de A/H3N2, 76 (47,5%) foram coletados em 2021, 82 (51,25%) em 2022 e duas (1,25%) em 2023. A análise filogenética mostrou que os genomas de A/H3N2 pertenciam a cinco clados distintos, são eles: 2a.1b (n = 1); 2a.2a (n = 5); 2a.3 (n = 18); 2a.2b (n = 20); e 2a.2 (n = 116). Todos geneticamente divergentes da cepa vacinal A/HongKong/2671/2019 preconizada para a temporada de 2021, mas geneticamente compatível com a cepa vacinal A/Darwin/6/2021-like, estabelecida para as temporadas de 2022 e 2023 do hemisfério sul. Em relação as cepas de A(H1N1)pdm09, 182 (94%) foram coletadas no ano de 2023 e 12 (6%) em 2022. No período analisado, observou-se a co-circulação do clado 6B.1A.5a.2a (n = 112) e clado 6B.1A.5a.2a.1 (n = 82). A maioria das cepas circulantes (72,7%) em 2022 eram geneticamente relacionadas com a cepa vacinal A/Victoria/2570/2019 preconizada para a temporada de 2022 do hemisfério Sul. Até maio de 2023, 60% dos vírus circulantes são geneticamente relacionados com a cepa vacinal A/Sydney/5/2021 disponível para o hemisfério sul, porém 40% são geneticamente relacionados com a cepa vacinal A/Wisconsin/588/2019, estabelecida para a temporada 2022/2023 do hemisfério Norte. Conclusão: Como consequência da alta variabilidade genética dos vírus influenza, os eventos de incompatibilidade entre a vacina e os vírus circulantes são observados e podem contribuir para uma carga adicional relacionada à doença devido à limitada proteção cruzada.

Published
2023
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47. PERFIL ETIOLÓGICO DAS INFECÇÕES RESPIRATÓRIAS AGUDAS (IRA) OCORRIDAS NO ESTADO DO ACRE

Author

Ágatha Monike Silva Nunes, Delana Andreza Melo Bezerra, Luana Soares Barbagelata, Amanda Mendes Silva Cruz, Wanderley Dias das Chagas Júnior, Edvaldo Tavares Penha Junior, Edna Filizzola, Alessandra Alves Polário, Maria Silvia Sousa de Lucena, Francy Anny Ribeiro Montero Mariscal, and Mirleide Cordeiro dos Santos

Subjects
IRA Vírus respiratórios Vigilância, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Introdução: As infecções respiratórias agudas (IRAs) são um grupo diversificado de doenças infecciosas, que acometem o trato respiratório de crianças e adultos pelo mundo, sendo os agentes etiológicos mais comuns os vírus. Apresentam sintomas muitos semelhantes, dificultando o diagnóstico clínico correto, o que evidencia a grande importância do diagnóstico laboratorial. Objetivo: Descrever o perfil etiológico dos casos de IRA ocorridos no estado do Acre, no período de janeiro de 2022 a maio de 2023 Materiais e métodos: Foram analisados 1207 espécimes clínicos (swab combinado ou aspirado de nasofaringe), coletados de pacientes com IRA de ambos os gêneros e diferentes faixas etárias. As amostras foram submetidas a extração de ácido viral nucléico viral utilizando kit comercial. O RNA viral foi analisado por reação em cadeia da polimerase em tempo real precedida de transcrição reversa (RT-qPCR) utilizando iniciadores específicos para 14 vírus diferentes, são eles: Adenovírus (AdV), Bocavírus (HBoV), Metapneumovirus (HMPV), Rinovírus (HRV), Parainfluenza 1 (PIV1), Parainfluenza 2 (PIV2), Parainfluenza 3 (PIV3), Coronavírus HKU1, Coronavírus 229E, Coronavírus OC43, Vírus Sincicial Respiratório (RSV), incluindo o vírus Influenza A e B (FluA/FluB), SARS-CoV-2 (SC2). Resultado: No total de amostras analisadas, 513 mostraram-se positivas (pos) para um ou mais dos agentes investigados. Sendo 198 (16,40%) pos para HRV, FluA 59 (4,89%) pos, HMPV 50 (4,14%) pos, AdV 50 (4,14%) pos, HBoV 45 (3,73%) pos, PIV3 32 (2,65%) pos, HKU1 21 (1,74%) pos, NL63 13 (1,08%) pos, RSV 9 (0,74%) pos, SC2 8 (0,66%) pos, PIV2 8 (0,66%) pos, PIV1 7 (0,58%) pos, OC43 7 (0,58%) pos, 229E 6 (0,50%) pos. A faixa etária de 0 a 5 anos foi a mais acometida pela IRA com o agente viral em destaque o HRV. Quanto ao perfil de circulação a maior incidência dos vírus respiratórios teve presença do HRV sendo notada em desde jan/2022 a out/2022 tendo um pico em jun/2022 acompanhado do HMPV. Conclusão: Nossos resultados evidenciaram a participação dos agentes virais na indução de IRA especialmente HRV, acometendo principalmente pacientes pediátricos. Corroborando assim, o papel do diagnóstico laboratorial na elucidação dos casos de IRA. O diagnóstico das infecções virais auxilia no manejo clínico dos casos de IRA, evitando desta forma, o uso desnecessário de antibioticoterapia ao tratamento dessas infecções.

Published
2023
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48. DETECÇÃO E CARACTERIZAÇÃO GENÉTICA DE VÍRUS SINCICIAL RESPIRATÓRIO HUMANO EM CASOS DE INFECÇÃO RESPIRATÓRIA AGUDA NO ESTADO DO AMAPÁ, BRASIL, DURANTE O ANO DE 2023

Author

Luana Soares Barbagelata, Amanda Mendes Silva Cruz, Edivaldo Costa Sousa Júnior, Wanderley Dias das Chagas Júnior, Delana Andreza Melo Bezerra, Agatha Monike Silva Nunes, Edvaldo Tavares da Penha Júnior, Edna Maria Acunã de Souza, Alessandra Alves Polaro Lima, Andreia Santos Costa, Márcia Socorro Pereira Cavalcante, Fernando Neto Tavares, and Mirleide Cordeiro dos Santos

Subjects
Vigilância Infecção respiratória aguda Vírus Sincicial Respiratório, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Introdução/Objetivos: As infecções respiratórias agudas (IRA) constituem um importante problema em saúde pública, especialmente aquelas desencadeadas pelo Vírus Sincicial Respiratório (VSR), um dos principais agentes virais associados à doença grave na população pediátrica em todo o mundo. O VSR pertence à família Pneumoviridae, gênero Orthopneumovirus e baseado em suas características antigênicas é classificado em dois subgrupos, VSRA e VSRB. Deste modo, este estudo objetivou identificar o subgrupo mais frequente e caracterizar geneticamente cepas de VSR em amostras oriundas de um surto de IRA, em pacientes de zero a dois anos de idade, ocorrido no Estado do Amapá, no período de março a maio de 2023. Métodos: Para tal, o Laboratório Central de Saúde Pública do Estado do Amapá enviou 188 amostras de secreção respiratória para a pesquisa de etiologia viral ao Laboratório de Vírus Respiratórios do Instituto Evandro Chagas (LVR-IEC), Laboratório de Referência junto a Rede Nacional de Vigilância de Influenza e outros vírus respiratórios do Ministério da Saúde. A análise das amostras envolveu a extração do ácido nucleico viral utilizando kit comercial, detecção e definição do subgrupo de VSR por Reação em Cadeia mediada pela Polimerase em tempo real precedida de Transcrição Reversa (RT-qPCR) e sequenciamento do genoma completo pela abordagem de metagenômica shotgun, na plataforma NextSeq 500 Illumina. Resultados: Das 188 amostras analisadas, 96 (51,06%) foram positivas para VSR, destas 61 (63,54%) pertencem ao subgrupo A e 16 (16,66%) ao B, em 19 amostras não foi possível identificar o subgrupo. O sequenciamento genômico foi realizado em duas cepas do subgrupo A e quatro do B. A análise genômica demonstrou que as cepas de VSRA agruparam no clado GA2.3.5 e as do subgrupo VSRB no clado GB5.0.5a. Conclusão: Nossos dados corroboram o importante papel do VSR na indução de IRA em pacientes pediátricos, com o VSRA sendo predominante na população investigada. A análise genética não evidenciou mudanças que possam conferir maior virulência, patogenicidade e/ou transmissibilidade das cepas detectadas no Amapá. Acredita-se que as medidas de proteção adotadas durante a pandemia de COVID-19 afetaram a circulação de outros vírus respiratórios, como o VSR, criando, desta forma, grupos suscetíveis à infecção. Nossos dados reforçam a importância do monitoramento constante do VSR, para auxiliar no melhor manejo clínico e controle de infecções por esse patógeno em crianças.

Published
2023
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49. PREDOMINÂNCIA DA LINHAGEM VICTORIA DO VÍRUS INFLUENZA B DURANTE A TEMPORADA DE INFLUENZA 2023 NAS REGIÕES NORTE E NORDESTE DO BRASIL

Author

Wanderley Dias das Chagas Junior, Amanda Mendes Silva, Luana Soares Barbagelata, Edivaldo Costa Sousa Junior, Agatha Monike Silva Nunes, Delana Andreza Melo Bezerra, Edvaldo Tavares da Penha Junior, Alessandra Alves Polaro Lima, Edna Maria Acunã de Souza, Maria Silvia Sousa da Lucena, Luana da Silva Soares Farias, Fernando Neto Tavares, and Mirleide Cordeiro dos Santos

Subjects
Vigilância genômica Gripe Influenza, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Introdução/objetivos: Dentre as doenças infecciosas de grande importância para a saúde pública, a gripe ou influenza desempenha um papel significativo nos índices de morbidade e mortalidade em todo o mundo. Tradicionalmente, os vírus influenza A são os mais descritos devido ao seu potencial de causar pandemias, no entanto os vírus influenza B apresentam grande impacto sendo associados a epidemias sazonais e ocasionando doenças graves, principalmente em crianças. Diante disto, este estudo objetivou investigar as propriedades moleculares dos vírus influenza B que circularam durante a epidemia sazonal em estados das Regiões Norte e Nordeste do Brasil no ano de 2023. Metodologia: Foram analisadas 387 amostras com resultado de RT-qPCR positivo para influenza B recebidas no Laboratório de Vírus Respiratório (LVR) do Instituto Evandro Chagas de janeiro a maio de 2023. Destas, 184 foram selecionadas para o sequenciamento genômico, adotando-se os seguintes critérios, amostras com Ct≤ 29, distribuídas por semanas epidemiológicas e unidades federativas, visando garantir que houvesse representatividade temporal e espacial. As bibliotecas foram preparadas utilizando Nextera XT DNA Library Preparation Kit (Ilumina) e submetidas ao sequenciamento de nova geração por amplicon, na plataforma MiSeq Illumina. As sequências obtidas foram montadas e alinhadas com cepas vacinais e outras obtidas de diferentes regiões do Brasil e do Mundo disponibilizadas no GISAID. Resultados: Durante o período analisado foram gerados 174 genomas completos de influenza B. A análise genética demonstrou que todas as amostras pertenciam a linhagem Victoria, clado V1A.3ª.2, que apresentam como marcadores genéticos a deleção de três aminoácidos (resíduos HÁ1 162-164), classificando-as no grupo V.1ª.3. Desta forma, as cepas circulantes apresentam-se geneticamente relacionada a cepa vacinal B/Austria/1359417/2021 (V.1ª.3ª.2) preconizada para o ano de 2023 no hemisfério sul. Conclusão: A vigilância genômica dos vírus influenza nos permite entender melhor os a dinâmica evolutiva destes agentes, gerando dados que nos permitem inferir sobre a compatibilidade das cepas circulantes com as que compõe a vacina. Desta forma, favorecendo a instituição de intervenções efetivas visando melhorar a aceitação da vacina contra influenza, garantindo assim um maior impacto da vacinação, especialmente no que tange a redução do ônus trazido por esta doença para a população humana.

Published
2023
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