NATHALIA NEVES NUNES
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Prediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective study(2022) FREIRE, Maristela Pinheiro; RINALDI, Matteo; TERRABUIO, Debora Raquel Benedita; FURTADO, Mariane; PASQUINI, Zeno; BARTOLETTI, Michele; OLIVEIRA, Tiago Almeida de; NUNES, Nathalia Neves; LEMOS, Gabriela Takeshigue; MACCARO, Angelo; SINISCALCHI, Antonio; LAICI, Cristiana; CESCON, Matteo; DT'ALBUQUERQUE, Luiz Augusto Carneiro; MORELLI, Maria Cristina; SONG, Alice T. W.; ABDALA, Edson; VIALE, Pierluigi; CHIAVEGATTO FILHO, Alexandre Dias Porto; GIANNELLA, MaddalenaBackground: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients' survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Methods: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. Results: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. Conclusions: We created a model able to predict CRE colonization at LT based on easyto-obtain features that could guide antibiotic prophylaxis
- Is U=U consistently known and implemented? A survey among different medical specialists in Brazil(2023) NUNES, Nathalia Neves; VASCONCELOS, Ricardo; CORTEZ, Andre Lazzeri; FERREIRA-FILHO, Edson; KOBAYASI, Renata; WILLETS, Clarissa; COCUZZA, Marcelo; I, Vivian Avelino-SilvaDespite solid scientific evidence, the concepts of treatment as prevention (TASP) and Undetectable = Untransmittable (U = U) remain unfamiliar and underutilized for some healthcare providers. We conducted a self-completion survey to evaluate the knowledge of TASP/U = U in different medical specialties. Wilcoxon Rank-Sum, Chi-square and Fisher's exact tests were used for group comparisons and a logistic regression model was used to assess factors independently associated with U = U-non-supportive attitudes. 197 physicians were included; 74% agreed/strongly agreed that people living with HIV (PLHIV) under regular treatment with undetectable viral do not transmit HIV sexually. However, only 66% agree/strongly agree that PLHIV should be informed about that. The knowledge about these concepts was poorer among gynecologists, urologists and internal medicine specialists when compared to infectious diseases specialists after adjustment for age, race/skin color, gender, and sexual orientation. Our study found that knowledge of crucial concepts of HIV prevention may be lacking for some medical specialties. This highlights the need of improvement in medical education.