VANUSA BARBOSA PINTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Assessment of the prevalence of vertical hepatitis B transmission in two consecutive generations(2018) NAKANO, Larissa Akeme; KATAYOSE, Jessica Toshie; ABREU, Rodrigo Martins; MENDES, Luis Claudio Alfaia; MARTINS, Maria Cleusa; PINTO, Vanusa Barbosa; CARRILHO, Flair Jose; ONO, Suzane KiokoIntroduction: Hepatitis B is an important public health problem in the world and one of the forms of contagion would be through vertical transmission. Precose diagnosis allows the adoption of prophylaxis measures, which results in prevention in more than 90% of cases. Objective: To describe the prevalences of vertical transmission and compare two generations (mother/patient and patient/child). Method: This was a cross-sectional study, which included 101 patients. The interviews were performed through the application of the instrument of data collection and information of the physical file before the medical consultation. Results: The mean +/- SD of age was 50.9 +/- 13.1 years, the male gender predominated, with 56.4% of the patients, and the predominance was white, with 43.6%. Vertical transmission between mother and patient occurred in 17.8% and between patient and child, in 7.9%. In all of the eight cases of vertical transmission, the diagnosis was after the birth of children infected with HBV, and in 3/8 (37.5%), there was more than one case of infection by this mechanism per patient, totaling 13 children with the disease. Conclusion: There was a reduction in vertical transmission, showing that preventive measures were effective.
- ECONOMIC IMPACT OF CALCIUM FREE BALANCED SOLUTION VERSUS 0.9% SALINE IN SIRS PATIENTS: A BRAZILIAN PUBLIC HOSPITAL PERSPECTIVE(2018) MENEZES, F. G.; OTUYAMA, L. J.; TOLENTINO, R. B.; GRESSE JUNIOR, S.; PINTO, V. B.; SFORSIN, A. C.; ARIZA, J. G.
- Pharmaceutical care-based interventions in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials(2020) NOGUEIRA, Marcel; OTUYAMA, Leonardo Jun; ROCHA, Priscilla Alves; PINTO, Vanusa BarbosaObjective: To investigate the impact of pharmaceutical care-based interventions on type 2 diabetes mellitus. Methods: PubMed (R), Cochrane and Web of Science data bases were searched for randomized controlled clinical trials. Studies evaluating pharmaceutical care-based interventions in type 2 diabetes mellitus published between 2012 and 2017 were included. Glycated hemoglobin was defined as the primary endpoint; blood pressure, triglycerides and cholesterol as secondary endpoints. The random effects model was used in meta-analysis. Results: Fifteen trials involving 2,325 participants were included. Meta-analysis revealed considerable heterogeneity (I-2 >97%; p<0.001), reduction in glycated hemoglobin (-1.07%; 95%CI: -1.32; -0.83; p<0.001), glucose (-29.91mg/dL; 95%CI: -43.2; -16.6; p<0.001), triglyceride (19.8mg/dL; 95%CI: -36.6; -3.04; p=0.021), systolic blood pressure (-4.65mmHg; 95%CI: -8.9; -0.4; p=0.032) levels, and increased HDL levels (4.43mg/d; 95%CI: 0.16; 8.70; p=0.042). Conclusion: Pharmaceutical care-based clincal and education interventions have significant impact on type 2 diabetes mellitus. The tools Summary of Diabetes Self-Care Activities and the Morisky Medication Adherence Scale may be useful to monitor patients.
- Access to antiviral therapy for chronic hepatitis B during COVID-19(2022) BERTOLLI, Marilia Rocha; ROCHA, Priscilla Alves; PINTO, Vanusa Barbosa; ONO, Suzane KiokoAbstract OBJECTIVE: Hepatitis B is an important public health concern. Currently, the COVID-19 pandemic is a major challenge for health systems, and the access to pharmacologic and non-pharmacologic treatment of chronic diseases, such as hepatitis B, may have been affected due to the contingency measures. This study aimed to evaluate the access to antiviral therapy during the ongoing pandemic. METHODS: This was a descriptive analysis of the access to treatment for chronic hepatitis B at a tertiary-level university hospital in São Paulo, integrated with the Brazilian health system. The study was conducted from April to December 2020. RESULTS: Access to antiviral therapy for 225 patients was assessed. The majority of the population was male (59%). The main type of service was the Programa Medicamento em Casa (Home Medication Delivery Program), which was availed by 144 (64%) patients. Women had poorer access to antiviral therapy (56%, p<0.05), and patients registered in the HMDP (68%, p<0.05) had better access. The age group of >48 years represented 70% of the group without access to antiviral therapy. Twenty-two pharmaceutical appointments were conducted through phone calls with patients without access to antiviral therapy. CONCLUSION: This study contributes to the rationalization of efforts in a public health crisis through the identification of groups with the highest risk of poor access to antiviral therapy and the demonstration of the benefits of a medication delivery system.
- Immunothrombosis and COVID-19-a nested post-hoc analysis from a 3186 patient cohort in a Latin American public reference hospital(2023) LIMA, Clarice Antunes de; GONCALVES, Fabio Augusto Rodrigues; BESEN, Bruno Adler Maccagnan Pinheiro; PEREIRA, Antonio Jose Rodrigues; PERAZZIO, Sandro Felix; TRINDADE, Evelinda Marramon; FONSECA, Luiz Augusto Marcondes; SUMITA, Nairo Massakazu; PINTO, Vanusa Barbosa; DUARTE, Alberto Jose da Silva; MANIN, Carolina Broco; LICHTENSTEIN, ArnaldoObjective: COVID-19 is associated with an elevated risk of thromboembolism and excess mortality. Difficulties with best anticoagulation practices and their implementation motivated the current analysis of COVID-19 patients who developed Venous Thromboembolism (VTE). Method: This is a post-hoc analysis of a COVID-19 cohort, described in an economic study already published. The authors analyzed a subset of patients with confirmed VTE. We described the characteristics of the cohort, such as demographics, clinical status, and laboratory results. We tested differences amid two subgroups of patients, those with VTE or not, with the competitive risk Fine and Gray model. Results: Out of 3186 adult patients with COVID-19, 245 (7.7%) were diagnosed with VTE, 174 (5.4%) of them dur-ing admission to the hospital. Four (2.3% of these 174) did not receive prophylactic anticoagulation and 19 (11%) discontinued anticoagulation for at least 3 days, resulting in 170 analyzed. During the first week of hospitaliza-tion, the laboratory most altered results were C-reactive protein and D-dimer. Patients with VTE were more criti-cal, had a higher mortality rate, worse SOFA score, and, on average, 50% longer hospital stay. Conclusion: Proven VTE incidence in this severe COVID-19 cohort was 7.7%, despite 87% of them complying completely with VTE prophylaxis. The clinician must be aware of the diagnosis of VTE in COVID-19, even in patients receiving proper prophylaxis.
conferenceObject Drug-Drug Interactions in the Era of Direct-Acting Antivirals and Clinical Outcome of Patients with Chronic Hepatitis C.(2018) NOGUEIRA, Marcel; LINO, Ana; OTUYAMA, Leonardo; LUCENA, Nayara; SANTOS, Graziella D'Agostino Ribeiro Dos; AMBROSIO, Veridiana; ROCHA, Priscilla Alves; TOLENTINO, Raphael; MARTINS, Maria Cleusa; PINTO, Vanusa Barbosa; CARRILHO, Flair Jose; ONO, Suzane Kiokoarticle 6 Citação(ões) na Scopus Off label pharmacological therapy in patients with short bowel syndrome(2013) GODOY, B. Z.; FAINTUCH, J.; MARIN, M. L. M.; NOGUEIRA, M. A.; PINTO, V. B.; POLLARA, W. M.BACKGROUND: Short bowel syndrome is a disabling disease requiring long-term nutritional support and ancillary drugs. Aiming to analyze the most commonly prescribed drugs, a retrospective analysis was conducted is an outpatient cohort. PATIENTS AND METHODS: Stable patients (N= 37, 59.5% males, age 51.1 +/- 20.1 years, body mass index 20.1 +/- 7.9 kg/m(2)) with three or more appointments in the Outpatient Service during the last 18 months were retrospectively analyzed. regarding oral pharmacologic prescriptions. Medications were classified as on label or off label. RESULTS: A total of 257 oral prescriptions were retrieved from computer files, encompassing 17 different preparations. The majority was employed on label however 28.8% (74/257) were classified as off label and scrutinized with regard to indications. The main categories were pharmacologic modulators of gastrointestinal secretions and motility, along with antibiotics. Virtually all patients required one or more of such drugs, without differences regarding demographic or clinical variables. Adverse effects or premature drug discontinuation were not observed. CONCLUSIONS: This is the first study to our knowledge highlighting the importance of adjuvant drugs, particularly with unconventional indications, in the management of short bowel syndrome. Antidiarrheic agents, pancrelipase micropellets, antacids and antibiotics represented the most relevant off label prescriptions for this population.- Clinical pharmacology profile of care in Hepatology clinic(2017) PASSOS, Talita Rocha; SANTOS, Fabiana Silva; MARTINS, Maria Cleusa; PINTO, Vanusa Barbosa; CARRILHO, Flair Jose; ONO, Suzane KiokoSince 2010, the Clinical Gastroenterology and Hepatology Division of the Central Institute of Hospital das Clinicas of the University of Sao Paulo Medical School (HC-FMUSP, in the Portuguese acronym) has been developing specialized electives assistance activities in the Outpatient Specialty Clinic, Secondary Level, in Sao Paulo NGA-63 Varzea do Carmo. The objective of this study was to analyze the pharmacotherapeutic profile of patients. This is a cross-sectional and retrospective study in which patients were seen at the Hepatology sector and the results were submitted to descriptive statistics. During the study period, 492 patients were treated at the clinic, with a mean age of 58.9 years and frequency of 61.2% female and 74.8% living in Sao Paulo. This population was served by various other medical specialties (cardiology and endocrine among others) and the major liver diagnoses were: chronic hepatitis B and C and fatty liver. Comorbidities were also identified, such as diabetes, hypertension and dyslipidemia. Most patients took their medication in the Basic Health Units. We found that 30% of patients use of more than five medications and the most prescribed were omeprazole 208 (42.3%), metformin 132 (26.8%) and losartan 80 (16.3%). Because it is an adult/elderly population, with several comorbidities and polymedication, it is important to be aware of the rational use of medication. The multidisciplinary team is important in applying correct conducts for the safe use of medicines, to reduce the burden on health spending and improving the quality of life of patients.
- A randomized crossover trial to assess therapeutic efficacy and cost reduction of acid ursodeoxycholic manufactured by the university hospital for the treatment of primary biliary cholangitis(2020) NAKANO, Larissa Akeme; CANCADO, Eduardo Luiz Rachid; CHAVES, Cleuber Esteves; MADEIRA, Maria Cristina Vaz; KATAYOSE, Jessica Toshie; NABESHIMA, Mariana Akemi; FOSSALUZA, Victor; UHRIGSHARDT, Gabriela Guimaraes; Zheng Liting; PINTO, Vanusa Barbosa; CARRILHO, Flair Jose; ONO, Suzane KiokoBackgroundHealth care costs are growing faster than the rest of the global economy, according to the World Health Organization (WHO). Countries' health expenditures include paying for general medicine, diagnostic procedures, hospitalizations and surgeries, as well as medications and prescribed treatment. Primary biliary cholangitis (PBC) is a rare autoimmune liver disease and the first line available treatment is ursodeoxycholic acid (UDCA), however, direct and indirect treatment costs are expensive. Main aim of this trial was to assess if the therapeutic efficacy of UDCA manufactured by the university hospital is equivalent to that of standard UDCA and treatment cost reduction in patients with PBC.MethodsIt is a prospective, interventional, randomized, and crossover study in patients diagnosed with PBC. UDCA 300mg tablets and capsules were developed and manufactured by the university hospital. Thirty patients under treatment with standard UDCA, in stable doses were randomized in sequence A and B, 15 patients in each arm. The groups were treated for 12weeks and after, the UDCA formulation was changed, following for another 12weeks of continuous therapy (tablets and capsules / capsules and tablets). Laboratory tests were performed at time T0 (beginning of treatment), T1 (at the 12week-therapy, before the crossing-over) and T2 (end of treatment). The evaluation was done by comparing the hepatic parameters ALP, GGT, ALT, AST and total bilirubin, also considering the adverse events. The comparison of costs was based on price of the manufactured UDCA and standard UDCA price of the hospital.ResultsHospital reduced 66.1% the PBC treatment costs using manufactured UDCA. There were no differences in the biochemical parameters between sequence (A and B) and tablets or capsules of UDCA formulations applied in the treatment of PBC.ConclusionsThe study showed that there was no significant difference between manufactured UDCA (capsule and tablet) and standard UDCA. Hospital reduced the PBC treatment costs using the manufactured UDCA by the university hospital.Trial registrationClinicalTrials.gov: NCT03489889 retrospectively registered on January 12th, 2018; Ethics Committee approved the study (ID: 1.790.088) on October 25th, 2016.
- Double-blind, Randomized, Placebo-controlled Trial With N-acetylcysteine for Treatment of Severe Acute Respiratory Syndrome Caused by Coronavirus Disease 2019 (COVID-19)(2021) ALENCAR, Julio Cesar Garcia de; MOREIRA, Claudia de Lucena; MULLER, Alicia Dudy; CHAVES, Cleuber Esteves; FUKUHARA, Marina Akemi; SILVA, Elizabeth Aparecida da; MIYAMOTO, Maria de Fatima Silva; PINTO, Vanusa Barbosa; BUENO, Caue Gasparotto; LAZAR NETO, Felippe; GOMEZ, Luz Marina Gomez; MENEZES, Maria Clara Saad; MARCHINI, Julio Flavio Meirelles; MARINO, Lucas Oliveira; BRANDAO NETO, Rodrigo Antonio; SOUZA, Heraldo PossoloBackground: A local increase in angiotensin 2 after inactivation of angiotensin-converting enzyme 2 by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce a redox imbalance in alveolar epithelium cells, causing apoptosis, increased inflammation and, consequently, impaired gas exchange. We hypothesized that N-acetylcysteine (NAC) administration could restore this redox homeostasis and suppress unfavorable evolution in patients with coronavirus disease 2019 (COVID-19). Methods: This was a double-blind, randomized, placebo-controlled, single-center trial conducted at the Emergency Department of Hospital das Clinicas, Sao Paulo, Brazil, to determine whether NAC in high doses can avoid respiratory failure in patients with COVID-19. We enrolled 135 patients with severe COVID-19 (confirmed or suspected), with an oxyhemoglobin saturation <94% or respiratory rate >24 breaths/minute. Patients were randomized to receive NAC 21 g (similar to 300 mg/kg) for 20 hours or dextrose 5%. The primary endpoint was the need for mechanical ventilation. Secondary endpoints were time of mechanical ventilation, admission to the intensive care unit (ICU), time in ICU, and mortality. Results: Baseline characteristics were similar between the 2 groups, with no significant differences in age, sex, comorbidities, medicines taken, and disease severity. Also, groups were similar in laboratory tests and chest computed tomography scan findings. Sixteen patients (23.9%) in the placebo group received endotracheal intubation and mechanical ventilation, compared with 14 patients (20.6%) in the NAC group (P = .675). No difference was observed in secondary endpoints. Conclusions: Administration of NAC in high doses did not affect the evolution of severe COVID-19.