SYLVIA COSTA LIMA FARHAT
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Point-of-care lung ultrasound score for predicting escalated care in children with respiratory distress(2023) GIORNO, Eliana P. C.; FORONDA, Flavia K.; PAULIS, Milena De; GHOSN, Danielle S. N. Bou; COUTO, Thomaz B.; SA, Fernanda V. M.; FRAGA, Andrea M. A.; FARHAT, Sylvia C. L.; PRETO-ZAMPERLINI, Marcela; SCHVARTSMAN, ClaudioPurpose: Respiratory distress due to lower respiratory illnesses is a leading cause of death in children. Early rec-ognition of high-risk populations is critical for the allocation of adequate resources. Our goal was to assess whether the lung ultrasound (US) score obtained at admission in children with respiratory distress predicts the need for escalated care. Methods: This prospective study included 0-18-year-old patients with respiratory distress admitted to three emergency departments in the state of Sao Paulo, Brazil, between July 2019 and September 2021. The enrolled patients underwent lung US performed by a pediatric emergency physician within two hours of arrival. Lung ul-trasound scores ranging from 0 to 36 were computed. The primary outcome was the need for high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), or mechanical ventilation within 24 h. Results: A total of 103 patients were included. The diagnoses included wheezing (33%), bronchiolitis (27%), pneu-monia (16%), asthma (9%), and miscellaneous (16%). Thirty-five patients (34%) required escalated care and had a higher lung ultrasound score: median 13 (0-34) vs 2 (0-21), p < 0.0001; area under the curve (AUC): 0.81 (95% confidence interval [CI]: 0.71-0.90). The best cut-off score derived from Youden's index was seven (sensitivity: 71.4%; specificity: 79.4%; odds ratio (OR): 9.6 [95% CI: 3.8-24.7]). A lung US score above 12 was highly specific and had a positive likelihood ratio of 8.74 (95% CI:3.21-23.86). Conclusion: An elevated lung US score measured in the first assessment of children with any type of respiratory distress was predictive of severity as defined by the need for escalated care with HFNC, NIV, or mechanical ventilation.
- How to incorporate telemedicine in medical residency: A Brazilian experience in pediatric emergency(2023) SEVERINI, Rafael da Silva Giannasi; MARCOVICI, Michelle; FARHAT, Sylvia Costa Lima; BIVANCO-LIMA, Danielle; COUTO, Thomaz Bittencourt; AMARANTE, Ana Carolina; RODRIGUES, Katharina Reichmann; GHOSN, Danielle Saad Nemer Bou; SCHVARTSMAN, ClaudioIntroduction:The exponential growth of telehealth services during the COVID-19 pandemic led to the implementa-tion of a telemedicine care service in a tertiary university pediatric hospital. It brought the need to develop a train-ing aimed at remote care within the pediatric emergency rotation program.Objective: To describe the implementation of a telemedicine training for pediatric residents and present the pre-liminary results.Methods: Descriptive prospective study (pre and post), with 40 resident physicians of the first year of pediatrics. Reaction Assessments were applied before and after training, in addition to a resident physician perception ques-tionnaire at the end of the training.Results: There was a significant difference in the resident's perception of experience and safety after initial train-ing. Most rated the proposal as good or excellent, considered teaching telemedicine relevant and that this experi-ence contributed to their learning on the subject.Conclusion: This study describes an innovative proposal for training in telemedicine. The preliminary results were encouraging, demonstrating the program's potential in training future pediatricians.
- Spatial analysis of vaccine coverage in children under the age of 1 year by mesoregions in Paraiba a northeastern Brazilian state(2023) CUNHA, Nairmara Soares Pimentel; OLINDA, Ricardo Alves de; FAHRAT, Sylvia Costa Lima; BARBIERI, Carolina Luisa Alves; BRAGA, Alfesio Luis Ferreira; PAMPLONA, Ysabely de Aguiar Pontes; MARTINS, Lourdes ConceicaoImmunization is one of the most effective measures in public health, and it is responsible for the reduction of vaccine-preventable diseases. In the present study, vaccine coverage (VC) and the spatial dynamics of homogeneity of VC (HVC) were compared and analyzed in the terms of the immunobiologicals administered to children aged < 1 year in a state in Paraiba, Brazil. This is a mixed ecological study that used public-domain secondary data from the years 2016 and 2017 from the Information System of the Brazilian National Immunization Program (SI-PNI) and the Brazilian National Information System of Live Births (SINASC). VC rates were calculated by dividing the number of administered doses by the number of live births. Then, VC was classified into four categories. The Municipal HVC was considered adequate when the overall VC exceeds 75%. The study included a descriptive analysis and a spatial autocorrelation analysis for HVC using global and local Moran's statistics. The stratified VC analysis revealed a significant number of municipalities in each of the state's mesoregions with low or very low VC rates for all immunobiologicals, with the Mata Paraibana mesoregion having the worst percentages in both years studied. The spatial analysis of HVC revealed several clusters of inadequate homogeneity, with Mata Paraibana being the worst mesoregion in 2016. The analysis of spatial dynamics and spatial statistics techniques allows the precise identification of vulnerable areas, ""vaccination pockets,"" making it possible to develop plans aimed at meeting the targets of the PNI.
- Effect of chronic exposure to fine particulate matter on cardiac tissue of NZBWF1 mice(2023) WAKED, Dunia; RODRIGUES, Ana Clara B.; SILVA, Thamires Moraes; YARIWAKE, Victor Yuji; FARHAT, Sylvia Costa Lima; VERAS, Mariana MateraEpidemiological and toxicological studies have shown that inhalation of particulate matter (PM) is associated with development of cardiovascular diseases. Long-term exposure to PM may increase the risk of cardiovascular events and reduce life expectancy. Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, autoimmune in nature, that is characterized by the production of autoantibodies that affects several organs, including the heart. Air pollution - which can be caused by several different factors - may be one of the most important points both at the onset and the natural history of SLE. Therefore this study aims to investigate whether exposure to air pollution promotes increased inflammation and cardiac remodelling in animals predisposed to SLE. Female NZBWF1 mice were exposed to an environmental particle concentrator. Aspects related to cardiac remodelling, inflammation and apoptosis were analysed in the myocardium. Body weight gain, cardiac trophism by heart/body weight ratio, relative area of cardiomyocytes and the fibrotic area of cardiac tissue were evaluated during the exposure period. Animals exposed to PM2.5 showed increased area of cardiomyocytes, and area of fibrosis; in addition, we observed an increase in IL-1 and C3 in the cardiac tissue, demonstrating increased inflammation. We suggest that air pollution is capable of promoting cardiac remodelling and increased inflammation in animals predisposed to SLE.
- Beyond respiratory effects: Air pollution and the health of children and adolescents(2023) VERAS, Mariana M.; FARHAT, Sylvia C. L.; RODRIGUES, Ana Clara; WAKED, Dunia; SALDIVA, Paulo H. N.In 2016, WHO report data revealed that air pollution (AP) contributed to around 300.000 deaths of children under five and to around 52.000 deaths of children adolescents aged between 5 and 15 years. Respiratory system is the entry for air pollutants, and therefore is the most impacted system. How-ever, in the last two decades, scientific evidence show that the other system is affected and exposure can be associated with lasting effects later in life. Beyond the respiratory system, the development and function of the cardiovascular system, the central nervous system, and the metabolism are affected. Indeed, there is an emerging concept that exposure to AP during gestation and early childhood increases the risk of disease in adulthood. In fact, the larger number of children breathing unhealthy air live in areas more prone to have other environmental threats, such as bad housing and precarious sanitation and lower access to health services, a situation that can be characterized as a multiple jeopardy, a scenario that children and their families fundamentally rely on public policies to be protected. Thus, actions aimed to reduce children's exposure to AP extrapolate the boundaries of health policies, to incorporate the contents of human rights and dignity.
- Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic(2023) CAMPOS, Reinan T.; LINDOSO, Livia; SOUSA, Renan A. de; HELITO, Alberto C.; IHARA, Bianca P.; STRABELLI, Claudia A. A.; PARADELAS, Levi M. V.; CARNEIRO, Beatriz O. L.; CARDOSO, Maria Paula R.; SOUZA, Jean Paulo V. de; FREIRE, Marianna R. de M.; ASTLEY, Camilla; LAURENTINO, Moises F.; BUSCATTI, Izabel M.; KOZU, Katia; AIKAWA, Nadia E.; SALLUM, Adriana M. E.; FERREIRA, Juliana C. O.; SIMON, Juliana R.; VIANA, Vivianne S. L.; QUEIROZ, Ligia B.; GUALANO, Bruno; ROSCHEL, Hamilton; PEREIRA, Rosa Maria R.; TOMA, Ricardo K.; WATANABE, Andreia; GRANGEIRO, Patricia M.; CASELLA, Caio B.; FARHAT, Sylvia C.; V, Guilherme Polanczyk; CAMPOS, Lucia Maria A.; SILVA, Clovis A.Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases.Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pitts-burgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0).Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inat-tention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent var-iables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00-7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08-3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12-4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93-0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95-0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16-0.77; p = 0.026) remained inversely associated with abnormal HI scores.Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppres-sive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal pro-gram to protect the mental health of adolescents with and without chronic illnesses during future pandemics.
- Mental health among children and adolescents after SARS-CoV-2 infection: A prospective study in a tertiary university hospital(2023) MATSUO, Olivia Mari; LINDOSO, Livia; MARQUES, Heloisa Helena de Sousa; V, Guilherme Polanczyk; FARHAT, Sylvia Costa Lima; BAIN, Vera; FINK, Thais T.; MARTINS, Fernanda; ASTLEY, Camilla; SUGUITA, Priscila; TRINDADE, Vitor; CORREA-SILVA, Simone; PALMEIRA, Patricia; SANSON, Camila; PAULA, Yoshino de; LITVINOV, Nadia; FERREIRA, Juliana Caires O. A.; SAKITA, Neusa Keico; GUALANO, Bruno; SILVA, Clovis Artur A.; PEREIRA, Maria Fernanda Badue