ADRIANA PASMANIK EISENCRAFT
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
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bookPart Emergências alérgicas: anafilaxia(2023) EISENCRAFT, Adriana Pasmanik; Sá, Fernanda Viveiros Moreira debookPart Medicamentos habitualmente usados no pronto-socorro pediátrico(2023) ANDRADE, Anarella Penha Meirelles de; EISENCRAFT, Adriana Pasmanik; PINHO, Marcus Vinícius Terashima de; MORATO, Thayza Marcelly RodriguesbookPart Vasculite por imunoglobulina A (púrpura de Henoch-Schönlein)(2023) RODRIGUES, Regina Maria; ELIAS, Adriana Maluf; BUSCATTI, Izabel Mantovani- Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study(2021) DOI, Dimitria; VALE, Romulo Ribeiro do; MONTEIRO, Jean Michell Correia; PLENS, Glauco Cabral Marinho; FERREIRA JUNIOR, Mario; FONSECA, Luiz Augusto Marcondes; PERAZZIO, Sandro Felix; BESEN, Bruno Adler Maccagnan Pinheiro; LICHTENSTEIN, Arnaldo; TANIGUCHI, Leandro Utino; SUMITA, Nairo Massakazu; CORA, Aline Pivetta; EISENCRAFT, Adriana Pasmanik; DUARTE, Alberto Jose da SilvaThe demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.
- Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome(2020) PEREIRA, Maria Fernanda Badue; LITVINOV, Nadia; FARHAT, Sylvia Costa Lima; EISENCRAFT, Adriana Pasmanik; GIBELLI, Maria Augusta Bento Cicaroni; CARVALHO, Werther Brunow de; FERNANDES, Vinicius Rodrigues; FINK, Thais de Toledo; FRAMIL, Juliana Valeria de Souza; GALLETI, Karine Vusberg; FANTE, Alice Lima; FONSECA, Maria Fernanda Mota; WATANABE, Andreia; PAULA, Camila Sanson Yoshino de; PALANDRI, Giovanna Gavros; LEAL, Gabriela Nunes; DINIZ, Maria de Fatima Rodrigues; PINHO, Joao Renato Rebello; SILVA, Clovis Artur; MARQUES, Heloisa Helena de SousaOBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p < 0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p < 0.001), vasoactive agent use (83% vs. 3%, p <0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p <0.001), and death (67% vs. 3%, p < 0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p < 0.001), aspirin therapy (50% vs. 0%, p < 0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39526.79; p <0 .0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.
- Gastrointestinal manifestations are associated with severe pediatric COVID-19: A study in tertiary hospital(2021) PAULA, Camila Sanson Yoshino de; PALANDRI, Giovanna Gavros; FONSECA, Taiane Siraisi; VENDRAMINI, Thais Cristina Annibale; FARHAT, Sylvia Costa Lima; PEREIRA, Maria Fernanda Badue; LITVINOV, Nadia; TOMA, Ricardo Katsuya; SA, Fernanda Viveiros Moreira de; RODRIGUES, Katharina Reichmann; SCHVARTSMAN, Claudio; FORSAIT, Silvana; SAKITA, Neusa Keico; KANUNFRE, Kelly Aparecida; ROCHA, Mussya Cisotto; SANTOS, Emilly Henrique dos; OKAY, Thelma Suely; PINHO, Joao Renato Rebello; CARVALHO, Werther Brunow de; CARNEIRO-SAMPAIO, Magda; SILVA, Clovis Artur Almeida; MARQUES, Heloisa Helena de Sousa; EISENCRAFT, Adriana Pasmanik; ROSSI JUNIOR, Alfio; DELGADO, Artur Figueiredo; LEAL, Gabriela Nunes; FRAMIL, Juliana Valeria de Souza; GIBELLI, Maria Augusta Bento Cicaroni; JORGE, Patricia Palmeira Daenekas
bookPart Emergências oncológicas(2023) EISENCRAFT, Adriana Pasmanik- Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view(2021) SIMON JUNIOR, Hany; SAKANO, Tania Miyuki Shimoda; RODRIGUES, Regina Maria; EISENCRAFT, Adriana Pasmanik; CARVALHO, Vitor Emanoel Lemos de; SCHVARTSMAN, Claudio; REIS, Amelia Gorete Afonso da CostaObjective: Multisystem inflammatory syndrome in children (MIS -C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart. Sources: The PubMed/MEDLINE/WHO COVID-19 databases were reviewed for original and review articles, systematic reviews, meta -analyses, case series, and recommendations from medical societies and health organizations published through July 3, 2020. The reference lists of the selected articles were manually searched to identify any additional articles. Summary of the findings: COVID-19 infection is less severe in children than in adults, but can present as MIS -C, even in patients without comorbidities. There is evidence of an exacerbated inflammatory response with potential systemic injury, and it may present with aspects similar to those of Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. MIS -C can develop weeks after COVID-19 infection, suggesting an immunomediated cause. The mostfrequent clinical manifestations include fever, gastrointestinal symptoms, rash, mucous membrane changes, and cardiac dysfunction. Elevated inflammatory markers, lymphopenia, and coagulopathy are common laboratory findings. Supportive treatment and early immunomodulation can control the intense inflammatory response and reduce complications and mortality. Conclusions: MIS -C associated with COVID-19 is serious, rare, and potentially fatal. The emergency department pediatrician must recognize and treat it early using immunomodulatory strategies to reduce systemic injury. Further studies are needed to identify the disease pathogenesis and establish the most appropriate treatment. (C) 2020 Sociedade Brasileira de Pediatria.
bookPart Linfo-histiocitose hemofagocítica e síndrome de ativação macrofágica(2023) ELIAS, Adriana Maluf; ZAMPERLINI NETTO, Gabriele; ZAMPERLINI, Marcela PretobookPart Emergências oncológicas(2018) EISENCRAFT, Adriana Pasmanik