HANY SIMON JUNIOR
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- 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.
- Clinical management of fever in children in Brazil: practical recommendations from an expert panel(2022) SIMON JUNIOR, Hany; PEDREIRA, Marcello Creado; BARBOSA, Silvia Maria de Macedo; FERNANDES, Tadeu Fernando; ESCOBAR, Ana Maria de UlhoaThe objective of this study was to answer several questions related to the assessment and treatment of fever, as well as other controversies that exist during its management in pediatric patients. First, an advisory board with medical experts was conducted to discuss the clinical journey of these patients, considering the main challenges and possible solutions. After this discussion, a non-systematic literature review was performed, between November 2019 and January 2020, to collect the most relevant evidence available in the scientific databases MEDLINE, Lilacs, and SciELO. A narrative review was carried out based on scientific evidence and on extensive experience of experts in clinical practice. The experts developed a set of recommendations and clarifications about the assessment of the severity of fever in pediatrics, the need for treatment and the choice of the most appropriate antipyretic. The most common controversies in the management of fever in pediatric patients were also addressed, such as alternating antipyretics, persistent fever, and dose equivalence. In primary management of pediatric patients, fever should be seen as a relevant symptom that requires treatment with antipyretics in potentially more complex or severe cases, when it causes discomfort to children or is associated with infectious diseases.