Submitted by Pedro Barros (pedro.silvabarros@ufpe.br) on 2018-08-07T17:35:30Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃO Renata Baltar da Silva.pdf: 1613088 bytes, checksum: 8fec2a7eed707edd49f18f2c26930d9c (MD5) / Approved for entry into archive by Alice Araujo (alice.caraujo@ufpe.br) on 2018-08-15T21:04:09Z (GMT) No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃO Renata Baltar da Silva.pdf: 1613088 bytes, checksum: 8fec2a7eed707edd49f18f2c26930d9c (MD5) / Made available in DSpace on 2018-08-15T21:04:09Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃO Renata Baltar da Silva.pdf: 1613088 bytes, checksum: 8fec2a7eed707edd49f18f2c26930d9c (MD5) Previous issue date: 2017-06-28 / Candidemias são infecções fúngicas caracterizadas pela presença de espécies de Candida na corrente sanguínea de pacientes. Cerca de 38% das infeções fúngicas são diagnosticadas durante a permanência de pacientes em Unidades de Terapia Intensiva (UTIs). O objetivo deste trabalho foi descrever as características epidemiológicas das candidemias e determinar os principais fatores de risco da doença em pacientes críticos. Este estudo prospectivo, transversal e observacional foi desenvolvido de janeiro de 2015 a julho de 2016, através da análise descritiva dos resultados de hemoculturas e da revisão dos prontuários médicos de pacientes internados na UTI de um Hospital Público Terciário do Nordeste do Brasil. Foram incluídos no estudo aqueles pacientes com sinais e sintomas de sepse, que tiveram um resultado confirmado de candidemia em hemocultura. Ocorreram 1.573 admissões no período estudado e 4.129 hemoculturas foram realizadas. A incidência de candidemia foi de 42,59 casos para cada 1000 admissões na UTI. A maioria dos pacientes era do sexo masculino (53,3%), com idade superior a 65 anos e permaneceram internados por período prolongado superior a 7 dias (86,6%). A infecção por Candida não-albicans foi predominante em 60% das hemoculturas. A mortalidade encontrada foi de 80% dos pacientes com candidemia. Antibioticoterapia de largo espectro foi prescrita em 98,4% dos pacientes. Entre os diagnósticos observados, sepse (73,3%), doença respiratória (60%) e doença do trato urinário (56,6%) foram os mais frequentes tanto em homens, quanto em mulheres, além de presença de tumores sólidos (15%) e doenças do trato gastrointestinal (23,3%). Procedimentos cirúrgicos foram realizados em 43% dos pacientes. Destes, 23,3% foram submetidos a cirurgias abdominais e tiveram mortalidade de 92,8%. Outros fatores de risco foram acesso venoso central (93,3%), ventilação mecânica (81,6%), sonda nasoenteral (83,3%), sonda nasogástrica (25%), sonda vesical de demora (88,3%), diabetes mellitus (38,3%), hemotransfusão (55%) e traqueostomia (36,6%). Os resultados sugerem que existe uma correlação positiva entre a presença de sonda vesical e o desfecho clínico de óbito (r = 0.07412, p = 0.0353). Observa-se a necessidade de uma adequada interação entre as equipes multidisciplinares assistenciais de cuidados intensivos, para um controle de infecções e diagnóstico laboratorial, que deve ser associado a suspeita de um diagnóstico clínico e a determinação de fatores de risco, de colonização por Candida spp. e da gravidade do quadro clínico para um desfecho mais favorável. / Candidemias are fungal infections characterized by the presence of Candida species in the bloodstream of patients. About 38% of fungal infections are diagnosed during the stay of patients in Intensive Care Units (ICUs). This prospective, transversal and observational study was carried out from January 2015 to July 2016, involving the descriptive analysis of the results of blood cultures and through the review of medical records of critically ill patients admitted to the ICU of a Tertiary Public Hospital in the Northeasthn. The objective of this work was to describe the epidemiological characteristics of candidemia and determine the main risk factors of the disease in critically ill patients. The study included those patients with signs and symptoms of sepsis, who had a confirmed result of candidemia in blood culture. There were 1,573 admissions during the study period and 4,129 blood cultures were performed. The incidence of candidemia was 42.59 cases per 1000 admissions in the ICU. The patients were male (53.3%), older than 65 years and were hospitalized for an extended period (86.6%). Candida non-albicans infection was predominant in 60% of blood cultures. Mortality was 80% of patients with candidemia. Broad spectrum antibiotic therapy was prescribed in 98.4% of patients. Among the diagnoses observed, sepsis (73.3%), respiratory disease (60%) and urinary tract disease (56.6%) were the most frequent in both men and women, besides the presence of solid tumors (15 %) Diseases of the gastrointestinal tract (23.3%). Surgical procedures were performed in 43% of the patients. Of these, 23.3% were submitted to abdominal surgeries and had a mortality rate of 92.8%. Other risk factors were central venous access (93.3%), mechanical ventilation (81.6%), nasoenteral catheter (83.3%), nasogastric tube (25%), vesical catheter delay (88.3%), , Diabetes mellitus (38.3%), hemotransfusion (55%) and tracheostomy (36.6%). The results suggest that there is a positive correlation between the presence of bladder catheter and the clinical outcome of death (r = 0.07412, p = 0.0353). It is observed the need for an adequate interaction between multidisciplinary care intensive care teams for infection control and laboratory diagnosis, which should be associated with suspicion of a clinical diagnosis and the determination of risk factors for colonization by Candida spp. and the severity of the clinical picture for a more favorable outcome..

Submitted by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-08-23T15:48:19Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação - Hilka F.B.E.S.A. Pereira.pdf: 2529320 bytes, checksum: 5c98a774e807abbf8029272ead88c623 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-08-23T15:48:45Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação - Hilka F.B.E.S.A. Pereira.pdf: 2529320 bytes, checksum: 5c98a774e807abbf8029272ead88c623 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-08-23T15:49:08Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação - Hilka F.B.E.S.A. Pereira.pdf: 2529320 bytes, checksum: 5c98a774e807abbf8029272ead88c623 (MD5) / Made available in DSpace on 2017-08-23T15:49:08Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação - Hilka F.B.E.S.A. Pereira.pdf: 2529320 bytes, checksum: 5c98a774e807abbf8029272ead88c623 (MD5) Previous issue date: 2016-12-16 / The breast cancer is a neoplasm of concerning epidemiology , once it brings expressive numbers among women all over the world. In Brazil 57,960 new breast cancer cases are expected to occur in 2016, and in Manaus –Amazon 680 cases were expected in 2015. This study aims to describe the epidemiological and clinical profile of patients , average age about at 40 years old with breast cancer who have been diagnosed and treated at Fundação Centro de Controle de Oncologia do Amazonas - FCECON, between 2003 and 2013. An epidemiological data analysis was performed relating age, histological type, staging, immunohistochemicalpanel , performed treatment , follow up , diagnosis accuracy, and therapy , through patient medical records registries. The data were computed in a database and analyzed upon descriptive statistics. 211 breast cancer patients below 40 years old were observed during the study period and they represent 9,83% of the total case number of about 2,147 women in 10 years. The most affected age group was between 35 and 40 years old , the predominant molecular type was triple negative. Mastectomy was performed on 158(70,6%) patients and quadrantectomy on 39 (18,5%) patients and there were 21(9,9%) death cases. Regarding the clinical staging 57 cases were on stage IIA when diagnosed. 71 patients had the screening method upon clinical exams or self-exams. Global survival was 81,6% and was negatively influenced by the advanced clinical staging for this group ,where stage IIIB determined the survival of 54,7%. The most aggressive treatment and the survival decrease are related to the advanced stage once they are not part of the mammographic screening. / O câncer de mama é uma neoplasia de epidemiologia preocupante, pois demonstra números expressivos entre as mulheres no mundo inteiro. No Brasil foi estimada para o ano de 2016, a ocorrência de 57.960 novos casos novos de câncer de mama e para o Estado do Amazonas, foram estimados 680 casos na cidade de Manaus em 2015. Este estudo buscou descrever o perfil epidemiológico e clinico de pacientes com câncer de mama com idade igual ou inferior a 40 anos diagnosticadas e tratadas na Fundação Centro de Controle de Oncologia do Amazonas - FCECON, no período de 2003 a 2013.Foi realizada a análise de dados epidemiológico relacionado a idade, tipo histológico, estadiamento, painel imunoistoquímico, tratamento realizado, follow-up e acurácia diagnóstica e terapêutica, através de busca de registros nos prontuários das pacientes. Os dados foram computados em banco de dados e analisados através de estatística descritiva. Observaram-se 211 pacientes abaixo de 40 anos com câncer de mama no período de estudo representando 9,83% do total de casos em 11 anos que foi de aproximadamente 2.147mulheres. A faixa etária mais acometida foi entre 35 e 40 anos, o tipo molecular predominante foi triplo negativo. A mastectomia foi realizada em 158 (70,6%) pacientes e quadrantectomia em 39 (18,5%) pacientes com 21(9,9%) casos de óbitos. Em relação ao estadiamento clínico 57 casos encontravam-se no estádio IIA ao diagnóstico. Quanto ao método de rastreio, 71 pacientes realizaram através do exame clínico ou autoexame. A sobrevida global foi de 81,6%, sendo influenciada negativamente pelo estadiamento clinico avançado desse grupo de mulheres, onde o estádio III B determinou a sobrevida de 54,7%. O tratamento mais agressivo e a diminuição da sobrevida estão relacionados ao estádio avançado já que não participam do rastreio mamográfico.

Submitted by Elizabete Silva (elizabete.silva@ufes.br) on 2015-08-26T20:29:07Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Avaliação da relação da densidade de vetores e da presença de A.aegypti infectados com a ocorrência de dengue na cidade de Vitória.pdf: 1488499 bytes, checksum: 862637f184216da84704652db2813d9f (MD5) / Approved for entry into archive by Morgana Andrade (morgana.andrade@ufes.br) on 2015-11-17T17:28:48Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Avaliação da relação da densidade de vetores e da presença de A.aegypti infectados com a ocorrência de dengue na cidade de Vitória.pdf: 1488499 bytes, checksum: 862637f184216da84704652db2813d9f (MD5) / Made available in DSpace on 2015-11-17T17:37:27Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Avaliação da relação da densidade de vetores e da presença de A.aegypti infectados com a ocorrência de dengue na cidade de Vitória.pdf: 1488499 bytes, checksum: 862637f184216da84704652db2813d9f (MD5) Previous issue date: 2013 / A dengue é uma doença febril aguda causada pelo DENV, o qual agrupa quatro sorotipos distintos. Sua transmissão se dá pela picada de fêmeas de mosquitos do gênero Aedes, sendo o Aedes aegypti o principal vetor de importância epidemiológica. O controle do vetor e a vigilância epidemiológica são as principais ferramentas para a contenção de novas epidemias. Assim, o objetivo deste trabalho foi avaliar a correlação entre densidade de vetores e presença de A. aegypti infectados com a ocorrência de dengue em Vitória, durante a epidemia de 2011. Para isso, foram analisados casos confirmados laboratorialmente e notificados no SINAN, bem como os dados fornecidos pelo programa MI – DENGUE. Para a identificação dos sorotipos circulantes, foram realizados ensaios de RT – PCR. Foi também realizado o geoprocessamento, por bairro, dos casos humanos, da densidade de vetores e das armadilhas contendo A. aegypti infectados. Os resultados mostraram uma ligeira predominância do sexo feminino na amostra analisada e que 64,18% dos casos ocorreram em pessoas acima de 18 anos. A maioria dos casos de dengue observados foi classificada como dengue clássica, enquanto cerca 10% foram classificados como as formas mais graves de dengue, como “dengue com complicações” ou “febre hemorrágica da dengue”. Em 8,23% dos casos houve a ocorrência de internação e dois óbitos foram contabilizados durante o período. Por meio da análise temporal, foi visto que o aumento da densidade de vetores ocorreu nas épocas mais quentes e chuvosas, e precedia o aumento do número de casos humanos. Não foi encontrada correlação entre a densidade de vetores e a incidência de dengue nos bairros (p=0.848) porém foi visto que os bairros onde foram encontrados mosquitos infectados possuíam maior incidência de dengue que os bairros sem mosquitos infectados (p=0.009). O principal sorotipo circulante em Vitória, em 2011, foi o DENV-1 seguido pelo o DENV-2. Portanto, este estudo demonstra que, tão importante quanto monitorar a densidade de vetores, é investigar a presença de vetores infectados nas cidades com o objetivo de predizer possíveis epidemias de dengue. / Dengue is an acute febrile disease caused by dengue virus (DENV), which groups four serotypes. It is transmitted by the bite of female mosquitoes of the gender Aedes, being the Aedes aegypti the principal vector with epidemiologic importance. Vector control and epimiological surveillance are the principal tools for epidemic’s contention. So, the objective of this study was to observe the relationship between vector density or infection of the vectors by DENV with the cases of dengue in Vitória. Confirmed and notified cases on SINAN and data from the programme MI –Dengue were analised. For the identification of virus serotypes, it was made RT-PCR. Also, it was described the spatial distribution of human cases of dengue, as well the spatial distribution of vector’s density and the traps where infected mosquitoes were found. As a result, it was found a small predominance of women in the sample analised (54,27%) and 64,18% of the cases occurred in people with more than 18 years old. 90,74% were classified as dengue fever, while 6,60% were classified as “dengue with complications” and 2,66% as “dengue haemorrhagic fever”. In 8,23% of the cases, there was the necessity of hospitalization and 2 deaths were contabilized during the period. Trough the temporal analysis, it was observed that the increase in vector’s density occurred in the warm and rainy times, and it preceeded the increase in human cases. During all the year of 2011, A. aegypti’s density in the city was considered as “moderate” or “critical”. It was not observed a correlation between vector’s density and incidence of dengue in the neighborhoods (p = 0.848), but the neighborhoods where it was found infected mosquitoes had greater incidence of dengue than the neighborhoods without infected vectors (0.009). By the RT-PCR assay, it was observed that the major serotype found in human samples and in vector samples was DENV-1 (96,56% e 82,35%, respectively). DENV-2 was also found in circulation, but in smaller rates.

Objetivo: Determinar las características epidemiológicas, clínicas y quirúrgicas de pacientes con COVID-19 operados de emergencia en el Hospital Regional Lambayeque durante el año 2020. Materiales y métodos: Estudio descriptivo, transversal, retrospectivo y observacional. Se recolectaron las historias clínicas físicas de pacientes con COVID-19 que fueron operados de emergencia por el Servicio de Cirugía General durante el año 2020 del Hospital Regional Lambayeque. Los datos obtenidos fueron ingresados desde una ficha de recolección de datos a una hoja de Excel (Microsoft 365 versión 2205) y posteriormente al SPSS (versión 21.0) para su análisis, donde se analizaron las características epidemiológicas clínicas y quirúrgicas con sus respectivas dimensiones como sexo, comorbilidades, riesgo quirúrgico cardiológico, grado de insuficiencia respiratoria, patología quirúrgica, intervención quirúrgica, etc. Resultados: Se incluyeron 88 pacientes, con una mediana de 26,5 años, la mayoría varones (61%). El 25% de los casos presentaron alguna comorbilidad, las principales fueron hipertensión arterial (8%) y obesidad (7%). Los riesgos quirúrgicos cardiológicos más frecuentes fueron RQ I (50%) y RQ II (45,5%). La mayoría de pacientes no presentaron ningún grado de insuficiencia respiratoria (94,3%). La mediana de vacío terapéutico fue de 94,13 horas. El 90,9% no requirió oxigeno postoperatorio inmediato. La patología quirúrgica más frecuente fue apendicitis (76,1%), así mismo la intervención quirúrgica principal fue la apendicectomía (76,1%). La mediana de tiempo de estancia hospitalaria postquirúrgica fue 3 días. Conclusión: Las características de mayor frecuencia en pacientes operados de emergencia con COVID-19 fueron el sexo masculino, la edad de 16 a 48 años, sin comorbilidades y la operación más realizada fue la apendicectomía. / Objective: To determine the epidemiological, clinical, and surgical characteristics of patients with COVID-19 undergoing emergency surgery at the Lambayeque Regional Hospital in 2020. Materials and methods: A descriptive, cross-sectional, retrospective, and observational study. All the physical medical records of COVID-19 patients who underwent emergency surgery by the general surgery service in 2020 at the Lambayeque Regional Hospital were collected. The data obtained were entered from a data collection sheet to an Excel sheet (Microsoft 365 version 2205) and then to the SPSS (version 21.0) for analysis, where the clinical and surgical epidemiological characteristics were analyzed with their respective dimensions such as sex, comorbidities, surgical risk, degree of respiratory failure, surgical pathology, surgical intervention, etc. Results: It included 88 patients, with a median age of 26.5 years, mostly men (61%). 25% of the cases had some comorbidity but the main ones were arterial hypertension (8%) and obesity (7%). The most frequent cardiac surgical risks were SR I (50%) and SR II (45.5%). Most patients did not present respiratory failure (94.3%). The median time elapsed from the beginning of complaints to admission to the emergency department was 94.13 hours. The 90.9% of patients didn’t require immediate postoperative oxygen. The most frequent surgical pathology was acute appendicitis (76.1%), likewise, the primary surgical intervention was appendectomy (76.1%). The median postoperative hospital stay time was 3 days. Conclusion: The most common characteristics of patients with COVID-19 operated in the emergency were male sex, ages between 16 and 48 years, without comorbidity, and the most common operation was appendectomy.

This dissertation is related to mathematical modelling of the spread of respiratory syncytial virus (RSV) in Valencia and is still causing a large number of hospitalizations of children in this community. A mathematical model based on a system of nonlinear differential equations of first order has been built. This model considers the population divided into two age groups to pay particular attention to children under one year who are the most affected by this disease. This model has been fitted with hospitalizations data of Valencia and has been used to perform a cost analysis of a potential vaccination strategy. We also propose a complete network model to study the seasonal evolution of RSV epidemics in which seasonal parameters were fitted with the previous continuous model. Both developments are contrasted. On the complete network model we propose a strategy for vaccination of children based on the administration of three doses, and develop a cost-effectiveness study for different vaccination rates. Finally we have defined a SIRS model for RSV epidemics on a random social network of contacts among individuals. In this model has not forced the seasonality. The seasonality arises naturally for certain values of the duration of immunity of a patient recovered, the number of contacts and the likelihood of infection from a contact in a day. In this social network model only a narrow range of parameters can support RSV epidemic seasons. / Moraño Fernández, JA. (2010). Mathematical modelling of Respiratory Syncytial Virus spread in the Spanish region of Valencia. Preventive applications [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/8638 / Palancia