118 results on '"Bellissimo-Rodrigues F"'
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2. ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016
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Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Kyle, U. G., Akcan-Arikan, A., Silva, J. C., Mackey, G., Lusk, J., Goldsworthy, M., Shekerdemian, L. S., Coss-Bu, J. A., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. G., Flowers, E., Curtis, A., Wood, C. A., Siu, K., Venkatesan, K., Muhammad, J. B. H., Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., de Molina, F. J. González, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, R. M., Palencia, E., Jareño, A., Granada, R. M., Ignacio, M. L., Cui, N., Liu, D., Wang, H., Su, L., Qiu, H., Li, R., Jaffal, K., Rouzé, A., Poissy, J., Sendid, B., Nseir, S., Paramythiotou, E., Rizos, M., Frantzeskaki, F., Antoniadou, A., Vourli, S., Zerva, L., Armaganidis, A., Riera, J., Gottlieb, J., Greer, M., Wiesner, O., Martínez, M., Acuña, M., Rello, J., Welte, T., Atchade, E., Mignot, T., Houzé, S., Jean-Baptiste, S., Thabut, G., Lortat-Jacob, B., Tanaka, S., Augustin, P., Desmard, M., Montravers, P., Soussi, S., Dudoignon, E., Ferry, A., Chaussard, M., Benyamina, M., Alanio, A., Touratier, S., Chaouat, M., Lafaurie, M., Mimoun, M., Mebazaa, A., Legrand, M., Sheils, M. A., Patel, C., Mohankumar, L., Akhtar, N., Noriega, S. K. Pacheco, Aldana, N. Navarrete, León, J. L. Ávila, Baquero, J. Durand, Bernal, F. Fernández, Ahmadnia, E., Hadley, J. S., Millar, M., Hall, D., Hewitt, H., Yasuda, H., Sanui, M., Komuro, T., Kawano, S., Andoh, K., Yamamoto, H., Noda, E., Hatakeyama, J., Saitou, N., Okamoto, H., Kobayashi, A., Takei, T., Matsukubo, S., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Gimillo, M. Rodriguez, Barinas, O. Diaz, Cortes, M. L. Blasco, Franco, J. Ferreres, Roca, J. M. Segura, Carratalá, A., Gonçalves, B., Turon, R., Mendes, A., Miranda, F., Mata, P. J., Cavalcanti, D., Melo, N., Lacerda, P., Kurtz, P., Righy, C., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Romero, J. C. García, Herrera, A. N. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Hualde, J. Barado, Hernández, A. Ansotegui, Irazabal, J. M. Guergué, Spatenkova, V., Bradac, O., Suchomel, P., Urli, T., Lazzeri, E. Heusch, Aspide, R., Zanello, M., Perez-Borrero, L., Garcia-Alvarez, J. M., Arias-Verdu, M. D., Aguilar-Alonso, E., Rivera-Fernandez, R., Mora-Ordoñez, J., De La Fuente-Martos, C., Castillo-Lorente, E., Guerrero-Lopez, F., Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Pertuz, E. D. Díaz, Hernández, A. Ansotegui, Romero, J. C. García, Sánchez, M. J. Gómez, Herrera, A. N. García, Ramírez, J. Roldán, Sanz, E. Regidor, Hualde, J. Barado, León, J. P. Tirapu, Navarro-Guillamón, L., Cordovilla-Guardia, S., Iglesias-Santiago, A., Guerrero-López, F., Fernández-Mondéjar, E., Vidal, A., Perez, M., Juez, A., Arias, N., Colino, L., Perez, J. L., Pérez, H., Calpe, P., Alcala, M. A., Robaglia, D., Perez, C., Lan, S. K., Cunha, M. M., Moreira, T., Santos, F., Lafuente, E., Fernandes, M. J., Silva, J. G., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Herrera, A. N. García, Romero, J. C. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Echeverría, J. G. Armando, Hernández, A. Ansotegui, Hualde, J. Barado, Podlepich, V., Sokolova, E., Alexandrova, E., Lapteva, K., Kurtz, P., Shuinotsuka, C., Rabello, L., Vianna, G., Reis, A., Cairus, C., Salluh, J., Bozza, F., Torres, J. C. Barrios, Araujo, N. J. Fernández, García-Olivares, P., Keough, E., Dalorzo, M., Tang, L. K., De Sousa, I., Díaz, M., Marcos-Zambrano, L. J., Guerrero, J. E., Gomez, S. E. Zamora, Lopez, G. D. Hernandez, Cuellar, A. I. Vazquez, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Bhasin, D., Rai, S., Singh, H., Gupta, O., Bhattal, M. K., Sampley, S., Sekhri, K., Nandha, R., Aliaga, F. A., Olivares, F., Appiani, F., Farias, P., Alberto, F., Hernández, A., Pons, S., Sonneville, R., Bouadma, L., Neuville, M., Mariotte, E., Radjou, A., Lebut, J., Chemam, S., Voiriot, G., Dilly, M. P., Mourvillier, B., Dorent, R., Nataf, P., Wolff, M., Timsit, J. F., Ediboglu, O., Ataman, S., Ozkarakas, H., Kirakli, C., Vakalos, A., Avramidis, V., Obukhova, O., Kurmukov, I. A., Kashiya, S., Golovnya, E., Baikova, V. N., Ageeva, T., Haritydi, T., Kulaga, E. V., Rios-Toro, J. J., Perez-Borrero, L., Aguilar-Alonso, E., Arias-Verdu, M. D., Garcia-Alvarez, J. M., Lopez-Caler, C., De La Fuente-Martos, C., Rodriguez-Fernandez, S., Sanchez-Orézzoli, M. Gomez, Martin-Gallardo, F., Nikhilesh, J., Joshi, V., Villarreal, E., Ruiz, J., Gordon, M., Quinza, A., Gimenez, J., Piñol, M., Castellanos, A., Ramirez, P., Jeon, Y. D., Jeong, W. Y., Kim, M. H., Jeong, I. Y., Ahn, M. Y., Ahn, J. Y., Han, S. H., Choi, J. Y., Song, Y. G., Kim, J. M., Ku, N. S., Shah, H., Kellner, F., Rezai, F., Mistry, N., Yodice, P., Ovnanian, V., Fless, K., Handler, E., Alejos, R. Martínez, Romeu, J. D. Martí, Antón, D. González, Quinart, A., Martí, A. Torres, Llaurado-Serra, M., Lobo-Civico, A., Ventura-Rosado, A., Piñol-Tena, A., Pi-Guerrero, M., Paños-Espinosa, C., Peralvo-Bernat, M., Marine-Vidal, J., Gonzalez-Engroba, R., Montesinos-Cerro, N., Treso-Geira, M., Valeiras-Valero, A., Martinez-Reyes, L., Sandiumenge, A., Jimenez-Herrera, M. F., Helyar, S., Riozzi, P., Noon, A., Hallows, G., Cotton, H., Keep, J., Hopkins, P. A., Taggu, A., Renuka, S., Sampath, S., Rood, P. J. T., Frenzel, T., Verhage, R., Bonn, M., Pickkers, P., van der Hoeven, J. G., van den Boogaard, M., Corradi, F., Melnyk, L., Moggia, F., Pienovi, R., Adriano, G., Brusasco, C., Mariotti, L., Lattuada, M., Bloomer, M. J., Coombs, M., Ranse, K., Endacott, R., Maertens, B., Blot, K., Blot, S., Amerongen, M. P. van Nieuw, van der Heiden, E. S., Twisk, J. W. R., Girbes, A. R. J., Spijkstra, J. J., Riozzi, P., Helyar, S., Cotton, H., Hallows, G., Noon, A., Bell, C., Peters, K., Feehan, A., Keep, J., Hopkins, P. A., Churchill, K., Hawkins, K., Brook, R., Paver, N., Endacott, R., Maistry, N., van Wijk, A., Rouw, N., van Galen, T., Evelein-Brugman, S., Taggu, A., Krishna, B., Sampath, S., Putzu, A., Fang, M., Berto, M. Boscolo, Belletti, A., Cassina, T., Cabrini, L., Mistry, M., Alhamdi, Y., Welters, I., Abrams, S. T., Toh, C. H., Han, H. S., Gil, E. M., Lee, D. S., Park, C. M., Winder-Rhodes, S., Lotay, R., Doyle, J., Ke, M. W., Huang, W. C., Chiang, C. H., Hung, W. T., Cheng, C. C., Lin, K. C., Lin, S. C., Chiou, K. R., Wann, S. R., Shu, C. W., Kang, P. L., Mar, G. Y., Liu, C. P., Dubó, S., Aquevedo, A., Jibaja, M., Berrutti, D., Labra, C., Lagos, R., García, M. F., Ramirez, V., Tobar, M., Picoita, F., Peláez, C., Carpio, D., Alegría, L., Hidalgo, C., Godoy, K., Bakker, J., Hernández, G., Sadamoto, Y., Katabami, K., Wada, T., Ono, Y., Maekawa, K., Hayakawa, M., Sawamura, A., Gando, S., Marin-Mateos, H., Perez-Vela, J. L., Garcia-Gigorro, R., Peiretti, M. A. Corres, Lopez-Gude, M. J., Chacon-Alves, S., Renes-Carreño, E., Montejo-González, J. C., Parlevliet, K. L., Touw, H. R. W., Beerepoot, M., Boer, C., Elbers, P. W. G., Tuinman, P. R., Abdelmonem, S. A., Helmy, T. A., El Sayed, I., Ghazal, S., Akhlagh, S. H., Masjedi, M., Hozhabri, K., Kamali, E., Zýková, I., Paldusová, B., Sedlák, P., Morman, D., Youn, A. M., Ohta, Y., Sakuma, M., Bates, D., Morimoto, T., Su, P. L., Chang, W. Y., Lin, W. C., Chen, C. W., Facchin, F., Zarantonello, F., Panciera, G., De Cassai, A., Venrdramin, A., Ballin, A., Tonetti, T., Persona, P., Ori, C., Del Sorbo, L., Rossi, S., Vergani, G., Cressoni, M., Chiumello, D., Chiurazzi, C., Brioni, M., Algieri, I., Tonetti, T., Guanziroli, M., Colombo, A., Tomic, I., Colombo, A., Crimella, F., Carlesso, E., Gasparovic, V., Gattinoni, L., Neto, A. Serpa, Schmidt, M., Pham, T., Combes, A., de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Katira, B. H., Engelberts, D., Giesinger, R. E., Ackerley, C., Yoshida, T., Zabini, D., Otulakowski, G., Post, M., Kuebler, W. M., McNamara, P. J., Kavanagh, B. P., Pirracchio, R., Rigon, M. Resche, Carone, M., Chevret, S., Annane, D., Eladawy, S., El-Hamamsy, M., Bazan, N., Elgendy, M., De Pascale, G., Vallecoccia, M. S., Cutuli, S. L., Di Gravio, V., Pennisi, M. A., Conti, G., Antonelli, M., Andreis, D. T., Khaliq, W., Singer, M., Hartmann, J., Harm, S., Carmona, S. Alcantara, Almudevar, P. Matia, Abellán, A. Naharro, Ramos, J. Veganzones, Pérez, L. Pérez, Valbuena, B. Lobo, Sanz, N. Martínez, Simón, I. Fernández, Arrigo, M., Feliot, E., Deye, N., Cariou, A., Guidet, B., Jaber, S., Leone, M., Resche-Rigon, M., Baron, A. Vieillard, Legrand, M., Gayat, E., Mebazaa, A., Balik, M., Kolnikova, I., Maly, M., Waldauf, P., Tavazzi, G., Kristof, J., Herpain, A., Su, F., Post, E., Taccone, F., Vincent, J. L., Creteur, J., Lee, C., Hatib, F., Jian, Z., Buddi, S., Cannesson, M., Fileković, S., Turel, M., Knafelj, R., Gorjup, V., Stanić, R., Gradišek, P., Cerović, O., Mirković, T., Noč, M., Tirkkonen, J., Hellevuo, H., Olkkola, K. T., Hoppu, S., Lin, K. C., Hung, W. T., Chiang, C. C., Huang, W. C., Juan, W. C., Lin, S. C., Cheng, C. C., Lin, P. H., Fong, K. Y., Hou, D. S., Kang, P. L., Wann, S. R., Chen, Y. S., Mar, G. Y., Liu, C. P., Paul, M., Bougouin, W., Geri, G., Dumas, F., Champigneulle, B., Legriel, S., Charpentier, J., Mira, J. P., Sandroni, C., Cariou, A., Zimmerman, J., Sullivan, E., Noursadeghi, M., Fox, B., Sampson, D., McHugh, L., Yager, T., Cermelli, S., Seldon, T., Bhide, S., Brandon, R. A., Brandon, R. B., Zwaag, J., Beunders, R., Pickkers, P., Kox, M., Gul, F., Arslantas, M. K., Genc, D., Zibandah, N., Topcu, L., Akkoc, T., Cinel, I., Greco, E., Lauretta, M. P., Andreis, D. T., Singer, M., Garcia, I. Palacios, Cordero, M., Martin, A. Diaz, Pallás, T. Aldabó, Montero, J. Garnacho, Rey, J. Revuelto, Malo, L. Roman, Montoya, A. A. Tanaka, Martinez, A. D. C. Amador, Ayala, L. Y. Delgado, Zepeda, E. Monares, Granillo, J. Franco, Sanchez, J. Aguirre, Alejo, G. Camarena, Cabrera, A. Rugerio, Montenegro, A. Pedraza, Pham, T., Beduneau, G., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Soilemezi, E., Koco, E., Savvidou, S., Nouris, C., Matamis, D., Di Mussi, R., Spadaro, S., Volta, C. A., Mariani, M., Colaprico, A., Antonio, C., Bruno, F., Grasso, S., Rodriguez, A., Martín-Loeches, I., Díaz, E., Masclans, J. R., Gordo, F., Solé-Violán, J., Bodí, M., Avilés-Jurado, F. X., Trefler, S., Magret, M., Reyes, L. F., Marín-Corral, J., Yebenes, J. C., Esteban, A., Anzueto, A., Aliberti, S., Restrepo, M. I., Larsson, J. Skytte, Redfors, B., Ricksten, S. E., Haines, R., Powell-Tuck, J., Leonard, H., Ostermann, M., Berthelsen, R. E., Itenov, T. S., Perner, A., Jensen, J. U., Ibsen, M., Jensen, A. E. K., Bestle, M. H., Bucknall, T., Dixon, J., Boa, F., MacPhee, I., Philips, B. J., Doyle, J., Saadat, F., Samuels, T., Huddart, S., McCormick, B., DeBrunnar, R., Preece, J., Swart, M., Peden, C., Richardson, S., Forni, L., Kalfon, P., Baumstarck, K., Estagnasie, P., Geantot, M. A., Berric, A., Simon, G., Floccard, B., Signouret, T., Boucekine, M., Fromentin, M., Nyunga, M., Sossou, A., Venot, M., Robert, R., Follin, A., Renault, A., Garrouste, M., Collange, O., Levrat, Q., Villard, I., Thévenin, D., Pottecher, J., Patrigeon, R. G., Revel, N., Vigne, C., Mimoz, O., Auquier, P., Pawar, S., Jacques, T., Deshpande, K., Pusapati, R., Wood, B., Pulham, R. A., Wray, J., Brown, K., Pierce, C., Nadel, S., Ramnarayan, P., Azevedo, J. R., Montenegro, W. S., Rodrigues, D. P., Sousa, S. C., Araujo, V. F., Leitao, A. L., Prazeres, P. H., Mendonca, A. V., Paula, M. P., Das Neves, A., Loudet, C. I., Busico, M., Vazquez, D., Villalba, D., Lischinsky, A., Veronesi, M., Emmerich, M., Descotte, E., Juliarena, A., Bisso, M. Carboni, Grando, M., Tapia, A., Camargo, M., Ulla, D. Villani, Corzo, L., dos Santos, H. Placido, Ramos, A., Doglia, J. A., Estenssoro, E., Carbonara, M., Magnoni, S., Donald, C. L. Mac, Shimony, J. S., Conte, V., Triulzi, F., Stretti, F., Macrì, M., Snyder, A. Z., Stocchetti, N., Brody, D. L., Podlepich, V., Shimanskiy, V., Savin, I., Lapteva, K., Chumaev, A., Tjepkema-Cloostermans, M. C., Hofmeijer, J., Beishuizen, A., Hom, H., Blans, M. J., van Putten, M. J. A. M., Longhi, L., Frigeni, B., Curinga, M., Mingone, D., Beretta, S., Patruno, A., Gandini, L., Vargiolu, A., Ferri, F., Ceriani, R., Rottoli, M. R., Lorini, L., Citerio, G., Pifferi, S., Battistini, M., Cordolcini, V., Agarossi, A., Di Rosso, R., Ortolano, F., Stocchetti, N., Lourido, C. Mora, Cabrera, J. L. Santana, Santana, J. D. Martín, Alzola, L. Melián, del Rosario, C. García, Pérez, H. Rodríguez, Torrent, R. Lorenzo, Eslami, S., Dalhuisen, A., Fiks, T., Schultz, M. J., Hanna, A. Abu, Spronk, P. E., Wood, M., Maslove, D., Muscedere, J., Scott, S. H., Saha, T., Hamilton, A., Petsikas, D., Payne, D., Boyd, J. G., Puthucheary, Z. A., McNelly, A. S., Rawal, J., Connolly, B., McPhail, M. J., Sidhu, P., Rowlerson, A., Moxham, J., Harridge, S. D., Hart, N., Montgomery, H. E., Jovaisa, T., Thomas, B., Gupta, D., Wijayatilake, D. S., Shum, H. P., King, H. S., Chan, K. C., Tang, K. B., Yan, W. W., Arias, C. Castro, Latorre, J., De La Rica, A. Suárez, Garrido, E. Maseda, Feijoo, A. Montero, Gancedo, C. Hernández, Tofiño, A. López, Rodríguez, F. Gilsanz, Gemmell, L. K., Campbell, R., Doherty, P., MacKay, A., Singh, N., Vitaller, S., Nagib, H., Prieto, J., Del Arco, A., Zayas, B., Gomez, C., Tirumala, S., Pasha, S. A., Kumari, B. K., Martinez-Lopez, P., Puerto-Morlán, A., Nuevo-Ortega, P., Pujol, L. Martinez, Dolset, R. Algarte, González, B. Sánchez, Riera, S. Quintana, Álvarez, J. Trenado, Quintana, S., Martínez, L., Algarte, R., Sánchez, B., Trenado, J., Tomas, E., Brock, N., Viegas, E., Filipe, E., Cottle, D., Traynor, T., Martínez, M. V. Trasmonte, Márquez, M. Pérez, Gómez, L. Colino, Martínez, N. Arias, Muñoz, J. M. Milicua, Bellver, B. Quesada, Varea, M. Muñoz, Llorente, M. Á. Alcalá, Calvo, C. Pérez, Hillier, S. D., Faulds, M. C., Hendra, H., Lawrence, N., Maekawa, K., Hayakawa, M., Ono, Y., Kodate, A., Sadamoto, Y., Tominaga, N., Mizugaki, A., Murakami, H., Yoshida, T., Katabami, K., Wada, T., Sawamura, A., Gando, S., Silva, S., Kerhuel, L., Malagurski, B., Citerio, G., Chabanne, R., Laureys, S., Puybasset, L., Nobile, L., Pognuz, E. R., Rossetti, A. O., Verginella, F., Gaspard, N., Creteur, J., Ben-Hamouda, N., Oddo, M., Taccone, F. S., Ono, Y., Hayakawa, M., Iijima, H., Maekawa, K., Kodate, A., Sadamoto, Y., Mizugaki, A., Murakami, H., Katabami, K., Wada, T., Sawamura, A., Gando, S., Kodate, A., Katabami, K., Wada, T., Ono, Y., Maekawa, K., Hayakawa, M., Sawamura, A., Gando, S., Andersen, L. W., Raymond, T., Berg, R., Nadkarni, V., Grossestreuer, A., Kurth, T., Donnino, M., Krüger, A., Ostadal, P., Janotka, M., Vondrakova, D., Kongpolprom, N., Cholkraisuwat, J., Pekkarinen, P. T., Ristagno, G., Masson, S., Latini, R., Bendel, S., Ala-Kokko, T., Varpula, T., Vaahersalo, J., Hoppu, S., Tiainen, M., Mion, M. M., Plebani, M., Pettilä, V., Skrifvars, M.B., Son, Y., Kim, K. S., Suh, G. J., Kwon, W. Y., Ko, J. I., Park, M. J., Cavicchi, F. Zama, Iesu, E., Nobile, L., Vincent, J. L., Creteur, J., Taccone, F. S., Tanaka, H., Otani, N., Ode, S., Ishimatsu, S., Martínez, L., Algarte, R., Sánchez, B., Romero, I., Martínez, F., Quintana, S., Trenado, J., Vondrakova, D., Ostadal, P., Kruger, A., Janotka, M., Malek, F., Neuzil, P., Yeh, Y. C., Chen, Y. S., Wang, C. H., Huang, C. H., Chao, A., Lee, C. T., Lai, C. H., Chan, W. S., Cheng, Y. J., Sun, W. Z., Kaese, S., Horstmann, C., Lebiedz, P., Mourad, M., Gaudard, P., Eliet, J., Zeroual, N., Colson, P., Ostadal, P., Mlcek, M., Hrachovina, M., Kruger, A., Vondrakova, D., Janotka, M., Mates, M., Hala, P., Kittnar, O., Neuzil, P., Jacky, A., Rudiger, A., Spahn, D. R., Bettex, D. A., Kara, A., Akin, S., Dos reis Miranda, D., Struijs, A., Caliskan, K., van Thiel, R. J., Dubois, E. A., de Wilde, W., Zijlstra, F., Gommers, D., Ince, C., Marca, L., Xini, A., Mongkolpun, W., Cordeiro, C. P. R., Leite, R. T., Lheureux, O., Bader, A., Rincon, L., Santacruz, C., Preiser, J. C., Chao, A., Chao, A. S., Chen, Y. S., Kim, W., Ahn, C., Cho, Y., Lim, T. 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Agudo, León, J. P. Tirapu, Irazabal, J. M. Guergue, Pérez, A. González, Fernández, P. Alvarez, Amor, L. Lopéz, Albaiceta, G. Muñiz, Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Hernández, A. Ansotegui, Sanz, E. Regidor, Sánchez, M. J. Gómez, Calvo, S. Aldunate, Herrera, A. N. García, Hualde, J. Barado, Pascual, O. Agudo, León, J. P. Tirapu, Corona, A., Ruffini, C., Spazzadeschi, A., Marrazzo, F., Gandola, A., Sciurti, R., Savi, C., Catena, E., Ke, M. W., Cheng, C. C., Huang, W. C., Chiang, C. H., Hung, W. T., Lin, K. C., Lin, S. C., Wann, S. R., Chiou, K. R., Tseng, C. J., Kang, P. L., Mar, G. Y., Liu, C. P., Bertini, P., De Sanctis, F., Guarracino, F., Bertini, P., Baldassarri, R., Guarracino, F., Buitinck, S. H., van der Voort, P. H. J., Oto, J., Nakataki, E., Tsunano, Y., Izawa, M., Tane, N., Onodera, M., Nishimura, M., Ghosh, S., Gupta, A., De Gasperi, A., Mazza, E., Limuti, R., Prosperi, M., Bissenova, N., Yergaliyeva, A., Talan, L., Yılmaz, G., Güven, G., Yoruk, F., Altıntas, N. D., Mukherjee, D. N., Agarwal, L. K., Mandal, K., Palomar, M., Balsera, B., Vallverdu, M., Martinez, M., Garcia, M., Castellana, D., Lopez, R., Barcenilla, F., Kaminsky, G. E., Carreño, R., Escribá, A., Fuentes, M., Gálvez, V., Del Olmo, R., Nieto, B., Vaquerizo, C., Alvarez, J., De la Torre, M. A., Torres, E., Bogossian, E., Nouer, S. Aranha, Salgado, D. Ribeiro, Brugger, S. Carvalho, Jiménez, G. Jiménez, Torner, M. Miralbés, Vidal, M. Vallverdú, Garrido, B. Balsera, Casals, X. Nuvials, Gaite, F. Barcenilla, Cabello, J. Trujillano, Martínez, M. Palomar, Doganci, M., Izdes, S., Besevli, S. Guzeldag, Alkan, A., Kayaaslan, B., Ramírez, C. Sánchez, Balcázar, L. Caipe, Santana, M. Cabrera, Viera, M. A. Hernández, Escalada, S. Hípola, Vázquez, C. F. Lübbe, Penichet, S. M. Marrero, Campelo, F. Artiles, López, M. A. De La Cal, Santana, P. Saavedra, Santana, S. Ruíz, Repessé, X., Artiguenave, M., Paktoris-Papine, S., Espinasse, F., Dinh, A., El Sayed, F., Charron, C., Géri, G., Vieillard-Baron, A., Marmanidou, K., Oikonomou, M., Nouris, C., Dimitroulakis, K., Soilemezi, E., Matamis, D., Ferré, A., Guillot, M., Teboul, J. L., Lichtenstein, D., Mézière, G., Richard, C., Monnet, X., Pham, T., Beduneau, G., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Prīdāne, S., Sabeļņikovs, O., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Beduneau, G., Pham, T., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Kondili, E., Psarologakis, C., Kokkini, S., Amargianitakis, V., Babalis, D., Chytas, A., Chouvarda, I., Vaporidi, K., Georgopoulos, D., Trapp, O., Kalenka, A., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Lozano, J. A. Benítez, Sánchez, P. Carmona, Francioni, J. E. Barrueco, Ferrón, F. Ruiz, Simón, J. M. Serrano, Spadaro, S., Karbing, D. S., Gioia, A., Moro, F., Corte, F. Dalla, Mauri, T., Volta, C. A., Rees, S. E., Petrova, M. V., Mohan, R., Butrov, A. V., Beeharry, S. D., Vatsik, M. V., Sakieva, F. I., Gobert, F., Yonis, H., Tapponnier, R., Fernandez, R., Labaune, M. A., Burle, J. F., Barbier, J., Vincent, B., Cleyet, M., Richard, J. C., Guérin, C., Shinotsuka, C. Righy, Creteur, J., Taccone, F. S., Törnblom, S., Nisula, S., Vaara, S., Poukkanen, M., Andersson, S., Pettilä, V., Pesonen, E., Xie, Z., Liao, X., Kang, Y., Zhang, J., Kubota, K., Egi, M., Mizobuchi, S., Hegazy, S., El-Keraie, A., El Sayed, E., El Hamid, M. Abd, Rodrigues, N. J., Pereira, M., Godinho, I., Gameiro, J., Neves, M., Gouveia, J., e Silva, Z. Costa, Lopes, J. A., Mckinlay, J., Kostalas, M., Kooner, G., Dudas, G., Horton, A., Kerr, C., Karanjia, N., Creagh-Brown, B., Forni, L., Yamazaki, A., Ganuza, M. Sanz, Molina, J. A. Martinez, Martinez, F. Hidalgo, Freile, M. T. Chiquito, Fernandez, N. Garcia, Travieso, P. Medrano, Bandert, A., Frithiof, R., Lipcsey, M., Smekal, D., Schlaepfer, P., Durovray, J. D., Plouhinec, V., Chiappa, C., Bellomo, R., Schneider, A. G., Mitchell, S., Durrant, J., Street, H., Dunthorne, E., Shears, J., Caballero, C. Hernandez, Hutchison, R., Schwarze, S., Ghabina, S., Thompson, E., Prowle, J. R., Kirwan, C. J., Gonzalez, C. A., Pinto, J. L., Orozco, V., Patiño, J. A., Garcia, P. K., Contreras, K. M., Rodriguez, P., Echeverri, J. E., GETGAG Working Group, JSEPTIC (Japanese Society of Education for Physicians and Trainees in Intensive Care) Clinical Trial Group, CAPCRI Study, for the ReVA Research Network and the PROVE Network Investigators, from the FROG ICU Investigators, The WIND study group, Plug Working Group, GETGAG/SEMICYUC, AKI Research Group, St George’s University of London, IPREA Study Group, FINNRESUSCI Study Group, PICS- HCPA: Programa Intrahospitalar de Combate à Sepse do Hospital de Clínicas de Porto Alegre, ENVIN-HELICS Study Group, ARIAM registry of adult cardiac surgery, The Rapid Diagnosis of Infections in the Critically Ill Team, Tokyo Womens Medical University, PLUG working group, PLUG Working Group, On behalf of Okayama Research Investigation Organizing Network (ORION)investigators, PS-ICU Group, Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group, Student Research Committee - Shiraz University of Medical Sciences, ARIAM-ANDALUCIA, The WIND study group, PLUG Working Group, The WIND study group, PLUG Working Group, and Plug working group
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- 2016
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3. Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center
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Feliciano, C.S., Nascimento, M.M.P., Anselmo, L.M.P., Pocente, R.H.C., Bellissimo-Rodrigues, F., and Bollela, V.R.
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- 2015
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4. The global hand-sanitizing relay: promoting hand hygiene through innovation
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Tartari, E., primary, Pires, D., additional, Bellissimo-Rodrigues, F., additional, De Kraker, M., additional, Borzykowski, T-H., additional, Allegranzi, B., additional, and Pittet, D., additional
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- 2017
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5. Role of parents in the promotion of hand hygiene in the paediatric setting: a systematic literature review
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Bellissimo-Rodrigues, F., primary, Pires, D., additional, Zingg, W., additional, and Pittet, D., additional
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- 2016
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6. Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment
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Auxiliadora-Martins, M., Alkmim-Teixeira, G.C., Machado-Viana, J., Nicolini, E.A., Martins-Filho, O.A., Bellissimo-Rodrigues, F., Carlotti Jr., C.G., and Basile-Filho, A.
- Subjects
ICU setting ,Meningoencephalitis ,Zygomycete ,Septic shock ,Status epilepticus - Abstract
Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39°C) lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus). Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.
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- 2010
7. Relationship between hand size, volume of alcohol-based handrub and time needed to dry hands. An experimental laboratory-based study
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Gayet-Ageron, A, primary, Bellissimo-Rodrigues, F, additional, Soule, H, additional, Martin, Y, additional, and Pittet, D, additional
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- 2015
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8. Evaluation of the efficacy of nasal application of silver sulfadiazine for decolonization of patients with methicillin-resistant Staphylococcus aureus in hospitals
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Ferreira, LR, primary, Menegueti, MG, additional, Gaspar, GG, additional, Silva, MFI, additional, David, G, additional, Anselmo, NM, additional, Gabriel, MJF, additional, Sakamoto, LM, additional, Martinez, R, additional, and Bellissimo-Rodrigues, F, additional
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- 2015
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9. Use of hand hygiene agents as a surrogate marker of compliance in hungarian long-term care facilities: first nationwide survey
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Szabó, R, primary, Morvai, J, additional, Bellissimo-Rodrigues, F, additional, and Pittet, D, additional
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- 2015
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10. The role of parents on hand hygiene promotion in the pediatric setting – a systematic review
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Bellissimo-Rodrigues, F, primary, Zingg, W, additional, and Pittet, D, additional
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- 2015
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11. Should alcohol-based handrub volume be customized according to the size of healthcare workers’ hands?
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Bellissimo-Rodrigues, F, primary, Soule, H, additional, Gayet-Ageron, A, additional, Martin, Y, additional, and Pittet, D, additional
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- 2015
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12. Train the trainers: replicating the message of hand hygiene promotion through the training of national experts, preliminary results
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Bellissimo-Rodrigues, F, primary, Agostinho, A, additional, and Pittet, D, additional
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- 2015
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13. Preventing central venous catheter-related bloodstream infections through implementation of a bundle intervention in the developing world: a quasi-experimental study
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Menegueti, MG, primary, Laus, AM, additional, Auxiliadora-Martins, M, additional, Gaspar, GG, additional, Ardison, KMM, additional, Martins-Filho, OA, additional, Basile-Filho, A, additional, and Bellissimo-Rodrigues, F, additional
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- 2015
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14. Controlling a VRE cluster on a surgical ward
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Bandiera-Clerc, C, primary, Coccault-Duverger, C, additional, Bellissimo-Rodrigues, F, additional, Albrecht, P, additional, Renzi, G, additional, Ris, F, additional, and Harbarth, S, additional
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- 2015
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15. Careful indication of the indwelling urinary catheter: impact on catheter-associated urinary tract infection rates
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Menegueti, MG, primary, Laus, AM, additional, Auxiliadora-Martins, M, additional, Gaspar, GG, additional, Puga, ML, additional, Feliciano, CA, additional, Basile-Filho, A, additional, and Bellissimo-Rodrigues, F, additional
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- 2015
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16. Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients
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Auxiliadora-Martins, M., primary, Menegueti, M.G., additional, Nicolini, E.A., additional, Alkmim-Teixeira, G.C., additional, Bellissimo-Rodrigues, F., additional, Martins-Filho, O.A., additional, and Basile-Filho, A., additional
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- 2012
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17. Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention
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Carmona, F., primary, Prado, S.I., additional, Silva, M.F.I., additional, Gaspar, G.G., additional, Bellissimo-Rodrigues, F., additional, Martinez, R., additional, Matsuno, A.K., additional, and Carlotti, A.P.C.P., additional
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- 2012
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18. Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment
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Auxiliadora-Martins, M., primary, Alkmim-Teixeira, G.C., additional, Machado-Viana, J., additional, Nicolini, E.A., additional, Martins-Filho, O.A., additional, Bellissimo-Rodrigues, F., additional, Carlotti Jr., C.G., additional, and Basile-Filho, A., additional
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- 2010
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19. ESICM LIVES 2016: part three : Milan, Italy. 1-5 October 2016
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Velasquez, T., Mackey, G., Lusk, J., Kyle, Ug, Fontenot, T., Marshall, P., Shekerdemian, Ls, Coss-Bu, Ja, Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, Jc, Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, Am, Ieperen, Sn, Kinderen, Ep, Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Akcan-Arikan, A., Silva, Jc, Goldsworthy, M., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano, Sm, Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, Ir, El Adawy, As, Mohammed, Hm, Mohamed, An, Parry, Sm, Knight, Ld, Denehy, L., Morton, N., Baldwin, Ce, Sani, D., Kayambu, G., Da Silva, Vz, Phongpagdi, P., Puthucheary, Za, Granger, Cl, Rydingsward, Je, Horkan, Cm, Christopher, Kb, Mcwilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, Lm, Rattray, J., Kenardy, J., Hull, Am, Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, Jc, Rocha, Ll, Freitas, Ff, Cavalheiro, Am, Lucinio, Nm, Lobato, Ms, Ebeling, G., Kraegpoeth, A., Laerkner, E., Brito-Ashurst, I., White, C., Gregory, S., Forni, Lg, Flowers, E., Curtis, A., Wood, Ca, Siu, K., Venkatesan, K., Muhammad, Jb, Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., Molina, Fj, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, Rm, Palencia, E., Jareño, A., Granada, Rm, Ignacio, Ml, Getgag, Working Group, Cui, N., Liu, D., Wang, H., Su, L., Qiu, H., Li, R., Jaffal, K., Rouzé, A., Poissy, J., Sendid, B., Nseir, S., Paramythiotou, E., Rizos, M., Frantzeskaki, F., Antoniadou, A., Vourli, S., Zerva, L., Armaganidis, A., Gottlieb, J., Greer, M., Wiesner, O., Martínez, M., Acuña, M., Rello, J., Welte, T., Mignot, T., Soussi, S., Dudoignon, E., Ferry, A., Chaussard, M., Benyamina, M., Alanio, A., Touratier, S., Chaouat, M., Lafaurie, M., Mimoun, M., Mebazaa, A., Legrand, M., Sheils, Ma, Patel, C., Mohankumar, L., Akhtar, N., Noriega, Sk, Aldana, Nn, León, Jl, Baquero, Jd, Bernal, Ff, Ahmadnia, E., Hadley, Js, Millar, M., Hall, D., Hewitt, H., Yasuda, H., Sanui, M., Komuro, T., Kawano, S., Andoh, K., Yamamoto, H., Noda, E., Hatakeyama, J., Saitou, N., Okamoto, H., Kobayashi, A., Takei, T., Matsukubo, S., Jseptic, Clinical Trial Group, Rotzel, Hb, Lázaro, As, Prada, Da, Gimillo, MR, Barinas, Od, Cortes, Ml, Franco, Jf, Roca, Jm, Carratalá, A., Gonçalves, B., Turon, R., Mendes, A., Miranda, F., Mata, Pj, Cavalcanti, D., Melo, N., Lacerda, P., Kurtz, P., Righy, C., Rosario, Le, Lesmes, Sp, Romero, Jc, Herrera, An, Pertuz, Ed, Sánchez, Mj, Sanz, Er, Hualde, Jb, Hernández, Aa, Irazabal, Jm, Spatenkova, V., Bradac, O., Suchomel, P., Urli, T., Lazzeri, Eh, Aspide, R., Zanello, M., Perez-Borrero, L., Garcia-Alvarez, Jm, Arias-Verdu, Md, Aguilar-Alonso, E., Rivera-Fernandez, R., Mora-Ordoñez, J., La Fuente-Martos, C., Castillo-Lorente, E., Guerrero-Lopez, F., Ramírez, Jr, León, Jp, Navarro-Guillamón, L., Cordovilla-Guardia, S., Iglesias-Santiago, A., Guerrero-López, F., Fernández-Mondéjar, E., Vidal, A., Perez, M., Juez, A., Arias, N., Colino, L., Perez, Jl, Pérez, H., Calpe, P., Alcala, Ma, Robaglia, D., Perez, C., Lan, Sk, Cunha, Mm, Moreira, T., Santos, F., Lafuente, E., Fernandes, Mj, Silva, Jg, Echeverría, Jg, 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L., Heunks, Lm, Chen, Gq, Sun, Xm, He, X., Yang, Yl, Shi, Zh, Xu, M., Zhou, Jx, Pereira, Sm, Tucci, MR, Tonelotto, Bf, Simoes, Cm, Morais, Cc, Pompeo, Ms, Kay, Fu, Amato, Mb, Vieira, Je, Suzuki, S., Mihara, Y., Hikasa, Y., Okahara, S., Morimatsu, H., Okayama Research Investigation Organizing Network (ORION)investigators, Kwon, Hm, Moon, Yj, Lee, Sh, Jung, Kw, Shin, Wj, Jun, Ig, Song, Jg, Hwang, Gs, Lee, S., Jung, K., Brianti, R., Fanzaghi, P., Tudor, Ba, Klaus, Da, Lebherz-Eichinger, D., Lechner, C., Schwarz, C., Bodingbauer, M., Seemann, R., Kaczirek, K., Fleischmann, E., Roth, Ga, Krenn, Cg, Malyshev, A., Sergey, S., Yoshitake, E., Kaneko, M., Tencé, N., Zaien, I., Wolf, M., Trouiller, P., Jacobs, Fm, Kelly, Jm, Veigas, P., Hollands, S., Min, A., Rizoli, S., Robles, Cm, Oca Sandoval, Ma, Tarabrin, O., Gavrychenko, D., Mazurenko, G., Tarabrin, P., Mendez, Mc, Orden, Va, Noval, Rl, Mccue, C., Gemmell, L., Luján, J., Villa, P., Llorente, B., Molina, R., Alcázar, L., Juanas, Ca, Rogero, S., Pascual, T., Cambronero, Ja, Almudévar, Pm, Domínguez, Jp, Castañeda, Dp, Lucendo, Ap, Rivas, Rf, Villamizar, Pr, Javadpour, S., Kalani, N., Amininejad, T., Jamali, S., Sobhanian, S., Laurent, A., Bonnet, M., Rigal, R., Aslanian, P., Hebert, P., Capellier, G., Ps-Icu, Group, Contreras, MR, Mejías, Cr, Ruiz, Fc, Lombardo, Md, Perez, Jc, Hoyos, Ea, Estella, A., Viciana, R., Fontaiña, Lp, Rico, T., Madueño, Vp, Recuerda, M., Fernández, L., Bonet, S., Mazo, C., Rubiera, M., Ruiz-Rodríguez, Jc, Gracia, Rm, Espinel, E., Pont, T., Kotsopoulos, A., Jansen, N., Abdo, Wf, Gopcevic, A., Gavranovic, Z., Vucic, M., Glogoski, Mz, Penavic, Lv, Horvat, A., Martin-Villen, L., Egea-Guerero, Jj, Revuelto-Rey, J., Aldabo-Pallas, T., Correa-Chamorro, E., Gallego-Corpa, Ai, Granados, Pr, Faivre, V., Wildenberg, L., Huot, B., Lukaszewicz, Ac, Simsir, M., Mengelle, C., Payen, D., La Fuente, Mv, Almudena, Pm, Muñoz, Jj, Abellan, An, Lucendo, Ma, Perez, Lp, Dominguez, Jp, Wee, S., Ong, C., Lau, Yh, Wong, Y., Olea-Jiménez, V., Mora-Ordóñez, Jm, Muñoz-Muñoz, Jl, Vallejo-Báez, J., Daga-Ruiz, D., Lebrón-Gallardo, M., Rialp, G., Raurich, Jm, Morán, I., Martín, Mc, Heras, G., Mas, A., Vallverdú, I., Hraiech, S., Bourenne, J., Guervilly, C., Forel, Jm, Adda, M., Sylla, P., Mouaci, A., Gainnier, M., Papazian, L., Bauer, Pr, Kumbamu, A., Wilson, Me, Pannu, Jk, Egginton, Js, Kashyap, R., Gajic, O., Yoshihiro, S., Sakuraya, M., Hirata, A., Kawamura, N., Tsutui, T., Yoshida, K., Hashimoto, Y., Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group, Chang, Ch, Hu, Hc, Chiu, Lc, Hung, Cy, Li, Sh, Kao, Kc, Sibley, S., Drover, J., D Arsigny, C., Parker, C., Howes, D., Moffatt, S., Erb, J., Ilan, R., Messenger, D., Ball, I., Harrison, M., Ridi, S., Andrade, Ah, Costa, Rc, Souza, Va, Gonzalez, V., Amorim, V., Rolla, F., Filho, Ca, Miranda, R., Atchasiri, S., Buranavanich, P., Wathanawatthu, T., Suwanpasu, S., Bureau, C., Rolland-Debord, C., Poitou, T., Clavel, M., Perbet, S., Kouatchet, A., Similowski, T., Demoule, A., Diaz, P., Nunes, J., Escórcio, S., Silva, G., Chaves, S., Jardim, M., Câmara, M., Fernandes, N., Duarte, R., Jardim, Jj, Pereira, Ca, Nóbrega, Jj, Chen, Cm, Lai, Cc, Cheng, Kc, Chou, W., Lee, Sj, Cha, Ys, Lee, Wy, Onodera, M., Nakataki, E., Oto, J., Imanaka, H., Nishimura, M., Khadjibaev, A., Sabirov, D., Rosstalnaya, A., Akalaev, R., Parpibaev, F., Antonucci, E., Rossini, P., Gandolfi, S., Montini, E., Orlando, S., Nes, M., Karachi, F., Hanekom, S., Pereira, Uv, Parkin, Ms, Moore, M., Carvalho, Kv, Min, Hj, Kim, Hj, Choi, Yy, Lee, Ey, Song, I., Kim, Dj, E, Yy, Kim, Jw, Park, Js, Lee, Jh, Suh, Jw, Jo, Yh, Ferrero-Calleja, J., Merino-Vega, D., González-Jiménez, Ai, Sigcha, Ms, Hernández-Tejedor, A., Martin-Vivas, A., Gabán-Díez, Á, Luna, Rr, La Calle-Pedrosa, N., Temprano-Gómez, I., Afonso-Rivero, D., Pellin-Ariño, Ji, Algora-Weber, A., Fumis, Rr, Ferraz, Ab, Junior, Jm, Kirca, H., Cakin, O., Unal, M., Mutlu, H., Ramazanoglu, A., Cengiz, M., Nicolini, Ea, Pelisson, Fg, Nunes, Rs, Da Silva, Sl, Carreira, Mm, Bellissimo-Rodrigues, F., Ferez, Ma, Basile-Filho, A., Chao, Hc, Chen, L., Hravnak, M., Clermont, G., Pinsky, M., Dubrawski, A., Varas, Jl, Montero, Rm, Sánchez-Elvira, La, Díaz, Pv, Delgado, Cp, Ruiz, Bl, Guerrero, Ap, Galache, Ja, Sherif, H., Hassanin, H., El Hossainy, R., Samy, W., Ly, H., David, H., Burtin, P., Charpentier, C., Barral, M., Courant, P., Fournel, E., Gaide-Chevronnay, L., Durand, M., Albaladejo, P., Payen, Jf, Chavanon, O., Ortiz, Ab, Pozzebon, S., Fumagalli, F., Scala, S., Affatato, R., Maglie, M., Zani, D., Novelli, D., Marra, C., Luciani, A., Luini, M., Letizia, T., Pravettoni, D., Staszewsky, L., Belloli, A., Di Giancamillo, M., Scanziani, E., Kye, Yc, Yu, Km, Babini, G., Grassi, L., Reinikainen, M., Skrifvars, M., Kappler, F., Blobner, M., Schaller, Sj, Roasio, A., Costanzo, E., Cardellino, S., Fontana, V., Park, M., You, Km, Ko, Sb, Beane, A., Thilakasiri, Mc, Silva, Ap, Stephens, T., Sigera, Cs, Athapattu, P., Jayasinghe, S., Padeniya, A., Haniffa, R., Sáez, Vc, Ruiz-Ruano, Rdel, González, As, Kunze-Szikszay, N., Wand, S., Klapsing, P., Wetz, A., Heyne, T., Schwerdtfeger, K., Troeltzsch, M., Bauer, M., Quintel, M., Moerer, O., Cook, Dj, Rutherford, Wb, Scales, Dc, Adhikari, Nk, Cuthbertson, Bh, Suzuki, T., Fushimi, K., Iwamoto, M., Nakagawa, S., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, Mw, Romero, Dg, Padilla, Ys, Kleinpell, R., Chouris, I., Radu, V., Stougianni, M., Lavrentieva, A., Lagonidis, D., Price, Rd, Day, A., Arora, N., Henderson, Ma, Hickey, S., Costa, Mi, Carvalho, Jp, Gomes, Aa, Mergulhão, Pj, Chan, Kk, Maghsoudi, B., Tabei, Sh, Sabetian, G., Tabatabaei, Hr, Akbarzadeh, A., Student Research Committee - Shiraz University of Medical Sciences, Saigal, S., Pakhare, A., Joshi, R., Pattnaik, Sk, Ray, B., Rousseau, Af, Michel, L., Bawin, M., Cavalier, E., Reginster, Jy, Damas, P., Bruyere, O., Zhou, Jc, Cauwenberghs, H., Backer, A., Neels, H., Deblier, I., 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C., Alvarez, J., La Torre, Ma, Torres, E., Bogossian, E., Nouer, Sa, Salgado, Dr, Jiménez, Gj, Gaite, Fb, Martínez, Mp, Doganci, M., Izdes, S., Besevli, Sg, Alkan, A., Kayaaslan, B., Penichet, Sm, López, Ma, Repessé, X., Artiguenave, M., Paktoris-Papine, S., Espinasse, F., Dinh, A., El Sayed, F., Charron, C., Géri, G., Vieillard-Baron, A., Dimitroulakis, K., Ferré, A., Guillot, M., Teboul, Jl, Lichtenstein, D., Mézière, G., Richard, C., Monnet, X., Prīdāne, S., Sabeļņikovs, O., Bianchi, I., Kondili, E., Psarologakis, C., Kokkini, S., Amargianitakis, V., Babalis, D., Chytas, A., Chouvarda, I., Vaporidi, K., Georgopoulos, D., Trapp, O., Kalenka, A., Karbing, Ds, Gioia, A., Moro, F., Corte, Fd, Mauri, T., Rees, Se, Plug working group, Petrova, Mv, Mohan, R., Butrov, Av, Beeharry, Sd, Vatsik, Mv, Sakieva, Fi, Gobert, F., Fernandez, R., Labaune, Ma, Burle, Jf, Barbier, J., Vincent, B., Cleyet, M., Shinotsuka, Cr, Törnblom, S., Nisula, S., Vaara, S., Poukkanen, M., Andersson, S., Pesonen, E., Xie, Z., Liao, X., Kang, Y., Zhang, J., Kubota, K., Egi, M., Mizobuchi, S., Hegazy, S., El-Keraie, A., El Sayed, E., El Hamid, Ma, Rodrigues, Nj, Pereira, M., Godinho, I., Gameiro, J., Neves, M., Gouveia, J., E Silva, Zc, Lopes, Ja, Mckinlay, J., Kostalas, M., Kooner, G., Dudas, G., Horton, A., Kerr, C., Karanjia, N., Creagh-Brown, B., Yamazaki, A., Ganuza, Ms, Molina, Ja, Martinez, Fh, Freile, Mt, Fernandez, Ng, Travieso, Pm, Bandert, A., Frithiof, R., Lipcsey, M., Smekal, D., Schlaepfer, P., Durovray, Jd, Plouhinec, V., Chiappa, C., Bellomo, R., Schneider, Ag, Mitchell, S., Durrant, J., Street, H., Dunthorne, E., Shears, J., Caballero, Ch, Hutchison, R., Schwarze, S., Ghabina, S., Thompson, E., Prowle, Jr, Kirwan, Cj, Gonzalez, Ca, Pinto, Jl, Orozco, V., Patiño, Ja, Garcia, Pk, Contreras, Km, Rodriguez, P., and Echeverri, Je
20. A research agenda for primary health care in the state of Sao Paulo, Brazil: The elect study,Uma agenda de pesquisa para a Atenção Primária à Saúde no estado de São Paulo, Brasil: O estudo ELECT,Una agenda de investigación para la Atención Primaria de Salud en el estado de Sao Paulo, Brasil: El estudio ELECT
- Author
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Orlandin, E. A. S., Moscovici, L., Franzon, A. C. A., Passos, A. D. C., Dal Fabbro, A. L., Vieira, E. M., Bellissimo-Rodrigues, F., Gusso, G. D. F., Ferreira, J. B. B., Marques, J. M. A., Ribeiro, L. C., Dos Santos, L. L., Marcelo Demarzo, Fontão, P. C. N., and Souza, J. P.
21. ESICM LIVES 2016: part three
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Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Akcan-Arikan, A., Silva, J. C., Goldsworthy, M., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. G., Flowers, E., Curtis, A., Wood, C. A., Siu, K., Venkatesan, K., Muhammad, J. B. H., Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., de Molina, F. J. González, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, R. M., Palencia, E., Jareño, A., Granada, R. M., Ignacio, M. L., Cui, N., Liu, D., Wang, H., Su, L., Qiu, H., Li, R., Jaffal, K., Rouzé, A., Poissy, J., Sendid, B., Nseir, S., Paramythiotou, E., Rizos, M., Frantzeskaki, F., Antoniadou, A., Vourli, S., Zerva, L., Armaganidis, A., Gottlieb, J., Greer, M., Wiesner, O., Martínez, M., Acuña, M., Rello, J., Welte, T., Mignot, T., Soussi, S., Dudoignon, E., Ferry, A., Chaussard, M., Benyamina, M., Alanio, A., Touratier, S., Chaouat, M., Lafaurie, M., Mimoun, M., Mebazaa, A., Legrand, M., Sheils, M. A., Patel, C., Mohankumar, L., Akhtar, N., Noriega, S. K. Pacheco, Aldana, N. Navarrete, León, J. L. Ávila, Baquero, J. Durand, Bernal, F. Fernández, Ahmadnia, E., Hadley, J. S., Millar, M., Hall, D., Hewitt, H., Yasuda, H., Sanui, M., Komuro, T., Kawano, S., Andoh, K., Yamamoto, H., Noda, E., Hatakeyama, J., Saitou, N., Okamoto, H., Kobayashi, A., Takei, T., Matsukubo, S., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Gimillo, M. Rodriguez, Barinas, O. Diaz, Cortes, M. L. Blasco, Franco, J. 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K., Cunha, M. M., Moreira, T., Santos, F., Lafuente, E., Fernandes, M. J., Silva, J. G., Echeverría, J. G. Armando, Podlepich, V., Sokolova, E., Alexandrova, E., Lapteva, K., Shuinotsuka, C., Rabello, L., Vianna, G., Reis, A., Cairus, C., Salluh, J., Bozza, F., Torres, J. C. Barrios, Araujo, N. J. Fernández, García-Olivares, P., Keough, E., Dalorzo, M., Tang, L. K., De Sousa, I., Díaz, M., Marcos-Zambrano, L. J., Guerrero, J. E., Gomez, S. E. Zamora, Lopez, G. D. Hernandez, Cuellar, A. I. Vazquez, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Bhasin, D., Rai, S., Singh, H., Gupta, O., Bhattal, M. K., Sampley, S., Sekhri, K., Nandha, R., Aliaga, F. A., Olivares, F., Appiani, F., Farias, P., Alberto, F., Hernández, A., Pons, S., Sonneville, R., Bouadma, L., Neuville, M., Mariotte, E., Radjou, A., Lebut, J., Chemam, S., Voiriot, G., Dilly, M. P., Mourvillier, B., Dorent, R., Nataf, P., Wolff, M., Timsit, J. 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Leal, McCue, C., Gemmell, L., Luján, J., Villa, P., Llorente, B., Molina, R., Alcázar, L., Juanas, C. Arenillas, Rogero, S., Pascual, T., Cambronero, J. A., Almudévar, P. Matía, Domínguez, J. Palamidessi, Carmona, S. Alcántara, Castañeda, D. Palacios, Lucendo, A. Pérez, Rivas, R. Fernández, Villamizar, P. Rodríguez, Javadpour, S., Kalani, N., Amininejad, T., Jamali, S., Sobhanian, S., Laurent, A., Bonnet, M., Rigal, R., Aslanian, P., Hebert, P., Capellier, G., Contreras, M. R. Diaz, Mejías, C. Rodriguez, Ruiz, F. C. Santiago, Lombardo, M. Duro, Perez, J. Castaño, de Hoyos, E. Aguayo, Estella, A., Viciana, R., Fontaiña, L. Perez, Rico, T., Madueño, V. Perez, Recuerda, M., Fernández, L., Bonet, S., Mazo, C., Rubiera, M., Ruiz-Rodríguez, J. C., Gracia, R. M., Espinel, E., Pont, T., Kotsopoulos, A., Jansen, N., Abdo, W. F., Gopcevic, A., Gavranovic, Z., Vucic, M., Glogoski, M. Zlatic, Penavic, L. Videc, Horvat, A., Martin-Villen, L., Egea-Guerero, J. J., Revuelto-Rey, J., Aldabo-Pallas, T., Correa-Chamorro, E., Gallego-Corpa, A. I., Granados, P. Ruiz del Portal-Ruiz, Faivre, V., Wildenberg, L., Huot, B., Lukaszewicz, A. C., Simsir, M., Mengelle, C., Payen, D., Sanz, N. Martinez, de la Fuente, M. Valdivia, Almudena, P. Matía, Abellán, A. Navarro, Muñoz, J. J. Rubio, Abellan, A. Naharro, Lucendo, M. A. Perez, Perez, L. Perez, Dominguez, J. Palamidessi, Rivas, R. Fernandez, Villamizar, P. Rodriguez, Wee, S., Ong, C., Lau, Y. H., Wong, Y., Olea-Jiménez, V., Mora-Ordóñez, J. M., Muñoz-Muñoz, J. L., Vallejo-Báez, J., Daga-Ruiz, D., Lebrón-Gallardo, M., Rialp, G., Raurich, J. M., Morán, I., Martín, M. C., Heras, G., Mas, A., Vallverdú, I., Hraiech, S., Bourenne, J., Guervilly, C., Forel, J. M., Adda, M., Sylla, P., Mouaci, A., Gainnier, M., Papazian, L., Bauer, P. R., Kumbamu, A., Wilson, M. E., Pannu, J. K., Egginton, J. S., Kashyap, R., Gajic, O., Yoshihiro, S., Sakuraya, M., Hirata, A., Kawamura, N., Tsutui, T., Yoshida, K., Hashimoto, Y., Chang, C. H., Hu, H. C., Chiu, L. C., Hung, C. Y., Li, S. H., Kao, K. C., Sibley, S., Drover, J., D’Arsigny, C., Parker, C., Howes, D., Moffatt, S., Erb, J., Ilan, R., Messenger, D., Ball, I., Harrison, M., Ridi, S., Andrade, A. H., Costa, R. C., Souza, V. A., Gonzalez, V., Amorim, V., Rolla, F., Filho, C. A. C. Abreu, Miranda, R., Atchasiri, S., Buranavanich, P., Wathanawatthu, T., Suwanpasu, S., Bureau, C., Rolland-Debord, C., Poitou, T., Clavel, M., Perbet, S., Kouatchet, A., Similowski, T., Demoule, A., Diaz, P., Nunes, J., Escórcio, S., Silva, G., Chaves, S., Jardim, M., Câmara, M., Fernandes, N., Duarte, R., Jardim, J. J., Pereira, C. A., Nóbrega, J. J., Chen, C. M., Lai, C. C., Cheng, K. C., Chou, W., Lee, S. J., Cha, Y. S., Lee, W. Y., Onodera, M., Nakataki, E., Oto, J., Imanaka, H., Nishimura, M., Khadjibaev, A., Sabirov, D., Rosstalnaya, A., Akalaev, R., Parpibaev, F., Antonucci, E., Rossini, P., Gandolfi, S., Montini, E., Orlando, S., van Nes, M., Karachi, F., Hanekom, S., Pereira, U. V., Parkin, M. S. W., Moore, M., Carvalho, K. V. Silva, Min, H. J., Kim, H. J., Choi, Y. Y., Lee, E. Y., Song, I., Kim, D. J., E, Y. Y., Kim, J. W., Park, J. S., Lee, J. H., Suh, J. W., Jo, Y. H., Ferrero-Calleja, J., Merino-Vega, D., González-Jiménez, A. I., Sigcha, M. Sigcha, Hernández-Tejedor, A., Martin-Vivas, A., Gabán-Díez, Á., Luna, R. Ruiz-de, De la Calle-Pedrosa, N., Temprano-Gómez, I., Afonso-Rivero, D., Pellin-Ariño, J. I., Algora-Weber, A., Fumis, R. R. L., Ferraz, A. B., Junior, J. M. Vieira, Kirca, H., Cakin, O., Unal, M., Mutlu, H., Ramazanoglu, A., Cengiz, M., Nicolini, E. A., Pelisson, F. G. F., Nunes, R. S., da Silva, S. L., Carreira, M. M., Bellissimo-Rodrigues, F., Ferez, M. A., Basile-Filho, A., Chao, H. C., Chen, L., Hravnak, M., Clermont, G., Pinsky, M., Dubrawski, A., Varas, J. Luján, Montero, R. Molina, Sánchez-Elvira, L. Alcázar, Díaz, P. Villa, Delgado, C. Pintado, Ruiz, B. Llorente, Guerrero, A. Pardo, Galache, J. A. Cambronero, Sherif, H., Hassanin, H., El Hossainy, R., Samy, W., Ly, H., David, H., Burtin, P., Charpentier, C., Barral, M., Courant, P., Fournel, E., Gaide-Chevronnay, L., Durand, M., Albaladejo, P., Payen, J. F., Chavanon, O., Ortiz, A. Blandino, Pozzebon, S., Fumagalli, F., Scala, S., Affatato, R., De Maglie, M., Zani, D., Novelli, D., Marra, C., Luciani, A., De Zani, D., Luini, M., Letizia, T., Pravettoni, D., Staszewsky, L., Belloli, A., Di Giancamillo, M., Scanziani, E., Kye, Y. C., Yu, K. M., Babini, G., Grassi, L., Reinikainen, M., Skrifvars, M., Kappler, F., Blobner, M., Schaller, S. J., Roasio, A., Costanzo, E., Cardellino, S., Fontana, V., Park, M., You, K. M., Ko, S. B., Beane, A., Thilakasiri, M. C. K. T., De Silva, A. P., Stephens, T., Sigera, C. S., Athapattu, P., Jayasinghe, S., Padeniya, A., Haniffa, R., Sáez, V. Chica, Ruiz-Ruano, R. de la Chica, González, A. Sánchez, Kunze-Szikszay, N., Wand, S., Klapsing, P., Wetz, A., Heyne, T., Schwerdtfeger, K., Troeltzsch, M., Bauer, M., Quintel, M., Moerer, O., Cook, D. J., Rutherford, W. B., Scales, D. C., Adhikari, N. K., Cuthbertson, B. H., Suzuki, T., Fushimi, K., Iwamoto, M., Nakagawa, S., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M. W., Romero, D. González, Padilla, Y. Santana, Kleinpell, R., Chouris, I., Radu, V., Stougianni, M., Lavrentieva, A., Lagonidis, D., Price, R. D. T., Day, A., Arora, N., Henderson, M. A., Hickey, S., Costa, M. I. Almeida, Carvalho, J. P., Gomes, A. A., Mergulhão, P. J., Chan, K. K. C., Maghsoudi, B., Tabei, S. H., Sabetian, G., Tabatabaei, H. R., Akbarzadeh, A., Saigal, S., Pakhare, A., Joshi, R., Pattnaik, S. K., Ray, B., Rousseau, A. F., Michel, L., Bawin, M., Cavalier, E., Reginster, J. Y., Damas, P., Bruyere, O., Zhou, J. C., Cauwenberghs, H., De Backer, A., Neels, H., Deblier, I., Berghmans, J., Himpe, D., Barea-Mendoza, J. A., Portillo, I. Prieto, Fernández, M. Valiente, Gigorro, R. Garcia, Vela, J. L. Perez, Mateos, H. Marín, Alves, S. Chacón, Varas, G. Morales, Rodriguez-Biendicho, A., Carreño, E. Renes, González, J. C. Montejo, Yang, J. S., Lin, K. L., Choi, Y. J., Yoon, S. Z., Gordillo-Brenes, A., Fernandez-Zamora, M. D., Herruzo-Aviles, A., Garcia-Delgado, M., Hinojosa-Perez, R., Pascual, O. Agudo, Irazabal, J. M. Guergue, Pérez, A. González, Fernández, P. Alvarez, Amor, L. Lopéz, Albaiceta, G. Muñiz, Calvo, S. Aldunate, Spazzadeschi, A., Marrazzo, F., Gandola, A., Sciurti, R., Savi, C., Tseng, C. J., Bertini, P., De Sanctis, F., Guarracino, F., Baldassarri, R., Buitinck, S. H., van der Voort, P. H. J., Tsunano, Y., Izawa, M., Tane, N., Ghosh, S., Gupta, A., De Gasperi, A., Mazza, E., Limuti, R., Prosperi, M., Bissenova, N., Yergaliyeva, A., Talan, L., Yılmaz, G., Güven, G., Yoruk, F., Altıntas, N. D., Mukherjee, D. N., Agarwal, L. K., Mandal, K., Balsera, B., Martinez, M., Garcia, M., Castellana, D., Lopez, R., Barcenilla, F., Kaminsky, G. E., Carreño, R., Escribá, A., Fuentes, M., Gálvez, V., Del Olmo, R., Nieto, B., Vaquerizo, C., Alvarez, J., De la Torre, M. A., Torres, E., Bogossian, E., Nouer, S. Aranha, Salgado, D. Ribeiro, Jiménez, G. Jiménez, Vidal, M. Vallverdú, Gaite, F. Barcenilla, Martínez, M. Palomar, Doganci, M., Izdes, S., Besevli, S. Guzeldag, Alkan, A., Kayaaslan, B., Penichet, S. M. Marrero, López, M. A. De La Cal, Santana, S. Ruíz, Repessé, X., Artiguenave, M., Paktoris-Papine, S., Espinasse, F., Dinh, A., El Sayed, F., Charron, C., Géri, G., Vieillard-Baron, A., Dimitroulakis, K., Ferré, A., Guillot, M., Teboul, J. L., Lichtenstein, D., Mézière, G., Richard, C., Monnet, X., Prīdāne, S., Sabeļņikovs, O., Bianchi, I., Kondili, E., Psarologakis, C., Kokkini, S., Amargianitakis, V., Babalis, D., Chytas, A., Chouvarda, I., Vaporidi, K., Georgopoulos, D., Trapp, O., Kalenka, A., Karbing, D. S., Gioia, A., Moro, F., Corte, F. Dalla, Mauri, T., Rees, S. E., Petrova, M. V., Mohan, R., Butrov, A. V., Beeharry, S. D., Vatsik, M. V., Sakieva, F. I., Gobert, F., Fernandez, R., Labaune, M. A., Burle, J. F., Barbier, J., Vincent, B., Cleyet, M., Shinotsuka, C. Righy, Törnblom, S., Nisula, S., Vaara, S., Poukkanen, M., Andersson, S., Pesonen, E., Xie, Z., Liao, X., Kang, Y., Zhang, J., Kubota, K., Egi, M., Mizobuchi, S., Hegazy, S., El-Keraie, A., El Sayed, E., El Hamid, M. Abd, Rodrigues, N. J., Pereira, M., Godinho, I., Gameiro, J., Neves, M., Gouveia, J., e Silva, Z. Costa, Lopes, J. A., Mckinlay, J., Kostalas, M., Kooner, G., Dudas, G., Horton, A., Kerr, C., Karanjia, N., Creagh-Brown, B., Yamazaki, A., Ganuza, M. Sanz, Molina, J. A. Martinez, Martinez, F. Hidalgo, Freile, M. T. Chiquito, Fernandez, N. Garcia, Travieso, P. Medrano, Bandert, A., Frithiof, R., Lipcsey, M., Smekal, D., Schlaepfer, P., Durovray, J. D., Plouhinec, V., Chiappa, C., Bellomo, R., Schneider, A. G., Mitchell, S., Durrant, J., Street, H., Dunthorne, E., Shears, J., Caballero, C. Hernandez, Hutchison, R., Schwarze, S., Ghabina, S., Thompson, E., Prowle, J. R., Kirwan, C. J., Gonzalez, C. A., Pinto, J. L., Orozco, V., Patiño, J. A., Garcia, P. K., Contreras, K. M., Rodriguez, P., and Echeverri, J. E.
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Meeting Abstracts - Full Text
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22. Evaluation of the adherence to surgical antibiotic prophylaxis recommendations and associated factors in a University Hospital: A cross-sectional study.
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Pereira LB, Feliciano CS, Bellissimo-Rodrigues F, and Pereira LRL
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- Humans, Cross-Sectional Studies, Male, Female, Middle Aged, Aged, Adult, Aged, 80 and over, Young Adult, Adolescent, Antibiotic Prophylaxis statistics & numerical data, Antibiotic Prophylaxis methods, Antibiotic Prophylaxis standards, Guideline Adherence statistics & numerical data, Hospitals, University, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Surgical Wound Infection prevention & control
- Abstract
Background: Surgical antibiotic prophylaxis (SAP) is an important preventive measure, aiming to minimize surgical site infections. However, despite evidence-based guidelines, adherence to SAP protocols remains suboptimal in clinical practice. The aim of this study was to assess the adequacy of SAP in a high-complexity hospital and investigate associated factors., Methods: A cross-sectional design was conducted, involving surgeries performed by expert teams in cardiology, urology, neurology, and gastrointestinal. SAP prescriptions were evaluated based on indication, antibiotic choice, dosage, and duration, according to the hospital protocol. Data analysis included descriptive statistics and association tests between protocol adherence and patient demographics, clinical variables, surgical teams, and types of surgeries., Results: Out of 1,864 surgeries, only 20.7% adhered to SAP protocols. Lower adherence rates were observed for antibiotic choice and duration of prophylaxis. Neurological surgeries exhibited significantly lower adherence, particularly concerning antibiotic choice and duration. Factors associated with nonadherence included elevated preoperative blood glucose levels, prolonged hospitalization, and extended surgical duration. Logistic regression analysis identified surgical teams as significant factors influencing protocol adherence., Conclusions: Despite the relatively high adherence to antibiotic dosage, challenges persist in antibiotic choice and duration adjustment. Poor glycemic control, prolonged surgery, and surgical teams were variables associated with inappropriate practice., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2024
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23. Methylene blue therapy in addition to standard treatment for acute-phase septic shock: a pilot randomized controlled trial.
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Luis-Silva F, Menegueti MG, Peres LM, Sepeda CDR, Jordani MC, Mestriner F, Petroski-Moraes BC, Brito-de-Sousa JP, Costa-Rocha IA, Cruz BL, Donadel MD, de Souza FB, Reis GHM, Bellissimo-Rodrigues F, Basile-Filho A, Becari C, Evora PRB, Martins-Filho OA, and Auxiliadora-Martins M
- Abstract
Purpose: Methylene blue (MB) has been used to increase blood pressure in patients with septic shock by acting on guanylate cyclase and nitric oxide synthase., Objective: To determine whether the administration of MB to patients in the initial phase of septic shock leads to a reduction in the use of vasopressors compared to the Control group., Methods: This was a 1:1 randomized clinical trial of two groups (MB and Control). Forty-two patients were included in the present study; 23 patients were allocated to the Control group, and 19 were randomized to the MB group. Both groups had access to standard treatment, consisting of fluid replacement, vasopressors, and antibiotic therapy. Patients received a loading dose of MB (3 mg/kg) and maintenance (0.5 mg/kg/h) for 48 h. Vasopressor doses, laboratory test results, inflammatory and anti-inflammatory cytokine levels, and hemodynamic monitoring were recorded before the infusion of MB (T1) and after 20 min (T2), 2 h (T3), 24 h (T4), 48 h after the infusion started (T5) and 24 h after weaning (T6)., Results: MB therapy was started together with the indication of vasopressin (VAS) as a second vasopressor. The MB group showed an immediate reduction in NOR dosage, an earlier reduction in VAS dosage, and higher IL-10 levels compared to the Control group., Conclusion: Early administration of MB in combination with standard treatment for septic shock might be reduce vasopressors dose. Continuous infusion of MB for 48 h was considered safe and there was no adverse events. These results highlight the potential of MB as a safe adjuvant therapeutic option in the treatment of septic shock., Clinical Trial Registration: https://clinicaltrials.gov/, identifier RBR-96584w4., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Luis-Silva, Menegueti, Peres, Sepeda, Jordani, Mestriner, Petroski-Moraes, Brito-de-Sousa, Costa-Rocha, Cruz, Donadel, de Souza, Reis, Bellissimo-Rodrigues, Basile-Filho, Becari, Evora, Martins-Filho and Auxiliadora-Martins.)
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- 2024
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24. In Vitro Synergistic Activity of Rifampicin Combined with Minimal Effective Antibiotic Concentration (MEAC) of Polymyxin B Against Extensively Drug-Resistant, Carbapenem-, and Polymyxin B-Resistant Klebsiella pneumoniae Clinical Isolates.
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Abichabki N, Gaspar GG, Zacharias LV, Pocente RHC, Lima DAFS, de Freitas NAB, Brancini GTP, Moreira NC, Braga GÚL, Bellissimo-Rodrigues F, Bollela VR, Darini ALC, and Andrade LN
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- Humans, Klebsiella Infections microbiology, Klebsiella Infections drug therapy, Polymyxin B pharmacology, Rifampin pharmacology, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae genetics, Microbial Sensitivity Tests, Anti-Bacterial Agents pharmacology, Drug Synergism, Carbapenems pharmacology, Drug Resistance, Multiple, Bacterial
- Abstract
We investigated the in vitro antibacterial activity of the combination rifampicin (RIF) + polymyxin B (PB) against extensively drug-resistant (XDR) Klebsiella pneumoniae isolates. We evaluated clinical isolates co-resistant to PB (non-mcr carriers; eptB, mgrB, pmr operon, and ramA mutations) and to carbapenems (KPC, CTX-M, and SHV producers; including KPC + NDM co-producer), belonging to sequence types (ST) ST16, ST11, ST258, ST340, and ST437. We used the standard broth microdilution method to determine RIF and PB minimum inhibitory concentration (MIC) and the checkerboard assay to evaluate the fractional inhibitory concentration index (FICI) of RIF + PB as well as to investigate the lowest concentrations of RIF and PB that combined (RIF + PB) had antibacterial activity. Time-kill assays were performed to evaluate the synergistic effect of the combination against selected isolates. PB MIC (32-256 µg/mL) and RIF MIC (32-1024 µg/mL) were determined. FICI (<0.5) indicated a synergistic effect for all isolates evaluated for the combination RIF + PB. Our results showed that low concentrations of PB (PB minimal effective antibiotic concentration [MEAC], ≤0.25-1 µg/mL) favor RIF (≤0.03-0.125 µg/mL) to reach the bacterial target and exert antibacterial activity against PB-resistant isolates, and the synergistic effect was also observed in time-kill results. The combination of RIF + PB showed in vitro antibacterial activity against XDR, carbapenem-, and PB-resistant K. pneumoniae and could be further studied as a potential combination therapy, with cost-effectiveness and promising efficacy., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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25. How Mild Is the Mild Long COVID? A Comprehensive Neuropsychological Assessment of Patients with Cognitive Complaints.
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Lopes-Santos LE, de Lacerda Ferreira D, de Angelis G, Foss MP, Trevisan AC, de Lacerda KJCC, Tumas V, Bellissimo-Rodrigues F, and Wichert-Ana L
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The global impact of the Coronavirus Disease (COVID-19) pandemic has extended beyond physical health, leading to widespread mental health issues. Beyond respiratory symptoms, there is a growing concern about long-term cognitive effects, particularly in individuals who experienced mild cases of the infection. We aimed to investigate the neuropsychological aspects of long-term COVID-19 in non-hospitalized adults compared with a control group. This cross-sectional study included 42 participants, 22 individuals with a history of mild COVID, and 20 healthy controls. The participants were recruited from the community and underwent a comprehensive neuropsychological assessment. Participants from the mild COVID group reported cognitive symptoms persisting for an average of 203.86 days and presented a higher frequency of psychological treatment history (81.8%) compared with the control group (25.0%). History of anxiety disorders was more prevalent in the mild COVID group (63.6%) than in the control group (20.0%). Significant reductions in verbal working memory were observed in the mild COVID group. Levels of anxiety were found to have a significant impact on difficulties with visual recognition memory. This study reveals important neuropsychological alterations in individuals following mild COVID-19, emphasizing executive functions deficits. Our findings underscore the persistence of these deficits even in non-hospitalized cases, suggesting potential inflammatory mechanisms in the central nervous system. The study highlights the need for comprehensive assessments and targeted interventions to address the diverse cognitive impacts on individuals recovering from COVID-19., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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26. Risk factors and mortality of candidemia in a children's public hospital in Sao Paulo, Brazil.
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Groisman Sieben R, Paternina-de la Ossa R, Waack A, Casale Aragon D, Bellissimo-Rodrigues F, Israel do Prado S, and Celia Cervi M
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- Humans, Brazil epidemiology, Risk Factors, Retrospective Studies, Child, Preschool, Infant, Child, Male, Female, Incidence, Cross-Sectional Studies, Adolescent, Infant, Newborn, Shock, Septic mortality, Shock, Septic epidemiology, Shock, Septic microbiology, Candida isolation & purification, Candidemia epidemiology, Candidemia mortality, Candidemia microbiology, Hospitals, Public statistics & numerical data, Hospitals, Pediatric statistics & numerical data
- Abstract
Candida bloodstream infections in children are of special concern in neonatal and pediatric intensive care and patients with comorbidities. This study aimed to estimate the incidence and risk factors associated with mortality in candidemia cases occurring in a public children's hospital in Ribeirao Preto, Brazil. It is a retrospective transversal study. Every patient under the age of 18 admitted to the study facility from January 1, 2013, to December 31, 2019, was considered potentially eligible to be included if they had candidemia. We collected clinical data from medical records. We included 113 blood cultures yielding positive results for Candida. The incidence rate was 2.12 per 1000 admissions. The most common Candida species was Candida parapsilosis. Septic shock during the candidemia episode was the only clinical outcome associated with a relative risk-adjusted (RRa) of 2.77 with an interval >1 (1.12-6.85). Our findings show that the incidence rate and mortality rates of candidemia are in line with those in other children's services in Brazil. We found a global mortality rate of 28.31% (32/113) from candidemia episodes. We highlight the predominance of non-albicans Candida species including C. parapsilosis. Septic shock was the most important factor showing a significant risk of mortality., (Copyright © 2024 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2024
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27. Extrahepatic cholestasis associated with paracoccidioidomycosis: Challenges in the differential diagnosis of biliopancreatic neoplasia.
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Dos Santos JS, de Moura Arrais V, Rosseto Ferreira WJ, Ribeiro Correa Filho R, Brunaldi MO, Kemp R, Sankanrakutty AK, Elias Junior J, Bellissimo-Rodrigues F, Martinez R, Zangiacomi Martinez E, and Ardengh JC
- Abstract
Background: Paracoccidioidomycosis (PCM) may involve the hepatic pedicle and peripancreatic lymph nodes, cause damage to the bile duct and manifest, exceptionally, in combination with extrahepatic cholestasis (EHC), making investigation and treatment challenging., Aim: To investigate the management of patients with visceral PCM admitted with EHC., Methods: All patients diagnosed with PCM treated in a public, tertiary teaching hospital between 1982 and 2020 were retrospectively evaluated. Those also identified with EHC were allocated to two groups according to the treatment approach for the purpose of comparing clinical, laboratory, and imaging findings, resources used for etiological diagnosis, treatment results, and prognosis. Statistical analyses were performed using the linear mixed-effects model (random and fixed effects), which was adjusted using the PROC MIXED procedure of the SAS
® 9.0 software, and Fisher's exact test., Results: Of 1645 patients diagnosed with PCM, 40 (2.4%) had EHC. Of these, 20 (50.0%) lived in the rural area and 29 (72.5%) were men, with a mean age of 27.1 years (3-65 years). Jaundice as first symptom and weight loss of at least 10 kg were observed in 16 patients (40.0%), and a mass in the head of the pancreas was observed in 8 (20.0%). The etiological diagnosis was made by tissue collection during surgery in 4 cases (10.0%) and by endoscopic methods in 3 cases (7.5%). Twenty-seven patients (67.5%) received drug treatment alone (Group 1), whereas 13 (32.5%) underwent endoscopic and/or surgical procedures in combination with drug treatment (Group 2). EHC was significantly reduced in both groups (40.7% in Group 1, with a mean time of 3 months; and 38.4% in Group 2, with a mean time of 7.5 months), with no statistically significant difference between them. EHC recurrence rates, associated mainly with treatment nonadherence, were similar in both groups: 37% in Group 1 and 15.4% in Group 2. The mortality rate was 18.5% in Group 1 and 23% in Group 2, with survival estimates of 71.3% and 72.5%, respectively, with no statistically significant difference., Conclusion: Although PCM-related EHC is rare, it needs to be included in the differential diagnosis of malignancies, as timely treatment can prevent hepatic and extrahepatic sequelae., Competing Interests: Conflict-of-interest statement: The authors report no conflicts of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)- Published
- 2024
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28. Matrix metalloproteinases are associated with severity of disease among COVID-19 patients: A possible pharmacological target.
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Cavalcante GL, Bonifacio LP, Sanches-Lopes JM, Puga FG, de Carvalho FS, Bellissimo-Rodrigues F, and Tanus-Santos JE
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- Humans, Tissue Inhibitor of Metalloproteinase-2, Tissue Inhibitor of Metalloproteinase-3, Matrix Metalloproteinase 9, Matrix Metalloproteinase 2, Severity of Illness Index, Tissue Inhibitor of Metalloproteinase-1, COVID-19
- Abstract
COVID-19 is a devastating disease and imbalanced matrix metalloproteinase (MMP) activity may contribute to its pathophysiology. This exploratory study examined whether increased circulating concentrations of MMP-2 and MMP-9, and their endogenous inhibitors, the tissue inhibitors of MMP (TIMP)-1, TIMP-2, TIMP-3 and TIMP-4 are persistently found in patients 2 weeks after their recovery from severe or critical COVID-19 as compared with those in healthy controls. Subjects who had severe (n = 26) or critical (n = 25) PCR-confirmed COVID-19 and healthy controls (n = 21) had blood samples drawn 2 weeks after recovery and serum MMP-2, MMP-9, TIMP-1, TIMP-2, TIMP-3 and TIMP-4 were determined using two Human Luminex® Discovery Assays. Circulating MMP activity was also determined by gel zymography. Patients who had severe or critical COVID-19 had increased circulating MMP-9 and MMP-2 concentrations, with increased MMP-9/TIMP-1 and MMP-2/TIMP-2 ratios indicating increased MMP activity, confirmed by gel zymography (all p < 0.05). Higher circulating MMP-9 (but not MMP-2) concentrations were found in critical versus severe COVID-19 (p < 0.05). We found increased circulating MMP-9 and MMP-2 concentrations and activity many days after recovery from the acute disease, with MMP-9 levels associated with disease severity. These biochemical alterations suggest that MMP-2 and MMP-9 may be important pharmacological targets in COVID-19., (© 2024 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). Published by John Wiley & Sons Ltd.)
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- 2024
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29. Updates and future directions regarding hand hygiene in the healthcare setting: insights from the 3rd ICPIC alcohol-based handrub (ABHR) task force.
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Tartari E, Bellissimo-Rodrigues F, Pires D, Fankhauser C, Lotfinejad N, Saito H, Suchomel M, Kramer A, Allegranzi B, Boyce J, Sax H, Stewardson AJ, and Pittet D
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- Humans, Hand Disinfection methods, Ethanol, Infection Control methods, Delivery of Health Care, Hand Hygiene methods, Cross Infection prevention & control
- Abstract
Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose threats to global health. Effective hand hygiene is essential for preventing HAIs and the spread of AMR in healthcare. We aimed to highlight the recent progress and future directions in hand hygiene and alcohol-based handrub (ABHR) use in the healthcare setting. In September 2023, 42 experts in infection prevention and control (IPC) convened at the 3rd International Conference on Prevention and Infection Control (ICPIC) ABHR Taskforce in Geneva, Switzerland. The purpose of this meeting was to provide a synthesis of recent evidence and formulate a research agenda on four critical areas for the implementation of effective hand hygiene practices: (1) ABHR formulations and hand rubbing techniques, (2) low-resource settings and local production of ABHR, (3) hand hygiene monitoring and technological innovations, and (4) hand hygiene standards and guidelines., (© 2024. The Author(s).)
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- 2024
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30. Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS), 1-week inception cohort.
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Ribeiro-do-Valle CC, Bonet M, Brizuela V, Abalos E, Baguiya A, Bellissimo-Rodrigues F, Budianu M, Puscasiu L, Knight M, Lissauer D, Dunlop C, Jacob ST, Shakoor S, Gadama L, Assarag B, Souza JP, and Cecatti JG
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- Pregnancy, Female, Humans, Anti-Bacterial Agents therapeutic use, Metronidazole therapeutic use, Cephalosporins therapeutic use, World Health Organization, Pregnancy Complications, Infectious drug therapy, Urinary Tract Infections drug therapy
- Abstract
Background: Pregnancy-related infections are important contributors to maternal sepsis and mortality. We aimed to describe clinical, microbiological characteristics and use of antibiotics by source of infection and country income, among hospitalized women with suspected or confirmed pregnancy-related infections., Methods: We used data from WHO Global Maternal Sepsis Study (GLOSS) on maternal infections in hospitalized women, in 52 low-middle- and high-income countries conducted between November 28th and December 4th, 2017, to describe the frequencies and medians of maternal demographic, obstetric, and clinical characteristics and outcomes, methods of infection diagnosis and causative pathogens, of single source pregnancy-related infection, other than breast, and initial use of therapeutic antibiotics. We included 1456 women., Results: We found infections of the genital (n = 745/1456, 51.2%) and the urinary tracts (UTI) (n = 531/1456, 36.5%) to be the most frequent. UTI (n = 339/531, 63.8%) and post-caesarean skin and soft tissue infections (SSTI) (n = 99/180, 55.0%) were the sources with more culture samples taken and microbiological confirmations. Escherichia coli was the major uropathogen (n = 103/118, 87.3%) and Staphylococcus aureus (n = 21/44, 47.7%) was the commonest pathogen in SSTI. For 13.1% (n = 191) of women, antibiotics were not prescribed on the same day of infection suspicion. Cephalosporins (n = 283/531, 53.3%) were the commonest antibiotic class prescribed for UTI, while metronidazole (n = 303/925, 32.8%) was the most prescribed for all other sources. Ceftriaxone with metronidazole was the commonest combination for the genital tract (n = 98/745, 13.2%) and SSTI (n = 22/180, 12.2%). Metronidazole (n = 137/235, 58.3%) was the most prescribed antibiotic in low-income countries while cephalosporins and co-amoxiclav (n = 129/186, 69.4%) were more commonly prescribed in high-income countries., Conclusions: Differences in antibiotics used across countries could be due to availability, local guidelines, prescribing culture, cost, and access to microbiology laboratory, despite having found similar sources and pathogens as previous studies. Better dissemination of recommendations in line with antimicrobial stewardship programmes might improve antibiotic prescription., (© 2024. The Author(s).)
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- 2024
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31. Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia.
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Bellissimo-Rodrigues WT and Bellissimo-Rodrigues F
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- Humans, Anti-Bacterial Agents therapeutic use, Administration, Inhalation, Amikacin therapeutic use, Pneumonia, Ventilator-Associated prevention & control, Pneumonia, Ventilator-Associated drug therapy
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- 2024
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32. Dengue fever: working towards global control considering biological, social, and planetary determinants.
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Bellissimo-Rodrigues F and Dal Fabbro AL
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- Humans, Disease Outbreaks, Dengue epidemiology, Dengue prevention & control
- Abstract
Competing Interests: We declare no competing interests.
- Published
- 2023
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33. Investigating autonomic nervous system dysfunction among patients with post-COVID condition and prolonged cardiovascular symptoms.
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da Silva FS, Bonifácio LP, Bellissimo-Rodrigues F, Joaquim LF, Martins Dias DP, Dias Romano MM, Schmidt A, Crescêncio JC, Buzinari TC, Fazan R Jr, and Salgado HC
- Abstract
Heart Rate Variability (HRV) and arterial pressure (AP) variability and their responses to head-up tilt test (HUTT) were investigated in Post-COVID-19 syndrome (PCS) patients reporting tachycardia and/or postural hypotension. Besides tachycardia, PCS patients also showed attenuation of the following HRV parameters: RMSSD [square root of the mean of the sum of the squares of differences between adjacent normal-to-normal (NN) intervals] from statistical measures; the power of RR (beat-to-beat interval) spectra at HF (high frequency) from the linear method spectral analysis; occurrence of 2UV (two unlike variation) pattern of RR from the nonlinear method symbolic analysis; and the new family of statistics named sample entropy, when compared to control subjects. Basal AP and LF (low frequency) power of systolic AP were similar between PCS patients and control subjects, while 0 V (zero variation) patterns of AP from the nonlinear method symbolic analysis were exacerbated in PCS patients. Despite tachycardia and a decrease in RMSSD, no parameter of HRV changed during HUTT in PCS patients compared to control subjects. PCS patients reassessed after 6 months showed higher HF power of RR spectra and a higher percentage of 2UV pattern of RR. Moreover, the reassessed PCS patients showed a lower occurrence of 0 V patterns of AP, while the HUTT elicited HR (heart rate) and AP responses identical to control subjects. The HRV and AP variability suggest an autonomic dysfunction with sympathetic predominance in PCS patients. In contrast, the lack of responses of HRV and AP variability indices during HUTT indicates a marked impairment of autonomic control. Of note, the reassessment of PCS patients showed that the noxious effect of COVID-19 on autonomic control tended to fade over time., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 da Silva, Bonifácio, Bellissimo-Rodrigues, Joaquim, Martins Dias, Dias Romano, Schmidt, Crescêncio, Buzinari, Fazan and Salgado.)
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- 2023
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34. Genomic epidemiology of SARS-CoV-2 in large university hospital cohort: the UnCoVER-Brazil project.
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de Carvalho FS, Slack SD, Barbosa-Júnior F, de Campos MR, Castro GS, Baroni S, Bueno LMT, Coeli FB, Yamamoto AY, Silva JM, Calado RDT, Fonseca BAL, Colli LM, and Bellissimo-Rodrigues F
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- Humans, Brazil epidemiology, Pandemics, Genomics, Hospitals, University, SARS-CoV-2 genetics, COVID-19 epidemiology
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This work aimed to study the role of different SARS-CoV-2 lineages in the epidemiology of multiple waves of the COVID-19 pandemic in Ribeirão Preto (São Paulo state), with comparison within Brazil and globally. Viral genomic sequencing was combined with clinical and sociodemographic information of 2,379 subjects at a large Brazilian hospital. On the whole 2,395 complete SARS-CoV-2 genomes were obtained from April 2020 to January 2022. We report variants of concern (VOC) and interest (VOI) dynamics and the role of Brazilian lineages. We identified three World Health Organization VOCs (Gamma, Delta, Omicron) and one VOI (Zeta), which caused distinct waves in this cohort. We also identified 47 distinct Pango lineages. Consistent with the high prevalence of Gamma in Brazil, Pango lineage P.1 dominated infections in this cohort for half of 2021. Each wave of infection largely consisted of a single variant group, with each new group quickly and completely rising to dominance. Despite increasing vaccination in Brazil starting in 2021, this pattern was observed throughout the study and is consistent with the hypothesis that herd immunity tends to be SARS-CoV-2 variant-specific and does not broadly protect against COVID-19.
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- 2023
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35. Efficacy and safety of Ixekizumab vs. low-dose IL-2 vs. Colchicine vs. standard of care in the treatment of patients hospitalized with moderate-to-critical COVID-19: A pilot randomized clinical trial (STRUCK: Survival Trial Using Cytokine Inhibitors).
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Bonifácio LP, Ramacciotti E, Agati LB, Vilar FC, Silva ACTD, Louzada Júnior P, Fonseca BALD, Souza HCC, Oliveira CCC, Aguiar VCR, Quadros CAA, Dusilek C, Itinose K, Risson R, Ferreira LRR, Lopes RD, Kallas EG, and Bellissimo-Rodrigues F
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- Humans, Interleukin-17, Interleukin-2, SARS-CoV-2, Colchicine adverse effects, Cytokines, COVID-19 Drug Treatment, Prospective Studies, Pilot Projects, Standard of Care, Treatment Outcome, COVID-19
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Background: Cases of coronavirus disease 2019 (COVID-19) requiring hospitalization continue to appear in vulnerable populations, highlighting the importance of novel treatments. The hyperinflammatory response underlies the severity of the disease, and targeting this pathway may be useful. Herein, we tested whether immunomodulation focusing on interleukin (IL)-6, IL-17, and IL-2, could improve the clinical outcomes of patients admitted with COVID-19., Methods: This multicenter, open-label, prospective, randomized controlled trial was conducted in Brazil. Sixty hospitalized patients with moderate-to-critical COVID-19 received in addition to standard of care (SOC): IL-17 inhibitor (ixekizumab 80 mg SC/week) 1 dose every 4 weeks; low-dose IL-2 (1.5 million IU per day) for 7 days or until discharge; or indirect IL-6 inhibitor (colchicine) orally (0.5 mg) every 8 hours for 3 days, followed by 4 weeks at 0.5 mg 2x/day; or SOC alone. The primary outcome was accessed in the "per protocol" population as the proportion of patients with clinical improvement, defined as a decrease greater or equal to two points on the World Health Organization's (WHO) seven-category ordinal scale by day 28., Results: All treatments were safe, and the efficacy outcomes did not differ significantly from those of SOC. Interestingly, in the colchicine group, all participants had an improvement of greater or equal to two points on the WHO seven-category ordinal scale and no deaths or patient deterioration were observed., Conclusions: Ixekizumab, colchicine, and IL-2 were demonstrated to be safe but ineffective for COVID-19 treatment. These results must be interpreted cautiously because of the limited sample size.
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- 2023
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36. Impact of a dental care intervention on the hospital mortality of critically ill patients admitted to intensive care units: A quasi-experimental study.
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Ribeiro ILA, Bellissimo-Rodrigues WT, Mussolin MG, Innocentini LMAR, Marangoni ATD, Macedo LD, Barbosa-Júnior F, de Souza HCC, Menegueti MG, Pereira APS, Gaspar GG, Schmidt A, Miranda CH, Lovato WJ, Puga ML, Auxiliadora-Martins M, Basile-Filho A, and Bellissimo-Rodrigues F
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- Dental Care, Hospital Mortality, Humans, Intensive Care Units, Critical Illness, Pneumonia, Ventilator-Associated epidemiology, Pneumonia, Ventilator-Associated prevention & control
- Abstract
Background: We aimed to evaluate the impact of providing dental care to critically ill patients on their risk of death and ventilator-associated pneumonia (VAP)., Methods: A quasi-experimental study was conducted in 2 intensive care units (ICU) from 2016 to 2019. The intervention consisted of implementing routine dental care, focusing on oral hygiene and periodontal treatment, at least 3 times a week, for patients admitted to the study units. In the pre-intervention period, routine oral hygiene was provided by the ICU nursing staff. The primary and secondary study outcomes were mortality, evaluated at the end of the ICU stay, and VAP incidence density, respectively. Data were analyzed using the ARIMA (autoregressive integrated moving average) time series model in R software., Results: During the intervention period, 5,147 dental procedures were performed among 355 patients. The time series showed that ICU mortality was 36.11%, 32.71%, and 32.30% within the 3 years before the intervention, and 28.71% during the intervention period (P = .015). VAP incidence density did not significantly change during the study period (P = .716)., Conclusion: A dental care intervention focused on oral hygiene and periodontal treatment regularly provided by dentists to critically ill patients may decrease their risk of dying in the ICU. Randomized clinical trials should be performed to confirm these findings., Trial Registration: WHO-affiliated Brazilian Clinical Trials Registry. RBR-4jmz36. Registered 7 October 2018, before first patient enrollment., (Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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37. Cannabidiol for COVID-19 Patients with Mild to Moderate Symptoms (CANDIDATE Study): A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
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Crippa JAS, Pacheco JC, Zuardi AW, Guimarães FS, Campos AC, Osório FL, Loureiro SR, Dos Santos RG, Souza JDS, Ushirohira JM, Ferreira RR, Mancini Costa KC, Scomparin DS, Scarante FF, Pires-Dos-Santos I, Mechoulam R, Kapczinski F, Fonseca BAL, Esposito DLA, Passos ADC, Dal Fabbro AL, Bellissimo-Rodrigues F, Arruda E, Scarpelini S, Andraus MH, Nather Junior JC, Wada DT, Koenigkam-Santos M, Santos AC, Busatto Filho G, and Hallak JEC
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- Humans, SARS-CoV-2, Antiviral Agents adverse effects, Double-Blind Method, Cannabidiol therapeutic use, COVID-19 Drug Treatment
- Abstract
Importance: Owing to its anti-inflammatory properties and antiviral "in vitro" effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cannabidiol (CBD) has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19). Objective: To investigate the safety and efficacy of CBD for treating patients with mild to moderate COVID-19. Design: Randomized, parallel-group, double-blind, placebo-controlled clinical trial conducted between July 7 and October 16, 2020, in two sites in Brazil. Setting: Patients were recruited in an emergency room. Participants: Block randomized patients (1:1 allocation ratio-by a researcher not directly involved in data collection) with mild and moderate COVID-19 living in Ribeirão Preto, Brazil, seeking medical consultation, and those who voluntarily agreed to participate in the study. Interventions: Patients received 300 mg of CBD or placebo added to standard symptomatic care during 14 days. Main Outcome and Measure: The primary outcome was reduction or prevention of the deterioration in clinical status from mild/moderate to severe/critical measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms. Primary study outcome was assessed on days 14, 21, and 28 after enrollment. Results: A total of 321 patients were recruited and assessed for eligibility, and 105 were randomly allocated either in CBD ( n =49) or in placebo ( n =42) group. Ninety-one participants were included in the analysis of efficacy. There were no baseline between-group differences regarding disease severity (χ
2 =0.025, p =0.988) and median time to symptom resolution (12 days [95% confidence interval, CI, 6.5-17.5] in the CBD group, 9 days [95% CI, 4.8-13.2] in the placebo group [χ2 =1.6, p =0.205 by log-rank test]). By day 28, 83.3% in the CBD group and 90.2% in the placebo group had resolved symptoms. There were no between-group differences on secondary measures. CBD was well tolerated, producing mostly mild and transient side effects (e.g., somnolence, fatigue, changes in appetite, lethargy, nausea, diarrhea, and fever), with no significant differences between CBD and placebo treatment groups. Conclusions and Relevance: Daily administration of 300 mg CBD for 14 days failed to alter the clinical evolution of COVID-19. Further trials should explore the therapeutic effect of CBD in patients with severe COVID-19, possibly trying higher doses than the used in our study. Trial Registration: ClinicalTrials.gov identifier NCT04467918 (date of registration: July 13, 2020).- Published
- 2022
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38. Comparing surgeons' skin tolerance and acceptability to alcohol-based surgical hand preparation vs traditional surgical scrub: A matched quasi-experimental study.
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Lopes AER, Menegueti MG, Gaspar GG, Tartari E, da Silva Canini SRM, Pittet D, and Bellissimo-Rodrigues F
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- Adult, Chlorhexidine, Ethanol, Female, Hand, Hand Disinfection, Humans, Male, Povidone-Iodine, Soaps, Surgical Wound Infection epidemiology, Water, Anti-Infective Agents, Anti-Infective Agents, Local therapeutic use, Surgeons
- Abstract
Background: We aimed to compare the tolerance and acceptability of alcohol-based surgical hand preparation versus handscrubbing with antimicrobial soap and water by surgeons., Methods: Matched quasi-experimental trial in an academic quaternary care hospital in Ribeirão Preto, Brazil, from April 1 to October, 31, 2017. Participants were cardiac and orthopedics surgeons from the study facility. In the first study phase, they performed handscrubbing with either 2% chlorhexidine (CHG) or 10% iodopovidone (PVP-I) and, in the second phase, they performed handrubbing with alcohol-based handrub (ABHR). Surgeons' skin tolerance and acceptability were evaluated using WHO-validated tools. Data were analyzed using the MacNemar's test within STATA., Results: A total of 33 surgeons participated to the "per protocol" population; the majority were male (94%); mean age of 35 years (SD, 8.5). On product tolerance, there was a minimal variation in redness, scaliness, fissures, and visual evaluation of the skin when handrubbing with ABHR was compared to handscrubbing with either PVP-I or CHX. Regarding acceptability, participants rated better handrubbing with ABHR than handscrubbing with PVP-I when assessing product smell (66.6% vs 0%, p=0.002), color (73.3% vs 0%, p=0.001), product texture (60% vs 0%, p=0.004), skin dryness (60% vs 0%, p=0.004), ease of application (66.6% vs 0%, p=0.002) and overall satisfaction (66.6% vs 6.7% p=0.011). Participants rated similarly handrubbing with ABHR and handscrubbing with CHX, except for product texture, where handrubbing rated better (71,4% vs. 0%, p=0.002). Handrubbing with ABHR was preferred by 73.3%., Conclusion: Although handrubbing and handscrubbing were equally well tolerated by surgeons, alcohol-based surgical hand preparation fell into the personal preference for most of them., Trial Registration: Brazilian Clinical Trials Registry (ReBEC), RBR-8ym9yj., (Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2022
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39. Customizing the indication of chlorhexidine mouthwash for critically ill patients: A reply letter to Honore P.M. and colleagues.
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Bellissimo-Rodrigues WT, Menegueti MG, Basile-Filho A, and Bellissimo-Rodrigues F
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- Critical Illness, Humans, Chlorhexidine, Mouthwashes
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- 2022
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40. Potential cannabidiol (CBD) repurposing as antibacterial and promising therapy of CBD plus polymyxin B (PB) against PB-resistant gram-negative bacilli.
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Abichabki N, Zacharias LV, Moreira NC, Bellissimo-Rodrigues F, Moreira FL, Benzi JRL, Ogasawara TMC, Ferreira JC, Ribeiro CM, Pavan FR, Pereira LRL, Brancini GTP, Braga GÚL, Zuardi AW, Hallak JEC, Crippa JAS, Lanchote VL, Cantón R, Darini ALC, and Andrade LN
- Subjects
- Anti-Bacterial Agents pharmacology, Drug Repositioning, Drug Resistance, Multiple, Bacterial, Drug Synergism, Gram-Negative Bacteria, Klebsiella pneumoniae, Microbial Sensitivity Tests, Cannabidiol pharmacology, Polymyxin B pharmacology
- Abstract
This study aimed to assess the ultrapure cannabidiol (CBD) antibacterial activity and to investigate the antibacterial activity of the combination CBD + polymyxin B (PB) against Gram-negative (GN) bacteria, including PB-resistant Gram-negative bacilli (GNB). We used the standard broth microdilution method, checkerboard assay, and time-kill assay. CBD exhibited antibacterial activity against Gram-positive bacteria, lipooligosaccharide (LOS)-expressing GN diplococcus (GND) (Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella catarrhalis), and Mycobacterium tuberculosis, but not against GNB. For most of the GNB studied, our results showed that low concentrations of PB (≤ 2 µg/mL) allow CBD (≤ 4 µg/mL) to exert antibacterial activity against GNB (e.g., Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii), including PB-resistant GNB. CBD + PB also showed additive and/or synergistic effect against LOS-expressing GND. Time-kill assays results showed that the combination CBD + PB leads to a greater reduction in the number of colony forming units per milliliter compared to CBD and PB alone, at the same concentration used in combination, and the combination CBD + PB was synergistic for all four PB-resistant K. pneumoniae isolates evaluated. Our results show that CBD has translational potential and should be further explored as a repurposed antibacterial agent in clinical trials. The antibacterial efficacy of the combination CBD + PB against multidrug-resistant and extensively drug-resistant GNB, especially PB-resistant K. pneumoniae, is particularly promising., (© 2022. The Author(s).)
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- 2022
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41. Long-Term Symptoms among COVID-19 Survivors in Prospective Cohort Study, Brazil.
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Bonifácio LP, Csizmar VNF, Barbosa-Júnior F, Pereira APS, Koenigkam-Santos M, Wada DT, Gaspar GG, Carvalho FS, Bollela VR, Santana RC, Souza JP, and Bellissimo-Rodrigues F
- Subjects
- Brazil epidemiology, Humans, Prospective Studies, SARS-CoV-2, Survivors, COVID-19
- Abstract
We conducted a prospective cohort study in a population with diverse ethnic backgrounds from Brazil to assess clinically meaningful symptoms after surviving coronavirus disease. For most of the 175 patients in the study, clinically meaningful symptoms, including fatigue, dyspnea, cough, headache, and muscle weakness, persisted for >120 days after disease onset.
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- 2022
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42. Assessment of preauthorization and 24-hour expert consultation as a restrictive antimicrobial stewardship bundle in a Brazilian tertiary-care hospital: an interrupted time series analysis.
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Doltrario AB, Gaspar GG, Ungari AQ, Martinez R, Pazin Filho A, Maciel BC, Bellissimo-Rodrigues F, and Santana RC
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Background: Worldwide, healthcare facilities face high and often inappropriate consumption of antimicrobials. However, there are limited antimicrobial stewardship (ASP) studies from low- and middle-income countries that include restrictive measures and their impacts on antimicrobial consumption., Aim: This study aims to assess the impact of a restrictive bundle (preauthorization requirements and offering consultation with an infectious diseases physician 24 hours a day) on antimicrobial consumption, in a tertiary hospital in Brazil., Methods: We conducted an interrupted time series analysis (ITS) with pharmacy-based data from January 2010 to December 2018 to evaluate changes of level and slope in antimicrobial consumption (expressed in DDD/1,000 patient-days) after the implementation of the restrictive bundle in September 2014. Fourteen restricted antimicrobials (amphotericin B deoxycholate, liposomal amphotericin B, micafungin, voriconazole, ganciclovir, amikacin, ampicillin/sulbactam, daptomycin, ertapenem, levofloxacin, linezolid, piperacillin/tazobactam, polymyxin B, and tigecycline) and eight unrestricted were analysed., Findings: Among the 14 restricted antimicrobials, four presented a significant negative level change: micafungin (-2,14, p=.027), voriconazole (-14.72, p<.001), ertapenem (-1.89, p=.007) and amikacin (-13.98, p<.001). The only negative slope change was observed for the liposomal amphotericin B, -0.532 (p=.009). The restricted antibiotics group presented an increased consumption trend (1.068, p=.002) compared to the pre-intervention period, a similar change was observed for the unrestricted antibiotics group (1.360, p<.001)., Conclusion: Preauthorization and 24 hour expert consultation were partially effective as a restrictive antimicrobial stewardship bundle in a Brazilian tertiary-care hospital. Increased consumption of unrestricted antimicrobials was observed as a side effect of the intervention., (© 2022 The Authors.)
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- 2022
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43. Prevalence of virological and serological markers of SARS-CoV-2 infection in the population of Ribeirão Preto, Southeast Brazil: an epidemiological survey.
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Martinez EZ, Passos ADC, Fabbro ALD, Silva ASD, Escarso AC, Pazin-Filho A, Fonseca BALD, Maciel BC, Araújo DCAE, Clé DV, Gaspar GG, Santos JLFD, Ferreira JBB, Souza JP, Mello LM, Santos LLD, Passos LMR, Siconelli MJL, Cavalli RC, Santana RC, Calado RDT, Scarpelini S, Bollela VR, Floriano VG, and Bellissimo-Rodrigues F
- Subjects
- Brazil epidemiology, Humans, Pandemics, Prevalence, COVID-19, SARS-CoV-2
- Abstract
Introduction: This epidemiological household survey aimed to estimate the prevalence of the current and past SARS-CoV-2 infections in Ribeirão Preto, a municipality of southeast Brazil., Methods: The survey was conducted in two phases using a clustered sampling scheme. The first phase spanned May 1-3 and involved 709 participants. The second phase spanned June 11-14, 2020, and involved 646 participants., Results: During the first phase, RT-PCR performed on nasopharyngeal swabs was positive at 0.14%. The serological tests were positive in 1.27% of the patients during the first phase and 2.79% during the second phase. People living in households with more than five members had a prevalence of 10.83% (95%CI: 1.58-74.27) higher than those living alone or with someone other. Considering the proportion of the positive serological test results with sex and age adjustments, approximately 2.37% (95%CI: 1.32-3.42) of the population had been cumulatively infected by mid-June 2020, which is equivalent to 16,670 people (95%CI: 9,267-24,074). Considering that 68 deaths from the disease in the residents of the city had been confirmed as at the date of the second phase of the survey, the infection fatality rate was estimated to be 0.41% (95%CI: 0.28-0.73). Our results suggest that approximately 88% of the cases of SARS-CoV-2 infection at the time of the survey were not reported to the local epidemiological surveillance service., Conclusions: The findings of this study provide in-depth knowledge of the COVID-19 pandemic in Brazil and are helpful for the preventive and decision-making policies of public managers.
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- 2021
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44. Ocular findings among patients surviving COVID-19.
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Costa ÍF, Bonifácio LP, Bellissimo-Rodrigues F, Rocha EM, Jorge R, Bollela VR, and Antunes-Foschini R
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- Adult, Aged, COVID-19 mortality, Disease Progression, Humans, Intraocular Pressure, Middle Aged, Ophthalmoscopy, Retrospective Studies, Survivors, Visual Acuity, COVID-19 epidemiology, Diabetic Retinopathy epidemiology, Eye Diseases epidemiology, Retinal Pigment Epithelium pathology, SARS-CoV-2 physiology
- Abstract
To describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID's symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0-0.2) and BCVA 0 (0-0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.
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- 2021
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45. Feasibility of very short-term forecast models for COVID-19 hospital-based surveillance.
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Martinez EZ, Passos ADC, Cinto AF, Escarso AC, Monteiro RA, Silva JME, Bellissimo-Rodrigues F, and Aragon DC
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- Bayes Theorem, Feasibility Studies, Forecasting, Hospitals, Humans, Models, Theoretical, SARS-CoV-2, COVID-19
- Abstract
Introduction: We evaluated the performance of Bayesian vector autoregressive (BVAR) and Holt's models to forecast the weekly COVID-19 reported cases in six units of a large hospital., Methods: Cases reported from epidemiologic weeks (EW) 12-37 were selected as the training period, and from EW 38-41 as the test period., Results: The models performed well in forecasting cases within one or two weeks following the end of the time-series, but forecasts for a more distant period were inaccurate., Conclusions: Both models offered reasonable performance in very short-term forecasts for confirmed cases of COVID-19.
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- 2021
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46. Effect of Wearing a Novel Electronic Wearable Device on Hand Hygiene Compliance Among Health Care Workers: A Stepped-Wedge Cluster Randomized Clinical Trial.
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Pires D, Gayet-Ageron A, Guitart C, Robert YA, Fankhauser C, Tartari E, Peters A, Tymurkaynak F, Fourquier S, Soule H, Beuchat R, Bellissimo-Rodrigues F, Martin Y, Zingg W, and Pittet D
- Subjects
- Adult, Age Factors, Female, Hand Hygiene, Humans, Male, Middle Aged, Nurses, Nursing Assistants, Physical Therapists, Quality Improvement, Random Allocation, Workload, Cross Infection prevention & control, Formative Feedback, Guideline Adherence, Hand Disinfection standards, Hand Sanitizers, Health Personnel, Wearable Electronic Devices
- Abstract
Importance: Hand hygiene (HH) is essential to prevent hospital-acquired infections., Objective: To determine whether providing real-time feedback on a simplified HH action improves compliance with the World Health Organization's "5 Moments" and the quality of the HH action., Design, Setting, and Participants: This open-label, cluster randomized, stepped-wedge clinical trial was conducted between June 1, 2017, and January 6, 2018 (with a follow-up in March 2018), in a geriatric hospital of the University of Geneva Hospitals, Switzerland. All 12 wards and 97 of 306 eligible health care workers (HCWs) volunteered to wear a novel electronic wearable device that delivered real-time feedback on duration of hand rubbing and application of a hand-sized customized volume of alcohol-based handrub (ABHR)., Interventions: This study had 3 sequential periods: baseline (no device), transition (device monitoring without feedback), and intervention (device monitoring and feedback). The start of the transition period was randomly allocated based on a computer-generated block randomization., Main Outcomes and Measures: The primary outcome was HH compliance, according to the direct observation method during intervention as compared with baseline. Secondary outcomes included the volume of ABHR and duration of hand rubbing measured by the device during intervention as compared with transition., Results: All wards and respective HCWs were evenly assigned to group 1 (26 participants), 2 (22 participants), 3 (25 participants), or 4 (24 participants). Twelve HCWs did not fully complete the intervention but were included in the analysis. During 759 observation sessions, 6878 HH opportunities were observed. HH compliance at intervention (62.9%; 95% CI, 61.1%-64.7%) was lower than at baseline (66.6%; 95% CI, 64.8%-68.4%). After adjusting for covariates, HH compliance was not different between periods (odds ratio, 1.03; 95% CI, 0.75-1.42; P = .85). Days since study onset (OR, 0.997; 95% CI, 0.994-0.998; P < .001), older age (OR, 0.97; 95% CI, 0.95-0.99; P = .015), and workload (OR, 0.29; 95% CI, 0.20-0.41; P < .001) were independently associated with reduced HH compliance. The median (interquartile range) volume of ABHR and duration of hand rubbing in transition and intervention increased from 1.12 (0.76-1.68) mL to 1.71 (1.01-2.76) mL and from 6.5 (4.5-10.5) seconds to 8 (4.5-15.5) seconds, respectively. There were no serious adverse events., Conclusions and Relevance: The use of this device did not change HH compliance, but increased the duration of hand rubbing and volume of ABHR used by HCWs., Trial Registration: isrctn.org Identifier: ISRCTN25430066.
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- 2021
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47. Impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among healthcare workers of an intensive care unit: a quasi-experimental study.
- Author
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Menegueti MG, Bellissimo-Rodrigues F, Ciol MA, Auxiliadora-Martins M, Basile-Filho A, da Silva Canini SRM, Gir E, and Laus AM
- Subjects
- Brazil, Health Personnel, Hospitals, University, Humans, Intensive Care Units, Powders, Tertiary Care Centers, Gloves, Protective classification, Guideline Adherence statistics & numerical data, Hand Hygiene standards
- Abstract
Background/objective: After wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU)., Methods: A quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual's percentage of compliance using the t test for paired data before and after the intervention., Results: Overall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% confidence interval [CI] 51-59%) using powdered latex gloves and 60% (95% CI 57-63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI 2.5-7.6%, p < 0.001)., Conclusion: Our data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.
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- 2021
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48. Surgical antibiotic prophylaxis: is the clinical practice based on evidence?
- Author
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Pereira LB, Feliciano CS, Siqueira DS, Bellissimo-Rodrigues F, and Pereira LRL
- Subjects
- Anti-Bacterial Agents therapeutic use, Antibiotic Prophylaxis adverse effects, Drug Utilization Review, Hospitalization, Humans, Surgical Procedures, Operative methods, Surgical Wound Infection prevention & control, Antibiotic Prophylaxis methods, Bacterial Infections drug therapy, Bacterial Infections prevention & control, Drug Prescriptions statistics & numerical data, Inpatients statistics & numerical data, Surgical Procedures, Operative adverse effects
- Abstract
Objective: To assess the surgical antibiotic prophylaxis., Methods: This was a descriptive study performed at a public tertiary care university hospital gathering prescription, sociodemographic and hospitalization data of inpatients admitted in 2014 who used antimicrobial drugs. This data were obtained from the hospital electronic database. The antimicrobial data were classified according to the anatomical, therapeutic chemical/defined daily dose per 1,000 inpatients. An exploratory analysis was performed using principal component analysis., Results: A total of 5,182 inpatients were prescribed surgical antibiotic prophylaxis. Of the total antimicrobial use, 11.7% were for surgical antibiotic prophylaxis. The orthopedic, thoracic and cardiovascular postoperative units, and postoperative intensive care unit comprised more than half of the total surgical antibiotic prophylaxis use (56.3%). The duration of antimicrobial use of these units were 2.2, 2.0, and 1.4 days, respectively. Third-generation cephalosporins and fluoroquinolones had the longest use among antimicrobial classes., Conclusion: Surgical antibiotic prophylaxis was inadequate in the orthopedic, postoperative intensive care, thoracic and cardiovascular postoperative, gynecology and obstetrics, and otolaryngology units. Therefore, the development and implementation of additional strategies to promote surgical antibiotic stewardship at hospitals are essential.
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- 2020
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49. Clinical, Demographic, and Tomographic Aspects Related to Iris Mammillations Among Patients With Keratoconus: A Cross-Sectional Study.
- Author
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Antunes-Foschini R, Costa RMS, Menezes-Filho CRÂ, Bellissimo-Rodrigues F, de Faria-E-Sousa SJ, and Rocha EM
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- Adolescent, Brazil epidemiology, Cornea pathology, Corneal Pachymetry, Corneal Topography, Cross-Sectional Studies, Demography, Female, Humans, Iris Diseases diagnostic imaging, Keratoconus diagnostic imaging, Male, Organ Size, ROC Curve, Visual Acuity physiology, Young Adult, Iris Diseases epidemiology, Keratoconus epidemiology, Tomography, X-Ray Computed
- Abstract
Purpose: Iris mammillations (IM) were previously described in patients with keratoconus, but the clinical implications of this finding have never been studied. Our aim was to investigate demographic, tomographic, and clinical characteristics potentially associated with the presence of IM among patients with keratoconus., Methods: This was a cross-sectional study performed among patients with keratoconus in a public-affiliated university hospital. All patients under follow-up were considered eligible to participate in the study. Participants were evaluated by 2 trained ophthalmologists and submitted to corneal tomography (Pentacam). Selected demographic, clinical, and tomographic characteristics were assessed and compared among participants with IM (IM group) and without IM (No-IM group) using the Wilcoxon test or 2-tailed Fisher exact test, as appropriate., Results: The study population consisted of 106 subjects and 19 (17.9%) presented with IM. The median age and interquartile range were 18 years old (14-24) in the IM group and 20 years old (17-24) in the No-IM group (P = 0.135). The female proportion was 47.3% in the IM group and 52.8% in the No-IM group (P = 0.801). Median (interquartile ranges) pachymetric values of the right eyes were 498 (466-525) for the IM group and 459 (421-482) for the No-IM group (P = 0.005). For the left eyes, the values were 490 (456-523) in the IM group and 450 (418-485) in the No-IM group (P = 0.024)., Conclusions: Subjects with keratoconus presenting with IM have thicker corneas than those without IM. Follow-up studies should be performed to evaluate the clinical implications of this finding.
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- 2020
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50. Are SARS-CoV-2 reinfection and Covid-19 recurrence possible? a case report from Brazil.
- Author
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Bonifácio LP, Pereira APS, Araújo DCAE, Balbão VDMP, Fonseca BALD, Passos ADC, and Bellissimo-Rodrigues F
- Subjects
- Antibodies, Viral blood, Betacoronavirus, Brazil, COVID-19, Female, Humans, Pandemics, RNA, Viral isolation & purification, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Young Adult, Coronavirus Infections diagnosis, Pneumonia, Viral diagnosis, Recurrence
- Abstract
With the large number of individuals infected and recovered from Covid-19, there is intense discussion about the quality and duration of the immunity elicited by SARS-CoV-2 infection, including the possibility of disease recurrence. Here we report a case with strong clinical, epidemiological and laboratorial evidence of, not only reinfection by SARS-CoV-2, but also clinical recurrence of Covid-19.
- Published
- 2020
- Full Text
- View/download PDF
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