http://hdl.handle.net/11422/25226 2026-05-03T03:51:02Z 2026-05-03T03:51:02Z Leitão, Isabela de Carvalho Calzolari, Yasmin Cerqueira http://hdl.handle.net/11422/26170 2025-06-25T03:00:10Z 2024-01-01T00:00:00Z

Title: COVID-19 pediátrico: perfil epidemiológico, sintomático e performance de testes diagnósticos Author(s)/Inventor(s): Leitão, Isabela de Carvalho; Calzolari, Yasmin Cerqueira Advisor: Castiñeiras, Terezinha Marta Pereira Pinto Abstract: With the first cases of SARS-CoV-2 infection in December 2019 and its global spread, the scientific community quickly mobilized to research and produce studies aimed at understanding this previously unknown disease. Initially, the majority of those affected were adults, and academic efforts were directed towards this age group. However, as the pandemic progressed, an increase in paediatric COVID-19 cases was observed, including severe outcomes, with a rising trend in the percentage of Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in children in Brazil. Despite this, studies on clinical presentation, outcomes, and diagnostic test performance in this population are still scarce. In this context, this study aims to describe the clinical manifestations of COVID-19 in individuals under 18 years of age, comparing them to the adult population, and to assess the performance of rapid antigen tests in diagnosing COVID-19 in this age group. This is a prospective observational cohort study conducted at the Centro de Triagem e Diagnóstico de COVID-19 at the Universidade Federal do Rio de Janeiro (CTD-UFRJ), analysing samples collected from August 2020 to November 2023. The cohort included 1,063 patients aged 0 to 18 years, representing 3.1% of the total number of individuals tested. Among children, the most prevalent symptoms were cough, runny nose, sneezing, and nasal congestion. Unlike adults, there was no association between COVID-19 diagnosis and the presence of cough, ageusia, chills, myalgia, or asthenia. However, in this age group, there was a positive association between headache and conjunctival congestion with a positive result, which was not seen in adults. Symptom distribution varied when comparing different paediatric age groups. Headache was positively associated with a COVID-19 diagnosis in those aged 6 to 12 years, while in those aged 13 to 18 years, fever and anosmia were positively associated, resembling the adult population. In the 0 to 5-year age group, no symptoms were positively associated with a COVID-19 diagnosis, and cough, nasal congestion, nausea, and vomiting were negatively associated. Regarding the comparison of viral load in respiratory samples, individuals under 18 had significantly lower values than adults, particularly those under 5 years of age. This lower viral load might correlate with poorer performance of antigen tests, as reported in the literature. However, it should be noted that test performance is associated with the type of sample collected, and no difference was found between adults and children when only nasal swabs were compared. In conclusion, clinical presentation in individuals under 18 differs from that in adults. Additionally, it varies within the paediatric population across different age groups, and symptoms, in general, have low predictive value for diagnosing COVID-19 in this population. Finally, the lower viral load detected in respiratory samples appears to be associated with the type of collection method (nasal vs nasopharyngeal) rather than the specific population. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z Baleta, Winnever Batista http://hdl.handle.net/11422/26169 2025-06-25T03:00:10Z 2024-01-01T00:00:00Z

Title: Perfil clínico e epidemiológico das infecções invasivas causadas por Candida spp. de um hospital terciário em 2023 Author(s)/Inventor(s): Baleta, Winnever Batista Advisor: Castiñeiras, Anna Carla Pinto Abstract: Candidemia has become an important cause of healthcare-associated infections (HAIs), being the fourth most isolated agent worldwide for bloodstream infections. Although Candida has been well-studied in immunocompromised patients due to hematological diseases or transplants, its role in critically ill surgical patients has been increasing. Materials and Methods: Twenty-five patients who were admitted from January 1 to December 31, 2023, to a tertiary hospital in Rio de Janeiro (HUCFF/UFRJ), Brazil, were included. A review of medical records was conducted for a period of 30 days or until clinical outcome (discharge or death). Episodes of candidemia were identified through microbiology laboratory records. Candidemia was defined as the first isolation of Candida spp. in a blood culture from a patient showing signs of infection. Results: Candidemia manifestations mainly occurred in elderly patients, those requiring intensive therapy support or were using central venous catheters (CVC). Only 5 transplanted patients were included, of which only 1 was hematological. The main isolates were C. albicans (32%; n=8), C. glabrata (12%; n=3), and C. tropicalis (8%; n=2). The 30-day mortality rate was 64%. Conclusion: The patients most affected by candidemia were those requiring intensive therapy, using CVC, and elderly patients. Patients in tertiary hospitals present high complexity, often having multiple comorbidities and risk factors for candidemia, which may contribute to the high mortality observed in the study. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z Khalil, Lucas Chiarella http://hdl.handle.net/11422/26168 2025-06-25T03:00:10Z 2024-01-01T00:00:00Z

Title: Tuberculose em pacientes submetidos a transplante renal: série de casos do HUCFF Author(s)/Inventor(s): Khalil, Lucas Chiarella Advisor: Lopes, Guilherme Santoro Abstract: Introduction: The objective of this study was to analyze the prognosis of tuberculosis (TB) in renal transplant patients, considering TB treatment outcomes and the occurrence of graft dysfunction. Methods: This was a retrospective descriptive case series study including patients who underwent renal transplantation at the Clementino Fraga Filho University Hospital between 1989 and 2012, with a microbiological diagnosis of TB. Data collected from physical and electronic medical records included demographic variables, transplant characteristics, immunosuppression regimens, TB diagnosis, treatment, and case progression. Results: Among the patients included in the study (n=14), the majority were male (n=10/14, 71.4%). The incidence of TB was predominantly observed in the first-year post-transplant, with clinical manifestations including fever, cough, and significant weight loss. Complications such as graft dysfunction and mortality were reported, with extrapulmonary and disseminated TB being frequent due to immunosuppression. Clinical and microbiological cure was achieved in eleven (78.6%) patients, clinical cure in two (14.3%), with one death (7.1%) attributed to TB. Three (21.4%) patients followed in the study returned to dialysis. Conclusions: The study concludes that TB in renal transplant patients represents a significant challenge, with high morbidity and a numerically higher risk of death compared to TB cases in immunocompetent individuals. The analysis underscores the need for screening and prevention strategies for latent TB in transplant candidates. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z Folgueral, Felipe Sabec Frigini, Luiza Zamperlini http://hdl.handle.net/11422/26167 2025-06-25T03:00:10Z 2024-01-01T00:00:00Z

Title: Avaliação das prevalências de Neisseria gonorrhoeae e Chlamydia trachomatis em swabs anal e oral e jato médio de urina de pacientes vivendo com HIV e acompanhados nos ambulatórios de infectologia geral do HUCFF/UFRJ Author(s)/Inventor(s): Folgueral, Felipe Sabec; Frigini, Luiza Zamperlini Advisor: Machado, Elizabeth Stankiewicz Abstract: Chlamydia and gonorrhea are sexually transmitted infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae, respectively, and are the most common bacterial STIs in the United States according to the CDC. The Brazilian Ministry of Health recommends screening for people living with HIV only at the time of diagnoses. The recommendation is to detect pathogens by molecular biology in clinical specimens compatible with exposure (urine, vaginal or endocervical, rectal and oral organ samples). One justification for the present study was to know the prevalence of infection by Chlamydia trachomatis and Neisseria gonorrhoeae in the general infectious diseases clinics at HUCFF/UFRJ. Between March and October 2024, 82 patients living with HIV from the HUCFF infectious disease outpatient clinics were recruited to investigate infection with N. gonorrhea and C. trachomatis in urine, anal/vaginal swabs and oral swabs. A portion of patients (6.7.3%) tested positive for at least one of the pathogens screened, 5 men and 1 woman. In these, a median age of 39 years was observed (1st quarter 26 – 3rd quarter 44), considerably lower than the rest of the studied population (53 years, 1st quarter 44 – 3rd quarter 60). All men in this group reported homosexual relationships, while only the female patient reported heterosexual relationships. All patients whose clinical samples revealed positive results for NG/CT were asymptomatic. This data contributes to affirming the objective of the present study, which aims to investigate the infection even in the absence of symptoms. The identification of this infection is crucial for the implementation of appropriate interventions, allowing the interruption of the transmission chain and complication rates. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

2024-01-01T00:00:00Z