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Article ; Online: Óbitos por eventos adversos a medicamentos no Brasil: Sistema de Informação sobre Mortalidade como fonte de informação.

Martins, Ana Cristina Marques / Giordani, Fabíola / Gonçalves, Mariana de Castro / Guaraldo, Lusiele / Rozenfeld, Suely

2022 Volume 38, Issue 8, Page(s) e00291221

Abstract: Adverse drug events (ADEs) are harmful events caused by medication, and some of which can lead to death. Death records are an important source of information when using codes from the 10th revision of the International Classification of Diseases (ICD-10) ...

Title translation	Deaths from adverse drug events in Brazil: Mortality Information System as a source of information.
Abstract	Adverse drug events (ADEs) are harmful events caused by medication, and some of which can lead to death. Death records are an important source of information when using codes from the 10th revision of the International Classification of Diseases (ICD-10) suggestive of ADE. This study aimed to identify the ADEs registered in Brazililian Mortality Information System (SIM), analyzing data distribution by year, age group, and type of event. This is an ecological study with retrospective data collection, identifying ADEs in the SIM, using the ICD-10 codes. The study included deaths that occurred in Brazil from 2008 to 2016. An increase in the number of deaths associated with ADE was observed from 2008 to 2016, with a mortality rate per 1 million inhabitants ranging from 8.70 to 14.40 in the period. Most events corresponded to mental and behavioral disorders due to the use of psychotropic drugs. Most deaths (12,311) related to ADE codes were identified in several chapters of the ICD-10. Chapter XX, about adverse events, allowed the identification of a smaller number of deaths (4,893). Higher event rates were observed among individuals aged 60 years and over (39.8/1 million) and children younger than one year (22.0/1 million). The identification of ADE-related deaths on the SIM is an important strategy for addressing undesirable drug-related events. Deaths related to the use of psychotropic drugs were the most frequent ADE-related deaths and the elderly were the age group most affected by ADEs.
MeSH term(s)	Aged ; Brazil/epidemiology ; Child ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Information Systems ; Middle Aged ; Psychotropic Drugs/adverse effects ; Retrospective Studies
Chemical Substances	Psychotropic Drugs
Language	Portuguese
Publishing date	2022-09-23
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	1115730-6
ISSN	1678-4464 ; 0102-311X
ISSN (online)	1678-4464
ISSN	0102-311X
DOI	10.1590/0102-311XPT291221
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Article ; Online: Frailty and health-related quality of life among older people living with HIV pre- and post-COVID-19 pandemic onset: A cross-sectional study.

Torres, Thiago S / Jesus, Jovanice S / Arabe, Daniel / Guaraldo, Lusiele / Lessa, Flavia Serrao / Facchinetti, Lívia Dumont / Estrela, Rita / Veloso, Valdilea G / Grinsztejn, Beatriz / Cardoso, Sandra W

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases

2024 Volume 28, Issue 1, Page(s) 103723

Abstract: Introduction: Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID- ... ...

Abstract	Introduction: Antiretroviral therapy increased the survival and life expectancy of People living With HIV (PWH). Frailty-related syndromes among older PWH (aged 50+ years) may affect their Health-related Quality of Life (HQoL). Additionally, the COVID-19 pandemic has impacted health-related outcomes. This study aimed to estimate the prevalence of frailty and pre-frailty among older PWH, and to explore associations of HQoL with the study assessment period and frailty status. Methods: Cross-sectional study conducted pre- (23-Mar-2019 to 5-Mar-2020) and post-COVID-19 pandemic onset (23-Jun-2021 to 5-May-2022), among older PWH at INI-Fiocruz, the largest cohort of PWH in Rio de Janeiro, Brazil. We measured frailty using Fried assessment, consisting of five domains: unintentional weight loss; self-reported exhaustion, weakness, slow walking speed, low physical activity. HQoL was assessed using the ACTG SF-21, which contains 21 questions divided into 8 domains. We used Chi-Square test, Fisher's exact test, Kruskal-Wallis and ranksum test for comparisons. Results: We included 250 older PWH: 109 (43.6 %) pre- and 141 (56.4 %) post-COVID-19 pandemic onset. Median age was 60-years (IQR: 55‒64). Most self-identified as cisgender men 152 (60.8 %), Pardo/Black 146 (58.4 %), with completed secondary education or less 181 (72.7 %) and low income 132 (52.8 %). Overall, prevalence of frailty and pre-frailty were 9.2 % (95 % CI: 8.1‒10.3) and 61.6 % (95 % CI: 54.0‒69.2). Prevalence of frailty in the pre- and pos-COVID-19 pandemic periods were 7.3 % and 10.6 % (p = 0.66). HQoL scores were lower among participants with frailty compared to those with non-frailty and pre-frailty in all eight domains, and among those included in the post-COVID-19 compared to pre-COVID-19 period for four domains. Conclusions: We observed low prevalence of frailty, but high prevalence of pre-frailty among older PWH. Frailty status did not differ according to the COVID-19 assessment period. Assessment of frailty and HQoL should be incorporated in clinical practice for older PWH. Programs to reverse or prevent frailty should be implemented within the public health system.
MeSH term(s)	Aged ; Male ; Humans ; Middle Aged ; Frailty/epidemiology ; Frailty/complications ; Frail Elderly ; Cross-Sectional Studies ; Quality of Life ; Pandemics ; Brazil/epidemiology ; COVID-19/complications ; HIV Infections/complications ; HIV Infections/epidemiology
Language	English
Publishing date	2024-02-15
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2041400-6
ISSN	1678-4391 ; 1413-8670
ISSN (online)	1678-4391
ISSN	1413-8670
DOI	10.1016/j.bjid.2024.103723
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Article: Methods to Assess Adult and Adolescent Patients' Adherence to Antimalarial Treatment: A Systematic Review.

Santos, Heloísa Ferreira Pinto / Guaraldo, Lusiele / Pedro, Renata Saraiva / Damasceno, Luana Santana / Daniel-Ribeiro, Cláudio Tadeu / Brasil, Patrícia

Frontiers in pharmacology

2022 Volume 13, Page(s) 796027

Abstract: Malaria is a curable disease for which early diagnosis and treatment, together with the elimination of vectors, are the principal control tools. Non-adherence to antimalarial treatment may contribute to therapeutic failure, development of antimalarial ... ...

Abstract	Malaria is a curable disease for which early diagnosis and treatment, together with the elimination of vectors, are the principal control tools. Non-adherence to antimalarial treatment may contribute to therapeutic failure, development of antimalarial resistance, introduction or resurgence of malaria in non-endemic areas, and increased healthcare costs. The literature describes several methods to directly or indirectly assess adherence to treatment, but no gold standard exists. The main purpose of this review is to systematize the methods used to assess patient adherence to antimalarial treatment. A systematic review was performed, in accordance with the PRISMA statement, of the following databases: LILACS, EMBASE, PUBMED, COCHRANE, GOOGLE SCHOLAR, WEB OF SCIENCE, SCOPUS, and OPENGREY, through 14 December 2021. A snowball search was also performed by screening the references of the included studies as well as those cited in relevant reviews. Inclusion criteria were reporting assessment of the patient's adherence to antimalarials in individuals with laboratory diagnosis of malaria, the description of antimalarials prescribed, and adherence estimates. Exclusion criteria were studies exclusively about directly observed therapy, studies of populations ≤12 yo and guidelines, commentaries, reviews, letters, or editorials. Study quality was assessed using MINORS and the Cochrane Risk of Bias Tool. Proportions were calculated to measure frequencies considering the number of articles as the denominator. Twenty-one studies were included in this review. Most of them (76.5%) assessed adherence to
Language	English
Publishing date	2022-04-27
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2022.796027
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Article ; Online: Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro.

Brendolin, Michelle / Fuller, Trevon / Wakimoto, Mayumi / Rangel, Larissa / Rodrigues, Gustavo Mourão / Rohloff, Roger D / Guaraldo, Lusiele / Nielsen-Saines, Karin / Brasil, Patrícia

IJID regions

2022 Volume 6, Page(s) 1–6

Abstract: Objectives: To identify factors associated with adverse maternal outcomes during the coronavirus disease 2019 (COVID-19) pandemic.: Methods: This was a single-centre prospective cohort study at a maternity department in a public general hospital in ... ...

Abstract	Objectives: To identify factors associated with adverse maternal outcomes during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a single-centre prospective cohort study at a maternity department in a public general hospital in Rio de Janeiro. All pregnant women evaluated for emergency care, labour and delivery, respiratory symptoms, obstetric reasons or medical reasons between May 2020 and March 2022 at the study institution were invited to enrol in this study. The endpoint was maternal mortality or intensive care unit (ICU) admission. Results: In total, 1609 pregnant women were enrolled in this study. Of these, 25.5% ( Conclusions: COVID-19 was significantly associated with the risk of severe maternal morbidity and mortality. Immunization of pregnant women against COVID-19 was highly protective against adverse outcomes, and should be encouraged during pregnancy.
Language	English
Publishing date	2022-11-10
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2022.11.004
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Article ; Online: Pharmacotherapeutic profile, polypharmacy and its associated factors in a cohort of people living with HIV in Brazil.

da Silva, Robson Pierre Nascimento / Marins, Luana M S / Guaraldo, Lusiele / Luz, Paula Mendes / Cardoso, Sandra W / Moreira, Ronaldo I / Oliveira, Vanessa da Gama / Veloso, Valdilea G / Grinsztejn, Beatriz / Estrela, Rita / Torres, Thiago S

AIDS research and therapy

2023 Volume 20, Issue 1, Page(s) 57

Abstract: Background: The increased survival provided by the access, development, and evolution of antiretroviral drugs (ARV) greatly increased the life expectancy of people living with HIV (PWH). This has also led to an increased occurrence of diseases or ... ...

Abstract	Background: The increased survival provided by the access, development, and evolution of antiretroviral drugs (ARV) greatly increased the life expectancy of people living with HIV (PWH). This has also led to an increased occurrence of diseases or morbidities related to aging. In individuals with multiple comorbidities, the simultaneous use of multiple medications, also known as polypharmacy, is common, and rational use of medications is essential. This study aims to describe the pharmacotherapeutic profile, estimate the prevalence of polypharmacy and identify factors associated with polypharmacy in a cohort of adult PWH from a referral unit in Rio de Janeiro, Brazil. Methods: Cross-sectional study including PWH on ARV who received at least one medical prescription (outpatient/hospitalized) in 2019. We described the proportion of prescribed medications according to ARV and Anatomical Therapeutic Chemical (ATC) classes stratified by age (< 50 vs. ≥50 years). Polypharmacy was defined as ≥ 5 medications prescribed beyond ARV. Logistic regression models assessed demographic and clinical factors associated with polypharmacy. Results: A total of 143,306 prescriptions of 4547 PWH were analyzed. Median age was 44.4 years (IQR:35.4-54.1) and 1615 (35.6%) were ≥ 50 years. A total of 2958 (65.1%) participants self-identified as cisgender man, 1365 (30.0%) as cisgender woman, and 224 (4.9%) as transgender women. Most self-declared Black/Pardo (2582; 65.1%) and 1984 (44.0%) completed elementary education or less. Median time since HIV diagnosis was 10.9 years (IQR:6.2-17.7). Most frequently prescribed concomitant medications were nervous system (64.8%), antiinfectives for systemic use (60.0%), alimentary tract and metabolism (45.9%), cardiovascular system (40.0%) and respiratory system (37.1%). Prevalence of polypharmacy was 50.6% (95%CI: 49.2-52.1). Model results indicated that being older, self-identify as cisgender woman, having less education and longer time since HIV diagnosis increased the odds of polypharmacy. Conclusions: We found high rates of polypharmacy and concomitant medication use in a cohort of PWH in Brazil. Targeted interventions should be prioritized to prevent interactions and improve treatment, especially among individuals using central nervous system and cardiovascular medications, as well as certain groups such as cisgender women, older individuals and those with lower education. Standardized protocols for continuous review of patients' therapeutic regimens should be implemented.
MeSH term(s)	Adult ; Male ; Humans ; Female ; Brazil/epidemiology ; Cross-Sectional Studies ; Polypharmacy ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Educational Status ; Anti-Retroviral Agents
Chemical Substances	Anti-Retroviral Agents
Language	English
Publishing date	2023-08-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2173450-1
ISSN	1742-6405 ; 1742-6405
ISSN (online)	1742-6405
ISSN	1742-6405
DOI	10.1186/s12981-023-00548-6
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Article ; Online: Reduced ability to neutralize the Omicron variant among adults after infection and complete vaccination with BNT162b2, ChAdOx1, or CoronaVac and heterologous boosting.

Espíndola, Otávio Melo / Fuller, Trevon L / de Araújo, Mia Ferreira / Tort, Luis Fernando Lopez / Guaraldo, Lusiele / Calvet, Guilherme / Resende, Paola / Bonaldo, Myrna / Whitworth, Jimmy / Smith, Chris / Siqueira, Marilda / Brasil, Patrícia

Scientific reports

2023 Volume 13, Issue 1, Page(s) 7437

Abstract: COVID-19 vaccines have dramatically reduced rates of severe infection requiring hospitalization. However, SARS-CoV-2 variants have reduced vaccine effectiveness at preventing any symptomatic infection. This real-world study analyzed binding and ... ...

Abstract	COVID-19 vaccines have dramatically reduced rates of severe infection requiring hospitalization. However, SARS-CoV-2 variants have reduced vaccine effectiveness at preventing any symptomatic infection. This real-world study analyzed binding and neutralizing antibodies generated after complete vaccination and boosting across three vaccine platforms. Binding antibodies decayed most slowly in people under 60 with hybrid immunity. Neutralizing antibodies against Omicron BA.1 were reduced compared to other variants. The anamnestic anti-spike IgG response to the first boost was more pronounced than after the second boost. Monitoring of the effects of SARS-CoV-2 mutations on disease severity and the effectiveness of therapeutics is warranted.
MeSH term(s)	Adult ; Humans ; COVID-19 Vaccines ; BNT162 Vaccine ; COVID-19/prevention & control ; SARS-CoV-2/genetics ; Vaccination ; Antibodies, Neutralizing ; Antibodies, Viral
Chemical Substances	sinovac COVID-19 vaccine ; COVID-19 Vaccines ; BNT162 Vaccine ; Antibodies, Neutralizing ; Antibodies, Viral
Language	English
Publishing date	2023-05-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-34035-9
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Article ; Online: The Role of Children in Household Transmission of SARS-CoV-2 Across Four Waves of the Pandemic.

Fuller, Trevon L / Bastos, Leonardo / Carvalho, Marilia Sá / Resende, Paola Cristina / Damasceno, Luana / Cruz, Oswaldo Gonçalves / Medeiros, Fernando / Calvet, Guilherme / Guaraldo, Lusiele / Nielsen-Saines, Karin / Whitworth, James / Smith, Christopher / Siqueira, Marilda / Brasil, Patrícia

Journal of the Pediatric Infectious Diseases Society

2023 Volume 12, Issue 7, Page(s) 413–420

Abstract: Background: It is important to understand the dynamics of SARS-CoV-2 transmission in close-contact settings such as households. We hypothesized that children would most often acquire SARS-CoV-2 from a symptomatic adult caregiver.: Methods: This ... ...

Abstract	Background: It is important to understand the dynamics of SARS-CoV-2 transmission in close-contact settings such as households. We hypothesized that children would most often acquire SARS-CoV-2 from a symptomatic adult caregiver. Methods: This prospective cohort study was conducted from April 2020 to July 2022 in a low-resource, urban settlement in Brazil. We recruited families who brought their children to a public clinic. We collected nasopharyngeal and oral swabs from household members and tracked symptoms and vaccination. Results: In total, 1256 participants in 298 households were tested for SARS-CoV-2. A total of 4073 RT-PCR tests were run with 893 SARS-CoV-2 positive results (21.9%). SARS-CoV-2 cases were defined as isolated cases (N = 158) or well-defined transmission events (N = 175). The risk of household transmission was lower if the index case was a child (OR: 0.3 [95% CI: 0.16-0.55], P < .001) or was vaccinated (OR: 0.29 [95% CI: 0.1-0.85], P = .024), and higher if the index was symptomatic (OR: 2.53 [95% CI: 1.51-4.26], P < .001). The secondary attack rate for child index cases to child contacts was 0.29, whereas the secondary attack rate for adult index cases to child contacts was 0.47 (P = .08). Conclusions: In this community, children were significantly less infectious to their household contacts than adolescents or adults. Most children were infected by a symptomatic adult, usually their mother. There was a double benefit of vaccination as it protected the vaccine from severe illness and prevented onward transmission to household contacts. Our findings may also be valid for similar populations throughout Latin America.
MeSH term(s)	Adult ; Female ; Adolescent ; Child ; Humans ; SARS-CoV-2 ; COVID-19/epidemiology ; Prospective Studies ; Pandemics/prevention & control ; Family Characteristics
Language	English
Publishing date	2023-06-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2668791-4
ISSN	2048-7207 ; 2048-7193
ISSN (online)	2048-7207
ISSN	2048-7193
DOI	10.1093/jpids/piad044
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Article ; Online: Preventable adverse drug events in critically ill HIV patients: Is the detection of potential drug-drug interactions a useful tool?

Ramos, Grazielle Viana / Japiassú, André Miguel / Bozza, Fernando Augusto / Guaraldo, Lusiele

Clinics (Sao Paulo, Brazil)

2018 Volume 73, Page(s) e148

Abstract: Objectives: The aim of this study was to develop a strategy to identify adverse drug events associated with drug-drug interactions by analyzing the prescriptions of critically ill patients.: Methods: This retrospective study included HIV/AIDS ... ...

Abstract	Objectives: The aim of this study was to develop a strategy to identify adverse drug events associated with drug-drug interactions by analyzing the prescriptions of critically ill patients. Methods: This retrospective study included HIV/AIDS patients who were admitted to an intensive care unit between November 2006 and September 2008. Data were collected in two stages. In the first stage, three prescriptions administered throughout the entire duration of these patients' hospitalization were reviewed, with the Micromedex database used to search for potential drug-drug interactions. In the second stage, a search for adverse drug events in all available medical, nursing and laboratory records was performed. The probability that a drug-drug interaction caused each adverse drug events was assessed using the Naranjo algorithm. Results: A total of 186 drug prescriptions of 62 HIV/AIDS patients were analyzed. There were 331 potential drug-drug interactions, and 9% of these potential interactions resulted in adverse drug events in 16 patients; these adverse drug events included treatment failure (16.7%) and adverse reactions (83.3%). Most of the adverse drug reactions were classified as possible based on the Naranjo algorithm. Conclusions: The approach used in this study allowed for the detection of adverse drug events related to 9% of the potential drug-drug interactions that were identified; these adverse drug events affected 26% of the study population. With the monitoring of adverse drug events based on prescriptions, a combination of the evaluation of potential drug-drug interactions by clinical pharmacy services and the monitoring of critically ill patients is an effective strategy that can be used as a complementary tool for safety assessments and the prevention of adverse drug events.
MeSH term(s)	Acquired Immunodeficiency Syndrome/complications ; Acquired Immunodeficiency Syndrome/drug therapy ; Acquired Immunodeficiency Syndrome/epidemiology ; Adult ; Aged ; Aged, 80 and over ; Antirheumatic Agents/adverse effects ; Brazil/epidemiology ; Critical Illness/epidemiology ; Critical Illness/therapy ; Databases, Factual ; Drug Interactions ; Drug Monitoring/methods ; Drug Prescriptions ; Drug-Related Side Effects and Adverse Reactions/diagnosis ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Failure
Chemical Substances	Antirheumatic Agents
Language	English
Publishing date	2018-02-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2182801-5
ISSN	1980-5322 ; 1807-5932
ISSN (online)	1980-5322
ISSN	1807-5932
DOI	10.6061/clinics/2018/e148
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Article ; Online: The authors reply.

Martins, Ana Cristina Marques / Giordani, Fabíola / Guaraldo, Lusiele / Tognoni, Gianni / Rozenfeld, Suely

Cadernos de saude publica

2019 Volume 35, Issue 3, Page(s) e00033319

MeSH term(s)	Brazil ; Drug-Related Side Effects and Adverse Reactions ; Humans ; International Classification of Diseases
Language	English
Publishing date	2019-03-25
Publishing country	Brazil
Document type	Letter ; Comment
ZDB-ID	1115730-6
ISSN	1678-4464 ; 0102-311X
ISSN (online)	1678-4464
ISSN	0102-311X
DOI	10.1590/0102-311X00033319
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Article ; Online: Long COVID-19 syndrome associated with Omicron XBB.1.5 infection: a case report.

Espíndola, Otávio / Resende, Paola C / Guaraldo, Lusiele / Calvet, Guilherme Amaral / Fuller, Trevon L / Penetra, Stephanie Lema Suarez / Santos, Heloisa Ferreira Pinto / Pina-Costa, Anielle / da Silva, Michele Fernanda Borges / Moraes, Isabella Campos Vargas / Medeiros, Fernando / Whitworth, Jimmy / Smith, Christopher / Nielsen-Saines, Karin / Siqueira, Marilda M / Brasil, Patrícia

Memorias do Instituto Oswaldo Cruz

2023 Volume 118, Page(s) e230069

Abstract: Background: There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long ... ...

Abstract	Background: There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long COVID-19 is associated with pre-existing comorbidities or initial COVID-19 severity, including infections due to new Omicron lineages which predominated in 2023. Objectives: The aim of this case report was to characterize the clinical features of acute XBB.1.5 infection followed by Long COVID-19. Methods: We followed a 73-year old female resident of Rio de Janeiro with laboratory-confirmed SARS-CoV-2 during acute infection and subsequent months. The SARS-CoV-2 lineage was determined by genome sequencing. Findings: The participant denied comorbidities and had completed a two-dose vaccination schedule followed by two booster doses eight months prior to SARS-CoV-2 infection. Primary infection by viral lineage XBB.1.5. was clinically mild, but the participant subsequently reported persistent fatigue. Main conclusions: This case demonstrates that Long COVID-19 may develop even after mild disease due to SARS-CoV-2 in fully vaccinated and boosted individuals without comorbidities. Continued monitoring of new SARS-CoV-2 lineages and associated clinical outcomes is warranted. Measures to prevent infection should continue to be implemented including development of new vaccines and antivirals effective against novel variants.
MeSH term(s)	Female ; Humans ; Aged ; COVID-19/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Brazil ; Chromosome Mapping
Language	English
Publishing date	2023-10-13
Publishing country	Brazil
Document type	Case Reports ; Journal Article
ZDB-ID	953293-6
ISSN	1678-8060 ; 0074-0276
ISSN (online)	1678-8060
ISSN	0074-0276
DOI	10.1590/0074-02760230069
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