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Article ; Online: Gastrointestinal manifestations and nutritional therapy during COVID-19 pandemic

Jane Oba / Werther Brunow de Carvalho / Clovis Artur Silva / Artur Figueiredo Delgado

Einstein (São Paulo), Vol

a practical guide for pediatricians

2020 Volume 18

Abstract: ABSTRACT Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has spread globally in pandemic proportions. Accumulative evidence suggests SARS-CoV-2 can be transmitted through ... ...

Abstract	ABSTRACT Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has spread globally in pandemic proportions. Accumulative evidence suggests SARS-CoV-2 can be transmitted through the digestive system, the so-called fecal-oral route of transmission, and may induce several gastrointestinal manifestations. MEDLINE® and Embase databases were extensively searched for major clinical manifestations of gastrointestinal involvement in children and adolescents with COVID-19 reported in medical literature, and for nutritional therapy-related data. Findings and recommendations were pragmatically described to facilitate overall pediatric approach. A total of 196 studies addressing gastrointestinal or nutritional aspects associated with the global COVID-19 pandemic were found. Of these, only 17 focused specifically on pediatric patients with regard to aforementioned gastrointestinal or nutritional aspects. Most articles were descriptive and six addressed guidelines, established protocols, or expert opinions. Children and adolescents with gastrointestinal symptoms, such as nausea, vomiting and diarrhea, should be seriously suspected of COVID-19. Gastrointestinal signs and symptoms may occur in 3% to 79% of children, adolescents and adults with COVID-19, and are more common in severe cases. These include diarrhea (2% to 50%), anorexia (40% to 50%), vomiting (4% to 67%), nausea (1% to 30%), abdominal pain (2% to 6%) and gastrointestinal bleeding (4% to 14%). Patients with inflammatory bowel disease or chronic liver disease are not at greater risk of infection by SARS-CoV-2 relative to the general population. Nutritional support plays an important role in treatment of pediatric patients, particularly those with severe or critical forms of the disease. The digestive system may be a potential route of COVID-19 transmission. Further research is needed to determine whether the fecal-oral route may be involved in viral spread. Nutritional therapy is vital to ...
Keywords	Coronavirus infections/complications ; COVID-19 ; Betacoronavirus ; SARS-CoV-2 ; Gastrointestinal diseases/etiology ; Nutritional therapy ; Inflammatory bowel diseases ; Child ; Adolescent ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Instituto Israelita de Ensino e Pesquisa Albert Einstein
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 and coinfection with Clostridioides (Clostridium) difficile in an infant with gastrointestinal manifestation

Jane Oba / Clovis Artur Silva / Ricardo Katsuya Toma / Werther Brunow de Carvalho / Artur Figueiredo Delgado

Einstein (São Paulo), Vol

2020 Volume 18

Abstract: ABSTRACT We report the clinical case of an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with gastrointestinal signs and symptoms, predominantly vomiting. The patient also had colic, poor feeding, mild diarrhea and ... ...

Abstract	ABSTRACT We report the clinical case of an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with gastrointestinal signs and symptoms, predominantly vomiting. The patient also had colic, poor feeding, mild diarrhea and mild rhinorrhea without fever. The child had evidence of altered coagulation, increased interleukin 10, moderate dehydration and she was admitted to the pediatric intensive care unit. Simultaneously, the patient was diagnosed as Clostridioides difficile infection, which possibly may have facilitated the persistence of SARS-CoV-2 in feces, for more than 27 days, even after the nasopharyngeal test turned negative. This coinfection might exacerbate the gastrointestinal signs and symptoms and increased the possibility of fecal-oral transmission of SARS-CoV-2 and Clostridioides . The patient was breastfed and received complementary infant formula, hydrated with intravenous fluid, and was discharged without complications, 4 days after admission.
Keywords	COVID-19 ; Coronavirus infections ; Coinfection ; Clostridium ; Gastrointestinal tract ; Infant ; Medicine ; R
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Instituto Israelita de Ensino e Pesquisa Albert Einstein
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of inflammatory bowel disease patients in the COVID-19 pandemic era

Natália Sousa Freitas Queiroz / Luísa Leite Barros / Matheus Freitas Cardoso de Azevedo / Jane Oba / Carlos Walter Sobrado / Alexandre de Sousa Carlos / Luciane Reis Milani / Aytan Miranda Sipahi / Aderson Omar Mourão Cintra Damião

Clinics, Vol

a Brazilian tertiary referral center guidance

2020 Volume 75

Abstract: The world is fighting the COVID-19 outbreak and health workers, including inflammatory bowel diseases specialists, have been challenged to address the specific clinical issues of their patients. We hereby summarize the current literature in the ... ...

Abstract	The world is fighting the COVID-19 outbreak and health workers, including inflammatory bowel diseases specialists, have been challenged to address the specific clinical issues of their patients. We hereby summarize the current literature in the management of inflammatory bowel disease (IBD) patients during the COVID-19 pandemic era that support the rearrangement of our IBD unit and the clinical advice provided to our patients.
Keywords	COVID-19 ; Inflammatory Bowel Disease ; Coronavirus ; Pandemic ; Medicine (General) ; R5-920
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy of Early Optimization of Infliximab Guided by Therapeutic Drug Monitoring during Induction—A Prospective Trial

Karoline Soares Garcia / Matheus Freitas Cardoso de Azevedo / Alexandre de Sousa Carlos / Luísa Leite Barros / Jane Oba / Carlos Walter Sobrado Junior / Aytan Miranda Sipahi / Olívia Duarte de Castro Alves / Tomás Navarro-Rodriguez / Rogério Serafim Parra / Júlio Maria Fonseca Chebli / Liliana Andrade Chebli / Cristina Flores / Andrea Vieira / Christianne Damasceno Arcelino do Ceará / Natália Sousa Freitas Queiroz / Aderson Omar Mourão Cintra Damião

Biomedicines, Vol 11, Iss 1757, p

2023 Volume 1757

Abstract: Therapeutic drug monitoring (TDM) during induction therapy with anti-tumor necrosis factor drugs has emerged as a strategy to optimize response to these biologics and avoid undesired outcomes related to inadequate drug exposure. This study aimed to ... ...

Abstract	Therapeutic drug monitoring (TDM) during induction therapy with anti-tumor necrosis factor drugs has emerged as a strategy to optimize response to these biologics and avoid undesired outcomes related to inadequate drug exposure. This study aimed to describe clinical, biological, and endoscopic remission rates at six months in Brazilian inflammatory bowel disease (IBD) patients following a proactive TDM algorithm guided by IFX trough levels (ITL) and antibodies to IFX (ATI) levels during induction, at week six. A total of 111 IBD patients were prospectively enrolled, excluding those previously exposed to the drug. ITL ≥ 10 μg/mL was considered optimal. Patients with suboptimal ITL (<10 µg/mL) were guided according to ATI levels. Those who presented ATI ≤ 200 ng/mL underwent dose intensification in the maintenance phase, and patients with ATI > 200 ng/mL discontinued IFX. In our study, proactive TDM was associated with persistence in the IFX rate at six months of 82.9%. At that time, rates of clinical, biological, and endoscopic remission in patients under IFX treatment were 80.2%, 73.9%, and 48.1%, respectively. Applying a simplified TDM-guided algorithm during induction seems feasible and can help improve patients’ outcomes in clinical practice.
Keywords	inflammatory bowel diseases ; tumor necrosis factor-alpha ; infliximab ; therapeutic drug monitoring ; Crohn’s disease ; ulcerative colitis ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recovery from COVID-19 Pneumonia in a Patient with Acute Severe Colitis

Karoline Soares Garcia / Bruna Damásio Moutinho / Matheus Freitas Cardoso de Azevedo / Natalia Sousa Freitas Queiroz / Luciane Reis Milani / Lucas Navarro Sanches / Luisa Leite Barros / Jane Oba / Alexandre de Sousa Carlos / Aderson Omar Mourão Cintra Damião / Aytan Miranda Sipahi

Inflammatory Intestinal Diseases, Vol 5, Iss 2, Pp 93-

2020 Volume 98

Abstract: Introduction: The coronavirus disease 2019 (COVID-19) pandemic has increased concern regarding SARS-CoV-2 infection in inflammatory bowel disease (IBD) patients, especially those on immunosuppressive therapies or with active disease. There are limited ... ...

Abstract	Introduction: The coronavirus disease 2019 (COVID-19) pandemic has increased concern regarding SARS-CoV-2 infection in inflammatory bowel disease (IBD) patients, especially those on immunosuppressive therapies or with active disease. There are limited reports describing the clinical features of COVID-19 in an IBD population, and the impact of immunosuppression on the severity of the infection remains unclear. Case Report: A 33-year-old female patient with a long history of ulcerative colitis, poorly controlled, was admitted with COVID-19 a few days after being discharged from the hospital for treatment of acute severe ulcerative colitis. High-risk factors for COVID-19 complications, i.e., high-dose steroids (40 mg prednisone) and severe active disease, were present at admission. Despite the development of extensive pulmonary involvement, the patient had a favorable outcome. Discussion: Management of IBD patients during the COVID-19 pandemic has been challenging. Measures to minimize the potential risk of SARS-CoV-2 infection, including strict social distancing and self-isolation, in the IBD population have been recommended, especially for high-risk patients. Although steroid tapering and persistence of biologics are advised by professional groups, the best treatment strategy for IBD patients presenting a flare during the outbreak has yet to be defined.
Keywords	colitis ; coronavirus infections ; covid-19 ; inflammatory bowel disease ; ulcerative colitis ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; covid19
Subject code	610
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Karger Publishers
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Concentração sérica de lípides e apolipoproteína B em recém-nascidos Concentration of serum lipids and apolipoprotein B in newborns

Sirlei Donegá / Jane Oba / Raul C. Maranhão

Arquivos Brasileiros de Cardiologia, Vol 86, Iss 6, Pp 419-

2006 Volume 424

Abstract: OBJETIVO: Determinar numa população de recém-nascidos de uma cidade do sul do Brasil as concentrações de lípides séricos e apolipoproteína B (apo-B) em neonatos normais a termo e pré-termo, analisando-se a influência da idade gestacional e do peso ao ... ...

Abstract	OBJETIVO: Determinar numa população de recém-nascidos de uma cidade do sul do Brasil as concentrações de lípides séricos e apolipoproteína B (apo-B) em neonatos normais a termo e pré-termo, analisando-se a influência da idade gestacional e do peso ao nascimento. MÉTODOS: Foram estudados 212 neonatos de ambos os sexos, deles, 142 a termo (>37 semanas de gestação) e 70 neonatos pré-termo (<37 semanas). Os neonatos a termo e pré-termo foram classificados pelo peso de nascimento em pequeno para a idade gestacional ou adequado para a idade gestacional. Utilizou-se o sangue do cordão umbilical para as análises bioquímicas. RESULTADOS: Os valores de colesterol total, LDL-C, HDL-C e de apo-B foram maiores nos neonatos pré-termo (79±34, 26±6, 45±15 e 36±14 mg/dL, respectivamente) do que nos neonatos a termo (58±19, 20±10, 31±14 e 28±7 mg/dL, respectivamente; p < 0,0001). Inversamente, os valores de triglicérides foram menores nos neonatos pré-termo (36±14 mg/dL) do que nos neonatos a termo (43±25 mg/dL; p < 0,0018). O sexo e o fato de o neonato ser pequeno ou adequado para a idade gestacional não influenciaram os valores de colesterol total e frações, de triglicérides e apo-B. CONCLUSÃO: As concentrações de lípides plasmáticos e de apo-B dos neonatos da população estudada são semelhantes às dos neonatos de outros países de continentes diversos reportados na literatura e, como esperado, é acentuadamente menor do que os valores referidos na literatura para as de crianças acima de dois anos. A maturidade fetal influencia a concentração de lípides dos neonatos, mas o peso de nascimento não tem efeito nesses parâmetros. OBJECTIVE: To determine the concentrations of serum lipids and apolipoprotein B (apo-B) in a population of normal full-term and preterm newborns in a city in Southern Brazil, and assess the impact of gestational age and birth weight on these values. METHODS: Two hundred and twelve newborns of both genders were studied, 142 of whom were full-term (>37 weeks of gestation) and 70 preterm (<37 weeks of gestation). According to their birth weights, the full-term and preterm newborns were classified as small for gestational age or appropriate for gestational age. Umbilical cord blood was collected for biochemical analysis. RESULTS: The total cholesterol, LDL-C, HDL-C and apo-B values were higher in preterm newborns (79±34, 26±6, 45±15 and 36±14 mg/dL, respectively ) than in full-term newborns (58±19, 20±10, 31±14 and 28±7 mg/dL, respectively; p < 0.0001). Inversely, triglyceride values were lower in preterm newborns (36±14 mg/dL) than in full-term newborns (43±25 mg/dL; p < 0.0018). Gender and size at birth did not have any impact on the values of total cholesterol and fractions, triglycerides, and apo-B. CONCLUSION: Plasma concentrations of lipids and apo-B in the population of newborns studied are similar to those in newborns from other countries and continents reported in medical literature and, as expected, are markedly lower than the values mentioned in literature for infants over two years of age. Fetal maturity has an impact on the concentration of lipids in newborns, but birth weight does not have any effect on these parameters.
Keywords	Recém-nascidos ; colesterol ; triglicérides ; lipoproteína de alta densidade ; lipoproteína de baixa densidade ; Newborns ; cholesterol ; triglycerides ; high-density lipoprotein ; low-density lipoprotein ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2006-06-01T00:00:00Z
Publisher	Sociedade Brasileira de Cardiologia - SBC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Celiac crisis with ataxia in a child

Jane Oba / Ana Maria Escobar / Benita G. S Schvartsman / José Luiz Gherpelli

Clinics, Vol 66, Iss 1, Pp 173-

2011 Volume 175

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2011-01-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

Alberto C. Helito / Livia Lindoso / Sofia M. Sieczkowska / Camilla Astley / Ligia B. Queiroz / Natalia Rose / Claudia Renata P. Santos / Thalis Bolzan / Rita María I.A. Peralta / Ruth R. Franco / Louise Cominato / Rosa Maria R. Pereira / Uenis Tannuri / Lucia Maria A. Campos / Benito Lourenço / Ricardo K. Toma / Karina Medeiros / Andréia Watanabe / Patricia Moreno Grangeiro /

Sylvia C. Farhat / Caio B. Casella / Guilherme V. Polanczyk / Bruno Gualano / Clovis A. Silva / Adriana M. E. Sallum / Amanda Y. Iraha / Bianca P. Ihara / Bruna C. Mazzolani / Claudia A. Martinez / Claudia A. A. Strabelli / Claudia B. Fonseca / Dandara C. C. Lima / Debora N. D. Setoue / Deborah F. P. Roz / Fabiana I. Smaira / Hamilton Roschel / Helena T. Miyatani / Isabela G. Marques / Jane Oba / Juliana C. O. Ferreira / Juliana R. Simon / Katia Kozu / Ligia P. Saccani / Lorena V. M. Martiniano / Luana C. A. Miranda / Luiz E. V. Silva / Moisés F. Laurentino / Nadia E. Aikawa / Neusa K. Sakita / Nicolas Y. Tanigava

Clinics, Vol

2021 Volume 76

Abstract: OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included ... ...

Abstract	OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality ...
Keywords	COVID-19 ; Sleep ; Adolescent ; Chronic Condition ; Health-Related Quality of Life ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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