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  1. Article ; Online: Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in São Paulo, Brazil.

    Perondi, Beatriz / Miethke-Morais, Anna / Montal, Amanda C / Harima, Leila / Segurado, Aluisio C

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

    2020  Volume 24, Issue 6, Page(s) 570–574

    Abstract: As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing ... ...

    Abstract As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900-bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients.
    MeSH term(s) Brazil ; COVID-19 ; Cities ; Continuity of Patient Care ; Coronavirus Infections/epidemiology ; Hospitals, Public ; Humans ; Latin America ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-31
    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.2020.09.005
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    Zs.A 5633: Show issues Location:
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  2. Article ; Online: Discrepancies Between Clinical and Autopsy Diagnoses in Rapid Response Team-Assisted Patients: What Are We Missing?

    Giugni, Fernando Rabioglio / Salvadori, Fernanda Aburesi / Smeili, Luciana Andrea Avena / Marcílio, Izabel / Perondi, Beatriz / Mauad, Thais / de Paiva, Edison Ferreira / Duarte-Neto, Amaro Nunes

    Journal of patient safety

    2022  Volume 18, Issue 7, Page(s) 653–658

    Abstract: Objectives: The rapid response team (RRT) assists hospitalized patients with sudden clinical deterioration. There is scarce evidence of diagnostic accuracy in this scenario, but it is possible that a considerable rate of misdiagnosis exists. Autopsy ... ...

    Abstract Objectives: The rapid response team (RRT) assists hospitalized patients with sudden clinical deterioration. There is scarce evidence of diagnostic accuracy in this scenario, but it is possible that a considerable rate of misdiagnosis exists. Autopsy remains a valuable tool for assessing such question. This study aimed to compare clinical (premortem) and autopsy (postmortem) diagnoses in patients assisted by the RRT and describe major discrepancies.
    Methods: We reviewed 104 clinical data and autopsies from patients assisted by the RRT during a cardiac arrest event in a tertiary care hospital in Brazil. Clinical and autopsy diagnostic discrepancies were classified using the Goldman criteria. Other clinical and pathological data were described, and the group with major diagnostic discrepancies was further analyzed.
    Results: We found 39 (37.5%) patients with major diagnostic discrepancies. Most frequent immediate causes of death in this group determined by autopsy were sepsis (36%), pulmonary embolism (23%) and hemorrhagic shock (21%). Pulmonary embolism was the cause of death significantly more frequent in the major discrepancy group than in the minor discrepancy group (23% versus 3%, P = 0.002). We individually described all major diagnostic discrepancies.
    Conclusions: We found a high rate (37.5%) of major misdiagnosis in autopsies from patients assisted by the RRT in a tertiary teaching hospital. Pulmonary embolism was the most inaccurate fatal diagnosis detected by autopsy.
    MeSH term(s) Autopsy ; Cause of Death ; Diagnostic Errors ; Hospital Rapid Response Team ; Humans ; Pulmonary Embolism ; Retrospective Studies
    Language English
    Publishing date 2022-01-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000962
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  3. Article: Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in São Paulo, Brazil

    Perondi, Beatriz / Miethke-Morais, Anna / Montal, Amanda C / Harima, Leila / Segurado, Aluisio C

    Braz. j. infect. dis

    Abstract: As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing ... ...

    Abstract As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900-bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #893643
    Database COVID19

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  4. Article ; Online: Setting up hospital care provision to patients with COVID-19

    Perondi, Beatriz / Miethke-Morais, Anna / Montal, Amanda C. / Harima, Leila / Segurado, Aluisio C.

    The Brazilian Journal of Infectious Diseases ; ISSN 1413-8670

    lessons learnt at a 2400-bed academic tertiary center in São Paulo, Brazil

    2020  

    Keywords Microbiology (medical) ; Infectious Diseases ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    DOI 10.1016/j.bjid.2020.09.005
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Phylogeographic patterns of the yellow fever virus around the metropolitan region of São Paulo, Brazil, 2016-2019.

    Cunha, Marielton Dos Passos / Duarte-Neto, Amaro Nunes / Pour, Shahab Zaki / Pereira, Bárbara Brito de Souza / Ho, Yeh-Li / Perondi, Beatriz / Sztajnbok, Jaques / Alves, Venancio Avancini Ferreira / da Silva, Luiz Fernando Ferraz / Dolhnikoff, Marisa / Saldiva, Paulo Hilário Nascimento / Zanotto, Paolo Marinho de Andrade

    PLoS neglected tropical diseases

    2022  Volume 16, Issue 9, Page(s) e0010705

    Abstract: From 2016 to 2019, the largest outbreak caused by the Yellow Fever virus (YFV) in the 21st century in the Americas occurred in southeastern Brazil. A sylvatic cycle of transmission was reported near densely populated areas, such as the large metropolitan ...

    Abstract From 2016 to 2019, the largest outbreak caused by the Yellow Fever virus (YFV) in the 21st century in the Americas occurred in southeastern Brazil. A sylvatic cycle of transmission was reported near densely populated areas, such as the large metropolitan area of the city of São Paulo. Here, we describe the origin, spread, and movement of the YFV throughout the state of São Paulo. Whole-genome sequences were obtained from tissues of two patients who died due to severe yellow fever, during 2018-2019. Molecular analysis indicated that all analyzed tissues were positive for YFV RNA, with the liver being the organ with the highest amount of viral RNA. Sequence analysis indicates that genomes belonged to the South American genotype I and were grouped in the epidemic clade II, which includes sequences from the states of Goiás, Minas Gerais, and São Paulo of previous years. The analysis of viral dispersion indicates that the outbreak originated in Goiás at the end of 2014 and reached the state of São Paulo through the state of Minas Gerais after 2016. When the virus reached near the urban area, it spread towards both the east and south regions of the state, not establishing an urban transmission cycle in the metropolitan region of São Paulo. The virus that moved towards the east met with YFV coming from the south of the state of Rio de Janeiro, and the YFV that was carried to the south reached the Brazilian states located in the south region of the country.
    MeSH term(s) Brazil/epidemiology ; Disease Outbreaks ; Humans ; Phylogeography ; RNA, Viral/genetics ; Yellow Fever ; Yellow fever virus/genetics
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2022-09-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0010705
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  6. Article ; Online: A decision-aid tool for ICU admission triage is associated with a reduction in potentially inappropriate intensive care unit admissions.

    Ramos, Joao Gabriel Rosa / Ranzani, Otavio T / Perondi, Beatriz / Dias, Roger Daglius / Jones, Daryl / Carvalho, Carlos Roberto Ribeiro / Velasco, Irineu Tadeu / Forte, Daniel Neves

    Journal of critical care

    2019  Volume 51, Page(s) 77–83

    Abstract: Purpose: Intensive care unit (ICU) admission triage occurs frequently and often involves highly subjective decisions that may lead to potentially inappropriate ICU admissions. In this study, we evaluated the effect of implementing a decision-aid tool ... ...

    Abstract Purpose: Intensive care unit (ICU) admission triage occurs frequently and often involves highly subjective decisions that may lead to potentially inappropriate ICU admissions. In this study, we evaluated the effect of implementing a decision-aid tool for ICU triage on ICU admission decisions.
    Methods: This was a prospective, before-after study. Urgent ICU referrals to ten ICUs in a tertiary hospital in Brazil were assessed before and after the implementation of the decision-aid tool. Our primary outcome was the proportion of potentially inappropriate ICU referrals (defined as priority 4B or 5 referrals, accordingly to the Society of Critical Care Medicine guidelines of 1999 and 2016, respectively) admitted to the ICU within 48 h. We conducted multivariate analyses to adjust for potential confounders and evaluated the interaction between phase and triage priority.
    Results: Of the 2201 patients analyzed, 1184 (53.8%) patients were admitted to the ICU. After adjustment for confounders, implementation of the decision-aid tool was associated with a reduction in potentially inappropriate ICU admissions using either the 1999 [adjOR (95% CI) = 0.36 (0.13-0.97)] or 2016 [adjOR (95%CI) = 0.35 (0.13-0.96)] definitions.
    Conclusion: Implementation of a decision-aid tool for ICU triage was associated with a reduction in potentially inappropriate ICU admissions.
    MeSH term(s) Adult ; Aged ; Brazil ; Critical Care/standards ; Decision Support Techniques ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multivariate Analysis ; Patient Admission/standards ; Prospective Studies ; Severity of Illness Index ; Tertiary Care Centers ; Triage
    Language English
    Publishing date 2019-02-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2019.02.002
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    Zs.A 2152: Show issues Location:
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  7. Book ; Online: Epidemiologic Surveillance in an academic hospital during the COVID-19 pandemic in Sao Paulo, Brazil

    Marcilio, Izabel / Miethke-Morais, Anna / Harima, Leila / Montal, Amanda C. / Perondi, Beatriz / Ayres, Jose Ricardo de Carvalho Mesquita / Gouveia, Nelson / Bonfa, Eloisa / Novaes, Hillegonda Maria Dutilh

    Clinics v.75 2020

    the key role of epidemiologic engagement in operational processes

    2020  

    Keywords covid19
    Language English
    Publishing date 2020-01-01
    Publisher Faculdade de Medicina / USP
    Publishing country br
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Transforming operating rooms into intensive care units and the versatility of the physician anesthesiologist during the COVID-19 crisis.

    Carmona, Maria José Carvalho / Quintão, Vinícius Caldeira / Melo, Brigite Feiner de / André, Rodrigo Guerson / Kayano, Rafael Priante / Perondi, Beatriz / Miethke-Morais, Anna / Rocha, Marcelo Cristiano / Malbouisson, Luiz Marcelo Sá / Auler-Júnior, José Otávio Costa

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e2023

    MeSH term(s) Anesthesiologists/education ; Betacoronavirus ; Brazil ; COVID-19 ; Coronavirus Infections/therapy ; Hospitals, University/standards ; Humans ; Intensive Care Units/standards ; Operating Rooms/standards ; Pandemics ; Pneumonia, Viral/therapy ; SARS-CoV-2 ; Ventilators, Mechanical
    Keywords covid19
    Language English
    Publishing date 2020-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e2023
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  9. Article ; Online: Epidemiologic Surveillance in an academic hospital during the COVID-19 pandemic in Sao Paulo, Brazil: the key role of epidemiologic engagement in operational processes.

    Marcilio, Izabel / Miethke-Morais, Anna / Harima, Leila / Montal, Amanda C / Perondi, Beatriz / Ayres, Jose Ricardo de Carvalho Mesquita / Gouveia, Nelson / Bonfa, Eloisa / Novaes, Hillegonda Maria Dutilh

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e2166

    MeSH term(s) Academic Medical Centers/organization & administration ; Betacoronavirus ; Brazil/epidemiology ; COVID-19 ; Coronavirus Infections/epidemiology ; Epidemiological Monitoring ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-07-22
    Publishing country United States
    Document type Editorial
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e2166
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  10. Article ; Online: Virtual visits to inpatients by their loved ones during COVID-19.

    Rios, Izabel Cristina / Carvalho, Ricardo Tavares de / Ruffini, Vitor Maia Teles / Montal, Amanda Cardoso / Harima, Leila Suemi / Crispim, Douglas Henrique / Arai, Lilian / Perondi, Beatriz / Morais, Anna Miethke / Andrade, Andrea Janaina de / Bonfa, Eloisa Silva Dutra de Oliveira

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e2171

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Humans ; Inpatients ; Internet ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Videoconferencing ; Visitors to Patients
    Keywords covid19
    Language English
    Publishing date 2020-07-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e2171
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