Publications by authors named "Avelino Silva"

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

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Background: Increasing syphilis infection rates are a concerning issue worldwide. Blood donation screening is an opportunity to monitor the burden of asymptomatic infections, providing information on contemporary factors associated with infection and public health insights into transmission.

Methods: Blood donations collected at five Brazilian blood centers between January 2020 and February 2022 were screened with treponemal or non-treponemal assays according to local protocols, followed by alternate Enzyme-Linked Immunosorbent Assay (ELISA); samples with reactive or indeterminate results in the alternate ELISA were further tested with the rapid plasma reagin (RPR), and categorized as RPR-positive or RPR-negative.

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Objective: To investigate differences in the prevalence of frailty between LGBT+ and non-LGBT+ older adults.

Methods: A cross-sectional study involving Brazilians aged 50 and over was performed. The participants were invited to participate in an anonymous online survey between August 2019 and January 2020.

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Objective: Vaccine hesitancy is a relevant driver of backslides in immunization rates globally. Myths and misinformation are key contributors to vaccine hesitancy. We aimed to investigate associations between beliefs in popular vaccine myths and vaccine incompleteness.

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Background: Older adults often require surgical care and are at elevated risk of delirium. We explored delirium risk profiles across the population of U.S.

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Background: General vaccination rates have been falling globally despite unequivocal health benefits. Noncompliance can result from access barriers and/or hesitant attitudes. Few studies have investigated the prevalence and determinants of noncompliance with COVID-19 vaccination in blood donors.

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Introduction: A substantial percentage of people with HIV are still admitted for care at advanced disease stages. Here, we investigate the availability of the supplies and infrastructure required to provide care for this population in healthcare facilities and explore correlations with local demand.

Methods: AIDS Healthcare Foundation's partner facilities were invited to respond to a survey addressing the availability of services to support clients with advanced HIV.

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Introduction: Mutations associated with HIV drug resistance (DR) affect clinical outcomes. Understanding the prevalence of HIV DR and its association with viral suppression and survival in the paediatric population is key to inform patient care and health policies.

Methods: We used Brazilian monitoring systems to identify genotyping tests performed in children living with HIV aged ≤18 months between 2009 and 2020.

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Article Synopsis
  • Vaccine hesitancy has been heightened during the COVID-19 pandemic, with social media playing a significant role in spreading both accurate information and misinformation.
  • The study analyzed open-ended responses regarding COVID-19 vaccine refusal, identifying five key themes: individuality, fear of side effects, political ideologies, skepticism about efficacy, and opposition to non-natural products.
  • Findings indicate that social media can amplify misinformation and foster vaccine hesitancy, highlighting the need for tailored health communication strategies to improve understanding and collective wellbeing.
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Background: Exposure to antiretrovirals at or early after HIV acquisition can suppress viral replication and blunt antibody (Ab) responses; a reduced HIV detectability could impact diagnosis and blood donation screening.

Methods: We used three antigen (Ag)/Ab assays and one nucleic acid test (NAT) to analyze samples collected in pre-exposure prophylaxis (PrEP) trials (iPrEx; Partners PrEP) before infection detection by Ab-only rapid diagnostic tests (RDTs), and in early antiretroviral treatment (ART) initiation studies (RV254; SIPP).

Results: Reactivity using NAT and Ag/Ab assays in samples collected up to 8 weeks prior to the first reactive RDT from 251 PrEP trials participants varied between 49-61% for active PrEP users and between 27-37% for placebo users.

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Article Synopsis
  • Cardiometabolic diseases can worsen COVID-19 outcomes, and this study aimed to see if variability in related health indicators affects hospitalizations and long-term symptoms (PCC) in generally healthy individuals.
  • The study involved 3,344 blood donors whose health data was analyzed over several years and found that higher variability in body mass index (BMI) was linked to increased hospitalization and PCC risk, while blood pressure and cholesterol variability did not show a significant relationship.
  • The findings suggest that maintaining consistent BMI could be important for reducing COVID-19 severity and associated long-term effects.
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Article Synopsis
  • Long COVID is a complex condition affecting about 12% of COVID-19 survivors, with various symptoms and no widely accepted definition, pushing researchers to study its immune profile.
  • A survey of over 33,000 blood donors revealed that higher levels of anti-nucleocapsid antibodies are linked to an increased risk of long COVID, while higher anti-spike IgG levels can reduce that risk.
  • The study identified four clinical subphenotypes—ranging from neurological to multi-systemic symptoms—suggesting that different immune responses may contribute to varied long COVID experiences.
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Background: HIV Pre-Exposure Pophylaxis (PrEP) is provided free of charge by the Brazilian national health system. Though effective in preventing HIV infection, little is known about its impact on the health-related Quality of Life (QoL) of users.

Objective: The present study aimed at assessing the impact of PrEP on the QoL of its users.

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Objectives: This study sought to explore and externally validate the Carpenter instrument's efficacy in predicting postdischarge fall risk among older adults admitted to the emergency department (ED) for reasons other than falls or related injuries.

Methods: A prospective cohort study was conducted on 779 patients aged ≥ 65 years from a tertiary hospital in São Paulo, Brazil, who were monitored for up to 6 months post-ED hospitalization. The Carpenter instrument, which evaluates the four risk factors nonhealing foot sores, self-reported depression, inability to self-clip toenails, and prior falls, was utilized to assess fall risk.

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Preparedness to endure extreme situations such as natural disasters or military conflicts is not commonplace in healthcare training programs. Moreover, multidisciplinary teams in health services rarely (if ever) include experts in security. However, when emergency situations occur, prevailing healthcare demands do not cease to exist, and unexpected demands often surge due to the shortage of other services and supplies or as a consequence of the emergency condition itself.

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Objective: Malnutrition is one of the most threatening conditions in geriatric populations. The gut microbiota has an important role in the host's metabolic and muscular health: however, its interplay with disease-related malnutrition is not well understood. We aimed to identify the association of malnutrition with the gut microbiota and predict clinical outcomes in hospitalized acutely ill older adults.

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Introduction: he challenge was to provide comprehensive health resources to a remote and underserved population living in the Brazil-Colombia-Peru border, amid the most disruptive global crisis of the century.

Methods: In August 2021, Fundação Oswaldo Cruz Amazonia (FIOCRUZ Amazônia) and partner collaborators implemented an overarching provisional program for SARS-CoV-2 detection and lineages characterization, training of laboratory personnel and healthcare providers, donation of diagnostic supplies and personal protective equipment, and COVID-19 vaccination. The expedition was conducted at the Port of Tabatinga, a busy terminal with an intense flux of people arriving and departing in boats of all sizes, located in the Amazon River basin.

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Background: Multiple short delirium detection tools have been validated in research studies and implemented in routine care, but there has been little study of these tools in real-world conditions. This systematic review synthesized literature reporting completion rates and/or delirium positive score rates of detection tools in large clinical populations in general hospital settings.

Methods: PROSPERO (CRD42022385166).

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Background: Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia.

Methods: This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged ≥ 60 years admitted to 38 hospitals from 19 cities in Brazil.

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Objectives: We investigated functional trajectories after severe COVID-19 and estimated their associations with adverse outcomes (falls, rehospitalizations, institutionalization, or death), cognition and post COVID-19 condition within 1-year of hospital discharge.

Design: Prospective cohort study.

Setting: A large academic medical center in Sao Paulo, Brazil.

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