Deep learning framework for epidemiological forecasting: A study on COVID-19 cases and deaths in the Amazon state of Pará, Brazil.

Modeling time series has been a particularly challenging aspect due to the need for constant adjustments in a rapidly changing environment, data uncertainty, dependencies between variables, volatile fluctuations, and the need to identify ideal hyperparameters. The present study presents a Framework capable of making projections from time series related to cases and deaths by COVID-19 in the Amazonian state of Pará, in Brazil. For the first time, deep learning models such as TCN, TRANSFORMER, TFT, N-BEATS, and N-HiTS were assessed for this purpose. The ARIMA statistical model was also used in post-processing for residual adjustment and short-term smoothing of the generated forecasts. The Framework generates probabilistic forecasts, with multivariate support, considering the following variables: daily cases per day of the first symptom, cases published daily, the occurrence of deaths, deaths published daily, and percentage of daily vaccination. The generated predictions are statistically evaluated by determining the best model for 7-day moving average projections using evaluating metrics such as MSE, RMSE, MAPE, sMAPE, r2, Coefficient of Variation, and residual analysis. As a result, the generated projections showed an average error of 5.4% for Cases Publication, 8.0% for Cases Symptoms, 11.12% for Deaths Publication, and 4.6% for Deaths Occurrence, with the N-HiTS and N-BEATS models obtaining better results. In general terms, the use of deep learning models to predict cases and deaths from COVID-19 has proven to be a valuable practice for analyzing the spread of the virus, which allows health managers to better understand and respond to this kind of pandemic outbreak.

Genomic Characterization of Aeromonas veronii Provides Insights into Taxonomic Assignment and Reveals Widespread Virulence and Resistance Genes throughout the World.

Aeromonas veronii is a Gram-negative bacterial species that causes disease in fish and is nowadays increasingly recurrent in enteric infections of humans. This study was performed to characterize newly sequenced isolates by comparing them with complete genomes deposited at the NCBI (National Center for Biotechnology Information). Nine isolates from fish, environments, and humans from the São Francisco Valley (Petrolina, Pernambuco, Brazil) were sequenced and compared with complete genomes available in public databases to gain insight into taxonomic assignment and to better understand virulence and resistance profiles of this species within the One Health context. One local genome and four NCBI genomes were misidentified as A. veronii. A total of 239 virulence genes were identified in the local genomes, with most encoding adhesion, motility, and secretion systems. In total, 60 genes involved with resistance to 22 classes of antibiotics were identified in the genomes, including mcr-7 and cphA. The results suggest that the use of methods such as ANI is essential to avoid misclassification of the genomes. The virulence content of A. veronii from local isolates is similar to those complete genomes deposited at the NCBI. Genes encoding colistin resistance are widespread in the species, requiring greater attention for surveillance systems.

In silico approach to identify microsatellite candidate biomarkers to differentiate the biovar of Corynebacterium pseudotuberculosis genomes.

Corynebacterium pseudotuberculosis is the causative bacterial agent of the zoonotic disease known as caseous lymphadenitis, and it presents several mechanisms of response to host defenses, including the presence of virulence factors (VFs). The genomes of these bacteria have several polymorphic markers known as microsatellites, or simple sequence repeats (SSRs), that can be used to characterize the genome, to study possible polymorphisms existing among strains, and to verify the effects of such polymorphic markers in coding regions and regions associated with VFs. In this study, several SSRs were identified within coding regions throughout the 54 genomes of this species, revealing possible polymorphisms associated with coding regions that could be used as strain-specific or serotype-specific identifiers of C. pseudotuberculosis. The similarities associated with SSRs amongst the different serum variants of C. pseudotuberculosis, biovars equi and ovis, were also evaluated, and it was possible to identify SSRs located in coding regions responsible for a VF enrolled in pathogenesis known to mediate bacterial adherence (SpaH-type pili virulence factor). Phylogenetic analyses revealed that strains sharing SSR patterns, including the possible polymorphisms identified in the same position of gene-coding regions, were displayed by strains with a common ancestor, corroborating with the Genome Tree Report of the NCBI. Statistical analysis showed that the microsatellite groups belonging to equi and ovis biovars have a significance of 0.006 (p-value) in similarity, thus indicating them as good biomarker candidates for C. pseudotuberculosis.

Text mining for identification of biological entities related to antibiotic resistant organisms.

Antimicrobial resistance is a significant public health problem worldwide. In recent years, the scientific community has been intensifying efforts to combat this problem; many experiments have been developed, and many articles are published in this area. However, the growing volume of biological literature increases the difficulty of the biocuration process due to the cost and time required. Modern text mining tools with the adoption of artificial intelligence technology are helpful to assist in the evolution of research. In this article, we propose a text mining model capable of identifying and ranking prioritizing scientific articles in the context of antimicrobial resistance. We retrieved scientific articles from the PubMed database, adopted machine learning techniques to generate the vector representation of the retrieved scientific articles, and identified their similarity with the context. As a result of this process, we obtained a dataset labeled "Relevant" and "Irrelevant" and used this dataset to implement one supervised learning algorithm to classify new records. The model's overall performance reached 90% accuracy and the f-measure (harmonic mean between the metrics) reached 82% accuracy for positive class and 93% for negative class, showing quality in the identification of scientific articles relevant to the context. The dataset, scripts and models are available at https://github.com/engbiopct/TextMiningAMR.

Bacteriocin Producing Streptococcus agalactiae Strains Isolated from Bovine Mastitis in Brazil.

Antibiotic resistance is one of the biggest health challenges of our time. We are now facing a post-antibiotic era in which microbial infections, currently treatable, could become fatal. In this scenario, antimicrobial peptides such as bacteriocins represent an alternative solution to traditional antibiotics because they are produced by many organisms and can inhibit bacteria, fungi, and/or viruses. Herein, we assessed the antimicrobial activity and biotechnological potential of 54 Streptococcus agalactiae strains isolated from bovine mastitis. Deferred plate antagonism assays revealed an inhibition spectrum focused on species of the genus Streptococcus-namely, S. pyogenes, S. agalactiae, S. porcinus, and S. uberis. Three genomes were successfully sequenced, allowing for their taxonomic confirmation via a multilocus sequence analysis (MLSA). Virulence potential and antibiotic resistance assessments showed that strain LGMAI_St_08 is slightly more pathogenic than the others. Moreover, the mreA gene was identified in the three strains. This gene is associated with resistance against erythromycin, azithromycin, and spiramycin. Assessments for secondary metabolites and antimicrobial peptides detected the bacteriocin zoocin A. Finally, comparative genomics evidenced high similarity among the genomes, with more significant similarity between the LGMAI_St_11 and LGMAI_St_14 strains. Thus, the current study shows promising antimicrobial and biotechnological potential for the Streptococcus agalactiae strains.

Genome Sequence of Pseudomonas sp. Strain LAP_36, A Rhizosphere Bacterium Isolated from King George Island, Antarctica.

Pseudomonas sp. strain LAP_36 was isolated from rhizosphere soil from Deschampsia antarctica on King George Island, South Shetland Islands, Antarctica. Here, we report on its draft genome sequence, which consists of 8,794,771 bp with 60.0% GC content and 8,011 protein-coding genes.

Correlation Between 2D Strain and Classic Echocardiographic Indices in the Diagnosis of Right Ventricular Dysfunction in COPD.

Purpose: This study aims to define which of the right ventricular myocardial deformation indices best correlates with the classic echocardiographic measurements and indices of right ventricular (RV) dysfunction in patients with stable chronic obstructive pulmonary disease (COPD). Patients and Methods: Ninety-one patients with stable COPD underwent clinical evaluation, spirometry, a 6-minute walk test, and echocardiographic examination. Patients were divided into two groups: "with RV dysfunction" (≥1 classic parameter) and "without RV dysfunction". We used speckle tracking to estimate myocardial deformation. For all analyses, results were considered significant if p < 0.05. Results: The mean age across all participants was 65 ± 9 years, with 53% (48/91) being male. Patients in the group with RV dysfunction were able to walk shorter distances and had higher estimated right ventricular systolic pressure (RVSP) and mean pulmonary arterial pressure (mPAP). The RV free wall longitudinal strain (RVFWLS) was the only deformation indices that showed a significant correlation with all classic measurements and indices in the diagnosis of RV dysfunction (Wald test, 10.24; p < 0.01; odds ratio, 1.61). In the ROC curve analysis, the absolute value <20% was the lowest cut-off point of this index for detection of RV dysfunction (AUC = 0.93, S: 95.8%, and E: 88%). Conclusion: In COPD patients, RVFWLS is the myocardial deformation index that best correlates with classic echocardiographic parameters for the diagnosis of RV dysfunction using <20% as a cut-off point.

Functional annotation of hypothetical proteins from the Exiguobacterium antarcticum strain B7 reveals proteins involved in adaptation to extreme environments, including high arsenic resistance.

Exiguobacterium antarcticum strain B7 is a psychrophilic Gram-positive bacterium that possesses enzymes that can be used for several biotechnological applications. However, many proteins from its genome are considered hypothetical proteins (HPs). These functionally unknown proteins may indicate important functions regarding the biological role of this bacterium, and the use of bioinformatics tools can assist in the biological understanding of this organism through functional annotation analysis. Thus, our study aimed to assign functions to proteins previously described as HPs, present in the genome of E. antarcticum B7. We used an extensive in silico workflow combining several bioinformatics tools for function annotation, sub-cellular localization and physicochemical characterization, three-dimensional structure determination, and protein-protein interactions. This genome contains 2772 genes, of which 765 CDS were annotated as HPs. The amino acid sequences of all HPs were submitted to our workflow and we successfully attributed function to 132 HPs. We identified 11 proteins that play important roles in the mechanisms of adaptation to adverse environments, such as flagellar biosynthesis, biofilm formation, carotenoids biosynthesis, and others. In addition, three predicted HPs are possibly related to arsenic tolerance. Through an in vitro assay, we verified that E. antarcticum B7 can grow at high concentrations of this metal. The approach used was important to precisely assign function to proteins from diverse classes and to infer relationships with proteins with functions already described in the literature. This approach aims to produce a better understanding of the mechanism by which this bacterium adapts to extreme environments and to the finding of targets with biotechnological interest.

Pan4Draft: A Computational Tool to Improve the Accuracy of Pan-Genomic Analysis Using Draft Genomes.

High-throughput sequencing technologies are a milestone in molecular biology for facilitating great advances in genomics by enabling the deposit of large volumes of biological data to public databases. The availability of such data has made possible the comparative genomic analysis through pipelines, using the entire gene repertoire of genomes. However, a large number of unfinished genomes exist in public databases; their number is approximately 16-fold higher than the number of complete genomes, which creates bias during comparative analyses. Therefore, the present work proposes a new tool called Pan4Drafts, an automated pipeline for pan-genomic analysis of draft prokaryotic genomes to maximize the representation and accuracy of the gene repertoire of unfinished genomes by using reads from sequencing data. Pan4Draft allows to perform comparative analyses using different methodologies such as combining complete and draft genomes, using only draft genomes or only complete genomes. Pan4Draft is available at http://www.computationalbiology.ufpa.br/pan4drafts and the test dataset is available at https://sourceforge.net/projects/pan4drafts .

GO FEAT: a rapid web-based functional annotation tool for genomic and transcriptomic data.

Downstream analysis of genomic and transcriptomic sequence data is often executed by functional annotation that can be performed by various bioinformatics tools and biological databases. However, a full fast integrated tool is not available for such analysis. Besides, the current available software is not able to produce analytic lists of annotations and graphs to help users in evaluating the output results. Therefore, we present the Gene Ontology Functional Enrichment Annotation Tool (GO FEAT), a free web platform for functional annotation and enrichment of genomic and transcriptomic data based on sequence homology search. The analysis can be customized and visualized as per users' needs and specifications. GO FEAT is freely available at http://computationalbiology.ufpa.br/gofeat/ and its source code is hosted at https://github.com/fabriciopa/gofeat .

PhageWeb - Web Interface for Rapid Identification and Characterization of Prophages in Bacterial Genomes.

This study developed a computational tool with a graphical interface and a web-service that allows the identification of phage regions through homology search and gene clustering. It uses G+C content variation evaluation and tRNA prediction sites as evidence to reinforce the presence of prophages in indeterminate regions. Also, it performs the functional characterization of the prophages regions through data integration of biological databases. The performance of PhageWeb was compared to other available tools (PHASTER, Prophinder, and PhiSpy) using Sensitivity (Sn) and Positive Predictive Value (PPV) tests. As a reference for the tests, more than 80 manually annotated genomes were used. In the PhageWeb analysis, the Sn index was 86.1% and the PPV was approximately 87%, while the second best tool presented Sn and PPV values of 83.3 and 86.5%, respectively. These numbers allowed us to observe a greater precision in the regions identified by PhageWeb while compared to other prediction tools submitted to the same tests. Additionally, PhageWeb was much faster than the other computational alternatives, decreasing the processing time to approximately one-ninth of the time required by the second best software. PhageWeb is freely available at http://computationalbiology.ufpa.br/phageweb.

PanWeb: A web interface for pan-genomic analysis.

With increased production of genomic data since the advent of next-generation sequencing (NGS), there has been a need to develop new bioinformatics tools and areas, such as comparative genomics. In comparative genomics, the genetic material of an organism is directly compared to that of another organism to better understand biological species. Moreover, the exponentially growing number of deposited prokaryote genomes has enabled the investigation of several genomic characteristics that are intrinsic to certain species. Thus, a new approach to comparative genomics, termed pan-genomics, was developed. In pan-genomics, various organisms of the same species or genus are compared. Currently, there are many tools that can perform pan-genomic analyses, such as PGAP (Pan-Genome Analysis Pipeline), Panseq (Pan-Genome Sequence Analysis Program) and PGAT (Prokaryotic Genome Analysis Tool). Among these software tools, PGAP was developed in the Perl scripting language and its reliance on UNIX platform terminals and its requirement for an extensive parameterized command line can become a problem for users without previous computational knowledge. Thus, the aim of this study was to develop a web application, known as PanWeb, that serves as a graphical interface for PGAP. In addition, using the output files of the PGAP pipeline, the application generates graphics using custom-developed scripts in the R programming language. PanWeb is freely available at http://www.computationalbiology.ufpa.br/panweb.

Malignant multiple sclerosis: clinical and demographic prognostic factors.

Patients with malignant multiple sclerosis (MMS) reach a significant level of disability within a short period of time (Expanded Disability Status Scale score of 6 within five years). The clinical profile and progression of the disease were analyzed in a Brazilian cohort of 293 patients. Twenty-five (8,53%) patients were found to have MMS and were compared with the remaining 268 (91,47%). Women, non-white patients, older age at disease onset, shorter intervals between the first attacks, and more attacks in the first two years of the disease were all more common in the MMS group. These findings could serve as prognostic factors when making therapeutic decisions.

Draft Genome Sequence of Corynebacterium pseudotuberculosis Strain PA07 Biovar ovis, Isolated from a Sheep Udder in Amazonia.

In this work, we present the draft genome sequence of Corynebacterium pseudotuberculosis strain PA07 biovar ovis, isolated from a caseous secretion from a sheep udder in Pará, Brazil. The genome contains 2,320,235 bp, 52.2% G+C content, 2,191 coding sequences (CDSs), five pseudogenes, 48 tRNAs, and three rRNAs.

Malignant multiple sclerosis: clinical and demographic prognostic factors / Esclerose múltipla maligna: fatores prognósticos clínicos e demográficos

ABSTRACT Patients with malignant multiple sclerosis (MMS) reach a significant level of disability within a short period of time (Expanded Disability Status Scale score of 6 within five years). The clinical profile and progression of the disease were analyzed in a Brazilian cohort of 293 patients. Twenty-five (8,53%) patients were found to have MMS and were compared with the remaining 268 (91,47%). Women, non-white patients, older age at disease onset, shorter intervals between the first attacks, and more attacks in the first two years of the disease were all more common in the MMS group. These findings could serve as prognostic factors when making therapeutic decisions.

RESUMO Os doentes com esclerose múltipla maligna (EMM) atingem um nível significativo de incapacidade dentro de um curto período de tempo (EDSS 6 em até 5 anos desde primeiro sintoma/sinal da doença). O perfil clínico e progressão da doença foram analisados em uma coorte brasileira de 293 pacientes. Vinte e cinco (8,53%) pacientes foram encontrados com EMM e foram comparados com os restantes 268 (91,47%). Mulheres, pacientes não-brancos, idade mais avançada no início da doença, intervalos mais curtos entre os primeiros ataques e, mais ataques nos dois primeiros anos da doença, foram mais comuns no grupo com EMM. Estes achados podem servir como fatores prognósticos na tomada de decisão terapêutica.

Automedida da pressão arterial para o controle das cifras tensionais e para a adesão ao tratamento / Self measurement of blood pressure for control of blood pressure levels and adherence to treatment

FUNDAMENTO: A medida da pressão arterial (PA) pelo próprio paciente, sem protocolos rígidos, com treinamento adequado, aparelhos validados e no próprio domicílio, é definida como automedida da pressão arterial (AMPA). OBJETIVO: Avaliar a interferência da AMPA na adesão ao tratamento e no controle pressórico. MÉTODOS: Participaram do estudo 57 pacientes, 38 no grupo de estudo (GE) e 19 no grupo de controle (GC). Esses pacientes foram seguidos por 12 meses e avaliados na randomização (V1), bem como no sexto (V2) e no décimo segundo mês (V3). Comparadas as médias da PA pela medida casual, pela AMPA e pela monitorização ambulatorial da pressão arterial (MAPA), exames laboratoriais e as respostas ao questionário sobre o estilo de vida. Os aparelhos utilizados foram: OMRON HEM 714, para a AMPA; OMRON 705 CP, para a medida casual; e Monitor SPACELABS 9002, para a MAPA. RESULTADOS: A idade média em anos foi de 62,05 ± 10,78 e de 55,42 ± 11,87 no GE e no GC (p = 0,03), respectivamente. Os valores da pressão arterial sistólica (PAS) pela medida casual no GE e no GC foram: 140,01 ± 16,73 mmHg e 141,79 ± 23,21 mmHg em V1 (p = 0,72); 135,49 ± 12,73 mmHg e 145,69 ± 19,31 mmHg em V2 (p = 0,02); 131,64 ± 19,28 mmHg e 134,88 ± 23,21 mmHg em V3 (p = 0,59). Os valores da pressão arterial diastólica (PAD) foram: 84,13 ± 10,71 mmHg e 86,29 ± 10,35 mmHg em V1 (p = 0,47); 81,69 ± 10,88 mmHg e 89,61 ± 11,58 mmHg em V2 (p = 0,02); 80,31 ± 11,83 mmHg e 86 ± 13,38 mmHg em V3 (p = 0,12). CONCLUSÃO: Os pacientes do GE apresentaram adesão ao tratamento não farmacológico semelhante ao GC, mas tiveram maior adesão ao tratamento medicamentoso e utilizaram menor número de drogas anti-hipertensivas. Não houve diferença entre os grupos na comparação do perfil metabólico e da função renal. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0).

BACKGROUND: The measurement of blood pressure (BP) by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP). OBJECTIVE: To evaluate the interference of the SMBP in treatment adherence and blood pressure control. METHODS: The study included 57 patients, 38 in the study group (SG) and 19 in the control group (CG). These patients were followed for 12 months and assessed at randomization (V1) as well as in the sixth (V2) and the twelfth month (V3). Compare the mean blood pressure by casual measurement, by SMBP and by ambulatory monitoring of blood pressure (AMBP), laboratory tests and the answers to the questionnaire on lifestyle. The instruments used were: OMRON HEM 714, for SMBP; OMRON 705 CP, for the casual measurement, and Monitor SPACELABS 9002 for the AMBP. RESULTS: The average age was 62.05 ± 10.78 in the SG and 55.42 ± 11.87 in the CG (p = 0.03). The values of systolic blood pressure (SBP) by casual measurement in the SG and CG were: 140.01 ± 16.73 mmHg and 141.79 ± 23.21 mmHg in V1 (p = 0.72), 135.49 ± 12.73 mmHg and 145.69 ± 19.31 mmHg in V2 (p = 0.02), 131.64 ± 19.28 mmHg and 134.88 ± 23.21 mmHg at V3 (p = 0.59). The values of diastolic blood pressure (DBP) were: 84.13 ± 10.71 mmHg and 86.29 ± 10.35 mmHg in V1 (p = 0.47), 81.69 ± 10.88 mmHg and 89.61 V2 ± 11.58 mmHg (p = 0.02), 80.31 ± 11.83 mmHg and 86 ± 13.38 mmHg in V3 (p = 0.12). CONCLUSION: Patients in the SG had adherence to non-pharmacological treatment similar to the CG, but they had greater adherence to drug treatment and used fewer antihypertensive drugs. There was no difference between groups when comparing the metabolic profile and renal function. (Arq Bras Cardiol. 2011; [online].ahead print, PP.0-0).

Self measurement of blood pressure for control of blood pressure levels and adherence to treatment.

BACKGROUND: The measurement of blood pressure (BP) by the patient himself without strict protocols, adequate training, and validated equipment at their own household is defined as self measured blood pressure (SMBP). OBJECTIVE: To evaluate the interference of the SMBP in treatment adherence and blood pressure control. METHODS: The study included 57 patients, 38 in the study group (SG) and 19 in the control group (CG). These patients were followed for 12 months and assessed at randomization (V1) as well as in the sixth (V2) and the twelfth month (V3). Compare the mean blood pressure by casual measurement, by SMBP and by ambulatory monitoring of blood pressure (AMBP), laboratory tests and the answers to the questionnaire on lifestyle. The instruments used were: OMRON HEM 714, for SMBP; OMRON 705 CP, for the casual measurement, and Monitor SPACELABS 9002 for the AMBP. RESULTS: The average age was 62.05 ± 10.78 in the SG and 55.42 ± 11.87 in the CG (p = 0.03). The values of systolic blood pressure (SBP) by casual measurement in the SG and CG were: 140.01 ± 16.73 mmHg and 141.79 ± 23.21 mmHg in V1 (p = 0.72), 135.49 ± 12.73 mmHg and 145.69 ± 19.31 mmHg in V2 (p = 0.02), 131.64 ± 19.28 mmHg and 134.88 ± 23.21 mmHg at V3 (p = 0.59). The values of diastolic blood pressure (DBP) were: 84.13 ± 10.71 mmHg and 86.29 ± 10.35 mmHg in V1 (p = 0.47), 81.69 ± 10.88 mmHg and 89.61 V2 ± 11.58 mmHg (p = 0.02), 80.31 ± 11.83 mmHg and 86 ± 13.38 mmHg in V3 (p = 0.12). CONCLUSION: Patients in the SG had adherence to non-pharmacological treatment similar to the CG, but they had greater adherence to drug treatment and used fewer antihypertensive drugs. There was no difference between groups when comparing the metabolic profile and renal function.

Comparação e correlação entre automedida, medida casual e monitorização ambulatorial da pressão arterial / Comparison and correlation between self-measured blood pressure, casual blood pressure measurement and ambulatory blood pressure monitoring / Comparación y correlación entre automedida, medida casual y monitorización ambulatoria de la presión arterial

FUNDAMENTO: A medida casual da pressão arterial (PA) pelos profissionais de saúde está sujeita a uma grande variabilidade, sendo necessário buscar novos métodos que possam superar essa limitação. OBJETIVO: Comparar e avaliar a correlação entre os níveis de PA obtidos por meio da automedida da pressão arterial (AMPA) com a medida casual e com a monitorização ambulatorial da pressão arterial (MAPA). MÉTODOS: Avaliamos hipertensos que realizaram as três metodologias de medida da PA com intervalo menor que 30 dias; as médias das pressões foram utilizadas para comparação e correlação. Foram empregados os aparelhos: OMRON 705 CP (medida casual), OMRON HEM 714 (AMPA) e SPACELABS 9002 (MAPA). RESULTADOS: Foram avaliados 32 pacientes, 50,09 por cento mulheres, idade média 59,7 (± 11,2) anos, média do IMC 26,04 (± 3,3) kg/m². Valores médios de pressão sistólica (PAS) e pressão diastólica (PAD) para a AMPA foram de 134 (± 15,71)mmHg e 79,32 (± 12,38) mmHg. Na medida casual as médias da PAS e PAD foram, respectivamente, 140,84 (± 16,15)mmHg e 85 (± 9,68) mmHg. Os valores médios da MAPA na vigília foram 130,47 (± 13,26) mmHg e 79,84 (± 9,82) mmHg para PAS e PAD, respectivamente. Na análise comparativa, a AMPA apresentou valores semelhantes aos da MAPA (p > 0,05) e diferentes da medida casual (p < 0,05). Na análise de correlação a AMPA foi superior à medida casual, considerando a MAPA como o padrão de referência nas medidas tensionais. CONCLUSÃO: A AMPA apresentou melhor comparação com a MAPA do que a medida casual e também se correlacionou melhor com a aquela, especialmente para a pressão diastólica, devendo ser considerada uma alternativa com baixo custo para o acompanhamento do paciente hipertenso.

BACKGROUND: Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE: To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS: We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS: A total of 32 patients were assessed, of which 50.09 percent were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m². Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION: SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

FUNDAMENTO: La medida casual de la presión arterial (PA), por los profesionales de la salud está sujeta a una gran variabilidad, siendo necesario buscar nuevos métodos que puedan superar esa limitación. OBJETIVO: Comparar y evaluar la correlación entre los niveles de PA obtenidos por medio de la automedida de la presión arterial (AMPA) con la medida casual y con la monitorización ambulatoria de la presión arterial (MAPA). MÉTODOS: Evaluamos hipertensos que realizaron las tres metodologías de medida de la PA con un intervalo menor que 30 días. Los promedios de las presiones fueron utilizados para la comparación y la correlación. Fueron usados los aparatos: OMRON 705 CP (medida casual), OMRON HEM 714 (AMPA) y SPACELABS 9002 (MAPA). RESULTADOS: Se evaluaron 32 pacientes, 50,09 por ciento mujeres, edad promedio 59,7(± 11,2) años, promedio del IMC 26,04 (± 3,3) kg/m². Los valores promedios de presión sistólica (PAS) y presión diastólica (PAD) para la AMPA fueron de 134 (± 15,71) mmHg y 79,32(± 12,38) mmHg. En la medida casual los promedios de la PAS y PAD fueron, respectivamente, 140,84 (± 16,15) mmHg y 85 (± 9,68) mmHg. Los valores promedios de la MAPA en la vigilia fueron 130,47 (± 13,26) mmHg y 79,84 (± 9,82) mmHg para PAS y PAD, respectivamente. En el análisis comparativo, la AMPA tuvo valores similares a los de la MAPA (p > 0,05) y diferentes de la medida casual (p < 0,05). En el análisis de correlación la AMPA fue superior a la medida casual, considerando la MAPA como el estándar de referencia en las medidas tensionales. CONCLUSIÓN: La AMPA presentó una mejor comparación con la MAPA que la medida casual y también se correlacionó mejor con aquella, especialmente para la presión diastólica, debiendo ser considerada como una alternativa con bajo coste para el seguimiento del paciente hipertenso.

Comparison and correlation between self-measured blood pressure, casual blood pressure measurement and ambulatory blood pressure monitoring.

BACKGROUND: Casual blood pressure (BP) measurement by healthcare professionals is subject to great variability and new methods are necessary to overcome this limitation. OBJECTIVE: To compare and assess the correlation between the BP levels obtained by self-measured BP (SMBP), casual BP measurement and ambulatory blood pressure monitoring (ABPM). METHODS: We assessed hypertensive individuals submitted to the three methods of BP measurement at an interval < 30 days; the BP means were used for comparison and correlation. The following devices were used: OMRON 705 CP (casual measurement), OMRON HEM 714 (SMBP) and SPACELABS 9002 (ABPM). RESULTS: A total of 32 patients were assessed, of which 50.09% were females, with a mean age of 59.7 (± 11.2), BMI mean of 26.04 (± 3.3) kg/m(2). Mean systolic (SBP) and diastolic blood pressure (DBP) for SMBP were 134 (± 15.71) mmHg and 79.32 (± 12.38) mmHg. The casual measurement means of SBP and DBP were, respectively, 140.84 (± 16.15) mmHg and 85 (± 9.68) mmHg. The mean values of ABPM during the wakefulness period were 130.47 (± 13.26) mmHg and 79.84 (± 9.82) mmHg for SBP and DBP, respectively. At the comparative analysis, the SMBP had similar results to those obtained at ABPM (p > 0.05) and different from the casual measurement (p < 0.05). At the analysis of correlation, SMBP values were higher than the casual measurements, considering ABPM as the reference standard in BP measurements. CONCLUSION: SMBP showed a better correlation with ABPM than the casual measurement and was also better correlated with the latter, especially regarding the DBP and should be considered as a low-cost alternative for the follow-up of the hypertensive patient.

Linfangioma cístico retrofaríngeo. Manifestação com SAHOS associada a laringomalácia. / Retropharyngeal cystic lymphangioma. Manifestation of sleep obstructive apnea syndrome associated to laryngomalacia.

O linfangioma cístico retrofaríngeo é uma malformação rara, geralmente única, que pode na criança coexistir com outra malformação cervical como a laringomalácia. Mesmo sem evidências clínicas de massa tumoral pode manifestar-se com dispnéia durante o sono (SAHOS). É descrito um caso raro de linfangioma cístico retofaríngeo em um criança de 15 meses de idade, diagnosticado por ressonância magnética (MRI) e tratado por cirurgia.

The cystic lynphangioma is a rare malformation, generally unique, which can coexist with another neck malformation like laryngomalacia in the child. Even without clinical evidence of tumoral mass, it can manifest with dyspnea during the sleep. It is described as a rare case of cystic lymphangioma of retropharinge in a 15-month-old child that was diagnosed by MRI and treated by surgery.