Percorrer por autor "Wiens, Astrid"
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- The effects of nutritional supplementation for children and adolescents with sickle cell disease: a systematic review and meta-analysesPublication . Orsi, Bruna C.; Gorski, Daniela; Krul, Naila E.; Wiens, Astrid; Brito, Miguel; Tonin, Fernanda; Pontarolo, RobertoBackground & aims: Sickle cell disease (SCD), a neglected chronic genetic blood disorder that severely impacts the pediatric population, often leading to premature death, is associated with compromised nutritional status. This study aimed to evaluate the effect of nutritional supplementation on SCD-related complications. Methods: A systematic review with searches in PubMed, Scopus, and Web of Science was performed. Randomized controlled trials (RCT) assessing diet or supplements as a complementary therapy for children and adolescents with SCD were included (PROSPERO: CRD42024532369). The data for outcomes of interest (efficacy, safety) were pooled using pairwise and network meta-analyses with ranking (p-score) analysis. The results were presented as odds ratio or mean differences with 95 % confidence intervals (NMAstudio2.0). Results: Twenty RCTs were included (2002–2023) (n = 2058), analyzing 9 dietary supplements on different regimens. All patients use hydroxyurea as an active treatment. Supplementation with fatty acids (n = 3 studies) and l-arginine (n = 4) presented higher efficacy and safety, significantly improving pain intensity, vaso-occlusive crises (VOC), and inflammation when compared to usual care/placebo (p < 0.05). Vitamin D3 (n = 6) at different dosages may reduce respiratory complications and length of hospital stay, yet further studies are needed to confirm its significant effects. Evidence is limited and of poor quality regarding the effects of add-on vitamin A (n = 2), magnesium sulfate (n = 2), and zinc (n = 4) for this population. Conclusions: The complementary use of certain supplements (fatty acids, l-arginine, vitamin D3) can enhance the management of VOC and improve patients' physiological functions. These supplements are often affordable and can contribute towards the reduction of opioid use and shorten patients' hospital stays - especially in low/middle-income countries where resources are scarce. Although further studies are needed to refine these findings (e.g., appropriate doses/regimens), practical guidelines and decision-makers may benefit from updated evidence.
- Use of biochemical tests and machine learning in the search for potential diagnostic biomarkers of COVID-19, HIV/AIDS, and pulmonary tuberculosisPublication . Cobre, Alexandre; Morais, Amiel; Selege, Fosfato; Stremel, Dile; Wiens, Astrid; Ferreira, Luana; Tonin, Fernanda; Pontarolo, RobertoThis study aims to develop, validate, and evaluate machine learning algorithms for predicting the diagnosis of coronavirus disease (COVID-19), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), pulmonary tuberculosis (TB), and HIV/TB co-infection. We also investigated potential biomarkers associated with the diagnosis. Data from biochemical and hematological tests of infected and controls were collected in a single general hospital, totalizing 6,418 patients. The discriminant analysis by partial least squares (PLS-DA) model had the highest performance in predicting the diagnosis of COVID-19, HIV/AIDS, TB, and HIV/TB co-infection with an accuracy of 94, 97, 95, and 96%, respectively. The biomarkers calcium, lactate dehydrogenase, red blood cells (RBC), white blood cells, neutrophils, basophils, eosinophils, hemoglobin, and hematocrit were associated with COVID-19. HIV infection was associated with mean corpuscular volume, platelets, neutrophils, and mean platelet volume. Red blood cell distribution width and urea were associated with infection by Mycobacterium tuberculosis. The following biomarkers were associated with HIV/TB co-infection: lymphocytes, RBC, hematocrit, hemoglobin, aspartate transaminase, alanine transaminase, and glycemia. The PLS-DA model can optimize COVID-19, HIV/AIDS, TB, and HIV/TB co-infection diagnostics. Some biomarkers were potential diagnostic indicators and could be evaluated during the screening of these diseases.