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Sleep disorders in patients with chronic pain: cross-sectional study
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Costa, Michelle dos Santos Severino

; Mageste, Caroline Carvalho

; Simão, Dierisson Souza

; Gomez, Renato Santiago

BrJP

Journal Metrics
- Sobre o periódico
- SciELO Analytics

dec 2023, Volume 6 N. 4 Pages 390 - 397

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain and its relationship with sleep disturbance are common conditions with great influence on the individual’s quality of life. The simultaneous occurrence of these two entities results in greater suffering, reduced functionality and well-being. The objective of this research was to evaluate the influence of chronic pain on sleep and its impact on quality of life. METHODS: This is an observational, cross-sectional, individual, uncontrolled study carried out at the Multidisciplinary Pain Center of the Clinical Hospital of the Federal University of Minas Gerais (Hospital das Clínicas da Universidade Federal de Minas Gerais - HC-UFMG). The patients answered a semi-structured, face-to-face interview via the pain center’s own computer system (avaliaDor®), using internet-connected mobile devices. Socioeconomic and pain data was collected, and then instruments were applied to assess pain intensity (Visual Numerical Scale - VNS), quality of life (Medical Outcomes Study 36 - Short Form Health Survey - SF-36), presence of psychiatric disturbances (Hospital Depression Anxiety Scale - HAD) and sleep (Mini Sleep Questionnaire - MSQ). RESULTS: One hundred and three patients participated in the study. Seventy two percent were women, the median age was 55 years, and the patients were predominantly married, white and with a low level of schooling. Of the entire study population 74.76% presented “severe difficulty” in sleeping, while 22.33% had “good quality” sleep. Regarding pain intensity, patients in the moderate and severe pain groups had a higher percentage of “severe difficulty” in sleeping, when compared to patients with mild pain. About the presence of anxiety and depression, it was observed lower scores on: “restless sleep”, “tiredness for no apparent reason”, “wakes up with a headache”, “wakes up and goes back to sleep”, “wakes up tired in the morning”, and finally “wakes up and does not go back to sleep”. The general data from the SF-36 points to a low quality of life for the patients in the present study and, based on the multivariate analysis, the items “SF-36-Pain and SF-36-Vitalidade” were shown to be protective factors for the presence of sleep disturbances. CONCLUSION: Sleep disorders in patients with chronic pain are common and show a worsening in quality of life. The frequency of this disturbance was higher in patients with anxiety and depression compared to patients without these psychiatric disorders. The early identification of sleep disturbances in individuals with chronic pain is necessary to improve well-being.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica e os distúrbios do sono são condições comuns. A ocorrência simultânea dessas duas entidades resulta em maior sofrimento pessoal e redução do bem-estar e da funcionalidade. O objetivo desta pesquisa foi avaliar a influência da dor crônica no sono e o seu impacto na qualidade de vida. MÉTODOS: Trata-se de um estudo observacional, transversal, individual e não controlado, realizado no Centro Multidisciplinar de Dor do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG). Os pacientes responderam a uma entrevista semiestruturada, face a face, por meio do sistema de computador do próprio centro de dor (avaliaDor®), utilizando dispositivos móveis conectados à internet. Foram coletados dados socioeconômicos e de dor; em seguida foram aplicados instrumentos para avaliar a intensidade da dor (Escala Visual Numérica - EVN), a qualidade de vida (Medical Outcomes Study 36 - Short Form Health Survey - SF-36), a presença de distúrbios psiquiátricos (Escala Hospitalar de Ansiedade e Depressão - HAD) e o sono (Mini Sleep Questionnaire - MSQ). RESULTADOS Cento e três pacientes participaram do estudo. Setenta e dois por cento eram do sexo feminino, com mediana de idade de 55 anos, com predominância de brancos com baixo nível de escolaridade. De toda a população estudada, 74,76% dos participantes apresentaram “dificuldade grave” para dormir, enquanto 22,33% tiveram “boa qualidade” de sono. Em relação à intensidade da dor, os pacientes dos grupos de dor moderada e intensa apresentaram maior percentual de “dificuldade grave” para dormir quando comparados aos pacientes com dor leve. Em relação à presença de ansiedade e depressão, observou-se maior pontuação nos itens: “sono agitado”, “cansaço sem motivo aparente”, “acorda com dor de cabeça”, “acorda e volta a dormir”, “acorda cansado pela manhã” e, por fim, “acorda e não volta a dormir”. Os dados gerais do SF-36 apontam para uma baixa qualidade de vida dos doentes do presente estudo e, com base na análise multivariada, os itens “SF-36-Dor e SF-36-Vitalidade” revelaram-se fatores protetores da presença de perturbações do sono. CONCLUSÃO: Os distúrbios de sono em pacientes com dor crônica são comuns e determinam piora na qualidade de vida. A frequência desse distúrbio foi maior nos pacientes com ansiedade e depressão, em comparação com os pacientes que não apresentaram essas desordens psiquiátricas. A identificação precoce dos distúrbios do sono, em indivíduos com dor crônica, é fundamental para alcançar maior bem-estar.

https://doi.org/10.5935/2595-0118.20230077-en

[SciELO Preprints] - FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT TO TERM COHORT OF PREGNANCY WOMEN OF AN INSURANCE, HEALTH COMPANY IN VALLE DEL CAUCA 2020-2021
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Oliveros, Simon Andres Giraldo Gomez, Nicole Dayana Chattes Gonzalez, Erick Daniel Estrada Forero, Krys Estefani Ramirez Benitez, Juan Guillermo Quintero

Journal Metrics
- Sobre o periódico
- SciELO Analytics

Publication date: 2023-08-30

Abstract: En Es

Introducción: El bajo peso al nacer a término (BPN) se define como el recién nacido que nace entre las 37 y 40 semanas de gestación y en su primera medición de peso este es menor a 2,500 gramos. Es un importante indicador de salud pública que demuestra directamente las condiciones de salud materna y neonatal. Objetivo: Identificar los factores sociodemográficos, clínicos y relacionados con la atención prenatal que mejor explican el bajo peso al nacer a término, en una cohorte 2020-2021 de gestantes de una aseguradora del Valle del Cauca. Metodología:se realizó un estudio observacional analítico retrospectivo de cohorte retrospectiva, tomando como variable respuesta el bajo peso al nacer a término, identificando los factores que mejor explican el bajo peso mediante tablas de contingencia con la prueba de chi cuadrado o prueba exacta de Fisher y regresión logarítmica binomial multivariada. análisis. Resultados: La cohorte de gestantes reside mayoritariamente en los municipios de Santiago de Cali, Tuluá, Buga y el distrito especial de Buenaventura, una edad promedio de 26 ± 6 años, el régimen subsidiado, la incidencia de bajo peso al nacer fue de 9.3%. a nivel general. Conclusiones:los factores que mejor explican el bajo peso al nacer a término fueron tener menos de 18 años o más de 35 años, pertenecer al régimen subsidiado, iniciar tardíamente el control prenatal, no asistir a cuidados nutricionales ni ginecológicos y no recibir ácido fólico, calcio o vitaminas.

Introducción: El bajo peso al nacer a término (BPNT) se define como el neonato que nace cumpliendo 37 a 40 semanas de gestación, y en su primera medición de peso esta es menor a 2.500 gramos. Es un importante indicador de salud pública que logra evidenciar directamente las condiciones de salud materna y neonatal. Objetivo: Identificar los factores sociodemográficos, clínicos y relacionados con los cuidados prenatales que mejor explican el bajo peso al nacer a término, en una cohorte de gestantes 2020-2021 de una aseguradora en el Valle del Cauca. Metodología: se realizó un estudio observacional analítico de cohorte retrospectiva, tomando como variable de respuesta el bajo peso al nacer a término, identificando los factores que mejor explican el bajo peso por medio de tablas de contingencia con la prueba chi cuadrado o exacta de Fisher y análisis multivariado de regresión log binomial. Resultados: La cohorte de gestantes en su mayoría tiene residencia en los municipios de Santiago de Cali, Tuluá, Buga y el Distrito especial de Buenaventura, una edad promedio de 26 ± 6 años, del régimen subsidiado, la incidencia de bajo peso al nacer fue de 9,3% a nivel general. Conclusiones: los factores que mejor explican el bajo peso a nacer a término fueron edad menor de 18 o mayor de 35 años, pertenecer al régimen subsidiado, inicio tardío al control prenatal, no asistencia a control nutricional ni de ginecología y no recibir efectivamente ácido fólico, calcio o vitaminas.

https://doi.org/10.1590/SciELOPreprints.6695

Evaluation of functionality and socioeconomic status of patients with chronic pain
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Costa, Michelle dos Santos Severino

; Gomez, Renato Santiago

; Lages, Gustavo Rodrigues Costa

; Américo, Ariel de Freitas Quintão

; Abreu, Joao Marcelo Guimarães de

; Faria, Fernanda Ribeiro

; Azevedo, Letícia Maia

Revista da Associação Médica Brasileira

Journal Metrics
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feb 2023, Volume 69 N. 2 Pages 308 - 313

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: This study aimed to evaluate the influence of chronic pain on functionality and its consequences on work and patient income. METHODS: A total of 103 patients from the Multidisciplinary Pain Center of the Clinics Hospital of Universidade Federal de Minas Gerais were interviewed between January 2020 and June 2021, applying questionnaires on mobile devices. Socioeconomic data, multidimensional characterization of pain, and instruments for assessing pain functionality and intensity were analyzed. Pain intensity was categorized as mild, moderate, or intense for comparative analysis. Ordinal logistic regression was used to identify risk factors and variables that jointly influence the outcome of pain intensity. RESULTS: The patients had a median age of 55 years, were predominantly female, married or in a stable relationship, white race, and completed high school. The median family income was R$2,200. Most patients were retired due to disability and pain-related causes. Functionality analysis showed severe disability directly associated with pain intensity. The financial impacts observed were correlated with the pain intensity of the patients. Age was a risk factor for pain intensity, while sex, family income, and duration of pain served as protective factors. CONCLUSION: Chronic pain was associated with severe disability, decreased productivity, and exit from the labor market, with a negative impact on financial condition. Age, sex, family income, and duration of pain were directly associated with pain intensity.

https://doi.org/10.1590/1806-9282.20221093

E-learning as a strategy in dentistry in the context of COVID-19: a path to follow?
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MARQUES-MEDEIROS, Ana Carolina

; MARTINS, Renata Castro

; SOUZA, Leandro Napier de

; GOMEZ, Ricardo Santiago

; SILVA, Maria Elisa de Souza e

; MARTINS, Maria Auxiliadora Parreiras

; ABREU, Mauro Henrique Nogueira Guimarães de

Brazilian Oral Research

Journal Metrics
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- SciELO Analytics

2023, Volume 37 elocation e060

Abstract: En | Text: En | PDF: En

Abstract The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff’s knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0060

Recomendaciones en el abordaje del hematoma intracerebral espontáneo durante la internación
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Pigretti, Santiago G.

; Mirofsky, Matías

; García, Darío E.

; Issac, Cristian

; Valdez, Pascual

; Persi, Gabriel G.

; Mamani, Carlos E.

; Guyon, Jorgelina

; Álvarez, Héctor

; Montes, Mariana

; Daza Aramayo, José M.

; Iturrieta, Pablo

; Chaves, Hernán

; Sarmiento, Verónica

; Tumino, Leandro

; Domeniconi, Gustavo

; Castagna, Rosa

; Sabio, Rodrigo

; Videtta, Walter

; Ciarrocchi, Nicolás

; Lerman, Damián

; Dossi, Daiana E.

; Balian, Natalia R.

; Velasquez, Mariela A.

; Rufino Saravia, Gonzalo

; Alet, Matías J.

; Rodríguez Lucci, Federico

; Ciardi, Celina

; Pujol Lereis, Virginia

; Claverie, Santiago

; Casanova, Matías

; González, Leonardo

; Mónaco, Juan Manuel

; Cárdenas, Rolando E.

; Cirio, Juan José

; Arturi, Jessica

; Requejo, Flavio

; Plou, Pedro L.

; Orzuza, Gabriela

; Bonardo, Pablo

; Díaz, María Fernanda

; Payaslian, Silvio

; Andrade, María Gabriela

; Gomez Schneider, Maia M.

; Romano, Marina

; Colla Machado, Pedro

; Arroyo, José

; Arcondo, María Florencia

; Svampa, Silvana

; Armenteros, Cristhian

; Tejada Jacob, Virginia

; Zurrú, María Cristina

Medicina (Buenos Aires)

Journal Metrics
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nov 2022, Volume 82 Suppl. 4 Pages 1 - 56

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El accidente cerebrovascular (ACV) constituye la principal causa de discapacidad de origen neuro- lógico en los adultos mayores a 40 años y la cuarta causa de muerte en Argentina. En los últimos diez años las publicaciones indexadas relacionadas al tratamiento del ACV isquémico fueron más numerosas que las de ACV hemorrágico. El objetivo de este material es proporcionar recomendaciones locales y actualiza- das del abordaje de pacientes con hematoma intraparenquimatoso espontáneo durante la internación. Para la redacción de este manuscrito se convocó a especialistas en esta enfermedad que conformaron grupos de trabajo. Se plantearon 10 tópicos centrales expresados como epidemiologia, atención inicial, imágenes, tratamiento de la presión arterial, reversión de antitrombóticos, indicación de cirugía, profilaxis anticonvulsivante, pronóstico, prevención de complicaciones y reinicio de antitrombóticos. De cada tópico se plantearon mediante preguntas PICO los interrogantes más frecuentes de la práctica diaria. Luego de una revisión sistemática de la literatura, se generaron recomendaciones evaluadas mediante sistema GRADE y consensuadas entre autores y pacientes.

Abstract Stroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracere- bral hemorrhage during hospitalization. For the writing of this manuscript, diferent specialists were convened to form working groups. Ten central topics expressed as epidemiology, initial care, imaging, blood pressure treatment, reversal of antithrombotics, indication for surgery, seizure prophylaxis, prognosis, prevention of complications and resumption of antithrombotics were raised. For each topic, the most frequent questions of daily practice were raised through PICO questions. After a systematic review of the literature, recommendations were generated, evaluated using the GRADE system and agreed between authors and patients.

Neumomediastino en trauma contuso: ¿son siempre necesarios los estudios invasivos para descartar lesión aerodigestiva?
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Salazar-Ochoa, Santiago

; Posada-Moreno, Pablo

; Guzmán-Arango, Natalia

; Velásquez-Gomez, Lina María

; Mejía-Toro, David Alejandro

; Ortega-Toscano, Cesar Andrés

; Montoya-Arboleda, Alejandro

; Henao-Ayora, Juan Diego

Revista Colombiana de Cirugía

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apr 2022, Volume 37 N. 2 Pages 237 - 244

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. La presencia de neumomediastino secundario a un trauma contuso es un hallazgo común, especialmente con el uso rutinario de la tomografía computarizada. Aunque en la mayoría de los casos es secundario a una causa benigna, la posibilidad de una lesión aerodigestiva subyacente ha llevado a que se recomiende el uso rutinario de estudios endoscópicos para descartarla. El propósito de este estudio fue determinar la incidencia de neumomediastino secundario a trauma contuso y de lesiones aerodigestivas asociadas y establecer la utilidad de la tomografía computarizada multidetector en el diagnóstico de las lesiones aerodigestivas. Métodos. Mediante tomografía computarizada multidetector se identificaron los pacientes con diagnóstico de neumomediastino secundario a un trauma contuso en un periodo de 4 años en un Centro de Trauma Nivel I. Resultados. Fueron incluidos en el estudio 41 pacientes con diagnóstico de neumomediastino secundario a un trauma contuso. Se documentaron en total tres lesiones aerodigestivas, dos lesiones traqueales y una esofágica. Dos de estas fueron sospechadas en tomografía computarizada multidetector y confirmadas mediante fibrobroncoscopia y endoscopia digestiva superior, respectivamente, y otra fue diagnosticada en cirugía. Conclusión. El uso rutinario de estudios endoscópicos en los pacientes con neumomediastino secundario a trauma contuso no está indicado cuando los hallazgos clínicos y tomográficos son poco sugestivos de lesión aerodigestiva.

Abstract Introduction. The presence of pneumomediastinum secondary to blunt trauma is a common finding, especially with the use of computed tomography. Although in most cases the presence of pneumomediastinum is secondary to a benign etiology, the possibility of an underlying aerodigestive injuries has led to the recommendation of the routine use of endoscopic studies to rule them out. The purpose of this study was to determine the incidence of pneumomediastinum secondary to blunt trauma and associated injuries and to establish the role of multidetector computed tomography in the diagnosis of aerodigestive injuries. Methods. Using multidetector computed tomography, patients with a diagnosis of pneumomediastinum secondary to blunt trauma were identified over a period of 4 years in a Level 1 Trauma Center. Results. Forty-one patients diagnosed with pneumomediastinum secondary to blunt trauma, were included in this study. Two airway ruptures were documented: two tracheal injuries and one esophageal injury. Two of them suspected on multidetector computed tomography and confirmed on bronchoscopy and esophagogastroduodenoscopy, respectively, and another was diagnosed in surgery. Conclusion. The routine use of endoscopic studies in patients with pneumomediastinum secondary to blunt trauma is not indicated when the clinical and tomographic findings are not suggestive of aerodigestive injury.

https://doi.org/10.30944/20117582.1150 36 downloads

Standardized Nutritional Intervention in Patients with COVID-19 Admitted to a Hospital in Bogotá, Colombia
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Sanchez-Pardo, Santiago

; Meza, Rafael

; Gomez, Diana

; Feria, Sandra

; Ramirez, Lina Maria

; Santamaria, Yeison

Infectio

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mar 2022, Volume 26 N. 1 Pages 24 - 32

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Antecedentes: los pacientes con enfermedad por coronavirus 2019 (COVID-19) presentan un aumento del estrés oxidativo, caracterizado por la producción de especies reactivas de oxígeno y una deficiencia concomitante de antioxidantes. Existen múltiples mecanismos de defensa que incluyen eliminadores enzimáticos y moléculas no enzimáticas (glutatión y vitaminas A, C, D, E y zinc). Métodos: En este estudio observacional, transversal y retrospectivo, el objetivo fue describir el comportamiento clínico de los pacientes hospitalizados por CO VID-19 (aquellos tratados con una intervención nutricional estandarizada versus aquellos que recibieron el tratamiento estándar COVID-19 disponible en el tiempo). Un total de 214 historias clínicas de los pacientes hospitalizados por COVID-19 que requirieron intervención nutricional. Se realizaron análisis descriptivos de variables continuas y categóricas. Se realizó una prueba de ANOVA para las variables numéricas. Un modelo de regresión logística y un emparejamiento por puntuación de propensión determinaron las diferencias entre los grupos emparejados. Resultados: el 33,6% de los pacientes ingresaron en la Unidad de Cuidados Intensivos (UCI), el 28,5% requirió ventilación mecánica invasiva y la mortalidad global fue del 19,6%.44 · 8% de los pacientes recibieron la intervención nutricional estandarizada. No hubo diferencias estadísticamente significativas entre los grupos de intervención, excepto por el tiempo de intervención, en el que la intervención nutricional estandarizada (días) se identificó como factor protector OR = 0 · 550 (p <0 · 05; IC = 0 · 324-0 · 936). Conclusiones: Este es el primer estudio en Colombia que considera una intervención nutricional estandarizada en pacientes hospitalizados por COVID-19. A pesar de no poder alcanzar los objetivos primarios, se deben realizar experimentos controlados para determinar el papel y los posibles efectos terapéuticos de los micro y macronutrientes en pacientes con COVID-19

Summary Background: Patients with coronavirus disease 2019 (COVID-19) present an increase in oxidative stress, characterized by the production of reactive oxygen species and a concomitant deficiency of antioxidants. There are multiple defense mechanisms including enzymatic scavengers and non-enzymatic molecules (glutathione and vitamins A, C, D, E, and zinc). Methods: In this observational, cross-sectional, retrospective study, we aimed to describe the clinical behavior of patients hospitalized due to COVID-19 (those trea ted with a standardized nutritional intervention versus those who received the COVID-19 standard treatment available at the time). A total of 214 medical records of patients hospitalized due to COVID-19 who required nutritional intervention were analyzed. Descriptive analyses of continuous and categorical variables were performed, and an ANOVA test was performed for numerical variables. A logistic regression model and a propensity score matching determined the differences between the matched groups. Findings: 33·6% of the patients were admitted to the Intensive Care Unit (ICU), 28·5% required invasive mechanical ventilation, and the overall mortality was 19·6%. 44·8% of the patients received the standardized nutritional intervention. There were no statistically significant differences between intervention groups, except for the intervention time, in which the standardized nutritional intervention (days) was identified as a protective factor OR=0·550 (p <0·05; CI=0·324-0·936). Conclusions: This is the first study in Colombia to consider a standardized nutritional intervention in patients hospitalized due to COVID-19. Despite not being able to meet the primary objectives, controlled experiments must be carried out to determine the role and possible therapeutic effects of micro and macronutrients in patients with COVID-19.

https://doi.org/10.22354/in.v26i1.990 37 downloads

Staff Knowledge and Attitudes Towards COVID-19 New Biosafety Practices at a Brazilian Dental School
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Marques-Medeiros, Ana Carolina

; Martins, Renata Castro

; Silva, Maria Elisa Souza e

; Vilaça, Ênio Lacerda

; Souza, Leandro Napier de

; Martins, Maria Auxiliadora Parreiras

; Gomez, Ricardo Santiago

; Guimarães de Abreu, Mauro Henrique Nogueira

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2022, Volume 22 elocation e210139

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To evaluate knowledge and attitudes towards biosafety recommendations during the COVID-19 pandemic at a Brazilian dental school. Material and Methods A cross-sectional study was performed in 2020 with the clinical staff of a Brazilian dental school. The whole clinical staff was sent pre-tested self-administered online questionnaires about knowledge and attitudes towards the recommendations for biosafety in dental settings in the context of the COVID-19 pandemic. Descriptive statistical analyses were carried out for proportion calculation. Results Disposable head covering caps, isolation gowns, and gloves were the most frequently reported personal protective equipment (PPE). The rates ranged from 52.9% to 88.5% for N95 respirators, from 68.6% to 92.6% for face shields, from 47.4% to 67.5% for conventional eye protection shields, and 45.1% to 77.4% for eye protection with solid side shields. Chlorhexidine gluconate was the most frequent mouthwash indicated before clinical dental care. The percentage of agreement to provide clinical care to patients with suspected COVID-19 varied from 23.5% to 50.0%. The percentage of respondents who agreed that bioaerosol-generating procedures should be avoided was higher than 74.5%. Less than 50% knew the correct sequence for doffing of PPE. Conclusion This study revealed important gaps in knowledge and attitudes towards prevention and control measures against infection in dental environments in the context of COVID-19, indicating the need for improvements.

https://doi.org/10.1590/pboci.2022.007

Effect of adding clonidine to lidocaine on ocular hemodynamics during sub-Tenon’s anesthesia: randomized double-blind study
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Cabral, Sigmar Aurea

; Carraretto, Antonio Roberto

; Sousa, Angela Maria

; Gomez, Renato Santiago

Brazilian Journal of Anesthesiology

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dec 2021, Volume 71 N. 6 Pages 628 - 634

Abstract: En | Text: En | PDF: En

Abstract Introduction and objectives Different regional anesthesia techniques for ophthalmology can have hemodynamic effects on the eye. We assessed the effects of adding clonidine to lidocaine on Intraocular Pressure (IOP), Ocular Pulse Amplitude (OPA), and Ocular Perfusion Pressure (OPP) after the sub-Tenon’s technique for cataract surgery. Methods The study included 40 patients randomly allocated into two groups: sub-Tenon’s blockade with Lidocaine plus Saline Solution (LS) or Lidocaine plus Clonidine (LC). IOP, OPA and OPP were measured before anesthesia, and 1, 5 and 10 minutes after the injection of anesthetic solution. Results There was no difference between the groups in IOP, OPA, and OPP baseline values. After the injection of the anesthetic solution, the IOP increased in both groups at minute one, with a mean difference of +4.67 mmHg (p= 0.001) and +2.15 mmHg (p= 0.013) at 5 minutes. The increase was lower in the LC group when compared to LS (p= 0.027). OPA decreased in both groups, with a baseline difference, after 1 minute, of -0.85 mmHg (p = -0.85 mmHg (p= 0.001), and at 5 and 10 minutes with differences of -1.17 (p= 0.001) and -0.89 mmHg (p= 0.001), respectively. The highest decrease was observed in group LC in relation to group LS (p= 0.03). There was no difference in OPP in relation to baseline measurements. Conclusions Adding clonidine to lidocaine for sub-Tenon’s anesthesia reduced IOP and OPA without significant changes in OPP.

https://doi.org/10.1016/j.bjane.2021.08.004

10.

Contaminación Bacteriana del Aerosol Dental con y sin Uso de una Cúpula de Acrílico en un Paciente en Pandemia COVID-19
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Venegas-Arques, María Cecilia

; Rojas-García, Carolina Pia

; Cataldo-Saavedra, Yuri Andrés

; Jiménez-Gomez, Paula Fernanda

; Arqués-Vergara, Victoria Inés

; Martinez, Benjamín

International journal of odontostomatology

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mar 2021, Volume 15 N. 1 Pages 14 - 22

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT: In the current PANDEMIC for COVID- 19, the clinical world has been forced to reinforce the use of protection in healthcare, due to the high degree of contagion and virulence of this virus. In dentistry, due to the production of aerosols, clinical care has been suspended to prevent infection. The objective of this research is to determine the amount of bacterial contamination, generated by the use of high-speed micromotor aerosol, carried out by dentists at the Hospital de La Florida, Santiago, Chile. The study included 10 patients per box, with 2 samples per patient, in total 40 culture plates, 20 Control, 20 Test and 3 Environmental. The culture medium was kept for 10 minutes, located in the front of the operator and the patient's chest. Simulation of the operation with a turbine was performed, without absolute isolation, with and without the use of an acrylic dome, placed on a healthy patient. The samples were analyzed macroscopically, incubated at 37ºC in an atmosphere of oxygen for 24 hours and Carbon dioxide after 48 hours. 43 plates were positive, noting a non-significant difference (p = 0.753) between the two groups in the bib samples, with an average difference of 56.76 CFU. In the plates of the operator's forehead, an average of 8.1 CFU in the box without dome and 3.9 CFU in the box with dome, finding a statistically significant difference (p = 0.0391). The environmental plates 28.33 UFC in the Box with the dome, 29 UFC in the Control Box and the Box without dome 46.66 UFC. When verifying that the acrylic dome effectively contains aerosols, it should be used as a biosafety standard to protect both dental equipment and patients in times of pandemic against COVID-19.

RESUMEN: En la actual pandemia por COVID-19, el mundo clínico se ha visto obligado a reforzar el uso de protección en el quehacer asistencial, debido al alto grado de contagio y virulencia de este virus. En odontología, debido a la producción de aerosoles, se han suspendido las atenciones clínicas para prevenir contagios. El objetivo de esta investigación es determinar la cantidad de contaminación bacteriana, generada por el uso de aerosol con micromotor de alta velocidad, realizado por dentistas del Hospital de La Florida, Santiago de Chile. El estudio contó con 10 pacientes por box, con 2 muestras por paciente, en total 40 placas de cultivo, 20 Control, 20 Prueba y 3 Ambientales. El medio de cultivo se mantuvo por 10 minutos, ubicado en la frente del ope rador y pechera del paciente, se realizó simulación de operatoria con turbina, sin aislamiento absoluto, con y sin uso de una cúpula de acrílico, puesta en un paciente sano. Las muestras fueron analizadas macroscópicamente, incubadas a 37 ºC en una atmósfera de oxígeno por 24 horas y dióxido de Carbono a las 48 horas. 43 placas fueron positivas, observándose, en las muestras de la peche ra una diferencia no significativa (p=0,753) entre ambos grupos, con una diferencia promedio de 56,76 UFC. En las placas de la fre nte del operador, un promedio de 8.1 UFC en Box sin cúpula y 3,9 UFC en el box con cúpula, encontrándose diferencia estadísticament e significativa (p= 0,0391). Las placas ambientales 28,33 UFC en el Box con cúpula, 29 UFC en el Box control y Box sin cúpula 46, 66 UFC. Al comprobar que la cúpula de acrílico contiene eficazmente los aerosoles, corresponde utilizarlo como norma de biosegurid ad para proteger tanto al equipo dental, como a los pacientes en tiempos de pandemia contra el COVID-19.

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11.

Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study
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Gonçalves, Pedro Marcos Silva e

; Vieira, Alexandra de Vasconcelos

; Silva, Claudia Helena Ribeiro da

; Gomez, Renato Santiago

Brazilian Journal of Anesthesiology

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feb 2021, Volume 71 N. 1 Pages 38 - 43

Abstract: En | Text: En | PDF: En

Abstract Introduction and objectives: The use of neuromuscular blockers during surgery represented a landmark for anesthesiology. However, their use can prompt residual Neuromuscular Blockade (RNMB) and objective monitoring of neuromuscular function is crucial to warrant the recovery of muscle strength. The present study aimed to estimate the incidence of RNMB and late Neuromuscular Blockade (LNMB) at the Post-Anesthetic Recovery Unit (PACU). Method: The study included 85 patients, 43 of which received cisatracurium and 42 of which, rocuronium. The depth of the Neuromuscular Blockade (NMB) was assessed by Train Of Four (TOF). NMB reversal was performed with the administration of neostigmine and atropine.RNMB was defined when a patient presented TOF below 90% at the PACU. Results: RNMB at the PACU was diagnosed in 39.5% and 40.5% of the patients receiving cisatracurium and rocuronium, respectively (p= 1.0). LNMB at the PACU was found in 32.6% and 16.7% of the patients receiving cisatracurium and rocuronium, respectively (p= 0.131). Conclusions: The incidence ofRNMB remains significant despite the use of intermediate-acting neuromuscular blockers and reversal agents. There was no statistically significant difference in the incidence of RNMB or LNMB in patients receiving cisatracurium or rocuronium. The use of objective NMB monitoring is effective for the diagnosis of RNMB, as well as for treatment management.

https://doi.org/10.1016/j.bjane.2020.12.009 172 downloads

12.

Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using midazolam or fentanyl associated with propofol
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Magnus, Gisela

; de Freitas Flausino, Gustavo

; de Siqueira, Caroline Guimaraes Dantas

; Coelho, Gabriela Carvalho Simões

; Caetano, Maria Eduarda Casasanta

; Gomez, Renato Santiago

Journal of Coloproctology (Rio de Janeiro)

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dec 2020, Volume 40 N. 4 Pages 368 - 375

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Comparar o tempo de recuperação pós-anestésica de pacientes sedados para colonoscopia usando duas combinações de fármacos: midazolam e propofol ou fentanil e propofol. Método: Cinquenta pacientes ASA I e II, entre 18 e 65 anos, candidatos a colonoscopia eletiva sob sedação administrada por anestesiologista, foram randomizados em dois grupos: Grupo A (midazolam e propofol) e Grupo B (fentanil e propofol). Cada paciente foi avaliado quanto ao tempo de realização do exame (TExame), tempo de permanência na sala de recuperação pós-anestésica 1 e 2 (TSRPA 1 e TSRPA2) e a alta domiciliar. Episódios de despertar, movimentação, queda de SpO2 < 90%, necessidade de assistência ventilatória, consumo de propofol, frequência cardíaca (FC) e pressão arterial média (PAM) também foram avaliados. Resultados: Pacientes do grupo B apresentaram tempo de recuperação na SRPA1 inferior estatisticamente ao grupo A. Em ambos os grupos o TSRPA1 foi considerado inversamente proporcional ao TSRPA2. O tempo de alta domiciliar foi semelhante entre os grupos. Pacientes do grupo B apresentaram redução significativa na PAM no tempos exame e final, em relação ao inicial e sedação. Entretanto, essa variação foi inferior a 20%. Não foram observados eventos adversos. Todos os pacientes evoluíram com alta domiciliar no mesmo dia, sem ocorrência de internação não prevista. Conclusões: O uso combinado de fentanil e propofol para sedação em colonoscopia produziu tempo de recuperação pós-anestésica na SRPA1 inferior a combinação midazolam e propofol. No entanto, o tempo de alta domiciliar foi semelhante entre os grupos.

ABSTRACT Objective: Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using two drug combinations: midazolam and propofol or fentanyl and propofol. Method: Fifty patients ASA I and II, from 18 to 65 years of age, candidates for elective colonoscopy under sedation administered by an anesthesiologist, were randomized in two groups: Group A (midazolam and propofol) and Group B (fentanyl and propofol). Each patient was evaluated as for the length of the exam (Exam length), length of stay in the post-anesthesia care unit 1 and 2 (LSPACU1 and LSPACU2) and hospital discharge. Episodes of awakening, and of movement, drop in SpO2 < 90%, need for mechanical ventilation, propofol consumption, heart rate (HR) and mean blood pressure (MBP) were also evaluated. Results: Patients of group B had a recovery time in LSPACU1 statistically shorter than that for those in group A. In both groups, LSPACU1 was considered inversely proportional to LSPACU2. Hospital discharge time was similar between groups. Patients of group B had a significant decrease in MBP during and at the end of the exam, when compared to the initial measurement and that during sedation. Nevertheless, this variation was lower than 20%. No adverse event was observed. All patients were discharged on the same day, with no unexpected hospitalization. Conclusions: The combined use of fentanyl and propofol for colonoscopy sedation had a post-anesthesia recovery time in LSPACU1 shorter than that with the combination of midazolam and propofol. Nevertheless hospital discharge time was similar between groups.

https://doi.org/10.1016/j.jcol.2020.07.007 424 downloads

13.

Desarrollo de una aplicación para la predicción de ingredientes y recetas de cocina por medio de TensorFlow y máquinas de soporte vectorial
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Muñoz-Castaño, Yeny

; Castillo-Ossa, Luis

; Castrillón-Gomez, Omar

; Buitrago-Carmona, Felipe

; Loaiza Giraldo, Santiago

Revista Ingenierías Universidad de Medellín

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dec 2020, Volume 19 N. 37 Pages 195 - 215

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen Este artículo es derivado de un proyecto de investigación en el cual se realizó el desarrollo de una aplicación para la predicción de ingredientes y recetas por medio de TensorFlow y máquinas de soporte vectorial. Se realizó un esquema de la arquitectura general, luego se desarrolló una red neuronal y después se efectuó la ejecución de la máquina de soporte vectorial. Finalmente, se realizó la integración en una aplicación que permite al usuario seleccionar imágenes de los ingredientes para su predicción y de la receta de cocina para desayunos de manera didáctica. Se concluyó que el sistema tiene un promedio de precisión del 75,8 % para las 17 categorías de ingredientes y de 71 % para el clasificador de recetas. Adicionalmente, se realizó un análisis de esta estabilidad y se observó que todos los resultados eran iguales en términos estadísticos.

Abstract This article is derived from a research project in which an application for the prediction of ingredients and recipes by TensorFlow and support-vector machines was developed. A scheme with general architecture was developed, then a neural network was implemented, and then, the support-vector machine was run. After that, they were integrated via an application that allows the user to select ingredients' images for their prediction and the prediction of kitchens recipe in a didactic manner. It was concluded that the system has an average precision value of 75.8% and 71% for 17 ingredients categories and recipes classifier. In addition, sensitivity testing was performed on the application resulting on statistically equivalent results.

Resumo Este artigo é derivado de um projeto de pesquisa no qual se realizou o desenvolvimento de um aplicativo para a predição de ingredientes e receitas por meio de TensorFlow e máquinas de suporte vetorial. Realizou-se um esquema da arquitetura geral, desenvolveu-se uma rede neuronal e depois efetuou-se a execução da máquina de suporte vetorial. Finalmente, realizou-se a integração num aplicativo que permite ao usuário selecionar imagens dos ingredientes para sua predição e da receita de cozinha para cafés da manhã de maneira didática. Concluiu-se que o sistema tem uma média de precisão de 75,8 % para as 17 categorias de ingredientes e de 71 % para o classificador de receitas. Adicionalmente, realizou-se uma análise dessa estabilidade e observou-se que todos os resultados eram iguais em termos estatísticos.

https://doi.org/10.22395/rium.v19n37a10 56 downloads

14.

[SciELO Preprints] - Immunocompromised patients and coronavirus disease 2019: a review and recommendations for dental health care
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Martins-Chaves, Roberta Rayra Gomes, Carolina Cavaliéri Gomez, Ricardo Santiago

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Publication date: 2020-05-11

Abstract: En

In less than four months, an unprecedented pandemic changed the world scenario, closing institutions and commerce, paralyzing sports championships, blocking frontiers, and putting almost all populations in a house quarantine regimen. Immunocompromised patients are within the high-risk group to severe outcomes from COVID-19. However, there is no clear evidence of the association between impaired immune host status and complications from SARS-CoV-2 infection so far. The virus is transmitted by inhalation or direct contact with infected secretions, and therefore the dental office is a highly susceptible environment for such transmission. Here, we review the literature and discuss immunological COVID-19 related issues. We also make suggestions for immunocompromised patients’ support in this new emerging context of clinical dental practice. Until comprehensive findings are published, individuals with impaired immunity should be considered as high-risk. Cross infection control procedures for the clinical care of immunocompromised patients should follow the same guidelines that are being proposed for immunocompetent ones. However, during the active outbreak, people under immunosuppressive conditions should not receive elective procedures, even if they do not have symptoms or exposure history to COVID-19, and in case of emergence, care must be done in a separate airborne room. In the pos-pandemic phase, the dental care general recommendations should be the same for all subjects. Changes in the current guidelines have been proposed to SARS-CoV-2 infection control in order to provide the best and safe dental practice. However, they still need to be validated by future studies.

https://doi.org/10.1590/1807-3107bor-2020.vol34.0048

15.

Immunocompromised patients and coronavirus disease 2019: a review and recommendations for dental health care
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MARTINS-CHAVES, Roberta Rayra

; GOMES, Carolina Cavaliéri

; GOMEZ, Ricardo Santiago

Brazilian Oral Research

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2020, Volume 34 elocation e048

Abstract: En | Text: En | PDF: En

Abstract In less than four months, an unprecedented pandemic changed the world scenario, closing institutions and commerce, paralyzing sports championships, blocking frontiers, and putting almost all populations in a house quarantine regimen. Immunocompromised patients are within the high-risk group to severe outcomes from COVID-19. However, there is no clear evidence of the association between impaired immune host status and complications from SARS-CoV-2 infection so far. The virus is transmitted by inhalation or direct contact with infected secretions, and therefore the dental office is a highly susceptible environment for such transmission. Here, we review the literature and discuss immunological COVID-19 related issues. We also make suggestions for immunocompromised patients’ support in this new emerging context of clinical dental practice. Until comprehensive findings are published, individuals with impaired immunity should be considered as high-risk. Cross infection control procedures for the clinical care of immunocompromised patients should follow the same guidelines that are being proposed for immunocompetent ones. However, during the active outbreak, people under immunosuppressive conditions should not receive elective procedures, even if they do not have symptoms or exposure history to COVID-19, and in case of emergence, care must be done in a separate airborne room. In the pos-pandemic phase, the dental care general recommendations should be the same for all subjects. Changes in the current guidelines have been proposed to SARS-CoV-2 infection control in order to provide the best and safe dental practice. However, they still need to be validated by future studies.

https://doi.org/10.1590/1807-3107bor-2020.vol34.0048 5002 downloads

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