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Abstract The leading cause of death and disability worldwide are due to atherosclerotic cardiovascular disease (ASCVD), entailing a heavy economic impact, in Portugal corresponding to 1% of the gross domestic product. The development and progression of ASCVD are closely related to hypercholesterolaemia, with high LDL-C levels being its most important and easily modifiable risk factor. Reducing LDL-C has been shown to decrease the incidence of cardiovascular events and European recommendations advocate LDL-C target values according to the patient's cardiovascular risk. The risk of hypercholesterolaemia is cumulative, making it relevant to reduce LDL-C as early as possible. Despite the efficacy and safety demonstrated by several existing lipid-lowering therapies, in the real world most patients do not achieve the recommended lipid values. Several limita-tions to adequate lipid control have been pointed out, namely the low adherence of patients to treatment. Inclisiran is the first drug to inhibit PCSK9 synthesis through RNA small interference mechanism. With a subcutaneous administration every six months after initial and 3-month dose, it allows a LDL-C reduction higher than 50%, with a good safety profile. The advantage of its long duration of action will potentially overcome the low compliance of patients to treat-ment and increase the effectiveness in reducing LDL-C, which may translate into a reduction in morbidity and mortality from ASCVD and its high economic impact.

Resumo A doença cardiovascular aterosclerótica (DCVA) lidera as principais causas de morte e incapacidade a nível mundial, acarretando um pesado impacto económico, correspondente a 1% do produto interno bruto em Portugal. O desenvolvimento e progressão da DCVA encontra-se em estreita relação com a hipercolesterolemia, sendo que níveis elevados de C-LDL são o seu fator de risco mais importante e facilmente modificável. A redução do C-LDL provou diminuir a incidência de eventos cardiovasculares e as recomendações europeias advogam valores alvo de C-LDL de acordo com o risco cardiovascular do doente. O risco da hipercolesterolemia é cumulativo, tornando-se relevante a redução do C-LDL o mais precocemente possível. Apesar da eficácia e segurança demonstrada pelas diversas terapêuticas hipolipemiantes existentes, no mundo real a maioria dos doentes não atinge os valores lipídicos recomendados. Várias limitações ao adequado controlo lipídico foram apontadas, nomeadamente a baixa adesão dos doentes ao tratamento. Inclisiran é o primeiro fármaco que permite inibir a síntese de PCSK9 através do mecanismo de RNA de interferência. Com uma administração subcutânea semestral, após administração nos dias 1 e 90, possibilita uma redução do C-LDL superior a 50%, com bom perfil de segurança. A vantagem da sua longa duração de ação permitirá potencialmente contornar a baixa adesão dos doentes ao tratamento e aumentar a efetividade na redução do C-LDL, que se poderá traduzir na redução da morbi-mortalidade por DCVA e do seu elevado impacto económico.

https://doi.org/10.24950/rspmi.1603

Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV
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Oliveira, Iara Katrynne Fonsêca

; Teixeira, Nayra do Socorro Caldas Carvalho de Almeida

; Rêgo, Beatriz de Mello Pereira

; Aires, Isabel Oliveira

; Rodrigues, Renata Rios Torres

; Araújo, Robson Eduardo da Silva

; Lima, Carlos Henrique Ribeiro

; Sousa, Rosana Rodrigues de

; Carvalho, Cecília Maria Resende Gonçalves de

; Costa, Dorcas Lamounier

; Santos, Marize Melo dos

; Paz, Suzana Maria Rebelo Sampaio da

; Paiva, Adriana de Azevedo

Nutrición Hospitalaria

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oct 2023, Volume 40 N. 5 Pages 1000 - 1008

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

Abstract Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 % CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.

Resumen Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.

https://doi.org/10.20960/nh.04402

Adherencia a las medidas higiénico dietéticas de adultos con diabetes mellitus de Asunción en 2022
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Recalde Mello, Laura

; Aguilera Fernández, Andrea Leticia

; Aveiro González, Tania Mariela

; Bareiro Vera, Mathías José Enrique

; Da Rocha Seixas, Bruno Max Félix

; Fariña Silvestre, Diana Isabel

; Fleitas Enciso, Cinthia Mabel

; Gaona Saucedo, César Augusto

; Quintana Alderete, Jazmín Soledad

; Riveros Servín, Dilson Marcelo Jonás

; Rocha Souza, Rodrigo

; Villasanti González, Alba Romina

; Gómez López, Hugo René

Revista Virtual de la Sociedad Paraguaya de Medicina Interna

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mar 2023, Volume 10 N. 1 Pages 20 - 28

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

ABSTRACT Introduction: Adherence to non-pharmacological treatment of diabetes mellitus is a key factor in avoiding or delaying the complications of this disease. Treatment compliance depends on multiple factors. Objective: To evaluate adherence to dietary hygienic treatment in patients with diabetes mellitus, especially nutrition and physical activity. Demographic variables and the presence of arterial hypertension were also measured. Methodology: An interview was conducted with adult male and female patients, carriers of diabetes mellitus, residing in the Sajonia neighborhood of Asunción, Paraguay, between May and October 2022. Demographic and clinical variables were measured. Adherence was determined with the Caro Bautista questionnaire, which consists of seven questions that evaluate the therapeutic practices of patients in the last week. The study was approved by the Ethics Committee of the Faculty of Medicine of the Universidad Privada del Este, Paraguay. Results: Two hundred fifty-seven people diagnosed with diabetes mellitus were interviewed, with a predominance of females (61.4%), 73.9% reported having their own income and 49% also suffered from arterial hypertension. The questionnaire detected that 20.1% followed a healthy diet all week, 15.5% performed daily physical exercises, and 14.3% performed capillary blood monitoring regularly. Conclusion: Between 10 and 22% of patients with diabetes mellitus perform adequate diet and exercise, as well as glycemia monitoring according to the recommendations of their physicians.

RESUMEN Introducción: la adherencia al tratamiento no farmacológico de la diabetes mellitus es un factor clave para evitar o retrasar las complicaciones de esta enfermedad. El cumplimento terapéutico depende de múltiples factores. Objetivo: evaluar la adherencia al tratamiento higiénico dietético en pacientes con diabetes mellitus, sobre todo la nutricional y la actividad física. Se midieron además las variables demográficas y presencia de hipertensión arterial. Metodología: se realizó una entrevista a pacientes adultos de ambos sexos, portadores de diabetes mellitus, que residen en el barrio Sajonia de Asunción, Paraguay, entre mayo y octubre del 2022. Se midieron variables demográficas y clínicas. La adherencia se determinó con el cuestionario de Caro Bautista que consta de 7 preguntas que evalúan las prácticas terapéuticas de los pacientes en la última semana. El estudio contó con la aprobación del Comité de ética de la Facultad de Medicina de la Universidad Privada del Este, Paraguay. Resultados: fueron entrevistados 257 personas con el diagnóstico de diabetes mellitus, con predominio del sexo femenino (61,4%), 73,9% refería tener ingresos propios y 49% padecía también de hipertensión arterial. El cuestionario detectó que 20,1% seguía una dieta saludable toda la semana, 15,5% realizaba ejercicios físicos diariamente y 14,3% realizaba los monitoreos de sangre capilar regularmente. Conclusión: entre 10 y 22% de los pacientes con diabetes mellitus realiza dieta y ejercicios adecuados, así como monitoreo de la glucemia según las recomendaciones de sus médicos.

https://doi.org/10.18004/rvspmi/2312-3893/2023.10.01.20

Predileção de riachos para o monitoramento da qualidade da água: um serviço ecossistêmico de provisão na bacia hidrográfica do rio Itajaí-Mirim (Brasil).
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Bohn, Isabel Cristina

; Costa, Vinícius Soares Correa da

; Cionek, Vivian de Mello

; Branco, Joaquim Olinto

; Ribeiro, Eduardo Augusto Werneck

Finisterra - Revista Portuguesa de Geografia

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dec 2022, N. 121 Pages 95 - 108

Abstract The Itajaí-Mirim river basin, SC (Brazil) is a reference in the collection of water for public supply compared to the other basins that make up its territory. However, it presents a greater contribution of sanitary sewage throughout its course. In this context, the objective of the present article is to select streams allocated to different land uses and to understand the influence of land use on water quality, as a provision ecosystem service and preponderant to the health of the population. The methodological steps developed for the choice of streams were geoprocessing and field activity, while for the monitoring of water quality, the analysis of physical-chemical parameters was carried out. The results obtained showed that the use of land influences the quality of water in streams, being negative in rural and urban areas, as a chemical and physical contaminant attribute regarding the discharge of untreated effluents into the watercourse; and positive to the potability of water in forested area. It is important to encourage action by the public power for the development of policies and guidelines aimed at territorial planning, whose essential resource for the provision of human activities is in potential degradation.

Résumé Le bassin hydrographique du Itajaí-Mirim, SC (Brésil) est une référence en matière de collecte d’eau pour l’approvisionnement public par comparaison des autres bassins qui composent son territoire. Toutefois, ce bassin présente le plus apport d’eaux usées sanitaires le long de son parcours. À cette occasion, l’objectif du présente article est de sélectionner des ruisseaux alloués à différentes utilisations des terres et de comprendre l’influence de l’utilisation des terres sur la qualité de l’eau, tandis que le service écosystémique de la provision et prépondérante pour la santé de la population. Les étapes méthodologiques développées pour le choix des cours d’eau ont été: le géotraitement et l’activité de terrain, tandis que pour le suivi de la qualité de l’eau, l’analyse des paramètres physico-chimiques a été réalisée. Les résultats obtenus indiquent que l’utilisation des terres influence la qualité de l’eau dans les ruisseaux, qui est négative dans les zones rurales et urbaines, en tant qu’attribut chimique et physique contaminant en ce qui concerne le rejet d’effluents non traités pas dans le cours d’eau; et positif pour la potabilité de l’eau dans le espace boisé. Il est important de susciter l’action du pouvoir public pour le développement des politiques et des directrices visant la planification du territoire, dont la ressource essentielle pour l’approvisionnement des activités humaines est en voie de dégradation.

Resumen La cuenca del río Itajaí-Mirim, SC (Brasil) es referencia en la captación de agua para abastecimiento público en comparación con otras cuencas que componen su territorio. Sin embargo, presenta un mayor aporte de alcantarillado sanitario a lo largo de su curso. En este contexto, el objetivo de lo presente artículo consiste en elegir riachuelos destinados a diferentes usos de la tierra y comprender la influencia del uso de la tierra en la calidad del agua, mientras un servicio ecosistémico de provisión y preponderante para la salud de la población. Las etapas metodológicas desarrolladas para la elección de riachuelos fueron: geoprocesamiento y la actividad de campo, mientras que para el monitoreo de la calidad del agua se realizó el análisis de parámetros físico-químicos. Los resultados obtenidos apuntan que el uso del suelo influye en la calidad del agua en los riachuelos, lo cual es negativo en las zonas rurales y urbanas, como atributo contaminante químico y físico mientras a la descarga de efluentes sin tratar al curso hídrico; y positivo a la potabilidad del agua en una zona boscosa. Surge la necesidad de una acción del poder público para el desarrollo de políticas y pautas destinadas a la ordenación territorial, cuyo recurso esencial para la provisión de las actividades humanas se encuentra en potencial degradación.

Resumo A bacia hidrográfica do rio Itajaí-Mirim, SC (Brasil) é referência na captação de água para abastecimento público em comparação com as demais bacias que compõem seu território. Entretanto, esta apresenta maior aporte de esgotamento sanitário ao longo de seu curso. Nesse ensejo, o objetivo do presente artigo consiste em selecionar riachos alocados em diferentes usos das terras e compreender a influência dos usos na qualidade da água, enquanto serviço ecossistêmico de provisão e preponderante à saúde da população. As etapas metodológicas desenvolvidas para a escolha dos riachos foram: geoprocessamento e atividade de campo. Já para o monitoramento da qualidade da água foi realizada a análise de parâmetros físico-químicos. Os resultados obtidos apontaram que o uso das terras influencia a qualidade da água nos riachos, sendo esta negativa em áreas rurais e urbanas, como atributo contaminante químico e físico no tocante ao despejo de efluentes sem tratamento ao curso hídrico, e positiva à potabilidade da água em área florestada. Emerge suscitar a ação do poder público para o desenvolvimento de políticas e diretrizes voltadas ao planejamento territorial, cujo recurso essencial ao provisionamento das atividades humanas encontra-se em potencial degradação.

https://doi.org/10.18055/finis28482

Screening for myeloid mutations in patients with myelodysplastic syndromes and AML with myelodysplasia-related changes
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Bezerra, Matheus F.

; Larrazábal, Bruna R.

; Lima, Aleide S.

; Mello, Mariana R.

; Pimentel, Raphael F.

; Weinhäuser, Isabel

; Costa, Fernando F.

; Fertrin, Kleber Y.

; Araújo, Aderson S.

; Machado, Cíntia G.

; Bezerra, Marcos A.

; Lucena-Araujo, Antonio R.

Hematology, Transfusion and Cell Therapy

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sep 2022, Volume 44 N. 3 Pages 328 - 331

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: One of the most critical complications in myelodysplastic syndromes (MDS) is the progression to acute myeloid leukemia (AML). The dynamics of clonal evolution in MDS and how acquired mutations can be used as biomarkers to track disease progression remains under investigation. Objective and method: Herein, we investigated the frequency of common myeloid clonal mutations (FLT3, NPM1, JAK2, IDH1 and IDH2) in 88 patients with MDS and 35 AML patients with myelodysplasia-related changes, followed at a single reference center in northeastern Brazil. Results: Overall, 9/88 (10%) ofthe MDSpatients and 9/35 (26%) of the secondary AML patients had at least one mutation. While the JAK2 V617F mutation was the most frequent in the MDS patients, the FLT3, NPM1, IDH1 and IDH2 mutations were more frequently found in the secondary AML group. Furthermore, there was a higher frequency of FLT3, NPM1, IDH1 and IDH2 mutations in MDS patients classified as high-risk subtypes than in those of lower risk. Conclusion: Despite the limited sample size, our data suggest that mutations in FLT3, NPM1, IDH1 and IDH2 genes could be potential biomarkers to detect early disease progression in MDS.

https://doi.org/10.1016/j.htct.2020.10.967

Phenolic profiling, organic acids and sugars composition of feijoa (Acca sellowiana (O. Berg) Burret) and uvaia (Eugenia pyriformis Cambess) from the southern Brazilian highlands
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Wanderley, Bruna Rafaela da Silva Monteiro

; Haas, Isabel Cristina da Silva

; Biluca, Fabíola Carina

; Brugnerotto, Patricia

; Gomes, Trilícia Margarida

; Aquino, Ana Carolina Moura de Sena

; Costa, Ana Carolina Oliveira

; Burin, Vívian Maria

; Amboni, Renata Dias de Mello Castanho

; Fritzen-Freire, Carlise Beddin

Ciência Rural

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2022, Volume 52 N. 12 elocation e20210458

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

RESUMO: O Brasil é um grande país e com elevada biodiversidade em suas diferentes regiões. Entretanto, espécies de frutas nativas amplamente encontradas no sul do Brasil ainda não foram devidamente exploradas, permanecendo desconhecidas e subutilizadas pela indústria de alimentos. Nesse sentido, o objetivo deste estudo foi avaliar o perfil fenólico, bem como a composição de ácidos orgânicos e de açúcares de polpas de feijoa (Acca sellowiana) e de uvaia (Eugenia pyriformis) provenientes do planalto sul brasileiro. A polpa de uvaia apresentou o maior teor de polifenóis totais e a maior capacidade antioxidante pelos métodos utilizados. A (+)-catequina (6.54 mg 100g-1) foi o principal composto fenólico da polpa da uvaia, o que ainda não foi relatado na literatura para frutas de outras regiões. Além disso, a polpa da feijoa se destacou pela presença de (-)-epicatequina (18.29 mg 100g-1). Dentre os ácidos orgânicos avaliados, as polpas de frutas nativas apresentaram valores para os ácidos cítrico e málico, sendo o ácido málico (553.00 mg 100g-1) o principal na polpa de uvaia, e o cítrico (455.60 mg 100g-1) na polpa de feijoa. Em relação aos açúcares, a polpa da feijoa apresentou o maior teor de açúcar total (11.14 g 100g-1) e foi a única polpa que continha sacarose. Já a polpa da uvaia apresentou a frutose (3.10 g 100g-1) como principal açúcar. Os resultados obtidos neste estudo contribuem para a valorização e conservação das espécies investigadas, representando uma alternativa promissora para a utilização dessas frutas nativas no desenvolvimento de novos produtos.

ABSTRACT: Brazil is a large country with high biodiversity in its different regions. However, species of native fruits widely reported in the southern Brazil have not been properly explored so far, remaining underutilized by the food industry. This study evaluated the polyphenolic profile, as well as the composition of organic acids and sugars of the pulps of the feijoa, and the uvaia from southern brazilian highlands. The uvaia pulp showed the highest total polyphenol content and the highest antioxidant capacity by the methods used. The polyphenol (+)-catechin (6.54 mg 100g-1) was the major phenolic compound in uvaia pulp, which has not yet been reported in the literature for fruits of other regions. In addition, the feijoa pulp stood out for the presence of (-)-epicatechin (18.29 mg 100g-1). The pulps of native fruits in this study only quantified values for citric and malic acids. Malic acid (553.00 mg 100g-1) was the main acid in the uvaia pulp, and citric acid (455.60 mg 100g-1) was the main acid in the feijoa pulp. It is possible to note that the feijoa pulp showed the highest total sugar content (11.14 g 100g-1) and was the only pulp that contained sucrose. The uvaia pulp, conversely, showed fructose (3.10 g 100g-1) as the main sugar. The results obtained in this study contributed to the valuation and conservation of the species investigated, representing a promising alternative for the use of these native fruits in the development of new products.

https://doi.org/10.1590/0103-8478cr20210458

A theoretical approach to dairy products from membrane processes
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CUNHA, Tamires Marques Paes da

; CANELLA, Maria Helena Machado

; HAAS, Isabel Cristina da Silva

; AMBONI, Renata Dias de Mello Castanho

; PRUDENCIO, Elane Schwinden

Food Science and Technology

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2022, Volume 42 elocation e12522

Abstract: En | Text: En | PDF: En

Abstract Milk is a food rich in nutrients and requires processing that promotes its conservation, such as concentration. The membrane process, as an emerging technology and lower energy consumption, has been applied to concentrate, purify, and adapt milk for fluid consumption or derivatives. The Microfiltration, Ultrafiltration, Nanofiltration, and Reverse Osmosis processes have already been applied to milk and the biggest challenge is in controlling phenomena such as fouling, and polarization influenced by the system's operating conditions. The membrane process has already been used in the production of cheese, ricotta, protein concentrates, powdered milk, and dairy beverages.

https://doi.org/10.1590/fst.12522

Elaboration and validation of a protocol for the care of patients with COVID-19 in hemodialysis centers
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Knebel, Graziela

; Breitsameter, Guilherme

; Proença, Maria Conceição da Costa

; Breitsameter, Renata de Mello Magdalena

; Figueiredo, Carolina Rossi de

; Echer, Isabel Cristina

Revista Gaúcha de Enfermagem

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2022, Volume 43 elocation e20200399

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

RESUMO Objetivo: Descrever a elaboração e validação de um protocolo para atendimento de pacientes suspeitos ou com Coronavirus Disease-19 (COVID-19) em hemodiálise. Método: Estudo metodológico conduzido de março a agosto/2020 em hospital do sul do Brasil. O estudo envolveu diagnóstico situacional, revisão da literatura, elaboração do protocolo e validação de conteúdo (abrangência, clareza e pertinência). Participaram da validação dez profissionais da equipe multidisciplinar com experiência no atendimento de pacientes com doença renal e um órgão oficial fiscalizatório de enfermagem. Obteve-se 100% de consenso entre os especialistas. Resultados: Foram elaborados: “Fluxo de atendimento para pacientes constituído de seis “etapas” e “Plano gerencial para centros de diálise”. A validação permitiu aprimorar e refinar o conteúdo atendendo preceitos de normas sanitárias, segurança e diretrizes clínicas. Considerações finais: A elaboração e validação do protocolo podem padronizar e nortear a prática clínica, promovendo a continuidade e a segurança no cuidado, podendo ser utilizado em outros centros.

ABSTRACT Objective: To describe the elaboration and validation of a protocol for the care of suspected patients with Coronavirus Disease-19 (COVID-19) undergoing hemodialysis. Method: A methodological study conducted from March to August 2020 at a hospital in southern Brazil. The study involved situational diagnosis, literature review, protocol elaboration and content validation (scope, clarity and relevance). Ten professionals from the multidisciplinary team with experience in caring for patients with kidney disease and an official Nursing supervisory body participated in the validation. 100% consensus was reached among the experts. Results: The following were elaborated: “Flow of patient care consisting of six stages” and “Management plan for dialysis centers”. The validation allowed improving and refining the content, complying with the precepts of health standards, safety and clinical guidelines. Final considerations: The elaboration and validation of the protocol can standardize and guide the clinical practice, promoting continuity and safety in care, and can be used in other centers.

RESUMEN Objetivo: Describir la elaboración y validación de un protocolo para la atención de pacientes sospechosos o con Coronavirus Disease-19 (COVID-19) en hemodiálisis. Método: estudio metodológico realizado de marzo a agosto / 2020 en un hospital del sur de Brasil. El estudio incluyó diagnóstico situacional, revisión de la literatura, elaboración de protocolos y validación de contenido (alcance, claridad y relevancia). En la validación participaron diez profesionales del equipo multidisciplinar con experiencia en el cuidado de pacientes con enfermedad renal y un órgano de control oficial de enfermería. Se alcanzó un consenso del 100% entre los expertos. Resultados: Fueron elaboraron: "Flujo de atención al paciente en seis etapas" y "Plan de gestión para centros de diálisis". La validación permitió mejorar y afinar el contenido, cumpliendo con los preceptos de las normas de salud, seguridad y guías clínicas. Consideraciones finales: La elaboración y validación del protocolo puede estandarizar y orientar la práctica clínica, promoviendo la continuidad y seguridad en la atención, pudiendo ser utilizado en otros centros.

https://doi.org/10.1590/1983-1447.2022.20200399.en

Telesimulation about home visits and child care: facilitators, barriers and perception of Nursing students
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Domingues, Aline Natália

; Hilário, Jeniffer Stephanie Marques

; Mello, Débora Falleiros de

; Parro Moreno, Ana Isabel

; Fonseca, Luciana Mara Monti

Revista Latino-Americana de Enfermagem

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2022, Volume 30 elocation e3672

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

Resumo Objetivo: avaliar as facilidades, barreiras e percepções de estudantes de enfermagem na aprendizagem sobre visita domiciliar e cuidado infantil por telessimulação na pandemia da COVID-19. Método: estudo qualitativo avaliativo de telessimulação por computador, fundamentado no modelo teórico de Kolb. Foram aplicados um questionário semiestruturado e a Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem, com análise descritiva e análise qualitativa temática sobre percepções de 41 graduandos de enfermagem. Resultados: a telessimulação contextualizada proporcionou oportunidades de aprendizagem em dimensões da estratégia pedagógica, cenário telessimulado, comunicação e especificidades do cuidado infantil em visita domiciliar. Atividade segura e dinâmica, auxiliou a solidificar conhecimentos e atitudes reflexivas, aproximação à realidade, desenvolvimento da interação, observação e tipos de abordagens. Houve restrições por falhas de conexão. Grande parte dos estudantes indicou níveis bons de satisfação e autoconfiança com a aprendizagem na escala aplicada. Conclusão: a situação clínica real com imersão remota permitiu observação, tomada de decisão, reflexão e elaboração de conclusões inerentes ao ciclo de aprendizagem experiencial. O conjunto de elementos desta telessimulação criou um ambiente que estimulou o interesse dos estudantes de enfermagem para outras etapas de aprendizagem, sugerindo um espaço que fortalece conhecimentos e que guarda interlocução com as práticas presenciais.

Abstract Objective: to evaluate the facilitators, barriers and perceptions of Nursing students in learning about home visiting and child care through Telesimulation during the COVID-19 pandemic. Method: a qualitative study to evaluate Telesimulation via computers, grounded on Kolb’s theoretical model. A semi-structured questionnaire and the Student Satisfaction and Self-Confidence in Learning Scale were applied, with descriptive analysis and qualitative thematic analysis on the perceptions of 41 Nursing students. Results: the contextualized Telesimulation provided learning opportunities in dimensions of the pedagogical strategy, telesimulated scenario, communication and specificities of child care in home visits. It was considered a safe and dynamic activity that helped knowledge consolidation and reflective attitudes, proximity to reality, and develop interaction, observation and types of approaches. There were restrictions due to Internet connection failures. A large percentage of the students indicated good satisfaction and self-confidence level with learning in the scale applied. Conclusion: the real clinical situation with remote immersion allowed observation, decision-making, reflection and elaboration of conclusions, inherent to the experiential learning cycle. The set of elements of this Telesimulation created an environment that stimulated the interest of Nursing students for other learning stages, suggesting a space that strengthens knowledge and maintains dialogue with face-to-face practices.

Resumen Objetivo: evaluar las facilidades, barreras y percepciones de estudiantes de enfermería en el aprendizaje sobre visita domiciliaria y cuidado infantil por telesimulación en la pandemia de COVID-19. Método: estudio cualitativo que evalúa la telesimulación por computadora, basado en el modelo teórico de Kolb. Se aplicó un cuestionario semiestructurado y la Escala de Satisfacción de los Estudiantes y Autoconfianza en el Aprendizaje, con análisis descriptivo y análisis temático cualitativo sobre las percepciones de 41 estudiantes de enfermería. Resultados: la telesimulación contextualizada brindó oportunidades de aprendizaje en los aspectos estrategia pedagógica, escenario telesimulado, comunicación y especificidades del cuidado infantil en visitas domiciliarias. Es una actividad segura y dinámica, que contribuyó a consolidar conocimientos y actitudes reflexivas, permitió un acercamiento a la realidad, el desarrollo de la interacción, observación y tipos de acercamientos. Hubo restricciones por fallas en la conexión. La mayoría de los estudiantes indicaron buenos niveles de satisfacción y confianza en sí mismos con el aprendizaje en la escala aplicada. Conclusión: la situación clínica real con participación a distancia permitió la observación, toma de decisiones, reflexión y elaboración de conclusiones inherentes al ciclo de aprendizaje experiencial. El conjunto de elementos de esta telesimulación creó un ambiente que estimuló el interés de los estudiantes de enfermería por otras etapas de aprendizaje, por lo que se considera un espacio que fortalece el conocimiento y dialoga con las prácticas presenciales.

https://doi.org/10.1590/1518-8345.6037.3672

10.

Repercussões da infodemia associada ao COVID-19 na saúde mental do idoso no Brasil
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Bezerra Cavalcante, Ricardo

; da Costa Carbogim, Fabio

; Fávero Bulgarelli, Alexandre

; Mello dos Santos, Camila

; Queiroz Ribeiro, Andréia

; Carvalho Pinto, Ione

; Machado Zacharias, Fabiana Costa

; Aparecida Fabriz, Luciana

; Moura de Oliveira, Deíse

; Toledo de Mendonça, Erica

; Ricardo Moreira, Tiago

; Miranda Machado, Richardson

; Ribeiro Bitencourt, Graziele

; Alfradique de Souza, Priscilla

; Fereira Santana, Rosimere

; Cabreira Panitz Cruz, Gylce Eloisa

; Rezende Freitas, Eduarda

; Salmazo da Silva, Henrique

; Viana Cruz, Fabiana

; Silva Fhon, Jack Roberto

; Shizuê Kitamura, Elisa

; Gonçalves Leite, Isabel Cristina

; Rodrigues Braz, Patricia

; Consolação dos Santos, Regina

; Prado Rocha, Flávia

; Aparecida Silva, Eveline

; Barreiros Tavares, Thais

; Duarte Martins, Jerusa Gonçalves

; Alves de Araújo Püschel, Vilanice

Revista Cubana de Información en Ciencias de la Salud

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2022, Volume 33 elocation e1871

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

RESUMO: O fenômeno denominado infodemia refere-se ao aumento do volume informacional sobre um tema em específico, que se multiplica rapidamente em um curto período de tempo, e tem-se destacado frente ao contexto da crise sanitária desencadeada pela pandemia de COVID-19. O excesso de informações pode suscitar sentimentos de medo, ansiedade, estresse e outras condições de sofrimento mental. O estudo tem como objetivo descrever o perfil de exposição a informações sobre COVID-19 e suas repercussões na saúde mental de idosos brasileiros. Trata-se de um estudo transversal realizado com 1924 idosos brasileiros. Coletaram-se dados por meio de web-based survey enviada aos idosos por redes sociais e e-mail, no período de julho a outubro de 2020. Os resultados da análise descritiva dos dados demonstram que a maioria dos idosos apresentou idade entre 60 e 69 anos (69,02%), é do sexo feminino (71,26%), casados (53,79%) e de cor branca (75,57%). Cerca de 21,67% (n = 417) concluíram a graduação, 19,75% (380) concluíram especialização e 16,63% (320) concluíram mestrado ou doutorado. Foram reportados como fontes frequentes de exposição às notícias ou informações sobre a COVID-19, a televisão 862 (44,80%) e as redes sociais 651 (33,84%). Os participantes assinalaram que a televisão (46,47%; n = 872), as redes sociais (30,81%; n = 575) e o rádio (14,48%; 251) os afetavam psicológica e/ou fisicamente. Receber notícias falsas sobre a COVID-19 pela televisão (n = 482; 19,8%) e pelas redes sociais (n = 415; 21,5%) repercutiu, principalmente, estresse e medo. As informações disseminadas contribuem para conscientização, mas, também, afetam física e/ou psicologicamente muitos idosos, principalmente gerando medo e estresse.

ABSTRACT The phenomenon called infodemia refers to the increase in the volume of information on a specific topic, which multiplies rapidly in a short period of time, and has stood out in the context of the health crisis triggered by the COVID-19 pandemic. Too much information can trigger feelings of fear, anxiety, stress, and other conditions of mental distress. The study aims to describe the profile of exposure to information about COVID-19 and its repercussions on the mental health of elderly Brazilians. This is a cross-sectional study carried out with 1924 elderly Brazilians. Data were collected through a web-based survey sent to the elderly via social networks and email, from July to October 2020. The results of the descriptive analysis of the data show that most of the elderly were aged between 60 and 69 years (69.02%), female (71.26%), married (53.79%) and white (75.57%). About 21.67% (n = 417) concluded their graduation, 19.75% (380) concluded their specialization and 16.63% (320) concluded their master's or doctoral degrees. Television 862 (44.80%) and social networks 651 (33.84%) were reported as frequent sources of exposure to news or information about COVID-19. Participants indicated that television (46.47%; n = 872), social networks (30.81%; n = 575) and radio (14.48%; 251) affected them psychologically and/or physically. Receiving fake news about COVID-19 on television (n = 482; 19.8%) and on social media (n = 415; 21.5%) mainly resulted in stress and fear. The disseminated information contributes to awareness, but also affects physically and/or psychologically many elderly people, mainly generating fear and stress.

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11.

[SciELO Preprints] - Elaboration and validation of protocol for patient care with COVID-19 in hemodialysis centers
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Knebel, Graziela Breitsameter, Guilherme Proença, Maria Conceição da Costa Breitsameter, Renata de Mello Magdalena Figueiredo, Carolina Rossi de Echer, Isabel Cristina

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Publication date: 2021-08-31

Abstract: En Es Pt

Objective: To describe the elaboration and validation of a protocol for the care of suspected patients with Coronavirus Disease-19 (COVID-19) undergoing hemodialysis.Method: Methodological study conducted from March to August 2020 at a referral hospital in southern Brazil. The study involved situational diagnosis, literature review, protocol elaboration and content validation (scope, clarity and relevance). Ten professionals from the multidisciplinary team with experience in caring for patients with kidney disease and an official nursing supervisory body participated in the validation. 100% consensus was reached among experts.Results: The following were elaborated: “Flow of patient care composed of six stages and” and “Management plan for dialysis centers”. The validation allowed to improve and refine the content, complying with the precepts of health standards, safety and clinical guidelines.Final considerations: The elaboration and validation of the protocol can standardize and guide clinical practice, promoting continuity and safety in care, and can be used in other centers.

Objetivo: Describir la elaboración y validación de un protocolo para la atención de pacientes sospechosos o con Coronavirus Disease-19 (COVID-19) en hemodiálisis.Método: studio metodológico realizado de marzo a agosto / 2020 en un hospital del sur de Brasil. El estudio incluyó diagnóstico situacional, revisión de la literatura, elaboración de protocolos y validación de contenido (alcance, claridad y relevancia). En la validación participaron diez profesionales del equipo multidisciplinar con experiencia en el cuidado de pacientes con enfermedad renal y un órgano de control oficial de enfermería. Se alcanzó un consenso del 100% entre los expertos.Resultados: Fueron elaboraron: "Flujo de atención al paciente en seis etapas" y "Plan de gestión para centros de diálisis". La validación permitió mejorar y afinar el contenido, cumpliendo con los preceptos de las normas de salud, seguridad y guías clínicas.Consideraciones finales: La elaboración y validación del protocolo puede estandarizar y orientar la práctica clínica, promoviendo la continuidad y seguridad en la atención, pudiendo ser utilizado en otros centros.

Objetivo: Descrever a elaboração e validação de um protocolo para atendimento de pacientes suspeitos ou com Coronavirus Disease-19 (COVID-19) em hemodiálise.Método: Estudo metodológico conduzido de março a agosto/2020 em hospital do sul do Brasil. O estudo envolveu diagnóstico situacional, revisão da literatura, elaboração do protocolo e validação de conteúdo (abrangência, clareza e pertinência). Participaram da validação dez profissionais da equipe multidisciplinar com experiência no atendimento de pacientes com doença renal e um órgão oficial fiscalizatório de enfermagem. Obteve-se 100% de consenso entre os especialistas.Resultados: Foram elaborados: “Fluxo de atendimento para pacientes constituído de seis “etapas” e “Plano gerencial para centros de diálise”. A validação permitiu aprimorar e refinar o conteúdo atendendo preceitos de normas sanitárias, segurança e diretrizes clínicas. Considerações finais: A elaboração e validação do protocolo podem padronizar e nortear a prática clínica, promovendo a continuidade e a segurança no cuidado, podendo ser utilizado em outros centros.

https://doi.org/10.1590/1983-1447.2021.20200399

12.

Assessing glyphosate concentrations in six reservoirs of Paraíba do Sul and Guandu River Basins in southeast Brazil
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Cristofaro, Carolina da Silva

; Branco, Christina Wyss Castelo

; Rocha, Maria Isabel de Almeida

; Portugal, Samira da Guia Mello

Revista Ambiente & Água

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2021, Volume 16 N. 1 elocation e2615

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

Resumo O glifosato é um herbicida popularmente usado em todo o mundo, vários estudos estão considerando-o como um risco ambiental e como afetando a saúde humana. O presente estudo teve como objetivo detectar o glifosato em seis diferentes reservatórios das bacias dos rios Paraíba do Sul e Guandu, no sudeste do Brasil, utilizados para diversos fins, incluindo atividades pesqueiras e abastecimento doméstico. A cromatografia iônica foi a técnica escolhida para analisar glifosato nas amostras de água como uma técnica rápida e ecologicamente amigável. Nossos resultados revelaram que, apesar das diferenças relacionadas ao estado trófico, estação do ano ou distância das áreas urbanas, glifosato foi detectado em todos os reservatórios e em três deles com concentrações acima do limite imposto pela legislação brasileira. Dentre as variáveis ambientais estudadas, a turbidez foi a que apresentou maior correlação com as concentrações de glifosato. O efeito das chuvas aumentando a turbidez nos rios reforça a importância do escoamento da água das áreas circundantes que transportam glifosato para os ecossistemas aquáticos. A detecção do herbicida nos diversos sistemas confirma o amplo uso desse composto nas bacias de drenagem dos reservatórios estudados e destaca a importância do monitoramento da água para este composto. Além disso, os resultados revelam quão urgente e importante é explorar, através de experimentos de laboratório, as vias de degradação desse herbicida em ambientes aquáticos tropicais e subtropicais, juntamente com seus efeitos na flora e fauna.

Abstract Glyphosate is a popular herbicide used worldwide, and several studies consider it to be an environmental hazard affecting human health. The present study aimed to detect glyphosate in six different reservoirs of Paraíba do Sul and Guandu River Basins in Southeast Brazil, used for multiple purposes, including fishery activities and domestic water supply. Ion chromatography was used to analyze the water samples, as it is a fast and environmentally friendly technique to detect glyphosate. Our results revealed that, despite differences related to trophic state, season of the year or distance to urban areas, glyphosate was detected in all reservoirs and in three of them with concentrations above the limit imposed by Brazilian legislation. Among the environmental variables studied, turbidity presented the highest correlation with glyphosate concentrations. The effect of rainfall increasing turbidity in the rivers reinforces the importance of draining waters from surrounding areas that transport glyphosate into the aquatic ecosystems. The detection of the herbicide in the various systems confirms the wide use of this compound in the drainage basins of the studied reservoirs and highlights the importance of water monitoring. Further, the results reveal how urgent and important it is to explore through laboratory experiments the pathways of degradation of this herbicide in tropical and subtropical aquatic environments together with its effects on flora and fauna.

https://doi.org/10.4136/ambi-agua.2615 529 downloads

13.

Purple grape juice consumption during the gestation reduces acetylcholinesterase activity and oxidative stress levels provoked by high-fat diet in hippocampus from adult female rats descendants
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PROENÇA, ISABEL C.T.

; GONÇALVES, LUCIANA K.

; SCHMITZ, FELIPE

; MELLO, ALEXANDRE

; FUNCHAL, CLAUDIA S.

; WYSE, ANGELA

; DANI, CAROLINE

Anais da Academia Brasileira de Ciências

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2021, Volume 93 N. 2 elocation e20191002

Abstract: En | Text: En | PDF: En

Abstract The enzyme acetylcholinesterase participates in the end of cholinergic transmission and it has been shown that its activity is increased in some diseases that affect the brain, including Alzheimer disease. The objective of this study was to investigate the effect of purple grape juice consumption with or without high-fat diet in the gestational and lactation period on acetylcholinesterase activity and oxidative stress parameters in the hippocampus of female descendants. During pregnancy and lactation, 40 female Wistar rats received a control diet or a high-fat diet, with half of them receiving grape juice. After lactation, the female descendants received water and control diet in ad libitum until euthanasia on the 120 postnatal day. Hippocampus from were removed for analysis of AChE activity, protein oxidation and lipid peroxidation. It was observed that high-fat diet consumption during the pregnancy increased the AChE activity and the grape juice reduced this activity in descendants. The same was observed in protein oxidation, the descendants from high-fat diet had significantly highest values, and grape juice decreased the levels. We conclude that dietary choices during pregnancy can alter the acetylcholinesterase levels and grape juice is an important alternative to improve this function in adulthood.

https://doi.org/10.1590/0001-3765202120191002 106 downloads

14.

Influence of long-term thermal stress on the in vitro maturation on embryo development and Heat Shock Protein abundance in zebu cattle
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Pöhland, Ralf

; Souza-Cácares, Mirela Brochado

; Datta, Tirtha Kumar

; Vanselow, Jens

; Martins, Maria Isabel Mello

; Silva, Wilian Aparecido Leite da

; Cardoso, Christopher Junior Tavares

; Melo-Sterza, Fabiana de Andrade

Animal Reproduction

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2020, Volume 17 N. 3 elocation e20190085

Abstract: En | Text: En | PDF: En

Abstract The objective of this study was to investigate the influence of long-term temperature stress during the in vitro maturation (IVM) of oocytes on the in vitro embryo production (IVP) and the abundance of HSP70 and HSP90 in zebu cattle. Viable cumulus-oocyte complexes (COCs) were incubated for 24 h at 37 °C, 38.5 °C, or 40 °C for the low-, physiological, and high-temperature stress treatments, respectively. Thereafter, they were subjected to in vitro fertilization and culture. Temperature did not affect the polar body extrusion. However, IVP was adversely affected when IVM took place at 37 °C and 40 °C. The highest abundance of HSP70 was observed in cumulus cells after maturation of COCs at 40 °C. In contrast, HSP70 was more abundant in oocytes at both 37 °C and 40 °C; however, at 40 °C, the difference to the control group (38.5 °C) was not significant. In contrast, the highest abundance of HSP90 was observed in oocytes and cumulus cells at 37 °C. It appears that HSP70 and HSP90 respond to cold and heat stress in different ways. In conclusion, moderately high (40 °C) and low (37 °C) thermal stress for 24 h during IVM is detrimental to the developmental competence of oocyte and is accompanied by changes in the abundances of HSP70 and HSP90, especially in cumulus cells.

https://doi.org/10.1590/1984-3143-ar2019-0085 1120 downloads

15.

Adverse drug events and the associated factors in patients with chronic Chagas disease
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Lopes, Luiza Braz da Cunha

; Pereira, Raquel Rodrigues

; Andrade, Patricia Mello

; Carneiro, Fernanda Martins

; Mediano, Mauro Felippe Felix

; Kilgore, Sophia Isabel Linnemann

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Oliveira, Manoel Marques Evangelista

; Saraiva, Roberto Magalhães

; Holanda, Marcelo Teixeira de

; Silva, Gilberto Marcelo Sperandio da

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190443

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Herein, we aimed to identify the factors associated with adverse drug events (ADEs) in chronic Chagas disease (CD) patients. METHODS: We analyzed 320 medical notes from 295 patients. The Naranjo algorithm was applied to determine the cause of ADEs. Mixed effects logistic regression was performed to evaluate the factors associated with ADEs. RESULTS: ADEs were described in 102 medical notes (31.9%). Captopril was most frequently associated with ADEs. Age (RR 0.96; 95%CI 0.94-0.99) and cardiac C/D stages (RR 3.24; 95%CI 1.30-4.58) were the most important clinical factors associated with ADEs. CONCLUSIONS: Close follow-up is warranted for CD patients.

https://doi.org/10.1590/0037-8682-0443-2019 452 downloads

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