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Decomposition, biochemical composition and nutrient cycling of macauba palm in a Cerrado Entisol
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Carvalho, Arminda Moreira de

; Quintana, Luciane Gomes

; Souza, Anderson Marcos de

; Coser, Thais Rodrigues

; Sousa, Thais Rodrigues de

; Oliveira, Alexsandra Duarte de

; Ramos, Maria Lucrecia Gerosa

Scientia Agricola

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2024, Volume 81 elocation e20220266

Abstract: En | Text: En | PDF: En

ABSTRACT Leaf litter decomposition and the release of nutrients from macauba palm leaves play a major role in nutrient return to the soil in a conservation environment. This study evaluated macauba palm leaf decomposition, macronutrient contents and biochemical composition under contrasting water conditions in the Brazilian Cerrado. Macauba leaves were collected from plants in two different environments (low and high water table conditions), placed in litter bags and evaluated according to their decomposition, macronutrients, lignin, cellulose and hemicellulose for 420 days. In addition, green and dry leaves were collected for macronutrient analyses. Litter decomposition ranged between 49 % and 59 % up to 180 days. The half-life of litter ranged from 141 to 198 days. The leaf litter decomposition of macauba was practically stable during the dry season, whereas at the beginning of the rainy season, decomposition resumed. Nitrogen, P and S were higher in the green leaves, whereas the Ca levels were higher in the dry leaves. In addition, the K levels were twofold higher in the green leaves than in the dry leaves. Lignin release from macauba residues was slower than cellulose and hemicellulose. The decomposition rates of hemicellulose were higher initially due to its high solubility, although it gradually decreased with the decomposition process. Lignin decomposition was also higher at the beginning of the process but stabilized during the drought period. The study indicates that the decomposition process and nutrient cycling of macauba are influenced by its biochemical composition.

https://doi.org/10.1590/1678-992x-2022-0266

Impact of Telemedicine use on clinical care indicators of pediatric intensive care units: protocol for a cluster randomized clinical trial
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Silva, Mariana Motta Dias da

; Klever, Emanuele König

; Rocha, Jacqueline Castro da

; Silva, Gabriela de Oliveira Laguna

; Amorim, Jerusa da Rocha de

; Dode, Andressa Dutra

; Simionato, Bárbara Marina

; Cunha, Luciane Gomes da

; Zaupa, Ana Paula Berni

; Krauzer, João Ronaldo Mafalda

; Pires, Aristóteles de Almeida

; Cabral, Felipe Cezar

; Moreira, Tais de Campos

; Constant, Hilda Maria Rodrigues Moleda

Critical Care Science

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sep 2023, Volume 35 N. 3 Pages 266 - 272

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

ABSTRACT The objective of this study is to present the protocol of a cluster randomized clinical trial to be conducted through the TeleICU project - Qualification of Intensive Care by Telemedicine. The study will consist of a cluster randomized clinical trial, open label, in pediatric intensive care units, with an allocation ratio of 1:1, to compare the intervention group (support of Telemedicine for patients admitted to the pediatric intensive care unit) with a control group (pediatric intensive care unit usual care). The study proposed to select 16 pediatric intensive care units, including 100 participants per site, with a total of 1,600 participants. The intervention group will receive telerounds from Monday to Friday and will have specialists and continuing education activities available. The primary outcome measure will be the length of stay in the pediatric intensive care unit, defined as the difference between the date of discharge of the participant and the date of admission to the intensive care unit. The secondary outcomes will be mortality rate, invasive mechanical ventilation-free days, days using antibiotics, days using vasoactive drugs and days using sedoanalgesia. This study will be conducted in accordance with Resolution 466/12 of the National Health Council, with approval by the Research Ethics Committee of the institutions involved. The present study has the potential to reproduce studies on Telemedicine in intensive care and may make important contributions to care in intensive care units in Brazil and other settings. If Telemedicine shows positive clinical care results compared to conventional treatment, more pediatric patients may benefit. ClinicalTrials.gov registry: NCT05260710

RESUMO O objetivo deste estudo será apresentar o protocolo de um ensaio clínico randomizado em cluster a ser realizado por meio do projeto TeleUTI - Qualificação da Assistência em Terapia Intensiva por Telemedicina. O estudo consistirá em um ensaio clínico randomizado por cluster, open label, em unidades de terapia intensiva pediátricas, com proporção de alocação de 1:1, com o intuito de comparar o grupo de intervenção (apoio da telemedicina para os pacientes internados na unidade de terapia intensiva pediátrica) com um grupo controle (cuidados habituais da unidade de terapia intensiva pediátrica). O estudo se propõe a selecionar 16 unidades de terapia intensiva pediátricas, incluindo 100 participantes por local, com o total de 1.600 participantes. O grupo intervenção receberá telerounds de segunda-feira a sexta-feira e terá à disposição especialistas e atividades de educação continuada. O desfecho primário a ser avaliado será o tempo de permanência nas unidades de terapia intensiva pediátricas, definido pela diferença entre a data de alta do participante com a data de admissão na unidade de terapia intensiva. Os desfechos secundários serão: taxa de mortalidade; dias livres de ventilação mecânica, dias de uso de antibióticos, dias de uso de drogas vasoativas e dias de uso de sedoanalgesia. Este estudo será conduzido em conformidade com a resolução 466/12 do Conselho Nacional de Saúde, com aprovação pelo Comitê de Ética em Pesquisa das instituições hospitalares envolvidas. O trabalho tem o potencial de reproduzir estudos sobre Telemedicina em cuidados intensivos, podendo trazer contribuições importantes ao atendimento em unidades de terapia intensiva no Brasil e em outras realidades. Se a Telemedicina mostrar resultados clínicos assistenciais positivos em relação ao tratamento convencional, mais pacientes pediátricos poderão ser beneficiados. Registro ClinicalTrials.gov: NCT05260710

https://doi.org/10.5935/2965-2774.20230223-en

Life cycle phases: Literature review and new classification proposal for application in healthcare
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MENEZES, Luciane Macedo de

; NEVES, Bruno Moreira das

; MOTTA, Bruna Barnard

; AZEREDO, Fabiane

; QUINTÃO, Cátia Cardoso Abdo

Dental Press Journal of Orthodontics

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2023, Volume 28 N. 5 elocation e23spe5

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

ABSTRACT Introduction: Although uncommon in dentistry, the concept of the life cycle holds great importance for dental professionals in identifying crucial intervention opportunities and determining the optimal timing for treatments and procedures. Objective: To carry out a review of the literature on life cycle classifications and their distinct phases, evaluating their applicability in healthcare. Methods: A literature review was performed, searching for articles in PubMed, SciELO, National Health Library (BvB), and Google Scholar databases, as well as relevant books. The keywords “life cycle,” “life stages,” “human development,” “age groups,” and “biological age” were used. Relevant articles were selected by analyzing their titles and abstracts, and read in full to confirm their inclusion in the research. Results: Nine distinct life cycle classifications were found, each with unique criteria. Conclusion: Based on the comprehensive literature review, a novel classification was proposed (The 10-phase Life Cycle), which encompasses dental, growth, physiological aging, sociocultural, and behavioral characteristics, aiming to enhance communication among healthcare professionals, particularly those engaged in the growth, development, and aging processes of human beings.

RESUMO Introdução: Embora incomum na Odontologia, o conceito de ciclo vital é de grande importância para ajudar os profissionais dessa área a identificar oportunidades cruciais para intervenções e para determinar o momento ideal para tratamentos e procedimentos. Objetivo: Realizar uma revisão da literatura sobre as classificações do ciclo vital e suas distintas fases, avaliando sua aplicabilidade na área da saúde. Métodos: Foi realizada uma revisão da literatura, buscando artigos nas bases de dados PubMed, SciELO, Biblioteca Nacional de Saúde (BvB) e Google Acadêmico; além de livros relevantes. Foram utilizadas as palavras-chave “ciclo vital”, “estágios de vida”, “desenvolvimento humano”, “faixas etárias” e “idade biológica”. Os artigos relevantes foram selecionados por meio da análise de seus títulos e resumos e lidos na íntegra para confirmar sua inclusão na pesquisa. Resultados: Nove classificações distintas de ciclo vital foram encontradas, cada uma com critérios únicos. Conclusão: Com base nessa revisão abrangente da literatura, é proposta uma nova classificação (o ciclo vital de 10 fases) que engloba características dentárias, de crescimento, envelhecimento fisiológico, socioculturais e comportamentais, com o objetivo de melhorar a comunicação entre os profissionais da área de saúde, particularmente aqueles envolvidos nos processos de crescimento, desenvolvimento e envelhecimento do ser humano.

https://doi.org/10.1590/2177-6709.28.5.e23spe5

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis

; Pujol-Luz, José Roberto

; Rafael, José Albertino

; Riccardi, Paula Raile

; Rodrigues, João Paulo Vinicios

; Roque, Fabio de Oliveira

; Sallum, Maria Anice Mureb

; Santis, Marcelo Domingos de

; Santos, Charles Morphy Dias dos

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Shimabukuro, Paloma Helena Fernandes

; Silva, Vera Cristina

; Schelesky-Prado, Daniel de Castro

; Silva-Neto, Alberto Moreira da

; Camargo, Alexssandro

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Wiedenbrug, Sofia

; Yamaguchi, Carolina

; Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

https://doi.org/10.1590/1806-9665-rbent-2023-0051

Prevalência de doenças crônicas não transmissíveis no sistema prisional: um desafio para a saúde pública
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Serra, Renata Moreira

; Ribeiro, Luciana Cisoto

; Ferreira, Janise Braga Barros

; Santos, Luciane Loures dos

Ciência & Saúde Coletiva

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dec 2022, Volume 27 N. 12 Pages 4475 - 4484

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

Resumo Para estimar a prevalência de fatores de risco e doenças crônicas não transmissíveis em pessoas privadas de liberdade, foi realizado um estudo descritivo, transversal e quantitativo, com aplicação de questionário, atendimento clínico e exames laboratoriais. Foram sorteados 202 participantes de uma penitenciária masculina, em 2019. A análise dos dados verificou associações por meio do teste exato de Fisher e do teste qui-quadrado. O perfil sociodemográfico predominante dos participantes consistiu em solteiros, negros, maiores de 30 anos, de baixa escolaridade e alta reincidência penitenciária. A maioria era sedentária, tabagista, com alto consumo de álcool e drogas antes do encarceramento. Encontrou-se prevalência de 24,8% de hipertensão arterial, 54,5% de dislipidemia, 49,9% de excesso de peso, 16,8% de síndrome metabólica e 2,5% de diabetes. A dificuldade de acesso aos serviços de saúde associada às longas penas e ao ambiente insalubre propiciam o desenvolvimento e agravamento de doenças crônicas e seus fatores de risco, representando um desafio para a organização da atenção à saúde prisional. Esse cenário reitera a necessidade de aplicação de recursos e esforços para a efetivação do cuidado integral, longitudinal e equânime para as pessoas privadas de liberdade.

Abstract A descriptive, cross-sectional, and quantitative study was conducted in 2019 with 202 participants randomly selected from a male penitentiary, with the application of a questionnaire, clinical care, and laboratory tests to estimate the prevalence of risk factors and noncommunicable chronic diseases in people deprived of their liberty. Data analysis verified associations using Fisher’s Exact Test and Chi-square Test. The predominant sociodemographic profile of the participants consisted of less-educated single, black, over 30 males with high prison recidivism. Most were sedentary smokers with high alcohol and drug consumption before incarceration. We identified prevalence levels of hypertension (24.8%), dyslipidemia (54.5%), overweight (49.9%), metabolic syndrome (16.8%), and diabetes (2.5%). The difficulty in accessing health services associated with long sentences and the unhealthy environment favors the development and deterioration of chronic diseases and their risk factors, a challenge for the organization of prison health care. This setting reiterates the need to apply resources and efforts to implement comprehensive, longitudinal, and equitable care for people deprived of liberty.

https://doi.org/10.1590/1413-812320222712.10072022

Retinopathy of prematurity: risk factors for its development in two neonatal intensive care units in Paraná-Brazil
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Mayer, Sylvia M. F.

; Mazarollo, Larissa K. G.

; Okamoto, Cristina

; Moreira, Luciane

; Hopker, Luisa M.

Arquivos Brasileiros de Oftalmologia

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aug 2022, Volume 85 N. 4 Pages 364 - 369

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

RESUMO Objetivos: Avaliar duas unidades de terapia intensiva neonatais do Paraná e identificar os fatores de risco que levam ao desenvolvimento da retinopatia da prematuridade nestas unidades neonatais. Metodos: Foi realizado um estudo de coorte, prospectivo, com avaliação dos bebês prematuros examinados no período de 12 meses com idade gestacional ≤32 semanas e/ou com peso de nascimento ≤1500 gramas, internados na unidade de cuidados intensivos neonatais do Hospital do Trabalhador e do Hospital infantil Waldemar Monastier, que recebe neonatos transportados das maternidades de todo o estado do Paraná. Resultados: A incidência de retinopatia da prematuridade foi maior no Hospital Infantil Waldemar Monastier, entre os prematuros que necessitaram de transporte do local de nascimento para a unidade de cuidados intensivos (52,2% vs 29,6%), Os fatores de risco associados ao desenvolvimento da doença foram; Maior número de dias de internamento, baixa idade gestacional ao nascimento, maior tempo de uso de oxigênio, uso de drogas vasoativas, ausência de uso de corticoide pré-natal, presença de hemorragia intracraniana e qualquer tipo de alteração da glicemia. Conclusão: Os cuidados neonatais precoces e o transporte do recém-nascido pré- termo podem influenciar a ocorrência e o prognostico da retinopatia da prematuridade.

ABSTRACT Purpose: Evaluate the patients in two neonatal intensive care units in Paraná/Brazil and identify the risk factors for the development of retinopathy of prematurity. Methods: We performed a prospective cohort study on premature infants with gestational age ≤32 wk and/or with birth weight ≤1500 g who were admitted to the neonatal intensive care unit of Hospital do Trabalhador and Hospital Infantil Waldemar Monastier. These hospitals admit patients referred from other maternity hospitals in the state of Paraná. The study duration was 12 mon. Results: The incidence of retinopathy of prematurity was higher in the Hospital Infantil Waldemar Monastier than in the Hospital do Trabalhador for premature infants who needed to be transported from their birthplace to the intensive care unit (52.2% vs. 29.6%). The following risk factors were associated with the development of the disease: longer hospitalization, low gestational age at birth, longer oxygen use, vasoactive drugs use, no antenatal corticosteroids use, intracranial hemorrhage, and any glycemic disorder. Low birth weight was an independent risk factor for the development of retinopathy of prematurity. Conclusion: Early neonatal care and transportation of premature infants may influence the occurrence and prognosis of retinopathy of prematurity.

https://doi.org/10.5935/0004-2749.20220049

Alteração refracional após capsulotomia posterior com laser Nd:YAG
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Hirt, Bruno

; Worma, Marcos Bortoluzzi

; Wojcik, Leandro Roberto

; Lacerda, Bruna Schimtt de

; Moreira, Luciane Bugmann

; Ferenczy, Peter Alexander von Harbach

Revista Brasileira de Oftalmologia

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2022, Volume 81 elocation e0006

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

RESUMO Objetivo: Identificar se há mudança refracional significativa após realização de capsulotomia posterior com laser Nd:YAG em olhos pseudofácicos. Métodos: Estudo retrospectivo com análise de prontuários de pacientes atendidos em um hospital com diagnóstico de opacificação de cápsula posterior do cristalino tratada com capsulotomia posterior com laser Nd:YAG no período de outubro de 2019 a março de 2021. A comparação entre a refração antes e após o procedimento foi realizada calculando-se o equivalente esférico. Também foi avaliada a mudança da acuidade visual, aferida por LogMAR. Resultados: Foram analisados 90 prontuários, totalizando 140 olhos, de pacientes submetidos à capsulotomia posterior com laser Nd:YAG. O equivalente esférico médio pré-procedimento foi de -0,07±0,89D, mínimo de -3,0D e máximo de +2,5D, mediana (intervalo interquartil) de 0,0D (-0,50D a +0,375D). A média pós-procedimento foi de -0,18±0,86D, mínimo de -3,5D e máximo de +2,25D, mediana (intervalo interquartil) de -0,125D (-0,50D a 0,0D). com p<0,0082. Dos 140 olhos, 66 sofreram miopização e 37 hipermetropização. A média de alteração do equivalente esférico geral foi de -0,12±0,51D, mínimo de -2,50D e máximo de +1,25D, mediana (intervalo interquartil) de 0,0D (-0,375D a +0,125D). Ao se comparar a diferença entre o equivalente esférico antes e após o procedimento do grupo de olhos que sofreu miopização (n=66) ou hipermetropização (n=37), separadamente, ambos obtiveram p<0,0001. Ao se compararem todos os olhos que sofreram alguma alteração refracional (n=103), foi encontrado p=0,008. A acuidade visual média pré-procedimento foi de 0,23±0,32, mínimo de 0,0 e máximo de 2,3. Pós-procedimento, a média foi de 0,06±0,13, mínimo de -0,12 e máximo de 0,7, com p<0,0001. Conclusão: A capsulotomia posterior com laser Nd:YAG gerou melhora significativa da acuidade visual nos pacientes do estudo, porém também gerou alteração refracional significativa após o procedimento, tanto para miopização (a mais frequente), quanto para hipermetropização.

ABSTRACT Objective: To identify if there is a significant change on refraction after Nd:YAG laser posterior capsulotomy in pseudophakic eyes. Methods: A retrospective study with analysis of medical records of patients treated at a hospital, with diagnosis of opacification of posterior lens capsule treated with Nd:YAG laser posterior capsulotomy, from October 2019 to March 2021. The comparison of refraction before and after the procedure was performed by calculating the spherical equivalent. Changes in visual acuity (VA), measured by LogMAR, were also evaluated. Results: A total of 90 medical records (140 eyes) of patients submitted to Nd:YAG laser posterior capsulotomy were analysed. The mean pre-procedure spherical equivalent was -0.07±0.89D, minimum of -3.0D and maximum of +2.5D, median (interquartile range) of 0.0D (-0.50D to +0.375D). The post-procedure mean was -0.18±0.86D, minimum of -3.5D and maximum of +2.25D, median (interquartile range) of -0.125D (-0.50D to 0.0D), with p <0.0082. Of the 140 eyes, 66 underwent myopia and 37 hyperopia, the mean change in the general spherical equivalent was -0.12±0.51D, minimum -2.50D and maximum +1.25D, median (interquartile range) of 0.0D (-0.375D to +0.125D). When comparing the difference between the spherical equivalent before and after the procedure of the group of eyes that underwent myopia (n=66) or hyperopia (n=37), separately, both obtained p<0.0001. When comparing all eyes that suffered any change on refraction (n=103), the p value was 0.008. The mean pre-procedure visual acuity was 0.23±0.32, minimum of 0.0 and maximum of 2.3. After the procedure, the mean was 0.06±0.13, minimum of -0.12 and maximum of 0.7, p<0.0001. Conclusion: Nd:YAG laser posterior capsulotomy significantly improved visual acuity of patients in this study; however, it also led to a significant change on refraction after the procedure, both for myopization, which was more frequent, and for hyperopization.

https://doi.org/10.37039/1982.8551.20220006

Severe acute respiratory syndrome coronavirus 2 infection among healthcare workers in a tertiary public hospital in Curitiba, Brazil
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Spalanzani, Regiane Nogueira

; Genelhoud, Gustavo

; Raboni, Sonia Mara

; Almeida, Sergio Monteiro de

; Pereira, Luciane Aparecida

; Rotta, Indianara

; Cavalli, Barbara Maria

; Moreira, Francielli Brusco

; Dino, Carolina Lumi Tanaka

; Takahashi, Gislene Reche de Almeida

; Cognialli, Regielly Caroline Raimundo

; Spiri, Beatriz Sanada

; Bochnia-Bueno, Lucas

; Oliveira, Jaqueline Carvalho de

; Adamoski, Douglas

; Gradia, Daniela Fiori

; Bonatto, Ana Cláudia

; Wassem, Roseli

; Alves, Juliana Mazini

; Padilha, Raquel da Silva

; Brasil, Vitor Jorge Woytuski

; Almeida, Bernardo Montesanti Machado de

; Nogueira, Meri Bordignon

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0265-2021

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: We aimed to describe the clinical characteristics of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Curitiba, Brazil. METHODS: Upper respiratory samples from 1077 HCWs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription polymerase chain reaction from June 16, 2020 to December 9, 2020. RESULTS: Overall, 32.7% of HCWs were infected. The positivity rates in symptomatic and asymptomatic HCWs were 39.2% and 15.9%, respectively. Hospital departments categorized as high-risk for exposure had the highest number of infected HCWs. CONCLUSIONS: Early diagnosis and isolation of infected HCWs remain key in controlling SARS-CoV-2 transmission because HCWs in close contact with COVID-19 patients are more likely to be infected than those who are not.

https://doi.org/10.1590/0037-8682-0265-2021

Effect of the Surgical Safety Checklist on the incidence of adverse events: contributions from a national study
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FARIA, LUCIANE RIBEIRO DE

; MOREIRA, TIAGO RICARDO

; CARBOGIM, FÁBIO DA COSTA

; BASTOS, RONALDO ROCHA

Revista do Colégio Brasileiro de Cirurgiões

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2022, Volume 49 elocation e20223286

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

RESUMO Objetivo: o estudo objetivou avaliar o efeito da utilização do checklist (CL) de cirurgia segura na incidência de eventos adversos (EA). Método: pesquisa transversal e retrospectiva com 851 pacientes submetidos a procedimentos cirúrgicos nos anos de 2012 (n=428) e 2015 (n=423), representando os períodos antes e após a implantação do CL. As incidências de EA para cada ano foram estimadas e posteriormente comparadas. Também foi analisada a associação entre a ocorrência do EA e a presença do CL no prontuário. Resultados: observou-se uma redução na estimativa pontual de EA de 13,6% (antes do uso do CL) para 11,8% (com a utilização do CL). No entanto, a diferença entre as proporções de EA nos períodos antes e após a utilização do CL não foi significativa (p=0,213). A ocorrência do EA mostrou associação significativa às seguintes características: risco anestésico do paciente, tempo de internação, tempo de cirurgia e classificação do procedimento segundo o potencial de contaminação. Considerando a proporção de óbitos ocorridos nas amostras, observou-se uma redução significativa de mortes (p=0,007) em pacientes cujo CL foi utilizado quando comparados aqueles sem o uso do instrumento. Não foi verificada associação significativa entre a presença do CL no prontuário e a ocorrência do EA de forma geral. Conclusão: a presença do CL no prontuário não garantiu uma redução esperada na incidência de EA. No entanto, acredita-se que o uso do instrumento integrado às demais estratégias de segurança do paciente possa melhorar a segurança/qualidade da assistência cirúrgica em longo prazo.

ABSTRACT Objective: the study evaluated the effect of using the safe surgery checklist (CL) on the incidence of adverse events (AE). Methods: cross-sectional and retrospective research with 851 patients undergoing surgical procedures in 2012 (n=428) and 2015 (n=423), representing the periods before and after CL implantation. The AE incidences for each year were estimated and compared. The association between the occurrence of AE and the presence of CL in the medical record was analyzed. Results: a reduction in the point estimate of AE was observed from 13.6% (before using the CL) to 11.8% (with the use of the CL). The difference between the proportions of AE in the periods before and after the use of CL was not significant (p=0.213). The occurrence of AE showed association with the following characteristics: anesthetic risk of the patient, length of stay, surgery time and classification of the procedure according to the potential for contamination. Considering the proportion of deaths, there was a significant reduction in deaths (p=0.007) in patients whose CL was used when compared to those without the use of the instrument. There was no significant association between the presence of CL and the occurrence of AE. It was concluded that the presence of CL in the medical record did not guarantee an expected reduction in the incidence of AE. Conclusion: however, it is believed that the use of the instrument integrated with other patient safety strategies can improve the safety/quality of surgical care in the long term.

https://doi.org/10.1590/0100-6991e-20223286_en

10.

Prevalência de doenças crônicas não transmissíveis no sistema prisional: um desafio para a saúde pública
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Serra, Renata Moreira

; Ribeiro, Luciana Cisoto

; Ferreira, Janise Braga Barros

; Santos, Luciane Loures dos

Ciência & Saúde Coletiva

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2022, Volume 27 N. 12 Pages 4475 - 4484

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

https://doi.org/10.1590/1413-812320222712.10072022

11.

Development and implementation of telehealth for peritoneal dialysis and kidney transplant patients monitoring during the COVID-19 pandemic
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Deboni, Luciane M

; Neermann, Eviline M V

; Calice-Silva, Viviane

; Hanauer, Marina A

; Moreira, Arnaldo

; Ambrósio, Andrei

; Guterres, Denise B

; Vieira, Marcos A

; Nerbass, Fabiana B

Brazilian Journal of Nephrology

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sep 2021, Volume 43 N. 3 Pages 422 - 428

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

Resumo A pandemia do coronavírus (Sars-CoV-2) trouxe a necessidade do isolamento social para a diminuição de sua propagação. Pacientes renais crônicos em terapia renal substitutiva são especialmente suscetíveis a desenvolverem a forma mais grave da covid-19, e, ao mesmo tempo, necessitam de acompanhamento médico e multidisciplinar regular com consultas periódicas. Em caráter emergencial, órgãos regulatórios profissionais brasileiros passaram a autorizar o atendimento da equipe de saúde por meio da teleconsulta, o que tornou possível a migração das consultas presenciais para consultas a distância nos serviços de saúde em todo o país, quando necessário. O principal objetivo deste artigo foi descrever o processo de desenvolvimento e implementação da teleorientação para acompanhamento de pacientes transplantados renais e em diálise peritoneal de um serviço de Joinville, SC, durante a pandemia de covid-19.

Abstract The coronavirus (Sars-Cov-2) pandemic raised the need for social distance to reduce its spread. Chronic kidney disease patients on renal replacement therapy are especially susceptible to developing the most severe form of COVID-19, and, at the same time, require regular medical and multidisciplinary periodic follow-up. On an emergency basis, Brazil’s professional regulatory bodies authorized telehealth assistance, which made possible to migrate from face-to-face to distance appointments in health services across the country, when necessary. This article’s main objective is to describe the process of developing and implementing telehealth for monitoring renal transplant patients and patients on peritoneal dialysis during the COVID-19 pandemic.

https://doi.org/10.1590/2175-8239-jbn-2020-0137 339 downloads

12.

Diretrizes brasileiras para o manejo de potenciais doadores de órgãos em morte encefálica. Uma força-tarefa composta por Associação de Medicina Intensiva Brasileira, Associação Brasileira de Transplantes de Órgãos, Brazilian Research in Critical Care Network e Coordenação Geral do Sistema Nacional de Transplantes
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Westphal, Glauco Adrieno

; Robinson, Caroline Cabral

; Cavalcanti, Alexandre Biasi

; Gonçalves, Anderson Ricardo Roman

; Guterres, Cátia Moreira

; Teixeira, Cassiano

; Stein, Cinara

; Franke, Cristiano Augusto

; Silva, Daiana Barbosa da

; Pontes, Daniela Ferreira Salomão

; Nunes, Diego Silva Leite

; Abdala, Edson

; Dal-Pizzol, Felipe

; Bozza, Fernando Augusto

; Machado, Flávia Ribeiro

; Andrade, Joel de

; Cruz, Luciane Nascimento

; Azevedo, Luciano César Pontes

; Machado, Miriam Cristine Vahl

; Rosa, Regis Goulart

; Manfro, Roberto Ceratti

; Nothen, Rosana Reis

; Lobo, Suzana Margareth

; Rech, Tatiana Helena

; Lisboa, Thiago Costa

; Colpani, Verônica

; Falavigna, Maicon

Revista Brasileira de Terapia Intensiva

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jan 2021, Volume 33 N. 1 Pages 1 - 11

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

RESUMO Objetivo: Fornecer recomendações para nortear o manejo clínico do potencial doador em morte encefálica. Métodos: O presente documento foi formulado em dois painéis compostos por uma força tarefa integrada por 27 especialistas de diferentes áreas que responderam a questões dirigidas aos seguintes temas: ventilação mecânica, hemodinâmica, suporte endócrino-metabólico, infecção, temperatura corporal, transfusão sanguínea, e uso de checklists. Os desfechos considerados foram: parada cardíaca, número de órgãos retirados ou transplantados e função/sobrevida dos órgãos transplantados. A qualidade das evidências das recomendações foi avaliada pelo sistema Grading of Recommendations Assessment, Development, and Evaluation. Resultados: Foram geradas 19 recomendações a partir do painel de especialistas. Dessas, 7 foram classificadas como fortes, 11 fracas e uma foi considerada boa prática clínica. Conclusão: Apesar da concordância entre os membros do painel em relação à maior parte das recomendações, o grau de recomendação é fraco em sua maioria.

Abstract Objective: To contribute to updating the recommendations for brain-dead potential organ donor management. Methods: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, answered questions related to the following topics were divided into mechanical ventilation, hemodynamics, endocrine-metabolic management, infection, body temperature, blood transfusion, and checklists use. The outcomes considered were cardiac arrests, number of organs removed or transplanted as well as function / survival of transplanted organs. The quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system to classify the recommendations. Results: A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong, 11 as weak and 1 was considered a good clinical practice. Conclusion: Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak.

https://doi.org/10.5935/0103-507x.20210001 742 downloads

13.

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Abstract: En | Text: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

14.

A Comunidade dos Países de Língua Portuguesa frente aos Direitos Humanos das Pessoas com Deficiência: análise comparativa entre Brasil e Portugal
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Guedes, Denyse Moreira

; Barbosa, Luciane Maria Molina

População e Sociedade

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dec 2020, N. 34 Pages 107 - 120

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

Abstract The article looks at the Convention on the Rights of Persons with Disabilities, being the first human rights instrument of the millennium, the main international treaty dealing with this topics, and highlights the commitment of the Community of Portuguese Speaking Countries, specifically Brazil and Portugal. Brazil has a vast system of protection for persons with disabilities, consisting of constitutional and infraconstitutional rules, as well as rules from international treaties incorporated into the legal system, and, together with Portugal, is committed to fulfil the principles and the objectives set out in the referred Convention, which is the most ratified civil and human rights treaty of the United Nations Member States. This wide compromise, and the pressure of Brazil and Portugal within the Community of Portuguese Speaking Countries, show that countries share the objective of making the inclusion of citizens with some type of disability a priority. The challenge is to put these rights into effect, in order to combat discrimination and to give full citizenship to these persons.

Resumo O artigo examina a Convenção sobre os Direitos das Pessoas com Deficiência, sendo este o primeiro instrumento de direitos humanos do milênio, e o principal tratado internacional que versa sobre a matéria, destacando o compromisso da Comunidade dos Países de Língua Portuguesa, especificamente Brasil e Portugal. O Brasil conta com um vasto sistema de proteção à pessoa com deficiência, composto por normas constitucionais e infraconstitucionais, bem como por normas provenientes de tratados internacionais incorporados ao ordenamento jurídico, e, em conjunto com Portugal, assume compromisso com aqueles que são os princípios e os objetivos plasmados na referida Convenção sendo esta o tratado sobre direitos civis e humanos mais ratificado dos Estados membros da Organização das Nações Unidas. Este compromisso alargado, e a pressão por parte do Brasil e de Portugal, demonstram que os países têm como objetivo de fazer da inclusão dos cidadãos com algum tipo de deficiência uma prioridade. O desafio é efetivar esses direitos, a fim de combater a discriminação e conferir plena cidadania a essas pessoas.

15.

Comparação de eficácia entre as sondas monocanalicular e bicanalicular no tratamento da obstrução congênita das vias lacrimais
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Hirt, Bruno

; Granzotto, Eduardo Euzieres

; Silva, Filipe Lennert

; Worma, Marcos Bortoluzzi

; Menezes, Nayra Funato

; Fachin, Natasha Danilow

; Nisihara, Renato Mitsunori

; Kormann, Rodrigo Beraldi

; Moreira, Luciane Bugmann

Revista Brasileira de Oftalmologia

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jan 2020, Volume 79 N. 1 Pages 33 - 37

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

Resumo Objetivo: Avaliar e comparar a taxa de sucesso da intubação monocanalicular ou bicanalicular em pacientes com obstrução congênita do ducto lacrimonasal (OCDLN), levando-se em consideração a taxa de sucesso, a dificuldade do procedimento e o custo dos tubos. Métodos: Foram analisados retrospectivamente 54 prontuários, totalizando 58 vias lacrimais com diagnóstico de OCDLN, que realizaram intubação das vias lacrimais monocanalicular ou bicanalicular com tubos de silicone. Anamnese, exame oftalmológico geral, testes específicos, como o Teste do Desaparecimento do Corante (TDC) e Teste de Observação de Fluoresceína na Orofaringe (TOFO), e, caso necessário, exames complementares como a dacriocistografia, foram utilizados para diagnóstico e inclusão na pesquisa. Foram tratados com intubação os pacientes sem resposta adequada ao tratamento prévio, ou seja, que permaneceram com sintomas de secreção e epífora contínua após a realização de massagem de Crigler e sondagem. Resultados: A intubação monocanalicular foi realizada em 27 vias lacrimais e a intubação bicanalicular, em 31 vias lacrimais. A taxa de sucesso foi alta em ambos os métodos, com melhora em 26 (96,3%) vias lacrimais com sonda monocanalicular e em 30 (96,8%), com sonda bicanalicular (p=0,718). As duas técnicas apresentaram 100% de sucesso nos pacientes com até 2 anos e acima de 4 anos de idade (p=1). A taxa de sucesso entre os 2 e 4 anos de idade foi de 91,5% para as monocanaliculares e 87,5% para as bicanaliculares, (p=0,652). Conclusão: o presente estudo não mostrou diferença significativa no sucesso da intubação quando utilizando sondas mono ou bicanaliculares. A intubação monocanalicular mostrou-se de mais fácil execução, ao passo que o tubo bicanalicular possui menor custo.

Abstract Objective: to evaluate and to compare the success rate of monocanalicular or bicanalicular intubation in congenital nasolacrimal duct obstruction (CNDO) carriers in terms of success rate, difficulty of the procedure, and cost of the tubes. Methods: fifty-four CNDO carriers with 58 obstructed lacrimal vies (LV) who were submitted to lacrimal system intubation using mono or bicanalicular stent had their medical records analyzed. A clinical history, a general ophthalmologic examination, specific tests such as the fluorescein dye disappearance test (FDDT) and observation test of fluorescein in the oropharynx (OTFO) were used for diagnosis and inclusion in the study. Patients who continued exhibiting discharge and continuous epiphora after previous treatment, Crigler massage and probing, were treated surgically with intubation. Results: Monocanalicular intubation was performed on 27 LV and bicanalicular intubation was performed on 31 LV. High success rates were observed, with improvement in 26 (96.3%) with monocanalicular intubation and in 30 LV (96.8%) with bicanalicular intubation (p=0.718). Furthermore, both techniques were 100% successful in patients up to 2 and over 4 years of age (p=1). The success rates between 2-4 years of age were 91.6% in monocanalicular intubation and 87.5% in bicanalicular intubation (p=0.652). Conclusion: The success rate using monocanalicular or bicanalicular intubation to treat CNDO had no significant difference in the studied children. Furthermore, the monocanalicular tube was easier to use, while the bicanalicular tube had a lower cost.

https://doi.org/10.5935/0034-7280.20200006 582 downloads

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