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Abstract Background Cardiovascular complications of COVID-19 are important aspects of the disease’s pathogenesis and prognosis. Evidence on the prognostic role of troponin and myocardial injury in Latin American hospitalized COVID-19 patients is still scarce. Objectives To evaluate myocardial injury as independent predictor of in-hospital mortality and invasive mechanical ventilation support in hospitalized patients, from the Brazilian COVID-19 Registry. Methods This cohort study is a substudy of the Brazilian COVID-19 Registry, conducted in 31 Brazilian hospitals of 17 cities, March-September 2020. Primary outcomes included in-hospital mortality and invasive mechanical ventilation support. Models for the primary outcomes were estimated by Poisson regression with robust variance, with statistical significance of p<0.05. Results Of 2,925 patients (median age of 60 years [48-71], 57.1% men), 27.3% presented myocardial injury. The proportion of patients with comorbidities was higher among patients with cardiac injury (median 2 [1-2] vs. 1 [0-2]). Patients with myocardial injury had higher median levels of brain natriuretic peptide, lactate dehydrogenase, creatine phosphokinase, N-terminal pro-brain natriuretic peptide, and C-reactive protein than patients without myocardial injury. As independent predictors, C-reactive protein and platelet counts were related to the risk of death, and neutrophils and platelet counts were related to the risk of invasive mechanical ventilation support. Patients with high troponin levels presented a higher risk of death (RR 2.03, 95% CI 1.60-2.58) and invasive mechanical ventilation support (RR 1.87, 95% CI 1.57-2.23), when compared to those with normal troponin levels. Conclusion Cardiac injury was an independent predictor of in-hospital mortality and the need for invasive mechanical ventilation support in hospitalized COVID-19 patients.

Resumo Fundamento As complicações cardiovasculares da COVID-19 são aspectos importantes da patogênese e do prognóstico da doença. Evidências do papel prognóstico da troponina e da lesão miocárdica em pacientes hospitalizados com COVID-19 na América Latina são ainda escassos. Objetivos Avaliar a lesão miocárdica como preditor independente de mortalidade hospitalar e suporte ventilatório mecânico em pacientes hospitalizados, do registro brasileiro de COVID-19. Métodos Este estudo coorte é um subestudo do registro brasileiro de COVID-19, conduzido em 31 hospitais brasileiros de 17 cidades, de março a setembro de 2020. Os desfechos primários incluíram mortalidade hospitalar e suporte ventilatório mecânico invasivo. Os modelos para os desfechos primários foram estimados por regressão de Poisson com variância robusta, com significância estatística de p<0,05. Resultados Dos 2925 pacientes [idade mediana de 60 anos (48-71), 57,1%], 27,3% apresentaram lesão miocárdica. A proporção de pacientes com comorbidades foi maior nos pacientes com lesão miocárdica [mediana 2 (1-2) vs. 1 (0-20)]. Os pacientes com lesão miocárdica apresentaram maiores valores medianos de peptídeo natriurético cerebral, lactato desidrogenase, creatina fosfoquinase, N-terminal do pró-peptídeo natriurético tipo B e proteína C reativa em comparação a pacientes sem lesão miocárdica. Como fatores independentes, proteína C reativa e contagem de plaquetas foram relacionados com o risco de morte, e neutrófilos e contagem de plaquetas foram relacionados ao risco de suporte ventilatório mecânico invasivo. Os pacientes com níveis elevados de troponina apresentaram um maior risco de morte (RR 2,03, IC95% 1,60-2,58) e suporte ventilatório mecânico (RR 1,87;IC95% 1,57-2,23), em comparação àqueles com níveis de troponina normais. Conclusão Lesão cardíaca foi um preditor independente de mortalidade hospitalar e necessidade de suporte ventilatório mecânico em pacientes hospitalizados com COVID-19.

https://doi.org/10.36660/abc.20220151

Mobilização passiva precoce aumenta a resposta de reatividade vascular em pacientes graves com sepse: um estudo quase-experimental
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Destro, Tamara Rodrigues da Silva

; Biazon, Thaís Marina Pires de Campos

; Pott-Junior, Henrique

; Caruso, Flávia Cristina Rossi

; Andaku, Daniela Kuguimoto

; Garcia, Naiara Molina

; Bonjorno-Junior, José Carlos

; Borghi-Silva, Audrey

; Kawakami, Débora Mayumi de Oliveira

; Castello-Simões, Viviane

; Mendes, Renata Gonçalves

Revista Brasileira de Terapia Intensiva

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dec 2022, Volume 34 N. 4 Pages 461 - 468

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

ABSTRACT Objective: To investigate the influence of a passive mobilization session on endothelial function in patients with sepsis. Methods: This was a quasi-experimental double-blind and single-arm study with a pre- and postintervention design. Twenty-five patients with a diagnosis of sepsis who were hospitalized in the intensive care unit were included. Endothelial function was assessed at baseline (preintervention) and immediately postintervention by brachial artery ultrasonography. Flow mediated dilatation, peak blood flow velocity and peak shear rate were obtained. Passive mobilization consisted of bilateral mobilization (ankles, knees, hips, wrists, elbows and shoulders), with three sets of ten repetitions each, totaling 15 minutes. Results: After mobilization, we found increased vascular reactivity function compared to preintervention: absolute flow-mediated dilatation (0.57mm ± 0.22 versus 0.17mm ± 0.31; p < 0.001) and relative flow-mediated dilatation (17.1% ± 8.25 versus 5.08% ± 9.16; p < 0.001). Reactive hyperemia peak flow (71.8cm/s ± 29.3 versus 95.3cm/s ± 32.2; p < 0.001) and shear rate (211s ± 113 versus 288s ± 144; p < 0.001) were also increased. Conclusion: A passive mobilization session increases endothelial function in critical patients with sepsis. Future studies should investigate whether a mobilization program can be applied as a beneficial intervention for clinical improvement of endothelial function in patients hospitalized due to sepsis.

RESUMO Objetivo: Investigar a influência de uma sessão de mobilização passiva na função endotelial de pacientes com sepse. Métodos: Este foi um estudo quase-experimental duplo-cego e de braço único com desenho pré e pós-intervenção. Participaram 25 pacientes com diagnóstico de sepse hospitalizados em unidade de terapia intensiva. Avaliou-se a função endotelial basal (pré-intervenção) e imediatamente pós-intervenção por meio de ultrassonografia da artéria braquial. Foram obtidas a dilatação mediada pelo fluxo, a velocidade pico de fluxo sanguíneo e a taxa de cisalhamento pico. A mobilização passiva consistiu na mobilização bilateral (tornozelos, joelhos, quadris, pulsos, cotovelos e ombros), com três séries de dez repetições cada, totalizando 15 minutos. Resultados: Após a mobilização, encontramos aumento da função de reatividade vascular em relação à pré-intervenção: dilatação mediada pelo fluxo absoluta (0,57mm ± 0,22 versus 0,17mm ± 0,31; p < 0,001) e dilatação mediada pelo fluxo relativa (17,1% ± 8,25 versus 5,08% ± 9,16; p < 0,001). O pico de fluxo sanguíneo na hiperemia (71,8cm/s ± 29,3 versus 95,3cm/s ± 32,2; p < 0,001) e a taxa de cisalhamento (211s ± 113 versus 288s ± 144; p < 0,001) também aumentaram. Conclusão: Uma sessão de mobilização passiva foi capaz de aumentar a função endotelial em pacientes graves com sepse. Estudos futuros são necessários para investigar se um programa de mobilização pode ser aplicado como intervenção benéfica para melhorar clinicamente a função endotelial em pacientes hospitalizados por sepse.

https://doi.org/10.5935/0103-507x.20220132-pt

Validation of blood components transport through a pneumatic tube system
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Garcia, Laís Oliveira

; Speransa, Daniela Michelim Rodriguez

; Rodrigues, Cristiane Braga

; Benites, Rosimari Melgarejo

; Garcia, Mariana Timm

; Sekine, Leo

; Franz, Juliana Pires Marafon

Hematology, Transfusion and Cell Therapy

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oct 2022, Volume 44 N. 4 Pages 519 - 525

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Urgent blood component transfusions may be life-saving for patients in hemorrhagic shock. Measures to reduce the time taken to provide these transfusions, such as uncrossmatched transfusion or abbreviated testing, are available. However, transport time is still an additional delay and the use of a pneumatic tube system (PTS) may be an alternative to shorten the transport time of blood components. Objectives: To assess pneumatic tube system transportation of blood components based on a validation protocol. Methods: Pre- and post-transport quality control laboratory parameters, visual appearance, transport time and temperature of the packed red blood cells (RBCs), thawed fresh plasma (TFP), cryoprecipitate (CR), and platelet concentrate (PC) were evaluated. Parameters were compared between transport via pneumatic tube and courier. Results: A total of 23 units of RBCs, 50 units of TFP, 30 units of CR and ten units of PC were evaluated. No statistically significant differences were found between pre- and post-transport laboratory results. There was also no difference in laboratory parameters between transport modalities (PTS versus courier). All blood components transported matched regulatory requirements for quality criteria. The temperature during transport remained stable and the transport time via PTS was significantly shorter than the courier’s transport time (p < 0.05). Conclusion: The PTS was considered a fast, safe and reliable means of transportation for blood components, also securing quality prerequisites.

https://doi.org/10.1016/j.htct.2021.07.010

Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain
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Pontes-Silva, André

; Bassi-Dibai, Daniela

; Fidelis-de-Paula-Gomes, Cid André

; Souza, Cesário da Silva

; Pires, Flavio de Oliveira

; Mostarda, Cristiano Teixeira

; Dibai Filho, Almir Vieira

Revista da Associação Médica Brasileira

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sep 2022, Volume 68 N. 9 Pages 1288 - 1296

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS: This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student’s t-test for comparisons and Spearman’s coefficient for correlations. RESULTS: We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS: Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.

https://doi.org/10.1590/1806-9282.20220406

Diretrizes para o tratamento farmacológico da COVID-19. Consenso da Associação de Medicina Intensiva Brasileira, da Sociedade Brasileira de Infectologia e da Sociedade Brasileira de Pneumologia e Tisiologia
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Falavigna, Maicon

; Colpani, Verônica

; Stein, Cinara

; Azevedo, Luciano Cesar Pontes

; Bagattini, Angela Maria

; Brito, Gabriela Vilela de

; Chatkin, José Miguel

; Cimerman, Sergio

; Corradi, Mirian de Freitas Dal Ben

; Cunha, Clovis Arns da

; Medeiros, Flávia Cordeiro de

; Oliveira Junior, Haliton Alves de

; Fritscher, Leandro Genehr

; Gazzana, Marcelo Basso

; Gräf, Débora Dalmas

; Marra, Lays Pires

; Matuoka, Jessica Yumi

; Nunes, Michelle Silva

; Pachito, Daniela Vianna

; Pagano, Cássia Garcia Moraes

; Parreira, Patrícia do Carmo Silva

; Riera, Rachel

; Silva Júnior, Amilton

; Tavares, Bruno de Melo

; Zavascki, Alexandre Prehn

; Rosa, Regis Goulart

; Dal-Pizzol, Felipe

Revista Brasileira de Terapia Intensiva

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jun 2020, Volume 32 N. 2 Pages 166 - 196

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

RESUMO Introdução: Há diversas terapias sendo utilizadas, consideradas ou propostas para o tratamento da COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é fornecer recomendações baseadas nas evidências científicas disponíveis e em sua interpretação transparente, para subsidiar decisões sobre o tratamento farmacológico da COVID-19 no Brasil. Métodos: Um grupo de 27 especialistas e metodologistas integraram a força-tarefa formada pela Associação de Medicina Intensiva Brasileira (AMIB), pela Sociedade Brasileira de Infectologia (SBI) e pela Sociedade Brasileira de Pneumologia e Tisiologia (SBPT). Foram realizadas revisões sistemáticas rápidas, atualizadas até 28 de abril de 2020. A qualidade das evidências e a elaboração das recomendações seguiram o sistema GRADE. As recomendações foram elaboradas nos dias 5, 8 e 13 de maio de 2020. Resultados: Foram geradas 11 recomendações, embasadas em evidência de nível baixo ou muito baixo. Não há indicação para uso de rotina de hidroxicloroquina, cloroquina, azitromicina, lopinavir/ritonavir, corticosteroides ou tocilizumabe no tratamento da COVID-19. Heparina deve ser utilizada em doses profiláticas no paciente hospitalizado, mas não deve ser realizada anticoagulação na ausência de indicação clínica específica. Antibacterianos e oseltamivir devem ser considerados somente nos pacientes em suspeita de coinfecção bacteriana ou por influenza, respectivamente. Conclusão: Até o momento, não há intervenções farmacológicas com efetividade e segurança comprovada que justifiquem seu uso de rotina no tratamento da COVID-19, devendo os pacientes serem tratados preferencialmente no contexto de pesquisa clínica. As recomendações serão revisadas continuamente, de forma a capturar a geração de novas evidências.

ABSTRACT Introduction: Different therapies are currently used, considered, or proposed for the treatment of COVID-19; for many of those therapies, no appropriate assessment of effectiveness and safety was performed. This document aims to provide scientifically available evidence-based information in a transparent interpretation, to subsidize decisions related to the pharmacological therapy of COVID-19 in Brazil. Methods: A group of 27 experts and methodologists integrated a task-force formed by professionals from the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB), the Brazilian Society of Infectious Diseases (Sociedad Brasileira de Infectologia - SBI) and the Brazilian Society of Pulmonology and Tisiology (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT). Rapid systematic reviews, updated on April 28, 2020, were conducted. The assessment of the quality of evidence and the development of recommendations followed the GRADE system. The recommendations were written on May 5, 8, and 13, 2020. Results: Eleven recommendations were issued based on low or very-low level evidence. We do not recommend the routine use of hydroxychloroquine, chloroquine, azithromycin, lopinavir/ritonavir, corticosteroids, or tocilizumab for the treatment of COVID-19. Prophylactic heparin should be used in hospitalized patients, however, no anticoagulation should be provided for patients without a specific clinical indication. Antibiotics and oseltamivir should only be considered for patients with suspected bacterial or influenza coinfection, respectively. Conclusion: So far no pharmacological intervention was proven effective and safe to warrant its use in the routine treatment of COVID-19 patients; therefore such patients should ideally be treated in the context of clinical trials. The recommendations herein provided will be revised continuously aiming to capture newly generated evidence.

https://doi.org/10.5935/0103-507x.20200039 44293 downloads

Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation
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Reis-Júnior, Jodimar Ribeiro

; Protázio, Jhonata Botelho

; Muribeca-de-Castro, Aila Maria

; Pinheiro, Jocassia Silva

; Takahasi, Henrique Yuji

; Pires, Flavio de Oliveira

; Souza, Sergio Augusto Rosa de

; Fidelis-de-Paula-Gomes, Cid André

; Rêgo, Adriana Sousa

; Bassi-Dibai, Daniela

; Dibai-Filho, Almir Vieira

Sao Paulo Medical Journal

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feb 2020, Volume 138 N. 1 Pages 11 - 18

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE: To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING: Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS: The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS: SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the SEFIP-sport items and alternatives. CONCLUSION: The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

https://doi.org/10.1590/1516-3180.2019.0375.r1.08102019 765 downloads

Insect (Hexapoda) diversity in the oceanic archipelago of Fernando de Noronha, Brazil: updated taxonomic checklist and new records
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Rafael, José Albertino

; Limeira-de-Oliveira, Francisco

; Hutchings, Roger William

; Miranda, Gil Felipe Gonçalves

; Silva Neto, Alberto Moreira da

; Somavilla, Alexandre

; Camargo, Alexssandro

; Asenjo, Angélico

; Pinto, Ângelo Parise

; Bello, Ayr de Moura

; Dalmorra, Camila

; Mello-Patiu, Cátia Antunes de

; Carvalho, Claudio José Barros de

; Takiya, Daniela Maeda

; Parizotto, Daniele Regina

; Marques, Dayse Willkenia Almeida

; Cavalheiro, Denis de Oliveira

; Mendes, Diego Matheus de Mello

; Zeppelini, Douglas

; Carneiro, Eduardo

; Lima, Élison Fabrício Bezerra

; Lima, Estevam Cipriano Araújo de

; Godoi, Fabio Siqueira Pitaluga de

; Pessoa, Felipe Arley Costa

; Vaz-de-Mello, Fernando Zagury

; Sosa-Duque, Francisco José

; Flores, Heloísa Fernandes

; Fernandes, Itanna Oliveira

; Silva-Júnior, José Osvaldo

; Gomes, Lucas Roberto Pereira

; Monné, Marcela Laura

; Castro, Marcelo Cutrim Moreira de

; Silva, Marcelo Peixoto Gomes da

; Couri, Márcia Souto

; Gottschalk, Marco Silva

; Soares, Matheus Mickael Mota

; Monné, Miguel Angel

; Rafael, Miriam Silva

; Casagrande, Mirna Martins

; Mielke, Olaf Hermann Hendrik

; Grossi, Paschoal Coelho

; Pinto, Paula Jéssica Costa

; Bartholomay, Pedro Reck

; Sobral, Rafael

; Heleodoro, Raphael Aquino

; Machado, Renato José Pires

; Corrêa, Robson Crepes

; Hutchings, Rosa Sá Gomes

; Ale-Rocha, Rosaly

; Santos, Sandra Duque dos

; Lima, Sheila Pereira de

; Mahlmann, Thiago

; Silva, Vera Cristina

; Fernandes, Daniell Rodrigo Rodrigues

Revista Brasileira de Entomologia

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2020, Volume 64 N. 3 elocation e20200052

Abstract: En | Text: En | PDF: En

ABSTRACT Hexapods, commonly known as insects, are a neglected taxonomic group in the Fernando de Noronha archipelago, with unanswered questions about their species richness and the ecological processes in which they are involved (e.g., colonization, introduction, establishment, and extinction). Herein, we provide an updated Hexapod checklist with current nomenclatural combinations. The entomofauna of the Fernando de Noronha archipelago is currently composed of 453 species in 21 orders. The orders, and their respective number of species, are: Blattaria (9), Coleoptera (118), Collembola (29), Dermaptera (3), Diplura (1), Diptera (134), Embioptera (1), Hemiptera (29), Hymenoptera (59), Isoptera (2), Lepidoptera (25), Mantodea (1), Neuroptera (3), Odonata (5), Orthoptera (11), Phasmatodea (1), Phthiraptera (6), Psocoptera (3), Siphonaptera (1), Thysanoptera (10), and Zygentoma (2). The archipelago has 263 new taxon records (family + genera + species). Thirty-eight species (3.39%) were described from local specimens and most of them are likely endemic species. This study more than doubles our knowledge (from the previous 190 records) of the entomofauna in this large Brazilian archipelago. This study also provides a baseline for studies on its conservation status and for implementing future environmental management programs.

https://doi.org/10.1590/1806-9665-rbent-2020-0052 2462 downloads

Arranjos de Desenvolvimento da Educação: da parceria público-privada à disputa pelo fundo público educacional
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Carvalho, Elma Júlia Gonçalves de

; Pires, Daniela de Oliveira

Educar em Revista

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2020, Volume 36 elocation e77538

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

RESUMO Neste artigo, considerando a redefinição do papel do Estado e o redimensionamento das relações entre o público e o privado, a partir dos anos de 1990, objetivamos abordar a nova forma de regramento do regime de colaboração entre os entes federados envolvendo a proposição de Arranjos de Desenvolvimento da Educação (ADEs). Para tanto, será apresentado o Projeto de Lei nº 5.182/19 (BRASIL, 2019), a fim de explicitar as novas estratégias de disputas do fundo público para a educação. Na análise, descrevemos a qualificação das entidades do terceiro setor, o investimento público na educação básica no Brasil, os mecanismos de transferência de recursos públicos para a iniciativa privada com ou sem fins de lucro e a particularidade da proposta dos ADEs. A metodologia utilizada se baseou tanto na pesquisa quantitativa, na análise documental e legislativa, como na pesquisa qualitativa. O estudo revelou que a institucionalização e o estímulo aos ADEs correspondem a um processo de construção de políticas educacionais para a educação básica, articulado aos interesses privados com ou sem fins de lucro.

ABSTRACT In this article, considering the redefinition of the role of the State and the re-dimensioning of the relations between the public and the private spheres from the 1990s onwards, we aim to approach the new regulation form of the collaboration regime between federated entities and the proposal of Education Development Arrangements (EDAs). For this reason, the Bill No. 5.182/19 (BRASIL, 2019) is presented in order to explain the new dispute strategies of the public fund for education. Along the analysis, we describe the qualification of entities in the third sector, public investment in basic education in Brazil, the transfer mechanisms of public resources to private initiative with or without profit purposes, and the particularity of the EDAs proposal. The methodology was based on quantitative research, documentary and legislative analysis, as well as qualitative research. The study revealed that the institutionalization and encouragement of EDAs correspond to a process of construction of educational policies for basic education, linked to private interests with or without profit motives.

https://doi.org/10.1590/0104-4060.77538 422 downloads

10.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults
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Barban, Juliana Bernardo

; Simões, Belinda Pinto

; Moraes, Bruna Del Guerra de Carvalho

; Anunciação, Cássia Rehem da

; Rocha, Cristiane Santos da

; Pintor, Daniela Cristina Querino

; Guerra, Daiane Cristina

; Silva, Deise Andrade

; Brandão, Edith de Castro Martins

; Kerbauy, Fábio

; Pires, Fernanda Ramos de Oliveira

; Morais, Graciele Lima

; Schmidt Filho, Jayr

; Sicchieri, Juliana Maria Faccioli

; Barroso, Karine Sampaio Nunes

; Viana, Luciana Verçoza

; Rocha, Mariana Hollanda Martins da

; Guimarães, Maysa Penteado

; Lazzari, Natalia Leonetti Couto

; Hamerschlak, Nelson

; Ramos, Patricia

; Gomes, Plinio Nascimento

; Mendonça, Priscila da Silva

; Oliveira, Raquel Candido de

; Scomparim, Renata Corrêa

; Chiattone, Ricardo

; Diez-Garcia, Rosa Wanda

; Cardenas, Thaís de Campos

; Miola, Thais Manfrinato

; Costa, Thalita Cristina de Mello

; Rocha, Vanderson

; Pereira, Andrea Z

einstein (São Paulo)

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2020, Volume 18 elocation AE4530

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

RESUMO O estado nutricional do paciente submetido ao transplante de células-tronco hematopoéticas é considerado fator de risco independente, podendo influenciar na qualidade de vida e na tolerância ao tratamento proposto. O comprometimento do estado nutricional durante o transplante de células-tronco hematopoéticas ocorre principalmente devido aos efeitos adversos decorrentes do condicionamento ao qual o paciente é submetido. Desta forma, a adequada avaliação nutricional e o acompanhamento durante o transplante de células-tronco hematopoéticas tornam-se imprescindíveis. Com o objetivo de salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente, o Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Adulto foi elaborado visando uniformizar e atualizar a Terapia Nutricional nesta área. Com a participação de nutricionistas, nutrólogos e hematologistas de 15 centros brasileiros referências em transplante de células-tronco hematopoéticas

ABSTRACT The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

https://doi.org/10.31744/einstein_journal/2020ae4530 3888 downloads

11.

Non-technical skills assessment scale in nursing: construction, development and validation
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Pires, Sara Martins Pereira

; Monteiro, Sara Otília Marques

; Pereira, Anabela Maria Sousa

; Stocker, Joana Novaes Machado

; Chaló, Daniela de Mascarenhas

; Melo, Elsa Maria de Oliveira Pinho de

Revista Latino-Americana de Enfermagem

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2018, Volume 26 elocation e3042

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

ABSTRACT The introduction of non-technical skills during nursing education is crucial to prepare nurses for the clinical context and increase patient safety. We found no instrument developed for this purpose. Objectives: to construct, develop and validate a non-technical skills assessment scale in nursing. Method: methodological research. Based on the literature review and experience of researchers on non-technical skills in healthcare and the knowledge of the principles of crisis resource management, a list of 63 items with a five-point Likert scale was constructed. The scale was applied to 177 nursing undergraduate students. Descriptive statistics, correlations, internal consistency analysis and exploratory factor analysis were performed to evaluate the psychometric properties of the scale. Results: scale items presented similar values for mean and median. The maximum and the minimum values presented a good distribution amongst all response options. Most items presented a significant and positive relationship. Cronbach alpha presented a good value (0.94), and most correlations were significant and positive. Exploratory factor analysis using the Kaiser-Meyer-Olkin test showed a value of 0.849, and the Bartlett’s test showed adequate sphericity values (χ2=6483.998; p=0.000). One-factor model explained 26% of the total variance. Conclusion: non-technical skills training and its measurement could be included in undergraduate or postgraduate courses in healthcare professions, or even be used to ascertain needs and improvements in healthcare contexts.

RESUMEN La introducción de habilidades no técnicas durante la educación de enfermería es fundamental para preparar a los enfermeros para el contexto clínico y aumentar la seguridad del paciente. No se encontraron instrumentos desarrollados para este propósito. Objetivos: construir, desarrollar y validar una escala de evaluación de habilidades no técnicas en enfermería. Método: investigación metodológica. Con base en la revisión de la literatura y la experiencia de los investigadores en habilidades no técnicas en el cuidado de la salud y el conocimiento de los principios del manejo de recursos en crisis, se construyó una lista de 63 ítems y con una escala Likert de cinco puntos. Se aplicó la escala a 177 estudiantes de pregrado en enfermería. Se realizaron estadísticas descriptivas, correlaciones, análisis de consistencia interna y análisis factorial exploratorio para evaluar las propiedades psicométricas de la escala. Resultados: los ítems de la escala presentaron valores similares para la media y la mediana. Los valores máximo y mínimo mostraron una buena distribución en todas las opciones de respuesta. La mayoría de los ítems presentaron una relación significativa y positiva. El alfa de Cronbach presentó un buen valor (0,94), y la mayoría de las correlaciones fueron significativas y positivas. El análisis factorial exploratorio mediante la prueba Kaiser-Meyer-Olkin mostró un valor de 0,849, y la prueba de Bartlett mostró valores de esfericidad adecuados (χ2=6483.998; p=0,000). El modelo de un factor explicó el 26% de la varianza total. Conclusión: la capacitación en habilidades no técnicas y su medición podrían incluirse en programas de grado y posgrado en profesiones de la salud, o incluso utilizarse para evaluar las necesidades y mejoras en los contextos de atención médica.

RESUMO A introdução de habilidades não técnicas durante o ensino de enfermagem é fundamental para preparar os enfermeiros para o contexto clínico e aumentar a segurança do paciente. Não foram encontrados quaisquer instrumentos desenvolvidos para essa finalidade. Objetivos: construir, desenvolver e validar uma escala de avaliação de habilidades não técnicas em enfermagem. Método: pesquisa metodológica. Com base na revisão da literatura e na experiência dos pesquisadores em habilidades não técnicas em saúde, e no conhecimento dos princípios do gerenciamento de recursos em crises, foi construída uma lista de 63 itens e com uma escala Likert de cinco pontos. A escala foi aplicada em 177 estudantes de graduação em enfermagem. Estatística descritiva, correlações, análises de consistência interna e análise fatorial exploratória foram realizadas para avaliar as propriedades psicométricas da escala. Resultados: os itens da escala apresentaram valores semelhantes para média e mediana. Os valores máximo e mínimo mostraram uma boa distribuição em todas as opções de resposta. A maioria dos itens apresentou uma relação significativa e positiva. O alfa de Cronbach apresentou um bom valor (0,94) e a maioria das correlações foi significativa e positiva. A análise fatorial exploratória através do teste de Kaiser-Meyer-Olkin apresentou um valor de 0,849, e o teste de Bartlett apresentou valores de esfericidade adequados (χ2=6483.998; p=0.000). O modelo de um fator explicou 26% da variância total. Conclusão: a formação em habilidades não técnicas e sua mensuração poderiam ser incluídos nos programas de graduação ou pós-graduação de profissões da saúde, ou até mesmo serem utilizadas para avaliar as necessidades e melhorias nos contextos de cuidados de saúde.

https://doi.org/10.1590/1518-8345.2383.3042 30 downloads

12.

Non-technical skills assessment scale in nursing: construction, development and validation
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Pires, Sara Martins Pereira

; Monteiro, Sara Otília Marques

; Pereira, Anabela Maria Sousa

; Stocker, Joana Novaes Machado

; Chaló, Daniela de Mascarenhas

; Melo, Elsa Maria de Oliveira Pinho de

Revista Latino-Americana de Enfermagem

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2018, Volume 26 elocation e3042

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

https://doi.org/10.1590/1518-8345.2383.3042 2813 downloads

13.

Effect of the implementation of the mixed cafeteria system in a hospital nutrition and dietetic service
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Carvalho, Kamila Pires de

; Martins, Flaviana Pereira de Oliveira

; Dias Custódio, Isis Danyelle

; Lima, Emanuelle do Nascimento Santos

; Souza, Daniela Nogueira Prado de

; Maia, Yara Cristina de Paiva

Nutrición Hospitalaria

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oct 2017, Volume 34 N. 5 Pages 1170 - 1177

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

Introduction: The type of service offered by the nutrition and dietetics service (NDS) of a hospital has a direct impact on food waste. Objective: To evaluate waste in the transition from a simple to a mixed cafeteria service. Methodology: The study was carried out in a NDS of a University Hospital during 60 days (30 days for each type of service). The meals prepared and distributed and the leftovers of lunch and dinner were weighed. Results: Per capita values of non-usable leftovers were below the acceptable range (7-25 g), not varying with the service transition (p = 0.3) at lunch. At dinner, on the contrary, values were above the acceptable range, with a median of 190 g and 202 g, also showing no difference with the service modification (p = 0.5). At lunch, with the transition, there was a reduction in the plate waste-ingestion (p < 0.0001), percentage of plate waste-ingestion (p < 0.0001) and percentage of non-usable foods (p = 0.007). At dinner, there was a reduction in the plate waste-ingestion (p < 0.0001) and in the percentage of plate waste-ingestion (p = 0.0001). Conclusion: The modification of the service type was effective in reducing the plate waste-ingestion, but did not lead to operational modifications of the service, since the amount of non-usable leftovers remained high at dinner. Greater control of the production and distribution of meals is suggested, as well as training of food handlers and supervisors, implementation of standardized operating procedures and cost control in order to reduce waste, which has an economic, social and political impact.

Introducción: el tipo de servicio ofrecido por el servicio de nutrición y dietética (SND) de un hospital tiene un impacto directo en el desperdicio de alimentos. Objetivo: evaluar el desperdicio en la transición de un servicio de cafetería simple a uno combinado. Metodología: el estudio fue llevado a cabo en el SND de un hospital universitario durante 60 días (30 días para cada tipo de servicio). Las comidas preparadas, distribuidas y las sobras del almuerzo y cena fueron pesadas. Resultados: los valores per cápita de las sobras no aprovechables estuvieron por debajo del rango aceptable (7-25 g), sin que variaran con la transición del servicio (p = 0,3) en el almuerzo. En la cena, por el contrario, los valores estuvieron por encima del rango aceptable, con una mediana de 190 g y 202 g, y sin mostrar tampoco una diferencia significativa con la modificación del servicio (p = 0,5). En el almuerzo, con la transición, hubo una reducción en el desperdicio de alimento-ingesta (p < 0,0001), porcentaje del desperdicio de alimento-ingesta (p < 0,0001) y porcentaje de comidas no utilizables (p = 0,007). En la cena, hubo una reducción en el desperdicio de alimento-ingesta (p < 0,0001) y en el porcentaje desperdicio-ingestión (p = 0,0001). Conclusión: la modificación del tipo de servicio fue efectiva a la hora de reducir el desperdicio de alimento-ingesta, pero no condujo a modificaciones operativas en el servicio ya que la cantidad de sobras no utilizables era mayor en la cena. Se sugiere un mayor control de la producción y distribución de las comidas, así como la formación de responsables y supervisores de comida, la implementación de procedimientos operativos estandarizados y el control del coste para reducir el desperdicio, que tiene un impacto económico, social y político.

https://doi.org/10.20960/nh.865 374 downloads

14.

Índice de Massa Corpórea, Competência Social e Problemas de Comportamento de Crianças e Cuidadores
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Dias, Doralice Oliveira Pires

; Neves, Sônia Maria Mello

; Zanini, Daniela Sacramento

Psicologia: Teoria e Pesquisa

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2016, Volume 32 N. 2 elocation e32225

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

RESUMO O objetivo deste estudo foi avaliar a relação entre competências sociais, problemas de comportamento e Índice de Massa Corpórea (IMC) das crianças participantes de um programa de intervenção multidisciplinar para excesso de peso da família. Participaram do estudo 22 cuidadores e 26 crianças. O CBCL e o ASR foram aplicados antes da intervenção. Resultados mostraram relações significativas entre problemas de comportamento internalizantes das crianças e seu IMC, e relações entre problemas de comportamento de cuidadores e de crianças. Sugere-se que o problema de comportamento das crianças seja uma variável mediacional entre o problema de comportamento dos cuidadores e o IMC das crianças, sendo assim necessário o desenvolvimento de intervenções para o excesso de peso que intervenham nos problemas de comportamento de ambos.

ABSTRACT This study aimed to investigate the relationship between social competences, behavioral problems, competences, and Body Mass Index (BMI) of children who participated in a multidisciplinary intervention program developed to deal with overweight of families. 22 caregivers and 25 children participated. Before the start of the intervention program the CBCL and ASR were administrated. The results show a significant relationship between the child's internalization of behavioral problems and the BMI as well as a relationship between the child's and the caregivers behavioral problems. The results suggest that the child's behavioral problem is a mediating variable between the caregiver's behavioral problem and the child's BMI. Therefore, the development of intervention programs of the overweight problem dealing with the behavioral problems of both is necessary.

https://doi.org/10.1590/0102-3772e32225 1571 downloads

15.

Limitação de esforço terapêutico na pessoa com lesão encefálica grave
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Gomes, Henrique de Alencar

; Almeida, Mônica Adelaide

; Matoso, Terezinha Valéria Ferreira

; Viana, Maria Angélica Assunção

; Rezende, Maria Bernadete Cardoso

; Bento, Maíza Ângela Ferreira

; Guimarães, Tatiane Santos Fonseca

; Alcântara, Sabrina Vilane de Oliveira

; Demétrio Júnior, Ary

; Silva, Ana Paula Gomes Costa

; Moreira, Cibele Renata de Paula

; Albergaria, Daniela Simplício Vieira

; Coutinho, Marília Káthya

; Medeiros, Marli

; Souza, Roseli Melo Silva de

; Dumont, Polianna Cristina Pires

Revista Bioética

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aug 2014, Volume 22 N. 2 Pages 282 - 290

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

As discussões a respeito das condutas de limitação de esforço terapêutico (LET) são frequentes nas unidades de terapia intensiva e na especialidade médica oncológica e são também importantes em contextos hospitalares de internação de longa permanência para vítimas de grandes traumas e agravos que necessitam de cuidados prolongados à saúde e de reinserção social. Na prática clínica, a tomada de decisão para LET é complexa e deve envolver o indivíduo, a família e a equipe multiprofissional. O objetivo deste artigo é discorrer a respeito da LET como um abrangente processo de "adequação de medidas" por agregação consensual de fatores centrado na pessoa, pautado por intensificação dos cuidados paliativos.

Discussions about the limitation of therapeutic effort are common in intensive care units and oncology and are also important in long stay hospitals for victims of major trauma and injuries that require long-term health care and social reintegration. In clinical practice, the decision making for limitation of therapeutic effort is complex and multifactorial and should involve the individual, the family and the multidisciplinary team. The purpose of this article is to discuss about limitation of therapeutic effort as a comprehensive process of "adjustment of measures" for consensual aggregation of person-centered factors, marked by intensification of palliative care.

Las discusiones acerca de las conductas de limitación del esfuerzo terapéutico (LET) son comunes en las unidades de cuidados intensivos y oncología y también son importantes en hospitales de larga estancia para las personas víctimas de traumatismos graves y lesiones que requieren atención de salud a largo plazo y la reintegración social. En la práctica clínica, la toma de decisiones para la LET es compleja y debe abordar al individuo, la familia y el equipo multiprofesional. El propósito de este artículo es discutir sobre LET como un proceso integral de "adecuación de medidas" mediante la agregación consensual de factores centrados en la persona, marcado por la intensificación de los cuidados paliativos.

https://doi.org/10.1590/1983-80422014222009 6301 downloads Cited 2 times in SciELO

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