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ABSTRACT Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units. Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours. Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events. Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.

RESUMO Objetivo: Determinar a prevalência e os fatores associados à reabilitação física de crianças em estado grave em unidades de terapia intensiva pediátrica brasileiras. Métodos: Realizou-se um estudo de prevalência pontual multicêntrico, transversal, de 2 dias, abrangendo 27 unidades de terapia intensiva pediátrica (do total de 738) no Brasil em abril e junho de 2019. Este estudo brasileiro fez parte de um grande estudo multinacional chamado Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). O desfecho primário foi a prevalência de mobilidade proporcionada pela fisioterapia ou pela terapia ocupacional. Foram coletados prospectivamente dados clínicos sobre a mobilidade do paciente, possíveis eventos de segurança de mobilidade e barreiras de mobilização em pacientes admitidos por ≥ 72 horas. Resultados: As crianças com idade inferior a 3 anos eram 68% da população de pacientes. A prevalência de mobilidade fornecida pelo terapeuta foi de 74%, ou 277 dos 375 pacientes-dia. A mobilidade para fora do leito foi mais positivamente associada à presença de familiares (razão de chance ajustada de 3,31; IC95% 1,70 - 6,43) e mais negativamente associada às linhas arteriais (razão de chance ajustada de 0,16; IC95% 0,05 - 0,57). Foram relatadas barreiras à mobilização em 27% dos pacientes-dia, sendo a mais comum a falta de prescrição médica (n = 18). Registaram-se eventuais eventos de segurança em 3% de todos os eventos de mobilização. Conclusão: A mobilidade proporcionada pelo terapeuta nas unidades de terapia intensiva pediátrica brasileiras é frequente. A presença de familiares foi alta e positivamente associada à mobilidade para fora do leito. A presença de fisioterapeutas 24 horas por dia nas unidades de terapia intensiva pediátrica brasileiras pode exercer papel importante na mobilização de crianças em estado grave.

https://doi.org/10.5935/2965-2774.20230388-en

Portugal1300: fome, clima e abastecimento em Portugal no final da Idade Média
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Silva, Marcelo Cândido da

; Sobreira, Victor Borges

; Tasso, Luís Otávio Pagano

; Erra, Felipe Mendes

; Fonseca, José Francisco Sanches

; Sanchez, Marina Duarte

; Vera, Rudyard Rezende

Medievalista

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jan 2023, N. 33 Pages 351 - 372

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.4000/medievalista.6316

Avaliação da sustentabilidade socioeconômica e ambiental em propriedades rurais de Minas Gerais a partir do método ISA
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Gabrielli, José Ricardo Miotto

; Santoyo, Alain Hernández

; Martins, Marcelo Rodrigues

; Rezende, Marcelo Lacerda

Revista de Economia e Sociologia Rural

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2023, Volume 61 N. 4 elocation e260860

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

Resumo: Quantificar e qualificar a sustentabilidade em unidades de produção agrícolas vêm se tornando uma necessidade para muitos produtores rurais, assim como para gestores de políticas voltadas ao setor. O objetivo deste estudo foi avaliar a sustentabilidade de propriedades rurais em municípios de Minas Gerais por meio da aplicação do método ISA. A partir de uma amostra de 39 unidades de produção familiar, foram avaliados indicadores relacionados à qualidade do solo, da água e da vegetação, e aos aspectos socioeconômicos dos agroecossistemas. As informações coletadas permitiram uma classificação das propriedades em quatro grupos distintos. O valor médio do ISA para as propriedades foi de 0,57 − abaixo do valor de 0,70, que é considerado ideal −, sendo esse conjunto classificado como em estado de desenvolvimento. Foi realizada uma comparação entre o ISA de 39 propriedades aplicadas nos anos de 2013 e 2016, permitindo verificar uma melhoria das condições de sustentabilidade após a implantação de diversas ações identificadas após a primeira aplicação. Assim, através dos resultados encontrados, chegou-se à conclusão de que o ISA é uma ferramenta adequada para avaliar a sustentabilidade de propriedades rurais, sugerir melhorias e ainda identificar trade-offs em termos de sustentabilidade, entre os aspectos socioeconômicos e ambientais.

Abstract: Quantifying and qualifying sustainability in agricultural production units has become a necessity for many rural producers, as well as for managers of policies aimed at the sector. The objective of this study was to evaluate the sustainability of rural properties in municipalities of Minas Gerais through the application of the ISA method. From a sample of 39 family production units, indicators related to the quality of soil, water, vegetation and the socioeconomic aspects of agroecosystems were evaluated. The information collected allowed a classification of properties into 4 distinct groups. The average value of the ISA for the properties was 0.57, below the value of 0.70, which is considered ideal, and this set is classified as in a state of development. A comparison was made between the ISA of 39 properties applied in the years 2013 and 2016, allowing to verify an improvement in sustainability conditions after the implementation of several actions identified after the first application. Thus, through the results found, it was concluded that the ISA is an adequate tool to assess the sustainability of rural properties, suggest improvements and identify trade-offs in terms of sustainability between socioeconomic and environmental aspects.

https://doi.org/10.1590/1806-9479.2022.260860

Partial replacement of portland cement by bamboo ashes
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Mendonça, Marcelly de Figueiredo

; Farias, Marcelo Martins

; Farias, Celestina Lima de Rezende

; Picanço, Marcelo de Souza

; Macêdo, Alcibíades Negrão

Matéria (Rio de Janeiro)

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2023, Volume 28 N. 2 elocation e20220298

Abstract: En | Text: En | PDF: En

ABSTRACT Partial replacement of Portland cement by industrial waste or materials of natural origin can improve the mechanical strength of concrete and mortar and reduce production cost. In this context, ash from burning bamboo appears as a potential material for use, as it is natural with a renewable source and fast growth, which presents a higher concentration of silica in the outer walls of the stalks. Therefore, the objective of this work is to evaluate the use of bamboo stalk ash (Bambusa Vulgaris) as a partial replacement for Portland cement. For this purpose, bamboo ash was produced at three calcination temperatures (500ºC, 600ºC and 700ºC). The ashes were not characterized as pozzolans based on their chemical composition, however the ash produced at 600ºC obtained a performance index higher than that established by the Standard. The hydration of cement partially replaced by this ash was evaluated, in proportions of 0%, 6%, 10% and 14%, in relation to its mass. Mortars with the same replacement proportions were evaluated in the fresh state and hardened. The consistency in the fresh state remained constant at 227 mm, while the compressive strength, in the hardened state, increased by 15% with the addition of bamboo stem ash.

https://doi.org/10.1590/1517-7076-rmat-2022-0298

CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION?
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IAMAGUCHI, RAQUEL BERNARDELLI

; DIAS, GUILHERME MOREIRA

; IWASE, FERNANDA DO CARMO

; REZENDE, MARCELO ROSA DE

; MATTAR JR, RAMES

Acta Ortopédica Brasileira

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2023, Volume 31 N. 6 elocation e267476

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

ABSTRACT We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Objective: To analyze patients with traumatic proximal wrist upper limb amputations with prolonged ischemic time who underwent temporary artery catheterization to assess stump viability and results. Methods: A case-series study including all patients with a proximal wrist upper limb amputation and a cold ischemic time equal to or above six hours from 2017 to 2021. Results: In total, two surgeons operated eight patients who had experienced forearm amputation injuries. Median ischemia time totaled eight hours. All patients required additional surgeries, most commonly split-thickness skin graft or fixation revision (three patients). This study obtained five successful macroreimplantations. The mean cold ischemia time was longer in the group with successful macroreimplantations (7.4 hours) than of the unsuccessful group (9 hours). Conclusion: Macroreplantations require immediate referral to microsurgery and, although temporary artery catheterization helps surgical decision making, the technique seems to fail to influence outcomes. Level of Evidence IV, Retrospective Case Series.

RESUMO Observa-se um atraso no referenciamento dos casos para o tratamento definitivo das amputações traumáticas de membros no Brasil. Casos com amputações proximais ao punho apresentam um prazo limite para reimplante, sendo lesões que promovem risco de vida ao paciente. Objetivo: Analisar os macrorreimplantes com tempo de isquemia prolongado submetidos à cateterização temporária da artéria, para determinar a viabilidade do coto de amputação, e seus resultados. Métodos: Série de casos de todos os pacientes com amputações traumáticas proximais ao punho, cujo tempo de isquemia fria foi igual ou superior a seis horas, entre 2017 e 2021. Resultados: A amostra foi composta por oito pacientes com amputações traumáticas de antebraço operados por dois cirurgiões. O tempo médio de isquemia foi de oito horas. Todos os pacientes necessitaram de cirurgias adicionais, sendo as mais comuns o enxerto de pele ou a revisão da fixação óssea. Sucesso do macrorreimplante foi observado em cinco pacientes. O tempo médio de isquemia fria foi maior no grupo com sucesso no macrorreimplante (7,4 horas) quando comparado com o grupo sem sucesso (9 horas). Conclusão: Os macrorreimplantes necessitam de transferência imediata para serviços especializados, e, apesar de a cateterização temporária arterial auxiliar no manejo cirúrgico, a técnica parece não interferir nos resultados. Nível de Evidência IV, Série de Casos.

https://doi.org/10.1590/1413-785220233105e267476

Escória de Alto Forno como substituição parcial ao cimento Portland
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Farias, Marcelo Martins

; Farias, Celestina Lima de Rezende

; Picanço, Marcelo de Souza

Matéria (Rio de Janeiro)

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2023, Volume 28 N. 2 elocation e20230120

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

ABSTRACT The civil construction industry is responsible for the emission of carbon dioxide (CO2), for each ton of cement produced, approximately one ton of carbon dioxide is emitted into the atmosphere. Therefore, the present work has as general objective to study the technical feasibility of using the Blast Furnace Slag (EAF), cooled instantly as a substitute for Portland cement. For this work, clinker, standardized sand, plaster, drinking water and EAF were used as materials. As a methodology, the materials were milled to the desired granulometry, which passed through the 0.075mm sieve. After this process, the characterization of these materials started, followed by the replacement of clinker, in the contents of 5, 15, 30, 50 and 75% by EAF. The results of this substitution showed that the tailings were characterized as an excellent by-product in the manufacture of cement, presenting characteristics for large-scale use in search of reducing CO2 emissions.

RESUMO A indústria de construção civil é uma das responsáveis na emissão de gás carbônico (CO2), para cada tonelada de cimento produzido é emitido na atmosfera aproximadamente uma tonelada de gás carbônico. Portanto, o presente trabalho tem como objetivo geral estudar a viabilidade técnica do uso do da Escória de Alto Forno (EAF), resfriada instantaneamente como substituição ao cimento Portland. Para este trabalho utilizou-se como materiais o clínquer, areia normatizada, gesso, água potável e EAF. Como metodologia dos ensaios foi realizado a moagem dos materiais, até a granulometria desejada, passante na peneira 0,075mm. Após esse processo iniciou-se caracterização desses materiais, sendo seguido, da substituição do clínquer, nos teores de 5, 15, 30, 50 e 75% pela EAF. Os resultados dessa substituição mostraram que o rejeito, caracterizou-se como um excelente subproduto na fabricação do cimento, apresentando características para o emprego em larga escala em busca da diminuição da emissão do CO2.

https://doi.org/10.1590/1517-7076-rmat-2023-0120

Radiological characteristics of hepatocellular carcinoma that achieved complete response after chemoembolization with drug-eluting beads for liver transplantation planning
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Valle, Leonardo Guedes Moreira

; Cunha, Marcela Juliano Silva

; Schmid, Bruno Pagnin

; Falsarella, Priscila Mina

; Rezende, Marcelo Bruno de

; Felga, Guilherme Eduardo Gonçalves

; Ogawa, Renata Emy

; Garcia, Rodrigo Gobbo

; Affonso, Breno Boueri

; Nasser, Felipe

; Galastri, Francisco Leonardo

einstein (São Paulo)

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2023, Volume 21 elocation eAO0307

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To describe the radiological characteristics of hepatocellular carcinoma (HCC) lesions that achieved a complete response following drug-eluting bead transarterial chemoembolization (DEB-TACE) preceding liver transplantation. Methods This single-center case-control study enrolled patients with hepatocellular carcinoma who underwent neoadjuvant DEB-TACE therapy, were followed up with contrast-enhanced magnetic resonance imaging or computed tomography, and were successively evaluated according to the modified Response Evaluation Criteria in Solid Tumors. The HCCs were divided into two groups based on their diameter (Group A: ≤3cm; Group B: 3cm). Viability was assessed using the Kaplan-Meier method according to tumor size categories. The relationship between tumor variables was analyzed using bivariate Cox regression. Results Three-hundred and twenty-eight patients with 667 hepatocellular carcinomas who underwent their first DEB-TACE session were enrolled. A total of 105 hepatocellular carcinomas in 59 patients exhibited complete response after the initial DEB-TACE session and were divided into Group A (92 HCCs) and Group B (13 HCCs). The diameter in Group A decreased significantly compared to the pre-procedure size until the second assessment (p<0.001), with no subsequent reduction in diameter, despite maintaining a complete response. In Group B, the reduction in diameter remained significant compared with the initial value until the sixth imaging evaluation (p=0.014). The average reduction was 45.1% for Group B and a maximum of 14.9% in Group A. Conclusion HCCs >3cm exhibited a greater reduction in size and a longer time to recurrence. HCCs ≤3cm had a shorter relapse time. The recurrence rates were similar. These findings may aid in planning for liver transplantation.

https://doi.org/10.31744/einstein_journal/2023ao0307

Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults
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Iamaguchi, Raquel Bernardelli

; Macedo, Lucas Sousa

; Cho, Alvaro Baik

; Rezende, Marcelo Rosa de

; Mattar Júnior, Rames

; Wei, Teng Hsiang

Revista Brasileira de Ortopedia

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oct 2022, Volume 57 N. 5 Pages 772 - 780

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

Resumo Objetivo Os avanços da microcirurgia reconstrutiva na cirurgia ortopédica proporcionaram melhores resultados funcionais e estéticos, evitando as muitas indicações de amputação. Nos hospitais de ortopedia e traumatologia com um grande volume de atendimento, a reconstrução microcirúrgica é essencial, a fim de reduzir os custos e as complicações destes complexos defeitos ortopédicos. Descrevemos uma abordagem microcirúrgica para feridas traumáticas, ressecção tumoral, defeitos ósseos e transferência muscular livre realizada por uma unidade ortopédica especializada em microcirurgia. O objetivo do presente estudo é avaliar os fatores preditivos de resultados dos retalhos microcirúrgicos na reconstrução dos membros, fornecendo uma análise descritiva dos retalhos microcirúrgicos para as indicações ortopédicas. Métodos Estudo prospectivo transversal, que incluiu todos os casos consecutivos de retalhos microcirúrgicos com indicação ortopédica de 2014 a 2020. Foram coletados os dados do histórico clínico pessoal, procedimentos microcirúrgicos intraoperatórios e exames laboratoriais. As complicações e os desfechos de retalho livre foram estudados mediante uma análise descritiva e estatística. Resultados Avaliamos 171 retalhos em 168 pacientes. A indicação mais frequente para a realização de um retalho microcirúrgico foi a traumática, em 66% dos pacientes. Foram observadas complicações cirúrgicas em 51 retalhos, conforme a classificação de Clavien-Dindo do tipo III. A taxa de êxito global dos retalhos microcirúrgicos foi de 88,3%. Na análise multivariada, foram identificados como fatores de risco para complicações tempo de isquemia ≥ 2 horas (p= 0,032) e obesidade (p= 0,007). A perda parcial do retalho foi mais comum em pacientes com trombocitose, com contagem de plaquetas pré-operatória (p= 0,001). Conclusão Os fatores de risco independentes para complicações de retalhos microcirúrgicos para a reconstrução de membro são obesidade e tempo de isquemia do retalho ≥ 2 horas, e a presença de trombocitose como fator de risco para perda parcial do retalho.

Abstract Objective Advances in reconstructive microsurgery in orthopedic surgery provided better functional and aesthetic results and avoided many indications for amputation. In high-volume trauma and orthopedic hospitals, microsurgical reconstruction is essential to reduce costs and complications for these complex orthopedic defects. We describe a microsurgical approach to traumatic wounds, tumor resection, bone defects, and free muscle transfer, performed by an orthopedic microsurgery unit. The objective of the present study was to evaluate predictor factors for outcomes of microsurgical flaps for limb reconstruction, and to provide a descriptive analysis of microsurgical flaps for orthopedic indications. Methods Cross-sectional prospective study that included all consecutive cases of microsurgical flaps for orthopedic indications from 2014 to 2020. Data were collected from personal medical history, intraoperative microsurgical procedure, and laboratory blood tests. Complications and free-flap outcomes were studied in a descriptive and statistical analysis. Results We evaluated 171 flaps in 168 patients; the indications were traumatic in 66% of the patients. Type III complications of the Clavien-Dindo Classification were observed in 51 flaps. The overall success rate of the microsurgical flaps was 88.3%. In the multivariate analysis, the risk factors for complications were ischemia time ≥ 2 hours (p= 0.032) and obesity (p= 0.007). Partial flap loss was more common in patients with thrombocytosis in the preoperative platelet count (p= 0.001). Conclusion The independent risk factors for complications of microsurgical flaps for limb reconstruction are obesity and flap ischemia time ≥ 2 hours, and presence of thrombocytosis is a risk factor for partial flap loss.

https://doi.org/10.1055/s-0041-1735946

Comparative Analysis of the Treatment of Skin Lesions of the Lower Limbs with Sural Flap versus Propeller Flap
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Tenezaca, Katherine V.

; Silva, Gustavo Bersani

; Iamaguchi, Raquel Bernardelli

; Rezende, Marcelo Rosa de

; Wei, Teng Hsiang

; Cho, Álvaro B.

Revista Brasileira de Ortopedia

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oct 2022, Volume 57 N. 5 Pages 781 - 787

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

Resumo Objetivo O objetivo do presente estudo foi comparar prospectivamente os retalhos sural e propeller para cobertura de partes moles da extremidade inferior. Foram avaliadas as seguintes variáveis: incidência de perda total ou parcial do retalho e morbidade da área doadora (fechamento primário versus enxerto de pele). Métodos Análise prospectiva e randomizada de dados coletados de todos os pacientes apresentando defeitos em tecidos moles da extremidade distal da perna e do retropé submetidos aos retalhos em questão. Resultados Foram avaliados 24 pacientes com idades entre 4 e 60 anos, entre 2011 e 2017. Cobertura completa foi obtida em 22 dos 24 pacientes (91,6%) e observamos falha em 2 retalhos (8,4%). O retalho sural, sendo a opção mais popular, continua a representar uma alternativa segura e versátil para defeitos cutâneos do terço distal da perna e da região do calcanhar. O retalho propeller, da mesma maneira, mostrou-se uma opção comparável para o tratamento destas lesões desafiadoras. Conclusão Os retalhos sural e propeller são boas opções para a cobertura de partes moles da extremidade inferior, demostrando baixas taxas de complicações como perda parcial ou total do retalho.

Abstract Objective The objective of the present study was to prospectively compare the sural and propeller flaps for soft-tissues coverage of the lower extremity. The following variables were evaluated: incidence of complete or partial flap loss and donor area morbidity (primary closure versus skin graft). Methods Prospective and randomized analysis of data collected from all patients presenting with soft tissue defects of the lower third of the leg and heel treated with reverse sural or propeller flaps. Results Twenty-four patients aged between 4 and 60 years old were evaluated between 2011 and 2017. Complete coverage was obtained in 22 of the 24 patients (91.6%). Two flaps failed (8.4%). The sural flap, being the most popular option, continues to represent a safe and versatile alternative for skin defects of the lower third of the leg and heel region. Likewise, the propeller flap was a comparable option to treat these challenging defects. Conclusion Sural and propeller flaps are good options for soft tissues coverage of the lower extremity, with low complication rates (partial or total flap loss).

https://doi.org/10.1055/s-0041-1740199

10.

Situational Analysis: Relevant Advances in Grounded Theory for Management Studies
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Ássimos, Bruno Medeiros

; Pinto, Marcelo de Rezende

Organizações & Sociedade

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sep 2022, Volume 29 N. 102 Pages 514 - 536

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

Resumo O presente artigo foi motivado por uma lacuna no campo das publicações baseadas na abordagem da Grounded Theory (GT), uma vez que pouco se avançou nas discussões referentes à aplicação da Análise Situacional (AS), proposta por Adele Clarke (2003, 2005) e Adele Clarke e outros (2018) nos estudos de gestão. Assim, neste artigo conceitual, buscamos situar a AS tanto nos aspectos ontológicos quanto epistemológicos, comentar suas formas de operacionalização e, por fim, apontar questões da AS que parecem relevantes para estudos de gestão. Nossa discussão jogou luz sobre aspectos relevantes da AS, os quais a colocam em uma posição que avança no sentido de priorizar métodos de pesquisa que contribuam para gerar políticas sociais mais justas e equitativas em diversos campos, além de atender demandas cotidianas da área de gestão. Como conclusão, a AS parece ter trazido novos direcionamentos para a GT depois da virada interpretativa, a saber: abordagens da cartografia, consideração de atores humanos e não-humanos e compromissos sociais, além de ter reunido estudos de discurso e agência, de ação e estrutura, de imagem, de texto e contexto, de história e do momento presente para analisar situações complexas de investigação.

Abstract This paper aims at closing a gap in literature referring to academic publications that approach grounded theory, considering that little advance has been noticed in discussions that encompass the application of situational analysis (SA) proposed by Clarke (2003, 2005) and Clarke, Friese and Washburn (2018) in management studies. Thus, this conceptual paper seeks to address situational analysis considering its ontological and epistemological aspects, to investigate its operationalization forms, and, finally, to indicate relevant situational analysis issues for management studies. Our discussion sheds light on relevant situational analysis aspects, which helps prioritizing research methods that may contribute to create fairer and more effective social policies in several fields and meeting daily demands of the management field. As a conclusion, situational analysis seems to bring new guidance to grounded theory after the interpretive turn: cartographic method, consideration of human and non-human actors, and social commitments; in addition, situational analysis gathers discourse and agency studies, action and structure, image, text and context, history, and the present moment to analyze complex investigations.

https://doi.org/10.1590/1984-92302022v29n0023en

11.

Evaluation of Circular Saw Injuries in a Reference Center in Microsurgery and Reimplantation
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Faccioni, Ana Lúcia Campos

; Kurebayashi, Leonardo

; Anjos, Kátia Campos dos

; Rezende, Marcelo Rosa de

Revista Brasileira de Ortopedia

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aug 2022, Volume 57 N. 4 Pages 629 - 635

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

Resumo Objetivo Avaliar o perfil epidemiológico, o tempo até o atendimento, e o tipo de conduta tomada em pacientes vítimas de acidentes com serra circular e lesões decorrentes, e fazer uma comparação com a literatura. Métodos Estudo descritivo transversal, com revisão do prontuário de pacientes atendidos de abril a dezembro de 2018, analisando idade, sexo, lado lesado, dedos acometidos, mês e horário do acidente, tipo de lesões, procedimentos realizados na urgência, tempo decorrido entre o trauma e entrada em sala cirúrgica, e reabordagem durante a internação. Resultados Foram atendidos 54 pacientes do sexo masculino com idade entre 15 e 72 anos. O lado esquerdo foi o mais acometido, e o tipo de lesão mais frequente, a amputação, envolvendo principalmente o polegar. No total, 23 pacientes foram submetidos a reimplante, e, entre eles, 3 macrorreimplantes. Quanto ao horário do trauma, 26 ocorreram entre 12h e 16h, e o tempo decorrido entre o acidente e a entrada em sala cirúrgica foi ≥ 6 horas em 84% dos pacientes. Conclusão As lesões por serra circular são predominantemente graves, com potencial de deixar sequelas permanentes, e acometem principalmente o polegar. A caracterização do tipo de lesão e as condições de atendimento inicial obtidas neste trabalho poderão ajudar na política de prevenção e atendimento a pacientes vítimas de ferimentos por serra circular. Nível de Evidência IV; Série de Casos.

Abstract Objective To evaluate the epidemiologic profile, the time until care, and the type of conduct taken regarding patients who are victims of accidents with circular saws and their resulting injuries, and to make a comparison with the literature. Methods A cross-sectional descriptive study reviewing the medical records of patients cared for from April to December 2018, analyzing age, gender, injured side, affected fingers, month and time of the accident, type of injuries, procedures performed in the emergency room, time elapsed between trauma and admission to the operating room, and reapproach during hospitalization. Results A total of 54 male patients aged between 15 and 72 years were care for. The left side was more affected, and the most frequent type of lesion involved the thumb, which had to be amputated in many cases. In total, 23 patients underwent reimplantation, 3 of which were macroreimplantations. Regarding the time of trauma, 26 cases occurred between noon and 4 p.m., and the time elapsed between the accident and the admission to the operating room was ≥ 6 hours in 84% of the patients. Conclusion Circular saw lesions are predominantly severe, with a potential for leaving permanent sequelae, and they affect mainly the thumb. The characterization of the type of injury and the initial care conditions obtained in the present study may contribute to the policy of prevention and care of patients who are victims of circular saw injuries. Level of Evidence IV; Case Series.

https://doi.org/10.1055/s-0041-1729940

12.

Professor or youtuber? The COVID-19 pandemic, changes in social practice, and the adoption of technologies for distance education
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Costa, Breno Giordane dos Santos

; Espigão, Helga Silva

; Pinto, Marcelo de Rezende

Cadernos EBAPE.BR

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jun 2022, Volume 20 N. 3 Pages 387 - 400

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

Resumo Nosso artigo discute os resultados da pesquisa em que o objetivo foi entender como a migração do ensino presencial para o ensino remoto ocorreu (ou tem ocorrido) devido ao distanciamento social provocado pela pandemia da COVID-19. O framework teórico do trabalho é a teoria da prática. Os dados foram obtidos por meio de entrevistas conduzidas com 12 professores de diferentes instituições de ensino brasileiras. Os dados foram analisados seguindo o princípio da análise de discurso francesa. Uma das conclusões é que dominar uma certa tecnologia não é o suficiente para o uso individual em atividades profissionais. Considerando os professores entrevistados, foi necessário a mudança de alguns elementos subjetivos; mais especificamente, eles precisaram modificar alguns entendimentos e cadeias de valores e projetos inerentes à prática de ensino presencial. Os achados do nosso trabalho podem contribuir para pesquisadores envolvidos no campo do consumo e para interessados em encontrar o que acontece quando um grupo de consumidores adotam uma nova tecnologia durante uma ruptura ou momento de incerteza. Além disso, os resultados também lançam luz sobre porque alguns consumidores conhecem as vantagens de certos produtos e tecnologias, sem, contudo, adotá-las em suas atividades diárias.

Abstract This article discusses the results of a study aiming to understand how the migration from in-person to distance learning due to social distancing practices to contain the COVID-19 pandemic occurred (or has been occurring). The theoretical framework was based on practice theory, and data were obtained through interviews with 12 professors of different Brazilian higher education institutions. The data were analyzed following the principles of French discourse analysis. One of the conclusions is that mastering a certain technology is not enough for an individual to use it in professional activities. The professors interviewed indicated the need to change a few subjective elements, more specifically, modify understandings and the chains of value and projects inherent in the practice of classroom teaching. The research findings contribute to researchers involved in the field of consumption interested in finding out what happens when a group of consumers adopts a new technology during a rupture or uncertain moment. In addition, the results shed light on why some consumers discover the advantages of certain products and technologies without adopting them in daily activities.

Resumen Nuestro artículo analiza los resultados de una investigación en la que el objetivo fue comprender cómo ocurrió la migración de la enseñanza presencial a la remota debido al distanciamiento social provocado por la pandemia de COVID-19. El marco teórico del trabajo es la teoría de la práctica. Los datos se obtuvieron a través de entrevistas realizadas a 12 profesores de diferentes instituciones educativas brasileñas y se analizaron siguiendo el principio del análisis del discurso francés. Una de las conclusiones es que dominar una determinada tecnología no es suficiente para el uso individual en actividades profesionales. Considerando los docentes entrevistados, fue necesario cambiar algunos elementos subjetivos; más específicamente, ellos tuvieron que modificar algunos entendimientos y cadenas de valor y proyectos inherentes a la práctica de la docencia presencial. Los hallazgos de nuestro trabajo pueden ser un aporte para los investigadores involucrados en el campo del consumo y para los interesados en saber qué sucede cuando un grupo de consumidores adopta una nueva tecnología durante una disrupción o momento de incertidumbre. Además, los resultados también arrojan luz sobre por qué algunos consumidores son conscientes de las ventajas de ciertos productos y tecnologías sin adoptarlos, sin embargo, en sus actividades diarias.

https://doi.org/10.1590/1679-395120210044x

13.

Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil
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Rezende, Ana Paula Rodrigues

; Alvarenga, Fernanda Rassi

; Ramos, Marcelo

; Franken, Débora Luiza

; Costa, Juvenal Soares Dias da

; Pattussi, Marcos Pascoal

; Paniz, Vera Maria Vieira

Revista Brasileira de Ginecologia e Obstetrícia

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feb 2022, Volume 44 N. 2 Pages 133 - 141

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

Resumo Objetivo Investigar a prevalência de síndrome pré-menstrual (SPM) e do transtorno disfórico pré-menstrual (TDPM) em alunas universitárias, os fatores associados à SPM, os sintomasmais prevalentes e a interferência dos sintomas nas atividades acadêmicas, familiares, sociais e de trabalho. Métodos Este estudo transversal incluiu 1.115 estudantes universitárias ≥18 anos da Universidade de Rio Verde, Goiás. Síndrome pré-menstrual e TDPM foram identificados por meio do Premenstrual Symptoms Screening Tool. As associações com fatores sociodemográficos, comportamentais, reprodutivos, nutricionais e de saúde foram investigadas utilizando-se a regressão de Poisson. Resultados A prevalência de SPM foi de 46,9% (intervalo de confiança [IC] de 95% 44,0-49,8) e de TDPM, 11,1% (IC 95% 9,3-13,0). Os sintomas mais prevalentes foram físicos, como sensibilidade mamária, distensão abdominal e ganho de peso (73%); seguidos por psicológicos, como comer demais/desejos por comida, chorar/mais sensível à rejeição (> 60%). Mais de 30% relataram que os sintomas interferiam de forma moderada a grave em suas atividades sociais e acadêmicas. Após análise ajustada, a SPM foi mais prevalente naquelas que estava cursando o 1°/2° semestre da faculdade (razão de prevalência [RP] 1,44; IC 95% 1,14-1,80), as que haviam consumido álcool nos últimos 30 dias (RP 1,23; IC 95% 1,04-1,47), e as que tinha depressão (RP 1,49; IC 95% 1,30-1,71). Conclusão Quase metade das universitárias tinha SPM e cerca de 11%, TDPM. Os sintomas físicos foram os mais comuns e interferiram de forma moderada a grave em vários aspectos da vida. Frequentar os primeiros semestres, consumir álcool e ter depressão foram fatores de risco para SPM. A identificação dos fatores de risco para a SPM é essencial para prevenir os sintomas e reduzir o impacto da síndrome.

Abstract Objective To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities. Methods This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression. Results The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-tosevere way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71). Conclusion Almost half of the university students had PMS and ~ 11%, PMDD. Physical symptoms were themost common and interfered in amoderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

https://doi.org/10.1055/s-0041-1741456

14.

Pilot study of the effect of therapeutic photobiomodulation on postoperative pain in knee arthroplasty
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Rezende, Marcia Uchoa de

; Varone, Bruno Butturi

; Martuscelli, Diego Ferreira

; Ocampos, Guilherme Pereira

; Freire, George Miguel Goes

; Pinto, Nathali Cordeiro

; Sousa, Marcelo Victor Pires de

Brazilian Journal of Anesthesiology

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feb 2022, Volume 72 N. 1 Pages 159 - 161

Abstract: En | Text: En | PDF: En

Abstract Nine participants undergoing primary TKA submitted to spinal anesthesia, sedation, ultrasound-guided obturator and Femoral nerve Block analgesia, and photobiomodulation Therapy (FBMT) were evaluated regarding postoperative pain and morphine consumption. FBMT sessions were performed in the Immediate Postoperative period (IPO) and after 24 hours. Participants received 16.7±15 mg of morphine up to the third postoperative day. At IPO, mean pain score was 4.8 ± 3.2 and 5.6 ± 3.5, at rest and on movement, respectively. Photo biomodulation therapy can be considered an option for mitigating pain for patients undergoing TKA.

https://doi.org/10.1016/j.bjane.2021.07.040

15.

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes

; Melo, Ana Karla Guedes de

; Cruz, Vítor Alves

; Souza, Viviane Angelina de

; Carvalho, Joana Starling de

; Machado, Ketty Lysie Libardi Lira

; Valadares, Lilian David de Azevedo

; Reis Neto, Edgard Torres dos

; Rezende, Rodrigo Poubel Vieira de

; Guimarães, Maria Fernanda Brandão de Resende

; Ferreira, Gilda Aparecida

; Braz, Alessandra de Sousa

; Vieira, Rejane Maria Rodrigues de Abreu

; Pinheiro, Marcelo de Medeiros

; Ribeiro, Sandra Lúcia Euzébio

; Bica, Blanca Elena Gomes Rios

; Baptista, Kátia Lino

; Costa, Izaias Pereira da

; Marques, Claudia Diniz Lopes

; Lopes, Maria Lúcia Lemos

; Martinez, José Eduardo

; Giorgi, Rina Dalva Neubarth

; Mota, Lícia Maria Henrique da

; Loures, Marcos Antônio Araújo da Rocha

; Paiva, Eduardo dos Santos

; Monticielo, Odirlei André

; Xavier, Ricardo Machado

; Kakehasi, Adriana Maria

; Pileggi, Gecilmara Cristina Salviato

Advances in Rheumatology

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2022, Volume 62 elocation 3

Abstract: En | Text: En | PDF: En

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

https://doi.org/10.1186/s42358-022-00234-7

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