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ABSTRACT Objective: To compare, within a cohort of patients with acute respiratory failure, the phenotypes of patients with and without COVID-19 in the context of the pandemic and evaluate whether COVID-19 is an independent predictor of intensive care unit mortality. Methods: This historical cohort study evaluated 1001 acute respiratory failure patients with suspected COVID-19 admitted to the intensive care unit of 8 hospitals. Patients were classified as COVID-19 cases and non-COVID-19 cases according to real-time polymerase chain reaction results. Data on clinical and demographic characteristics were collected on intensive care unit admission, as well as daily clinical and laboratory data and intensive care unit outcomes. Results: Although the groups did not differ in terms of APACHE II or SOFA scores at admission, the COVID-19 group had more initial symptoms of fever, myalgia and diarrhea, had a longer duration of symptoms, and had a higher prevalence of obesity. They also had a lower PaO2/FiO2 ratio, lower platelet levels than non-COVID-19 patients, and more metabolic changes, such as higher levels of blood glucose, C-reactive protein, and lactic dehydrogenase. Patients with non-COVID-19 acute respiratory failure had a higher prevalence of chronic obstructive pulmonary disease/asthma and cardiopathy. Patients with COVID-19 stayed in the hospital longer and had more complications, such as acute kidney failure, severe acute respiratory distress syndrome and severe infection. The all-cause mortality rate was also higher in this group (43.7% in the COVID-19 group versus 27.4% in the non-COVID-19 group). The diagnosis of COVID-19 was a predictor of intensive care unit mortality (odds ratio, 2.77; 95%CI, 1.89 - 4.07; p < 0.001), regardless of age or Charlson Comorbidity Index score. Conclusion: In a prospective cohort of patients admitted with acute respiratory failure, patients with COVID-19 had a clearly different phenotype and a higher mortality than non-COVID-19 patients. This may help to outline more accurate screening and appropriate and timely treatment for these patients.

RESUMO Objetivo: Comparar, em uma coorte de pacientes com insuficiência respiratória aguda, os fenótipos de pacientes com e sem COVID-19, no contexto da pandemia, e avaliar se a COVID-19 é um preditor independente de mortalidade na unidade de terapia intensiva. Métodos: Este estudo de coorte histórico avaliou 1.001 pacientes com insuficiência respiratória aguda e suspeita de COVID-19 internados na unidade de terapia intensiva de oito hospitais. Os pacientes foram classificados como casos com e sem COVID-19 segundo os resultados da RT-PCR. Foram coletados dados sobre características clínicas e demográficas na admissão à unidade de terapia intensiva, bem como dados clínicos e laboratoriais diários e desfechos da unidade de terapia intensiva. Resultados: Embora os grupos não tenham diferido nos escores APACHE II ou SOFA na admissão, o grupo COVID-19 apresentou mais sintomas iniciais de febre, mialgia e diarreia e teve maior duração dos sintomas e maior prevalência de obesidade. Eles também apresentaram menor relação PaO2/FiO2 e níveis mais baixos de plaquetas do que os pacientes sem COVID-19 e mais alterações metabólicas, como níveis mais altos de glicemia, proteína C-reativa e desidrogenase lática. Os pacientes com insuficiência respiratória aguda sem COVID-19 apresentaram maior prevalência de doença pulmonar obstrutiva crônica/asma e cardiopatia. Os pacientes com COVID-19 permaneceram mais tempo no hospital e tiveram mais complicações, como insuficiência renal aguda, síndrome do desconforto respiratório agudo grave e infecção grave. A taxa de mortalidade por todas as causas também foi maior nesse grupo (43,7% no grupo com COVID-19 versus 27,4% no grupo sem COVID-19). O diagnóstico de COVID-19 foi um preditor de mortalidade na unidade de terapia intensiva (razão de chances de 2,77; IC95% 1,89 - 4,07; p < 0,001), independentemente da idade ou da pontuação do Índice de Comorbidade de Charlson. Conclusão: Em uma coorte prospectiva de pacientes admitidos com insuficiência respiratória aguda, os pacientes com COVID-19 apresentaram fenótipo claramente diferente e uma mortalidade mais alta do que os pacientes sem COVID-19. Isso pode ajudar a traçar uma triagem mais precisa e um tratamento adequado e oportuno para esses pacientes.

https://doi.org/10.5935/2965-2774.20230015-en

Fatores associados aos sintomas depressivos em agentes comunitários de saúde
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Barbosa, Mariane Silveira

; Brito, Maria Fernanda Santos Figueiredo

; Rossi-Barbosa, Luiza Augusta Rosa

; Santos, Gustavo Ribeiro dos

; Moreira, Kênia Souto

PsychTech & Health Journal

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sep 2023, Volume 7 N. 1 Pages 30 - 40

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

Abstract The objective of the present study was to answer the question, “What are the factors associated with the prevalence of depressive symptoms in community health agents”. This cross-sectional, quantitative, and analytical study used a Patient Health Questionnaire - 9 to check the depressive symptoms and a questionnaire on the socio-demographic and occupational conditions. A Poisson multiple regression with robust variance was performed, considering a significance level of 5% (p < .05). Six hundred seventy-three community health agents participated in the study. The depressive symptoms prevalence was 19.0% (N = 128). There was an association with females (RP:1.09; IC:1.03-1.05), working time as a community health agent over six years (RP:1.12; IC:1.06-1.17), job dissatisfaction (RP:1.13; IC:1.07-1.19) and the variable being religious (RP:.90; IC:.84-.97) as a protection factor. There was high depressive symptoms prevalence among the community health agents associated with socio-demographic factors.

Resumo O objetivo do presente estudo foi responder à pergunta “Quais são os fatores associados à prevalência de sintomas depressivos em agentes comunitários de saúde”. É um estudo transversal, quantitativo e analítico no qual utilizou instrumento Patient Health Questionnaire - 9 para verificar os sintomas depressivos e um questionário sobre as condições sociodemográficas e ocupacionais. Realizou-se regressão múltipla de Poisson com variância robusta, considerando um nível de significância de 5% (p < .05). Participaram do estudo 673 agentes comunitários de saúde. A prevalência para os sintomas depressivos foi de 19.0% (N = 128). Houve associação com o sexo feminino (RP:1.09; IC:1.03-1.05), tempo de trabalho como agente comunitário de saúde acima de 6 anos (RP:1.12; IC:1.06-1.17), insatisfação no trabalho (RP:1.13; IC:1.07-1.19) e a variável ser religioso (RP:.90; IC:.84-.97) como fator de proteção. Verificou-se alta prevalência de sintomas depressivos entre agentes comunitários de saúde havendo associação com fatores sociodemográficos e ocupacionais.

https://doi.org/10.26580/pthj.art56-2023

Intensidade de sombreamento e formulação de substrato afetam a qualidade de mudas de Cordia trichotoma
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Almeida, Rodolfo Soares de

; Cunha, Fernanda Leite

; Rossi, Jamille Alonso

; Melo, Lucas Amaral de

Ciência Florestal

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sep 2023, Volume 33 N. 3 elocation e69010

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

ABSTRACT Cordia trichotomais a native species with economic potential due to its wood quality. However, knowledge regarding the production of quality seedlings of the species is still incipient. Thus, the objective was to evaluate the use of agricultural residues as a substrate compound and the shading intensities in the nursery phase forCordia trichotomaseedlings production. Five substrate compositions were tested: S1 (80% CF-coconut fiber- and 20% CCC-carbonized coffee husks); S2 (60% FC and 40% CCC); S3 (80% FC and 20% CAC-carbonized rice husk); S4 (60% FC and 40% CAC); S5 (100% commercial substrate). Also, we tested four different shading levels: 0%; 30%; 50%;80%. The experiment was in a factorial design with a completely randomized design. At 180 days, we measured seedling height, stem diameter, shoot dry mass, and root system dry mass and calculated the robustness index and Dickson Quality Index. We observed that carbonized husks provided lower growth than the use of a commercial substrate in all analyzed variables. Furthermore, shading provided negative quadratic growth in the analyzed variables. Thus, it is recommended the use of commercial substrate and shading of 50% in seedlings of Cordia trichotoma

RESUMO Cordia trichotoma é uma espécie nativa que possui grande importância econômica devido à valorização da qualidade de sua madeira. No entanto, os conhecimentos quanto a produção de mudas de qualidade da espécie ainda são incipientes. Dessa forma, objetivou-se avaliar o uso de resíduos agrícolas como composto de substrato e as intensidades de sombreamento em fase de viveiro, para a produção de mudas de Cordia trichotoma. Foram testadas cinco composições de substrato: S1 (80% FC-fibra de coco- e 20% CCC-casca de café carbonizada); S2 (60% FC e 40% CCC); S3 (80% FC e 20% CAC-casca de arroz carbonizada); S4 (60% FC e 40% CAC); S5 (100% substrato comercial). E quatro diferentes níveis de sombreamento: 0%; 30%; 50%; 80%. O delineamento experimental foi inteiramente casualizado em esquema fatorial. Foram mensurados aos 180 dias, a altura das mudas, o diâmetro de coleto, a massa seca da parte aérea, a massa seca do sistema radicular e calculados o índice de robustez e o Índice de Qualidade de Dickson. Foi observado que o uso de cascas proporcionou crescimento inferior ao uso de substrato comercial, em todas as variáveis analisadas. Ademais, o sombreamento proporcionou comportamento quadrático negativo nas variáveis analisadas. Assim, recomenda-se a utilização de substrato comercial e de sombreamento de 50%, em mudas de Cordia trichotoma.

https://doi.org/10.5902/1980509869010

Corpo, Yoga e Formação Continuada de Professoras: experiências e sensibilizações
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Rossi, Fernanda

; Ehrenberg, Mônica Caldas

Educação & Realidade

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2023, Volume 48 elocation e120442

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

ABSTRACT This study analyzes the potentiality of experiences with yoga in continuing teacher education for the reinterpretation of the corporeality of Kindergarten and Elementary School teachers. This was a qualitative research with 45 teachers of Physical Education, Pedagogy, Art and Special Education, from a city in the interior of São Paulo, with data generated through a focus group and questionnaire. Bodily experiences, as the guiding line of the training process, were shown to contribute to the blurring of the boundaries between what is experienced and what is taught, between the cognitive and the sensitive, enhancing for teachers the expansion of their understanding of themselves and the relationship with the other, in order to reverberate in personal and professional teaching profession.

RESUMO Analisa-se a potencialidade das experiências com o yoga na formação continuada para as ressignificações da corporalidade de professoras da Educação Infantil e dos anos iniciais do Ensino Fundamental. Participaram da pesquisa qualitativa 45 professoras de Educação Física, Pedagogia, Arte e Educação Especial, de uma cidade do interior paulista, com dados gerados por meio de grupo focal e questionário. Evidenciou-se que as experiências corporais, como o fio condutor do processo formativo, contribuem para a diluição das fronteiras entre o vivido e o ensinado, entre o cognitivo e o sensível, potencializando às professoras a expansão da compreensão de si e da relação com o outro, de modo a reverberar na formação pessoal e profissional docente.

https://doi.org/10.1590/2175-6236120442vs01

Lifetime cannabis use and childhood trauma increase risk of psychosis in carriers of CNR1 genetic variants: findings from the STREAM study
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Loureiro, Camila Marcelino

; Corsi-Zuelli, Fabiana

; Fachim, Helene Aparecida

; Shuhama, Rosana

; de Oliveira, Adrielle Martins

; Menezes, Paulo Rossi

; Dalton, Caroline F.

; Louzada-Junior, Paulo

; Belangero, Sintia Iole

; Coeli-Lacchini, Fernanda

; Reynolds, Gavin P.

; Lacchini, Riccardo

; Del-Ben, Cristina Marta

Brazilian Journal of Psychiatry

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2023, Volume 45 N. 3 Pages 226 - 235

Abstract: En | Text: En | PDF: En

Objectives: Gene-environment interactions increase the risk of psychosis. The objective of this study was to investigate gene-gene and gene-environment interactions in psychosis, including single nucleotide variants (SNVs) of dopamine-2 receptor (D2R), N-methyl-d-aspartate receptor (NMDAR), and cannabinoid receptor type 1 (CB1R), lifetime cannabis use, and childhood trauma. Methods: Twenty-three SNVs of genes encoding D2R (DRD2: rs1799978, rs7131056, rs6275), NMDAR (GRIN1: rs4880213, rs11146020; GRIN2A: rs1420040, rs11866328; GRIN2B: rs890, rs2098469, rs7298664), and CB1R (CNR1: rs806380, rs806379, rs1049353, rs6454674, rs1535255, rs2023239, rs12720071, rs6928499, rs806374, rs7766029, rs806378, rs10485170, rs9450898) were genotyped in 143 first-episode psychosis patients (FEPp) and 286 community-based controls by Illumina HumanCoreExome-24 BeadChip. Gene-gene and gene-environment associations were assessed using nonparametric Multifactor Dimensionality Reduction software. Results: Single-locus analyses among the 23 SNVs for psychosis and gene-gene interactions were not significant (p > 0.05 for all comparisons); however, both environmental risk factors showed an association with psychosis (p < 0.001). Moreover, gene-environment interactions were significant for an SNV in CNR1 and cannabis use. The best-performing model was the combination of CNR1 rs12720071 and lifetime cannabis use (p < 0.001), suggesting an increased risk of psychosis. Conclusion: Our study supports the hypothesis of gene-environment interactions for psychosis involving T-allele carriers of CNR1 SNVs, childhood trauma, and cannabis use.

https://doi.org/10.47626/1516-4446-2022-2882

Decreasing delays in the diagnosis and treatment of rheumatoid arthritis in Brazil: a nationwide multicenter observational study
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Albuquerque, Cleandro Pires de

; Reis, Ana Paula Monteiro Gomides

; Santos, Ana Beatriz Vargas

; Bértolo, Manoel Barros

; Louzada Júnior, Paulo

; Giorgi, Rina Dalva Neubarth

; Radominski, Sebastião Cezar

; Guimarães, Maria Fernanda B. Resende

; Bonfiglioli, Karina Rossi

; Sauma, Maria de Fátima L. da Cunha

; Pereira, Ivânio Alves

; Brenol, Claiton Viegas

; Mota, Licia Maria Henrique da

; Santos Neto, Leopoldo

; Pinheiro, Geraldo R. Castelar

Advances in Rheumatology

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2023, Volume 63 elocation 3

Abstract: En | Text: En | PDF: En

Abstract Background Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil. Methods Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann–Kendall trend test, chi-squared tests with Cramer’s V effect sizes and analysis of variance were conducted. Results We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = - 0.677, p < 0.001) and treatment (tau = - 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011–2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4–12) and 11 (5–17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window. Conclusion The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.

https://doi.org/10.1186/s42358-022-00265-0

Do it fast! Early access to specialized care improved long-term outcomes in rheumatoid arthritis: data from the REAL multicenter observational study
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Albuquerque, Cleandro Pires

; Reis, Ana Paula Monteiro Gomides

; Santos, Ana Beatriz Vargas

; Bértolo, Manoel Barros

; Louzada Júnior, Paulo

; Giorgi, Rina Dalva Neubarth

; Radominski, Sebastião Cezar

; Guimarães, Maria Fernanda B. Resende

; Bonfiglioli, Karina Rossi

; Sauma, Maria de Fátima L Cunha

; Pereira, Ivânio Alves

; Brenol, Claiton Viegas

; Mota, Licia Maria Henrique

; Santos Neto, Leopoldo

; Pinheiro, Geraldo Rocha Castelar

Advances in Rheumatology

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2023, Volume 63 elocation 17

Abstract: En | Text: En | PDF: En

Abstract Background Early rheumatoid arthritis (RA) offers an opportunity for better treatment outcomes. In real-life settings, grasping this opportunity might depend on access to specialized care. We evaluated the effects of early versus late assessment by the rheumatologist on the diagnosis, treatment initiation and long-term outcomes of RA under real-life conditions. Methods Adults meeting the ACR/EULAR (2010) or ARA (1987) criteria for RA were included. Structured interviews were conducted. The specialized assessment was deemed “early” when the rheumatologist was the first or second physician consulted after symptoms onset, and “late” when performed afterwards. Delays in RA diagnosis and treatment were inquired. Disease activity (DAS28-CRP) and physical function (HAQ-DI) were evaluated. Student's t, Mann-Whitney U, chi-squared and correlation tests, and multiple linear regression were performed. For sensitivity analysis, a propensity score-matched subsample of early- vs. late-assessed participants was derived based on logistic regression. The study received ethical approval; all participants signed informed consent. Results We included 1057 participants (89.4% female, 56.5% white); mean (SD) age: 56.9 (11.5) years; disease duration: 173.1 (114.5) months. Median (IQR) delays from symptoms onset to both RA diagnosis and initial treatment coincided: 12 (6–36) months, with no significant delay between diagnosis and treatment. Most participants (64.6%) first sought a general practitioner. Notwithstanding, 80.7% had the diagnosis established only by the rheumatologist. Only a minority (28.7%) attained early RA treatment (≤ 6 months of symptoms). Diagnostic and treatment delays were strongly correlated (rho 0.816; p < 0.001). The chances of missing early treatment more than doubled when the assessment by the rheumatologist was belated (OR 2.77; 95% CI: 1.93, 3.97). After long disease duration, late-assessed participants still presented lower chances of remission/low disease activity (OR 0.74; 95% CI: 0.55, 0.99), while the early-assessed ones showed better DAS28-CRP and HAQ-DI scores (difference in means [95% CI]: −0.25 [−0.46, −0.04] and − 0.196 [−0.306, −0.087] respectively). The results in the propensity-score matched subsample confirmed those observed in the original (whole) sample. Conclusions Early diagnosis and treatment initiation in patients with RA was critically dependent on early access to the rheumatologist; late specialized assessment was associated with worse long-term clinical outcomes.

https://doi.org/10.1186/s42358-023-00301-7

Extra-articular manifestations of rheumatoid arthritis remain a major challenge: data from a large, multi-centric cohort
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Bonfiglioli, Karina Rossi

; Ribeiro, Ana Cristina de Medeiros

; Carnieletto, Ana Paula

; Pereira, Ivânio

; Domiciano, Diogo Souza

; Silva, Henrique Carriço da

; Pugliesi, Alisson

; Pereira, Leticia Rocha

; Guimarães, Maria Fernanda Resende

; Giorgi, Rina Dalva Neubarth

; Reis, Ana Paula Monteiro Gomides

; Brenol, Claiton Viegas

; Louzada-Júnior, Paulo

; Sauma, Maria de Fátima Lobato da Cunha

; Radominski, Sebastião Cezar

; Mota, Licia Maria Henrique da

; Castelar-Pinheiro, Geraldo da Rocha

Advances in Rheumatology

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2023, Volume 63 elocation 34

Abstract: En | Text: En | PDF: En

Abstract Introduction Although Rheumatoid Arthritis (RA) extra-articular manifestations (ExtRA) occurrence has been decreasing over time, they are still a major mortality risk factor for patients. Objective To determine the prevalence of ExtRA in a large cohort, and its association with demographic and clinical variables. Method Cross-sectional and observational study, based on a multi-centric database from a prospective cohort, in which 11 public rheumatology centres enrolled RA patients (1987 ARA or 2010 ACR-EULAR). Data collection began in 08-2015, using a single online electronic medical record. Continuous variables were compared using Mann–Whit-ney U-test, and Fisher's exact test or chi-square test, as appropriate, were used for categorical variables. The level of significance was set at 5% (p < 0.05). Results 1115 patients were included: 89% women, age [mean ± SD] 58.2 ± 11.5 years, disease duration 14.5 ± 12.2 years, positive Rheumatoid Factor (RF, n = 1108) in 77%, positive anti-cyclic citrullinated peptide (ACPA, n = 477) in 78%. Regarding ExtRA, 334 occurrences were registered in 261 patients, resulting in an overall prevalence of 23.4% in the cohort. The comparison among ExtRA and Non-ExtRA groups shows significant higher age (p < 0.001), disease duration (p < 0.001), RF high titers (p = 0.018), Clinical Disease Activity index (CDAI) (p < 0.001), Disease Activity Index 28 (DAS 28) (p < 0.001), and Health Assessment Questionnaire (HAQ) (p < 0.001) in ExtRA group. Treatment with Azathioprine (p = 0.002), Etanercept (p = 0.049) Glucocorticoids (GC) (‘p = 0.002), and non-steroidal anti-inflammatory drugs (NSAIDs) (p < 0.001) were more frequent in ExtRA group. Conclusions ExtRA manifestations still show an expressive occurrence that should not be underestimated. Our findings reinforce that long-term seropositive disease, associated with significant disability and persistent inflammatory activity are the key factors related to ExtRA development.

https://doi.org/10.1186/s42358-023-00318-y

The post-COVID-19 pandemic: perspectives of professional practice in nursing
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Robazzi, Maria Lucia do Carmo Cruz

; Rocha, Fernanda Ludmilla Rossi

; Marziale, Maria Helena Palucci

Revista Brasileira de Enfermagem

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2023, Volume 76 Suppl. 1 elocation e76Suppl101

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

https://doi.org/10.1590/0034-7167.202376suppl101

10.

Management of traumatic superficial palmar arch pseudoaneurysm: a therapeutic challenge pseudoaneurysm
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Metzger, Patrick Bastos

; Paixão Neto, Fernando Antonio Falcão

; Carvalho, Sarah Fernandez Coutinho de

; Fernandez, Miguel Godeiro

; Metzger, Simone Lessa

; Brandão, Maria Fernanda Lima

; Monteiro, Rafael Borges

; Rossi, Fabio Henrique

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230073

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

Resumo O pseudoaneurisma do arco palmar é uma entidade rara, cujo diagnóstico depende de alta suspeição clínica. Apresentamos o caso de um paciente encaminhado ao pronto-socorro com história de traumatismo penetrante por vidro na face palmar, com massa pulsátil e sangramento em jato. A ultrassonografia com Doppler evidenciou pseudoaneurisma parcialmente trombosado, e a angiotomografia demonstrou formação sacular originada do arco palmar superficial. Uma abordagem cirúrgica convencional foi indicada. Para prosseguir com o diagnóstico correto, essa suspeita clínica deve ser aventada. Modalidades de imagem são necessárias para identificar o pseudoaneurisma e planejar o curso do tratamento. No entanto, a sequência diagnóstica é individual, pois uma avaliação mais aprofundada, com diferentes métodos de imagem, pode não alterar o racional da intervenção. Em nossa experiência, a remoção cirúrgica convencional é preferível, visto sua segurança e seus resultados bem estabelecidos. rara prontosocorro pronto socorro jato trombosado superficial indicada correto aventada tratamento entanto individual aprofundada intervenção experiência preferível estabelecidos

Abstract Pseudoaneurysm of the palmar arch is a rare entity. Diagnosis is dependent on high clinical suspicion. We present a case referred to the emergency department, with a history of glass penetrating trauma to the palmar surface with a pulsatile mass and jet bleeding. Doppler ultrasound evidenced a partially thrombosed pseudoaneurysm. A CT angiography examination showed a saccular formation arising from the superficial palmar arch. A conventional surgical approach was indicated. A clinical suspicion must be ventured to arrive at the correct diagnosis. Imaging modalities are needed to identify the pseudoaneurysm and plan the treatment course. Nonetheless, the sequence of diagnosis is individual, because further evaluation with different imaging methods may not change the rationale for the intervention. In our experience, conventional surgical removal is preferable, due to its safety and well-established outcomes. entity department bleeding indicated course Nonetheless individual intervention experience preferable wellestablished well established outcomes

https://doi.org/10.1590/1677-5449.202300732

11.

Identifying patient safety competences among anesthesiology residents: systematic review
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Pereira, Fernanda Silva Hojas

; Garcia, Daniela Bianchi

; Ribeiro, Elaine Rossi

Brazilian Journal of Anesthesiology

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oct 2022, Volume 72 N. 5 Pages 657 - 665

Abstract: En | Text: En | PDF: En

Abstract Introduction and objective Patient safety is a concept of great importance to managers, health professionals, and patients and their families, given patient safety promotes more effective care and reduces costs. Moreover, while analyzing the area of anesthesiology, one can realize the epidemiological changes, increased complexity and number of procedures, and the adoption of a new matrix of essential skills mandatory for residents of anesthesiology in Brazil. Thus, it is relevant to identify current patient safety competences among anesthesiology residents. Methods A systematic review was elaborated using PubMed, SciELO, BVS, Cochrane Library, LILACS and CAPES databases with the descriptors “anesthesiology”, “patient safety”, “residency” and “competence”. Results and conclusions Thirteen articles published in the past 10 years were analyzed. The articles depicted competences grouped into three categories: knowledge (identification, prevention and management of adverse events; use of correct and up-to-date information; understanding of human factors; and continuous learning), skills (efficient communication; teamwork; leadership; decision-making; and self-confidence), and attitude (management of stress and fatigue; and infection control). All these skills can be developed and assessed through simulation and active learning methods, profiting from a multidisciplinary approach. Studies also reveal that residents perform poorly in certain patient safety domains due to lack of effective in-depth understanding, appreciation of the topic and ineffective teaching. As a result, greater investment in the topic is needed by teaching and health institutions and researchers.

https://doi.org/10.1016/j.bjane.2021.06.029

12.

[SciELO Preprints] - Corporeality and dance for babies: a systematic review study
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Rossini, Amanda Paulino Rossi, Fernanda

Journal Metrics
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Publication date: 2022-07-15

Abstract: En Es Pt

With the objective of identifying the state of the art of academic production about pedagogical processes that relate corporeity and dance for babies, this systematic literature review study investigated the potential of the results found in the studies to boost dance in nurseries, as well as the gaps related to the topic. This is a descriptive and bibliographic study, which analyzed 21 works published between 2007 and 2020. We found that there is a growing recognition of the human totality (without overcoming the body and intellect dichotomy), as well as an increase in works that discuss the specificities of babies, especially in studies from the southern region of the country. The studies highlighted the process of changes through which the conceptions of body and Physical Education for babies go and, for the most part, considered them as active subjects who communicate, create culture and discover the world (physical, social and cultural) through the body. In addition, studies have considered dance and the arts as paths to integral human development since babies. We conclude that despite the relationship between corporeity and dance for babies being a topic that has been little studied in the academic-scientific field, the symbolic and humanizing potential of this relationship was considered in the studies, showing that there are spaces for the elaboration of other researches and pedagogical actions with this theme, filling the existing gaps.

Con el objetivo de identificar el estado del arte de la producción académica sobre los procesos pedagógicos que relacionan la corporeidad y la danza para bebés, este estudio de revisión sistemática de la literatura investigó el potencial de los resultados encontrados en los estudios para impulsar la danza en las guarderías, así como los vacíos relacionados con el tema. Se trata de un estudio descriptivo y bibliográfico, que analizó 21 trabajos publicados entre 2007 y 2020. Encontramos que hay un reconocimiento creciente de la totalidad humana (sin superar la dicotomía cuerpo e intelecto), así como un aumento de trabajos que discuten la especificidades de los bebés, especialmente en estudios de la región sur del país. Los estudios destacaron el proceso de cambios por el que pasan las concepciones del cuerpo y la Educación Física de los bebés y, en su mayoría, los consideraron como sujetos activos que se comunican, crean cultura y descubren el mundo (físico, social y cultural) a través del cuerpo. . Además, los estudios han considerado la danza y las artes como caminos para el desarrollo humano integral desde bebés. Concluimos que a pesar de que la relación entre corporeidad y danza para bebés es un tema poco estudiado en el campo académico-científico, el potencial simbólico y humanizador de esta relación fue considerado en los estudios, mostrando que existen espacios para la elaboración de otras investigaciones y acciones pedagógicas con esta temática, llenando los vacíos existentes.

Com o objetivo de identificar o estado da arte da produção acadêmica acerca de processos pedagógicos que relacionem corporeidade e dança para bebês, este estudo de revisão sistemática da literatura investigou as potencialidades dos resultados encontrados nos estudos para impulsionar a dança nos berçários, bem como as lacunas relacionadas ao tema. Trata-se de um estudo de natureza descritiva e bibliográfica, que analisou 21 trabalhos publicados entre os anos de 2007 e 2020. Constatamos que há um reconhecimento crescente da totalidade humana (sem superação da dicotomia corpo e intelecto), assim como o aumento de trabalhos que discutem as especificidades dos bebês, especialmente nos estudos advindos da região Sul do país. Os estudos destacaram o processo de mudanças pelo qual passam as concepções de corpo e de Educação Física para os bebês e, na sua maioria, consideraram-nos como sujeitos ativos que se comunicam, criam cultura e descobrem o mundo (físico, social e cultural) por meio do corpo. Ademais, estudos consideraram a dança e as artes como caminhos para o desenvolvimento humano integral desde os bebês. Concluímos que apesar da relação entre corporeidade e dança para os bebês ser um tema pouco estudado no campo acadêmico-científico, o potencial simbólico e humanizador desta relação foi considerado nos estudos, evidenciando que há espaços para a elaboração de outras pesquisas e ações pedagógicas com este tema, suprindo as lacunas existentes.

https://doi.org/10.1590/SciELOPreprints.4266

13.

Recomendaciones de manejo de los anticoagulantes orales directos (DOACs) anti Xa y anti IIa
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Ceresetto, José M.

; Tajer, Carlos

; Duboscq, Cristina

; Bottaro, Federico

; Casais, Patricia

; Korin, Jorge

; Fondevila, Carlos

; Giumelli, Carla

; Scazziota, Alejandra

; Rossi, Andrea

; Botto, Fernando

; Ariscancela, Maria Ester

; Martinuzzo, Marta

; Zaidel, Ezequiel

; Fitz Maurice, Mario

; Bahit, Cecilia

; Vazquez, Fernando

; Molnar, Soledad

; Saizberg, Simón

; Negri Aranguren, Pedro

; Rosa, Claudio

; Fedele, José Luis

; Comignani, Pablo

; Pombo, Gonzalo

; Raña, Pablo

; Adamczuk, Yolanda

; Martí, Alejandra

; Charask, Adrián

; Penchasky, Diana

; Riveros, Dardo

; Mariani, Javier

; Puente, Dolores

; Celebrin, Lucia

; Bosio, Martín

; Brodsky, Andrés

; Sanchez Lucero, Analía

; Castillo Costa, Yanina

; Hirschson, Alfredo

; Arbesú, Guillermo

; Viñuales, Susana

; Kazelian, Lucía

; Maneyro, Alberto

; Gutierrez, Victoria

; Castro Rios, Miguel

; Gagliardi, Juan

; Lescano, Adrián

; Repetto, Fernanda

Medicina (Buenos Aires)

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apr 2022, Volume 82 Suppl. 2 Pages 1 - 55

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

Abstract Direct oral anticoagulants have emerged as the drugs that have changed the man agement of the antithrombotic treatment in the last 15 years. Their advantages, like a more friendly way of anticoagulation and their lower risk of bleeding, especially in the brain, have positioned these new anticoagu lants as the first drug of choice in the two most frequent indications of anticoagulation, atrial fibrillation, and the venous thromboembolic disease. However, not all the patients can receive these agents, not all the direct oral anticoagulants have the same characteristics, and most importantly, not all the diseases with an indication of an anticoagulant drug can be treated with them. Therefore, it is mandatory that all the faculties involved in the management of these drugs must know them in depth, to decide the best treatment for the patient. This position paper, from a group of experts in anticoagulation in Argentina, can help the general practitioner in the daily use of direct oral anticoagulants based on the new evidence and the experience of a wide group of professionals. The way we relate to the anticoagulant treatment has changed in the last years. The doctors who work with them must also do so.

Resumen Los anticoagulantes orales directos han surgido como una de las herramientas que ha cambiado el manejo de la enfermedad trombótica en los últimos 15 años. Sus ventajas, desde el punto de vista de la facilidad de uso y menor riesgo de sangrado, especialmente de sangrado cerebral, han posicionado a estos nuevos anticoagulantes como la primera alternativa de tratamiento en las dos indicaciones más frecuentes en que necesitamos estas drogas, la fibrilación auricular y la enfermedad tromboembólica venosa. Sin embargo, no todos los pacientes pueden recibir estos agentes, no todos los anticoagulantes directos tienen las mismas pro piedades y fundamentalmente, no todas las enfermedades con indicación de un anticoagulante pueden tratarse con ellos;con lo cual es necesario que todos los profesionales que están involucrados en el manejo de estos medicamentos estén obligados a conocerlos en profundidad, para poder decidir el mejor tratamiento en cada caso particular. Este documento de posición de expertos de diferentes especialidades de Argentina, presenta lineamientos para el uso correcto de los anticoagulantes directos en base a nueva evidencia y a la experiencia de uso de un amplio grupo de profesionales. La forma de relacionarnos con el tratamiento anticoagulante ha cambiado. Los médicos que trabajamos con ellos también debemos hacerlo.

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14.

[SciELO Preprints] - Risk of COVID-19 in frontline healthcare workers and interventions: a systematic review
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Marziale, Maria Helena Palucci Cassenote, Alex Jones Flores Mininel, Vivian Aline Fracarolli, Isabela Fernanda Larios Santos, Heloisa Ehmke Cardoso dos Garcia, Gracielle Pereira Aires Robazzi, Maria Lúcia do Carmo Cruz Rocha, Fernanda Ludmilla Rossi Palha, Pedro Fredemir Terra, Fábio de Souza Ballestero, Jaqueline Garcia de Almeida Fortunato, Maria Alice Barbosa Lima, Marcelo Marques de

Journal Metrics
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Publication date: 2022-03-17

Abstract: En Pt

Objective: to identify the evidence related to the risks of SARS-CoV-2 exposure in healthcare workers and the interventions adopted. Method: systematic literature review in eight scientific databases and three gray literature repositories. Results: 26 studies identified as risk factors: scarcity, inadequate use or reuse of personal equipment; low adherence to precautionary measures; working in intensive care and COVID-19 sectors; long stay in a closed work environment; sharing eating areas without the use of masks and distance; low knowledge and unpreparedness for disease management. 12 studies identified as interventions: health surveillance programs with early detection, diagnosis and early withdrawal; organization of care flows; double triage; telemedicine; limitation of visits; creation of exclusive sectors for care to COVID-19; qualification and training with virtual tools and simulation. Conclusion: besides the risk of infection, individual, psychosocial and organizational factors made the healthcare work environment unsafe. Interventions should be adopted to mitigate the risks and decrease the professionals' morbidity and mortality.

Objetivo: identificar as evidências relacionadas aos riscos de exposição ao SARS-CoV-2 em profissionais de saúde e as intervenções adotadas. Método: revisão sistemática de literatura em oito bases de dados científicas e três repositórios de literatura cinzenta. Resultados: 26 estudos identificaram como fator de risco: escassez, uso inadequado ou reuso de equipamentos individuais; baixa adesão às medidas de precaução; atuação em terapia intensiva e setores COVID-19; longa permanência em ambiente de trabalho fechado; compartilhamento de espaços para alimentação sem uso de máscara e distanciamento; baixo conhecimento e despreparo para atendimento à doença. 12 estudos identificaram como intervenções: programas de vigilância em saúde com detecção precoce, diagnóstico e afastamento precoce; organização de fluxos de atendimento; triagem dupla; telemedicina; limitação de visitas; criação de setores exclusivos para atendimento à COVID-19; capacitações e treinamentos com ferramentas virtuais e simulação. Conclusão: além do risco de infecção, fatores individuais, psicossociais e organizacionais tornaram o ambiente de trabalho em saúde inseguro. Intervenções devem ser adotadas para mitigar os riscos e diminuir a morbimortalidade dos profissionais.

https://doi.org/10.1590/SciELOPreprints.3745

15.

Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life
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Mattiello, Rita

; Kotoski, Aline

; Ayala, Camila Ospina

; Recha, Carine Lucena

; Quiroga, Carolina Villanova

; Machado, Cátia Regina

; Roxo, Cristiano de Oliveira

; Varela, Fernanda Hammes

; Couto, Giovanna Trevisan

; Cassão, Gisele

; Lopes, Jéssica Blatt

; Gonçalves, João Ismael Budelon

; Silva, Juliana Fernandes da

; Barh, Mariana Barth de

; Rocha, Natalie Duran

; Albuquerque, Nathalia Saraiva de

; Corte, Ricardo Arlindo Dalla

; Bernardes, Rossana

; Richter, Samanta Andresa

; Rossi, Tainá

; Santos, Ina S.

Jornal de Pediatria

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feb 2022, Volume 98 N. 1 Pages 39 - 45

Abstract: En | Text: En | PDF: En

Abstract Objective: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. Methods: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question “Would you be willing to try to breastfeed exclusively for the first 6 months?”, in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. Results: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4–19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35–1.98) and in those who intended to smoke 4–7 days/week after delivery (PR, 1.42; 1.11–1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19–0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38–0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. Conclusions: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

https://doi.org/10.1016/j.jped.2021.02.006

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