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Improving breastfeeding among adolescent mothers: a prospective cohort
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Pinho-Pompeu, Maira

; Nakamura, Renan Massao

; Zambrano, Erika

; Surita, Fernanda Garanhani

Sao Paulo Medical Journal

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2024, Volume 142 N. 3 elocation e2022647

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Exclusive breastfeeding is recommended for the first six months, and mother’s age impact early weaning. Educational support and relevant information can increase breastfeeding rates. OBJECTIVE: To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. DESIGN AND SETTING: A prospective cohort study involving primiparous adolescents who gave birth at the Woman’s Hospital (CAISM), Universidade Estadual de Campinas, Brazil. METHODS: Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman’s Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student’s t-test, Mann–Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. RESULTS: The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. CONCLUSION: Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.

https://doi.org/10.1590/1516-3180.2022.0647.r1.260723

Characterizing two models for abortion care in Argentina pre-Law 27.610: 2016–2019
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Atienzo, Erika E.

; Grosso, Belén

; Zurbriggen, Ruth

; Zambrano, David

; Vivas, María

; Keefe-Oates, Brianna

; Gerdts, Caitlin

; Wollum, Alexandra

Revista de Saúde Pública

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2023, Volume 57 elocation 36

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

RESUMEN OBJETIVO Explorar la utilización de dos modelos para la atención al aborto en Argentina en el período 2016–2019: abortos con proveedores de servicios médicos privados proderechos y abortos acompañados (vía autogestión y vía instituciones de salud); y comparar el perfil de quiénes acceden a estos modelos y cuándo. MÉTODOS Utilizamos datos de sistematizaciones de colectivas de acompañamiento en Socorristas en Red y de proveedores de servicios privados. Estimamos tasas anuales de abortos mediante estos servicios y comparamos el perfil de las poblaciones por tipo de servicio y edad gestacional (2019) utilizando estadísticas descriptivas y prueba chi-cuadrado. RESULTADOS En el 2016, 37 personas por cada 100,000 mujeres en edad reproductiva obtuvieron abortos acompañados vía autogestión, aumentando a 111 por 100,000 en 2019, es decir, se triplicó. La tasa de abortos con proveedores fue de 18 por 100,000 en 2016 y de 33 en 2019. Mayor proporción de quienes acudieron con proveedores tenía 30 años o más y mayor proporción de personas acompañadas tenía 19 años o menos; el 11% de quienes obtuvieron abortos acompañados vía autogestión tenía más de 12 semanas de gestación en comparación con el 7% entre quienes tuvieron abortos acompañados vía instituciones de salud y el 0.2% entre quienes abortaron con proveedores. Una mayor proporción de quienes accedieron a abortos acompañados después de 12 semanas de gestación tenía menor nivel educativo, no trabajaban ni tenían cobertura de obra social, y habían tenido más embarazos e intentado interrumpir su embarazo comparando con quienes abortaron acompañadas a las 12 semanas o antes. CONCLUSIONES En Argentina existen modelos de atención que han garantizado el acceso a abortos seguros desde antes de la Ley 27.610. Es importante continuar visibilizando y legitimando estos modelos para que todas las personas que deciden abortar, dentro o fuera de instituciones de salud, tengan experiencias seguras y positivas.

ABSTRACT OBJECTIVE Explore the use of two abortion care models in Argentina over the period 2016–2019: pro-rights private medical service providers and abortion accompaniment (via self-management and via health institutions); and compare the profile of who accesses these models and when. METHODS We used data from accompaniment collectives in the Socorristas en Red and private service providers. We estimated annual abortion rates via these service models and compared the profile of the populations by type of service and gestational age (2019) using descriptive statistics and chi-square tests. RESULTS In 2016, 37 people per 100,000 women of reproductive age obtained accompanied self-managed abortions, and the number increased to 111 per 100,000 in 2019, a threefold increase. The rate of abortions via care providers was 18 per 100,000 in 2016 and 33 in 2019. Higher proportions of those who obtained abortion via care providers were 30 years or older. A higher proportion of those accompanied were 19 years or younger; 11% of those who obtained accompanied self-managed abortions were more than 12 weeks gestation compared with 7% among those who had accompanied abortions via health institutions and 0.2% among those who had abortions with private providers. A higher proportion of those who accessed accompanied abortions after 12 weeks gestation had lower educational levels, did not work or have social security coverage, had more past pregnancies, and attempted to terminate their pregnancies prior to contacting the Socorristas compared to those who had accompanied abortions at 12 weeks or earlier. CONCLUSIONS In Argentina, prior to Law 27.610 models of care guaranteed access to safe abortion. It is important to continue making visible and legitimizing these models of care so that all those who decide to have an abortion, whether inside or outside health institutions, have safe and positive experiences.

https://doi.org/10.11606/s1518-8787.2023057004993

Characterizing two models for abortion care in Argentina pre-Law 27.610: 2016–2019
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Atienzo, Erika E.

; Grosso, Belén

; Zurbriggen, Ruth

; Zambrano, David

; Vivas, María

; Keefe-Oates, Brianna

; Gerdts, Caitlin

; Wollum, Alexandra

Revista de Saúde Pública

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2023, Volume 57 elocation 36

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

https://doi.org/10.11606/s1518-8787.2023057004993

Modelación y simulación computacional de fluido del Piptocoma discolor (pigüe) para la optimización de la combustión en el Ecuador
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González, Juan Elías

; Oliva M, Deny

; Zambrano Vera, David

; Ledesma, Rubén Darío

; Bonilla, Mario Jorge

; Casco G, Erika Clara

; Zúñiga, Édison Ernesto

Enfoque UTE

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jun 2022, Volume 13 N. 2 Pages 48 - 67

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

Abstract Computational modeling and simulation represents a competitive and functional tool that effectively supports the study of thermochemical behavior in combustion optimization, guaranteeing reliable results through modeling, design and allowed the validation of excess thermodynamic properties applied for combustion. of the biomass of Piptocoma discolor (pigüe) from the Amazonian region of Ecuador and Latin America. The model parameters were physical, chemical and thermal through computational fluid dynamics in combustion optimization. And the mathematical model of combustion was obtained under the transport method of the species. In the simulation, the variables of primary air flow and moisture content were observed. The variable of the combustion parameters were N2, O2, CO, H, pressure, temperature, humidity, total energy and burning time of the biomass particles. The geometric configuration was developed according to the fundamental principles of CFD within Ansys Fluent to obtain the behavior of speed, turbulence, pressure, etc. of the composition of the optimal fuel 91.75% of a complete combustion and compared to other species that show 86% of the reactions of the combustion of the species.

Resumen La modelación y simulación computacional representan una herramienta competitiva y funcional que apoya eficazmente al estudio del comportamiento termoquímico en la optimización de la combustión. Garantiza resultados confiables a través de la modelación y diseño, y permitió la validación de las propiedades termodinámicas en exceso aplicados para la combustión de la biomasa del Piptocoma discolor (pigüe) de la región amazónica del Ecuador y América Latina. Los parámetros del modelo fueron físicos, químicos y térmicos a través de los fluidos dinámicos computacionales en optimización de la combustión. Se obtuvo el modelo matemático de la combustión bajo el método de transporte de la especie. En la simulación se consideró las variables del flujo de aire primario, contenido de humedad. Las variables de los parámetros de la combustión fueron N2, O2, CO, H, presión, temperatura, humedad, energía total y tiempo de quemado de las partículas de biomasa. La configuración geométrica fue desarrollada según los principios fundamentales de CFD dentro de Ansys Fluent para obtener el comportamiento de la velocidad, turbulencia, presión, etc. de la composición del combustible óptimo 91.75 % de una combustión completa y frente a otras especies que arrojan el 86 % de las reacciones de la combustión de las especies.

https://doi.org/10.29019/enfoqueute.795 25 downloads

Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
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Bento, Silvana Ferreira

; Borovac-Pinheiro, Anderson

; Tanaka, Erika Zambrano

; Silveira, Carla

; Pacagnella, Rodolfo Carvalho

Revista Brasileira de Ginecologia e Obstetrícia

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sep 2021, Volume 43 N. 9 Pages 648 - 654

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

Resumo Objetivo Identificar como os profissionais de saúde reconhecem precocemente os casos de hemorragia pós-parto e as suas dificuldades. Métodos Realizou-se um estudo exploratório, descritivo, com uma abordagem qualitativa por meio da técnica de entrevista semiestruturada. Por meio de um convite, participaram do estudo 27 profissionais saúde (técnicas de enfermagem, enfermeiras, residentes de Ginecologia e Obstetrícia, e médicos contratados e docentes) que trabalhavam em um hospital de nível terciário de referência no atendimento à saúde da mulher no estado de São Paulo. Depois que os participantes aceitaram o convite, eles assinaram o termo de consentimento livre e esclarecido. Todas as entrevistas foram gravadas, transcritas, e realizou-se uma análise temática. Identificaram-se três categorias de análise: a) percepção da gravidade: “há algo de errado com as mulheres”; b) dificuldades no diagnóstico precoce da hemorragia pós-parto; e c) o processo para melhorar a atenção em obstetrícia. Resultados Os profissionais de saúde acreditavam que o trabalho em equipe e a comunicação deviam ser aperfeiçoados. Além da estimativa visual da perda de sangue, a equipe de enfermagem estava atenta a sintomas comportamentais como irritabilidade, ao passo que o pessoal médico seguia protocolos e procurava sinais objetivos, como sinais vitais alterados. Conclusão Além das avaliações objetivas, as percepções subjetivas dos provedores estão envolvidas no julgamento clínico do diagnóstico de hemorragia pós-parto, e isto deve ser incluído em uma estratégia de diagnóstico mais ampla.

Abstract Objective To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it. Methods An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing tech nicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women’s health care in the State of São Paulo, Brazil, participated in the study through an invitation. After they accepted the invitation, they signed the free and informed consent form. All interviews were recorded and transcribed, and a thematic analysis was conducted. We found three analysis categories: a) perception of the severity: “there is something wrong with the women”; b) difficulties in the early diagnosis of postpartum hemorrhage; and c) the process to improve obstetrical care. Results Caregivers believe teamwork and communication should be improved. Besides the visual estimation of blood loss, the nursing team is attentive to behavioral symptoms like irritability, while the medical staff follow protocols and look for objective signs, such as altered vital signs. Conclusion Besides the objective evaluations, the subjective perceptions of the providers are involved in the clinical judgement regarding the diagnosis of postpartum hemorrhage, and this should be included in a broader diagnosis strategy.

https://doi.org/10.1055/s-0041-1733997

Buenas prácticas en la atención prenatal a adolescentes embarazadas: perspectivas de profesionales de la salud
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del Risco-Sánchez, Odette

; Zambrano-Tanaka, Erika

; Guerrero-Borrego, Natividad

; Surita, Fernanda

Revista Colombiana de Obstetricia y Ginecología

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sep 2021, Volume 72 N. 3 Pages 244 - 257

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

RESUMEN Objetivo: sistematizar buenas prácticas de atención prenatal en un servicio de referencia para adolescentes embarazadas en Campinas, São Paulo, Brasil, desde la perspectiva de profesionales de la salud. Materiales y métodos: estudio cualitativo desarrollado entre junio y julio de 2017, se emplearon entrevistas semiestructuradas y se realizó un grupo focal con 10 profesionales de la salud que prestaban atención a adolescentes embarazadas en una unidad hospitalaria del sistema público de la región de Campinas, São Paulo, Brasil. Los datos fueron examinados mediante la técnica de análisis de contenido temático de donde surgieron nuevas categorías de análisis. Se hizo validación a través de triangulación de los resultados. Se identificó la aplicabilidad teórica y práctica de los principales hallazgos. Resultados: fueron elaboradas tres categorías emergentes del discurso de los profesionales y de las evidencias en la literatura: 1) análisis integral de las adolescentes en situación de embarazo; 2) experiencias profesionales en la atención a las adolescentes embarazadas que evidencian calidad en el servicio; 3) fortalezas y oportunidades del servicio con posibilidades de replicación como modelo asistencial. Son consideradas buenas prácticas durante el cuidado prenatal aquellas que priorizan la atención integral a las adolescentes embarazadas; estas son coordinadas por un equipo multidisciplinario, y consiguen tener un abordaje multidimensional, sobre todo, valorando la complejidad que supone la maternidad en la adolescencia. Conclusión: dentro de los servicios de salud sexual y reproductiva es recomendable el desarrollo de estrategias educativas, el fortalecimiento de la atención en grupos y la inclusión de la red de apoyo de las adolescentes en la atención, con el fin de favorecer una experiencia positiva durante el cuidado prenatal cuando el proceso de volverse madre acontece durante la adolescencia.

ABSTRACT Objective: To systematize good prenatal care practices in a referral center for pregnant teenagers in Campinas, São Paulo, Brazil, from the perspective of healthcare professionals. Material and methods: Qualitative study conducted between June and July 2017 using semi-structured interviews and a focus group with 10 healthcare professionals providing care to pregnant teenagers in a public hospital in the region of Campinas, São Paulo, Brazil. Data were examined using the thematic content analysis technique, which gave rise to new analytical categories. Triangulation of the results was used for validation. The theoretical and practical applicability of the main findings was identified. Results: The study looked into three categories arising from the discourse of the professionals and the evidence found in the literature: 1) comprehensive analysis of pregnant teenagers; 2) professional experiences related to the care of pregnant teenagers reflecting service quality; and 3) strengths and improvement opportunities potentially replicable as a care model. Good practices in prenatal care are those which prioritize comprehensive care for pregnant teenagers, are coordinated by a multidisciplinary team and result in a multidimensional approach, valuing the complexity of motherhood in the teenage years. Conclusion: It is advisable to develop education strategies, strengthen group care and involve the teenager's support network as part of sexual and reproductive health services in order to promote a positive experience during prenatal care when the process of becoming a mother takes place during adolescence.

RESUMO Objetivo Sistematizar as boas práticas de atenção pré-natal em um serviço de referência para adolescentes grávidas em Campinas, São Paulo/Brasil desde a perspectiva dos professionais da saúde. Materiais e métodos: Estudo qualitativo desenvolvido entre junho e julho de 2017. Empregaram-se entrevistas semiestruturadas e grupo focal com 10 profissionais da saúde que prestavam atendimento à adolescentes grávidas em uma unidade hospitalar da rede pública da região de Campinas, São Paulo/Brasil. Os dados foram analisados por meio da técnica de análise de conteúdo temática onde surgiram as categorias de análise. Realizou-se validação através de triangulação dos resultados e foi identificada a aplicabilidade teórica e prática dos principais achados. Resultados: Foram elaboradas três categorias emergentes do discurso dos professionais e das evidências na literatura: 1) análise compreensiva das adolescentes em situação de gravidez; 2) vivências profissionais no cuidado de adolescentes grávidas que mostram a qualidade no atendimento; 3) potencialidades e oportunidades do serviço com possibilidades de replicação como modelo assistencial. No atendimento pré-natal, são consideradas como boas práticas aquelas que priorizam a atenção integral à gestante adolescente; as que são coordenadas por uma equipe multidisciplinar e conseguem ter uma abordagem multidimensional, sobretudo, avaliando a complexidade que supõe a maternidade durante a adolescência. Conclusões: Dentro dos serviços de saúde sexual e reprodutiva, é recomendável o desenvolvimento de estratégias educativas, o fortalecimento da atenção em grupos e a inclusão da rede de apoio das adolescentes na atenção para favorecer uma experiência positiva durante o cuidado pré-natal levando em consideração o processo de tornar-se mãe durante a adolescência.

https://doi.org/10.18597/rcog.3695 252 downloads

Tuberculosis Meníngea En Un Paciente Pediátrico: Reporte De Un Caso Clínico
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Yánez-Lema, Gilda

; Toapanta-Guayta, Byron

; Ramírez-Jaramillo, Erika

; Zambrano-Leal, Mildred

Revista Ecuatoriana de Neurología

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jul 2021, Volume 30 N. 1 Pages 218 - 222

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

Abstract Tuberculosis is a global public health problem. In pediatric ages it represents between 3% and 40% of the total disease. In countries with high incidence, such as Ecuador, the presence of cases of childhood tuberculosis always indicates the circulation of Mycobacterium tuberculosis or contact with an untreated patient or undiagnosed. In our country there is a high percentage of underdiagnosis of childhood tuberculosis and a lower burden than expected, mainly in children under 5 years of age. Meningeal tuberculosis is the most serious form of presentation of infection by M. tuberculosis in pediatric age since it causes many deaths and disability. The diagnosis of tuberculous meningitis is achieved considering epidemiological criteria, laboratory studies in blood, cerebrospinal fluid, and neuroimaging. Early treatment improves the prognosis, but the problem lies in making an early diagnosis, since it has different forms of clinical presentation ranging from nonspecific symptoms to severe neurological involvement.

Resumen La tuberculosis constituye un problema mundial de salud pública. En edades pediátricas representa entre el 3% y el 40% del total de la enfermedad. En países con alta incidencia, como Ecuador, la presencia de casos de tuberculosis infantil siempre indica la circulación de Mycobacterium tuberculosis o el contacto con un enfermo no tratado o no diagnosticado. En nuestro país se presenta un alto porcentaje de subdiagnóstico de tuberculosis infantil y una carga menor a la esperada, principalmente en menores de 5 años. La tuberculosis meníngea es la forma más grave de presentación de infección por M. Tuberculosis en la edad pediátrica, ya que ocasiona una gran parte de muertes y discapacidad. El diagnóstico de la meningitis tuberculosa se logra teniendo en cuenta criterios epidemiológicos, estudios de laboratorio en sangre, líquido cefalorraquídeo y neuroimágenes. El tratamiento temprano mejora el pronóstico, pero el problema radica en hacer el diagnóstico temprano, ya que tiene diferentes formas de presentación clínica que van desde síntomas inespecíficos hasta afectación neurológica grave

https://doi.org/10.46997/revecuatneurol30100218 312 downloads

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con Enfermedad Renal Crónica en diálisis
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Yomayusa González, Nancy

; Yama, Erika

; González, Camilo

; Ariza, Amaury

; Aroca, Gustavo

; Baquero, Richard

; Rico, Jorge

; Vargas, Juan Guillermo

; Ramirez, Roberto

; Chacón, Kelly

; Robayo, Adriana

; Peña Wilches, Adalberto

; Meza, Adriana

; Bunch, Alfonso

; Mercado, Alvaro

; Calderón, Angélica

; Wancjer, Benjamín

; Zambrano, Betty

; Lozano, Carlos

; Buitrago, Cristóbal

; Ballesteros, David

; Chacón, Diana

; Vargas, Diana

; Villafañe, Douglas

; López, Francisco

; Pinzón, Freddy

; Guerrero, Gustavo

; Cárdenas, Héctor

; Benavides, Helman

; Villanueva, Ignacio

; Raoch, Ingrid

; Cáceres, Jimena

; Coronado, Jorge

; Pulido, Jorge

; Contreras, Kateir

; Valderrama Cometa, Luis Alfonso

; Gómez, María

; Vargas Brochero, María José

; Carrascal, Martha

; Rodríguez, Martha

; Guerrero, Mauricio

; Alfaro Tejeda, Mercedes

; Tobón, Natalia

; Rodríguez, Paula

; Gómez, Rafael

; Daza, Rodrigo

; Torres, Rodolfo

; Espitaleta, Zilac

; Burgos, Álvaro

Revista Colombiana de Nefrología

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dec 2020, Volume 7 Suppl. 2 Pages 119 - 159

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

Resumen Introducción: Las personas con diálisis de mantenimiento se consideran una población en alto riesgo de infección por SARS-CoV-2, complicaciones y muerte. La periodicidad de la diálisis, la organización y la demanda en las unidades de diálisis y las limitaciones de alfabetización en salud poblacional limitan el cumplimiento del aislamiento y el distanciamiento social. Objetivo: Desarrollar, mediante un consenso de expertos, recomendaciones informadas en evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Materiales y métodos: Se realizó una revisión rápida de literatura en Pubmed, Embase y sociedades científicas. La calidad de evidencia fue evaluada según el tipo de estudio incluido. El acuerdo se definió para cada recomendación con umbral de al menos 70% de aprobación. La fuerza de las recomendaciones fue graduada como fuerte o débil. Resultados: El colectivo fue consultado entre el 17 y 19 de mayo de 2020. Se obtuvo respuesta de 44 expertos clínicos que declararon conflicto de interés previo a la consulta. El acuerdo de las recomendaciones estuvo entre 70,5 y 100%. Se presentan las recomendaciones de un colectivo experto para la prevención, el diagnóstico y el manejo de infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Conclusión: Debido a la reciente aparición de la infección por SARS-CoV-2 y las incertidumbres respecto a la prevención, el diagnóstico y el manejo, las recomendaciones presentadas se conciben como un estándar colombiano que permita garantizar un cuidado centrado en las personas con enfermedad renal crónica y la protección de los profesionales de la salud.

Abstract Introduction: People with chronic dialysis are considered a population at high risk of SARS CoV2 infection and its derived complications and death. The need to go to strict dialysis schedules, the high demand in the kidney facilities and the difficulties derived from the time and space organization in the rooms in the face to the pandemic added to the difficult learning, teaching and adapting new protocols manifest the needed of standard recommendation according to this problem in people who couldn't have an ideal isolation. Objective: Develop through an expert consensus, evidence-informed recommendations for the prevention, diagnosis, and management of SARS-CoV-2/COVID-19 infection in patients with chronic kidney disease on Dialysis. Materials and methods: We carried out a quick literature review, PubMed, Embase and scientific societies were consulted. The quality of the evidence was considered according to the type of study included. The agreement threshold defined for each recommendation was > 70% approval among experts. The strength of the recommendations was rated as strong or weak. Results: Between May 17 and 19, 2020, was conformed a team of 44 clinical experts who declared their interest conflict prior to the consultation. The agreement of the recommendations was between 70.5% and 100%. The recommendations were separated in prevention, early identification, and diagnostic, isolation in hemodialysis facilities and peritoneal dialysis, and team protection. Ethical considerations also were included. Conclusion: Due to the recent appearance of SARS-CoV-2 infection and the uncertainties regarding prevention, diagnosis and management, the recommendations presented are conceived as a Colombian standard that allows guaranteeing focused care for people with chronic kidney disease and the protection of health team.

https://doi.org/10.22265/acnef.7.supl.2.474 347 downloads

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la lesión renal aguda por SARS-CoV-2/COVID-19
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González, Camilo

; Yama, Erika

; Yomayusa, Nancy

; Vargas, Juan

; Rico, Jorge

; Ariza, Amaury

; Aroca, Gustavo

; Baquero, Richard

; Ramírez, Roberto

; Chacón, Kelly

; Torres, Rodolfo

; Robayo, Adriana

; Peña, Adalberto

; Meza, Adriana

; Molano, Alejandra

; Lizarazo, Alexandra

; Caicedo, Andrea

; Acevedo, Andrés

; Calderón, Angélica

; Zambrano, Betty

; Musso, Carlos Guido

; Lozano, Carlos

; Buitrago, Cristóbal

; Ballesteros, David

; Chacón, Diana

; Vargas, Diana

; Gayón, Diana

; Villafañe, Douglas

; López, Francisco

; Ardila, Freddy

; Pinzón, Guillermo

; Guerrero, Gustavo

; Benavides, Helman

; Villanueva, Ignacio

; Raoch, Ingrid

; Galeano, Javier

; Gordon, Jennifer

; Cáceres, Jimena

; Pulido, Jorge

; Pérez, Jorge

; Contreras, Kateir

; Aristizábal, Leidy

; Valderrama, Luis

; Gómez, María

; Vargas, María José

; Carrascal, Martha

; Rodríguez, Martha

; Guerrero, Mauricio

; Alfaro, Mercedes

; Tobón, Natalia

; García, Paola

; Rodríguez, Paula

; Daza, Rodrigo

; Espitaleta, Zilac

Revista Colombiana de Nefrología

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dec 2020, Volume 7 Suppl. 2 Pages 89 - 117

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

resumen está disponible en el texto completo

Abstract Introduction: Acute kidney injury is a frequent complication in patients with COVID-19 and its occurrence is a potential indicator of multi-organ dysfunction and disease severity. Objective: Develop, through an expert consensus, evidence-based recommendations for the prevention, diagnosis, and management of acute kidney injury in patients with SARS CoV2 / COVID-19 infection. Materials and methods: Based on a rapid systematic review in Embase and Pubmed databases and documents from scientific societies, we made preliminary recommendations and consulted with an expert group through an online tool. Then we defined agreement after at least 70 % consensus approval. Quality evidence was evaluated according to the type of document included. The strength of the recommendations was graded as strong or weak. Results: Fifty clinical experts declared their conflict of interest; the consultation took place between May 2 and 29, 2020. The range of agreement ranged from 75.5 % to 100 %. Recommendations for prevention, diagnosis and management of acute kidney injury in patients with SARS CoV2 infection are presented. Conclusions: Although the good quality information available regarding acute kidney injury in patients with COVID-19 is scarce, the recommendations of clinical experts will guide clinical decision-making and strategies around patients with this complication, guaranteeing care focused on the people, with high quality standards, and the generation of safety, health and wellness policies for multidisciplinary care teams.

https://doi.org/10.22265/acnef.7.supl.2.73 434 downloads

10.

DIFICULDADES DA ASSISTÊNCIA AO PARTO DOMICILIAR NA ÓTICA DE ENFERMEIRAS OBSTETRAS
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Pascoto, Gabriela dos Santos

; Tanaka, Erika Zambrano

; Fernandes, Luciane Cristina Rodrigues

; Shimo, Antonieta Keiko Kakuda

; Sanfelice, Clara Fróes de Oliveira

Revista Baiana de Enfermagem

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2020, Volume 34 elocation e36633

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

Objective: to investigate the difficulties encountered by obstetric nurses who are working in home birth care. Method: descriptive study, with qualitative approach. Data collection was performed through a semi-structured interview with nine obstetric nurses who had been attending home births for more than one year. The data were analyzed according to Content Analysis. Results: the statements gave rise to three categories that revealed difficulties related to: scarcity of information about home birth; transfer from home to hospital and gaps in the work process. Conclusion: obstetric nurses faced social and practical difficulties that weakened and hindered home birth care. These difficulties seem to be related to the lack of regulation of this model of delivery care in the country's public health policies.

Objetivo: investigar las dificultades encontradas por las enfermeras obstétricas que trabajan en la asistencia al parto domiciliario. Método: estudio descriptivo y de enfoque cualitativo. La recolección de datos se realizó a través de una entrevista semiestructurada con nueve enfermeras obstétricas que realizaban partos domiciliarios durante más de un año. Los datos se analizaron de acuerdo con el Análisis de Contenido. Resultados: de las declaraciones, surgieron tres categorías que revelaron dificultades relacionadas con: escasez de información sobre el parto domiciliario; transferencia de casa al hospital y lagunas en el proceso de trabajo. Conclusión: las enfermeras obstétricas encontraron dificultades sociales y prácticas que debilitaron y obstaculizaron la atención al parto domiciliario. Estas dificultades parecen estar relacionadas con la falta de regulación de este modelo de atención de la prestación en las políticas de salud pública del país.

Objetivo: investigar as dificuldades encontradas pelas enfermeiras obstetras que estão atuando na assistência ao parto domiciliar. Método: estudo descritivo e de abordagem qualitativa. A coleta de dados foi realizada por meio de uma entrevista semiestruturada com nove enfermeiras obstetras que atendiam partos domiciliares há mais de um ano. Os dados foram analisados segundo a Análise de Conteúdo. Resultados: os depoimentos deram origem a três categorias que revelaram dificuldades relacionadas à: escassez de informações sobre o parto domiciliar; transferência do domicílio para o hospital; e lacunas do processo de trabalho. Conclusão: as enfermeiras obstetras enfrentavam dificuldades de ordem social e prática que fragilizavam e dificultavam a assistência ao parto domiciliar. Estas dificuldades parecem estar relacionadas à falta de regulamentação desse modelo de atenção ao parto nas políticas públicas de saúde do país.

https://doi.org/10.18471/rbe.v34.36633 479 downloads

11.

Validation of an Instrument to guide Nursing Staffing in Obstetric Rooming in
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Dini, Ariane Polidoro

; Damasceno, Vanessa Farias

; Oliveira, Henrique Ceretta

; Tanaka, Erika Zambrano

; Padilha, Kátia Melissa

; Gasparino, Renata Cristina

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 4 elocation e20190159

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

ABSTRACT Objectives: to construct and validate an instrument for the classification of mother-baby binomials that subsidizes personnel Staffing in in-rooming units. Method: methodological study. The construction was based on theoretical and legal references. Content validity was performed by experts through the content validity index measurement. Then, the instrument was applied to a sample of 122 binomials, and exploratory factor analysis was performed using the principal components analysis. Results: the instrument consisted of seven care indicators: Birth route; Maternal morbidity; Neonatal morbidity; Breastfeeding; Social aggravating factors; Care guidance; and interaction and bonding. All with content validity index of 1. The construct was composed of 3 domains, with Cronbach’s alpha of 0.62, 0.85 and 0.89. Conclusions: the classification instrument of mother-baby binomials allows the classification of mother-baby binomials and may support personnel Staffing in in-rooming units.

RESUMEN Objetivos: elaborar y validar un instrumento para clasificación de binomios puerperio neonatal que subsidie el dimensionamiento de personal en unidades de alojamiento conjunto. Métodos: estudio metodológico. La construcción ha sido basada en referencias teóricas y legales. La validez de contenido ha sido realizada por expertos por medio de medición del índice de validez de contenido. Luego, el instrumento ha sido aplicado en una muestra de 122 binomios, y ha sido realizado análisis factorial exploratoria por el método de componentes principales. Resultados: el instrumento ha quedó constituido por siete indicadores de cuidado: Vía de parto; Morbilidad materna; Morbilidad neonatal; Amamantamiento; Agravantes sociales; Orientación de cuidados; e Interacción y vínculo. Todos con índice de validez de contenido iguales a 1. El constructo ha sido compuesto por 3 dominios, con Alfa de Cronbach de 0,62, 0,85 y 0,89. Conclusiones: el instrumento para la clasificación de binomios puerperio neonatal permite la clasificación de binomios puerperio neonatal y podrá basarse el dimensionamiento de personal en alojamiento conjunto.

RESUMO Objetivos: construir e validar um instrumento para classificação de binômios puérpera-neonato que subsidie o dimensionamento de pessoal em unidades de alojamento conjunto. Métodos: estudo metodológico. A construção foi embasada em referenciais teóricos e legais. A validade de conteúdo foi realizada por expertos por meio de mensuração do índice de validade de conteúdo. Em seguida, o instrumento foi aplicado em uma amostra de 122 binômios, e foi realizada análise fatorial exploratória pelo método de componentes principais. Resultados: o instrumento ficou constituído por sete indicadores de cuidado: Via de parto; Morbidade materna; Morbidade neonatal; Aleitamento; Agravantes sociais; Orientação de cuidados; e Interação e vínculo. Todos com índice de validade de conteúdo iguais a 1. O constructo foi composto por 3 domínios, com Alfa de Cronbach de 0,62, 0,85 e 0,89. Conclusões: o instrumento para a classificação de binômios puérpera-neonato permite a classificação de binômios puérpera-neonato e poderá embasar o dimensionamento de pessoal em alojamento conjunto.

https://doi.org/10.1590/0034-7167-2019-0159 91 downloads

12.

El perfil de usuarios de benzodiazepinas en servicios de atención primaria de la salud de la ciudad de Chapecó, Santa Catarina, Brasil
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Friestino, Jane Kelly Oliveira

; Luzardo, Adriana Remião

; Gralak, Érika Zachi

; Gass, Letícia Scherer

; Guimarães, Patrícia Gonçalves Zambrano

; Barbato, Paulo Roberto

Salud Colectiva

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2020, Volume 16 elocation e2495

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

ABSTRACT Primary Health Care is a transversal point in the Psychosocial Care Network, responsible for attending to demands related to mental suffering. Although medication represents the main treatment option, the prolonged use of benzodiazepines may lead to tolerance and consequent dependence. The objective of this study is to analyze the frequency and characteristics of benzodiazepine users attending primary healthcare services, through a cross-sectional study conducted in Chapecó, Santa Catarina, a municipality in southern Brazil. Higher proportional prescription was observed in adult and elderly women, with predominance among individuals who were women (80%), white (67.9%), and married (50.7%), with a median age of 56 years. These findings suggest a need to plan and implement changes in the procedures for prescribing and administering benzodiazepines.

RESUMEN La atención primaria de la salud es un punto transversal dentro de la Red de Atención Psicosocial, y atiende las demandas relacionadas con el sufrimiento mental. Si bien los medicamentos representan la principal opción de tratamiento, el uso prolongado de benzodiazepinas puede desarrollar tolerancia y dependencia. El objetivo es analizar la frecuencia y las características de los usuarios de benzodiazepinas en los servicios de atención primaria de la salud, a través de un estudio transversal realizado en la ciudad de Chapecó, estado de Santa Catarina, un municipio del sur de Brasil. Se verificó un elevado número de prescripciones proporcionales entre mujeres, adultos y ancianos y un predominio de personas de sexo femenino (80%), color de piel blanca (67,9%), casadas (50,7%), con una media de edad de 56 años, que señala la necesidad de diseñar e implementar cambios en los procedimientos de prescripción y dispendio de benzodiazepinas.

https://doi.org/10.18294/sc.2020.2495

13.

El perfil de usuarios de benzodiazepinas en servicios de atención primaria de la salud de la ciudad de Chapecó, Santa Catarina, Brasil
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Friestino, Jane Kelly Oliveira

; Luzardo, Adriana Remião

; Gralak, Érika Zachi

; Gass, Letícia Scherer

; Guimarães, Patrícia Gonçalves Zambrano

; Barbato, Paulo Roberto

Salud colectiva

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2020, Volume 16 elocation e2495

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

https://doi.org/10.18294/sc.2020.2495 136 downloads

14.

Validation of an Instrument to guide Nursing Staffing in Obstetric Rooming in
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Dini, Ariane Polidoro

; Damasceno, Vanessa Farias

; Oliveira, Henrique Ceretta

; Tanaka, Erika Zambrano

; Padilha, Kátia Melissa

; Gasparino, Renata Cristina

Revista Brasileira de Enfermagem

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2020, Volume 73 N. 4 elocation e20190159

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

https://doi.org/10.1590/0034-7167-2019-0159 1284 downloads

15.

Knowledge of Pregnant Adolescents about Human Papillomavirus
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Tanaka, Erika Zambrano

; Kamizaki, Sílvia Souza

; Quintana, Silvana Maria

; Pacagnella, Rodolfo de Carvalho

; Surita, Fernanda Garanhani

Revista Brasileira de Ginecologia e Obstetrícia

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may 2019, Volume 41 N. 5 Pages 291 - 297

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

Resumo Objetivo Avaliar o nível de informação que as adolescentes gestantes possuem em relação ao papilomavírus humano (HPV). Métodos Estudo descritivo desenvolvido no ambulatório pré-natal adolescente de um hospital terciário do estado de São Paulo, Brasil. Os dados foram coletados entre junho e dezembro de 2017, após a aprovação do comitê de ética e pesquisa (CAAE: 1.887.892/2017). A amostra foi composta por adolescentes gestantes com ≤18 anos que frequentaram o ambulatório. Foram excluídas as com transtorno psiquiátrico diagnosticado e as portadoras de deficiência auditiva ou de cognição. Após aceitarem participar do presente estudo, as adolescentes grávidas assinaram o termo de assentimento e consentimento livre e esclarecido. Para as análises estatísticas, foramutilizados os testes de qui-quadrado e exato de Fisher. Resultados Em relação ao conhecimento sobre o HPV, 123 (80,92%) já tinham ouvido falar sobre o assunto; destas adolescentes, 77 (50,66%) receberam as informações que tinham através de suas escolas, e 101 (66,45%) pacientes não sabiam como poderiam contrair o vírus. A variação da idade das adolescentes entrevistadas não influenciou se estas sabiam ou não como se prevenir contra o HPV (p = 0,2562). A variável vacina está associada à prevenção contra o HPV (p < 0,0001). Conclusão As gestantes avaliadas possuem conhecimento sobre o HPV, mas não fazem a prevenção adequada, visto que um pouco mais da metade se vacinaram, não relataram o preservativo e a vacina como métodos eficazes de prevenção, e não relacionaram o HPV com o câncer de colo de útero.

Abstract Objective To evaluate the level of information possessed by pregnant adolescents regarding the human papillomavirus (HPV). Methods Descriptive study developed in the adolescent prenatal outpatient clinic of a tertiary hospital fromthe state of São Paulo, Brazil. Data were collected between June and December 2017 following approval from the ethics and research committee (CAAE: 1.887.892/2017). Pregnant adolescents, ≤18 years old, who attended the abovementioned outpatient section, composed the sample. Those diagnosed with a psychiatric disorder and those with hearing or cognitive disabilities were excluded. After acceptance to participate in the present study, the pregnant adolescents signed an Informed Consent Form. Regarding the statistical analysis, the chi-squared test and the Fisher exact test were used. Results Regarding the knowledge about HPV, 123 (80.92%) of the participants had already heard about the subject; for 77 (50.66%), their schools had been the source of the information; 101 (66.45%) did not know how they could be infected by the virus. Age variation did not influence their knowledge on how to prevent themselves from HPV (p = 0.2562). The variable vaccine is associated with HPV prevention (p < 0.0001). Conclusion The pregnant adolescents composing the sample have shown to have knowledge about HPV. However, they do not prevent themselves from it appropriately, given that little more than half of the sample was vaccinated, had not reported an understanding that the use of preservatives and vaccination are effective means of prevention, and did not correlate HPV with uterine cervical cancer.

https://doi.org/10.1055/s-0039-1688708 1384 downloads

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