Pesquisa | SciELO

Abstract Objective To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020. Methods This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation. Results Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p <0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p <0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p <0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p <0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p <0.001). Children aged 2-4y old had the best QoLscores. Conclusions Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.

https://doi.org/10.1016/j.jped.2023.07.006

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

; Klever, Emanuele König

; Rocha, Jacqueline Castro da

; Silva, Gabriela de Oliveira Laguna

; Amorim, Jerusa da Rocha de

; Dode, Andressa Dutra

; Simionato, Bárbara Marina

; Cunha, Luciane Gomes da

; Zaupa, Ana Paula Berni

; Krauzer, João Ronaldo Mafalda

; Pires, Aristóteles de Almeida

; Cabral, Felipe Cezar

; Moreira, Tais de Campos

; Constant, Hilda Maria Rodrigues Moleda

Critical Care Science

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Set 2023, Volume 35 Nº 3 Páginas 266 - 272

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

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

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

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

The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Araujo, Cintia Laura Pereira de

; Barbosa, Alexandre Naime

; Belli, Karlyse Claudino

; Colpani, Verônica

; Dal-Pizzol, Felipe

; Silva, Rosemeri Maurici da

; Azevedo, Luciano César Pontes de

; Dias, Maria Beatriz Souza

; Amaral, José Luiz Gomes do

; Dorneles, Gilson Pires

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Machado, Flávia Ribeiro

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Parahiba, Suena Medeiros

; Rosa, Regis Goulart

; Santos, Vania Cristina Canuto

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Stein, Cinara

; Carvalho, Carlos Roberto Ribeiro de

Critical Care Science

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Set 2023, Volume 35 Nº 3 Páginas 243 - 255

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Multimorbidity of chronic noncommunicable diseases: Data from the Brazilian National Health Survey
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Perroni Pires, Maiara

; Moreira, Caroline Camila

; de Souza Andrade, Amanda Cristina

; Melo Rodrigues, Paulo Rogério

; Muraro, Ana Paula

; Gronau Luz, Verônica

; Ferraz Moreira, Naiara

Revista chilena de nutrición

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Fev 2023, Volume 50 Nº 1 Páginas 7 - 19

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Objetivo: Estimar la prevalencia de simultaneidad de obesidad, hipertensión y/o diabetes y la asociación con variables sociodemográficas y relacionadas con el estilo de vida. Métodos: Los datos fueron obtenido en la Encuesta Nacional de Salud Brasileña, una encuesta a nivel nacional, realizada en los hogares brasileños y llevada a cabo en 2013. La presencia de dos /tres enfermedades (obesidad, hipertensión y diabetes) se consideró multimorbilidad de las enfermedades no transmisibles (ENT). El modelo de regresión logística de probabilidades proporcionales, estratificado por sexo, se utilizó para evaluar los factores sociodemográficos y de estilo de vida asociados con la multimorbilidad de las ENT, considerando la complejidad de la muestra y los pesos de la muestra. Resultados: La prevalencia de multimorbilidad de las ENT fue del 9,6%. Las probabilidades de multimorbilidad son más altas con el aumento de la edad, entre los negros, pero más bajas en la región norte en comparación con otras regiones del país para los dos sexos. Las probabilidades de multimorbilidad de las ENT aumentaron entre las mujeres que tenían niveles más bajos de educación y pasaban más tiempo viendo la televisión, y entre los hombres que vivían con una pareja y no practicaban la actividad física recomendada para el tiempo libre. Conclusión: Los factores sociodemográficos y los comportamientos relacionados con el estilo de vida se asociaron con la presencia de obesidad, hipertensión y/o diabetes.

ABSTRACT Objective: To estimate the prevalence of simultaneity of obesity, hypertension and/or diabetes and the association with sociodemographic and lifestyle-related behavior variables. Methods: This is a cross-sectional study with data from the 2013 National Health Survey. The presence of two/three diseases (obesity, hypertension, and diabetes) was considered multimorbidity of noncommunicable diseases (NCDs). Proportional odds logistic regression model, stratified by sex, was used to assess the sociodemographic and lifestyle factors associated with multimorbidity of NCDs, considering the sample complexity and sample weights. Results: The prevalence of multimorbidity of NCDs was 9.6%. The odds of multimorbidity are higher with increasing age, among blacks, but lower in the north region when compared with other regions of the country for both sexes. The odds of multimorbidity of NDCs increased among women who had lower levels of education and spent more time TV watching, and among men who lived with a partner and did not practice the recommended leisure-time physical activity. Conclusion: Sociodemographic factors and lifestyle-related behaviors were associated with the presence of obesity, hypertension, and/or diabetes.

Hipertensão em mulheres presas no Brasil: muito além do biológico
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Silva, Paula Negrão da

; Kendall, Carl

; Silva, Ana Zaira da

; Mota, Rosa Maria Salani

; Araújo, Larissa Fortunato

; Pires Neto, Roberto da Justa

; Leal Júnior, Francisco Marto Pinheiro

; Macena, Raimunda Hermelinda Maia

; Kerr, Ligia Regina Franco Sansigolo

Ciência & Saúde Coletiva

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Jan 2023, Volume 28 Nº 1 Páginas 37 - 48

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto e estavam obesas, também foram associadas de forma independente com maior prevalência de HA. O maior número de pessoas com que a presa divide cela esteve associado à maior prevalência de há, sem uma relação dose-resposta. Conclui-se que idade, etnia/cor, obesidade, inatividade física e estresse são fatores de risco para HA em mulheres presas.

Abstract The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

https://doi.org/10.1590/1413-81232023281.10672022

Hipertensão em mulheres presas no Brasil: muito além do biológico
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Silva, Paula Negrão da

; Kendall, Carl

; Silva, Ana Zaira da

; Mota, Rosa Maria Salani

; Araújo, Larissa Fortunato

; Pires Neto, Roberto da Justa

; Leal Júnior, Francisco Marto Pinheiro

; Macena, Raimunda Hermelinda Maia

; Kerr, Ligia Regina Franco Sansigolo

Ciência & Saúde Coletiva

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Jan 2023, Volume 28 Nº 1 Páginas 37 - 48

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232023281.10672022

ELMO CPAP: an innovative type of ventilatory support for COVID-19-related acute respiratory distress syndrome
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Beliero, Andréa Mazza

; Lázaro, Ana Paula Pires

; Zaranza, Marza de Sousa

; Lima, Giovanna Mazza Cruz

; Guimarães, Álvaro Rolim

; Aragão, Nilcyeli Linhares

; Meneses, Gdayllon Cavalcante

; Holanda, Marcelo Alcantara

; Albuquerque, Polianna Lemos Moura Moreira

; Silva Júnior, Geraldo Bezerra da

; Fernandes, Paula Frassinetti Castelo Branco Camurça

Jornal Brasileiro de Pneumologia

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2023, Volume 49 Nº 6 elocation e20230227

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To assess whether the use of ELMO, a helmet for noninvasive ventilation created in Brazil, had a positive impact on the prognosis of patients with hypoxemic respiratory failure caused by severe COVID-19. Methods: This is a retrospective study of 50 critically ill COVID-19 patients. Epidemiological, clinical, and laboratory data were collected on ICU admission, as well as before, during, and after ELMO use. Patients were divided into two groups (success and failure) according to the outcome. Results: ELMO use improved oxygenation parameters such as Pao2, Fio2, and the Pao2/Fio2 ratio, and this contributed to a gradual reduction in Fio2, without an increase in CO2, as determined by arterial blood gas analysis. Patients in the success group had significantly longer survival (p < 0.001), as determined by the Kaplan-Meier analysis, less need for intubation (p < 0.001), fewer days of hospitalization, and a lower incidence of acute kidney injury in comparison with those in the failure group. Conclusions: The significant improvement in oxygenation parameters, the longer survival, as reflected by the reduced need for intubation and by the mortality rate, and the absence of acute kidney injury suggest that the ELMO CPAP system is a promising tool for treating ARDS and similar clinical conditions.

RESUMO Objetivo: Avaliar se o uso do ELMO, um capacete para ventilação não invasiva criado no Brasil, teve impacto positivo no prognóstico de pacientes com insuficiência respiratória hipoxêmica por COVID-19 grave. Métodos: Estudo retrospectivo com 50 pacientes críticos com COVID-19. Dados epidemiológicos, clínicos e laboratoriais foram coletados na admissão na UTI e antes, durante e após o uso do ELMO. Os pacientes foram divididos em dois grupos (sucesso e falha) de acordo com o desfecho. Resultados: O uso do ELMO melhorou parâmetros de oxigenação como Pao2, Fio2 e relação Pao2/Fio2, e isso contribuiu para uma redução gradual da Fio2, sem aumento do CO2, conforme determinado pela gasometria arterial. Os pacientes do grupo sucesso apresentaram sobrevida significativamente maior (p < 0,001), conforme determinado pela análise de Kaplan-Meier, menor necessidade de intubação (p < 0,001), menos dias de hospitalização e menor incidência de lesão renal aguda em comparação com os do grupo falha. Conclusões: A significativa melhora nos parâmetros de oxigenação, a maior sobrevida, refletida pela menor necessidade de intubação e pela taxa de mortalidade, e a ausência de lesão renal aguda sugerem que o sistema ELMO CPAP é uma ferramenta promissora para o tratamento da SDRA e de condições clínicas semelhantes.

https://doi.org/10.36416/1806-3756/e20230227

Intake and apparent nutrient digestibility, ruminal parameters, and nitrogen balance of lambs fed with corn and forage-free diets with sodium bicarbonate
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Vicente, Ana Carolina Silva

; Carlis, Matheus Sousa de Paula

; Santos, Isabela Jorge dos

; Silva, Adrielly Lais Alves da

; Dias Junior, Paulo César Gonzales

; Eckermann, Nathalia Rubio

; Souza, Terezinha Teixeira de

; Polizel, Daniel Montanher

; Baggio, Marcelo

; Biava, Janaina Socolovski

; Pires, Alexandre Vaz

; Ferreira, Evandro Maia

Ciência Rural

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2023, Volume 53 Nº 9 elocation e20220406

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT: This study evaluated forage-free diets supplemented with sodium bicarbonate (SB) based on ground flint corn on intake, apparent nutrient digestibility, ruminal parameters, and N balance. Four rumen-cannulatedDorper × Santa Inês lambs, with a body weight of 43.4 ± 0.85 kg (mean ± standard deviation) were used. The experimental design was a 4×4 Latin square. Each experimental period lasted 21 days. Experimental diets were: positive control, a diet without SB containing 400 g/kg DM of soybean hulls (CONT), and three diets based on ground flint corn, containing 10 (10SB), 20 (20SB) or 30 (30SB) g/kg DM of SB. Intake of neutral and acid detergent fiber was greater for CONT (P < 0.01) when compared to SB. Intake and apparent nutrient digestibility of dry and organic matter, ether extract, and crude protein did not differ. Intake (P = 0.01) and digestibility (P < 0.01) of non-fiber carbohydrates were greater for SB diets and neutral detergent fiber digestibility was greater (P = 0.03) for CONT. The total digestible nutrients and metabolizable energy were greater for SB (P = 0.04). Rumen concentrations of acetate (P < 0.01), isobutyrate (P < 0.01), butyrate (P < 0.01), isovalerate (P < 0.01), and total short-chain fatty acids (P < 0.01) were greater for CONT. Ruminal pH showed a quadratic (P = 0.05) response to SB levels, with greater values for 20SB. Sodium bicarbonate was efficient in increasing ruminal pH at the level of 20 g/kg DM without interfering with the intake and apparent nutrient digestibility characteristics.

RESUMO: O presente estudo avaliou a suplementação de bicarbonato de sódio (BS) em dietas sem forragem à base de milho moído sobre o consumo e a digestibilidade aparente dos nutrientes, os parâmetros ruminais e o balanço de N. Foram utilizados quatro cordeiros Dorper × Santa Inês, com um peso corporal inicial de 43,4 ± 0,85 kg (média ± desvio padrão). O delineamento experimental foi quadrado latino 4×4. Cada período experimental durou 21 dias. As dietas experimentais foram: controle positivo, sem BS, contendo 400 g/kg de MS de casca de soja (CONT) e três dietas à base de milho moído, sem casca de soja, contendo 10 (10BS), 20 (20BS) ou 30 (30BS) g/kg de MS de BS. O consumo de fibra em detergente neutro e ácido foi maior (P < 0,01)para o CONT quando comparado com BS. O consumo e a digestibilidade aparente da matéria seca, matéria orgânica, extrato etéreo e proteína bruta não diferiram entre os tratamentos. O consumo (P = 0,01) e digestibilidade (P < 0,01) dos carboidratos não fibrosos foram superiores para as dietas contendo BS e a digestibilidade da fibra em detergente neutro foi maior para o CONT. Os teores de nutrientes digestivos totais e energia metabolizável foram superiores para as dietas contendo BS (P = 0,04). A concentração ruminal de acetato (P < 0,01), isobutirato (P < 0,01), butirato (P < 0,01), isovalerato (P < 0,01) e ácidos graxos totais de cadeia curta (P < 0,01) foram mais elevadas para o CONT. O pHruminal apresentou resposta quadrática (P = 0,05) em relação aos níveis de BS, sendo observado maior pH para os animais alimentados com a dieta 20BS. O BS foi eficiente em aumentar o pHruminal no teor de 20 g/kg MS sem interferir no consumo e na digestibilidade aparente dos nutrientes. Portanto, 20 g/kg de MS é a dose indicada de BS em dietas sem forragem para terminação de cordeiros em confinamento.

https://doi.org/10.1590/0103-8478cr20220406

AVALIAÇÃO DE PRESCRIÇÕES MÉDICAS DE MEDICAMENTOS EM UMA EMERGÊNCIA HOSPITALAR
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Costa, Laiza Carvalho

; Oliveira, Ana Paula de Freitas

; Pires, Patricia da Silva

; Cunha, Juliana Xavier Pinheiro da

; Nunes, Emanuelle Caires Dias Araújo

; Jesus, Jaqueline Santos de

Cogitare Enfermagem

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2023, Volume 28 elocation e90954

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective: To evaluate the adherence of medical prescriptions to patient safety recommendations using the Medication Prescription Safety Checklist. Method: This is an observational, cross-sectional study carried out between May and June 2022, with 341 medical prescriptions for medicines in a hospital emergency room in the interior of Bahia - Brazil, whose data were analyzed through descriptive analysis. Results: 80% to 89% of the prescriptions adhered to the safety recommendations; the item with the highest adherence was identification of the date of the prescription, and the lowest adherence was having drugs with similar names identified in upper case or bold. Around 18.63% (n=514) of the drugs prescribed are on the list of potentially dangerous drugs for hospital use. Conclusion: The evaluation of medical prescriptions for medicines highlighted existing barriers in clinical practice, which makes it possible to develop more effective mechanisms to promote patient safety.

RESUMEN Objetivo: Evaluar la adhesión de las prescripciones médicas a las recomendaciones de seguridad del paciente utilizando la checklist - Lista de verificación de la Seguridad de la Prescripción de Medicamentos. Método: Se trata de un estudio observacional, transversal, realizado entre mayo y junio de 2022, con 341 prescripciones médicas de medicamentos, en la sala de urgencias de un hospital del interior de Bahia - Brasil, cuyos datos fueron analizados mediante análisis descriptivo. Resultados: Entre el 80% y el 89% de las prescripciones cumplieron las recomendaciones de seguridad; el punto con mayor cumplimiento fue la identificación de la fecha de la prescripción, y el de menor cumplimiento, que los medicamentos con nombres similares se identificaran en mayúsculas o en negrita. Alrededor del 18,63% (n=514) de los medicamentos prescriptos figuran en la lista de medicamentos potencialmente peligrosos de uso hospitalario. Conclusiones: La evaluación de las prescripciones médicas de medicamentos puso de manifiesto los obstáculos existentes en la práctica clínica, lo que permite desarrollar mecanismos más eficaces para promover la seguridad de los pacientes.

RESUMO Objetivo: avaliar a adesão das prescrições médicas de medicamentos às recomendações para segurança do paciente por meio do checklist - Lista de Verificação de Segurança na Prescrição de Medicamentos. Método: trata-se de um estudo observacional, transversal, realizado entre maio a junho de 2022, com 341 prescrições médicas de medicamentos, numa emergência hospitalar no interior da Bahia - Brasil, cujos dados foram analisados através de análise descritiva. Resultados: 80% a 89% das prescrições tiveram adesão às recomendações de segurança; o item de maior adesão foi identificação da data da prescrição, menor adesão foi possuir medicamentos com nomes semelhantes identificados com caixa alta ou negrito. Cerca de 18,63% (n=514) dos medicamentos prescritos fazem parte da lista de medicamentos potencialmente perigosos de uso hospitalar. Conclusão: a avaliação das prescrições médicas de medicamentos evidenciou barreiras existentes na prática clínica, o que possibilita a elaboração de mecanismos mais efetivos para promoção da segurança do paciente.

https://doi.org/10.1590/ce.v28i0.90954

10.

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

11.

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

Resumo: En | Texto: 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

12.

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

Resumo: En | Texto: 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

13.

Coconut oil: an overview of cardiometabolic effects and the public health burden of misinformation oil
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Spiazzi, Bernardo Frison

; Duarte, Ana Cláudia

; Zingano, Carolina Pires

; Teixeira, Paula Portal

; Amazarray, Carmen Raya

; Merello, Eduarda Nunes

; Wayerbacher, Laura Fink

; Farenzena, Laura Penso

; Correia, Poliana Espíndola

; Bertoluci, Marcello Casaccia

; Gerchman, Fernando

; Colpani, Verônica

Archives of Endocrinology and Metabolism

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2023, Volume 67 Nº 6 elocation e000641

Resumo: En | Texto: En | PDF: En

ABSTRACT Recent data from meta-analyses of randomized clinical trials (RCTs) suggest that dietary intake of coconut oil, rich in saturated fatty acids, does not result in cardiometabolic benefits, nor in improvements in anthropometric, lipid, glycemic, and subclinical inflammation parameters. Nevertheless, its consumption has surged in recent years all over the world, a phenomenon which can possibly be explained by an increasing belief among health professionals that this oil is as healthy as, or perhaps even healthier than, other oils, in addition to social network misinformation spread. The objective of this review is to present nutritional and epidemiological aspects related to coconut oil, its relationship with metabolic and cardiovascular health, as well as possible hypotheses to explain its high rate of consumption, in spite of the most recent data regarding its actual effects. metaanalyses meta analyses RCTs (RCTs acids benefits anthropometric lipid glycemic parameters Nevertheless world than oils spread effects

https://doi.org/10.20945/2359-3997000000641

14.

Revisores 2022
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Castro, Adriana Miranda de

; Noronha, Ana Paula Porto

; Viera Gómez, Andrea Jimena

; Câmara, Andreza Franco

; Costa Ball, César Daniel

; Blezio Ducret, Cecilia

; Marotta, Cecilia

; Arrivillaga, Christiane

; Ferreira, Clarice Regina Catelan

; Kern, Elisa

; Borges, Elisabete

; Dorta, Germán Antonio

; Pinto, Heider

; Barros, Irene

; Matos, Izabella Barison

; Pires, Jeferson

; Fernández, María Eugenia

; Lladó, Mónica

; Flores-Kanter, Pablo E.

; Freitas De León, Paribanú

; Alves, Railda Sabino Fernandes

; Machiñena, Rossina

; Navarro, Santiago

; Contino, Silvana

; Salessi, Solana

; Papalini, Vanina

Psicología, Conocimiento y Sociedad

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Nov 2022, Volume 12 Nº 3 Páginas 99 - 100

Resumo: Es | Texto: Es | PDF: Es

https://doi.org/10.26864/pcs.v12.n3.rev

15.

Ser, estar e habitar a desinstitucionalização da saúde mental brasileira
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Guljor, Ana Paula Freitas

; Guerrero, André Vinicius Pires

; Vaz, Barbara Coelho

; Severo, Fernanda Maria Duarte

; Scafuto, June Corrêa Borges

; Cruz, Karine Dutra Ferreira da

; Yasui, Silvio

Ciência & Saúde Coletiva

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Jan 2022, Volume 27 Nº 1 Páginas 4 - 4

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232027271.20912021

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