Pesquisa | SciELO

Abstract Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers. healthcare suffering disease vigilance addictions trust area education surveillance testing teams strengths weaknesses

https://doi.org/10.1016/j.bjane.2023.07.008

Malignant hyperthermia: new knowledge changing perspectives hyperthermia
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Simões, Cláudia Marquez

Brazilian Journal of Anesthesiology

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Abr 2023, Volume 73 Nº 2 Páginas 125 - 127

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.03.001

[SciELO Preprints] - Strategies for promoting mental health among residents: scoping review protocol.
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Riera, Rachel Latorraca, Carolina de Oliveira Cruz Padovez, Roberta Carreira Moreira Martimbianco, Ana Luiza Cabrera Simões, Cláudia Marquez Pacheco, Rafael Leite

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Data de publicação: 2022-07-21

Resumo: En

Health professionals are encouraged to attend a residency period of two to seven years after graduating. The typical demands of this in-service training modality have been associated with reduced sleep quality, decreased exercise frequency, and detachment from family and social relationships, leading to an increased diagnosis of anxiety, depression, and burnout syndrome. Therefore, conducting a scoping review to identify strategies aimed at promoting mental health and wellbeing among residents from different health areas is essential to support any forthcoming preventive action.

https://doi.org/10.1590/SciELOPreprints.4473

Two years of the COVID-19 pandemic: an anesthesiology perspective
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Schmidt, André P.

; Módolo, Norma S.P.

; de Amorim, Célio G.

; Simões, Cláudia M.

; Kraychete, Durval C.

; Joaquim, Eduardo H.G.

; Lineburger, Eric B.

; Papa, Fábio V.

; Fernandes, Fátima C.

; Mendes, Florentino F.

; Guimarães, Gabriel M.N.

; Barros, Guilherme A.M.

; Silva-Jr, João M.

; Lima, Laís H. Navarro e

; Azi, Liana M.T.A.

; Carvalho, Lorena I.M.

; Stefani, Luciana C.

; Garcia, Luis V.

; Carmona, Maria José C.

; Salgado Filho, Marcello F.

; Nascimento Junior, Paulo do

; Alves, Rodrigo L.

; Carvalho, Vanessa H.

; Quintão, Vinicius C.

; Carmona, Maria José C.

Brazilian Journal of Anesthesiology

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Abr 2022, Volume 72 Nº 2 Páginas 165 - 168

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2022.02.004

Drug abuse amongst anesthetists in Brazil: a national survey
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Sousa, Gabriel Soares de

; Fitzsimons, Michael Gerald

; Mueller, Ariel

; Quintão, Vinicius Caldeira

; Simões, Cláudia Marquez

Brazilian Journal of Anesthesiology

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Ago 2021, Volume 71 Nº 4 Páginas 326 - 332

Resumo: En | Texto: En | PDF: En

Abstract Background The prevalence of Substance Use Disorders (SUD) and acceptance of drug testing among anesthetists in Brazil has not been determined. Methods An internet-based survey was performed to investigate the prevalence of SUD among anesthetists in Brazil, to explore the attitudes of anesthetists regarding whether SUD jeopardizes the health of an impaired provider or their patient, and to determine the provider's perspective regarding acceptance and effectiveness of drug testing to reduce SUD. The questionnaire was distributed via social media. REDCap was utilized to capture data. A sample size of 350 to achieve a confidence level of 95% and confidence interval of 5 was estimated. Study report was based on STROBE and CHERRIES statements. Results The survey was returned from 1,295 individuals. Most individuals knew an anesthesia provider with a SUD (82.07%), while 23% admitted personal use. The most common identified substances of abuse were opioids (67.05%). Very few respondents worked in a setting that performs drug testing (n = 17, 1.33%). Most individuals believed that drug testing could improve personal safety (82.83%) or the safety of patients (85.41%). Individuals with a personal history of SUD were less likely to believe in the effectiveness of drug testing to reduce one's own risk (74.92% vs. 85.18%, p< 0.0001) or improve the safety of patients (76.27% vs. 88.13%, p< 0.001). Conclusions SUDs are common among anesthetists in Brazil. Drug testing would be accepted as a viable means to reduce the incidence although a larger study should be performed to investigate the logistical feasibility.

https://doi.org/10.1016/j.bjane.2021.03.006 359 downloads

First Brazilian pediatric hospital to adopt 1-hour preoperative fasting time for clear fluids for elective surgeries
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Cardoso, Priscilla Ferreira Neto

; Quintão, Vinicius Caldeira

; Perini, Bruno

; Carmona, Maria José Carvalho

; Carlos, Ricardo Vieira

; Simões, Cláudia Marquez

Clinics

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2021, Volume 76 elocation e3336

Resumo: En | Texto: En | PDF: En

https://doi.org/10.6061/clinics/2021/e3336 95 downloads

SPIDS – simplified predictive intubation difficulty score
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Quintão, Vinícius Caldeira

; Simões, Cláudia Marquez

; Carmona, Maria José Carvalho

Revista Brasileira de Anestesiologia

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Dez 2020, Volume 70 Nº 6 Páginas 569 -

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

https://doi.org/10.1016/j.bjane.2020.10.008 229 downloads

The anesthesiologist and COVID-19
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Quintão, Vinícius Caldeira

; Simões, Cláudia Marquez

; Lima, Laís Helena Navarro e

; Barros, Guilherme Antônio Moreira de

; Salgado-Filho, Marcello Fonseca

; Guimarães, Gabriel Magalhães Nunes

; Alves, Rodrigo Leal

; Caetano, Ana Maria Menezes

; Schmidt, André Prato

; Carmona, Maria José Carvalho

Revista Brasileira de Anestesiologia

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Abr 2020, Volume 70 Nº 2 Páginas 77 - 81

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

https://doi.org/10.1016/j.bjane.2020.03.002 904 downloads

Patient 4.0 - The challenge of care for elderly patients
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Carmona, Maria José Carvalho

; Simões, Cláudia Marquez

Revista Brasileira de Anestesiologia

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Fev 2020, Volume 70 Nº 1 Páginas 1 - 2

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

https://doi.org/10.1016/j.bjane.2020.03.001 263 downloads

10.

Development of nanoparticles coated with cassava bagasse pectin (Manihot esculenta Crantz) containing β-carotene for mucoadhesive applications
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COELHO, BIANCA

; MAZZARINO, LETÍCIA

; PITZ, HELOÍSA S.

; FELTRIN, CLARISSA

; VOYTENA, ANA PAULA L.

; COELHO, DANIELA S.

; SCHNEIDER, NAIRA F.Z.

; NEUBERT, ENILTO O.

; SIMÕES, CLÁUDIA M.O.

; MARASCHIN, MARCELO

Anais da Academia Brasileira de Ciências

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2020, Volume 92 Nº 4 elocation e20200134

Resumo: En | Texto: En | PDF: En

Abstract Pectin (PC) extracted from a solid residue from cassava roots (Manihot esculenta Crantz) was used to coat nanoparticles (NP) containing β-carotene (BC) aiming at the gastrointestinal administration of this lipophilic nutraceutical. The NP were prepared by spontaneous emulsification method using food grade components. Pectin-coated NP have been successfully prepared as confirmed by the increased particle size and negative surface charges due to the pectin’s anionic nature. NP showed spherical shape and monodisperse distribution, with a mean size of 21.3 nm (polydispersity index (PDI) 0.29) for BC PC T80-NP (nanoparticle with β-carotene, pectin and Tween 80) and 261.4 nm (PDI 0.1) for BC PC T20-NP (nanoparticle with β-carotene, pectin and Tween 20). BC was encapsulated at amounts of 530 and 324 µg/ml for BC PC T80-NP and BC PC T20-NP, respectively, with high encapsulation efficiency (> 95%), increasing its antioxidant capacity in vitro, besides no cytotoxic effect. However, only BC PC T20-NP was stable over a 90 days storage period (4°C) and revealed a strong interaction between pectin and mucin. These results suggest that pectin-coated BC PC T20-NP is a promising strategy to improve the bioavailability and permeation of BC for administration through mucosal surfaces.

https://doi.org/10.1590/0001-3765202020190134 573 downloads

11.

Customer orientation and financial performance relationship: the mediating role of innovative capability
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Santos, Mirela Jeffman dos

; Perin, Marcelo Gattermann

; Simões, Cláudia

; Sampaio, Cláudio Hoffmann

Gestão & Produção

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2020, Volume 27 Nº 4 elocation e4706

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

Resumo: A pesquisa existente estabelece que a orientação ao cliente (CO), por si só, é insuficiente para atingir níveis mais elevados de desempenho financeiro (FP). Tal raciocínio sugere a necessidade de habilidades e capacidades adicionais, como a capacidade de inovação (IC). Além disso, as variáveis ambientais (por exemplo, turbulência tecnológica – TT) podem afetar essas relações. Este artigo explora as relações e os efeitos da CO e da CI no FP em diferentes condições de TT, tendo sido desenvolvido um modelo teórico correspondente. Tal modelo envolve as seguintes relações: (i) a influência direta da CO no FP; (II) o papel mediador da IC na relação CO/FP; (III) o papel moderado do TT sobre a mediação da IC na relação CO/FP. O trabalho de campo incluiu uma etapa exploratória, seguida de um levantamento transversal aplicado aos gestores de empresas de médio porte no Brasil. Os achados revelaram que a CI tem mediação parcial na relação entre CO e FP, em particular em ambientes de alta TT. Implicações gerenciais e sugestões para futuras pesquisas são apresentadas.

Abstract: Existing research establishes customer orientation (CO) per se as insufficient to achieve higher levels of financial performance (FP). Such reasoning suggests the need for additional skills and capabilities, such as, innovative capability (IC). In addition, environmental variables (e.g., Technological Turbulence – TT) affect these relationships. This paper explores the relationships and effects of CO and IC on FP under different TT conditions. A research framework and hypotheses were developed. The framework captures the following relationships: (i) the direct influence of CO on FP; (ii) the mediating role of IC on the CO/FP relationship; (iii) the moderating role of TT over the mediation of IC on the CO/FP relationship. The fieldwork included an exploratory stage, followed by a cross-sectional survey applied to managers in medium-sized companies in Brazil. Findings revealed that IC partially mediates the relationship between CO and FP, in particular in high TT environments. Managerial implications and avenues for future research are presented.

https://doi.org/10.1590/0104-530x4706-20 1139 downloads

12.

Chemical Constituents and Pharmacology properties of Aristolochia triangularis: a south brazilian highly-consumed botanical with multiple bioactivities
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OLIVEIRA, SIMONE Q.

; KRATZ, JADEL M.

; CHAVES, VITOR C.

; GUIMARÃES, TATIANA R.

; COSTA, DANIELLE T.M.

; DIMITRAKOUDI, SAPFO

; VONTZALIDOU, ARGYRO

; BORDIGNON, SÉRGIO A.L.

; SIMIONATO, CESAR P.

; STEINDEL, MÁRIO

; REGINATTO, FLÁVIO H.

; SIMÕES, CLÁUDIA M.O.

; SCHENKEL, ELOIR P.

Anais da Academia Brasileira de Ciências

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2019, Volume 91 Nº 3 elocation e20180621

Resumo: En | Texto: En | PDF: En

Abstract: Aristolochia triangularis Cham., is one of the most frequently used medicinal plant in Southern Brazil. Preparations containing the leaves and/or stems are traditionally used as anti-inflammatory, diuretic, as well as antidote against snakebites. This study screened A. triangularis extracts, fractions and isolated compounds for different bioactivities. A weak antiproliferative activity against human lung cancer cell line (A549) was observed only for chloroform fraction obtained from stems (CFstems - CC50: 2.93 µg/mL). Also, a moderate antimicrobial activity against Staphylococcus aureus was detected just for chloroform fraction obtained from leaves (CFleaves -13-16 mm inhibition zone). Additionally, two semi-purified fractions (CFstems-4 and CFleaves-4) selectively inhibited HSV-1 replication (IC50 values of 0.40 and 2.61 µg/mL, respectively), while only CFleaves showed promising results against Leishmania amazonensis. Fractionation of extracts resulted in the isolation of one neolignan (-) cubebin and one lignan (+) galbacin. However, these compounds are not responsible for the in vitro bioactivities herein detected. The presence of aristolochic acid I and aristolochic acid II in the crude ethanol extract of stems (CEEstems) and leaves (CEEleaves) was also investigated. The HPLC analysis of these extracts did not display any peak with retention time or UV spectra comparable to aristolochic acids I and II.

https://doi.org/10.1590/0001-3765201920180621 1213 downloads

13.

Retinoic acid increases the effect of bone morphogenetic protein type 2 on osteogenic differentiation of human adipose-derived stem cells
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CRUZ, Ariadne Cristiane Cabral

; CARDOZO, Francielle Tramontini Gomes de Souza

; MAGINI, Ricardo de Souza

; SIMÕES, Cláudia Maria Oliveira

Journal of Applied Oral Science

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2019, Volume 27 elocation e20180317

Resumo: En | Texto: En | PDF: En

Abstract Bone morphogenetic protein type 2 (BMP-2) and retinoic acid (RA) are osteoinductive factors that stimulate endogenous mechanisms of bone repair which can be applied on management of osseous defects in oral and maxillofacial fields. Objective Considering the different results of RA on osteogenesis and its possible use to substitute/potency BMP-2 effects, this study evaluated the outcomes of BMP-2, RA, and BMP-2+RA treatments on in vitro osteogenic differentiation of human adipose-derived stem cells (ASCs) and the signaling pathway(s) involved. Material and Methods ASCs were treated every other day with basic osteogenic medium (OM) alone or supplemented with BMP-2, RA, or BMP-2+RA. Alkaline phosphatase (ALP) activity was determined using the r-nitrophenol method. Extracellular matrix mineralization was evaluated using von Kossa staining and calcium quantification. Expression of osteonectin and osteocalcin mRNA were determined using qPCR. Smad1, Smad4, phosphorylated Smad1/5/8, BMP-4, and BMP-7 proteins expressions were analyzed using western blotting. Signaling pathway was evaluated using the IPA® software. Results RA promoted the highest ALP activity at days 7, 14, 21, and 28, in comparison to BMP-2 and BMP-2+RA. BMP-2+RA best stimulated phosphorylated Smad1/5/8 protein expression at day 7 and Smad4 expression at days 7, 14, 21, and 28. Osteocalcin and osteonectin mRNA expressions were best stimulated by BMP-2+RA at day 7. Matrix mineralization was most improved by BMP-2+RA at days 12 and 32. Additionally, BMP-2+RA promoted the highest BMP signaling pathway activation at days 7 and 14, and demonstrated more activation of differentiation of bone-forming cells than OM alone. Conclusions In summary, RA increased the effect of BMP-2 on osteogenic differentiation of human ASCs.

https://doi.org/10.1590/1678-7757-2018-0317 1852 downloads

14.

ANESTESIA PARA CIRURGIA ORTOPÉDICA DE URGÊNCIA EM PACIENTE PORTADOR DE PORFIRIA HEPÁTICARELATO DE CASO
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Zamprogna, Marília A.

; Fonseca, Heráclito B.

; Cruz, Ana Luiza C. Da

; Simões, Cláudia M.

Anestesia Analgesia Reanimación

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Nov 2017, Volume 30 Nº spe Páginas 41 - 41

Resumo: Pt | Texto: Pt | PDF: Pt

RESUMO Justificativa e Objetivos: As porfiriassãodistúrbiosenvolvendo enzimas do processo de síntese do heme. As manifestações agudas incluemdor abdominal, hiperatividade simpática, neuropatia periférica e sintomas psiquiátricos, com importante morbimortalidade. A fisiopatogenia resulta da toxicidade dos precursores de porfirina, podendo ser desencadeada por fármacos de uso comum, restrição intensa de carboidratos e estressemetabólico. Aqui relatamosum caso de porfiria hepática, necessitando de cirurgia de urgência. Relato do Caso: Paciente feminina, 74 anoscomporfiria hepática, submetida a cirurgiapara correção de fraturaexposta de rádio. Avaliaçãopré-anestésica minuciosa, visando minimizar a chance de criseporfírica por medicações anestésicas. Optado por anestesia geral balanceada (induçãocom propofol e manutençãocom óxido nitroso),evitando-se os principaisdesencadeantes. Procedimentosemintercorrência; paciente recebeu alta hospitalarapós setedias. Discussão: A avaliaçãopré-anestésica do paciente porfíricodeve atentar para neuropatia periférica einstabilidadeautonômica. O jejumdeve ser o menor possível. Somenteprescrevermedicaçõesapós consultar a lista de fármacos proibidos.Quantoaos medicamentos contra-indicados, citamos: barbitúricos,etomidato, cetamina, enflurano, dipirona, dimenidrato, metoclopramida e esteroides. O propofol é seguro para indução anestésica, porém, nãose recomenda a infusãocontínua.Entre as medicações seguras estão: óxido nitroso, isoflurano, rocurônio, atracúrio, cisatracúrio,succinilcolina, opioides,ondasetrona e a maioria dos anestésicos locais e benzodiazepínicos. Conclusões: A porfiria é umdistúrbio raro, o qual pode ser desencadeado por medicamentos frequentemente usados na anestesia e na prática médicageral. Nesse sentido, a avaliaçãopré-anestésicamostra-se comouma grande ferramenta para a segurança e sucesso da anestesia.

1260 downloads

15.

In vitro intestinal permeability studies, pharmacokinetics and tissue distribution of 6-methylcoumarin after oral and intraperitoneal administration in Wistar rats
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Cárdenas, Paola Andrea

; Kratz, Jadel Müller

; Hernández, Aura

; Costa, Geison Modesti

; Ospina, Luis Fernando

; Baena, Yolima

; Simões, Cláudia Maria Oliveira

; Jimenez-Kairuz, Álvaro

; Aragon, Marcela

Brazilian Journal of Pharmaceutical Sciences

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2017, Volume 53 Nº 1 elocation e16081

Resumo: En | Texto: En | PDF: En

ABSTRACT 6-Methylcoumarin (6MC) is a semisynthetic coumarin with important in vitro and in vivo anti-inflammatory activity. In order to continue the pre-clinical characterization of this molecule, in vitro intestinal permeability, plasma profile and tissue distribution after oral administration in rats were studied. The permeability of 6MC was evaluated by the Caco-2 cellular model in both the apical-basal (A-B) and basal-apical (B-A) directions. The pharmacokinetics and biodistribution were evaluated in rats after oral and intraperitoneal administration at doses of 200 mg/kg. Transport experiments with Caco-2 cells showed that 6MC presented high permeability at all concentrations evaluated. This finding suggested that 6MC could be transported across the gut wall by passive diffusion. The plasma concentration-time curve showed that the maximum concentration (Cmax) was 17.13 ± 2.90 µg/mL at maximum time (Tmax) of 30 min for the oral route and Cmax 26.18 ± 2.47 µg/mL at 6.0 min for the intraperitoneal administration, with elimination constant of (Ke ) 0.0070 min-1 and a short life half time of (T1/2 ) lower that 120 min. The distribution study showed that 6MC has high accumulation in the liver, and widespread distribution in all the organs evaluated.

https://doi.org/10.1590/s2175-97902017000116081 5061 downloads

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