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Production and Partial Biochemical Characterization of Multiple Forms of Lipases
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Zavarise, Julio Pansiere

; Belei Neto, Henrique

; Gomes, Beatriz Guisso

; Barbosa, Wallefer Rodrigues

; Oliveira, Daleth Silva

; Pinotti, Laura Marina

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24220613

Resumo: En | Texto: En | PDF: En

Abstract The total cost of processes that use lipases can be reduced by using the mycelium or not purified crude extract with lipolytic activity. These catalysts can be used without complex purification and can show desirable properties to emerging applications like hydrolysis and biotransformation of vegetable oils. To explore the potential of multiple forms of lipases (produced by the same filamentous fungus species), this work investigated intracellular and extracellular lipases produced by Trichoderma koningii (intracellular lipases were never studied), Penicillium spp. F02 (isolated from industrial grease trap) and Aspergillus niger. For this, batch fermentations were conducted for 96h using olive oil as a carbon source. The submerged culture was interrupted with vacuum filtration to isolate the mycelium and crude extract. The lipolytic activities were determined by the hydrolysis method of olive oil. The best results were obtained for intracellular activity with T. koningii (81.5 U/g of dry biomass) and for extracellular activity with A. niger (10.6 U/mL of crude extract). Both were attained in 96h of fermentation. T. koningii showed an accumulation of intracellular lipases and a depreciated extracellular activity in the initial 24 hours, which can be reasonable indications that there is strong retention of lipases in the mycelium. Statistical analysis within the range of 37°C to 44°C associated with pH from 7.8 to 8.0 favored the activity of lipases from T. koningii. All these findings are promising for future studies in the enzymatic synthesis of biodiesel with lipases (intracellular and extracellular) from T. koningii.

https://doi.org/10.1590/1678-4324-2024220613

Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review
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Silva, Maria Vitoria Gomes da

; Pereira, Laura Resende Guimarães

; Avó, Lucimar Retto da Silva de

; Germano, Carla Maria Ramos

; Melo, Débora Gusmão

Sao Paulo Medical Journal

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2024, Volume 142 Nº 2 elocation e2023015

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Down syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVE: To systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTING: This integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODS: This review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTS: A total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSION: Individuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATION: The Open Science Framework registered the research protocol (https://osf.io/jyb97/).

https://doi.org/10.1590/1516-3180.2023.0015.r1.230523

Telehealth and oropharyngeal dysphagia: An integrative review
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Araújo, Nataly Santana de

; Magalhães, Raíssa Gomes

; Frois, Camila de Alencar

; Mangilli, Laura Davison

Revista CEFAC

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2024, Volume 26 Nº 1 elocation e5423

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

ABSTRACT Purpose: to analyze the telehealth speech therapy approach in patients with oropharyngeal dysphagia and determine the applications and effects of this practice. Methods: the following descriptors were used for selection: Telerehabilitation, Telemedicine, "Remote Consultation", "Healthcare Delivery", "Distance Counseling", "Therapy, Computer-Assisted", "Speech-Language Pathology", "Speech Therapy", "Swallowing Disorders", Dysphagia, “Bottle Feeding" and "Enteral Nutrition” in PubMed, MedLine, Scopus and Web of Science databases and in the gray literature, by Google Scholar and ProQuest. Studies were selected without time limits, in Portuguese, English and Spanish, that described the applicability and/or effects of telehealth in speech therapy practice in patients with swallowing disorders/dysphagia, regardless of gender and age. For analysis, the following were considered: level of scientific evidence and recommendation, telehealth modality, objectives, methods and results/conclusion. Literature Review: 490 articles were found and, after exclusion of duplicates, analysis of titles, abstracts and reading of full articles, 22 studies were selected. The articles were classified into telehealth modalities: tele-education, telediagnosis, teleconsulting, teleregulation and telemonitoring. Conclusion: the telehealth modalities described had a great potential to promote significant improvements in patients presented with swallowing disorders/dysphagia, suggesting them as viable for speech therapy services. Among them, teleconsultation was the least addressed.

RESUMO Objetivo: analisar a abordagem fonoaudiológica por meio da telessaúde em pacientes com disfagia e determinar as aplicações e efeitos desta prática. Métodos: para seleção foram utilizados os descritores: Telerehabilitation, Telemedicine, "Remote Consultation", "Delivery of Health Care", "Distance Counseling", "Therapy, Computer-Assisted", “Speech-Language Pathology”, "Speech Therapy", "Deglutition Disorders", Dysphagia, “Bottle Feeding" e "Enteral Nutrition” nas bases de dados PubMed, MedLine, Scopus e Web of Science e na literatura cinzenta, por meio do Google Acadêmico e ProQuest. Foram selecionados estudos sem delimitação de tempo, nas línguas português, inglês e espanhol, que descrevessem a aplicabilidade e/ou efeitos da telessaúde na prática fonoaudiológica junto à pacientes com alteração da deglutição/disfagia, sem restrição de sexo e idade. Para análise considerou-se: nível de evidência científica e recomendação, modalidade de telessaúde, objetivos, métodos e resultados/conclusão. Revisão da Literatura: foram encontrados 490 artigos e, após exclusão de duplicatas, análise dos títulos, resumos e leitura completa dos artigos, 22 estudos foram selecionados. Os artigos foram classificados nas modalidades da telessaúde: tele-educação, telediagnóstico, teleconsultoria, telerregulação e telemonitoramento. Conclusão: as modalidades de telessaúde descritas tiveram grande potencial para promover melhoras significativas em pacientes com alteração de deglutição/disfagia, sugerindo-as como viáveis para serviços fonoaudiológicos. Entre elas, a teleconsulta foi a menos explorada.

https://doi.org/10.1590/1982-0216/20242615423

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

Case for diagnosis. Bilateral ulcerations on the distal phalanges of the second and third fingers - Ulcerative carpal tunnel syndrome
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Almeida Jr., Hiram Larangeira de

; Garcia, Fernanda Pinto

; Gomes, Laura de Moraes

; Almeida, Antônia Larangeira de

Anais Brasileiros de Dermatologia

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Ago 2023, Volume 98 Nº 4 Páginas 531 - 533

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.abd.2022.03.008

Langerhans cell histiocytosis: a rare case of the multisystemic form in an infant histiocytosis
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Utiyama, Thaís Oliveira

; Malzoni, Maria Laura

; Vasques, Thalita Gabrieli Sanches

; Gomes, Cassiano Tamura Vieira

Anais Brasileiros de Dermatologia

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Jun 2023, Volume 98 Nº 3 Páginas 394 - 395

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.abd.2021.06.011

Age and Type of Delivery as Risk Indicators for Maternal Mortality
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Oliveira, Isabella Mantovani Gomes Dias de

; Fonseca, Emílio Prado da

; França, Fabiana Mantovani Gomes

; Cortellazzi, Karine Laura

; Pardi, Vanessa

; Pereira, Antonio Carlos

; Tagliaferro, Elaine Pereira da Silva

Revista Brasileira de Ginecologia e Obstetrícia

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Mar 2023, Volume 45 Nº 3 Páginas 134 - 141

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

Abstract Objective: This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015. Methods: This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis. Results: Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged > 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death. Conclusion: Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.

Resumo Objetivo: Esse estudo avaliou a mortalidade materna (MM) e fatores relacionados em um município de grande porte da região sudeste do Brasil (Campinas, São Paulo) no período de 2000-2015. Métodos: Esse estudo consistiu de duas fases: 1. Uma fase analítica de caso-controle que avaliou o impacto de variáveis individuais e contextuais na MM; 2. Uma fase ecológica delineada para contextualizar as mortes maternas por meio de análise espacial. O grupo caso consistiu de 87 mortes maternas e o grupo controle de 348 mulheres que tiveram bebês durante o mesmo período. Os dados foram analisados por estatística descritiva, testes de associação e regressão logística múltipla (RLM) (p < 0,05) assim como análise espacial. Resultados: A taxa de mortalidade materna foi de 37 mortes para cada 100.000 nascidos vivos. As mortes foram dispersas por todo o território urbano e não se observou formação de clusters. Na RLM observou-se que mulheres grávidas com idade > 35 anos (OR = 2,63) ou aquelas que passaram por cesárea (OR = 2,51) foram mais propensas à morte materna. Conclusão: As mortes maternas foram distribuídas dispersamente entre os diferentes níveis socioeconômicos e mais propensas a ocorrer entre mulheres > 35 anos de idade ou que passaram por cesárea.

https://doi.org/10.1055/s-0043-1768456

Check-All-That-Apply method for sensory characterization of pork from immunocastrated male pigs fed different oil sources
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Silva, Julia Pereira Martins da

; Almeida, Vivian Vezzoni

; Schinckel, Allan Paul

; Meira, Ariana Nascimento

; Moreira, Gabriel Costa Monteiro

; Pian, Laura Woigt

; Campos, Débora de

; Gomes, Julia Dezen

; Gonçales, Janaína Lustosa

; Dargelio, Mariana Damiames Baccarin

; Patinho, Iliani

; Saldaña, Erick

; Contreras-Castillo, Carmen Josefina

; Coutinho, Luiz Lehmann

; Luchiari Filho, Albino

; Nuñez, Amoracyr José Costa

; Cesar, Aline Silva Mello

Scientia Agricola

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2023, Volume 80 elocation e20220019

Resumo: En | Texto: En | PDF: En

ABSTRACT In the last decade, other quality attributes have emerged as the main aspects that impact pork consumers acceptance, such as environmentally friendly production, nutritional value, and animal welfare. This study applies a Check-All-That-Apply (CATA) questionnaire for sensory characterization of loins from genetically lean immunocastrated male pigs fed diets containing either a standard commercial diet with 1.5 % soybean oil (control) or 3 % oil from either soybean oil (SO), canola oil (CO), or fish oil (FO) during the growing-finishing phases. Twenty CATA attributes for loin samples were generated. We interviewed 101 consumers to select all the CATA terms that they considered suitable to characterize sensory attributes of longissimus lumborum muscle samples of pigs from each dietary treatment. The CATA results indicated differences among pork loin samples depending on the source and inclusion level of dietary oil. Loins from pigs fed 3 % SO were characterized by a higher frequency of the “juicy texture” attribute (p < 0.05) and a lower frequency of the “dry texture” attribute (p < 0.05) compared to loins from 3 % FO-fed pigs. Moreover, loins from pigs fed 3 % SO had a lower citation frequency of the “tasteless” attribute (p < 0.05) compared to loins from 3 % FO-fed pigs. The attributes “cooked pork meat-like taste”, “juicy texture”, “tender texture”, and “brightness” were placed close to the overall liking. “Tender texture”, “juicy texture”, “pork meat-like” (odor and taste), and “cooked pork meat-like taste” attributes were considered drivers of liking. Feeding genetically lean immunocastrated male pigs with diets containing 3 % SO may be advisable from a pork sensory quality perspective.

https://doi.org/10.1590/1678-992x-2022-0019

Vascular complications in 305 severely ill patients with COVID-19: a cohort study
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Correia, Rebeca Mangabeira

; Santos, Brena Costa

; Carvalho, Ana Alyra Garcia

; Areias, Libnah Leal

; Kuramoto, Danielle Akemi Bergara

; Pereda, Mariana Raffo

; Aidar, Ana Laura e Silva

; Clezar, Caroline Nicacio Bessa

; Reicher, Marcello Erich

; Amorim, Jorge Eduardo de

; Flumignan, Ronald Luiz Gomes

; Nakano, Luis Carlos Uta

Sao Paulo Medical Journal

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2023, Volume 141 Nº 5 elocation e2022171

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Although an association has been made between coronavirus disease 2019 (COVID-19) and microvascular disease, data on vascular complications (other than venous thromboembolism) are sparse. OBJECTIVE: To investigate the vascular complications in severely ill patients hospitalized with COVID-19 and their association with all-cause mortality. DESIGN AND SETTING: This cohort study was conducted at the Universidade Federal de São Paulo, Brazil. METHODS: All 305 consecutive patients diagnosed with COVID-19 and hospitalized in the intensive care unit (ICU) of a tertiary university hospital from April 2 to July 17, 2021, were included and followed up for 30 days. RESULTS: Of these, 193 (63.3%) were male, and the mean age was 59.9 years (standard deviation = 14.34). The mortality rate was 56.3% (172 patients), and 72 (23.6%) patients developed at least one vascular complication during the follow-up period. Vascular complications were more prevalent in the non-survivors (28.5%) than in the survivors (17.3%) group and included disseminated intravascular coagulation (DIC, 10.8%), deep vein thrombosis (8.2%), acrocyanosis (7.5%), and necrosis of the extremities (2%). DIC (adjusted odds ratio (aOR) 2.30, 95% confidence interval (CI) 1.01–5.24, P = 0.046) and acrocyanosis (aOR 5.21, 95% CI 1.48–18.27, P = 0.009) were significantly more prevalent in the non-survivors than in the survivors group. CONCLUSION: Vascular complications in critically ill COVID-19 patients are common (23.6%) and can be closely related to the mortality rate (56.3%) until 30 days after ICU admission. Macrovascular complications have direct implications for mortality, which is the main outcome of the management of COVID-19. REGISTRATION: RBR-4qjzh7 (https://ensaiosclinicos.gov.br/rg/RBR-4qjzh7).

https://doi.org/10.1590/1516-3180.2022.0171.r2.17102022

10.

ARTIGO - AVALIAÇÃO MISTA PARA PROMOÇÃO DA QUALIDADE DA EDUCAÇÃO INFANTIL: POTENCIALIDADES E TENSÕES EM PRODUÇÃO COLETIVA
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SILVA, ANA PAULA SOARES DA

; MACEDO, BIANCA OLIVEIRA DE

; GUAL, LAURA RESENDE

; STENCEL, LETICIA MICHELE

; ALMEIDA, RAUL GOMES DE

Educação em Revista

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2023, Volume 39 elocation e38459

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

ABSTRACT: The evaluation of the quality of Early Childhood Education constitutes a field of knowledge and practices that mobilize structural aspects into the area considering the competence of the different agents in the evaluation processes and their effects in the effectiveness of public policy. In the framework of an evaluation aligned with the promotion of quality and the recognition of Early Childhood Education as a public policy subordinate to social control, we propose to discuss the potentialities and tensions present in the mixed-method evaluation, a model that combines internal and external procedures and instruments inside and outside of institutions. The discussion starts from a mixed-method evaluation experience carried out in conjunction with the technical team of the Public Ministry of the State of São Paulo (MPSP), in the Special Education Group of Ribeirão Preto. The results indicate that the mixed evaluation was powerful because of its dialogic format: the external evaluation allowed a technical and multiprofessional look aligned with the public quality policy; the internal evaluation facilitated a collective self-reflection on quality but showed different strengths and weaknesses in terms of critical views. By combining these perspectives, possibilities are created for overcoming the limitations of each type of evaluation, and also for reflecting on the dynamics of relationships between individuals and public agencies.

RESUMEN: La evaluación de la calidad en y de la Educación Infantil constituye un campo de conocimientos y prácticas que movilizan aspectos estructurales para el área, que pasan de la competencia de los diferentes agentes en los procesos de evaluación a sus efectos en la efectividad de las políticas públicas. En el marco de una evaluación alineada con la promoción de la calidad y en el reconocimiento de la Educación Infantil como política pública sujeta a control social, proponemos discutir las potencialidades y tensiones presentes en la evaluación de método mixto, un modelo de evaluación que conjuga procedimientos e instrumentos internos y externos a las instituciones. La discusión es parte de una experiencia de evaluación de método mixto realizada en conjunto con el equipo de Asesoramiento Técnico del Ministerio Público del Estado de São Paulo (MPSP), en el Grupo de Educación Especial de Ribeirão Preto. Los resultados indican que la evaluación mixta fue poderosa por su formato dialógico: la evaluación externa permitió una mirada técnica y multiprofesional alineada con los planteamientos de la política pública de calidad; la evaluación interna promovió una autorreflexión colectiva sobre la calidad, pero mostró diferentes facultades y debilidades en cuanto a la visión crítica de algunas instituciones. Se concluye que es en la intersección de estas perspectivas que se crean posibilidades para superar los límites de cada tipo de evaluación y también invita a reflexionar sobre los desafíos que se presentan en la dinámica de las relaciones entre las personas y los organismos públicos.

RESUMO: A avaliação da qualidade na e da Educação Infantil constitui-se como um campo de conhecimentos e práticas mobilizadores de aspectos estruturantes para a área, que transitam da competência dos diferentes agentes nos processos avaliativos aos seus efeitos na efetivação da política pública. Nos marcos de uma avaliação alinhada à promoção da qualidade e no reconhecimento da Educação Infantil como uma política pública submetida ao controle social, propõe-se a discussão sobre as potencialidades e tensões presentes na avaliação mista, um modelo de avaliação que combina procedimentos e instrumentos internos e externos às instituições. A discussão parte de uma experiência de avaliação mista realizada junto com a equipe técnica do Núcleo de Assessoria Técnica (NAT) do Ministério Público do Estado de São Paulo (MPSP), no âmbito do Grupo de Atuação Especial de Educação - Núcleo Ribeirão Preto (GEDUC-RP). Os resultados indicam que a avaliação mista foi potente devido ao seu formato dialógico: a avaliação externa possibilitou um olhar técnico e multiprofissional alinhado às proposições da política pública de qualidade; a avaliação interna promoveu uma autorreflexão coletiva da qualidade, mas evidenciou poderes diferenciados e fragilidades no que se refere ao olhar crítico de algumas instituições. Conclui-se que é no cruzamento destes olhares que se criam possibilidades de superação dos limites de cada tipo de avaliação e também convida à reflexão sobre os desafios que se instauram na dinâmica das relações entre as pessoas e órgãos públicos.

https://doi.org/10.1590/0102-469838459

11.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence
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Santos, Lorena Altafin

; Pinheiro, Dyovana Gomes

; Silva, Jéssica Malek da

; Borges, Giovanna Lombardi Bonini

; Silva, Paula Fernanda da

; Ricci-Vitor, Ana Laura

; Vanderlei, Luiz Carlos Marques

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 Nº 2 Páginas 235 - 243

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale “perceived need”, PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The “access” barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

https://doi.org/10.21470/1678-9741-2021-0436

12.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence
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Santos, Lorena Altafin

; Pinheiro, Dyovana Gomes

; Silva, Jéssica Malek da

; Borges, Giovanna Lombardi Bonini

; Silva, Paula Fernanda da

; Ricci-Vitor, Ana Laura

; Vanderlei, Luiz Carlos Marques

Brazilian Journal of Cardiovascular Surgery

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2023, Nº ahead

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-2021-0436

13.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

14.

Preditores de mortalidade e tempo médio de sobrevivência dos pacientes críticos
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Oliveira, Jussiely Cunha

; Vasconcelos, Geferson Messias Teles

; Bispo, Laura Dayane Gois

; Magro, Marcia Cristina da Silva

; Fonseca, Cassiane Dezoti da

; Pinheiro, Fernanda Gomes de Magalhães Soares

; Santana-Santos, Eduesley

Acta Paulista de Enfermagem

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2023, Volume 36 elocation eAPE01192

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

Abstract Objective To analyze the predictors of mortality and the average survival time of patients hospitalized in Intensive Care Units. Methods This is a prospective cohort, carried out from August 2018 to July 2019, in four adult Intensive Care Units (ICU) from the public and private network of the State of Sergipe. All adult patients were included, provided they had a minimum length of stay of 24 hours in the unit. The primary outcome was death. Secondary outcomes were dialysis, pressure injury, Acute Kidney Injury, need for invasive mechanical ventilation for more than 48 hours, infection, and length of hospital stay. Results Of the 432 patients, there was a predominance of death in male patients, older and coming from the emergency unit. The presence of heart failure, creatinine values >1.5 mg/dL at admission, diabetes mellitus, liver disease and smoking were also associated with the death outcome. As for the other predictors, the longest hospital stay, higher Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology (SAPS 3) and Nursing Activities Score (NAS) scores, in addition to the use of noradrenaline, stand out. The use of fentanyl was associated with increased survival time and the overall median survival time was 28 days. Conclusion The mortality predictors of patients admitted to the ICU in Sergipe were longer length of stay; the highest SOFA, SAPS-3 and NAS scores; creatinine >1.5mg/dl on admission; use of vasopressor drugs and the need for dialysis.

Resumen Objetivo Analizar los predictores de mortalidad y el tiempo promedio de supervivencia de los pacientes internados en unidades de cuidados intensivos. Métodos Cohorte prospectivo, realizado durante el período de agosto de 2018 a julio de 2019, en cuatro Unidades de Cuidados Intensivos (UCI) de adultos, de la red pública y privada del estado de Sergipe. Se incluyeron todos los pacientes adultos, con tiempo de permanencia mínima de 24 horas en la unidad. El criterio principal de valoración fue la defunción. Los criterios secundarios fueron: diálisis, úlcera por presión, lesión renal aguda, necesidad de ventilación mecánica invasiva durante más de 48 horas, infección y el tiempo de internación. Resultados De los 432 pacientes, hubo un predominio de defunciones en pacientes del sexo masculino, con edad más avanzada y procedentes de la unidad de emergencia. La presencia de insuficiencia cardíaca, valores de creatinina >1,5 mg/dL en la admisión, diabetes mellitus, enfermedad hepática y tabaquismo también estuvieron asociados con el desenlace de defunción. Con relación a los demás predictores, se destacaron el mayor tiempo de internación; mayores puntuaciones del Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) y Nursing Activies Score (NAS), además del uso de noradrenalina. El uso de fentanilo estuvo asociado con el aumento del tiempo de sobrevida y el tiempo promedio de supervivencia general fue de 28 días. Conclusión Los predictores de mortalidad de los pacientes internados en una UCI de Sergipe fueron: el mayor tiempo de internación; los puntajes más altos de SOFA, SAPS-3 y de NAS; creatinina >1,5mg/dl en la admisión; uso de drogas vasoactivas y la necesidad de diálisis.

Resumo Objetivo Analisar os preditores de mortalidade e o tempo médio de sobrevivência dos pacientes internados nas unidades de terapias intensivas. Métodos Coorte prospectiva, realizada no período de agosto de 2018 a julho de 2019, em quatro Unidades de Terapia Intensiva (UTI) de adultos, da rede pública e privada do Estado de Sergipe. Foram incluídos todos os pacientes adultos, desde que possuíssem o tempo de permanência mínima de 24 horas na unidade. O desfecho primário foi o óbito. Os desfechos secundários foram: diálise, lesão por pressão, lesão renal aguda, necessidade de ventilação mecânica invasiva por mais de 48 horas, infecção e o tempo de internação. Resultados Dos 432 pacientes, houve predomínio de óbito em pacientes do sexo masculino, com idade mais avançada e procedentes da unidade de emergência. A presença de insuficiência cardíaca, valores de creatinina >1,5 mg/dL na admissão, diabetes mellitus, doença hepática e tabagismo também tiveram associação com o desfecho óbito. Quanto aos demais preditores, destacaram-se o maior tempo de internação; maiores escores do Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) e Nursing Activies Score (NAS), além do uso de noradrenalina. O uso do fentanil foi associado ao aumento do tempo de sobrevida e o tempo médio de sobrevivência geral foi 28 dias. Conclusão Os preditores de mortalidade dos pacientes internados em UTI de Sergipe foram o maior tempo de internação; os maiores escores de SOFA, SAPS-3 e NAS; creatinina >1,5mg/dl na admissão; uso de drogas vasopressoras e a necessidade de diálise.

https://doi.org/10.37689/acta-ape/2023ao01192

15.

Strategies for reducing the impact of clubroot on broccoli cultivation in tropical mountain regions
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Santos, Carlos Antônio dos

; Amaral Sobrinho, Nelson Moura Brasil do

; Gonçalves, Rafael Gomes da Mota

; Lima, Jéssica de Oliveira

; Cruz, Laura Carine Candido Diniz

; Carmo, Margarida Goréte Ferreira do

Acta Scientiarum. Agronomy

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2023, Volume 45 elocation e61448

Resumo: En | Texto: En | PDF: En

ABSTRACT. Brassica spp. production can be negatively affected by clubroot, which is caused by the protozoan Plasmodiophora brassicae Woronin. Most of the information on clubroot control is derived from studies in temperate regions. Here, management strategies were evaluated to reduce broccoli (Brassica oleracea L. var. italica Plenck) crop losses owing to clubroot in tropical mountain regions. The first experiment revealed the effect of green manure from coriander (Coriandrum sativum L.), sunn hemp (Crotalaria juncea L.), sweet corn (Zea mays L.), and spontaneous vegetation (control) associated with broccoli seedlings of 4 different sizes. In the second experiment, the effect of soil amendments (limestone and steel slag) in conjunction with poultry litter (fresh or composted for 45 days) and without poultry litter (control), was assessed. Both field experiments sought to evaluate the disease intensity, plant development (root growth, biomass, and nutrient accumulation), and yield. Sunn hemp and coriander biomass resulted in higher healthy root volumes and dry weights of broccoli. However, such benefits were not derived from corn treatment. Compared to smaller seedlings (10 mL cell and 20 days of age, and 16 mL cell and 24 days of age), the use of larger seedlings (35 mL cell and 28 days of age, and 50 mL cell and 32 days of age) resulted in lower intensity of clubroot and increased the average yield by 143% in summer crops. Steel slag, like limestone, corrected soil acidity and resulted in plant growth; however, clubroot intensity was not significantly affected. Fresh and composted poultry litter increased the percentage of diseased roots compared with the control; however, broccoli yield was not affected by the treatments. Using green manure (sunn hemp or coriander) and well-developed seedlings is recommended as a strategy to reduce losses induced by clubroot during broccoli cultivation.

https://doi.org/10.4025/actasciagron.v45i1.61448

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