RESUMO Objetivo: Reconhecer e abordar a síndrome de Patau, apesar de sua raridade e da baixa expectativa de vida associada, por meio da apresentação de um estudo de caso de uma paciente de dois anos que recebe cuidados em casa por intermédio de serviços de home care. Descrição do caso: Apresentamos uma paciente do sexo feminino que desafiou as probabilidades, com sobrevivência prolongada devida, possivelmente, ao home care. Ela nasceu por cesariana, com 31 semanas + 4 dias, em razão da restrição do crescimento uterino. A mãe, de 36 anos, recebeu cuidados pré-natais adequados e gozava de boa saúde. O diagnóstico da síndrome de Patau foi confirmado por meio de cariótipo após o nascimento. Apesar da gravidade clínica do caso, a paciente, hoje com dois anos, recebe atendimento domiciliar especializado, apoiado por traqueostomia e gastrostomia. Um técnico de enfermagem dedicado 24 horas garante acompanhamento contínuo, e a paciente beneficia-se de check-ups médicos regulares, fisioterapia cinco vezes por semana, sessões semanais de fonoaudiologia, consultas mensais com nutricionista e apoio psicológico contínuo aos familiares. Comentários: Esta abordagem multidisciplinar resultou em melhora motora discreta, destacando o impacto positivo do cuidado integral no seu bem-estar geral. A existência de uma rede robusta de apoio às famílias que enfrentam desafios semelhantes é crucial, e um cuidado multidisciplinar pode prevenir eficazmente as complicações associadas a esta impactante síndrome. Objetivo associada care probabilidades devida possivelmente cesariana 3 dias uterino mãe prénatais pré natais saúde nascimento especializado gastrostomia 2 beneficiase beneficia se checkups check ups regulares semana fonoaudiologia familiares Comentários discreta bemestar bem estar geral crucial

ABSTRACT Objective: To recognize and address Patau’s syndrome, despite its rarity and associated low life expectancy, through the presentation of a case study of a 2-year-old patient receiving Home Care services. Case description: We present a female patient who defied the odds with a prolonged survival, possible due to Home Care. She was delivered via cesarean section at 31 weeks + 4 days due to restricted uterine growth. The mother, aged 36, had received proper prenatal care and was in good health. The diagnosis of Patau’s syndrome was confirmed through karyotyping after birth. Despite the severe clinical nature of the case, the patient, now with two years old, receives specialized home-based care, supported by a tracheostomy and gastrostomy. A dedicated 24-hour nursing technician ensures continuous monitoring, and the patient benefits from regular medical check-ups, physiotherapy five times a week, weekly speech therapy sessions, monthly consultations with a nutritionist, and ongoing psychological support for her family members. Comments: This multidisciplinary approach has resulted in a slight motor response, highlighting the positive impact of comprehensive care on her overall well-being. The existence of a robust support network for families facing similar challenges is crucial, and a multidisciplinary care can effectively prevent complications associated with this impactful syndrome. Objective Pataus Patau s expectancy 2yearold yearold 2 year old services description survival 3 growth mother 36 health birth homebased home based gastrostomy 24hour hour 24 monitoring checkups, checkups check ups, ups check-ups week sessions nutritionist members Comments response wellbeing. wellbeing well being. being well-being crucial

Abstract Dentures are used to restore missing teeth and are traditionally fabricated using the lostwax technique. The flasking process is arduous, time-consuming, error-prone, and requires a skilled technician. The development of 3D printing technology has made rapid prototyping of dentures more feasible. This case report describes the functional rehabilitation of a completely edentulous patient with complete dentures by a manufacturer-independent workflow with conventional clinical steps combined with computer-aided design, computer-aided manufacturing (CAD/CAM), and 3D printing technology. The result was 3D-printed complete dentures that were fully adapted, economical, and well-accepted by the patient.

Resumo As próteses são usadas para restaurar dentes perdidos e são tradicionalmente fabricadas usando a técnica de cera perdida através da muflagem. O processo de muflagem é trabalhoso, demorado, sujeito a erros e requer um técnico experiente. O desenvolvimento da tecnologia de impressão 3D tornou a prototipagem rápida de próteses uma alternativa viável. Este caso relata a reabilitação funcional de um paciente completamente edêntulo com próteses totais. É descrito o fluxo de trabalho na realização de próteses totais impressas com desenho e execução assistida por computador (CAD-CAM) e um fluxo de trabalho independente do fabricante com etapas clínicas convencionais combinadas com a tecnologia de impressão 3D. O resultado foi uma prótese total 3D totalmente adaptada, económica e bem aceite pelo paciente.

RESUMEN Para contribuir a solventar las insuficiencias en el tratamiento a las relaciones entre los contenidos químicos y los profesionales, en la formación del Técnico Medio en Agronomía, se elabora el presente artículo. El empleo de métodos del nivel teórico como: analítico-sintético; inductivo-deductivo; hermético-dialéctico e inducción-deducción, permite que se presente como principal resultado, los referentes teóricos, que, a juicio de los autores, fundamentan el proceso de enseñanza-aprendizaje de la Química y la profesionalización de sus contenidos. Desde las posiciones críticas que se asumen, se comprenden los procesos referidos y se conforma el marco teórico y contextual de la investigación en curso.

ABSTRACT In order to contribute to solve the insufficiencies in the treatment of the relations between the chemical contents and the professional ones, in the formation of the Middle Technician in Agronomy, the present article is elaborated. The use of theoretical level methods such as: analytical-synthetic; inductive-deductive; hermetic-dialectic and induction-deduction, allows presenting as main result, the theoretical referents, which, in the authors' opinion, support the teaching-learning process of Chemistry and the professionalization of its contents. From the critical positions assumed, the referred processes are understood and the theoretical and contextual framework of the current research is formed.

RESUMEN Introducción: en Paraguay en 1996 se crea la Escuela de Instrumentación y Área Quirúrgica, vinculada a una universidad pública, a partir del 2008 se crean otras ofertas en el sector privado. El instrumentador quirúrgico puede desempeñarse como instrumentador, circulante, coordinador general de quirófanos y coordinador de la central de esterilización. Objetivo: conocer la situación del ejercicio profesional del licenciado instrumentador quirúrgico en Paraguay. Metodología: estudio descriptivo, cuantitativo y trasversal. La muestra es de 167 licenciados, egresados de instituciones pública y privadas. Muestreo no probabilístico por conveniencia, el instrumento de recolección de datos es un cuestionario electrónico. Resultados: el 74 % son mujeres, el 50 % presenta un rango de edad de 21 a 30 años, 79,6 % egresados de una institución pública, 40 % dice tener dificultad moderada para el primer empleo. El acceso al empleo, 71 % fue por contactos personales, el 72 % se dedica a instrumentar, el 60 % tiene una antigüedad laboral de 1 a 5 años. Entre los posgrados, el 30 % posee didáctica universitaria. Discusión: instrumentador quirúrgico, reúne las exigencias para ocupar otras funciones además de instrumentar y circular en el quirófano. Igualmente, en otros estudios se evidencia menor participación en el área administrativa, docencia, mercadeo y ventas. Han trascurrido 20 años del egreso de las primeras promociones, siendo una profesión novel, poco visualizado. Es de subrayar que el estado puede ahorrar recursos económicos al contratar a instrumentadores, puesto que son expertos en los cuidados asépticos y competentes en optimizar los tiempos quirúrgicos al que se expone el paciente.

ABSTRACT Introduction: In Paraguay the school of Instrumentation and Surgical Area was created in 1996 linked to the National University, and in 2008 onwards other offers were created in the private sector. The Surgical Instrument Technician can work as instrumentalist, circulating nurse, general coordinator of operating rooms, and coordinator of the central sterilization unit. Objective: to know the work environment of the professional and licensed Surgical Instrument Technician in Paraguay. Methodology: descriptive, quantitative and cross-sectional study. The sample is 167 graduates, graduates of public and private institutions. Non-probability sampling for convenience, the data collection instrument is an electronic questionnaire. Results: 74% are women, 50% have an age range between 21 and 30 years old, 79.6% graduated from a public institution, 40% say they have moderate difficulty finding their first job in the field. Access to employment, 71% was through personal contacts, 72% is dedicated to work as Instrument Technicians, 60% have a job seniority of 1 to 5 years. Among the postgraduates, 30% are university didactics certified. Discussion: Surgical Instrument Technicians meet the requirements to perform other functions in addition to instrumentation and circulating nurses in the operating room. Similarly, other studies show less participation in the administrative area, teaching, marketing and sales. 20 years have elapsed since the first Technicians graduated, being a new profession, not given the importance it deserves. It is noteworthy that the state can save economic resources by hiring Surgical Instrument Technicians, since they are experts in aseptic care and competent in minimizing the amount of time the patient spends in surgery.

ABSTRACT An investigation related to the technological innovation was carried out in the Health Nursing-Technology Faculty from Santiago de Cuba, during the school course 2019-2020, aimed at designing an educational software for the subject Stratification of Environmental Risks, directed to medium technician students in Surveillance and Vector Control. The theoretical methods used were: analysis-synthesis, historical-logical, modelation, systemic-structural and inductive-deductive; and the empiric methods were: observation and documental analysis. The sample had 44 students and 6 professors chosen at random. It was concluded that the proposed software is feasible, pertinent and necessary as teaching aid; provides up-to-date information, it is easy and interesting to surf internet, and allows the self-appraisal of students in the interaction with themselves, what contributes to improve the independent work.

RESUMEN Se realizó una investigación relacionada con la innovación tecnológica, en la Facultad de Enfermería-Tecnología de la Salud de Santiago de Cuba, durante el curso escolar 2019-2020, con el objetivo de diseñar un software educativo para la asignatura Estratificación de Riesgos Medioambientales, dirigido a los estudiantes de técnico medio en Vigilancia y Lucha Antivectorial. Se utilizaron los métodos teóricos: análisis-síntesis, histórico-lógico, modelación, sistémico-estructural e inductivo-deductivo; y empíricos: observación y análisis documental. La muestra fue de 44 estudiantes y 6 profesores escogidos al azar. Se concluye que el software propuesto es factible, pertinente y necesario como medio de enseñanza; proporciona información actualizada, su navegación es fácil y amena, y permite la autoevaluación de los estudiantes al interactuar con él mismo, lo que contribuye a mejorar el trabajo independiente.

Resumo A formação de técnicos de nível médio com uma sólida preparação profissional é baseado na prática de trabalho na educação técnica e profissional, especificamente na rotação pelos postos de trabalho. Estudos prévios sobre este processo identificaram muitas deficiências cuja solução consiste em modelar a rotação por postos de tabalho. Entre os métodos utilizados estão a sistematização teórica, modelagem, entrevistas, entre outros, que contribuem para a contextualização da rotação ao objeto de trabalho da empresa e ao objeto da profissão; elimina-se a dispersão teórica da rotação ao ser conceitualizada como forma de organizar o processo ensino-aprendizagem; se reconhecem as características dos estudantes nos centros de produção didática e a classificação da rotação é estabelecida como uma forma que responde às características dos postos de trabalho.

Resumen La formación de técnicos medios con una sólida preparación profesional, tiene como modalidad en la Educación Técnica y Profesional la práctica laboral, en específico la rotación por puesto de trabajo. En estudios precedentes sobre este proceso se identifican múltiples insuficiencias. Cuya solución está en modelar la rotación por puesto de trabajo como una forma de organización de la práctica laboral de este profesional, entre los métodos utilizados están la sistematización teórica, la modelación, entrevista, entre otros; que aporta la contextualización de la rotación al objeto de trabajo de la empresa y del objeto de la profesión; se elimina la dispersión teórica de la rotación al ser conceptualizada como forma de organización del proceso de enseñanza-aprendizaje; se reconocen las características del estudiantes en los centro de producción docente y se establece clasificación de la rotación como forma que responde a las características de los puestos de trabajo.

Abstract The formation of mid-level technicians with a solid professional training includes as a modality in the Technical and Vocational Education the "trainee period", which consists of job rotation. Previous studies on this process have shown multiple insufficiencies, and its solution lies in using job rotation as a form of organization during the trainee period of this professional. Among the methods used are theoretical systematization, modeling, interview, among others; which contribute to the contextualization of the rotation to the work object of the business and the object of the profession; the theoretical dispersion of the rotation is eliminated by being conceptualized as a form of organization of the teaching-learning process; the characteristics of the students in the teaching production centers are recognized and the classification of the rotation is established as a form that responds to the characteristics of the work places.

For many decades the literature has regularly reported that there is a discrepancy between what is taught in dental school and what is practised, especially in the field of removable partial dentures. Not only that, but for more than 60 years reports from around the world have shown that, usually, the majority of clinicians abdicate their responsibility to design a removable partial denture (RPD) and instead leave this to the dental technician, who has no knowledge of the clinical condition of the patient and works only from a cast. Most patients around the world who require RPDs to improve aesthetics and chewing can only afford a removable prosthesis simply because the majority are poor. But RPDs can improve these aspects and contribute to an improved quality of life.

For many decades the literature has regularly reported that there is a discrepancy between what is taught in dental school and what is practised, especially in the field of removable partial dentures. Not only that, but for more than 60 years reports from around the world have shown that, usually, the majority of clinicians abdicate their responsibility to design a removable partial denture (RPD) and instead leave this to the dental technician, who has no knowledge of the clinical condition of the patient and works only from a cast. Most patients around the world who require RPDs to improve aesthetics and chewing can only afford a removable prosthesis simply because the majority are poor. But RPDs can improve these aspects and contribute to an improved quality of life. The purpose of this series of articles is to derive the basic, evidence-informed principles of partial denture design and to suggest a simplified explanation and application of those principles in the hope that clinicians will increasingly take responsibility for the design of partial dentures. Part 1 summarised studies revealing what can only be described as the malpractice of abdication of responsibility for design by clinicians, and then explained the evidence-informed basic principles of design; Part 2 looked at the biomechanical basis of those principles in terms of support; Part 3 did the same for the biomechanical basis of retention; this part will provide a simple seven-step approach to design, applied to an example of an acrylic resin-based and a metal framework-based denture for the same partially edentulous arch; and Part 5 will provide examples of designs for RPDs that have been successfully worn by patients, for each of the Kennedy Classifications of partially dentate arches. Much of this is referenced from an electronic book on the Fundamental of removable partial dentures.¹

Abstract Federal higher education institutions in Brazil have particularities in terms of construction, geographical location, use of buildings, organizational structures and allocation of budgetary resources. These characteristics make managing the Fire Protection System a significant challenge, requiring an even higher level of attention and commitment. This article aims to present data describing the current context of Fire Protection and Fire Fighting System management at Federal higher education institutions in Brazil (Federal universities and institutes). The data collection was a survey, in which 87 employees, representing 69 institutions, occupying the positions of Occupational Safety Engineer or Technician took part. Among the results, the following stand out: 51% of the institutions do not have a Fire Protection System Management Plan and 32% are in the process of creating one. All institutions inspect and maintain fire extinguishers; only a minority monitor other equipment. Operational routines are weakened by a lack of management (35%), financial resources (31%) and technical staff to carry out the service (24%). Only 9% of the institutions have a Fire Department Inspection Certificate for all their buildings and 5% have an active fire department in all their buildings. Only 9% of institutions have a Fire Department Inspection Certificate for all buildings and 5% have an active fire department in all buildings. The management of the Fire Protection System in Federal higher education institutions in Brazil faces significant challenges, including a lack of management plans, insufficient control of devices and limited resources, resulting in low compliance with fire safety regulations. construction location challenge commitment institutes. institutes . institutes) survey 8 employees 6 part results 51 32 one extinguishers equipment 35%, 35 35% , (35%) 31% 31 (31% 24%. 24 24% (24%) 9 5 challenges plans regulations 3 (35% (31 2 (24% (35 (3 (24 ( (2

ABSTRACT Purpose: Timely screening and treatment are essential for preventing diabetic retinopathy blindness. Improving screening workflows can reduce waiting times for specialist evaluation and thus enhance patient outcomes. This study assessed different screening approaches in a Brazilian public healthcare setting. Methods: This retrospective study evaluated a telemedicine-based diabetic retinopathy screening implemented during the COVID-19 pandemic and compared it with in-person strategies. The evaluation was conducted from the perspective of a specialized referral center in an urban area of Central-West Brazil. In the telemedicine approach, a trained technician would capture retinal images by using a handheld camera. These images were sent to specialists for remote evaluation. Patient variables, including age, gender, duration of diabetes diagnosis, diabetes treatment, comorbidities, and waiting time, were analyzed and compared. Results: In total, 437 patients with diabetes mellitus were included in the study (mean age: 62.5 ± 11.0 years, female: 61.7%, mean diabetes duration: 15.3 ± 9.7 years, insulin users: 67.8%). In the in-person assessment group, the average waiting time between primary care referral and specialist evaluation was 292.3 ± 213.9 days, and the referral rate was 73.29%. In the telemedicine group, the average waiting time was 158.8 ± 192.4 days, and the referral rate was 29.38%. The telemedicine approach significantly reduced the waiting time (p<0.001) and significantly lowered the referral rate (p<0.001). Conclusion: The telemedicine approach significantly reduced the waiting time for specialist evaluation in a real-world setting. Employing portable retinal cameras may address the burden of diabetic retinopathy, especially in resource-limited settings. Purpose blindness outcomes setting Methods telemedicinebased based COVID19 COVID 19 COVID-1 inperson person strategies CentralWest Central West Brazil camera variables age gender diagnosis comorbidities Results total 43 625 62 5 62. 110 11 0 11. years female 617 61 7 61.7% 153 15 3 15. 97 9 9. users 67.8%. 678 67.8% . 67 8 67.8%) group 2923 292 292. 2139 213 213. days 7329 73 29 73.29% 1588 158 158. 1924 192 4 192. 2938 38 29.38% p<0.001 p0001 p 001 (p<0.001 p<0.001. Conclusion realworld real world resourcelimited resource limited settings COVID1 1 COVID- 6 61.7 67.8 21 732 2 73.29 293 29.38 p<0.00 p000 00 (p<0.00 61. 67. 73.2 29.3 p<0.0 p00 (p<0.0 73. 29. p<0. p0 (p<0. p<0 (p<0 p< (p< (p

Abstract Objective To investigate the prevalence and associated factors of depression and anxiety among hospital healthcare workers during the COVID-19 pandemic in the extreme south of Brazil. Method Cross-sectional study was conducted with 264 healthcare workers, between August and December 2020. Depression and anxiety were assessed using the Patient Health Questionnaire and the Generalized Anxiety Scale. Multivariable linear regression analysis was performed. Results The prevalence of depression and anxiety among healthcare workers was 32.4% and 26.2%, respectively. The profession of nursing technician, having a family member who had lost a job, being responsible for family income, being 50 or more years old, being divorced or widowed, having a test for COVID-19, having suffered a traumatic event in life and having received psychological counseling at work were associated with depression and anxiety. Conclusion In this study, receiving psychological counseling at work was a protective factor for anxiety and depression. COVID19 COVID 19 COVID-1 Brazil Crosssectional Cross sectional 26 2020 Scale performed 324 32 4 32.4 262 2 26.2% respectively technician job income 5 old widowed COVID19, 19, COVID1 1 COVID- 202 3 32. 26.2 20 26.

Resumo Objetivo Investigar a prevalência e os fatores associados à depressão e ansiedade entre profissionais de saúde durante a pandemia de COVID-19 no extremo sul do Brasil. Método Estudo transversal realizado com 264 profissionais de saúde, entre agosto e dezembro de 2020. Depressão e ansiedade foram avaliadas por meio do Questionário de Saúde do Paciente e da Escala de Ansiedade Generalizada. Foi realizada análise de regressão linear multivariável. Resultados A prevalência de depressão e ansiedade entre os profissionais de saúde foi de 32,4% e 26,2%, respectivamente. Ser técnico de enfermagem, ter familiar que tenha perdido o emprego, ser responsável pela renda familiar, ter 50 anos ou mais, ser divorciado/viúvo, ter feito exame para COVID-19, ter sofrido evento traumático na vida e ter recebido aconselhamento psicológico no trabalho esteve associado a depressão e ansiedade. Conclusão Neste estudo, receber aconselhamento psicológico no trabalho foi um fator de proteção para ansiedade e depressão. COVID19 COVID 19 COVID-1 Brasil 26 2020 Generalizada multivariável 324 32 4 32,4 262 2 26,2% respectivamente enfermagem emprego 5 mais divorciadoviúvo divorciado viúvo divorciado/viúvo COVID19, 19, estudo COVID1 1 COVID- 202 3 32, 26,2 20 26,

Resumen El objetivo del estudio presentado fue evaluar la percepción de la calidad del proceso de aprendizaje en el entorno virtual de los alumnos del Programa Salud con Agentes. Se trató de un estudio transversal realizado en 2022 con 9.145 alumnos de los cursos de Técnico en Agente Comunitario de Salud y Técnico en Vigilancia Sanitaria con énfasis en la lucha contra las enfermedades endémicas. La información sobre la calidad del proceso de aprendizaje se obtuvo a través de la Encuesta Constructivist On-Line Learning Environment Survey, que consta de 24 preguntas agrupadas en seis dimensiones: relevancia, reflexión crítica, interacción, apoyo de los tutores, apoyo de los alumnos y comprensión. Se evaluó el perfil sociodemográfico de los participantes y las principales vías de acceso al curso y seguimiento. Se realizó un análisis descriptivo y se utilizó la prueba de chi-cuadrado o la prueba exacta de Fisher para analizar las asociaciones. Los participantes eran en su mayoría mujeres, en la franja de edad 40 a 49 años, de la región Nordeste; realizaban las actividades en casa y utilizaban teléfonos móviles/smartphones. Al considerar las seis dimensiones evaluadas, la relevancia, la interacción y el apoyo de los compañeros mostraron diferencias estadísticamente significativas entre los alumnos de los cursos de Técnico en Agente Comunitario de Salud y Técnico en Vigilancia Sanitaria con Énfasis en la Lucha contra las Enfermedades Endémicas. Agentes 202 9145 9 145 9.14 endémicas OnLine On Line Survey 2 relevancia crítica tutores comprensión seguimiento chicuadrado chi cuadrado asociaciones mujeres 4 años Nordeste móvilessmartphones móviles smartphones móviles/smartphones evaluadas Endémicas 20 914 14 9.1 91 1 9.

Abstract The study presented here aimed to evaluate the perception of the quality of the learning process in the virtual environment of the students of the Health Program with Agent. It was a cross-sectional study conducted in 2022 with 9,145 students from the Community Health Agent Technician and Health Surveillance Technician courses with an Emphasis on Combating Endemic Diseases. Information on the quality of the learning process was obtained through the Constructivist On-Line Learning Environment Survey, which consists of 24 questions grouped into six dimensions: relevance, critical reflection, interaction, tutor support, peer support, and understanding. The sociodemographic profile of the participants and the primary forms of access to the course and monitoring were evaluated. Descriptive analysis was performed; for association analysis, the chi-square or Fisher’s exact test was used. Most participants are females aged 40 to 49 from the Northeast region; they perform activities at home and use their cell phones/smartphones. When considering the six dimensions evaluated, relevance, interaction, and support of colleagues obtained statistically significant differences between the students of the courses of Community Health Agent Technician and Health Surveillance Technician with Emphasis on Combating Endemic Diseases. crosssectional cross sectional 202 9145 9 145 9,14 Diseases OnLine On Line Survey 2 relevance reflection interaction understanding evaluated performed chisquare chi square Fishers Fisher s used 4 region phonessmartphones phones smartphones phones/smartphones 20 914 14 9,1 91 1 9,

Resumo O estudo aqui apresentado teve por objetivo avaliar a percepção da qualidade do processo de aprendizagem no ambiente virtual dos estudantes do Programa Saúde com Agente. Tratou-se de um estudo transversal, realizado em 2022, com 9.145 estudantes dos cursos de Técnico em Agente Comunitário de Saúde e Técnico em Vigilância em Saúde com Ênfase no Combate às Endemias. Informações sobre a qualidade do processo de aprendizagem foram obtidas por meio do questionário Constructivist On-Line Learning Environment Survey, que consiste em 24 questões agrupadas em seis dimensões: relevância, reflexão crítica, interação, apoio dos tutores, apoio dos colegas e compreensão. Avaliaram-se o perfil sociodemográfico dos participantes e as principais formas de acesso ao curso e acompanhamento. Realizou-se análise descritiva; para análise de associação, utilizou-se o teste qui-quadrado ou exato de Fisher. A maioria dos participantes é do sexo feminino, faixa etária de 40 a 49 anos, da região Nordeste; realiza as atividades em casa e usa o celular/smartphone. Ao se considerarem as seis dimensões avaliadas, relevância, interação e apoio dos colegas obtiveram diferenças estatisticamente significativas entre os estudantes dos cursos de Técnico em Agente Comunitário de Saúde e Técnico em Vigilância em Saúde com Ênfase no Combate às Endemias. Tratouse Tratou transversal 2022 9145 9 145 9.14 Endemias OnLine On Line Survey 2 relevância crítica tutores compreensão Avaliaramse Avaliaram acompanhamento Realizouse Realizou descritiva associação utilizouse utilizou quiquadrado qui quadrado Fisher feminino 4 anos Nordeste celularsmartphone celular smartphone celular/smartphone avaliadas 202 914 14 9.1 20 91 1 9.

Resumen Introducción: La Intubación orotraqueal (IOT) profiláctica en pacientes con sospecha de Injuria Inhalatoria (II) es una práctica clínica extendida en nuestro país. La misma puede estar asociada a complicaciones y a un aumento de los costos asistenciales. Objetivo: caracterizar a la población de pacientes que ingresaron con IOT al Centro Nacional de Quemados, determinar la incidencia de Intubación orotraqueal no necesaria (IOTNN) así como las complicaciones vinculadas a la misma. Método: Estudio retrospectivo, observacional, analítico. Se incluyeron todos los pacientes con quemadura térmica ingresados al CENAQUE con vía aérea artificial entre enero de 2015 y julio 2023. Se determinaron características demográficas, circunstancias de la injuria, lugar y técnico que realizo la IOT, porcentaje de superficie corporal total quemada (SCTQ), scores de severidad, días de ARM, estado al alta y diagnóstico de II por fibrobroncoscopía. Se analizaron las complicaciones asociadas a la IOT y ARM. Dichas variables fueron contrastadas entre el grupo extubado exitosamente en las primeras 48 horas (IOTNN) y aquellos extubados luego de las 48 horas (IOTP). Resultados: Se incluyeron 562 pacientes. La incidencia de IOTNN fue 41,7% e II 46,7%. Se observaron diferencias significativas entre IOTNN y IOTP para edad [34 (24-48) versus 45 (30-62); p <0,001, para SCTQ [4% (1-11) versus 20% (6-36); p <0,001], ABSI [4 (3-5) versus 7 (5-9) p<0,001], Rev. Baux [48 (33-62) versus 77 (60-99), p <0,001], incidencia de II (32% versus 56,6%, p <0,001). La aspiración de VA (30% versus 20,2% p 0,018), extubación durante el traslado (2% versus 0% p 0,043) e incidencia de NA (Neumonía aspirativa) y NAVP (neumonía asociada a la ventilación mecánica precoz) (56,3% versus 15% p <0,001) fueron mayores en el grupo IOTP. Conclusiones: La IOTNN en los pacientes con quemaduras es frecuente en nuestro medio y se asocia a complicaciones. La misma es realizada por médicos sin formación en el manejo de la vía aérea.

Resumo Introdução: A intubação orotraqueal (IOT) profilática em pacientes com suspeita de lesão por inalação (LI) é uma prática clínica difundida em nosso país. Esta prática pode estar associada a complicações e ao aumento dos custos assistenciais. Objetivo: Caracterizar a população de pacientes que ingressaram com IOT no Centro Nacional de Queimados, determinar a incidência de intubação orotraqueal desnecessária (IOTD) e as complicações associadas. Método: Estudo retrospectivo, observacional, analítico. Foram incluídos todos os pacientes com queimadura térmica admitidos no CENAQUE com via aérea artificial entre janeiro de 2015 e julho de 2023. Foram determinadas características demográficas, circunstâncias da lesão, local e técnico que realizou a IOT, porcentagem da superfície corporal total queimada (SCTQ), escores de gravidade, dias de ventilação mecânica, estado na alta e diagnóstico de LI por fibrobroncoscopia. Complicações associadas à IOT e à ventilação mecânica foram analisadas. Essas variáveis foram comparadas entre o grupo extubado com sucesso nas primeiras 48 horas (IOTD) e aqueles extubados após 48 horas (IOTP). Resultados: Foram incluídos 562 pacientes. A incidência de IOTD foi de 41,7% e LI de 46,7%. Diferenças significativas foram observadas entre IOTD e IOTP em relação à idade [34 (24-48) versus 45 (30-62); p <0,001], SCTQ [4% (1-11) versus 20% (6-36); p <0,001], ABSI [4 (3-5) versus 7 (5-9) p<0,001], índice de Baux [48 (33-62) versus 77 (60-99), p <0,001], incidência de LI (32% versus 56,6%, p <0,001). A aspiração de via aérea (30% versus 20,2% p 0,018), extubação durante o transporte (2% versus 0% p 0,043) e incidência de pneumonia aspirativa (PA) e pneumonia associada à ventilação mecânica precoce (NAVM) (56,3% versus 15% p <0,001) foram maiores no grupo IOTP. Conclusões: A IOTD em pacientes com queimaduras é frequente em nosso meio e está associada a complicações. A mesma é realizada por médicos sem formação no manejo da via aérea.

Abstract Introduction: Prophylactic Orotracheal Intubation (OTI) in patients with suspected Inhalation Injury (II) is a widespread clinical practice in our country. It can be associated with complications and increased healthcare costs. Objective: To characterize the population of patients admitted with OTI to the National Burn Center, determine the incidence of unnecessary Orotracheal Intubation (UOTI), and the associated complications. Method: Retrospective, observational, analytical study. All patients with thermal burns admitted to the National Burn Center (CENAQUE) with an artificial airway between January 2015 and July 2023 were included. Demographic characteristics, injury circumstances, location, and technician performing the OTI, percentage of total body surface area burned (TBSA), severity scores, days on mechanical ventilation, discharge status, and diagnosis of II by fibrobronchoscopy were determined. Complications associated with OTI and mechanical ventilation were analyzed. These variables were compared between the group extubated successfully within the first 48 hours (UOTI) and those extubated after 48 hours (necessary OTI, NOTI). Results: 562 patients were included. The incidence of UOTI was 41,7% and II 46,7%. Significant differences were observed between UOTI and NOTI in age [34 (24-48) versus 45 (30-62); p <0.001], TBSA [4% (1-11) versus 20% (6-36); p <0,001], ABSI [4 (3-5) versus 7 (5-9) p<0,001], Baux score [48 (33-62) versus 77 (60-99), p <0,001], incidence of II (32% versus 56.6%, p <0,001). Aspiration of the airway (30% versus 20,2% p 0,018), extubation during transport (2% versus 0% p 0,043), and incidence of aspiration pneumonia (AP) and early ventilator-associated pneumonia (VAP) (56,3% versus 15% p <0,001) were higher in the NOTI group. Conclusions: UOTI in burn patients is frequent in our setting and is associated with complications. It is performed by physicians without training in airway management.

RESUMEN Introducción. La fase pre-analítica es un componente esencial en el algoritmo de análisis clínicos, que conlleva una serie de pasos y procedimientos. Objetivo. Describir el nivel de cumplimiento de los indicadores preanalíticos en las áreas de química y hematología del laboratorio clínico del Hospital Distrital Inmaculada Concepción. Materiales y método. Se aplicó un diseño no experimental con un enfoque mixto de corte transversal y alcance descriptivo. Se incluyeron tres bioquímicos y cien pacientes mediante un muestreo por conveniencia. Los datos fueron obtenidos por observación estructurada a pacientes y entrevista semiestructurada a los funcionarios del hospital. Resultados. El nivel de desempeño de los bioquímicos con relación a los indicadores preanalíticos presenta aspectos tanto positivos como negativos, de los cuales resalta el aspecto positivo en un 61% y el 39% corresponde a aspectos considerados como deficientes. Las dificultades existentes son la identificación correcta del paciente y la comunicación entre el médico tratante y/o técnico con ellos, los cuales en su gran mayoría no tienen conocimiento de las condiciones en las cuales deben presentarse para un examen médico. Conclusión. La adecuada realización de las acciones correctas, como la calidad de las mismas, en la fase pre-analítica se relaciona de manera directa con los resultados que se obtienen, que luego serán utilizados por los profesionales solicitantes para toma de decisiones, por lo que es un eslabón inicial que afecta a todo el proceso posterior.

ABSTRACT Introduction. The pre-analytical phase is a vital component of the clinical analysis algorithm. This involves a series of steps and procedures. Objective. To describe the level of compliance with the preanalytical indicators in the areas of chemistry and haematology of the clinical laboratory at a local Hospital in Caaguazú. Materiales y método. A non-experimental design and a mixed cross-sectional approach were applied. Three biochemists and one hundred patients were includer. Results. Our data was obtained by structured observation to patients and semi-structured interviews to three biochemists. The level of performance of the biochemists about the pre-analytical indicators presents both positive and negative aspects, of which the positive aspect stands out in 61% and 39% corresponds to aspects considered as deficient. The existing difficulties are the correct identification of the patient and the communication between the treating physician and/or technician, most of whom are unaware of the conditions in which they should present themselves for a medical examination. Conclusion. The correct performance, as well as their quality, in the pre-analytical phase, is directly related to the results obtained, which the requesting professionals will later use for decision-making, so it is an initial link that affects the entire subsequent process and must always be considered essential.

Resumo Objetivos: Avaliar a comunicação entre médicos dentistas e técnicos de prótese dentária em Lisboa para a confeção de uma estrutura de prótese parcial removível esquelética. Métodos: Foi realizado um estudo observacional cuja população-alvo foram laboratórios na área metropolitana de Lisboa. A recolha de dados foi realizada através de um questionário, que recolheu informação de 6 categorias: guia de requisição médica, impressão definitiva convencional e respetiva desinfeção, impressão digital, análise dos modelos de estudo e de trabalho, e desenho e construção da estrutura metálica. O preenchimento do questionário foi realizado pelos técnicos de prótese com consulta das requisições médicas e dos modelos de gesso. Foi realizada estatística descritiva das variáveis. Resultados: Três laboratórios aceitaram participar no estudo. A amostra incluiu 53 questionários completamente preenchidos. Todos os modelos definitivos foram obtidos por impressão convencional, com moldeira universal (67,9%) e alginato (84,9%). Todas as impressões foram desinfetadas no laboratório, maioritariamente com hipoclorito de sódio (98,1%). A análise com paralelómetro foi realizada pelo técnico de prótese em 84,9% dos casos e 66% dos modelos de trabalho não tinham preparações pré-protéticas. Verificou-se que o médico dentista transmitiu instruções sobre o desenho em 5 casos e apenas num caso enviou o desenho em papel. Todas as estruturas metálicas foram obtidas em cobalto-crómio e o método mais usado foi a fundição por indução eletrónica (96,6%). Conclusões: A maior parte das instruções do desenho e do planeamento para a construção de próteses parciais removíveis não foram fornecidas pelo médico dentista ao técnico de prótese dentária, verificando-se uma comunicação insuficiente entre clínicas e laboratórios em Lisboa.

Abstract Objectives: To evaluate the communication between dentists and dental technicians in Lisbon for the construction of metal frameworks for removable partial dentures (RPDs). Methods: This observational study’s target population was laboratories in Lisbon. Data were collected through a questionnaire including six categories: medical prescription, conventional definitive impression and its disinfection, digital impression, analysis of study and working casts, and design and construction of the metallic structure. Dental technicians completed the questionnaire after consulting the medical instructions and observing the stone casts. The variables were subjected to descriptive statistics. Results: Three laboratories agreed to participate in this study, and the final sample included 53 entirely completed questionnaires. All definitive casts were obtained by conventional impression, with a universal tray (67.9%) and alginate (84.9%). The laboratories disinfected all impressions, mostly with sodium hypochlorite (98.1%), and the dental technician analyzed 84.9% of the casts in the parallelometer. There were no pre-prosthetic preparations in 66% of the working casts. The dentists provided design instructions in five cases, and only one delivered a drawing on paper. All metal frameworks were made in cobalt-chromium, mainly by electronic induction casting (96.6%). Conclusions: The dentist did not provide the dental technician with most of the design and planning instructions required for constructing removable partial dentures. This finding confirms the lack of communication between clinics and laboratories in Lisbon.