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[SciELO Preprints] - POSSIBILITIES AND CHALLENGES OF ACTIONS FOR GENDER EQUITY AND RESEARCH TEACHING FOR TEENAGE
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Franzolin, Fernanda Pavão Teixeira Papalardo, Silvana Boccuzzi Santana, Carolina Maria Dutra das Neves, Franciele da Silva Tanajura, Vanessa Bonfá Diare Alvares, Eliana Ely de Almeida, Ester Aparecida Dos Santos Calegari, Andreia Damasceno Costa, Daiana Martho Landinho, Flávia Andrade Hamada, Natasha Bueno, Kely Cristina Reis Soares, João Paulo Santos de Cerqueira, Bruno Rafael

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Publication date: 2024-12-19

Abstract: En Es Pt

Gender equity still needs to be fostered in society, and education can help change this scenario. This research aimed to investigate the impact of a didactic sequence involving inquiry-based science education and actions aimed at gender equity and deconstructing stereotypes in promoting more equitable participation among adolescent girls and boys. This is an action research in an extension activity, which analysed evaluative data from video recordings and questionnaires. The analysis involved immersion in the data, its categorisation and coding, and the determination of counting rules. The results indicate that inquiry based science education and jointly planned actions can help avoid sexist examples, foster examples of women's participation in Science, and enable equal participation between girls and boys, enabling them to interact and engage equally. Among the challenges identified, we have the greater difficulty in stimulating argumentation and explanation from both girls and boys and stimulating verbal participation from students who are not very participative.

La equidad de género sigue siendo un tema pendiente de fomentar en la sociedad y la educación puede contribuir a cambiar este escenario. Esta investigación se propuso investigar el impacto de una secuencia didáctica que incluía educación científica basada en la indagación y acciones dirigidas a la equidad de género y a la deconstrucción de estereotipos en la promoción de una participación más equitativa entre las niñas y los niños adolescentes. Se trata de una investigación-acción en una actividad de extensión, que analizó datos evaluativos de grabaciones de vídeo y cuestionarios. El análisis implicó la inmersión en los datos, su categorización y codificación, y la determinación de reglas de conteo. Los resultados indican que la educación científica basada en la indagación y las acciones planificadas conjuntamente pueden ayudar a evitar ejemplos sexistas, fomentar ejemplos de participación de mujeres en la Ciencia y permitir la participación igualitaria entre niñas y niños, permitiéndoles interactuar y participar en igualdad de condiciones. Entre los retos identificados, tenemos la mayor dificultad para estimular la argumentación y la explicación tanto de las niñas como de los niños y estimular la participación verbal de los/as estudiantes poco participativos/as.

A equidade de gênero ainda precisa ser fomentada na sociedade e a educação pode contribuir para mudar este cenário. Nesta pesquisa, objetivamos investigar o impacto de uma sequência didática envolvendo o Ensino de Ciências por Investigação e ações voltadas para equidade de gênero e desconstrução de estereotipias na promoção de uma participação mais equitativa entre meninas e meninos adolescentes. Trata-se de uma pesquisa-ação em uma atividade extensionista, que analisou dados avaliativos proveninentes de videogravações e questionários. A análise envolveu a imersão nos dados, sua categorização e codificação e a determinação de regras de contagem. Os resultados apontam que o Ensino de Ciências por Investigação e as ações conjuntamente planejadas podem ajudar a evitar exemplos sexistas, fomentar exemplos da participação das mulheres nas Ciências e possibilitar a equidade de participação entre meninas e meninos possibilitando-lhes interação e engajamentos equitativos. Entre os desafios identificados temos: a maior dificuldade de estimular a argumentação e a explicação tanto de meninas como de meninos, e estimular a participação verbal dos alunas/os pouco participativas/os.

https://doi.org/10.1590/SciELOPreprints.10495

Analysis of the Accuracy of CAM-type Deformity Resection on a Low-cost Arthroscopic Simulator in a Training Scenario CAMtype CAM type Lowcost Low cost
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Souza, Bruno Gonçalves Schroder e

; Vieira, Vitor Homero

; Miranda, Marcos

; Carvalho, Luiz Guilherme Vidal Assad de

; Bastos, Flavia de Souza

; Boas, João Vitor Delgado Vilas

Revista Brasileira de Ortopedia

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jun 2024, Volume 59 N. 3 Pages 449 - 455

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

Abstract Objective To evaluate surgeons’ performance in resecting CAM-type deformities using a realistic arthroscopic surgery simulator. Methods An arthroscopic simulator was created using low-cost materials with the help of a GTMax Core A1 3D printer and the programs Invesalius and Meshmixer 2017, which were used to develop femoral head parts in ABS material, with the presence of a CAM-type deformity, to mimic a femoroacetabular impact situation. After the operations were performed by 16 surgeons, the femurs were compared to a previous model with deformity and another without, using Cloudcompare, and parameters such as the volumetric difference between the operated femurs, with and without deformity, the minimum and maximum distance between them, the percentage of the deformity resected, the estimated time for total resection of the deformity, as well as a qualitative analysis based on the images and graphs provided by the program representing the areas of the parts resected, were evaluated at the end. Results The average resection speed was 34.66 mm3/min (SD = 46 mm3/min, max = 147.33; min = −2.66). The average resection rate was 26.2% (SD = 34.7%, max = 111; min = −2). Qualitative analysis showed hyporesection of deformities and sometimes hyperresection of nondeformed areas. The simulator was highly rated by the surgeons, with a tactile sensation very similar to real surgery, according to them. Conclusion Arthroscopic simulators have proved very useful in training less experienced surgeons. surgeons CAMtype CAM type lowcost low cost A D 2017 material situation 1 Cloudcompare them resected end 3466 34 66 34.6 mm3min mmmin mm3 mm SD 4 147.33 14733 147 33 −2.66. 266 −2.66 . 2 −2.66) 262 26 26.2 347 7 34.7% 111 −2. −2 −2) 201 346 3 6 34. 147.3 1473 14 −2.6 26. 34.7 11 − 20 147.

Resumo Objetivo Avaliar o desempenho de cirurgiões na ressecção de deformidades tipo CAME fazendo uso de um simulador realista de cirurgia artroscópica. Métodos Um simulador artroscópico foi criado a partir de materiais de baixo custo com auxílio de uma impressora 3D GTMax Core A1 e dos programas Invesalius e Meshmixer 2017, que foram utilizados para criar peças de cabeça de fêmur em material ABS, com a presença de uma deformidade tipo CAME, a fim de mimetizar uma situação de impacto femoroacetabular. Após as operações serem realizadas por 16 cirurgiões, os fêmures foram comparados a um modelo prévio com e outro sem deformidade pelo programa Cloudcompare, sendo avaliados ao final parâmetros como diferença volumétrica entre os fêmures operados, com e sem deformidade, distância mínima e máxima entre eles, porcentagem da deformidade ressecada, tempo estimado para ressecção total da deformidade, além de uma análise qualitativa feita com base nas imagens e gráficos fornecidos pelo programa representando as áreas das peças efetivamente ressecadas. Resultados A velocidade média de resseção foi de 34,66mm3/minuto (DP = 46 mm3/min, max = 147,33 mm3/min; min = −2,66 mm3/min). A média de ressecção obtida foi de 26,2% (DP = 34,7%, max = 111%; min = −2%). A análise qualitativa demonstrou uma hiporresecção das deformidades e, por vezes, hiperresecção de áreas não deformadas. O simulador foi muito bem avaliado pelos cirurgiões, tendo uma sensação tátil bem semelhante à cirurgia real segundo os mesmos. Conclusão Simuladores artroscópicos se mostraram muito úteis no treinamento de cirurgiões menos experientes. artroscópica D 2017 ABS femoroacetabular 1 Cloudcompare operados eles ressecada ressecadas 3466mm3minuto mmminuto 34 66mm3 minuto mm DP 4 mm3min mmmin mm3 mm3/min 14733 147 33 147,3 266 2 66 −2,6 mm3/min. . mm3/min) 262 26 26,2 347 7 34,7% 111% 111 −2%. −2% −2%) vezes deformadas mesmos experientes 201 3 66mm 1473 14 147, 6 −2, 26, 34,7 11 −2 20 34, −

https://doi.org/10.1055/s-0044-1785666

[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bacal, Fernando Bocchi, Edimar Alcides Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco

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Publication date: 2024-04-08

Abstract: Pt Es En

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

https://doi.org/10.1590/SciELOPreprints.8394

Conversación pública sobre vacunas en la pandemia de covid-19 en Argentina, 2021-2022
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Demonte, Flavia

; Bruno, Daniela Paola

; Lozano, Leandro Simón

; Mena, Maria Florencia

; Pereira, Andrés Martín

Salud Colectiva

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2024, Volume 20 elocation e4580

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

ABSTRACT In the face of declining vaccination coverage and the dissemination of health-related information, conversations in the public/mediatic digital sphere constitute a relevant study area for the field of health communication. Through a qualitative study based on the analysis of government publications, digital press, and social media, we characterize the public conversation on vaccines - in terms of topics, moments, axes, and framings in Argentina during the 2020-2021 period - marked by the debate on covid-19 vaccines. The results show that public conversation focused on covid-19 vaccination, structured in two distinct moments (vaccine production and vaccination campaign), and under moral framings grounded in vaccination as a care practice and science as an authoritative voice. Simultaneously, doubts about the safety and efficacy of vaccines shaped arguments of vaccine hesitancy, which we understand as part of extended practices associated with distrust towards institutions and reinterpretations of scientific knowledge and care.

RESUMEN Ante la caída de las coberturas vacunales y la circulación informativa sobre salud, las conversaciones en el entorno público/mediático digital constituyen un ámbito de estudio relevante para el campo de la comunicación en salud. A través de un estudio cualitativo, basado en el análisis de publicaciones del gobierno, la prensa digital y las redes sociales, caracterizamos la conversación pública sobre vacunas -en términos de temas, momentos, ejes y encuadres en Argentina en el período 2020-2021- signada por el debate sobre las vacunas covid-19. Los resultados muestran que la conversación pública se centralizó en la vacunación contra el covid-19, se estructuró en dos momentos diferenciados (producción de vacunas y campaña de vacunación) y bajo encuadres morales sustentados en la vacunación como práctica de cuidado y la ciencia como voz autorizada. En simultáneo, las dudas sobre la seguridad y eficacia de las vacunas estructuraron argumentos de reticencia vacunal, que entendemos como parte de prácticas extendidas, asociadas con las desconfianzas hacia las instituciones y reinterpretaciones del conocimiento científico y del cuidado.

https://doi.org/10.18294/sc.2024.4580

Marketing digital de fórmulas comerciales infantiles en Argentina: un estudio etnográfico digital
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Demonte, Flavia

; Bruno, Daniela Paola

; Nessier, María Celeste

; Zapata, María Elisa

Salud Colectiva

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2024, Volume 20 elocation e4776

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

RESUMEN Si bien es extendida la evidencia de los beneficios de la lactancia materna, diversos son los desafíos para iniciarla y sostenerla. Las empresas productoras de fórmulas infantiles utilizan estrategias de marketing violatorias de las regulaciones existentes, contribuyendo a su temprano abandono. Exploramos la exposición al marketing digital de las fórmulas infantiles en Argentina mediante el análisis de las interacciones de la población con las marcas y las huellas de dichas interacciones en conversaciones entabladas en grupos de Facebook durante 2022, desde un enfoque cualitativo basado en la etnografía digital. Los resultados muestran que las empresas despliegan tácticas elusivas de las regulaciones y buscan el contacto con las madres. Las usuarias no interactúan con las cuentas, pero están expuestas a sus estrategias dado el correlato entre los atributos del producto presentes en la publicidad con sus motivaciones y aspiraciones. Los mediadores entre el marketing y las madres son los profesionales médicos, utilizados como recursos del marketing. Concluimos que las autoridades deben promover nuevos acuerdos sobre las prácticas de los profesionales médicos y desarrollar regulaciones teniendo en cuenta los entornos digitales.

ABSTRACT Although evidence of the benefits of breastfeeding is widespread, there are several challenges to initiate and sustain it. Infant formula companies use marketing strategies that violate existing regulations, contributing to its early abandonment. We explore the digital marketing exposure of infant formulas in Argentina by analyzing people’s interactions with brands and the traces of these interactions in conversations engaged in Facebook groups during 2022, from a qualitative approach based on digital ethnography. Results show that companies deploy regulatory avoidance tactics and seek contact with mothers. Users do not interact with the accounts but are exposed to their strategies given the correlation between product attributes present in advertising with their motivations and aspirations. The mediators between marketing and mothers are medical professionals, used as marketing resources. We conclude that authorities should promote new agreements on the practices of medical professionals and develop regulations taking into account digital environments.

https://doi.org/10.18294/sc.2024.4776

Conversación pública sobre vacunas en la pandemia de covid-19 en Argentina, 2021-2022
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Demonte, Flavia

; Bruno, Daniela Paola

; Lozano, Leandro Simón

; Mena, Maria Florencia

; Pereira, Andrés Martín

Salud colectiva

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2024, Volume 20 elocation e4580

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

https://doi.org/10.18294/sc.2024.4580

LA COMUNICACIÓN EN/DE LA INVESTIGACIÓN SOCIAL: UNA REVISIÓN DE LA LITERATURA CIENTÍFICA IBEROAMERICANA RECIENTE
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Bruno, Daniela

; Becerro, Verónica

; Demonte, Flavia

Perspectivas de la comunicación

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2024, Volume 17 elocation 10

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

Abstract: Introduction: Currently, among the multiple debates associated with technoscience, there is concern about the role of communication and technology in a cultural, scientific, and technological context characterized by the renewal of social institutions involved in science. Objectives: Explore the function of communication in new contexts, reconstructing prevailing models and rationalities. Methods: We carried out a review of the literature on recent research carried out in Ibero-American countries. Results: Science communication is gradually incorporated into the expected work of researchers, although the prevailing of broadcasting. Discussion: Although the potential of social networks to propose interactions with society is recognized, there is a training deficit in the development of these skills, a lack of use of them, and an emphasis on communication between specialists, all aided by the productivity logics of scientific work. Conclusions: Discussions about science and technology are necessary to rethink the prevailing communication model and advocate for another critique of science, multi-actor, multimedia, and participatory model.

Resumen: Introducción: En la actualidad, entre los múltiples debates asociados a la tecnociencia se encuentra la preocupación por el rol de la comunicación y la tecnología en un contexto cultural, científico y tecnológico caracterizado por la renovación de las instituciones sociales involucradas en la ciencia. Objetivos: Explorar la función de la comunicación en los nuevos contextos, reconstruyendo modelos y racionalidades imperantes. Metodología: Realizamos una revisión de la literatura sobre investigaciones recientes realizadas en países iberoamericanos. Resultados: La comunicación de la ciencia está siendo paulatinamente integrada a la labor esperable de los/las investigadores, aunque el modelo de comunicación imperante es todavía difusionista. Discusión: Si bien se reconocen las potencialidades de las redes sociales, se advierte un déficit formativo en el desarrollo de estas competencias, un desaprovechamiento de las mismas y un énfasis en la comunicación entre especialistas, todo ello coadyuvado por las lógicas de productividad del trabajo científico. Conclusiones: Son necesarias discusiones sobre la ciencia y la tecnología para repensar el modelo de comunicación imperante y abogar por otro crítico de la ciencia, multiactoral, multimediático y participativo.

https://doi.org/10.56754/0718-4867.2024.3527

Adherence to low tidal volume in the transition to spontaneous ventilation in patients with acute respiratory failure in intensive care units in Latin America (SPIRAL): a study protocol SPIRAL (SPIRAL) (SPIRAL
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Diniz-Silva, Fabia

; Pinheiro, Bruno Valle

; Reyes, Luis Felipe

; Cavalcanti, Alexandre Biasi

; Figueredo, Belinda

; Rios, Fernando

; Machado, Flávia Ribeiro

; Preda, Gabriel

; Bugedo, Guillermo

; Maia, Israel Silva

; Silveira, Leda Tomiko Yamada da

; Herrera, Luis

; Jibaja, Manuel

; Ibarra-Estrada, Miguel

; Cestari, Mino

; Nin, Nicolás

; Roldan, Rollin

; Santos, Tiago Mendonça dos

; Veiga, Viviane Cordeiro

; Bruhn, Alejandro

; Ferreira, Juliana Carvalho

Critical Care Science

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2024, Volume 36 elocation e20240044en

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

ABSTRACT Objective: Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival. Methods: We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America. Results: We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation. Conclusion: In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials. Objective exchange however injury strategies ≤ ( 8mLkg mLkg 8mL kg mL weight 30cmH2O cmHO cmH O syndrome However levels 2 ventilatorfree ventilator free survival Methods multicenter multinational 28day 28 followup follow up pressurefraction fraction 300mmHg mmHg America Results 42 countries mortality sedation Conclusion trials 4

RESUMO Objetivo: Pacientes com insuficiência respiratória aguda frequentemente necessitam de ventilação mecânica para reduzir o trabalho respiratório e melhorar a troca gasosa; no entanto, a ventilação mecânica pode exacerbar a lesão pulmonar. As estratégias de ventilação protetora, caracterizadas por baixo volume corrente (≤ 8mL/kg de peso corporal previsto) e pressão de platô limitada abaixo de 30cmH2O, mostraram melhores desfechos em pacientes com síndrome do desconforto respiratório agudo. No entanto, na transição para a ventilação espontânea, manter o volume corrente dentro dos níveis de proteção pode ser desafiador, e não está claro se o volume corrente baixo durante a ventilação espontânea afeta os desfechos dos pacientes. Desenvolvemos um protocolo de estudo para estimar a prevalência de ventilação com volume corrente baixo nas primeiras 24 horas de ventilação espontânea em pacientes com insuficiência respiratória aguda hipoxêmica e sua associação com dias livres da ventilação mecânica e sobrevida. Métodos: Desenhamos um estudo de coorte multicêntrico, multinacional, com seguimento de 28 dias, que incluirá pacientes com insuficiência respiratória aguda, definida como pressão parcial de oxigênio/fração inspirada de oxigênio < 300mmHg, em transição para ventilação espontânea em unidades de terapia intensiva na América Latina. Resultados: Pretendemos incluir 422 pacientes em 10 países. Os desfechos primários são a prevalência de baixo volume corrente nas primeiras 24 horas de ventilação espontânea e dias livres da ventilação mecânica no dia 28. Os desfechos secundários são mortalidade hospitalar e na unidade de terapia intensiva, incidência de assincronia e retorno à ventilação controlada e sedação. Conclusão: Neste estudo, avaliaremos a prevalência de volume corrente baixo durante a ventilação espontânea e sua associação com os desfechos clínicos, o que pode informar a prática clínica e futuros ensaios clínicos. Objetivo gasosa entanto pulmonar protetora ≤ ( 8mLkg mLkg 8mL kg mL previsto 30cmH2O cmHO cmH O agudo desafiador 2 sobrevida Métodos multicêntrico multinacional oxigêniofração fração 300mmHg mmHg Latina Resultados 42 1 países sedação Conclusão clínicos 4

https://doi.org/10.62675/2965-2774.20240044-en

Marketing digital de fórmulas comerciales infantiles en Argentina: un estudio etnográfico digital
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Demonte, Flavia

; Bruno, Daniela Paola

; Nessier, María Celeste

; Zapata, María Elisa

Salud colectiva

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2024, Volume 20 elocation e4776

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

https://doi.org/10.18294/sc.2024.4776

10.

Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan Prospective randomized pressurelimiting pressure limiting communityacquired community acquired STAMINA trial)
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Maia, Israel Silva

; Medrado Jr, Fernando Azevedo

; Tramujas, Lucas

; Tomazini, Bruno Martins

; Oliveira, Júlia Souza

; Sady, Erica Regina Ribeiro

; Barbante, Letícia Galvão

; Nicola, Marina Lazzari

; Gurgel, Rodrigo Magalhães

; Damiani, Lucas Petri

; Negrelli, Karina Leal

; Miranda, Tamiris Abait

; Santucci, Eliana

; Valeis, Nanci

; Laranjeira, Ligia Nasi

; Westphal, Glauco Adrieno

; Fernandes, Ruthy Perotto

; Zandonai, Cássio Luis

; Pincelli, Mariangela Pimentel

; Figueiredo, Rodrigo Cruvinel

; Bustamante, Cíntia Loss Sartori

; Norbin, Luiz Fernando

; Boschi, Emerson

; Lessa, Rafael

; Romano, Marcelo Pereira

; Miura, Mieko Cláudia

; Alencar Filho, Meton Soares de

; Dantas, Vicente Cés de Souza

; Barreto, Priscilla Alves

; Hernandes, Mauro Esteves

; Grion, Cintia Magalhães Carvalho

; Laranjeira, Alexandre Sanches

; Mezzaroba, Ana Luiza

; Bahl, Marina

; Starke, Ana Carolina

; Biondi, Rodrigo Santos

; Dal-Pizzol, Felipe

; Caser, Eliana Bernadete

; Thompson, Marlus Muri

; Padial, Andrea Allegrini

; Veiga, Viviane Cordeiro

; Leite, Rodrigo Thot

; Araújo, Gustavo

; Guimarães, Mário

; Martins, Priscilla de Aquino

; Lacerda, Fábio Holanda

; Hoffmann Filho, Conrado Roberto

; Melro, Livia

; Pacheco, Eduardo

; Ospina-Táscon, Gustavo Adolfo

; Ferreira, Juliana Carvalho

; Freires, Fabricio Jocundo Calado

; Machado, Flávia Ribeiro

; Cavalcanti, Alexandre Biasi

; Zampieri, Fernando Godinho

Critical Care Science

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2024, Volume 36 elocation e20240210en

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

ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5

https://doi.org/10.62675/2965-2774.20240210-en

11.

Trisomy 13 with unusual histological features typically described in Beckwith-Wiedemann Spectrum 1 BeckwithWiedemann Beckwith Wiedemann
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Martins, Wilker Dias

; Chaves, Elisa França

; Aquino, Flavia Cristina Gonçalves de

; Oliveira, Sean Brasil de

; Pasa, Isabela Dorneles

; Marcarini, Bruno Guimarães

; Paes, Vitor Ribeiro

; Kim, Chong Ae

; Schultz, Regina

Autopsy and Case Reports

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2024, Volume 14 elocation e2024486

Abstract: En | Text: En | PDF: En

ABSTRACT Trisomy 13, known as Patau syndrome, is a common aneuploidy with a well-known clinical phenotype. This case report describes a trisomy 13 patient with unusual autopsy findings, including features resembling the Beckwith-Wiedemann Spectrum. Due to abnormalities of gestational ultrasounds, a prenatal karyotype of amniotic fluid cells was performed, which resulted in 47, XY+13. Autopsy microscopy studies identified leptomeningeal glioneuronal heterotopia, which was not described as belonging to Patau syndrome. Other atypical findings were diffuse hyperplasia of pancreatic islets of Langerhans and adrenals enlargement with marked adrenocortical cytomegaly, characteristically seen in the Beckwith-Wiedemann Spectrum. Molecular genetic tests were not performed for the Beckwith-Wiedemann Spectrum. Still, due to the rarity of both disorders, this report may support the evidence that trisomy 13 can affect tissue organization and lead to unusual histopathologic features resembling classic overgrowth disorders. syndrome wellknown well phenotype 1 BeckwithWiedemann Beckwith Wiedemann Spectrum ultrasounds 47 XY13 XY XY+13 heterotopia cytomegaly Still disorders 4 XY1 XY+1 XY+

https://doi.org/10.4322/acr.2024.486

12.

Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio

; Simões, Marcus V.

; Correia, Edileide de Barros

; Marcondes-Braga, Fabiana Goulart

; Coelho-Filho, Otavio Rizzi

; Mesquita, Cláudio Tinoco

; Mathias Junior, Wilson

; Antunes, Murillo de Oliveira

; Arteaga-Fernández, Edmundo

; Rochitte, Carlos Eduardo

; Ramires, Felix José Alvarez

; Alves, Silvia Marinho Martins

; Montera, Marcelo Westerlund

; Lopes, Renato Delascio

; Oliveira Junior, Mucio Tavares de

; Scolari, Fernando Luis

; Avila, Walkiria Samuel

; Canesin, Manoel Fernandes

; Bocchi, Edimar Alcides

; Bacal, Fernando

; Moura, Lidia Zytynski

; Saad, Eduardo Benchimol

; Scanavacca, Mauricio Ibrahim

; Valdigem, Bruno Pereira

; Cano, Manuel Nicolas

; Abizaid, Alexandre Antonio Cunha

; Ribeiro, Henrique Barbosa

; Lemos Neto, Pedro Alves

; Ribeiro, Gustavo Calado de Aguiar

; Jatene, Fabio Biscegli

; Dias, Ricardo Ribeiro

; Beck-da-Silva, Luis

; Rohde, Luis Eduardo Paim

; Bittencourt, Marcelo Imbroinise

; Pereira, Alexandre da Costa

; Krieger, José Eduardo

; Villacorta Junior, Humberto

; Martins, Wolney de Andrade

; Figueiredo Neto, José Albuquerque de

; Cardoso, Juliano Novaes

; Pastore, Carlos Alberto

; Jatene, Ieda Biscegli

; Tanaka, Ana Cristina Sayuri

; Hotta, Viviane Tiemi

; Romano, Minna Moreira Dias

; Albuquerque, Denilson Campos de

; Mourilhe-Rocha, Ricardo

; Hajjar, Ludhmila Abrahão

; Brito Junior, Fabio Sandoli de

; Caramelli, Bruno

; Calderaro, Daniela

; Farsky, Pedro Silvio

; Colafranceschi, Alexandre Siciliano

; Pinto, Ibraim Masciarelli Francisco

; Vieira, Marcelo Luiz Campos

; Danzmann, Luiz Claudio

; Barberato, Silvio Henrique

; Mady, Charles

; Martinelli Filho, Martino

; Torbey, Ana Flavia Malheiros

; Schwartzmann, Pedro Vellosa

; Macedo, Ariane Vieira Scarlatelli

; Ferreira, Silvia Moreira Ayub

; Schmidt, Andre

; Melo, Marcelo Dantas Tavares de

; Lima Filho, Moysés Oliveira

; Sposito, Andrei C.

; Brito, Flávio de Souza

; Biolo, Andreia

; Madrini Junior, Vagner

; Rizk, Stephanie Itala

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e202400415

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

https://doi.org/10.36660/abc.20240415

13.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Preoperative Clinical and Laboratory Assessment of the Patient hematology management
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Silva, Roberto Luiz da

; Benites, Bruno Deltreggia

; Leite, Flavia

; Soriano, Selma

; Alves, Susankerle de Oliveira Costa

; Rizzo, Silvia Renata Cornélio Parolin

; Rabello, Guilherme

; Langhi Junior, Dante Mario

Hematology, Transfusion and Cell Therapy

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2024, Volume 46 Suppl. 1 Pages 12 - 16

Abstract: En | Text: En | PDF: En

Abstract The preoperative clinical and laboratory evaluations of the patient is an essential step to ensure the safety and success of any surgical procedure. This assessment aims to identify any underlying medical conditions and risk factors and determine suitability for surgery. With this step, the medical team can adapt the care plan to meet each patient's specific needs, increasing the chances of a successful procedure. Good clinical assessment and comprehensive laboratory testing, when integrated into a Patient Blood Management approach, are invaluable in promoting safety of care, reducing transfusion risks, improving surgical outcomes, and optimizing resource utilization. This approach not only elevates the quality of care, but is also aligned with evidence-based practice and patient-centered principles, making it an essential component of the perioperative process. procedure surgery patients s needs testing risks outcomes utilization evidencebased evidence based patientcentered centered principles process

https://doi.org/10.1016/j.htct.2024.02.007

14.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Preoperative Phase - Preoperative management of the patient's anemia hematology patients s
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Benites, Bruno Deltreggia

; Leite, Flavia

; Soriano, Selma

; Silva, Roberto Luiz da

; Alves, Susankerle de Oliveira Costa

; Rizzo, Silvia Renata Cornélio Parolin

; Rabello, Guilherme

; Langhi Junior, Dante Mario

Hematology, Transfusion and Cell Therapy

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2024, Volume 46 Suppl. 1 Pages 17 - 23

Abstract: En | Text: En | PDF: En

Abstract Managing anemia before surgery is extremely important as it is a clinical condition that can significantly increase surgical risk and affect patient outcomes. Anemia is characterized by a reduction in the number of red blood cells or hemoglobin levels leading to a lower oxygen-carrying capacity of the blood. Proper treatment requires a multifaceted approach to ensure patients are in the best possible condition for surgery and to minimize potential complications. The challenge is recognizing anemia early and implementing a timely intervention to correct it. Anemic patients are more susceptible to surgical complications such as increased infection rates, slower wound healing and increased risk of cardiovascular events during and after surgery. Additionally, anemia can exacerbate existing medical conditions, causing greater strain on organs and organ systems. To correct anemia and optimize patient outcomes, several essential measures must be taken with the most common being identifying and correcting iron deficiency. outcomes oxygencarrying oxygen carrying rates Additionally conditions systems deficiency

https://doi.org/10.1016/j.htct.2024.02.006

15.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Assessment and management of coagulation in the preoperative period hematology
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Leite, Flavia

; Benites, Bruno Deltreggia

; Silva, Roberto Luiz da

; Soriano, Selma

; Alves, Susankerle de Oliveira Costa

; Rizzo, Silvia Renata Cornélio Parolin

; Rabello, Guilherme

; Langhi Junior, Dante Mario

Hematology, Transfusion and Cell Therapy

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2024, Volume 46 Suppl. 1 Pages 24 - 31

Abstract: En | Text: En | PDF: En

Abstract Managing coagulation disorders and potential bleeding risks, especially in the context of anticoagulant medications, is of immense value both clinically and prior to surgery. Coagulation disorders can lead to bleeding complications, affecting patient safety and surgical outcomes. The use of Patient Blood Management protocols offers a comprehensive, evidence-based approach that effectively addresses these challenges. The problem is to find a delicate balance between preventing thromboembolic events (blood clots) and reducing the risk of bleeding. Anticoagulant medications, although crucial to preventing clot formation, can increase the potential for bleeding during surgical procedures. Patient blood management protocols aim to optimize patient outcomes by minimizing blood loss and unnecessary transfusions. risks medications surgery complications comprehensive evidencebased evidence based challenges clots formation procedures transfusions

https://doi.org/10.1016/j.htct.2024.02.005

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