ABSTRACT Purpose: The microbiology pattern of neonatal conjunctivitis has changed over time, and the incidence of gonococcal conjunctivitis is almost nil. This study aimed to determine the etiology of neonatal conjunctivitis cases referred to a tertiary health center in Brazil. Methods: From 2017 to 2020, conjunctival swabs were taken from neonates with clinical signs of conjunctivitis and tested with bacterial culture and polymerase chain reaction for Neisseria gonorrhoeae and Chlamydia trachomatis. Results: A total of 51 neonates were included in the 3-year study. Chlamydial conjunctivitis was diagnosed in 39 (76.5%) patients, and microbial growth was detected in 13 (25.5%) patients. The most isolated bacterium was Staphylococcus epidermidis (n=6, 11.8%), followed by other coagulase-negative Staphylococcus species (n=4, 7.8%) and S. aureus (n=2, 3.9%). One S. aureus isolate was resistant to oxacillin. There were no cases of gonococcal conjunctivitis. Ten (19.6%) patients showed polymerase chain reaction-negative C. trachomatis and negative bacterial culture test results. Conclusion: Findings show that C. trachomatis is the most common pathogen causing neonatal conjunctivitis. The high prevalence of C. trachomatis infection highlights the importance of screening and treating pregnant woman. Purpose time nil Brazil Methods 201 2020 Results 5 3year year 3 76.5% 765 76 (76.5% 1 25.5% 255 25 (25.5% n=6, n6 n 6 (n=6 11.8%, 118 11.8% , 11 8 11.8%) coagulasenegative coagulase n=4, n4 4 (n=4 7.8% 78 7 S n=2, n2 2 (n=2 3.9%. 3.9% . 9 3.9%) oxacillin 19.6% 196 19 (19.6% reactionnegative C results Conclusion woman 20 202 76.5 (76.5 25.5 (25.5 n=6 (n= 11.8 n=4 7.8 n=2 3.9 19.6 (19.6 76. (76. 25. (25. n= (n 11. 7. 3. 19. (19. (76 (25 (19 (7 (2 (1 (

Abstract Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In Part I, recommendations on the use of a computerized microbiological data management system in clinical practice, data and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In Part II, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Resumen La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en el cual el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

Abstract Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In the first part, recommendations on the use of a computerized microbiological data management system in clinical practice, data, and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In the second part, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Resumen La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en los cuales el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso, hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, así como y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

RESUMO Contexto A traqueobronquite associada ao ventilador é uma condição comum entre pacientes ventilados invasivamente em unidades de terapia intensiva, para a qual se desconhece atualmente a melhor estratégia de tratamento. Desenhamos o estudo VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) para avaliar se uma estratégia de tratamento antibiótico de espera vigilante não é inferior ao tratamento antibiótico de rotina para traqueobronquite associada ao ventilador em relação aos dias sem ventilador mecânico. Métodos O VATICAN é um estudo randomizado, controlado, aberto e multicêntrico de não inferioridade. Os pacientes com suspeita de traqueobronquite associada ao ventilador sem evidência de pneumonia associada ao ventilador ou instabilidade hemodinâmica devido a uma provável infecção serão designados para uma estratégia de espera vigilante, sem administração profilática de antimicrobianos contra traqueobronquite associada ao ventilador e prescrição de antimicrobianos somente em casos de pneumonia associada ao ventilador, sepse ou choque séptico, ou outro diagnóstico infeccioso, ou para uma estratégia de tratamento antimicrobiano de rotina por 7 dias. O desfecho primário será o número de dias sem ventilador mecânico em 28 dias, e um desfecho secundário importante será a sobrevida sem pneumonia associada ao ventilador. Por meio de uma estrutura de intenção de tratar com análise de sensibilidade por protocolo, a análise do desfecho primário abordará a não inferioridade com margem de 20%, o que se traduz em uma diferença de 1,5 dia sem ventilador. Outras análises seguirão uma estrutura de análise de superioridade. Conclusão O VATICAN seguirá todos os padrões éticos nacionais e internacionais. O objetivo é publicar o estudo em um periódico geral de alta visibilidade e apresentá-lo em conferências de cuidados intensivos e doenças infecciosas para divulgação. Estes resultados provavelmente serão imediatamente aplicáveis à beira do leito após a conclusão do estudo e fornecerão informações com baixo risco de viés para o desenvolvimento de diretrizes. intensiva VentilatorAssociated Ventilator Associated Evaluation randomizado controlado séptico infeccioso 2 protocolo 20 20% 15 1 5 1, superioridade internacionais apresentálo apresentá lo divulgação diretrizes

ABSTRACT Background Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. Methods VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. Conclusion The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development. Ventilatorassociated Ventilator associated units unknown VentilatorAssociated Associated Evaluation ventilatorassociated ventilator ventilation randomized controlled openlabel, openlabel open label, label open-label shock diagnosis ventilationfree 2 pneumoniafree survival intentiontotreat intention treat perprotocol per protocol 20 margin 15 1 5 1. ventilatorfree standards highvisibility high visibility dissemination development

An integral part of Brazil’s public health system, psychiatric emergency services have been instrumental in improving qualified support for crisis situations involving mental disorders in an equitable, universally accessible, and humanized way. The purpose of this article is to present a systematic review and consensus on the infrastructure and the ideal team for psychiatric emergencies services in Brazil. The authors searched electronic databases including MEDLINE (PubMed), SciELO, and Cochrane, in addition to documents from the World Health Organization, the Brazilian Ministry of Health, and other authorities. Of the 6839 manuscripts found, 46 were included. The content analysis summarized consensus statements through the Delphi method, and, after a series of interactive versions, a final report was produced. Models for changing psychiatric emergency services are assessed. It was determined that the emergency care network must be supervised by qualified management, and all health equipment and units must be effectively integrated. Psychiatric emergency services need adequate infrastructure, qualified staff (including a psychiatrist), sufficient consultation and observation space, tools and resources for differential diagnosis, training for all staff members, and communication with the health care network to facilitate referrals following patient discharge. Standardized models should be available to public health managers to guide the development of new services and adjust existing ones, always seeking improvement. The authors propose a model of psychiatric emergency services. Brazils Brazil s system equitable accessible way PubMed, PubMed , (PubMed) SciELO Cochrane Organization authorities 683 found 4 included method versions produced assessed management integrated psychiatrist, psychiatrist psychiatrist) space diagnosis members discharge ones improvement (PubMed 68 6

Resumen A principios del año 2021 fue modificado el marco teórico-legal bajo el cual se reglamenta la interrupción del embarazo. Entre los meses de agosto 2021 y abril 2022, realizamos una encuesta a 310 trabajadores del Hospital General de Agudos Dr. Teodoro Álvarez (HGATA) y del Centro de Salud y Acción Comunitaria Nº 34 (CeSAC Nº 34), con el objetivo de evaluar su conocimiento al respecto y su capacidad de brindar una respuesta acorde ante la demanda de dicha práctica. Del total de las personas encuestadas, el 72.9% fueron mujeres, el rango etario predominante fue el de 26-35 años y la ocupación mayoritariamente referida fue “residente” (31.3%). Entre los encuestados, definimos dos grupos: conocedores (8.7%, n = 27) y no conocedores (91.3%, n = 283). El 100% de los conocedores brindó una respuesta acorde, mientras que, con relación a los no conocedores, solo el 82.7% pudo hacerlo. La mayoría de los encuestados (85.5%) consideró útil poder recibir capacitación y actualización sobre esta temática en el futuro. Concluimos que la mayoría de los trabajadores del HGATA y del CeSAC Nº 34 desconocen el marco teórico-legal bajo el cual está reglamentada la interrupción del embarazo. Los no conocedores tuvieron dificultades para brindar una respuesta apropiada. Estos resultados muestran el déficit formativo que existe en relación con el marco teórico-legal de esta práctica, por ello, consideramos que esta información sería útil para la identificación tanto de barreras como de facilitadores de acceso a la interrupción del embarazo.

Abstract In early 2021, the theoretical and legal framework for the termination of pregnancy was modified. From August 2021 until April 2022, a survey was conducted among 310 healthcare staff from the General Hospital for Acute Care Dr. Teodoro Álvarez (HGATA, for its acronym in Spanish) and the Health & Community Action Center No. 34 (CeSAC Nº 34, for its acronym in Spanish) to assess their knowledge of the subject and their ability to provide an adequate response to patients inquiring about the procedure. Out of the total number of people surveyed, 72.9% were women, the largest age group was 26-35 years old and the most mentioned occupation was “resident” (31.3%). According to their answers, the respondents were divided into two groups: those who were informed (8.7%, n = 27) and those who were uninformed (91.3%, n = 283). 100% of the informed group were able to provide patients with a correct response while only 82,7% of the uninformed group were able to do so. The majority of the respondents (85.5%) deemed it helpful to receive training and updates on voluntary termination of pregnancy in the near future. Most of the healthcare staff from the HGATA and from the CeSAC No. 34 are unaware of the theoretical-legal framework under which the interruption of pregnancy is regulated. The uninformed presented difficulties in providing an appropriate response. These results show the formative deficit that exists in relation to the theoretical-legal framework. This information could be useful for the identification of barriers and facilitators of access to an interruption.

RESUMO Os Centros de Atenção Psicossocial (Caps) são serviços comunitários que visam promover a reabilitação psicossocial para pessoas com sofrimento mental e com problemas recorrentes do consumo prejudicial de Substâncias Psicoativas (SPA). A avaliação da qualidade desses serviços pode ser medida por meio de indicadores de saúde mental, campo em desenvolvimento. Este estudo é um relato de experiência com objetivo de discorrer sobre o processo de construção de indicadores de saúde mental de um Caps Adulto e Caps Álcool e Drogas de uma região de saúde da cidade de São Paulo, realizado no período entre 2020 e 2021. Como resultado desse trabalho, foram criados coletivamente os indicadores de processo: articulação com a atenção primária e atenção à crise e o indicador específico de resultado para cada Caps: reabilitação psicossocial. A construção colaborativa proporcionou a análise e reflexão sobre o processo de trabalho, evidenciou-se a potencialidade da elaboração participativa dos indicadores de saúde mental que impactou na revisão da prática assistencial individual do trabalhador e de cada serviço. Identificouse desafios nesta construção quanto à disponibilidade de agenda, lacuna na formação dos profissionais, escassez de literatura específica e pausas no percurso devido às contingências da pandemia Covid-19.

ABSTRACT Psychosocial Care Centers (CAPS) are community services that aim to promote rehabilitation for people with mental suffering. Quality assessment can be measured through mental health indicators, a field that is under development. This study is an experience report that has the discourse objective of the process of collective construction of mental health indicators of a CAPS Adult and CAPS Alcohol and Drugs in a health region of the city of São Paulo, carried out in the period between 2020 and 2021. As a result of these, the work indicators of the process were collectively created: articulation with primary care and crisis care and the specific result indicator for each CAPS: psychosocial rehabilitation. The collaborative construction of the mental health analysis process and the reflection on the indicators-evidence of the potential of the participatory elaboration of the assistance individuals of the work and of each service. It was identified in this construction as the availability of challenges, gap in the training of professionals, course of specific literature and pauses due to the contingencies of the COVID-19 pandemic.

Abstract This study assessed the effect of different periods of post-hatch fasting on animal performance and breast and digestive system growth in European quail. Quail chicks were distributed in a completely randomized design, with four fasting periods (0, 24, 36, and 48 hs) and four replications of 40 birds per treatment. In 1 to 14-day-old chicks, weight gain decreased with increasing fasting time. Compensatory gain was observed from 15 days of age onward. Fasted quail had a lower length and relative weight of the digestive system than fed animals for up to 14 days. Histologically, the duodenal villus height was significantly lower in 3-day-old quail fasted for 36 hs than in those fasted for 48 hs, but this effect was not observed at 7 days. Scanning electron microscopy showed no differences in the small intestinal mucosa between fasted and fed birds at 3 days of age. Post-hatch fasting reduced the relative weight of the breast in quail aged 1 to 14 days but did not affect type IIa and IIb fiber diameter at 35 days. On the basis of these results, it is recommended that European quail raised for meat should not be fasted for more than 48 hs post-hatch. posthatch post hatch design 0, 0 (0 24 4 treatment 14dayold dayold day old time onward Histologically 3dayold Posthatch Post results posthatch. hatch. ( 2

ABSTRACT Background: Chronic conditions increase the risk of invasive pneumococcal diseases (IPD). Pneumococcal vaccination remarkably reduced IPD morbimortality in vulnerable populations. In Brazil, pneumococcal vaccines are included in the National Immunization Program (PNI): PCV10 for < 2 years-old, and PPV23 for high risk-patients aged ≥ 2 years and institutionalized ≥ 60 years. PCV13 is available in private clinics and recommended in the PNI for individuals with certain underlying conditions. Methods: A retrospective study was performed using clinical data from all inpatients from five hospitals with IPD from 2016 to 2018 and the corresponding data on serotype and antimicrobial-non-susceptibility of pneumococcus. Vaccine-serotype-coverage was estimated. Patients were classified according to presence of comorbidities: healthy, without comorbidities; at-risk, included immunocompetent persons with specific medical conditions; high-risk, with immunocompromising conditions and others Results: 406 IPD cases were evaluated. Among 324 cases with information on medical conditions, children < 5 years were mostly healthy (55.9%), while presence of comorbidity prevailed in adults ≥ 18 years old (> 82.0%). Presence of ≥1 risk condition was reported in ≥ 34.8% of adults. High-risk conditions were more frequent than at-risk in all age groups. Among high-risk comorbidity (n = 211), cancer (28%), HIV/AIDS (25.7%) and hematological diseases (24.5%) were the most frequent. Among at-risk conditions (n = 89), asthma (16.5%) and diabetes (8.1%) were the most frequent. Among 404 isolates, 42.9% belonged to five serotypes: 19A (14.1%), 3 (8.7%), 6C (7.7%), 4 and 8 (6.2% each); 19A and 6C expressed antimicrobial-non-susceptibility. The vaccine-serotype-coverage was: PCV10, 19.1%, PCV13, 43.8%; PCV15, 47.8%; PCV20, 62.9%; PCV21, 65.8%, and PPV23, 67.3%. Information on hospital outcome was available for 283 patients, of which 28.6% died. Mortality was 54.2% for those with meningitis. Conclusion: Vaccine with expanded valence of serotypes is necessary to offer broad prevention to IPD. The present data contribute to pneumococcal vaccination public health policies for vulnerable patients, mainly those with comorbidity and the elderly. Background . (IPD) populations Brazil (PNI) PCV PCV1 yearsold, yearsold old, years-old PPV PPV2 riskpatients patients 6 Methods 201 antimicrobialnonsusceptibility antimicrobial non susceptibility pneumococcus Vaccineserotypecoverage coverage estimated comorbidities atrisk, atrisk at risk, highrisk, highrisk Results 40 evaluated 32 55.9%, 559 55.9% , 55 9 (55.9%) 1 > ( 82.0%. 820 82.0% 82 0 82.0%) 348 34 34.8 Highrisk High groups n 211, 211 211) 28%, 28 28% (28%) HIVAIDS HIV AIDS 25.7% 257 25 7 (25.7% 24.5% 245 24 (24.5% 89, 89 89) 16.5% 165 16 (16.5% 8.1% 81 (8.1% isolates 429 42 42.9 14.1%, 141 14.1% 14 (14.1%) 8.7%, 87 8.7% (8.7%) C 7.7%, 77 7.7% (7.7%) 6.2% 62 (6.2 each each) antimicrobialnonsusceptibility. susceptibility. vaccineserotypecoverage vaccine 191 19 19.1% 43.8% 438 43 PCV15 47.8% 478 47 PCV20 62.9% 629 PCV21 658 65 65.8% 673 67 67.3% 286 28.6 died 542 54 54.2 meningitis Conclusion elderly (IPD (PNI 20 55.9 (55.9% 82.0 34. 21 (28% 25.7 (25.7 24.5 (24.5 16.5 (16.5 8.1 (8.1 42. 14.1 (14.1% 8.7 (8.7% 7.7 (7.7% 6.2 (6. 19.1 43.8 47.8 PCV2 62.9 65.8 67.3 28. 54. 55. (55.9 82. (28 25. (25. 24. (24. 16. (16. 8. (8. 14. (14.1 (8.7 7. (7.7 6. (6 19. 43. 47. 62. 65. 67. (55. (2 (25 (24 (16 (8 (14. (7. (55 (1 (14 (7 (5

RESUMO Os Centros de Atenção Psicossocial (Caps) são serviços comunitários que visam promover a reabilitação psicossocial para pessoas com sofrimento mental e com problemas recorrentes do consumo prejudicial de Substâncias Psicoativas (SPA). A avaliação da qualidade desses serviços pode ser medida por meio de indicadores de saúde mental, campo em desenvolvimento. Este estudo é um relato de experiência com objetivo de discorrer sobre o processo de construção de indicadores de saúde mental de um Caps Adulto e Caps Álcool e Drogas de uma região de saúde da cidade de São Paulo, realizado no período entre 2020 e 2021. Como resultado desse trabalho, foram criados coletivamente os indicadores de processo: articulação com a atenção primária e atenção à crise e o indicador específico de resultado para cada Caps: reabilitação psicossocial. A construção colaborativa proporcionou a análise e reflexão sobre o processo de trabalho, evidenciou-se a potencialidade da elaboração participativa dos indicadores de saúde mental que impactou na revisão da prática assistencial individual do trabalhador e de cada serviço. Identificouse desafios nesta construção quanto à disponibilidade de agenda, lacuna na formação dos profissionais, escassez de literatura específica e pausas no percurso devido às contingências da pandemia Covid-19. (Caps SPA. SPA . (SPA) desenvolvimento Paulo 202 2021 trabalho evidenciouse evidenciou se serviço agenda profissionais Covid19. Covid19 Covid 19. 19 Covid-19 (SPA 20 Covid1 1 Covid-1 2 Covid-

ABSTRACT Psychosocial Care Centers (CAPS) are community services that aim to promote rehabilitation for people with mental suffering. Quality assessment can be measured through mental health indicators, a field that is under development. This study is an experience report that has the discourse objective of the process of collective construction of mental health indicators of a CAPS Adult and CAPS Alcohol and Drugs in a health region of the city of São Paulo, carried out in the period between 2020 and 2021. As a result of these, the work indicators of the process were collectively created: articulation with primary care and crisis care and the specific result indicator for each CAPS: psychosocial rehabilitation. The collaborative construction of the mental health analysis process and the reflection on the indicators-evidence of the potential of the participatory elaboration of the assistance individuals of the work and of each service. It was identified in this construction as the availability of challenges, gap in the training of professionals, course of specific literature and pauses due to the contingencies of the COVID-19 pandemic. (CAPS suffering development Paulo 202 2021 these created indicatorsevidence evidence service challenges professionals COVID19 COVID 19 COVID-1 pandemic 20 COVID1 1 COVID- 2

RESUMO Objetivo: Avaliar fatores preditivos de maior precisão diagnóstica com EBUS com sonda radial. Métodos: Revisão retrospectiva de pacientes consecutivos submetidos a EBUS radial entre fevereiro de 2012 e janeiro de 2020. Parâmetros como a presença do sinal brônquico na TC, a posição da sonda radial de EBUS, o tamanho da lesão, a localização da lesão e o tipo de lesão foram analisados em relação a dois desfechos definidos (diagnóstico final ou sem diagnóstico). A análise univariada foi usada para explorar os efeitos individuais de cada parâmetro na precisão do diagnóstico. A regressão logística multivariada foi realizada para identificar preditores significativos de precisão diagnóstica. Resultados: O EBUS radial foi usado para fins diagnósticos em 101 pacientes. A lesão era < 3 cm em 59 pacientes (58,4%) e predominantemente sólida em 60,3%. Houve correlação positiva entre a posição da sonda radial de EBUS e a precisão do diagnóstico (p = 0,036), sendo que 80,9% dos pacientes apresentaram o sinal brônquico na TC. Além disso, 89% dos pacientes apresentaram o sinal brônquico na TC e correlação com a precisão do diagnóstico (p = 0,030), sendo que 65,8% das lesões localizavam-se no lobo superior esquerdo/direito (p = 0,046). Com a sonda radial de EBUS dentro da lesão-alvo, o rendimento diagnóstico foi de 80,8%. Com a sonda adjacente à lesão, o rendimento diagnóstico foi de 19,2%. O sinal brônquico na TC foi o único parâmetro que influenciou de forma independente a precisão do diagnóstico (OR ajustada = 3,20; IC95%: 1,081-9,770; p = 0,036). Conclusões: O sinal brônquico na TC é um poderoso preditor de diagnóstico bem-sucedido por meio de EBUS radial. Objetivo Métodos 201 2020 . diagnóstico) Resultados 10 5 58,4% 584 58 4 (58,4% 603 60 60,3% 0,036, 0036 0,036 , 0 036 0,036) 809 80 9 80,9 disso 89 0,030, 0030 0,030 030 0,030) 658 65 8 65,8 localizavamse localizavam se esquerdodireito esquerdo direito 0,046. 0046 0,046 046 0,046) lesãoalvo, lesãoalvo alvo, alvo lesão-alvo 808 80,8% 192 19 2 19,2% OR 3,20 320 20 IC95% IC95 IC 1,0819,770 10819770 1,081 9,770 1 081 770 1,081-9,770 0,036. Conclusões bemsucedido bem sucedido 202 58,4 (58,4 6 60,3 003 0,03 03 80, 65, 004 0,04 04 80,8 19,2 3,2 32 IC9 0819 1,0819,77 1081977 1081 1,08 9770 9,77 08 77 1,081-9,77 58, (58, 60, 00 0,0 19, 3, 1,0819,7 108197 108 1,0 977 9,7 7 1,081-9,7 (58 0, 1,0819, 10819 1, 97 9, 1,081-9, (5 1,0819 1,081-9 ( 1,081-

ABSTRACT Objective: To assess predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS (RP-EBUS). Methods: This was a retrospective review of consecutive patients undergoing RP-EBUS between February of 2012 and January of 2020. Parameters including the presence of a bronchus sign on CT scans, the position of the radial EBUS probe, lesion size, lesion location, and lesion type were analyzed in relation to two defined outcomes (final diagnosis or no diagnosis). Univariate analysis was used in order to explore the individual effects of each parameter on diagnostic accuracy. Multivariate logistic regression was performed to identify significant predictors of diagnostic accuracy. Results: RP-EBUS was used for diagnostic purposes in 101 patients. The lesion was < 3 cm in size in 59 patients (58.4%) and predominantly solid in 60.3%. There was a positive correlation between radial EBUS probe position and diagnostic accuracy (p = 0.036), with 80.9% of the patients showing a bronchus sign on CT scans. Furthermore, 89% of the patients showed a bronchus sign on CT scans and a correlation with diagnostic accuracy (p = 0.030), with 65.8% of the lesions being located in the left/right upper lobe (p = 0.046). When the radial EBUS probe was within the target lesion, the diagnostic yield was = 80.8%. When the probe was adjacent to the lesion, the diagnostic yield was = 19.2%. A bronchus sign on CT scans was the only parameter that independently influenced diagnostic accuracy (adjusted OR, 3.20; 95% CI, 1.081-9.770; p = 0.036). Conclusions: A bronchus sign on CT scans is a powerful predictor of successful diagnosis by RP-EBUS. Objective radialprobe RPEBUS. RPEBUS RP . (RP-EBUS) Methods 201 2020 location final diagnosis. diagnosis) Results 10 5 58.4% 584 58 4 (58.4% 603 60 60.3% 0.036, 0036 0.036 , 0 036 0.036) 809 80 9 80.9 Furthermore 89 0.030, 0030 0.030 030 0.030) 658 65 8 65.8 leftright left right 0.046. 0046 0.046 046 0.046) 808 80.8% 192 19 2 19.2% adjusted OR 3.20 320 20 95 CI 1.0819.770 10819770 1.081 9.770 1 081 770 1.081-9.770 0.036. Conclusions EBUS. (RP-EBUS 202 58.4 (58.4 6 60.3 003 0.03 03 80. 65. 004 0.04 04 80.8 19.2 3.2 32 0819 1.0819.77 1081977 1081 1.08 9770 9.77 08 77 1.081-9.77 58. (58. 60. 00 0.0 19. 3. 1.0819.7 108197 108 1.0 977 9.7 7 1.081-9.7 (58 0. 1.0819. 10819 1. 97 9. 1.081-9. (5 1.0819 1.081-9 ( 1.081-

RESUMO Objetivo: Investigar a influência de uma sessão de mobilização passiva na função endotelial de pacientes com sepse. Métodos: Este foi um estudo quase-experimental duplo-cego e de braço único com desenho pré e pós-intervenção. Participaram 25 pacientes com diagnóstico de sepse hospitalizados em unidade de terapia intensiva. Avaliou-se a função endotelial basal (pré-intervenção) e imediatamente pós-intervenção por meio de ultrassonografia da artéria braquial. Foram obtidas a dilatação mediada pelo fluxo, a velocidade pico de fluxo sanguíneo e a taxa de cisalhamento pico. A mobilização passiva consistiu na mobilização bilateral (tornozelos, joelhos, quadris, pulsos, cotovelos e ombros), com três séries de dez repetições cada, totalizando 15 minutos. Resultados: Após a mobilização, encontramos aumento da função de reatividade vascular em relação à pré-intervenção: dilatação mediada pelo fluxo absoluta (0,57mm ± 0,22 versus 0,17mm ± 0,31; p < 0,001) e dilatação mediada pelo fluxo relativa (17,1% ± 8,25 versus 5,08% ± 9,16; p < 0,001). O pico de fluxo sanguíneo na hiperemia (71,8cm/s ± 29,3 versus 95,3cm/s ± 32,2; p < 0,001) e a taxa de cisalhamento (211s ± 113 versus 288s ± 144; p < 0,001) também aumentaram. Conclusão: Uma sessão de mobilização passiva foi capaz de aumentar a função endotelial em pacientes graves com sepse. Estudos futuros são necessários para investigar se um programa de mobilização pode ser aplicado como intervenção benéfica para melhorar clinicamente a função endotelial em pacientes hospitalizados por sepse. Objetivo Métodos quaseexperimental quase experimental duplocego duplo cego pósintervenção. pósintervenção pós intervenção. 2 intensiva Avaliouse Avaliou préintervenção (pré-intervenção braquial tornozelos, tornozelos (tornozelos joelhos quadris pulsos ombros, ombros , ombros) cada 1 minutos Resultados pré-intervenção 0,57mm 057mm mm 0 57mm 022 22 0,2 017mm 17mm 0,31 031 31 0,001 0001 001 17,1% 171 17 (17,1 825 8 8,2 508 5 08 5,08 9,16 916 9 16 0,001. . 71,8cm/s 718cms cms 71 8cm s cm 293 29 3 29, 953cms 95 3cm 32,2 322 32 211s 11 144 aumentaram Conclusão 02 0, 0,3 03 0,00 000 00 17,1 (17, 82 8, 50 5,0 9,1 91 7 32, 14 0,0 17, (17 5, 9, (1 (

ABSTRACT Objective: To investigate the influence of a passive mobilization session on endothelial function in patients with sepsis. Methods: This was a quasi-experimental double-blind and single-arm study with a pre- and postintervention design. Twenty-five patients with a diagnosis of sepsis who were hospitalized in the intensive care unit were included. Endothelial function was assessed at baseline (preintervention) and immediately postintervention by brachial artery ultrasonography. Flow mediated dilatation, peak blood flow velocity and peak shear rate were obtained. Passive mobilization consisted of bilateral mobilization (ankles, knees, hips, wrists, elbows and shoulders), with three sets of ten repetitions each, totaling 15 minutes. Results: After mobilization, we found increased vascular reactivity function compared to preintervention: absolute flow-mediated dilatation (0.57mm ± 0.22 versus 0.17mm ± 0.31; p < 0.001) and relative flow-mediated dilatation (17.1% ± 8.25 versus 5.08% ± 9.16; p < 0.001). Reactive hyperemia peak flow (71.8cm/s ± 29.3 versus 95.3cm/s ± 32.2; p < 0.001) and shear rate (211s ± 113 versus 288s ± 144; p < 0.001) were also increased. Conclusion: A passive mobilization session increases endothelial function in critical patients with sepsis. Future studies should investigate whether a mobilization program can be applied as a beneficial intervention for clinical improvement of endothelial function in patients hospitalized due to sepsis. Objective Methods quasiexperimental quasi experimental doubleblind double blind singlearm single arm pre design Twentyfive Twenty five included preintervention (preintervention ultrasonography obtained ankles, ankles (ankles knees hips wrists shoulders, shoulders , shoulders) each 1 minutes Results flowmediated 0.57mm 057mm mm 0 57mm 022 22 0.2 017mm 17mm 0.31 031 31 0.001 0001 001 17.1% 171 17 (17.1 825 8 25 8.2 508 5 08 5.08 9.16 916 9 16 0.001. . 71.8cm/s 718cms cms 71 8cm s cm 293 29 3 29. 953cms 95 3cm 32.2 322 32 2 211s 11 144 Conclusion 02 0. 0.3 03 0.00 000 00 17.1 (17. 82 8. 50 5.0 9.1 91 7 32. 14 0.0 17. (17 5. 9. (1 (

Resumo A microbiota intestinal tem importância na saúde e na patogénese de algumas doenças, pois além da digestão, interfere no sistema imunológico e até mesmo na saúde da pele. Evidências mostram que alterações intestinais podem gerar manifestações dermatológicas, como rosácea, acne e dermatite atópica. O uso de probióticos vem sendo estudado pois é possível criar estratégias para modular o sistema imunológico, os quais diminuem a manifestação dessas doenças. Nesse estudo, foi realizado uma revisão bibliográfica das evidências clínicas sobre o uso dos probióticos orais no tratamento da rosácea, acne e dermatite atópica através de uma pesquisa nos bancos de dados eletrônicos, como PubMed, Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana em Ciências da Saúde (LILACS) e Google Scholar, nos últimos 5 anos. Foram encontrados um número limitado de estudos, mas todos evidenciaram o benefício e melhora das lesões da rosácea, acne e dermatite atópica, assim como a diminuição de citocinas pró-inflamatorias. Os resultados encontrados sugerem que o uso de Lactobacillus acidophilus, Bifidobacterium lactis e Bifidobacterium bifidum são promissores nas três patologias. Concomitante, os estudos mostraram que os probióticos usados em conjunto aos antibióticos orais obtiveram melhores respostas do que usados isoladamente. Apesar da resposta positiva, são imprescindíveis mais esforços para a compreensão total dos mecanismos exatos e efeitos terapêuticos dos probióticos orais no manejo de doenças dermatológicas inflamatórias.

Abstract The gut microbiome is an important in the health and pathogenesis of some diseases. Beyond digestion, it interferes with the immune system and even with the skin health. Evidence shows that intestinal changes can be involved in dermatological manifestations, such as rosacea, acne, and atopic dermatitis. The use of probiotics has been studied, because it is possible to create a strategy to modulate the immune system and reduce the manifestations of these diseases. In this study, we performed a bibliographic review of the clinical evidence on the use of oral probiotics in the treatment of rosacea, acne, and atopic dermatitis. The search was made in electronic databases, such as PubMed, Scientific Electronic Library Online (SCIELO), Latin American Literature in Health Sciences (LILACS), and Google Scholar, in the past 5 years. A limited number of studies have been found, but all have shown the benefit and improvement of lesions in patients, as well as the reduction of pro-inflammatory cytokines by the mechanism of immunomodulation. Search results found out that the use of Lactobacillus acidophilus, Bifidobacterium lactis, and Bifidobacterium bifidum are promising in the three pathologies. Moreover, probiotics used in association with oral antibiotics obtained better responses than when used alone. Despite the positive response, more efforts are required to fully understand the exact mechanisms and therapeutic effects of probiotics in the management of inflammatory dermatological diseases.

Abstract The growth, sexual maturity and fertility-related parameters related of young Nellore bulls with divergent residual feed intake (RFI) raised on pasture were evaluated. After classification of 48 young males as low and high RFI (more and less efficient, respectively), the animals were evaluated for growth and reproductive parameters at 28-day intervals from 14.3 to 24.6 months of age. The semen was cryopreserved in the last sampling and fresh and post-thaw semen samples were evaluated. Low RFI bulls exhibited higher initial and final body weight (P < 0.05), but feed intake, body condition score and growth measures evaluated by carcass ultrasound were unaffected by RFI (P > 0.05). The scrotal circumference, sperm concentration, defects, and quality of fresh semen, and ultrasonographic testicular characteristics were unaffected by RFI (P > 0.05). However, velocity parameters such as average path and curvilinear velocities determined by computer-assisted sperm analysis of thawed semen submitted to the rapid thermoresistance test were improved (P < 0.05) in low RFI bulls, but this improvement in quality did not enhance in vitro sperm fertilizing ability. Our results demonstrated significant differences in metabolism and growth performance between bulls of divergent RFI. In addition, there was slight improvement in the semen quality of bulls with low RFI bulls, but this did not enhance in vitro fertilizing ability. Selection of beef bulls for RFI can be performed, which will result in economic benefits by improving the growth performance of the animals without affecting reproductive parameters.

O objetivo desta pesquisa foi sintetizar evidências das práticas colaborativas interprofissionais segundo os domínios de competências essenciais do Canadian Interprofessional Health Collaborative (CIHC). Foi conduzida revisão integrativa da literatura, dos últimos dez anos, nas bases Pubmed, Web of Science e Biblioteca Virtual em Saúde e síntese das práticas segundo a estrutura proposta pela CIHC. Dos 364 artigos selecionados, 21 foram incluídos com amostras entre 12 e 972 participantes; 11 estudos utilizaram instrumentos para avaliação das práticas; 43% evidenciaram os seis domínios essenciais; e 38%, de três a quatro. A resolução de conflitos interprofissionais não foi abordada em 48% dos artigos. Foi observada a adesão aos domínios de competências essenciais, o que tende a qualificar o processo de trabalho. Entretanto, a lacuna observada na abordagem do enfrentamento dos conflitos interprofissionais representa um obstáculo para vencer a formação uniprofissional.

The aim of this study was to synthesize evidence of collaborative practices based on the core competency domains proposed by the Canadian Interprofessional Health Collaborative (CIHC). We conducted an integrative literature review of articles published over the last 10 years. Searches were performed of the PubMed, Web of Science and Virtual Health Library databases and a synthesis of the practices based on the framework proposed by the CIHC. The search yielded 364 articles, 21 of which were included in the sample. The included studies used samples of between 12 and 972 participants. Eleven of the studies used practice assessment instruments; 43% included all six core competency domains and 38% included three to four. Forty-eight per cent of the studies did not address interprofessional conflict resolution. The findings demonstrate that adherence to the core competency domains tends to improve the quality of work process. However, the gap represented by the failure to address interprofessional conflict resolution is an obstacle to overcoming uniprofessional training.

El objetivo de este estudio fue sintetizar evidencias de las prácticas colaborativas interprofesionales según los dominios de competencias esenciales del Canadian Interprofessional Health Collaborative (CIHC). Se realizó una revisión integradora de la literatura de los últimos diez años en las bases Pubmed, Web of Science y Biblioteca Virtual em Saúde y síntesis de las prácticas según la estructura propuesta por la CIHC. De los 364 artículos seleccionados se incluyeron 21, con muestras entre 12 y 972 participantes. Once estudios utilizaron instrumentos para evaluación de las prácticas, el 43% puso en evidencia los seis dominios esenciales, y el 38% de 3 a 4. La resolución de conflictos interprofesionales no se abordó en el 48% de los artículos. Se observó la adhesión a los dominios de competencias esenciales, lo que tiende a calificar el proceso de trabajo. Sin embargo, la brecha observada en el abordaje del enfrentamiento de los conflictos interprofesionales representa un obstáculo para vencer la formación uniprofesional.