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Abstract Sheep production systems face numerous challenges, which make decision-making a process fraught with risks and uncertainties. Modelling is a helpful tool in this respect, as it allows decision-makers to evaluate the behaviour of variables and their interrelationships, in addition to using previous or related information to predict results and simulate different scenarios. The advent of prediction models has made it possible to monitor the weight of an animal and determine the best time for its sale. Additionally, it allows producers to estimate the weights of the carcass and major marketable cuts before slaughter. All this information is directly associated with the profitability and success of the production activity. Therefore, in view of the different applications of mathematical models in production systems, this literature review examines concepts in modelling studies and the importance of using prediction models in meat sheep production. Furthermore, it addresses the practical application of modelling studies in predicting dry matter intake and carcass traits of meat sheep through correlated variables.

Resumen Los sistemas de producción ovina se enfrentan a numerosos desafíos, que hacen de la toma de decisiones un proceso lleno de riesgos e incertidumbres. En este sentido, la modelación es una herramienta útil, ya que permite a los tomadores de decisiones evaluar el comportamiento de las variables y sus interrelaciones, además de utilizar información previa o relacionada para predecir resultados y simular diferentes escenarios. El advenimiento de los modelos de predicción ha permitido monitorear el peso de un animal y determinar el mejor momento para su venta. Además, permite a los productores estimar los pesos de la canal y los principales cortes comercializables antes del sacrificio. Toda esta información está directamente asociada a la rentabilidad y el éxito de la actividad productiva. Por lo tanto, en vista de las diferentes aplicaciones de los modelos matemáticos en los sistemas de producción, esta revisión de la literatura examina los conceptos en los estudios de modelación y la importancia de utilizar modelos de predicción en la producción de ovinos de carne. Además, aborda la aplicación práctica de los estudios de modelación en la predicción de la ingesta de materia seca y los rasgos de la canal de ovinos de carne a través de variables correlacionadas.

https://doi.org/10.22319/rmcp.v14i1.6126

Health-related quality of life in children with cerebral palsy associated with congenital Zika infection
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Marques, Fernanda Jordão Pinto

; Carvalho, Alessandra Lemos de

; Borigato, Eliana Valverde Magro

; Oliveira, Luiz Felipe Vieira de

; Duarte, Lenamaris Mendes Rocha

; Silva, Adriana Goncalves da

; Amarante, Claret Luiz Dias

; Pereira, Laura Jácome de Melo

; Tavares, Elise Ferreira

; Costa, Lilian Gleice de Sena da

; Alcântara, Carolina Alves Rezende

; Salinas, Andrea Nakamura

; Pinto, Fernanda de Lourdes da Cunha

; Alcântara, Gerliane Carvalho de

; Utsch, Fabiana

; Silva, Cinthia Ramos Diniz

; Reis, Dirlene Araujo dos

; Bessa, Wilerson Marques

; Dutra, Rafaela Christine

; Ventura, Paloma

; Oliveira, Tatiana Souza

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2022016

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

Abstract Objective: To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. Methods: Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. Results: The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. Conclusions: Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.

RESUMO Objetivo: Descrever a qualidade de vida relacionada à saúde em crianças com paralisia cerebral associada à infecção congênita pelo zika. Métodos: Estudo transversal de série consecutiva de casos de crianças acompanhadas em uma rede multicêntrica de reabilitação no Brasil. Convidamos o(s) cuidador(es) a responder à versão brasileira do Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM). A análise estatística foi realizada com o pacote estatístico Statistical Package for the Social Sciences (SPSS) 26.0™. Para variáveis categóricas, foram utilizadas frequências absolutas e relativas e, para variáveis contínuas, média e desvio padrão. Resultados: Cento e noventa e três crianças, com idade média de 50,3±7,6 meses, foram incluídas. Observou-se predomínio de crianças com paralisia cerebral Gross Motor Function Classification System (GMFCS) nível V (93,7%). Epilepsia (88,4%) foi a comorbidade mais comum. As pontuações médias do CPCHILDTM foram: atividades de vida diária/cuidados pessoais 43,2±12,6; posicionamento, transferência e mobilidade 33,7±16,5; conforto e emoções 84,4±15,2; comunicação e interação social 48,2±24,3; saúde 70,9±17,1; e qualidade de vida geral 72,1±17,1. A pontuação total foi 54,8±11,3. Conclusões: Entre as crianças com paralisia cerebral relacionada à síndrome do zika congênita, as atividades de posicionamento, transferência e mobilidade tiveram maior impacto na qualidade de vida relacionada à saúde, semelhantemente a outras etiologias de paralisia cerebral. As estratégias de reabilitação e as políticas públicas devem priorizar os aspectos relacionados à mobilidade dessa população.

https://doi.org/10.1590/1984-0462/2023/41/2022016

Comparação da fragilidade em pessoas idosas longevas pelo Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) e pela Edmonton Frail Scale (EFS)
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Freitas, Tahiana Ferreira

; Caixeta, Walker Henrique Viana

; Freitas, Ronilson Ferreira

; Caldeira, Antônio Prates

; Costa, Fernanda Marques da

; Carneiro, Jair Almeida

Revista Brasileira de Geriatria e Gerontologia

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2023, Volume 26 elocation e230072

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

Abstract Objective To compare Clinical-Functional Vulnerability Index-20 (IVCF-20) and Edmonton Frail Scale (EFS) scores among community-dwelling older people aged ≥80 years for prevalence and degree of agreement. Method A cross-sectional study nested within a population-based cohort, was conducted. Baseline sampling was probabilistic by two-stage clustering. In the first stage, the census tract was used as the sampling unit. In the second stage, the number of households was defined according to the population density of individuals aged ≥60 years. Sensitivity, specificity and predictive values were determined and Kappa statistics expressed degree of agreement between the instruments. Results 92 oldest-old people were evaluated. The prevalence of high risk of clinical and functional vulnerability on the IVCF, indicating frailty, was 45,7%, whereas the prevalence of frailty using the EFS was 44,6%. Sensitivity, specificity, positive predictive value and negative predictive values were 88,23%, 87,80%, 90,0% and 85,71%, respectively. Accuracy was 88,04% and the Kappa statistic 0.759 (p<0.001). Conclusion The IVCF-20 and EFS instruments showed good accuracy and strong agreement when applied to community-dwelling oldest-old people. The identification of frailty was superior using the IVCF-20. These results show that the instruments detected similar frailty prevalence in community-dwelling oldest-old people.

Resumo Objetivo Comparar os escores do Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) e da Edmonton Frail Scale (EFS) entre pessoas idosas com 80 anos ou mais de idade que vivem na comunidade, considerando a prevalência e o grau de concordância. Método Trata-se de estudo transversal, aninhado a uma coorte de base populacional. A amostragem na linha de base foi probabilística, por conglomerados, em dois estágios. No primeiro, utilizou-se como unidade amostral o setor censitário. No segundo, definiu-se o número de domicílios segundo a densidade populacional de pessoas idosas. Foram determinados a sensibilidade, a especificidade e os valores preditivos. A estatística Kappa analisou o grau de concordância entre os instrumentos. Resultados Foram avaliadas 92 pessoas idosas longevas. A prevalência do alto risco de vulnerabilidade clínico-funcional, considerado pessoa idosa frágil, foi de 45,7% pelo IVCF-20 e a prevalência de fragilidade pela EFS foi de 44,6%. Os valores de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo foram, respectivamente, 88,23%, 87,80%, 90,0% e 85,71%. A acurácia foi de 88,04%. A estatística Kappa foi 0,759 (p<0,001). Conclusão Os instrumentos IVCF-20 e EFS possuem boa acurácia e concordância forte, quando aplicado em pessoas idosas longevos que vivem na comunidade. A identificação da fragilidade foi superior, quando utilizado o IVCF-20. O resultado indica que os instrumentos avaliados possuem similaridade na prevalência da fragilidade em pessoas idosas longevas comunitárias.

https://doi.org/10.1590/1981-22562023026.230072.pt

Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022
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Oliveira, Glaucia Maria Moraes de

; Almeida, Maria Cristina Costa de

; Marques-Santos, Celi

; Costa, Maria Elizabeth Navegantes Caetano

; Carvalho, Regina Coeli Marques de

; Freire, Cláudia Maria Vilas

; Magalhães, Lucelia Batista Neves Cunha

; Hajjar, Ludhmila Abrahão

; Rivera, Maria Alayde Mendonça

; Castro, Marildes Luiza de

; Avila, Walkiria Samuel

; Lucena, Alexandre Jorge Gomes de

; Brandão, Andréa Araujo

; Macedo, Ariane Vieira Scarlatelli

; Lantieri, Carla Janice Baister

; Polanczyk, Carisi Anne

; Albuquerque, Carlos Japhet da Matta

; Born, Daniel

; Falcheto, Eduardo Belisário

; Bragança, Érika Olivier Vilela

; Braga, Fabiana Goulart Marcondes

; Colombo, Fernanda M. Consolim

; Jatene, Ieda Biscegli

; Costa, Isabela Bispo Santos da Silva

; Rivera, Ivan Romero

; Scholz, Jaqueline Ribeiro

; Melo Filho, José Xavier de

; Santos, Magaly Arrais dos

; Izar, Maria Cristina de Oliveira

; Azevedo, Maria Fátima

; Moura, Maria Sanali

; Campos, Milena dos Santos Barros

; Souza, Olga Ferreira de

; Medeiros, Orlando Otávio de

; Silva, Sheyla Cristina Tonheiro Ferro da

; Rizk, Stéphanie Itala

; Rodrigues, Thais de Carvalho Vieira

; Salim, Thaís Rocha

; Lemke, Viviana de Mello Guzzo

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 815 - 882

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

https://doi.org/10.36660/abc.20220734

Analysis of death in children not submitted to cardiopulmonary resuscitation
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Leite, Márcia Marques

; Bello, Fernanda Paixão Silveira

; Sakano, Tânia Miyuki Shimoda

; Schvartsman, Claudio

; Costa Reis, Amélia Gorete Afonso da

Jornal de Pediatria

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sep 2022, Volume 98 N. 5 Pages 477 - 483

Abstract: En | Text: En | PDF: En

Abstract Objective Describe the epidemiology of deaths in children not submitted to CPR, compare to a CPR group and evaluate patients’ medical records of those not submitted to CPR. Methods Observational cross-sectional study assessing deaths between 2015 and 2018 in a pediatric tertiary hospital, divided into two groups: CPR and no- CPR. The source of data included the cardiorespiratory arrest register, based on Utstein style. Children's medical records in no-CPR group were researched by hand. Results 241 deaths were included, 162 in CPR group and 79 in the no-CPR group. Preexisting diseases were observed in 98.3% of patients and prior advanced intervention in 78%. Of the 241 deaths, 212 (88%) occurred in the PICU, being 138/162 (85.2%) in CPR group and 74/79 (93.7%) in no-CPR group (p= 0.018). Bradycardia as the initial rhythm was five times more frequent in the CPR group (OR 5.06, 95% CI 1.94-13,19). There was no statistically significant difference regarding age, gender, preexisting diseases, and period of the day of the occurrence of death. Medical records revealed factors related to the family decision-making process or the suitability of therapeutic effort. Discrepancies between the practice of CPR and medical records were identified in 9/79 (11,4%) records allocated to the no-CPR group. Conclusion Most deaths with CPR and with the no-CPR occurred in the PICU. Bradycardia as the initial rhythm was five times more frequent in the CPR group. Medical records reflected the complexity of the decision not to perform CPR. Discrepancies were identified between practice and medical records in the no-CPR group.

https://doi.org/10.1016/j.jped.2021.12.008

Brazilian practice guidelines for stroke rehabilitation: part II
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Minelli, Cesar

; Luvizutto, Gustavo José

; Cacho, Roberta de Oliveira

; Neves, Luciana de Oliveira

; Magalhães, Sheila Cristina Sayuri Abe

; Pedatella, Marco Túlio Araújo

; Mendonça, Lucia Iracema Zanotto de

; Ortiz, Karin Zazo

; Lange, Marcos Christiano

; Ribeiro, Priscila Watson

; Souza, Luciane Aparecida Pascucci Sande de

; Milani, Cristiano

; Cruz, Daniel Marinho Cezar da

; Costa, Rafael Dalle Molle da

; Conforto, Adriana Bastos

; Carvalho, Fernanda Martins Maia

; Ciarlini, Bruna Silva

; Frota, Norberto Anizio Ferreira

; Almeida, Kelson James

; Schochat, Eliane

; Oliveira, Tatiana de Paula

; Miranda, Camila

; Piemonte, Maria Elisa Pimentel

; Lopes, Laura Cardia Gomes

; Lopes, Camila Galvão

; Tosin, Michelle Hyczy de Siqueira

; Oliveira, Bianca Campos

; Oliveira, Beatriz Guitton Renaud Baptista de

; Castro, Shamyr Sulyvan de

; Andrade, João Brainier Clares de

; Silva, Gisele Sampaio

; Pontes-Neto, Octávio Marques

; Carvalho, João José Freitas de

; Martins, Sheila C. Ouriques

; Bazan, Rodrigo

Arquivos de Neuro-Psiquiatria

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jul 2022, Volume 80 N. 7 Pages 741 - 758

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

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

https://doi.org/10.1055/s-0042-1757692

Genetic and symbiotic characterization of rhizobia nodulating legumes in a mining area in southeast Brazil
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Lopez, Bruna Daniela Ortiz

; Teixeira, Anita Fernanda dos Santos

; Michel, Daniele Cabral

; Guimarães, Amanda Azarias

; Costa, Amanda Monique da

; Costa, Juliana Santos

; Pereira, Marcela de Souza

; Duarte, Bárbara Luyse Marques

; Moreira, Fatima Maria de Souza

Scientia Agricola

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2022, Volume 79 N. 2 elocation e20200238

Abstract: En | Text: En | PDF: En

ABSTRACT: Identification and selection of nitrogen-fixing bacterial strains for inoculation into native leguminous tree species can assist in the recovery of degraded areas. Additionally, native strains from these areas are genetic resources adapted to these conditions and are thus suitable for selection. The aim of this study was to symbiotically and genetically characterize 18 bacterial strains from the Rhizobium and Bradyrhizobium genera isolated from Machaerium nyctitans, Platypodium elegans, and Ormosia arborea grown in a nursery in an iron mining area. Three experiments were conducted under axenic conditions in a greenhouse. The nodulation capacity of the strains was evaluated by the number (NN) and dry matter (NDM) of nodules. Symbiotic efficiency was evaluated based on the following parameters: SPAD index (SPAD), shoot dry matter (SDM), root dry matter (RDM), and total dry matter (TDM) of the plants, relative efficiency (RE), shoot nitrogen content (SNC), and total nitrogen content in the plant (TNC). The atpD and gyrB housekeeping genes and the nifH gene were sequenced for phylogenetic analysis, and the nodC and nodD symbiotic genes of the strains were amplified. Out of the 18 strains, 16 were authenticated by nodulation capacity in the species of origin. The SPAD variable allowed for the detection of differences between treatments before the SDM. Additionally, the SPAD index showed correlation with TNC, and the strain Bradyrhizobium sp., UFLA01-839, which may represent a new species, was outstanding in Machaerium nyctitans. The nifH, nodD, and nodC genes were detected in UFLA01-839.

https://doi.org/10.1590/1678-992x-2020-0238 263 downloads

CARTA AO EDITOR SOBRE O ARTIGO - AVALIAÇÃO DO RISCO DE EXPOSIÇÃO PROFISSIONAL AO COVID-19: ADAPTAÇÃO TRANSCULTURAL
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Marziale, Maria Helena Palucci

; Rocha, Fernanda Ludmilla Rossi

; Cassenote, Alex Jones Flores

; Robazzi, Maria Lúcia do Carmo Cruz

; Palha, Pedro Fredemir

; Ballestero, Jaqueline Garcia de Almeida

; Terra, Fábio de Souza

; Mininel, Vivian Aline

; Santos, Heloisa Ehmke Cardoso dos

; Fracarolli, Isabela Fernanda Larios

; Garcia, Gracielle Pereira Aires

; Fortunato, Maria Alice Barbosa

; Lima, Marcelo Marques de

; Dutra, Herica Silva

; Thofehrn, Maira Buss

; Dutra, Lidiane Silva

; Araújo, Camila Ribeiro

; Braga, Luciene Muniz

; Carbogim, Fábio da Costa

; Coelho, Angélica da Conceição Oliveira

Texto & Contexto - Enfermagem

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2022, Volume 31 elocation e2022c001

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/1980-265x-tce-2022-c001

SARS-CoV-2 and rhinovirus infections: are there differences in clinical presentation, laboratory abnormalities, and outcomes in the pediatric population?
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Pereira, Maria Fernanda Bádue

; Suguita, Priscila

; Litvinov, Nadia

; Farhat, Sylvia Costa Lima

; Paula, Camila Sanson Yoshino de

; Lázari, Carolina dos Santos

; Bedê, Pedro Vale

; Framil, Juliana Valeria de Souza

; Bueno, Catarina

; Branas, Priscila Cristina Abduch Adas

; Guimarães, Irina Monteiro da Costa

; Leite, Marcia Marques

; Navega, Ana Carolina Barsaglini

; Nanbu, Danilo Yamamoto

; Schvartsman, Claudio

; Pinho, João Renato Rebello

; Silva, Clovis Artur Almeida

; Marques, Heloisa Helena de Sousa

; Eisencraft, Adriana Pasmanik

; Rossi Jr, Alfio

; Delgado, Artur Figueiredo

; Leal, Gabriela Nunes

; Gibelli, Maria Augusta Cicaroni

; Palmeira, Patricia

; Sakita, Neusa Keico

; Santos, Emilly Henrique dos

; Rocha, Mussya Cisotto

; Kanunfre, Kelly Aparecida

; Okay, Thelma Suely

; Carneiro-Sampaio, Magda

; Carvalho, Werther Brunow de

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e34

Abstract: En | Text: En | PDF: En

ABSTRACT This study aims to assess COVID-19 and other respiratory viruses in pediatric patients. Between April 17 and September 30, 2020, we collected 1,566 respiratory samples from 1,044 symptomatic patients who were younger than 18 years old to assess SARS-CoV-2 infection. Of these, 919 were analyzed for other respiratory pathogens (ORP). Patients with laboratory-confirmed COVID-19 or ORP were included. We evaluated 76 pediatric COVID-19 infections and 157 other respiratory virus infections. Rhinovirus occurred in 132/157 (84%). COVID-19 patients who were significantly older, had more fevers, headaches and pneumonia than those with ORP. The median white blood cell count was lower in patients with SARS-CoV-2 than in those with ORP (6,470 versus 8,170; p=0.02). COVID-19 patients had significantly worse symptoms than those with ORP.

https://doi.org/10.1590/s1678-9946202264034

10.

Piora da fragilidade em pessoas idosas comunitárias com hipertensão e fatores associados
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Soares, Marianne Silva

; Brito, Gabriela Alves de

; Horta, Isamara Corrêa Guimarães

; Gomes, Isabella Ribeiro

; Carneiro, Jair Almeida

; Costa, Fernanda Marques da

Revista Brasileira de Geriatria e Gerontologia

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2022, Volume 25 N. 3 elocation e220188

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

Abstract Objective To estimate the prevalence and factors associated with the worsening of frailty in older people with arterial hypertension. Methods Quantitative, longitudinal, prospective and analytical study. Carried out in community-dwelling hypertensive older people from Minas Gerais. Sampling was probabilistic, by clusters in two stages. Data collection took place at the older people's homes in two moments. Demographic, socioeconomic and clinical-assistance variables were analyzed. Frailty was measured by the Edmonton Frailty Scale. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios. Results 281 older people participated in the study, 23.1% showed a worsening of their state of frailty. The prevalence of frailty increased from 38.0% in the base year to 31.2% in the first wave. The worsening of frailty was associated with negative self-perception of health, polypharmacy and hospitalization in the last 12 months. Conclusion There was a transition between states of frailty. An important contingent of the older people showed worsening frailty.

Resumo Objetivo Estimar a prevalência e fatores associados à piora da fragilidade em idosos com hipertensão arterial. Métodos Estudo quantitativo, longitudinal prospectivo e analítico. Realizado em idosos hipertensos comunitários mineiros. A amostragem foi probabilística, por conglomerados em duas etapas. A coleta de dados ocorreu no domicílio dos idosos em dois momentos. Foram analisadas variáveis demográficas, socioeconômicas e clínico-assistenciais. A fragilidade foi mensurada pela Escala de Fragilidade de Edmonton. Utilizou-se a regressão de Poisson com variância robusta para obter as razões de prevalência brutas e ajustadas Resultados Participaram do estudo 281 idosos, 23,1% apresentaram piora do seu estado de fragilidade. A prevalência de fragilidade passou de 38,0%, no ano base, para 31,2% na primeira onda. A piora da fragilidade foi associada a autopercepção negativa da saúde, à polifarmácia e à internação nos últimos 12 mese Conclusão Houve transição entre os estados de fragilidade. Um contingente importante dos idosos apresentou piora da fragilidade.

https://doi.org/10.1590/1981-22562022025.220188.pt

11.

Multimorbidade em idosos comunitários: prevalência e fatores associados
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Gusmão, Maria Suely Fernandes

; Cunha, Pâmela de Oliveira

; Santos, Brenda Gomes dos

; Costa, Fernanda Marques da

; Caldeira, Antônio Prates

; Carneiro, Jair Almeida

Revista Brasileira de Geriatria e Gerontologia

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2022, Volume 25 N. 1 elocation e220115

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

Abstract Objective to analyze the prevalence of multimorbidity in the elderly and its associated factors. Method cross-sectional study, part of a population-based cohort, carried out in Montes Claros, Minas Gerais, Brazil. A probabilistic sampling was carried out, by conglomerates, in two stages: by census sector and by households, according to the population density of the elderly. The dependent variable was multimorbidity, considering the simultaneous accumulation of two or more and three or more chronic diseases in community-dwelling elderly. Prevalence ratios were estimated using Poisson regression, with robust variance. Result the prevalence of multimorbidity in the elderly, considering two or more and three or more chronic diseases, was 67.8% and 43.4%, respectively. After multiple analysis, the female sex (PRaj=1.15; 95%CI 1.04-126)/(PRaj=1.19; 95%CI108-1.31), frailty (PRaj=1.15; 95%CI 1.05-1.27)/(PRaj= 1.28; 95%CI 1.16-1.41) and medical consultation in the last 12 months (PRaj=1.25; 95%CI 1.06-1 .47)/(PRaj=1.22; 95%CI 1.06-1.41) were associated with multimorbidity, both with two or more and with three or more chronic diseases, respectively. Poor self-perception of health (PRaj=1.20; 95%CI1.09-1.32) was associated with multimorbidity with two or more chronic diseases, while not having a private health plan (PRaj=1.14; 95%CI1.04-1.25) was associated with multimorbidity with three or more chronic diseases. Conclusion The prevalence of multimorbidity was high in community-dwelling elderly, considering two or more and three or more chronic diseases. Knowledge of these conditions can help in health promotion, prevention and surveillance actions for community-dwelling elderly people.

Resumo Objetivo analisar a prevalência de multimorbidade em idosos e seus fatores associados. Método estudo transversal, parte de uma coorte de base populacional, realizado em Montes Claros, Minas Gerais, Brasil. Realizou-se uma amostragem probabilística, por conglomerados, em dois estágios: por setor censitário e por domicílios, segundo a densidade populacional de idosos. A variável dependente foi a multimorbidade, considerando o acúmulo simultâneo de duas ou mais e três ou mais doenças crônicas em idosos comunitários. Foram estimadas as razões de prevalência por meio da regressão de Poisson, com variância robusta. Resultado: a prevalência de multimorbidade em idosos, com duas ou mais e três ou mais doenças crônicas, foi de 67,8% e 43,4%, respectivamente. Após análise múltipla, o sexo feminino (RPaj=1,15; IC95% 1,04-126)/(RPaj=1,19; IC95%108-1,31), a fragilidade (RPaj=1,15; IC95%1,05-1,27)/(RPaj= 1,28; IC95% 1,16-1,41) e a realização de consulta médica nos últimos 12 meses (RPaj=1,25; IC95%1,06-1,47)/(RPaj=1,22; IC95% 1,06-1,41) relacionaram-se à multimorbidade, tanto com duas ou mais, quanto com três ou mais doenças crônicas, respectivamente. A autopercepção de saúde ruim (RPaj=1,20; IC95%1,09-1,32) associou-se à multimorbidade com duas ou mais doenças crônicas, enquanto não possuir plano de saúde particular (RPaj=1,14; IC95%1,04-1,25) foi associado à multimorbidade com três ou mais doenças crônicas. Conclusão A prevalência de multimorbidade foi alta em idosos comunitários, considerando duas ou mais e três ou mais doenças crônicas. O conhecimento dessas condições pode auxiliar nas ações de promoção, prevenção e vigilância em saúde de idosos comunitários.

https://doi.org/10.1590/1981-22562022025.220115.pt

12.

Controle e utilização da talidomida: adequados à ampliação do uso e mitigação do risco de teratogenicidade no Brasil?
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Campos, Fernanda Torres

; Santos, Roberta Márcia Marques dos

; Costa, Josilene Pereira

; Pádua, Cristiane Aparecida Menezes de

Ciência & Saúde Coletiva

Journal Metrics
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sep 2021, Volume 26 N. 9 Pages 4233 - 4242

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

Resumo Estudo de utilização de medicamento que descreve o controle da talidomida no Brasil e sua utilização em Minas Gerais. Questionário online foi enviado às unidades federativas do Brasil para coleta de dados de distribuição, dispensação, cadastro de usuários e eventos adversos da talidomida. Dados de distribuição (2011-2018) e dispensação (2015-2018) de Minas Gerais foram obtidos pelo sistema de gerenciamento da assistência farmacêutica. Análise de variância e teste de Tukey foram empregados para comparações dos dados. Das 16 unidades federativas participantes, 100% e 50% utilizavam sistema eletrônico para distribuição e dispensação, respectivamente, e cerca de 43% cadastravam usuários. Sistemas de notificação de eventos adversos eram escassos. Houve redução de 44% na distribuição em Minas Gerais no período. A dispensação manteve-se constante (média 0,0004 DDD/1000 hab./dia) e ocorreu principalmente para eritema nodoso hansênico e mieloma múltiplo. O uso off-label (2,2%) foi crescente. A maioria dos usuários era do sexo masculino (idade média 56 anos). Das mulheres, 30% estavam em idade fértil. A vigilância da talidomida é um desafio em saúde pública. Apesar da ampliação do uso e obrigatoriedade de controle, não há padronização em nível nacional e a notificação de eventos adversos é incipiente.

Abstract Drug utilization research to describe the control of thalidomide in Brazil and its use in Minas Gerais state. An online questionnaire was sent to the Brazilian federative units to collect data concerning distribution, dispensation, user registration, and thalidomide adverse events. Distribution (2011-2018) and dispensing (2015-2018) data in Minas Gerais were obtained through the pharmaceutical care management system. Analysis of variance and Tukey test were used for data comparisons. Of the 16 participating federative units, 100% and 50% used electronic distribution and dispensing systems, respectively, and about 43% registered users. Adverse event reporting systems were scarce. A 44% reduction was observed in the distribution in Minas Gerais for the period. Dispensing remained constant (mean 0.0004 DDD/1,000 inhabitants/day) and occurred mainly for erythema nodosum leprosum and multiple myeloma. Off-label use (2.2%) was increasing. Most users were male (mean age 56 years) and thirty percent of women were of childbearing age. Thalidomide surveillance is a public health challenge. Despite the increased use and mandatory control, there is no national standardization, and adverse event reporting is incipient.

https://doi.org/10.1590/1413-81232021269.19462020

13.

Controle e utilização da talidomida: adequados à ampliação do uso e mitigação do risco de teratogenicidade no Brasil?
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Campos, Fernanda Torres

; Santos, Roberta Márcia Marques dos

; Costa, Josilene Pereira

; Pádua, Cristiane Aparecida Menezes de

Ciência & Saúde Coletiva

Journal Metrics
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sep 2021, Volume 26 N. 9 Pages 4233 - 4242

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

https://doi.org/10.1590/1413-81232021269.19462020 118 downloads

14.

Late follow-up of peripheral neural decompression in leprosy: functional and clinical outcomes
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Tiago, Liliane Marques de Pinho

; Barbosa, Maria Fernanda Ferreira

; Santos, Diogo Fernandes dos

; Faria, Adelmo Divino

; Gonçalves, Maria Aparecida

; Costa, Adeilson Vieira

; Goulart, Isabela Maria Bernardes

Arquivos de Neuro-Psiquiatria

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aug 2021, Volume 79 N. 8 Pages 716 - 723

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

RESUMO Antecedentes: A descompressão cirúrgica neural periférica (DCNP) é usada como uma terapia complementar ao tratamento clínico da neurite hansênica para preservar a função neural. Objetivo: Avaliar a longo prazo (≥ 1 ano) os resultados clínicos e funcionais da DCNP na neurite hansênica. Métodos: Este estudo transversal incluiu pacientes que estavam no pós-operatório tardio (POT) de cirurgia de descompressão dos nervos ulnares, medianos, tibiais e fibulares. Foram coletados dados socioeconômicos, epidemiológicos e clínicos. Os instrumentos utilizados foram: escala visual analógica de dor (EVA), questionário de dor neuropática 4 (DN4), escala SALSA e protocolo de avaliação neurológica simplificada. Os resultados obtidos foram comparados com os do pré-operatório (PrO) e pós-operatório de 180 dias (PO180). Resultados: Foram avaliados 246 nervos de 90 pacientes: 56,6% estavam em poliquimioterapia (PQT) e 43,3% em alta da PQT. Escores motores e intensidade da dor apresentaram melhora significante (p<0,01). Houve aumento nos escores sensitivos nos nervos ulnares bilaterais (p<0,05). Neurite ulnar foi indicação cirúrgica em 26,0% dos casos operados, seguida pela neurite tibial (23,6%). Dor neuropática foi relatada em 41% dos casos. Dose diária de prednisona reduziu de 39,6 mg (±3,0) na PrO, 16,3 mg (±5,2) na PO180, para 1,7 mg (±0,8) na POT. Escala SALSA mostrou limitação leve da atividade em 51% e moderada em 34% dos pacientes. 80% dos indivíduos relataram que os resultados atingiram suas expectativas. Conclusão: DCNP na hanseníase foi eficaz a longo prazo na redução da prevalência e intensidade da dor, na melhora da função motora e redução da dose de corticosteroides, refletindo na satisfação do paciente.

ABSTRACT Background: Peripheral neural surgical decompression (PNSD) is used as a complementary therapy to the clinical treatment of neuritis to preserve neural function. Objective: To evaluate the long-term (≥ 1 year) clinical and functional results for PNSD in leprosy neuritis. Methods: This cross-sectional study included leprosy patients who were in late postoperative period (LPO) of surgical decompression of ulnar, median, tibial, and fibular nerves. Socioeconomic, epidemiological, and clinical data were collected. The following instruments were used in this evaluation: visual analogue pain scale (VAS), Douleur Neuropathique en 4 Questions (DN4), SALSA scale, and simplified neurological assessment protocol. The preoperative (PrO) and 180-day postoperative (PO180) results were compared. Results: We evaluated 246 nerves from 90 patients: 56.6% were on multidrug therapy (MDT) and 43.3% discharged from MDT. Motor scores and pain intensity showed statistically significant improvement (p<0.01). There was an increase in sensory scores only for bilateral ulnar nerves (p<0.05). Of the operated cases, 26.0% of patients were referred for surgery of ulnar neuritis and 23.6% of tibial neuritis. Neuropathic pain was reported in 41% of cases. Daily dose of prednisone reduced from 39.6 mg (±3.0) in PrO, 16.3 mg (±5.2) in PO180, to 1.7 mg (±0.8) in LPO. The SALSA scale results showed mild activity limitation in 51% and moderate in 34% of patients. Eighty percent of individuals reported that the results reached their expectations. Conclusions: PNSD in leprosy was effective in the long term to decrease the prevalence and intensity of pain, improve motor function, and reduce the dose of corticosteroids, which is reflected in the patients’ satisfaction.

https://doi.org/10.1590/0004-282x-anp-2020-0032 153 downloads

15.

Independência funcional e espirometria em pacientes adultos pós-unidade de terapia intensiva
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Abentroth, Lilian Regina Lengler

; Osaku, Erica Fernanda

; Silva, Mayara Manzoni Marques da

; Jaskowiak, Jaiane Luiza

; Zaponi, Renata de Souza

; Ogasawara, Suely Mariko

; Leite, Marcela Aparecida

; Costa, Cláudia Rejane Lima de Macedo

; Porto, Itamar Regazzo Pedreschi

; Jorge, Amaury Cezar

; Duarte, Péricles Almeida Delfino

Revista Brasileira de Terapia Intensiva

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apr 2021, Volume 33 N. 2 Pages 243 - 250

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

RESUMO Objetivo: Relatar a independência funcional e o grau de comprometimento pulmonar em pacientes adultos 3 meses após a alta da unidade de terapia intensiva. Métodos: Este foi um estudo de coorte retrospectiva conduzido em uma unidade de terapia intensiva multiprofissional para pacientes adultos em um único centro. Incluíram-se pacientes admitidos à unidade de terapia intensiva entre janeiro de 2012 e dezembro de 2013 que, 3 meses mais tarde, foram submetidos à espirometria e responderam ao questionário Medida de Independência Funcional. Resultados: Os pacientes foram divididos em grupos segundo sua classificação de independência funcional e espirometria. O estudo incluiu 197 pacientes, que foram divididos entre os grupos maior dependência (n = 4), menor dependência (n = 12) e independente (n = 181). Na comparação dos três grupos com relação à classificação pela Medida de Independência Funcional, pacientes com maior dependência tinham escores Acute Physiology and Chronic Health Evaluation II e Sequential Organ Failure Assessment mais altos quando da admissão à unidade de terapia intensiva, idade mais avançada, mais dias sob ventilação mecânica e tempo mais longo de permanência na unidade de terapia intensiva e no hospital. A maioria dos pacientes apresentava comprometimento pulmonar, sendo o padrão obstrutivo o mais frequentemente observado. Na comparação da independência funcional com a função pulmonar, observou-se que, quanto pior a condição funcional, pior a função pulmonar, observando-se diferenças significantes em relação ao pico de fluxo expiratório (p = 0,030). Conclusão: Em sua maioria, os pacientes que retornaram ao ambulatório 3 meses após a alta tinham boa condição funcional, porém apresentavam comprometimento pulmonar relacionado com o grau de dependência funcional.

ABSTRACT Objective: To relate functional independence to the degree of pulmonary impairment in adult patients 3 months after discharge from the intensive care unit. Methods: This was a retrospective cohort study conducted in one adult intensive care unit and a multi-professional post-intensive care unit outpatient clinic of a single center. Patients admitted to the intensive care unit from January 2012 to December 2013 who underwent (3 months later) spirometry and answered the Functional Independence Measure Questionnaire were included. Results: Patients were divided into groups according to the classification of functional independence and spirometry. The study included 197 patients who were divided into greater dependence (n = 4), lower dependence (n = 12) and independent (n = 181) groups. Comparing the three groups, regarding the classification of the Functional Independence Measure, patients with greater dependence had higher Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment values at intensive care unit admission with more advanced age, more days on mechanical ventilation, and longer stay in the intensive care unit and hospital. The majority of patients presented with pulmonary impairment, which was the obstructive pattern observed most frequently. When comparing functional independence with pulmonary function, it was observed that the lower the functional status, the worse the pulmonary function, with a significant difference being observed in peak expiratory flow (p = 0.030). Conclusion: The majority of patients who returned to the outpatient clinic 3 months after discharge had good functional status but did present with pulmonary impairment, which is related to the degree of functional dependence.

https://doi.org/10.5935/0103-507x.20210031 208 downloads

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