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Resumo Introdução: A promoção da literacia em saúde é crucial para que os utentes possam tomar decisões adequadas em matéria de saúde, promovendo uma utilização mais eficiente dos recursos e contribuindo para a sua sustentabilidade. Objetivos: Promover a literacia em saúde entre os utentes de seis Unidades de Saúde Familiar (USF) no Norte de Portugal acerca da organização e estrutura dos cuidados de saúde primários (CSP) e a especialidade médica de medicina geral e familiar (MGF). Métodos: Estudo observacional, prospetivo, do tipo coorte. Foram aplicados questionários em formato Google® Docs a utentes com 18 ou mais anos, que preenchiam os critérios de inclusão, antes e após um mês da intervenção. A intervenção consistiu na visualização de um vídeo formativo preparado pelos autores acerca da organização e os recursos dos CSP e a especialidade de MGF. Resultados: O questionário pré-intervenção foi preenchido por 274 utentes, 165 visualizaram o vídeo educativo e 113 preencheram o questionário pós-intervenção. Apenas 88 utilizadores participaram em todas as fases do projeto e foram considerados elegíveis para a interpretação dos resultados. Após a intervenção verificou-se uma melhoria estatisticamente significativa na classificação geral obtida no questionário, com um aumento na percentagem de respostas corretas de 66,7% para 72,7% (p=0,004; IC 95%). Verificou-se também um aumento na taxa de respostas corretas em quase todas as questões aplicadas. Discussão e Conclusão: A literacia em saúde ajuda os cidadãos a tomar melhores decisões em relação à sua saúde, com um consequente impacto económico e social. Este projeto culminou na criação de uma ferramenta multimédia capaz de melhorar os conhecimentos dos utentes portugueses acerca dos CSP, passível de ser replicada noutros locais do País.

Abstract Introduction: Promoting health literacy is essential for patients to make informed healthcare decisions, ensuring more efficient resource utilization and contributing to long-term sustainability. Objectives: Enhance health literacy among patients in six health units in Northern Portugal, focusing on the organization and structure of primary healthcare services (PHC) and the medical specialty of general practice/family medicine (GPFM). Methods: An observational, prospective cohort study was conducted. Questionnaires in Google® Docs format were administered to patients aged 18 and older who met the inclusion criteria, both before and one month after the intervention. The intervention involved watching an educational video created by the authors about PHC's organization, resources, and GPFM specialty. Results: The pre-intervention questionnaire received responses from 274 patients, with 165 of them viewing the educational video and 113 completing the post-intervention questionnaire. Eighty-eight participants engaged in all phases of the project and were considered eligible for result analysis. After the intervention, there was a statistically significant improvement in the overall questionnaire score, with the percentage of correct answers increasing from 66.7% to 72.7% (p=0.004; CI 95%). Correct answer rates also improved across most of the questions. Discussion and Conclusion: Health literacy empowers individuals to make informed health choices, resulting in economic and social benefits. This project led to the creation of a multimedia tool that can enhance the understanding of Portuguese patients regarding PHC, with potential for replication in other regions of the country.

https://doi.org/10.32385/rpmgf.v40i1.13773

O racismo institucional na universidade e consequências na vida de estudantes negros: um estudo misto
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Guerra, Nathalia Ester Martins

; Stofel, Natália Sevilha

; Borges, Flávio Adriano

; Luna, Willian Fernandes

; Salim, Natália Rejane

; Sá, Barbara Stefani Morais

; Monteiro, Juliana

Ciência & Saúde Coletiva

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2024, Volume 29 N. 3 elocation e04232023

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

Abstract This article aimed to analyze how institutional racism at a Brazilian public university affects the lives of Black students. This mixed study was developed by applying an online self-administered questionnaire to university students who self-declared as Blacks. Quantitative data were analyzed using descriptive statistics, bivariate analysis using chi-square, and multinomial logistic regression. Qualitative data analysis was performed using IRAMUTEQ. Sixty-eight (54.4%) of the 125 respondents claimed to have suffered racism at least once within the university. We noticed that racist situations experienced by Black people within the university environment call into question the student’s self-confidence and motivation, directly affecting their mental health and performance in the course. The importance of receptive groups for strengthening students’ belonging was highlighted.

Resumo O objetivo do artigo foi analisar como o racismo institucional em uma universidade pública brasileira afeta a vida de estudantes negros e negras. Trata-se de um estudo misto, desenvolvido por meio da aplicação de questionário autoaplicado online a estudantes universitários que se autodeclararam negros. Os dados quantitativos foram analisados por estatística descritiva, análise bivariável por meio do qui-quadrado e regressão logística multinominal. A análise dos dados qualitativos foi feita no Iramuteq. Do total de 125 respondentes, 68 (54,4%) afirmaram ter sofrido racismo pelo menos uma vez dentro da universidade. Percebeu-se que as situações racistas vividas pelas pessoas negras dentro do ambiente universitário colocam em questão a autoconfiança e a motivação do estudante, afetando diretamente a sua saúde mental e seu desempenho no curso. Evidenciou-se a importância dos coletivos para acolhimento e fortalecimento do pertencimento dos estudantes.

https://doi.org/10.1590/1413-81232024293.04232023

Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study
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Gomes, Orlando Vieira

; Guimarães, Manoel Pereira

; Barbosa, Bárbara Maria Batista

; Marinho, Christielle Lidianne Alencar

; Nicacio, Jandir Mendonça

; Barreira, Matheus Pereira

; Rodrigues, Mateus de Sousa

; Santana, Leonardo Fernandes e

; Elihimas Júnior, Ubiracé Fernando

; Schwingel, Paulo Adriano

Sao Paulo Medical Journal

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2024, Volume 142 N. 1 elocation e2022644

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke. OBJECTIVE: To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis. DESIGN AND SETTING: Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil. METHODS: A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke. CONCLUSIONS: Patients on hemodialysis, especially women and older people, have little knowledge about stroke.

https://doi.org/10.1590/1516-3180.2022.0644.r1.24042023

Increased monocytes are associated with overweight in children and adolescents with autism spectrum disorder
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Gonçalves, Bárbara P.

; Silva, Eduarda de S

; Luçardo, Josiane da C

; Fernandes, Mayra P

; Grokoski, Kamila C

; Vaz, Juliana dos S

; Valle, Sandra C.

Nutrición Hospitalaria

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dec 2023, Volume 40 N. 6 Pages 1136 - 1143

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

Resumen Objetivo: investigar el recuento de monocitos y su asociación con el estado nutricional en niños y adolescentes con trastorno del espectro autista (TEA). Método: estudio transversal realizado en el Centro de Neurodesarrollo, en el sur de Brasil, con 68 pacientes con TEA de 3 a 18 años de edad. Se determinó el número de monocitos (por mm3) en muestras de sangre. El estado nutricional se definió como IMC para la edad según los estándares de la OMS. Se aplicó a los cuidadores el Cuestionario de Conducta Alimentaria Infantil y un cuestionario estándar para recoger características sociodemográficas y clínicas. Las comparaciones entre las variables sociodemográficas, clínicas y de conducta alimentaria se realizaron con pruebas paramétricas. Se utilizó la regresión lineal para probar la asociación entre el estado nutricional y el recuento de monocitos. Resultados: la edad media fue de 8,6 ± 3,3 años, el 79 % eran varones y el 66 % tenían sobrepeso. En la regresión no ajustada, el sobrepeso se asoció a un mayor número de monocitos en comparación con los que no tenían sobrepeso (B: 64,0; IC 95 %: 13,9 a 114,1; β: 0,30; p = 0,01). Esta asociación siguió siendo significativa tras ajustar la subescala de “sobrealimentación emocional” (B: 37,0; IC 95 %: 17,1 a 91,3; β: 0,29; p = 0,02). La variabilidad en el recuento de monocitos atribuida al sobrepeso fue del 14 %. Conclusiones: el sobrepeso se asocia a un mayor recuento de monocitos en niños y adolescentes con TEA. La intervención nutricional para controlar el sobrepeso es esencial para mitigar el impacto negativo sobre la actividad inflamatoria y la disfunción inmune en estos pacientes.

Abstract Objective: to investigate the monocyte count and its association with nutritional status in children and adolescents with autism spectrum disorder (ASD). Methods: a cross-sectional study carried out at a Neurodevelopmental Center in the south of Brazil, with 68 ASD patients aged 3 to 18 years. The number of monocytes (per mm3) was determined in blood samples. Nutritional status was defined as BMI-for-age according to WHO standards. The Children's Eating Behaviour Questionnaire and a standard questionnaire to collect sociodemographic and clinical characteristics were administered to caregivers. Comparisons between sociodemographic, clinical, and eating behavior variables were performed with parametric tests. Linear regression was used to test the association between nutritional status and monocyte count. Results: mean age was 8.6 ± 3.3 years, 79 % were males and 66 % were overweight. In the unadjusted regression overweight was associated with higher monocyte counts compared to those non-overweight (B: 64.0; 95 % CI, 13.9 to 114.1; β: 0.30, p = 0.01). This association remained significant after adjustment for the subscale of “emotional overeating” (B: 37.0; 95 % CI, 17.1 to 91.3; β: 0.29; p = 0.02). The variability in monocyte count attributed to overweight was 14 %. Conclusions: overweight is associated with a higher monocyte count in children and adolescents with ASD. Nutritional intervention to control overweight is essential to mitigate the negative impact on inflammatory activity and immune dysfunction in these patients.

https://doi.org/10.20960/nh.04472

A tessitura da construção coletiva de indicadores de saúde mental em Centros de Atenção Psicossocial
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Rossi, Aline Fernandes de

; Paula, Bárbara Arvelino de

; Israel, Flávia Meirelles

; Camargos, Melina Alves de

Saúde em Debate

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jun 2023, Volume 47 N. 137 Pages 333 - 345

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

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.

https://doi.org/10.1590/0103-1104202313723

Case for diagnosis. Vascular malformations, hemihypertrophy and macrodactyly: Proteus syndrome diagnosis malformations macrodactyly
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Barbosa, Bárbara Elias do Carmo

; Alfredo, Melissa de Almeida Corrêa

; Abbade, Luciana Patrícia Fernandes

; Miot, Hélio Amante

Anais Brasileiros de Dermatologia

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jun 2023, Volume 98 N. 3 Pages 384 - 386

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.abd.2021.11.012

Interdisciplinariedad entre diseño e ingeniería: Nuevas competencias en la docencia de proyectos para la innovación circular
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Alves, Jorge Lino

; Facca, Claudia Alquezar

; Fernandes, Adriana Patrícia

; Rangel, Bárbara

; Barbosa, Ana Mae

Cuadernos del Centro de Estudios en Diseño y Comunicación. Ensayos

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jan 2023, N. 114 Pages 177 - 206

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

Resumen Este artículo analiza la relación entre diseño e ingeniería a través de experiencias de enseñanza interdisciplinarias para crear conciencia sobre la economía circular. La educación es esencial para permitir este proceso de manera sistémica para futuros profesionales en ambas áreas, introduciendo metodologías integradas de proyectos en el diseño de productos y sus medios de producción. El objetivo es que, además de las áreas de especialización (arquitectura, diseño, gestión e ingeniería), se establezcan perspectivas futuras para repensar el camino actual del desarrollo económico. Esto creará una base de habilidades para promover la innovación circular, alineada con la necesidad de que las sociedades modernas avancen hacia un paradigma más sostenible.

Abstract This paper discusses the relationship between design and engineering through interdisciplinary teaching experiences for raising circular economy awareness. Education is essential to enable this process in a systemic way for future professionals in both areas, introducing integrated project methodologies in product design and manufacturing. The goal is that in addition to the areas of expertise (architecture, design, management and engineering), prospects are established to rethink the current path of economic development. This will create a skills base to promote circular innovation, aligned with the need for modern societies to move towards a more sustainable paradigm.

Resumo Este artigo discute as relações entre design e engenharia por meio de experiências interdisciplinares de ensino para uma sensibilização para a economia circular. A educação é essencial para viabilizar esse processo de maneira sistémica nos futuros profissionais de ambas as áreas, introduzindo metodologias integradas de projeto no design de produtos e respectivos meios de produção. O objetivo é que, além das áreas deespecialização (arquitetura, design, gestão e engenharia), sejam estabelecidas perspectivas futuras para repensar o caminho atual do desenvolvimento económico.Será assim possível criar uma base de competências para promover a inovação circular, alinhada pela necessidade das sociedades modernas avançarem para um paradigma mais sustentável.

https://doi.org/10.18682/cdc.vi114.4121

Echocardiogram in Critically ill Patients with COVID-19: ECOVID Study
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Gomes, Bruno Ferraz de Oliveira

; Cantisano, Armando Luis

; Menezes, Iliana Regina Ribeiro

; Azevedo, Anny de Sousa

; Silva, Thiago Moreira Bastos da

; Silva, Valdilene Lima

; Dutra, Giovanni Possamai

; Paula, Suzanna Andressa Morais de

; Mendes, Barbara Ferreira da Silva

; Carmo Junior, Plinio Resende do

; Pereira, Basilio de Bragança

; Petriz, Joao Luiz Fernandes

; Oliveira, Glaucia Maria Moraes de

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20210114

Abstract: En | Text: En | PDF: En

Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram.

https://doi.org/10.36660/ijcs.20210114

Factors associated with acute kidney injury in patients undergoing extracorporeal membrane oxygenation: retrospective cohort
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Coelho, Filipe Utuari de Andrade

; Gadioli, Barbara

; Freitas, Flavia Fernandes Manfredi de

; Vattimo, Maria de Fatima Fernandes

Revista da Escola de Enfermagem da USP

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2023, Volume 57 elocation e20220299

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

ABSTRACT Objective: To identify factors associated with acute kidney injury in patients undergoing extracorporeal membrane oxygenation. Method: Retrospective cohort study conducted in an adult Intensive Care Unit with patients undergoing extracorporeal membrane oxygenation from 2012 to 2021. The research used the Kidney Disease Improving Global Outcomes as criteria for definition and classification of acute kidney injury. A multiple logistic regression model was developed to analyze the associated factors. Results: The sample was composed of 122 individuals, of these, 98 developed acute kidney injury (80.3%). In multiple regression, the associated factors found were vasopressin use, Nursing Activities Score, and glomerular filtration rate. Conclusion: The use of vasopressin, the Nursing Activities Score, and the glomerular filtration rate were considered as factors related to the development of acute kidney injury in patients undergoing extracorporeal membrane oxygenation.

RESUMEN Objetivo: Identificar los factores asociados a la lesión renal aguda en pacientes sometidos a oxigenación por membrana extracorpórea. Material y método: Estudio de cohortes retrospectivo realizado en una unidad de cuidados intensivos de adultos con pacientes sometidos a oxigenación por membrana extracorpórea entre 2012 y 2021. El criterio de definición y clasificación de lesión renal aguda fue el Kidney Disease Improving Global Outcomes. Se desarrolló un modelo de regresión logística múltiple para el análisis de los factores asociados. Resultados: La muestra estuvo compuesta por 122 individuos, de estos, 98 desarrollaron lesión renal aguda (80,3%). En la regresión múltiple, los factores asociados encontrados fueron el uso de vasopresina, el Nursing Activities Score y la tasa de filtración glomerular. Conclusión: El uso de vasopresina, el Nursing Activities Score y la tasa de filtración glomerular se consideraron factores relacionados con el desarrollo de lesión renal aguda en pacientes sometidos a oxigenación por membrana extracorpórea.

RESUMO Objetivo: Identificar os fatores associados à lesão renal aguda em pacientes submetidos a oxigenação por membrana extracorpórea. Método: Estudo de coorte retrospectivo, realizado em uma Unidade de Terapia Intensiva adulta, com pacientes submetidos à oxigenação por membrana extracorpórea, no período de 2012 a 2021. O critério para definição e classificação da lesão renal aguda foi o da Kidney Disease Improving Global Outcomes. Para a análise dos fatores associados foi elaborado um modelo de regressão logística múltipla. Resultados: A amostra foi composta por 122 indivíduos, destes, 98 desenvolveram lesão renal aguda (80,3%). Na regressão múltipla, os fatores associados encontrados foram a utilização de vasopressina, o Nursing Activities Score e a taxa de filtração glomerular. Conclusão: O uso da vasopressina, o Nursing Activities Score e a taxa de filtração glomerular foram considerados como fatores relacionados ao desenvolvimento de lesão renal aguda em paciente submetido à oxigenação por membrana extracorpórea.

https://doi.org/10.1590/1980-220x-reeusp-2022-0299en

10.

Lesão Miocárdica e Prognóstico em Pacientes Hospitalizados com COVID-19 no Brasil: Resultados do Registro Nacional de COVID-19
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Barbosa, Hannah Cardoso

; Martins, Maria Auxiliadora Parreiras

; Jesus, Jordana Cristina de

; Meira, Karina Cardoso

; Passaglia, Luiz Guilherme

; Sacioto, Manuela Furtado

; Bezerra, Adriana Falangola Benjamin

; Schwarzbold, Alexandre Vargas

; Maurílio, Amanda de Oliveira

; Farace, Barbara Lopes

; Silva, Carla Thais Cândida Alves da

; Cimini, Christiane Corrêa Rodrigues

; Silveira, Daniel Vitorio

; Carazai, Daniela do Reis

; Ponce, Daniela

; Costa, Emanuel Victor Alves

; Manenti, Euler Roberto Fernandes

; Cenci, Evelin Paola de Almeida

; Bartolazzi, Frederico

; Madeira, Glícia Cristina de Castro

; Nascimento, Guilherme Fagundes

; Velloso, Isabela Vasconcellos Pires

; Batista, Joanna d’Arc Lyra

; Morais, Júlia Drumond Parreiras de

; Carvalho, Juliana da Silva Nogueira

; Ruschel, Karen Brasil

; Martins, Karina Paula Medeiros Prado

; Zandoná, Liege Barella

; Menezes, Luanna Silva Monteiro

; Kopittke, Luciane

; Castro, Luís César de

; Nasi, Luiz Antônio

; Floriani, Maiara Anschau

; Souza, Maíra Dias

; Carneiro, Marcelo

; Bicalho, Maria Aparecida Camargos

; Lima, Maria Clara Pontello Barbosa

; Godoy, Mariana Frizzo de

; Guimarães-Júnior, Milton Henriques

; Mendes, Paulo Mascarenhas

; Delfino-Pereira, Polianna

; Ribeiro, Raquel Jaqueline Eder

; Finger, Renan Goulart

; Menezes, Rochele Mosmann

; Francisco, Saionara Cristina

; Araújo, Silvia Ferreira

; Oliveira, Talita Fischer

; Oliveira, Thainara Conceição de

; Polanczyk, Carisi Anne

; Marcolino, Milena Soriano

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 2 elocation e20220151

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

Abstract Background Cardiovascular complications of COVID-19 are important aspects of the disease’s pathogenesis and prognosis. Evidence on the prognostic role of troponin and myocardial injury in Latin American hospitalized COVID-19 patients is still scarce. Objectives To evaluate myocardial injury as independent predictor of in-hospital mortality and invasive mechanical ventilation support in hospitalized patients, from the Brazilian COVID-19 Registry. Methods This cohort study is a substudy of the Brazilian COVID-19 Registry, conducted in 31 Brazilian hospitals of 17 cities, March-September 2020. Primary outcomes included in-hospital mortality and invasive mechanical ventilation support. Models for the primary outcomes were estimated by Poisson regression with robust variance, with statistical significance of p<0.05. Results Of 2,925 patients (median age of 60 years [48-71], 57.1% men), 27.3% presented myocardial injury. The proportion of patients with comorbidities was higher among patients with cardiac injury (median 2 [1-2] vs. 1 [0-2]). Patients with myocardial injury had higher median levels of brain natriuretic peptide, lactate dehydrogenase, creatine phosphokinase, N-terminal pro-brain natriuretic peptide, and C-reactive protein than patients without myocardial injury. As independent predictors, C-reactive protein and platelet counts were related to the risk of death, and neutrophils and platelet counts were related to the risk of invasive mechanical ventilation support. Patients with high troponin levels presented a higher risk of death (RR 2.03, 95% CI 1.60-2.58) and invasive mechanical ventilation support (RR 1.87, 95% CI 1.57-2.23), when compared to those with normal troponin levels. Conclusion Cardiac injury was an independent predictor of in-hospital mortality and the need for invasive mechanical ventilation support in hospitalized COVID-19 patients.

Resumo Fundamento As complicações cardiovasculares da COVID-19 são aspectos importantes da patogênese e do prognóstico da doença. Evidências do papel prognóstico da troponina e da lesão miocárdica em pacientes hospitalizados com COVID-19 na América Latina são ainda escassos. Objetivos Avaliar a lesão miocárdica como preditor independente de mortalidade hospitalar e suporte ventilatório mecânico em pacientes hospitalizados, do registro brasileiro de COVID-19. Métodos Este estudo coorte é um subestudo do registro brasileiro de COVID-19, conduzido em 31 hospitais brasileiros de 17 cidades, de março a setembro de 2020. Os desfechos primários incluíram mortalidade hospitalar e suporte ventilatório mecânico invasivo. Os modelos para os desfechos primários foram estimados por regressão de Poisson com variância robusta, com significância estatística de p<0,05. Resultados Dos 2925 pacientes [idade mediana de 60 anos (48-71), 57,1%], 27,3% apresentaram lesão miocárdica. A proporção de pacientes com comorbidades foi maior nos pacientes com lesão miocárdica [mediana 2 (1-2) vs. 1 (0-20)]. Os pacientes com lesão miocárdica apresentaram maiores valores medianos de peptídeo natriurético cerebral, lactato desidrogenase, creatina fosfoquinase, N-terminal do pró-peptídeo natriurético tipo B e proteína C reativa em comparação a pacientes sem lesão miocárdica. Como fatores independentes, proteína C reativa e contagem de plaquetas foram relacionados com o risco de morte, e neutrófilos e contagem de plaquetas foram relacionados ao risco de suporte ventilatório mecânico invasivo. Os pacientes com níveis elevados de troponina apresentaram um maior risco de morte (RR 2,03, IC95% 1,60-2,58) e suporte ventilatório mecânico (RR 1,87;IC95% 1,57-2,23), em comparação àqueles com níveis de troponina normais. Conclusão Lesão cardíaca foi um preditor independente de mortalidade hospitalar e necessidade de suporte ventilatório mecânico em pacientes hospitalizados com COVID-19.

https://doi.org/10.36660/abc.20220151

11.

Determination of the dynamic parameters of Speswhite kaolin with resonant column and centrifuge tests
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Fernandes, Filipe Cavalcanti

; Moura, Bárbara Luiza Riz de

; Almeida, Marcio de Souza Soares de

; Souza Junior, Luciano de Oliveira

; Tarazona, Samuel Felipe Mollepaza

; Almeida, Maria Cascão Ferreira de

; Barros, José Maria de Camargo

Soils and Rocks

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2023, Volume 46 N. 2 elocation e2023013422

Abstract: En | Text: En | PDF: En

Abstract Understanding the dynamic behavior of soils is essential to the study of the influence of seismic loads on the instability of submarine slopes, an important issue in Brazil and other countries. The shear modulus and the damping ratio are two fundamental parameters for the study of this behavior. Determining these parameters for Speswhite kaolin clay is the object of the present study using resonant column tests and dynamic centrifuge tests with accelerometers and pairs of bender elements. The curves obtained in the laboratory are compared with empirical curves and comparable data in the literature. Good agreement was observed between experimental data and the empirical prediction for the degradation curve of the normalized shear modulus. The damping curve for very low strains, obtained with resonant column tests, was consistent with the empirical curve. However, consistent with a trend observed in the literature, the centrifuge test results presented considerable scatter (dispersion), attributable to the difficulty in modelling damping dissipation mechanisms in the centrifuge.

https://doi.org/10.28927/sr.2023.013422

12.

Data imputation of water quality parameters through feed-forward neural networks
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Peixoto, Luis Otávio Miranda

; Lima, Bárbara Alves de

; Almeida, Camila de Carvalho

; Fernandes, Cristóvão Vicente Scapulatempo

; Centeno, Jorge Antonio Silva

; Azevedo, Júlio César Rodrigues de

RBRH

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2023, Volume 28 elocation e14

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

ABSTRACT The constant monitoring of water quality is fundamental for the understanding of the aquatic environment, yet it demands great financial investments and is susceptible to inconsistencies and missing values. Using a database composed of 59 sampling campaigns, performed for 12 years, on 10 monitoring stations along the Iguassu River Basin (Southern Brazil), this study presents a model, based on feed-forward neural networks, which imputed 1,370 values for 11 traditional water quality parameters, as well as 3 contaminants of emerging concern (caffeine, estradiol and ethinylestradiol). The model validation errors varied from 0.978 mg L-1 and 0.017 mg L-1 for the traditional parameters, for caffeine the validation error was of 0.212 µg L-1 and for the hormones, the errors were of 0.04 µg L-1 (E1) and 0.044 µg L-1 (EE1). The models underwent two techniques to understand the operations performed within the model (isolation and nullification), which were consistent to those explained by natural processes. The results point to the validity of modeling water quality parameters (especially the concentrations of caffeine) through neural networks, which could lead to better resource allocation in environmental monitoring, as well as improving available datasets and valuing previous monitoring efforts.

RESUMO O monitoramento constante da qualidade da água é fundamental para o entendimento dos ambientes aquáticos, mas este esforço demanda grandes investimentos financeiros, além de estar suscetível a inconsistências e falhas na obtenção dos valores. Usando uma base de dados composta por 59 campanhas amostrais, realizadas durante um período de 12 anos, em 10 estações de monitoramento ao longo da bacia do rio Iguaçú, este trabalho apresentou um modelo baseado em redes neurais artificiais que preencheu 1.370 valores para onze parâmetros tradicionais de qualidade da água. Os erros de validação do modelo variaram de 0,978 mg L-1 a 0,017 mg L-1 para os parâmetros tradicionais, enquanto para a cafeína, este erro foi de 0,212 µg L-1 e para os hormônios de 0,04 µg L-1 (E1) e 0,044 µg L-1 (EE1). Duas técnicas (isolamento e anulação) foram aplicadas nos modelos para se entender o relacionamento treinado pelo modelo entre as variáveis de entrada e saída. Os resultados apontam para a viabilidade da aplicação de redes neurais para a modelagem de parâmetros de qualidade da água (em especial, a cafeína), o que poderia levar a uma melhor alocação de recursos no monitoramento ambiental, além de expandir os bancos de dados disponíveis e valorizar os esforços despendidos para este monitoramento.

https://doi.org/10.1590/2318-0331.282320220118

13.

Intention of breastfeeding and association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women
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Castilho, Bárbara Moreira de

; Fernandes, Renata Cordeiro

; Höfelmann, Doroteia Aparecida

Revista Brasileira de Saúde Materno Infantil

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2023, Volume 23 elocation e20220097

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

Abstract Objectives: to estimate the intention of breastfeeding (IBF) duration and its association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women undergoing prenatal care. Methods: cross-sectional study, with pregnant women undergoing prenatal care in public health services in Colombo, Paraná, Brazil. The duration of IBF was questioned to pregnant women. Negative binomial Poisson regression with robust variance adjustment allowed estimating crude and adjusted prevalence ratios (PR), and 95% confidence intervals (CI95%) of the association between IBF duration and exposure variables. Results: among the participating pregnant women (n = 604), 7.9% reported having IBF for less than six months, 28.0% from six to 11 months, 38.3% from 12 to 23 and 25.9% for 24 months or more. The mean IBF time was 13.5 ± 8.4 and median of 12 months. Pregnant women with moderate food insecurity (PR=1.34; CI95%=1.04-1.73), multiparous women (PR=1.13; CI95%=1.00-1.26), and who reported having been breastfed as babies (PR=1.19; CI95%=1.02-1.40) had a longer IBF time. Conclusions: food security situation, primiparity and exposure to breastfeeding in childhood are determinants of IBF during pregnancy.

Resumo Objetivos: estimar o tempo de intenção de amamentar (IA) e sua associação com características sociodemográficas, obstétricas e experiência com amamentação entre gestantes em acompanhamento pré-natal. Métodos: estudo transversal com gestantes em serviços públicos de saúde em Colombo, Paraná. O tempo de IA foi questionado às gestantes. Regressão de Poisson binomial negativa com ajuste robusto da variância permitiu estimar razões de prevalência (RP) brutas e ajustadas, e intervalos de confiança de 95% (IC95%) da associação entre tempo de IA e variáveis de exposição. Resultados: dentre as gestantes (n = 604), 7,9% afirmaram IA por menos de 6 meses, 28,0% de 6 a 11 meses, 38,3% de 12 a 23 e 25,9% por 24 meses ou mais. O tempo médio de IA foi de 13,5 ± 8,4 e mediana de 12 meses. Gestantes em insegurança alimentar moderada (RP=1,34; IC95%=1,04-1,73), multíparas (RP=1,13; IC95%=1,00-1,26), e que referiram terem sido amamentadas quando bebês (RP=1,19; IC95%=1,02-1,40) apresentaram maior tempo de IA. Conclusões: situação de segurança alimentar, primiparidade e exposição ao aleitamento materno na infância são determinantes da IA na gestação.

https://doi.org/10.1590/1806-9304202300000097-en

14.

A tessitura da construção coletiva de indicadores de saúde mental em Centros de Atenção Psicossocial
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Rossi, Aline Fernandes de

; Paula, Bárbara Arvelino de

; Israel, Flávia Meirelles

; Camargos, Melina Alves de

Saúde em Debate

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2023, Volume 47 N. 137 Pages 333 - 345

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

https://doi.org/10.1590/0103-1104202313723

15.

Ursolic Acid Derivatives Down Regulate Inflammatory Mediators
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Scherrer, Elaine C.

; Valadares, Ydia M.

; Alves, Caio C. S.

; Carli, Alessandra P.

; Fernandes, Bárbara G. R.

; Carvalho, Paloma E.

; Ramos, Karla A.

; Salvador, Maiara R.

; Silva, Jeferson G. da

; Silva, Fernando S.

; Denadai, Ângelo M. L.

; Castro, Sandra B. R.

Journal of the Brazilian Chemical Society

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2023, Volume 34 N. 9 Pages 1250 - 1261

Abstract: En | Text: En | PDF: En

Ursolic acid (UA) is being investigated due to its anti-inflammatory potential, and structural modifications can enhance its biological activities. The aim of this study was to evaluate the immunomodulatory effect of the ursolic acid derivatives (UAD) in macrophages and in the carrageenan-induced paw edema model. RAW264.7 cells were cultured in the presence or absence of UA or UAD (1-18). Nitric oxide (NO), nuclear factor kappa B (NF-κB), tumor necrosis factor (TNF), and cellular viability were measured. 30 min before the carrageenan-induced paw edema, the UAD1 and UAD2 (200 mg kg-1) were administered intraperitoneally. The results showed that UAD2-4, UAD7, UAD9-11 had half maximal inhibitory concentration (IC50) greater than 90 µM and were able to reduce NO, NF-κB and TNF production. Moreover, UAD1 and UAD2 reduced paw edema and IL-6 production. In conclusion, the results obtained demonstrated a variation in the response between the derivatives due to the chemical modifications, showing potential to reduce the inflammatory mediators, deserving further investigations.

https://doi.org/10.21577/0103-5053.20230036

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