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Efectos de la neurorrehabilitación sobre el trastorno del espectro alcohólico fetal: un estudio de caso único
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Fernandes-Magalhaes, Roberto

; Torroba, Rocío

; Hernández, Laura

; Fernández, Carmen

; Ferrera, David

; Peláez, Irene

; Carpio, Alberto

; Mercado, Francisco

Revista de la Asociación Española de Neuropsiquiatría

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jun 2023, Volume 43 N. 143 Pages 89 - 115

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

Abstract: The present investigation consisted of a single case study of a 10-year-old child from international adoption with symptoms of Fetal Alcohol Spectrum Disorder (FASD). Due to the symptomatological complexity of the disorder and its diagnosis, currently there are no effective treatments. The study started with a neurocognitive evaluation where alterations in attention, memory and executive functions were observed, which manifested themselves in great impulsivity, as well as in difficulties in self-regulation. A 96-ses- sion neurorehabilitation program was designed, focusing on a multidisciplinary approach to the altered cognitive, behavioral and functional aspects. The application of the rehabilitation program produced a general improvement in the patient's functional capacity, specially in attention processes and the capacity for self-regulation. The results obtained highlight the value of the application of multidisciplinary neurorehabilitation programs as an effective tool in the treatment of the clinical symptoms of FASD and the improvement in the adaptation of patients to the demands of their daily lives.

Resumen: La presente investigación consistió en un estudio de caso único de un niño de 10 años, procedente de adopción internacional, con síntomas compatibles con trastorno del espectro alcohólico fetal (TEAF). Debido a la complejidad sintomatológica del trastorno y de su diagnóstico, en la actualidad no existen tratamientos contrastados. El estudio comenzó con una evaluación neurocognitiva donde se observaron alteraciones en atención, memoria y funciones ejecutivas, que se manifestaron en una gran impulsividad, así como en dificultades para la autorregulación. Se diseñó un programa de neurorreha- bilitación, de 96 sesiones, centrado en el abordaje multidisciplinar de los aspectos cognitivos, conductuales y funcionales alterados. La aplicación del programa de rehabilitación produjo mejora general en la capacidad funcional del paciente, destacando los procesos de atención y en la capacidad de autorregulación. Los resultados obtenidos ponen en valor la aplicación de programas de neurorrehabilitación multidisciplinares al revelarse como una herramienta eficaz en el tratamiento de la sintomatología clínica del TEAF y la mejora en la adaptación de los pacientes a las exigencias de su vida diaria.

https://doi.org/10.4321/s0211-57352023000100006

O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos
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Pereira, Rui Antunes

; Sousa, Marta

; Cidade, José Pedro

; Melo, Luís

; Lopes, Diogo

; Ventura, Sara

; Aragão, Irene

; Lima Neto, Raul Miguel de Freitas

; Molinos, Elena

; Marques, Ana

; Cardoso, Nelson

; Marino, Flávio

; Monteiro, Filipa Brás

; Oliveira, Ana Pinho

; Silva, Rogério C

; Real, André Miguel Neto

; Banheiro, Bruno Sarmento

; Reis, Renato

; Adão-Serrano, Maria

; Cracium, Ana

; Valadas, Ana

; Ribeiro, João Miguel

; Póvoa, Pedro

; Tapadinhas, Camila

; Mendes, Vítor

; Coelho, Luís

; Maia, Raquel

; Freitas, Paulo Telles

; Ferreira, Isabel Amorim

; Ramires, Tiago

; Val-Flores, Luís Silva

; Cascão, Mariana

; Alves, Rita

; Rodeia, Simão C

; Barrigoto, Cleide

; Cardiga, Rosa

; Silva, Maria João Ferreira da

; Vale, Bruno

; Fonseca, Tatiana

; Rios, Ana Lúcia

; Camões, João

; Pérez, Danay

; Cabral, Susana

; Ribeiro, Maria Inês

; Mendes, João João

; Gouveia, João

; Fernandes, Susana Mendes

Revista Brasileira de Terapia Intensiva

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dec 2022, Volume 34 N. 4 Pages 433 - 442

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

ABSTRACT Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave.

RESUMO Objetivo: Analisar e comparar as características de pacientes críticos com a COVID-19, a abordagem clínica e os resultados entre os períodos de pico e de platô na primeira onda pandêmica em Portugal. Métodos: Este foi um estudo de coorte multicêntrico ambispectivo, que incluiu pacientes consecutivos com a forma grave da COVID-19 entre março e agosto de 2020 de 16 unidades de terapia intensiva portuguesas. Definiram-se as semanas 10 - 16 e 17 - 34 como os períodos de pico e platô. Resultados: Incluíram-se 541 pacientes adultos com mediana de idade de 65 [57 - 74] anos, a maioria do sexo masculino (71,2%). Não houve diferenças significativas na mediana de idade (p = 0,3), no Simplified Acute Physiology Score II (40 versus 39; p = 0,8), na pressão parcial de oxigênio/fração inspirada de oxigênio (139 versus 136; p = 0,6), na terapia com antibióticos na admissão (57% versus 64%; p = 0,2) ou na mortalidade aos 28 dias (24,4% versus 22,8%; p = 0,7) entre o período de pico e platô. Durante o período de pico, os pacientes tiveram menos comorbidades (1 [0 - 3] versus 2 [0 - 5]; p = 0,002); fizeram mais uso de vasopressores (47% versus 36%; p < 0,001) e ventilação mecânica invasiva na admissão (58,1% versus 49,2%; p < 0,001), e tiveram mais prescrição de hidroxicloroquina (59% versus 10%; p < 0,001), lopinavir/ritonavir (41% versus 10%; p < 0,001) e posição prona (45% versus 36%; p = 0,04). Entretanto, durante o platô, observou-se maior uso de cânulas nasais de alto fluxo (5% versus 16%; p < 0,001) na admissão, remdesivir (0,3% versus 15%; p < 0,001) e corticosteroides (29% versus 52%; p < 0,001), além de menor tempo de internação na unidade de terapia intensiva (12 versus 8 dias; p < 0,001). Conclusão: Houve mudanças significativas nas comorbidades dos pacientes, nos tratamentos da unidade de terapia intensiva e no tempo de internação entre os períodos de pico e platô na primeira onda da COVID-19.

https://doi.org/10.5935/0103-507x.20210037-pt

Revisores 2022
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Castro, Adriana Miranda de

; Noronha, Ana Paula Porto

; Viera Gómez, Andrea Jimena

; Câmara, Andreza Franco

; Costa Ball, César Daniel

; Blezio Ducret, Cecilia

; Marotta, Cecilia

; Arrivillaga, Christiane

; Ferreira, Clarice Regina Catelan

; Kern, Elisa

; Borges, Elisabete

; Dorta, Germán Antonio

; Pinto, Heider

; Barros, Irene

; Matos, Izabella Barison

; Pires, Jeferson

; Fernández, María Eugenia

; Lladó, Mónica

; Flores-Kanter, Pablo E.

; Freitas De León, Paribanú

; Alves, Railda Sabino Fernandes

; Machiñena, Rossina

; Navarro, Santiago

; Contino, Silvana

; Salessi, Solana

; Papalini, Vanina

Psicología, Conocimiento y Sociedad

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nov 2022, Volume 12 N. 3 Pages 99 - 100

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.26864/pcs.v12.n3.rev

Dialysis-related thrombocytopenia: a case report
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Duayer, Irene Faria

; Araújo, Maria Júlia Correia Lima Nepomuceno

; Nihei, Camila Hitomi

; Barcelos, Maria Alice Fernandes

; Braga, Osni

; Britto, Zita Maria Leme

; Elias, Rosilene Mota

Brazilian Journal of Nephrology

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mar 2022, Volume 44 N. 1 Pages 116 - 120

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

Resumo Plaquetopenia é frequentemente observada em pacientes em hemodiálise, e sua correta investigação e controle permanecem um desafio. Estima-se que, durante a sessão de hemodiálise, ocorra queda de até 15% da contagem de plaquetas, com recuperação após o término do tratamento. Essa queda de plaquetas é decorrente de adesão plaquetária e ativação do complemento, independentemente do material da membrana. Vários estudos com marcadores de superfície plaquetária demonstram aumento da ativação e agregação plaquetária secundários à exposição à circulação extracorpórea. Este relato de caso mostra um paciente dialítico que evoluiu com plaquetopenia severa durante internação. Realizada investigação e exclusão de causas mais comuns: plaquetopenia relacionada à heparina, reação adversa a medicamentos, hiperesplenismo e doenças hematológicas, foi então aventada a possibilidade de plaquetopenia relacionada à hemodiálise após observação de que a queda se acentuava durante as sessões de hemodiálise com recuperação parcial após. Mudança do dialisador, atenção ao método de esterilização e realização do reuso devem ser consideradas para correção. No presente caso, a utilização do reuso minimizou a plaquetopenia associada a hemodiálise.

Abstract Thrombocytopenia is frequently observed in hemodialysis patients, and its correct investigation and control remain a challenge. It is estimated that during the hemodialysis session there is a drop of up to 15% in the platelet count, with recovery after the end of treatment. This reduction in platelets is due to platelet adhesion and complement activation, regardless of the membrane material. Several studies with platelet surface markers demonstrate increased platelet activation and aggregation secondary to exposure to cardiopulmonary bypass. This case report describes a patient on hemodialysis who developed severe thrombocytopenia during hospitalization. Investigation and exclusion of the most common causes were carried out: heparin-related thrombocytopenia, adverse drug reaction, hypersplenism, and hematological diseases. Afterwards, the possibility of hemodialysis-related thrombocytopenia was raised, since the fall was accentuated during the sessions with partial recovery after the dialyzer change. Attention to the sterilization method and dialyzer reuse must be considered for correction. In the current case, reusing the dialyzer minimized the drop in platelet counts associated with hemodialysis.

https://doi.org/10.1590/2175-8239-jbn-2020-0109

Development and characterization of PLGA-Bupivacaine and PLGA-S75:R25 Bupivacaine (Novabupi®) biodegradable implants for postoperative pain
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Castro, Matheus Augusto de

; Cunha, Gabriella Maria Fernandes

; Andrade, Gracielle Ferreira

; Yoshida, Maria Irene

; Faria, Ana Luiza de

; Silva-Cunha, Armando

Brazilian Journal of Pharmaceutical Sciences

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2022, Volume 58 elocation e21310

Abstract: En | Text: En | PDF: En

Abstract In the hospital environment, postoperative pain is a common occurrence that impairs patient recovery and rehabilitation and lengthens hospitalization time. Racemic bupivacaine hydrochloride (CBV) and Novabupi® (NBV) (S (-) 75% R (+) 25% bupivacaine hydrochloride) are two examples of local anesthetics used in pain management, the latter being an alternative with less deleterious effects. In the present study, biodegradable implants were developed using Poly(L-lactide-co-glycolide) through a hot molding technique, evaluating their physicochemical properties and their in vitro drug release. Different proportions of drugs and polymer were tested, and the proportion of 25%:75% was the most stable for molding the implants. Thermal and spectrometric analyses were performed, and they revealed no unwanted chemical interactions between drugs and polymer. They also confirmed that heating and freeze-drying used for manufacturing did not interfere with stability. The in vitro release results revealed drugs sustained release, reaching 64% for NBV-PLGA and 52% for CBV-PLGA up to 30 days. The drug release mechanism was confirmed by microscopy, which involved pores formation and polymeric erosion, visualized in the first 72 h of the in vitro release test. These findings suggest that the developed implants are interesting alternatives to control postoperative pain efficiently.

https://doi.org/10.1590/s2175-97902022e21310

CO2 Fertilizer Effect on Growth, Polyphenols, and Endophytes in Two Baccharis Species
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Oki, Yumi

; Arantes-Garcia, Lucas

; Costa, Marina Batista Morais

; Nunes, Bárbara Cristina

; Silveira, Bárbara Rúbia

; Gélvez-Zúñiga, Irene

; Franco, Augusto

; Fernandes, Geraldo Wilson

Brazilian Archives of Biology and Technology

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2020, Volume 63 elocation e20190302

Abstract: En | Text: En | PDF: En

Abstract In a climate change context, the buildup of CO2 will affect plant communities worldwide. This study evaluated the effects of CO2 enrichment on the development and defense of two Cerrado native species Baccharis dracunculifolia and B. platypoda and their associated endophytic fungi richness. The study took place in Open-Top Chambers, two with ambient CO2 concentration (~400 ppm) and two in an enriched environment (~800 ppm). Baccharis platypoda developed 20% more leaves under enriched CO2 conditions, whereas B. dracunculifolia was 30% taller and showed 27% more leaves than those under ambient conditions. In both species, leaf polyphenol concentration did not differ between treatments. Nevertheless, polyphenol content had a positive correlation with plant height on both species’ individuals grown under CO2 enriched conditions. Endophytic fungi richness and colonization rate on both plant species did not differ between ambient and enriched conditions. Our results show the positive effect of CO2 fertilizer in at least one of the measured growth parameters. An important new finding was a synergistic increase in growth and chemical defense in both studied species under enriched CO2 conditions, suggesting higher carbon assimilation and accumulation. This study suggests that the effects on primary productivity and secondary metabolites of Baccharis species will potentially reflect on the diversity and distribution of Cerrado plants and their associated animal communities.

https://doi.org/10.1590/1678-4324-2020190302 625 downloads

Ampliação e validação do protocolo de avaliação miofuncional orofacial para indivíduos com fissura labiopalatina
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Graziani, Andréia Fernandes

; Fukushiro, Ana Paula

; Marchesan, Irene Queiroz

; Berretin-Félix, Giédre

; Genaro, Katia Flores

CoDAS

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2019, Volume 31 N. 1 elocation e20180109

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

RESUMO Objetivo Realizar a ampliação, validação de conteúdo, critério e construto de um protocolo de avaliação miofuncional orofacial para indivíduos com fissura labiopalatina e definir parâmetros de avaliação para a utilização do instrumento. Método A ampliação do instrumento foi realizada com base no protocolo MBGR; os itens, subitens e possibilidades de respostas do instrumento ampliado foram analisados quanto à clareza por sete examinadores para a validação do conteúdo. Parâmetros de avaliação para a utilização do instrumento foram estabelecidos a fim de minimizar a subjetividade. Quatro examinadores compararam os aspectos do protocolo aos de outro instrumento para a validação de critério, e a validação de construto foi realizada comparando os resultados pré e pós-tratamento cirúrgico do avanço da maxila. Aplicou-se o Índice de Validação do Conteúdo e os testes Kappa, Correlação de Spearman e Wilcoxon para as validações. Resultados Foram acrescentados os aspectos da avaliação da mobilidade, tonicidade e sensibilidade ao protocolo; na validação do conteúdo, 72% dos itens foram classificados como muito claro e 28%, como claro; construiu-se um manual com parâmetros de avaliação para todos os itens e subitens do protocolo. A concordância interexaminadores apresentou-se moderada. Na comparação dos protocolos, para a validação de critério, foi observada boa relação entre eles. Para a validação do construto, o protocolo demonstrou ser capaz de identificar resultado de tratamento após a realização do tratamento. Conclusão O protocolo foi ampliado e considerado validado em sua totalidade: conteúdo, critério e construto, e estabelecidos parâmetros de avaliação para a sua utilização.

ABSTRACT Purpose To perform the expansion, validation of the content, criterion and construct of an orofacial myofunctional assessment protocol for individuals with cleft lip and palate; and to define evaluation parameters for the instrument use. Methods The expansion of the instrument was performed based on the MBGR protocol; the items, sub items and possibilities of answers of the amplified instrument were analyzed for their clarity by seven examiners for the content validation.. Assessment parameters were developed for the use of the instrument in order to minimize the subjectivity. Four examiners compared the aspects of the protocol to those of another instrument for the criterion validation, and the construct validation was performed comparing the results of pre and post orthognathic surgery treatment. The Content Validation Index and the Kappa, Spearman and Wilcoxon Correlation tests were applied for the validations. Results The mobility, tonicity and sensitivity aspects of the evaluation were added to the protocol and at content validation, 72% of the items were classified as very clear and 28% as clear. A manual with assessment parameters for all items and sub items of the protocol was constructed. The inter-examiner agreement was moderate. In the comparison of the protocols, for the validation of the criterion, a good relation among them was observed. For the validation of the construct the protocol was able to identify outcome after the treatment. Conclusion The protocol was expanded and considered validated in its entirety: content, criterion and construct, and evaluation parameters for its use were established.

https://doi.org/10.1590/2317-1782/20182018109 2807 downloads

Together yet separate: variation in soil chemistry determines differences in the arboreal-shrub structure of two contiguous rupestrian environments
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Almeida, Hernani Alves

; Bahia, Thaíse de Oliveira

; Gélvez-Zúñiga, Irene

; Fernandes, Geraldo Wilson

Acta Botanica Brasilica

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dec 2018, Volume 32 N. 4 Pages 578 - 587

Abstract: En | Text: En | PDF: En

ABSTRACT Rupestrian landscapes are characterized by vegetation mosaics comprised of different plant communities and strongly linked to environmental filters. These environments are nutrient-impoverished, and possess water retention deficits and high solar exposure. This study aimed to determine whether chemical properties of the soil shape the arboreal-shrub vegetation structure in two neighboring habitats; a rupestrian cerrado and a rupestrian grassland. We hypothesized that the habitat with higher soil chemical properties would have higher parameters for vegetation structure, and different species composition. We expected higher chemical properties of the soil to favor a greater variety of plant life-forms. A total of 1349 individuals of 85 species belonging to 24 families were recorded; 1141 individuals (65 species) in the rupestrian cerrado, and 208 individuals (20 species) in the rupestrian grassland. Overall, Asteraceae, Fabaceae and Melastomataceae had greater species richness in both areas. Both habitats floristic composition was strongly influenced by differences in soil chemistry. In the cerrado, species richness, composition, soil nutrient availability and acidity were greater than in the grassland. We demonstrated that variation in soil chemistry influences plant species richness and composition, and structural complexity of vegetation, in both contiguous rupestrian environments, and that soil chemistry heterogeneity yields different plant life-form strategies.

https://doi.org/10.1590/0102-33062018abb0013 1054 downloads

Desfechos psicológicos em longo prazo após alta da terapia intensiva
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Pereira, Sara

; Cavaco, Sara

; Fernandes, Joana

; Moreira, Inês

; Almeida, Eduarda

; Seabra-Pereira, Filipa

; Castro, Heloísa

; Malheiro, Maria de Jesus

; Cardoso, Ana Filipa

; Aragão, Irene

; Cardoso, Teresa

Revista Brasileira de Terapia Intensiva

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mar 2018, Volume 30 N. 1 Pages 28 - 34

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

RESUMO Objetivo: Investigar o desfecho psicológico em longo prazo em sobreviventes de doenças críticas, após alta da unidade de terapia intensiva. Métodos: Avaliou-se coorte prospectiva de pacientes sobreviventes após admissão a uma unidade de terapia intensiva mista entre janeiro e setembro de 2010, 6 meses e 5 anos após a alta hospitalar. Aplicaram-se em todos os momentos as seguintes escalas: Dementia Rating Scale-2, Hospital Anxiety and Depression Scale, Post-Traumatic Stress Syndrome 14-Questions Inventory, Euro Quality of Life 5 Dimensions (EQ-5-D) e Visual Analogue Scale (EQ VAS). Resultados: Dentre 267 pacientes, 25 foram avaliados após 6 meses (idade: 62 ± 16 anos). Aos 6 meses, 48% apresentavam comprometimento cognitivo; 24% ansiedade, 16% depressão e 16% transtorno de estresse pós-traumático. Foram reavaliados 5 anos após a alta 17 pacientes, com idade: 65 ± 15 anos. Dentre eles, a frequência de comprometimento cognitivo caiu de 47% para 18% (p = 0,063), em razão da melhora destes pacientes ao longo do tempo e do não surgimento desta condição em outros pacientes após a alta. Ainda após 5 anos, apenas 12% da amostra relatou ansiedade, e nenhum tinha depressão ou transtorno de estresse pós-traumático. Não se encontraram diferenças em termos das escalas EQ-5-D e EQ VAS entre as avaliações após 6 meses e 5 anos. Conclusão: Os sobreviventes não apresentaram declínio progressivo da função cognitiva ou da qualidade de vida dentro de 5 anos após a alta da unidade de terapia intensiva. Os sintomas psicopatológicos tenderam a diminuir com o tempo.

ABSTRACT Objective: To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge. Methods: A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods. Results: Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS. Conclusion: Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.

https://doi.org/10.5935/0103-507x.20180008 2201 downloads

10.

Tecnologia móvel para coleta de dados de pesquisas em saúde
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Pereira, Irene Mari

; Bonfim, Daiana

; Peres, Heloisa Helena Ciqueto

; Góes, Ricardo Fernandes

; Gaidzinski, Raquel Rapone

Acta Paulista de Enfermagem

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oct 2017, Volume 30 N. 5 Pages 479 - 488

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

Abstract Objective: Describe the development of a mobile application for data collection in time and movement research with health professionals from the Family Health Strategy Program when conducting care interventions/activities. Methods: Applied research of technological production based on the concept of prototyping and the steps of definition, development, and maintenance, for the design and validation of the application: instrumento de medida de carga de trabalho dos profissionais de saúde na atenção primária (Workload measurement instrument for health professionals in primary care). This will be for a mobile Motorola® tablet with Android® 3.2 operating system, with the goal of collecting data for a time and movement study, using the work sampling technique, and identifying the workload of health professionals from family health units (FHUs) located in all five Brazilian geographic regions, presenting an excellent performance in the Primary Care Access and Quality Improvement Program - cycle 1. Results: The application intensified data collection and facilitated data recording and storage; data transmission; and data organization and processing; and ensured greater reliability in the analysis of results, maintaining data integrity in all these steps. Data transmission and extraction were performed on a daily basis, through file synchronization in Dropbox®. The mobile application was used during the observation of all 418 health professionals from the 27 family health units. In total 85,398 observations of interventions/activities were registered. Conclusion: The application allowed for more dynamic data collection; maintained data integrity; supported data transmission and storage; facilitated data organization and processing; and provided greater reliability in the analysis of results.

Resumo Objetivo: Descrever o desenvolvimento de aplicativo de tecnologia móvel para coleta de dados em pesquisa de tempo e movimento dos profissionais de saúde do Programa Estratégia de Saúde da Família, na realização das intervenções/atividades de cuidado. Métodos: Pesquisa aplicada de produção tecnológica fundamentada no conceito de prototipagem e nas fases de definição, desenvolvimento e manutenção, para construção e validação de aplicativo do “instrumento de medida de carga de trabalho dos profissionais de saúde na atenção primária”, para dispositivo móvel tablet Motorola® com sistema operacional Android® 3.2, com a finalidade de coletar dados em pesquisa de tempo e movimento, por meio da técnica de amostragem do trabalho e identificar a carga de trabalho de profissionais de saúde, lotados em unidades de saúde da família, localizadas nas cinco regiões geográficas do Brasil, consideradas de ótimo desempenho pelo Programa de Melhoria do Acesso e da Qualidade da Atenção Básica - ciclo 1. Resultados: O aplicativo potencializou a coleta de dados e facilitou as seguintes etapas: registro e armazenamento dos dados; manutenção da integridade da informação; transmissão e armazenamento dos dados; organização e processamento das informações e maior segurança na análise dos resultados. A transmissão e a extração dos dados foram realizadas diariamente, através da sincronização dos arquivos no Dropbox®. O aplicativo eletrônico foi utilizado durante as observações dos 418 profissionais de saúde das 27 unidades de saúde da família, no total foram registrados 85.398 observações de intervenções/atividades. Conclusão: O aplicativo possibilitou uma coleta de dados mais dinâmica; manteve a integridade da informação; auxiliou a transmissão e o armazenamento de dados; facilitou a organização e o processamento das informações e proporcionou maior segurança na análise dos resultados.

https://doi.org/10.1590/1982-0194201700069 71 downloads

11.

Tecnologia móvel para coleta de dados de pesquisas em saúde
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Pereira, Irene Mari

; Bonfim, Daiana

; Peres, Heloisa Helena Ciqueto

; Góes, Ricardo Fernandes

; Gaidzinski, Raquel Rapone

Acta Paulista de Enfermagem

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oct 2017, Volume 30 N. 5 Pages 479 - 488

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

https://doi.org/10.1590/1982-0194201700069 7113 downloads

12.

Relato de Caso: mama tuberosa
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SILVA, TULIO MARTINS

; OHANA, BIANCA MARIA BARROS

; FERNANDES, BRUNO PERRELLI SÁ FREIRE

; BARRA, IRENE DAHER

; REZENDE, MARIA ALICE DOMINGUES

; BOECHAT, CELSO EDUARDO JANDRE

Revista Brasileira de Cirurgia Plástica

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sep 2017, Volume 32 N. 3 Pages 450 - 453

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

ABSTRACT To report a case of tuberous breast with significant breast asymmetry, describe the technique used and evaluate the outcome of the case. Different techniques were used on each breast, although studies in literature recommend the use of similar strategy in both breasts. The patient progressed without complications and had, 6 months after the surgery, extremely satisfactory result without tuberous breast stigmas, and significant improvement of breast asymmetry. The literature establishes that not only one surgical technique is adequate to correct different types of malformations. Tuberous breast constitutes a challenge in breast plastic surgery and it becomes more complex when the asymmetry is more severe. However, surgeons who is trained in a variety of aesthetic and breast reconstructive techniques can achieve a satisfactory result.

RESUMO Descrever um caso de mama tuberosa com importante assimetria mamária, descrever a técnica e avaliar o resultado de caso. Diferentes técnicas foram usadas em cada mama, apesar de na literatura dizer que é importante empregar uma estratégia semelhante em ambas as mamas. A paciente evoluiu sem complicações e apresenta, com 6 meses de pós-operatório, resultado extremamente satisfatório, sem estigmas de mama tuberosa e com melhora importante da assimetria mamária. Na literatura é estabelecido que não há uma única técnica cirúrgica adequada para a correção dos diferentes tipos de malformações. A mama tuberosa representa um desafio nas cirurgias plásticas da mama e se tornam mais complexas quando a assimetria é mais exacerbada. Porém, o cirurgião que dominar as mais diversas técnicas mamárias estéticas e reconstrutoras poderá alcançar um resultado satisfatório.

https://doi.org/10.5935/2177-1235.2017rbcp0074

13.

Caracterização do grau de sobrecarga dos cuidadores de utentes dependentes da Unidade de Saúde Familiar USF Descobertas
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Trindade, Irene

; Almeida, Diogo

; Romão, Margarida

; Rocha, Sara

; Fernandes, Sofia

; Varela, Vasco

; Braga, Márcia

Revista Portuguesa de Medicina Geral e Familiar

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jul 2017, Volume 33 N. 3 Pages 178 - 186

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

Objetivos: Caracterizar o grau de sobrecarga dos cuidadores de indivíduos dependentes em programa de cuidados domiciliários da Unidade de Saúde Familiar (USF) Descobertas. Correlacionar o grau de sobrecarga com o grau de dependência e identificar as dimensões do bem-estar do cuidador mais afetadas. Tipo de estudo: Observacional transversal analítico. Local: USF Descobertas. População: Cuidadores informais de indivíduos dependentes em cuidados domiciliários médicos ou enfermagem da USF Descobertas, entre janeiro e fevereiro de 2015. Métodos: Foram incluídos todos os cuidadores informais de indivíduos dependentes em programa de cuidados domiciliários médicos ou de enfermagem realizados durante dois meses. Foram aplicados telefonicamente três questionários: um para a caracterização sociodemográfica do cuidador, a escala de Katz ao indivíduo dependente e a escala de Zarit ao cuidador. Foram utilizados o coeficiente de Spearman e o teste de Kruskal-Wallis para a análise dos dados. Resultados: Foram identificados 174 dependentes, 65 dos quais cumpriam os critérios de inclusão e corresponderam a 60 cuidadores. Cinco cuidadores prestavam assistência a dois dependentes simultaneamente. Em relação à escala de Zarit, 44,6% (n=29) dos cuidadores apresentou sobrecarga intensa, 20,0% (n=13) sobrecarga ligeira e 35,4% (n=23) não apresentou sobrecarga. A média do valor da escala de Katz foi de 2,78. Não se estabeleceu relação estatisticamente significativa entre o grau de sobrecarga do cuidador e o nível de dependência (p=0,053). Conclusões: A maioria dos cuidadores apresentou sobrecarga, sobretudo a nível intenso. Os resultados obtidos corroboraram os dados apresentados noutros estudos nacionais. A avaliação sistemática da sobrecarga do cuidador e mobilização dos recursos adequados constituem intervenções a incluir nos planos realizados pelos profissionais de saúde. Perante a escassez de estudos neste domínio considerou-se importante a futura realização de estudos numa população de maior dimensão

Objectives: To characterize caregiver burden in the care of dependent individuals in the home care program of the Descobertas Family Health Unit, to test the association between caregiver burden and the level of dependence of the patient, and to identify the dimensions of caregiver wellbeing that were affected. Study design: Observational study. Location: USF Descobertas. Population: Informal caregivers of dependent individuals in a home care program. Methods: Each informal caregiver of a dependent individual in the medical and nursing home care program was included in the study over a two-month period. We conducted interviews by telephone using three questionnaires: a social and demographic description of the caregivers, the Katz scale to evaluate the level of dependency of the patient, and the Zarit caregiver burden interview. Spearman coefficients and Kruskal-Wallis tests were used to test for associations between variables. Results: A total of 174 dependent patients were identified, 65 of whom fulfilled the inclusion criteria and who were cared for by 60 caregivers. Five caregivers were taking care of two dependents simultaneously. Regarding the Zarit scale, 44.6% (n=29) of the caregivers reported a heavy burden, 20.0% (n=13) a light burden and 35.4% (n=23) no burden. The mean value of the Katz scale was 2.78. There was no statistically significant correlation between caregiver burden and the level of dependency of the patient (p=0.053). Conclusion: The burden of caregiving was identified in the majority of informal caregivers and was reported to be at an intense level. The items identified on the Zarit Scale were similar to those found in other national studies. Healthcare professionals should perform a systematic evaluation of caregiver burden and be able to intervene when needed. Further study of this issue is required in larger populations

2654 downloads

14.

Can anti-bothropstoxin-I antibodies discriminate between Bothrops jararaca and Bothrops jararacussu venoms?
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Araujo, Ricardo Teixeira

; Corrêa-Netto, Carlos

; Brazil-Más, Leonora

; Silveira, Caio Raony Farina

; Fernandes, Irene

; Zingali, Russolina Benedeta

Journal of Venomous Animals and Toxins including Tropical Diseases

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2017, Volume 23 elocation 12

Abstract: En | Text: En | PDF: En

Abstract Background Snakes of the genus Bothrops, popularly known as pit vipers, are responsible for most cases of snakebite in Brazil. Within this genus, Bothrops jararacussu and B. jararaca deserve special attention due to the severity of their bites and for inhabiting densely populated areas. Regarding the treatment of snakebites by Bothrops jararacussu, questions have been raised about the effectiveness of the specific bothropic antivenom in neutralizing myotoxic effects; however, there are no accurate data for humans. Thus, the development of a differential diagnostic kit for this species would be of great interest because it provides, for healthcare professionals, a tool that would allow us to determine whether the accident was caused by B. jararacussu or other species of the genus. It would also make it possible to evaluate the specificity of the treatment and to provide data for epidemiological studies. Methods First, we produced a species-specific polyclonal antibody – a potential biomarker of Bothrops jararacussu venom – against bothropstoxin-I (BthTx-I), which is also found in smaller quantities in the venoms of B. jararaca from southern Brazil. Results Polyclonal antibodies against bothropstoxin-I could be separated into several species-specific immunoglobulins. Then, aiming to develop a system of safe and standardized immunoassay, we produced monoclonal antibodies. Seven hybridomas were obtained. Five of them were specific to the venom of B. jararacussu and two recognized the venom of B. jararaca from the southeastern population. The use of monoclonal antibodies also made it possible to differentiate B. jararacussu from B. jararaca venom obtained from the southern population. Analyzing the reactivity of monoclonal antibodies against other bothropic venoms, we found mAb Bt-3 to be more specific than others for B. jararacussu venom. Conclusions These results show the potential of BthTx-I for producing monoclonal antibodies that differentiate between B. jararacussu and other Bothrops species venoms.

https://doi.org/10.1186/s40409-017-0105-z 695 downloads

15.

Nectar robbing in Collaea cipoensis (Fabaceae), an endemic shrub of the Brazilian rupestrian grasslands
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Gelvez-Zúñiga, Irene

; Aguirre, Armando

; Martén-Rodríguez, Silvana

; Matos-Gomes, Vanessa

; Barbosa, Arleu

; Bordignon, Leandra

; Rocha, Rosana

; Fernandes, Geraldo W.

Revista mexicana de biodiversidad

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dec 2016, Volume 87 N. 4 Pages 1352 - 1355

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

Abstract: Nectar robbery is common in flowering plants with tubular corollas and can affect plant reproductive success. Our study characterized the interaction between potential pollinators and nectar robbers, and assessed the effects on flower abortion in a population of the restricted endemic Collaea cipoensis (Fabaceae) at Serra do Cipó, Brazil. We conducted observations of floral visitors to identify potential pollinators from nectar robbers and described visitor behavior. We also analyzed the frequency of robbery and its relationship with flower visitation. Trigona spinipes and Apis mellifera were identified as the main nectar robbers and two hummingbird species Colibri serrirostris and Eupetomena macroura, as potential pollinators. Overall, 570 sampled flowers presented robber damage while 716 were intact. Intact flowers received more visits than flowers with damage. Mean flower abortion ratio did not vary between damaged and intact flowers. Accordingly, a survey of developed fruits indicated that 86% of fruits came from intact flowers. Our results suggest that the damage by nectar robbers in C. cipoensis flowers could affect the reproductive success of this species, interfering with fruit production.

Resumen: El robo de néctar es común en plantas con flores de corolas tubulares y puede afectar su éxito reproductivo. Se caracteriza la interacción entre robadores de néctar y polinizadores, así como sus consecuencias en la aborción de flores en una especie endémica, Collaea cipoensis (Fabaceae) en la Serra do Cipó, Brasil. Se realizaron observaciones de visitantes florales para identificar a los polinizadores, así como a los robadores de néctar basados en su conducta. Se analizó la frecuencia de robo y su relación con los visitantes florales. Trigona spinipes y Apis mellifera fueron los principales ladrones de néctar y 2 especies de colibrí Colibri serrirostris y Eupetomena macroura, como polinizadores potenciales. Se presentó daño en 570 flores y 716 estuvieron intactas. Las flores sin daño recibieron más visitas vs. las flores dañadas. El promedio de flores abortadas no difirió entre flores dañadas vs. intactas. El 86% de los frutos proviene de flores intactas. Los resultados sugieren que el robo de néctar en C. cipoensis podría afectar negativamente el éxito reproductivo de esta especie interfiriendo con la producción de frutos.

https://doi.org/10.1016/j.rmb.2016.09.004 418 downloads

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