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Exclusive breastfeeding intention among pregnant women and associated variables: a cross-sectional study in a Brazilian community
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Silva, Lorena Fonseca

; Cortellazzi, Karine Laura

; Melo, Letícia Santos Alves de

; Silva, Silvio Rocha Corrêa da

; Rosell, Fernanda Lopez

; Valsecki Júnior, Aylton

; Tagliaferro, Elaine Pereira da Silva

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2022192

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

ABSTRACT Objective: To investigate exclusive breastfeeding (EBF) intention and associated variables among women in the third trimester of pregnancy. Methods: The data were collected with a questionnaire for the pregnant women (n=653), from December/2018 to November/2019. They answered the Infant Feeding Intentions (IFI) scale, translated and adapted to Brazilian Portuguese, and a questionnaire on sociodemographic, biological, family, pregnancy, breastfeeding, health care, and habits variables. Descriptive statistics and multiple logistic regression analyses were performed with a 5% significance level, following a multilevel hierarchical model that estimated the association between the dependent and independent variables. The outcome EBF intention measured by the IFI score was dichotomized by the median (<16 or =16). Results: Mean±standard deviation score for the IFI scale was 14.4±2.6 (score 0: very strong intention to not breastfeed at all; score 16: very strong EBF intention up to six months). The results from the regression analysis showed that pregnant women who had no intention to bottle feed (OR=4.33; 95%CI 2.79-6.72) or did not know (OR=1.85; 95%CI 1.21–2.82), those who planned the pregnancy (OR=1.52; 95%CI 1.09–2.12), those who believed they would have help to care for the baby (OR=3.60; 95%CI 1.51–8.56) or did not know (OR=3.97; 95%CI 1.26–12.51), and those who reported knowing the World Health Organization recommendations on breastfeeding (OR=1.73; 95%CI 1.13–2.64) were more likely to show a very strong EBF intention. Conclusions: Pregnant women in the third trimester of pregnancy presented a strong EBF intention. The higher EBF intention score was significantly associated with the structural, setting, and individual determinants.

RESUMO Objetivo: Investigar a intenção materna de amamentar exclusivamente (IMA) e variáveis associadas entre as mulheres no terceiro trimestre de gravidez. Métodos: A coleta de dados foi realizada por meio de entrevista e questionário semiestruturado e autoadministrado, entre dezembro/2018 e novembro/2019. As gestantes (n=653) responderam à escala Infant Feeding Intentions (IFI) testada, traduzida e adaptada para o português do Brasil e ao questionário contendo perguntas sobre variáveis sociodemográficas, biológicas e familiares, bem como relacionadas à gestação, ao aleitamento materno, à assistência à saúde e a hábitos. Foram realizadas análises estatísticas descritivas e de regressão logística múltipla hierarquizada, com nível de significância de 5%, para estimar a associação entre as variáveis independentes e o desfecho. A IMA, medida pela escala IFI, foi dicotomizada pela mediana (<16 ou =16). Resultados: A pontuação média±desvio padrão para a escala IFI foi de 14,4±2,6. Os resultados da análise de regressão mostraram que as gestantes que não tinham intenção de oferecer mamadeira (OR=4,33; IC95% 2,79-6,72) ou não sabiam (OR=1,85; IC95% 1,21–2,82), que planejaram a gestação (OR=1,52; IC95% 1,09–2,12), aquelas que acreditavam que teriam ajuda nos cuidados com o bebê (OR=3,60; IC95% 1,51–8,56) ou que não sabiam (OR=3,97; IC95% 1,26–12,51), bem como aquelas que relataram conhecer as recomendações da Organização Mundial de Saúde sobre amamentação (OR=1,73; IC95% 1.13–2.64) tinham mais chances de mostrar uma IMA muito forte. Conclusões: As gestantes no terceiro trimestre de gestação apresentaram forte IMA. A maior IMA esteve significativamente associada aos determinantes estruturais, contextuais e individuais.

https://doi.org/10.1590/1984-0462/2024/42/2022192

[SciELO Preprints] - NON ADHERENCE TO TUBERCULOSIS TREATMENT IN SÃO PAULO STATE: REFLECTIONS ON HEALTH MANAGEMENT AND NURSING
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Fonseca, Emílio Prado da Melo, Lair Bianchi de Pereira, Antônio Carlos Mendes, Karine Laura Cortellazzi Verdi, Márcia Regina Dal Medico Meneghim, Marcelo de Castro

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Publication date: 2023-10-09

Abstract: En Pt

Objective: To associate abandonment of tuberculosis treatment with the variables of access to health services in the state of São Paulo was estimated. Methods: was an epidemiological observational study with data to individuals diagnosed with tuberculosis, residing in the state of São Paulo in the period 2012 to 2017. Generalized Estimating Equations models were used to analyze the relationships between independent variables and noncompliance with tuberculosis treatment over time. Results: A prevalence of over 12% of noncompliance with tuberculosis treatment was identified. Individuals residing in medium and large-sized municipalities had, 2.64 (95% CI: 2.15-3;24) and 4.48 (CI 95%: 4.62-5.55) times more risk, respectively, of abandoning TB treatment when compared with those living in small cities (p<0.05). Moreover, presence of Psychosocial Care Centers did not contribute to the reduction of treatment abandonment [1.20 (1.03-1.40) p<0.05]. Conclusions: Was an association between municipal size and abandonment of tuberculosis treatment.

Introdução: Estimou-se a associação entre o abandono do tratamento da tuberculose com variáveis de acesso ao serviço de saúde no estado de São Paulo. Métodos: Trata-se de um estudo epidemiológico ecológico com fonte de dados secundários de indivíduos diagnosticados com tuberculose, no período de janeiro/2012 a dezembro/2017 residentes no estado de São Paulo. A variável desfecho é o abandono do tratamento da tuberculose. Foram efetuadas análises e considerada a distribuição de Poisson, estimados os riscos relativos brutos e ajustados, dispostas em dois blocos de variáveis considerando nível de significância de 5%. Resultados: Identificou-se uma prevalência superior a 12% no abandono do tratamento da TB no estado de São Paulo no período estudado. Indivíduos residentes em municípios de médio e grande porte têm, respectivamente, 2,64 (IC95%: 2,15-3,24) e 4,48 (IC95%: 4,62-5,55) vezes mais risco de abandonar o tratamento da TB quando comparados ao que vivem em municípios pequeno porte (p<0,05), bem como, municípios com a presença do CAPS não contribuíram para a diminuição do abandono [1,20 (1,03-1,40) p<0,05]. Conclusão: houve associação entre o porte municipal e o abandono do tratamento de Tuberculose.

https://doi.org/10.1590/SciELOPreprints.7106

External cephalic version - what do portuguese obstetricians think?
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Cruz, Laura

; Fonseca, Andreia

; Santo, Susana

; Pinto, Luísa

; Clode, Nuno

Acta Obstétrica e Ginecológica Portuguesa

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sep 2023, Volume 17 N. 3 Pages 213 - 220

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

Abstract Introduction: External cephalic version (ECV) is a procedure to change the presentation of the fetus from breech, transverse, or oblique to vertex by applying pressure externally to the fetus through the gravid abdomen. Aim: To evaluate the use of external cephalic version (ECV) among the portuguese obstetric community and the reasons for not performing this procedure. Study design: Cross-sectional study. Population: Doctors attending the 5th national Congress of Obstetrics and Maternal-Fetal Medicine in 2019. Methods: A cross-sectional survey using self-administered questionnaires was conducted among doctors attending the national obstetrics congress in 2019. The survey evaluated the local of work, the level of experience, motivation, and capability of performing an ECV by the participants as well as the reasons for not suggesting or performing an ECV. The statistical analysis included descriptive and comparative analysis. The chi-square test was used with a significance level < 0,05. Results: Ninety-nine clinicians answered the questionnaire; fifty-two worked in a differentiated perinatal hospital. ECV was mainly recommended by doctors from differentiated perinatal hospital (n=29) when compared to doctors from private hospitals (n=2) and perinatal hospitals (n=10) (p =0,010). Most clinicians (n=58) would not recommend this procedure to pregnant women. The main reasons for this were the lack of clinical experience (n=39) and the fact that participants believed that cesarean was a more adequate procedure (n=15). Eighty-one participants were interested in attending training sessions to learn how to perform an EVC in safe conditions. Conclusion: Overall, ECV is not widely practiced in Portugal despite being a safe procedure recommended by the Portuguese Society of Obstetrics and Maternal-Fetal Medicine. Efforts should be done to implement this safe technique among clinicians through training sessions or to enhance referral of these patients to institutions where ECV is performed.

Resumo Introdução: A versão cefálica externa (VCE) permite, utilizando manobras externas sobre o abdómen materno, converter um feto em apresentação não cefálica num feto em apresentação cefálica. Objetivo: Avaliar a opinião da comunidade obstétrica nacional sobre a VCE e quais os condicionantes para a sua não realização. Desenho do estudo: Estudo transversal. População: Médicos que participaram no V Congresso Nacional de Obstetrícia e Medicina Materno-Fetal em 2019. Métodos: Distribuição de questionários anónimos aos participantes do congresso. O questionário avaliou o local de trabalho habitual, o nível de experiência clínica do inquirido, a experiência, motivação, e capacidade de realização da VCE e as razões apresentadas pelos clínicos para não proporem/realizarem a manobra. A análise estatística incluiu a analise descritiva e comparativa. Foi utilizado o teste qui-quadrado e considerou-se um nível de significância de p<0,05. Resultados: Noventa e nove médicos responderam ao questionário. A maioria dos participantes (n=58) não proporia a VCE às grávidas. As principais razões apontadas foram a falta de experiência na realização da manobra (n=39) e o facto de os participantes considerarem a cesariana um procedimento mais adequado (n=15). Cinquenta e dois pertenciam a um hospital de apoio perinatal diferenciado. A VCE foi proposta com maior frequência nos hospitais de apoio perinatal diferenciado (n=29) face aos hospitais de apoio perinatal (n=10) e hospitais privados (n=2), (p=0,010). A maioria dos participantes (n=81) estaria interessado em participar em sessões de treino sobre a execução da manobra. Conclusão: A VCE não parece ser amplamente realizada nos hospitais portugueses, apesar de ser uma manobra segura e recomendada pela Sociedade Portuguesa de Obstetrícia e Medicina Materno-Fetal. É fundamental difundir a VCE na comunidade obstétrica nacional, investir em sessões de formação para que os clínicos adquiram competências na sua execução e fomentar a referenciação destas doentes para centros onde a VCE seja realizada.

Age and Type of Delivery as Risk Indicators for Maternal Mortality
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Oliveira, Isabella Mantovani Gomes Dias de

; Fonseca, Emílio Prado da

; França, Fabiana Mantovani Gomes

; Cortellazzi, Karine Laura

; Pardi, Vanessa

; Pereira, Antonio Carlos

; Tagliaferro, Elaine Pereira da Silva

Revista Brasileira de Ginecologia e Obstetrícia

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mar 2023, Volume 45 N. 3 Pages 134 - 141

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

Abstract Objective: This study assessed maternal mortality (MM) and related factors in a large-sized municipality in the Southeastern region of Brazil (Campinas, São Paulo) during the period 2000-2015. Methods: This study consisted of two phases: 1. An analytical nested case-control phase that assessed the impact of individual and contextual variables on MM; and 2. an ecological phase designed to contextualize maternal deaths by means of spatial analysis. The case group consisted of all maternal deaths (n = 87) and the control group consisted of 348 women who gave birth during the same period. Data analysis included descriptive statistics, association, and multiple logistic regression (MLR) tests at p < 0.05 as well as spatial analysis. Results: Maternal Mortality Ratio was 37 deaths per 100.000 live births. Deaths were dispersed throughout the urban territory and no formation of cluster was observed. MLR showed that pregnant women aged > 35 years old (OR = 2.63) or those with cesarean delivery (OR = 2.51) were more prone to maternal death. Conclusion: Maternal deaths were distributed dispersedly among the different socioeconomic levels and more prone to occur among older women or those undergoing cesarean deliveries.

Resumo Objetivo: Esse estudo avaliou a mortalidade materna (MM) e fatores relacionados em um município de grande porte da região sudeste do Brasil (Campinas, São Paulo) no período de 2000-2015. Métodos: Esse estudo consistiu de duas fases: 1. Uma fase analítica de caso-controle que avaliou o impacto de variáveis individuais e contextuais na MM; 2. Uma fase ecológica delineada para contextualizar as mortes maternas por meio de análise espacial. O grupo caso consistiu de 87 mortes maternas e o grupo controle de 348 mulheres que tiveram bebês durante o mesmo período. Os dados foram analisados por estatística descritiva, testes de associação e regressão logística múltipla (RLM) (p < 0,05) assim como análise espacial. Resultados: A taxa de mortalidade materna foi de 37 mortes para cada 100.000 nascidos vivos. As mortes foram dispersas por todo o território urbano e não se observou formação de clusters. Na RLM observou-se que mulheres grávidas com idade > 35 anos (OR = 2,63) ou aquelas que passaram por cesárea (OR = 2,51) foram mais propensas à morte materna. Conclusão: As mortes maternas foram distribuídas dispersamente entre os diferentes níveis socioeconômicos e mais propensas a ocorrer entre mulheres > 35 anos de idade ou que passaram por cesárea.

https://doi.org/10.1055/s-0043-1768456

Sumak Mama, historias de vida: Fotografía de retrato para concientizar sobre la cultura de la rehabilitación postquimio en mujeres que han padecido cáncer de mama
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Wisst Tait, Laura Brigit

; Fonseca Falla, Silvia Gisell

Zincografía

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2023, Volume 7 N. 14 Pages 69 - 85

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

Abstract The present research focuses on the analysis of breast cancer and its relationship with the physical and psychological sequelae that affect the female identity and self-concept of survivors, causing emotional exhaustion and a possible identity crisis in them. In Peru, during 2019, 6,985 new cases of breast cancer were reported, of which 1,858 were fatal and 5,127 managed to recover (National Institute of Neoplastic Diseases [INEN], 2020). Accordingly, the following question is asked: What happens after having won the battle against breast cancer? In response to this situation, Sumak Mama, life stories, was born, a design and photography project that seeks to raise awareness about the physical and psychological consequences of breast cancer treatment based on the testimonies of patients and survivors of the disease. Using photographic portraits, the project aims to communicate to survivors the importance of undergoing psychological therapy to accompany their physical recovery; and promote the prevention of the disease, as well as respect for patients, making their experience known. In this framework, the project highlighted the need to create spaces dedicated to exposing problems related to women's health that encourage dialogue and expose aspects that could improve the quality of life of those affected. Likewise, the importance of support from the family environment and the community was demonstrated to achieve comprehensive rehabilitation in breast cancer survivors and patients.

Resumen La presente investigación se enfoca en el análisis del cáncer de mama y su relación con las secuelas físicas y psicológicas que afectan la identidad femenina y el autoconcepto de las sobrevivientes, originando en ellas un desgaste emocional y una posible crisis de identidad. En Perú, durante 2019, se reportaron 6 985 casos nuevos de cáncer de mama, de los cuales 1 858 fueron letales y 5 127 lograron recuperarse (Instituto Nacional de Enfermedades Neoplásicas [INEN], 2020). De acuerdo con esto, se formula la siguiente pregunta: ¿Qué sucede después de haber vencido la batalla contra el cáncer de mama? En respuesta a esta situación nace Sumak Mama, historias de vida, un proyecto de diseño y fotografía que busca concientizar sobre las secuelas físicas y psicológicas del tratamiento oncológico mamario con base en los testimonios de las pacientes y sobrevivientes de la enfermedad. Utilizando el retrato fotográfico, el proyecto tiene como objetivos comunicar a las sobrevivientes la importancia de llevar una terapia psicológica que acompañe su recuperación física; y promover la prevención de la enfermedad, así como el respeto a las pacientes, dando a conocer su experiencia. En ese marco, el proyecto evidenció la necesidad de crear espacios dedicados a exponer problemáticas relacionadas con la salud de la mujer que fomenten el diálogo y expongan aspectos que podrían mejorar la calidad de vida de las afectadas. Asimismo, se demostró la importancia del apoyo del entorno familiar y de la comunidad para lograr una rehabilitación integral en las sobrevivientes y pacientes de cáncer de mama.

https://doi.org/10.32870/zcr.v7i14.207

Floristic data to support conservation in the Amazonian canga
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Silva, Livia Gadelha

; Lovo, Juliana

; Fonseca-da-Silva, Taiana Laura da

; Riul, Pablo

; Silva-Luz, Cíntia Luíza da

; Zappi, Daniela C.

Biota Neotropica

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2023, Volume 23 N. 4 elocation e20231517

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

Abstract Canga is an environment of great natural and economic value because it harbours a considerable number of endemic species on a substrate that is rich in iron ore. In the Amazon, this open vegetation type grows on top of isolated outcrops in a dense forest matrix found in the Carajás region, in southeastern Pará. Of these outcrops, the Parque Nacional dos Campos Ferruginosos (PNCF) is the only area of Amazonian canga with a strict protection status. Therefore, industrial activity in the region needs to implement mitigation actions to ensure species and habitat conservation. The objective of this study is to complement and review the floristic list of this recently created protected area, enabling us to compare the floristic similarity between it and other 14 Amazonian canga outcrops found outside the conservation units of full protection in the region. This data provides a basis to understand the floristic and phylogenetic complementarity of those patches to support conservation action. For this, six field trips were carried out in the Serra da Bocaina and two in the Serra do Tarzan, respectively, in order to increase the sampling efforts in PNCF and to obtain a more comprehensive plant list. Floristic composition was investigated using multivariate analyses (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) and phylogenetic structure across studied areas. We added 159 species to the floristic list of the PNCF and the results of the analyses showed that all 16 areas (n.b. PNCF comprises two of these sites) have an overall floristic similarity of 42%, with the least similar areas at 35% and the most similar at 50%. The different micro-habitats found in each study site highlight the high beta diversity of the Amazonian canga sites, making each area unique. Therefore, even if the Parque Nacional dos Campos Ferruginosos does not harbour all the species found in the other Amazonian canga sites, it is strategic for the conservation of the vegetation on ferruginous outcrops in the Amazon, protecting its biodiversity, different habitats, and associated ecosystem services.

Resumo Canga é um ambiente de grande valor natural e econômico por abrigar um número considerável de espécies endêmicas sobre substrato rico em minério de ferro. Na Amazônia, esse tipo de vegetação aberta cresce sobre afloramentos isolados em uma matriz de floresta densa encontrada na região de Carajás, no sudeste do Pará. Dentre esses afloramentos, o Parque Nacional dos Campos Ferruginosos (PNCF) é a única área de canga Amazônica que apresenta o status de proteção integral permanente. Dessa forma, a atividade industrial presente na região necessita implementar ações de mitigação para assegurar a conservação de espécies e habitats relacionados às cangas. O objetivo deste estudo é complementar e revisar a lista florística dessa área protegida, recentemente criada, permitindo comparar a sua similaridade florística com outros 14 afloramentos de cangas Amazônicas localizados fora de unidades de conservação de proteção integral encontradas na região. Tais dados fornecem subsídio para entender a complementaridade florística e filogenética desses fragmentos para apoiar ações de conservação. Para isso, foram realizadas seis viagens de coleta à Serra da Bocaina e à Serra do Tarzan, respectivamente, para aumentar o esforço amostral no PNCF e obter uma lista de plantas mais abrangente. A composição florística foi investigada por meio de análises multivariadas (non-metric multidimensional scaling and unweighted pair group method with arithmetic mean) e estrutura filogenética nas áreas estudadas. Nós adicionamos 159 espécies na lista florística do PNCF e os resultados das análises demonstraram que todas as 16 áreas (n.b. o PNCF compreende duas dessas áreas) têm uma similaridade florística total de 42%, com áreas menos similares de 35% e as mais similares de 50%. Os micro-habitats encontrados em cada área de estudo evidenciam a alta diversidade beta das áreas de cangas Amazônicas, o que as tornam únicas. Portanto, ainda que o Parque Nacional dos Campos Ferruginosos não abrigue todas as espécies encontradas em outras áreas de cangas Amazônicas, ele é estratégico para a conservação dos afloramentos ferruginosos na Amazônia, protegendo a sua biodiversidade, os diferentes habitats e os serviços ecossistêmicos associados.

https://doi.org/10.1590/1676-0611-bn-2023-1517

Efectos de las intervenciones basadas en mindfulness sobre el estrés laboral en agentes de policía: revisión sistemática
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Olaya López, Ángela María

; Benavides Ríos, Andrea Patricia

; Delgado Fonseca, Jesús Antonio

; García Belinchón, Laura

Revista de la Asociación Española de Especialistas en Medicina del Trabajo

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2023, Volume 32 N. 4 Pages 345 - 354

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

RESUMEN. Objetivo: Describir los efectos de las intervenciones basadas en mindfulness sobre el estrés laboral en agentes de policía. Material y Métodos: Se realizó una revisión sistemática basada en la literatura publicada desde el 2014 hasta diciembre de 2021. Se evaluó la calidad mediante el cuestionario CONSORT y TREND y el nivel de evidencia y grado de recomendación mediante la herramienta SIGN. Resultados: Se obtuvieron 80 referencias que al aplicar los criterios de inclusión y exclusión dieron como resultado 10 estudios. 7 estudios encontraron diferencias estadísticamente significativas en los niveles de estrés tras las intervenciones del mindfulness. Conclusiones: Los resultados demuestran la eficacia de las intervenciones basadas en mindfulness sobre la disminución del estrés laboral en agentes de policía. Estas intervenciones confieren además beneficios como la mejoría de la calidad de sueño y la disminución del consumo de alcohol.

ABSTRACT Objective: To describe the effectiveness of mindfulness-based interventions on occupational stress in police officers. Material and Methods: A systematic review was carried out based on the literature published from 2014 to december 2021. Quality was assessed using the CONSORT and TREND questionnaires and the level of evidence and degree of recommendation using the SIGN tool. Results: 80 references were identified and 10 studies met the inclusion and exclusion criteria. 7 studies reported statistically significant differences in stress levels after the mindfulness intervention. Conclusions: The results of this systematic review demonstrate the effectiveness of mindfulness-based interventions in reducing occupational stress in police officers. These interventions also confer protective benefits such as improved sleep quality and decreased alcohol consumption.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

Preditores de mortalidade e tempo médio de sobrevivência dos pacientes críticos
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Oliveira, Jussiely Cunha

; Vasconcelos, Geferson Messias Teles

; Bispo, Laura Dayane Gois

; Magro, Marcia Cristina da Silva

; Fonseca, Cassiane Dezoti da

; Pinheiro, Fernanda Gomes de Magalhães Soares

; Santana-Santos, Eduesley

Acta Paulista de Enfermagem

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2023, Volume 36 elocation eAPE01192

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

Abstract Objective To analyze the predictors of mortality and the average survival time of patients hospitalized in Intensive Care Units. Methods This is a prospective cohort, carried out from August 2018 to July 2019, in four adult Intensive Care Units (ICU) from the public and private network of the State of Sergipe. All adult patients were included, provided they had a minimum length of stay of 24 hours in the unit. The primary outcome was death. Secondary outcomes were dialysis, pressure injury, Acute Kidney Injury, need for invasive mechanical ventilation for more than 48 hours, infection, and length of hospital stay. Results Of the 432 patients, there was a predominance of death in male patients, older and coming from the emergency unit. The presence of heart failure, creatinine values >1.5 mg/dL at admission, diabetes mellitus, liver disease and smoking were also associated with the death outcome. As for the other predictors, the longest hospital stay, higher Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology (SAPS 3) and Nursing Activities Score (NAS) scores, in addition to the use of noradrenaline, stand out. The use of fentanyl was associated with increased survival time and the overall median survival time was 28 days. Conclusion The mortality predictors of patients admitted to the ICU in Sergipe were longer length of stay; the highest SOFA, SAPS-3 and NAS scores; creatinine >1.5mg/dl on admission; use of vasopressor drugs and the need for dialysis.

Resumen Objetivo Analizar los predictores de mortalidad y el tiempo promedio de supervivencia de los pacientes internados en unidades de cuidados intensivos. Métodos Cohorte prospectivo, realizado durante el período de agosto de 2018 a julio de 2019, en cuatro Unidades de Cuidados Intensivos (UCI) de adultos, de la red pública y privada del estado de Sergipe. Se incluyeron todos los pacientes adultos, con tiempo de permanencia mínima de 24 horas en la unidad. El criterio principal de valoración fue la defunción. Los criterios secundarios fueron: diálisis, úlcera por presión, lesión renal aguda, necesidad de ventilación mecánica invasiva durante más de 48 horas, infección y el tiempo de internación. Resultados De los 432 pacientes, hubo un predominio de defunciones en pacientes del sexo masculino, con edad más avanzada y procedentes de la unidad de emergencia. La presencia de insuficiencia cardíaca, valores de creatinina >1,5 mg/dL en la admisión, diabetes mellitus, enfermedad hepática y tabaquismo también estuvieron asociados con el desenlace de defunción. Con relación a los demás predictores, se destacaron el mayor tiempo de internación; mayores puntuaciones del Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) y Nursing Activies Score (NAS), además del uso de noradrenalina. El uso de fentanilo estuvo asociado con el aumento del tiempo de sobrevida y el tiempo promedio de supervivencia general fue de 28 días. Conclusión Los predictores de mortalidad de los pacientes internados en una UCI de Sergipe fueron: el mayor tiempo de internación; los puntajes más altos de SOFA, SAPS-3 y de NAS; creatinina >1,5mg/dl en la admisión; uso de drogas vasoactivas y la necesidad de diálisis.

Resumo Objetivo Analisar os preditores de mortalidade e o tempo médio de sobrevivência dos pacientes internados nas unidades de terapias intensivas. Métodos Coorte prospectiva, realizada no período de agosto de 2018 a julho de 2019, em quatro Unidades de Terapia Intensiva (UTI) de adultos, da rede pública e privada do Estado de Sergipe. Foram incluídos todos os pacientes adultos, desde que possuíssem o tempo de permanência mínima de 24 horas na unidade. O desfecho primário foi o óbito. Os desfechos secundários foram: diálise, lesão por pressão, lesão renal aguda, necessidade de ventilação mecânica invasiva por mais de 48 horas, infecção e o tempo de internação. Resultados Dos 432 pacientes, houve predomínio de óbito em pacientes do sexo masculino, com idade mais avançada e procedentes da unidade de emergência. A presença de insuficiência cardíaca, valores de creatinina >1,5 mg/dL na admissão, diabetes mellitus, doença hepática e tabagismo também tiveram associação com o desfecho óbito. Quanto aos demais preditores, destacaram-se o maior tempo de internação; maiores escores do Sequential Organ Failure Assessment (SOFA), Simplified Acute Phisiology (SAPS 3) e Nursing Activies Score (NAS), além do uso de noradrenalina. O uso do fentanil foi associado ao aumento do tempo de sobrevida e o tempo médio de sobrevivência geral foi 28 dias. Conclusão Os preditores de mortalidade dos pacientes internados em UTI de Sergipe foram o maior tempo de internação; os maiores escores de SOFA, SAPS-3 e NAS; creatinina >1,5mg/dl na admissão; uso de drogas vasopressoras e a necessidade de diálise.

https://doi.org/10.37689/acta-ape/2023ao01192

10.

Ultrassonografia como instrumento de avaliação do linfedema secundário ao câncer de mama: revisão sistemática
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Rezende, Laura Ferreira de

; Piloni, João Paulo Martins

; Kempa, Vitória Livorato

; Silva, Júlia Franco Ramos

; Vilas Boas, Vanessa Fonseca

; Carvalho, Regiane Luz

; Marx, Ângela Gonçalves

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20220144

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

Abstract Lymphedema is a chronic and progressive disease characterized by fluid accumulation, causing tissue edema as a result of a compromised lymphatic system. Diagnostic ultrasound (DUS) is a method capable of assessing soft tissue characteristics that can be used reliably to diagnose lymphedema as well as for measuring tissue compliance in a clinical setting. This is a systematic review, aiming to evaluate articles that made use of DUS in management of lymphedema secondary to breast cancer. A total of 570 articles were selected, exported to the Rayyan QCRI review program, and then screened by two researchers. From this search, 25 articles were selected after the authors reached consensus and were catalogued as to their main results. Diagnostic ultrasound was identified as an advantageous method that is safe, minimally invasive, low cost, and radiation free and is useful for evaluating the efficacy of therapies used in lymphedema treatment.

Resumo O linfedema é uma doença crônica e progressiva caracterizada pelo acúmulo de fluidos, provocando edema tecidual em decorrência de um sistema linfático comprometido. A ultrassonografia diagnóstica (USD) é um método capaz de avaliar as características dos tecidos moles, podendo ser utilizada de maneira confiável para o diagnóstico do linfedema, além de mensurar a complacência tecidual em um cenário clínico. Esta é uma revisão sistemática, objetivando avaliar artigos que fizessem o uso da USD na abordagem do linfedema secundário ao câncer de mama. Foram selecionados 565 artigos, que foram exportados para o programa de revisão Rayyan QCRI e, em seguida, triados por dois pesquisadores. Dessa busca, foram obtidos 25 artigos selecionados após consenso entre os autores e que foram catalogados quanto aos seus resultados principais. A USD foi identificada como um método vantajoso por ser seguro, pouco invasivo, de baixo custo, sem uso de radiação, além de ser útil para avaliar a eficácia de terapias no tratamento do linfedema.

https://doi.org/10.1590/1677-5449.202201441

11.

Multidisciplinary Scientific Cruises for Environmental Characterization in the Santos Basin – Methods and Sampling Design
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Moreira, Daniel L.

; Dalto, Adriana G.

; Figueiredo JR, Alberto G.

; Valerio, Aline M.

; Detoni, Amalia M. S.

; Bonecker, Ana C. T.

; Signori, Camila N.

; Namiki, Cláudia

; Sasaki, Dalton K.

; Pupo, Daniel V.

; Silva, Danilo A.

; Kutner, Deborah S.

; Duque-Castaño, Diana C.

; Marcon, Eduardo H.

; Gallotta, Fabiana D. C.

; Paula, Fabiana S.

; Gallucci, Fabiane

; Roque, Gabriela C. F.

; Campos, Giulia S.

; Fonseca, Gustavo

; Mattos, Gustavo

; Lavrado, Helena P.

; Silveira, Ilson C. A. da

; Costa, Jessica O.

; Santos Filho, João R. dos

; Carneiro, Juliane C.

; Moreira, Julio C.F.

; Rozo, Laura

; Araujo, Leandro F.M.

; Lazzari, Letícia

; Silva, Letícia O. da

; Michelazzo, Luan S.

; Fernandes, Luciano F.

; Dottori, Marcelo

; Araújo Jr., Marcus A. G. de

; Chuqui, Mateus G.

; Ceccopieri, Milena

; Borges-Silva, Milton

; Kampel, Milton

; Bergo, Natascha M.

; Silva, Paulo V. M.

; Tura, Pedro M.

; Moura, Rafael B. de

; Romano, Renato G.

; Martins, Renato P.

; Carreira, Renato S.

; Toledo, Rodrigo G.A.

; Bonecker, Sérgio L.C.

; Disaró, Sibelle T.

; Rodrigues, Silvana V.

; Corbisier, Thais N.

; Vicente, Thaisa M.

; Paiva, Vitor G. de

; Pellizari, Vivian H.

; Belo, Wellington C.

; Brandini, Frederico P.

; Sousa, Silvia H.M

Ocean and Coastal Research

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2023, Volume 71 Suppl. 3 elocation e23022

Abstract: En | Text: En | PDF: En

Abstract The Santos Basin (SB) is the main petroliferous basin in the Brazilian continental margin and one of the most studied marine areas in Brazil. However, historical data suggest that new efforts should be carried out to acquire quantitative biological data, especially in the deep sea, to establish the baseline of essential ocean variables in different ecosystems for future monitoring programs. The Brazilian energy company Petrobras planned and executed 24 oceanographic cruises over a period of 2 years to assess the benthic (SANSED cruise) and pelagic (SANAGU cruise) systems of the SB (356 days at sea in 2019 and 2021/2022). These efforts were part of the Santos Project, which comprised a comprehensive environmental study aimed at investigating benthic and pelagic variables to characterize ecology, biogeochemistry, thermohaline properties of water masses, and ocean circulation patterns, geomorphology, and sedimentology, as well as organic and inorganic chemistry. Here we present the detailed sampling designs and the field methods employed on board, during the SB scientific cruises. All sampling protocols were based on standardized approaches. For the benthos analyses, triplicate sediment samples were performed using a GOMEX-type box corer (0.25 m²) or a large modified Van Veen grab (0.75 m²) at 100 stations ranging from 25 to 2400 m depth. At each station, 25 geochemical and physico-chemical parameters were analyzed in addition to micro-, meio-, and macrofauna and living foraminifera samples. For the pelagic system, 60 stations were selected to investigate the plankton community, ranging in size from pico- to macroplankton, through vertical, horizontal, and oblique net hauls (20, 200, and 500 μm mesh size), as well as 25 biogeochemical parameters collected with an aid of a CTD-rosette sampler. Part of this scientific information also serves the Regional Environmental Characterization Project (PCR-BS) in support of Petrobras’ Santos Basin drilling licensing process led by the Brazilian Environmental Agency – IBAMA. This project contributes to the sustainable development of the SB, in line with the guidelines of the United Nations Decade of Ocean Science for Sustainable Development.

https://doi.org/10.1590/2675-2824071.22072dlm

12.

Sedimentary organic matter accumulation provinces in the Santos Basin, SW Atlantic: insights from multiple bulk proxies
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Carreira, Renato S.

; Lazzari, Letícia

; Ceccopieri, Milena

; Rozo, Laura

; Martins, Dayanne

; Fonseca, Gustavo

; Vieira, Danilo C.

; Massone, Carlos G.

Ocean and Coastal Research

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2023, Volume 71 Suppl. 3 elocation e23030

Abstract: En | Text: En | PDF: En

Abstract The organic matter (OM) of surface sediments (0–2 cm) from the Santos Basin was characterized by employing elemental (C, N, P), isotopic (δ 13C and δ 15N), biochemical (total carbohydrates, proteins, and lipids), and pigment (chlorophyll-a and phaeopigments) proxies, as part of the Santos Project – The Santos Basin Regional Environmental Characterization (PCR-BS) – coordinated by PETROBRAS. Samples were collected in a regional scale throughout the entire basin, including 11 isobaths from eight cross-margin transects ranging from 25 to 2,400 m water depths, and 12 additional samples obtained from the São Paulo Plateau. The aims of this study were two-fold, namely, to identify the major oceanographic and depositional processes driving OM transport and accumulation and to provide information on OM origin and availability to benthic secondary producers. The multiple employed proxies and the use of machine learning allowed to categorize distinct OM accumulation provinces displaying two major regional features: shallow sediments (< 50-m isobaths) are OM-poor (TOC < 2.0 mg g -1) but the available amount is readily hydrolysable, and mid-shelf deposits (75-m and 100-m isobaths) throughout the entire basin present muddy and OM-rich sediments (TOC ranging from 7.0 to 14.0 mg g-1) seemingly available to heterotrophs. Similarly, relatively OM-rich deposits are found at depths ranging from 700 to 1,300-m isobaths throughout the basin, but their composition and nutritional value (as suggested by biochemical indicators) are not related to mid-shelf deposits. The general overview of OM accumulation and composition provided herein validated the selected organic geochemical proxies for benthic ecology studies at the shelf and deep ocean sectors of the studied region.

https://doi.org/10.1590/2675-2824071.22061rsc

13.

The challenge of tobacco and nicotine use among women
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Corrêa, Paulo César Rodrigues P.

; Sales, Roberta Karla B. de

; Knorst, Marli Maria

; Pinto, Suzianne Ruth H. Lima

; Ragnini, Laura Fonseca Queiroz

; Tourinho, Cristiane Almeida Pires

; Storrer, Karin Mueller

; Scuarcialupi, Maria Enedina C. De A.

; Castellano, Maria Vera C. De O.

; Albuquerque Neto, Aldo Agra De

; Ravara, Sofia Belo

Revista da Associação Médica Brasileira

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2023, Volume 69 Suppl. 1 elocation e2023S124

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.2023s124

14.

Efeito de condicionadores à base de bagaço de azeitona na estabilidade da agregação do solo: resultados preliminares de ensaio à micro-escala
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Royer, Ana Caroline

; Silvestre, Laura Martins

; Figueiredo, Daniel

; Figueiredo, Tomás de

; Baldo, Maria Cleide

; Fonseca, Felícia

; Hernández, Zulimar

Revista de Ciências Agrárias

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dec 2022, Volume 45 N. 4 Pages 551 - 560

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

Resumo A aplicação de condicionadores ao solo visa o reforço da estabilidade da agregação (EA) e da sua resistência à erosão. O bagaço de azeitona (BA) húmido, proveniente da produção de azeite em duas fases, pode ser utilizado na compostagem e obtenção de condicionadores orgânicos (CBA). O trabalho tem como objetivo apresentar resultados de ensaio experimental realizado para avaliar a influência de CBA na EA. O ensaio comportou dois solos de potencialmente distinto grau de agregação (1, franco-limoso; 2, franco-argiloso), nos quais se aplicaram três CBA, em três doses. Amostras de agregados (1-2 mm) foram misturadas com condicionador moído (<0,75 mm), submetidas a ciclos diários de humedecimento e secagem, e coletadas em 5 momentos ao longo do período experimental de 30 dias. A EA foi determinada por agitação e crivagem em húmido. Confirmou-se a hipótese de o solo 2 possuir EA significativamente superior à do solo 1. Neste, a adição dos condicionadores aumentou significativamente a proporção de agregados estáveis relativamente ao solo original, em todas as dosagens, o que não se verificou no solo 2. A incorporação de CBA em solos cultivados com olival, contribuindo para a economia circular, melhora a proteção do solo pelo incremento de agregados estáveis.

Abstract The application of soil conditioners aims to reinforce aggregate stability (AS) and soil resistance to erosion. The wet olive pomace (OP), from olive oil production in two phases, can be used in composting and obtaining organic conditioners (OPC). The objective of this work is to present the results of an experiment carried out to evaluate the influence of OPC on AS. The experiment involved two soils of potentially different degrees of aggregation (1, silt loam; 2, clay loam), in which three OPC were applied, in three doses. Aggregate samples (1-2 mm) were mixed with conditioner (<0.75 mm), subjected to daily cycles of wetting and drying, and collected at 5 moments along the 30-day experimental period. AS was determined by shaking and wet sieving. The hypothesis that soil 2 has a significantly higher AS than soil 1 was confirmed. In this, the addition of conditioners significantly increased the proportion of stable aggregates as compared to the original soil, at all dosages, which was not observed in soil 2. The incorporation of OPC in soils cultivated with olive groves, contributing to the circular economy, improves soil protection by increasing stable aggregates.

https://doi.org/10.19084/rca.28536

15.

Pesar no óbito fetal: luto sem voz
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Oliveira, Hélio Tadeu Luciano de

; Fonseca, Laura Fernanda

; Estancione, Laura Maria Brandão

; Corrêa, Maria Cristina Silva Montenegro

; Oliveira, Nathalie de Rezende

; Dias, Vanessa do Valle Vieira Amoroso

Revista Bioética

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sep 2022, Volume 30 N. 3 Pages 644 - 651

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

Resumo O Ministério da Saúde orienta que a declaração de óbito não seja emitida em casos de óbito fetal com gestação inferior a 20 semanas ou feto com peso inferior a 500 g ou estatura menor que 25 cm, acrescentando que a legislação permite a emissão da declaração em casos em que a família deseje fazer o sepultamento do feto. Nesse contexto, são poucos os casos de aborto em que a declaração é feita. Este artigo realizou revisão integrativa que responde à pergunta: os rituais de fechamento, particularmente o sepultamento (possibilitado pela emissão da declaração de óbito) em caso de morte fetal inferior a 20 semanas de idade gestacional, ajudariam no processo de luto dos pais? A literatura consultada trouxe informações favoráveis à emissão da declaração de óbito e possibilitou discussão médica, jurídica e antropológica do tema.

Abstract The Ministry of Health advises that death certificates should not be issued in cases of fetal death for a pregnancy of less than 20 weeks or fetus weighing less than 500 g or shorter than 25 cm in height; however, the legislation allows the issuance of the certificate in cases where the family wishes to bury the fetus. Given this context, abortion cases in which the certificate is issued are few. This article presents an integrative review that answers the question: would the death ceremonies, particularly the burial (made possible by the issuance of the death certificate), in case of fetal death under 20 weeks of gestational age help in the parents’ mourning process? The literature consulted presented favorable information for the issuance of the death certificate and enabled a medical, legal and anthropological discussion of the theme.

Resumen El Ministerio de Salud brasileño recomienda que no se debe emitir el certificado de defunción en los casos de muerte fetal de menos de 20 semanas de gestación, feto con peso inferior a 500 g o estatura inferior a 25 cm, pero agrega que se puede permitirlo cuando la familia opta por el entierro del feto. En este contexto, el certificado se emite en pocos casos de aborto. Este artículo realizó una revisión integradora a partir de la pregunta: ¿Ayudarían en el proceso de duelo de los padres los rituales de inhumación, sobre todo el entierro (habilitado mediante la emisión de un certificado de defunción) en caso de muerte fetal con menos de 20 semanas de edad gestacional? La literatura consultada aportó con informaciones favorables a la emisión del certificado de defunción y permitió fomentar la discusión médica, jurídica y antropológica del tema.

https://doi.org/10.1590/1983-80422022303558pt

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