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Abstract Objective The study aimed to validate the script content of an audiovisual resource for people living with HIV. Methods This methodological study had a quantitative approach and was guided by the methodological theoretical framework of psychometrics. Content validation was performed by expert judges in the thematic area using the Delphi technique. The sample consisted of 22 judges in the first validation analysis and seven judges in the second analysis. Results All domains analyzed had a content validity coefficient (CVC) >0.80, with a total CVC (CVCt) of 0.96, almost perfect internal consistency, Cronbach’s alpha of 0.988, ICC of 0.982 [95%CI 0.969-0.991], and p<0.005 which was significant in the first round of expert evaluation. In the second analysis, the criteria used for content validation showed a CVCt of 0.97, with the criteria of objectivity, simplicity, clarity, relevance, accuracy, variety, credibility, and balance achieving 100% approval. Conclusion The script was validated in terms of content, showing to be a representative and relevant instrument for building the audiovisual resource. It contributes to the advancement of scientific knowledge as it presents results with methodological accuracy and innovations in the field of health education for people living with HIV.

Resumen Objetivo Validar el contenido del guion de un recurso audiovisual para personas que viven con el VIH Métodos Estudio metodológico con enfoque cuantitativo, norteado por el marco referencial teórico metodológico de la psicometría. La validación de contenido fue realizada por jueces especialistas en el área temática mediante el uso del método Delphi. La muestra estuvo compuesta por 22 jueces en el primer análisis de validación y siete jueces en el segundo análisis. Resultados Todos los dominios analizados presentaron coeficiente de validez de contenido (CVC) >0,80, con un CVC total (CVCt) de 0,96, consistencia interna casi perfecta, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95 % 0,969-0,991] y p<0,005 significativo en la primera ronda de evaluación de los especialistas. En el segundo análisis, los criterios usados para la validación de contenido presentaron un CVCt de 0,97, con los criterios de objetividad, simplicidad, claridad, relevancia, precisión, variedad, credibilidad y equilibrio, con un 100 % de aprobación. Conclusión Se validó el guion en cuanto al contenido, lo que demuestra que es un instrumento representativo y pertinente para la elaboración del recurso audiovisual. Contribuye al avance del conocimiento científico ya que presenta resultados con rigor metodológico, con innovaciones en el campo de la educación para la salud para personas que viven con el VIH.

Resumo Objetivo Validar o conteúdo do roteiro de um recurso audiovisual para pessoas vivendo com HIV. Métodos Estudo metodológico com abordagem quantitativa, norteado pelo referencial teórico metodológico da psicometria. A validação de conteúdo foi realizada por juízes especialistas na área temática usando a técnica Delphi. A amostra foi composta por 22 juízes na primeira análise de validação e sete juízes na segunda análise. Resultados Todos domínios analisados apresentaram coeficiente de validade de conteúdo (CVC) >0,80, com CVC total (CVCt) de 0,96, consistência interna quase perfeita, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95% 0,969-0,991] e p<0,005 significativo na primeira rodada de avaliação dos especialistas. Na segunda análise, os critérios usados para validação de conteúdo apresentaram CVCt de 0,97, com os critérios de objetividade, simplicidade, clareza, relevância, precisão, variedade, credibilidade e equilíbrio, atingindo 100% de aprovação. Conclusão O roteiro foi validado quanto ao conteúdo, mostrando ser um instrumento representativo e pertinente para construção do recurso audiovisual. Ele contribui para o avanço do conhecimento científico pois apresenta resultados com rigor metodológico, com inovações no campo da educação em saúde para pessoas vivendo com HIV.

https://doi.org/10.37689/acta-ape/2024ao0001361

Medicines Evaluation: The “Simplified” Complexity
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Costa, Fernando Leal da

Portuguese Journal of Public Health

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dec 2023, Volume 41 N. 3 Pages 165 - 169

Abstract: En | Text: En | PDF: En

https://doi.org/10.1159/000533961

Radial Nerve Supracondylar Block Versus Fracture Hematoma Block. Comparison of Their Efficacy in Cases of Fractures of the Distal Third of the Radius
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Maia, Guilherme de Albuquerque Souza

; Cunha, Jean Castro

; Feijó, Carolina Queiroz

; Leal, Daniel Mendes

; Moreira, Juan Javier

; Herrero, Carlos Fernando Pereira da Silva

Revista Brasileira de Ortopedia

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aug 2023, Volume 58 N. 4 Pages 557 - 562

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

Abstract Objective The present study compares the analgesic efficacy of two techniques to perform non-surgical reduction: fracture hematoma block and radial nerve supracondylar block. Methods Forty patients with fractures of the distal third of the radius, who required reduction, were selected in a quasi-randomized clinical trial to receive one of the anesthetic techniques. All patients signed the informed consent form, except for those who did not wish to participate in the study, had neurological injury, had contraindication to the procedure in the emergency room, or with contraindication to the use of lidocaine. To measure analgesia, the numerical pain rate scale was used at four different moments: preblock, postblock, during reduction, and after reduction; then three differences were calculated: the first between before and after blocking; the second between during reduction and after blockade; and the third between before blocking and after reduction. Results The fracture hematoma and supracondylar block groups showed the following mean values, respectively: 3.90 (1–10) and 3.50 (-6–10) in difference 1; 4.35 (-5–10) and 5.00 (-3–10) in difference 2; and 4.65 (1–10) and 3.80 (-3–10) in difference 3. Conclusion Both techniques proved to be efficient for analgesia, with mild superiority of hematoma block, but without statistical significance.

Resumo Objetivo O estudo compara a eficácia analgésica de duas técnicas para realizar redução incruenta: o bloqueio de hematoma da fratura e o bloqueio supracondilar de nervo radial. Métodos Quarenta pacientes com fraturas do terço distal do rádio, que necessitassem redução, foram selecionados em um ensaio clínico quasi-randomizado, para receber uma das técnicas anestésicas. Todos os pacientes assinaram o termo de consentimento ou assentimento, com exceção daqueles que não desejassem participar do estudo, tivessem lesão neurológica, com contraindicação ao procedimento na sala de emergências, ou com contraindicação ao uso da lidocaína. Para aferir a analgesia foi utilizada a escala numérica da dor em quatro momentos distintos: pré-bloqueio, pós-bloqueio, durante a redução e após a redução; em seguida, foram calculadas três diferenças: a primeira entre antes e após o bloqueio; a segunda entre durante a redução e após o bloqueio; e a terceira entre antes do bloqueio e após a redução. Resultados Os grupos do bloqueio de hematoma de fratura e bloqueio supracondilar apresentaram respectivamente os seguintes valores médios: 3.90 (1–10) e 3.50 (-6–10) na diferença 1; 4.35 (-5–10) e 5.00 (-3–10) na diferença 2; e 4.65 (1–10) e 3.80 (-3–10) na diferença 3. Conclusão As duas técnicas se provaram eficientes para analgesia, com discreta superioridade do bloqueio de hematoma, mas sem significância estatística.

https://doi.org/10.1055/s-0043-1768623

Extraction Induced by Microemulsion Breaking and Square Wave Voltammetry: A Promising Union to Monitor Cd, Pb and Cu in Biodiesel
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Krause, Cristian H.

; Schneider, Alexandre B.

; Silva, Márcia M. da

; Mazzei, Marina B.

; Kolling, Leandro

; Leal, Fernando N.

Journal of the Brazilian Chemical Society

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may 2023, Volume 34 N. 5 Pages 713 - 724

Abstract: En | Text: En | PDF: En

A new approach involving square wave anodic stripping voltammetry was developed to simultaneously determine cadmium and lead and, in the same cell, sequentially copper, in biodiesel after extraction induced by microemulsion breaking. The composition of the water-in-oil microemulsion involved 10.50 mL biodiesel, 4.20 mL n-propanol and 0.30 mL of the 6.0 mol L 1 HNO3 solution. The extraction was carried out by adding 1.10 mL ultrapure water resulting in two well separated phases: an upper organic phase, and a lower aqueous phase containing the analytes. The apparatus comprised a portable potentiostat and a cell with an in situ plated mercury film glassy carbon electrode as working electrode. The limits of detection for Cd, Pb and Cu were 0.33, 0.48 and 0.66 µg L 1, respectively. The accuracy of the method was evaluated by recovery assays of spiked samples and by analyzing a standard reference material.

https://doi.org/10.21577/0103-5053.20220142

El ventarrón de la transgresión y la singularidad en las narrativas de Pedro Juan Gutiérrez y Fernando Vallejo
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Leal, Heber

Autoctonía (Santiago)

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jan 2023, Volume 7 N. 1 Pages 323 - 356

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

Resumen: El presente artículo, tiene como propósito analizar el contenido político y transgresivo de las narrativas de Pedro Juan Gutiérrez y Fernando Vallejo. El método que se emplea es el diálogo con la crítica precedente, la operacionalización de conceptos filosóficos y el comentario textual e intertextual de textos literarios; para ello se efectúa un examen textual desde la perspectiva filosófica, que incluye los aportes de Foucault y Onfray. Los resultados visibilizan los desplieges singulares de forma y fondo presentes en un corpus representativo de textos escogidos de estos escritores latinoamericanos del siglo XX. De ese estudio decantan mecanismos y trasfondos de poder y transgresión que conectan la ficción con la realidad regional de los escritores abordados. Se concluye que estas narrativas expresan la singularidad nómade y la transgresión en la voz de sus narradores, quienes contradicen el principio de sumisión.

Abstract: The purpose of this article is to analyze the political and transgressive content of the narratives of Pedro Juan Gutiérrez and Fernando Vallejo. The method used is the dialogue with previous criticism, the operationalization of philosophical concepts and the textual and intertextual commentary of literary texts; For this, a textual examination is carried out from the philosophical perspective that includes the contributions of Foucault and Onfray. The results make visible the singular displays of form and content present in a representative corpus of selected texts by these Latin American writers of the 20th century. From this study, mechanisms and backgrounds of power and transgression are decanted that connect fiction with the regional reality of the writers addressed. It is concluded that these narratives express the nomadic singularity and the transgression in the voice of their narrators, who contradict the principle of submission.

https://doi.org/10.23854/autoc.v7i1.287

Use of bedside echocardiography in the care of critically ill patients - a joint consensus document of the Associação de Medicina Intensiva Brasileira, Associação Brasileira de Medicina de Emergência, and Sociedade Brasileira de Medicina Hospitalar. Part 1 - Competence in bedside echocardiography
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Pellegrini, José Augusto Santos

; Mendes, Ciro Leite

; Gottardo, Paulo César

; Feitosa, Khalil

; John, Josiane França

; Oliveira, Ana Cláudia Tonelli de

; Negri, Alexandre Jorge de Andrade

; Grumann, Ana Burigo

; Barros, Dalton de Souza

; Negri, Fátima Elizabeth Fonseca de Oliveira

; Macedo, Gérson Luiz de

; Neves, Júlio Leal Bandeira

; Rodrigues, Márcio da Silveira

; Spagnól, Marcio Fernando

; Ferez, Marcus Antonio

; Chalhub, Ricardo Ávila

; Cordioli, Ricardo Luiz

Critical Care Science

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jan 2023, Volume 35 N. 1 Pages 2 - 10

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

ABSTRACT The use of echocardiography by physicians who are not echocardiographers has become common throughout the world across highly diverse settings where the care of acutely ill patients is provided. Echocardiographic evaluation performed in a point-of-care manner can provide relevant information regarding the mechanism of causes of shock, for example, increasing the rates of correct diagnosis and allowing for faster informed decision-making than through evaluation methods. Considering that the accurate diagnosis of life-threatening situations is essential for professionals working with acutely ill patients, several international associations recommend that physicians responsible for critically ill patients acquire and develop the ability to perform bedside ultrasound examinations, including echocardiographic examinations. However, there is no consensus in the literature regarding which specific applications should be included in the list of skills for nonechocardiographer physicians. Taking into account the multiplicity of applications of echocardiography in different scenarios related to acutely ill patients; the differences in the published protocols, with regard to both the teaching methodology and competence verification; and the heterogeneity of training among highly diverse specialties responsible for their care at different levels, this consensus document aimed to reflect the position of representatives of related Brazilian medical societies on the subject and may thus serve as a starting point both for standardization among different specialties and for the transmission of knowledge and verification of the corresponding competencies.

RESUMO O emprego da ecocardiografia por médicos não ecocardiografistas tem se tornado comum em todo o mundo nos mais diversos ambientes em que se dá o cuidado do paciente agudamente doente. A avaliação ecocardiográfica realizada de forma point-of-care pode fornecer informações pertinentes em relação ao mecanismo das causas de choque, por exemplo, incrementando as taxas de diagnóstico correto e possibilitando a tomada de decisão fundamentada de forma mais rápida do que por meio dos métodos tradicionais de avaliação. Considerando que o diagnóstico preciso de situações ameaçadoras à vida é indispensável a profissionais atuando junto a pacientes agudamente enfermos, diversas entidades associativas internacionais recomendam que médicos responsáveis por pacientes gravemente doentes devam adquirir e desenvolver a habilidade para realizar exames ultrassonográficos à beira do leito, inclusive ecocardiográficos. Entretanto, não há consenso na literatura acerca de quais aplicações específicas devam compor o rol de habilidades do médico não ecocardiografista. Levando-se em consideração a multiplicidade de aplicações da ecocardiografia em diversos cenários relativos ao paciente agudamente enfermo; as diferenças nos protocolos publicados, tanto no que diz respeito à metodologia de ensino como de verificação de competências, bem como a heterogeneidade da formação entre as mais diversas especialidades responsáveis pelo seu cuidado em diferentes níveis, este documento de consenso teve o objetivo de refletir o posicionamento de representantes de sociedades médicas brasileiras afins acerca do tema, podendo, assim, servir de ponto de partida para a uniformização entre diferentes especialidades, bem como para a transmissão de conhecimento e a verificação das competências correspondentes.

https://doi.org/10.5935/2965-2774.20230307-en

Digital transformation in maintenance: interoperability-based adequacy aiming smart legacy systems
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Venâncio, André Luiz Alcântara Castilho

; Brezinski, Guilherme Louro

; Leal, Gabriel da Silva Serapião

; Loures, Eduardo de Freitas Rocha

; Deschamps, Fernando

Production

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2023, Volume 33 elocation e20220098

Abstract: En | Text: En | PDF: En

Abstract Paper aims The Industry 4.0 movement highlights the importance of information and communication technologies and the two main reasons for this are advances in digitalization and automation. However, organizations trying to implement technologies face several barriers in their systems. These barriers are intensified in legacy systems, tightly coupled to organizational processes. Thus, to overcome these barriers, an adequacy strategy was structured, and detailed in the context of interoperability. Originality This article proposes a digital transformation framework focused on interoperability in maintenance systems. Research method Aiming to make legacy systems work together with cyber-physical systems, the proposed framework suggests its suitability based on strategic decisions, using Multicriteria Decision Making (MCDM) methods. Main findings The framework outputs demonstrate that people are the main drivers of digital transformation and that the strategies proposed by it are coherent with the actual development of both cases, proven in a new interview one year apart from its application. Implications for theory and practice Real industrial cases demonstrate that the framework can guarantee interoperability while facilitating strategic decisions to implement technologies in legacy maintenance systems. In the end, the legacy system, which will interoperate with the new technologies, is called Smart Legacy System.

https://doi.org/10.1590/0103-6513.20220098

Microencapsulated herbal components in the diet of Lacaune ewes: impacts on physiology and milk production and quality
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CUNHA, MARILY G. DA

; ALBA, DAVI FERNANDO

; LEAL, KAROLINE W.

; MARCON, HIAM

; MILARCH, CARINE F.

; BALDISSERA, MATHEUS D.

; KAVALEK, RENATA L.

; KEMPKA, ANIELA P.

; VEDOVATTO, MARCELO

; SILVA, ALEKSANDRO S. DA

Anais da Academia Brasileira de Ciências

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2023, Volume 95 N. 2 elocation e20201805

Abstract: En | Text: En | PDF: En

Abstract This study aimed to determine whether the addition of a microencapsulated herbal blend (MHB) based on thymol, carvacrol, and cinnamaldehyde in dairy sheep feed would improve production efficiency, milk quality, and animal health. Thirty lactating Lacaune ewes were divided into three groups: Control (T0), 150 mg blend/kg of feed (T150), and 250 mg blend/kg of feed (T250). Milk was measured before the beginning of the experiment (d 0), at the end of the adaptation period (d 15), and during the experiment (d 20). In milk samples, was measured the composition, somatic cell count (SCC), reactive oxygen species (ROS), lipoperoxidation (LPO), and total antioxidant capacity. The MHB improved the milk production (only T150 vs. T0 sheep on d 20), productive efficiency and feed efficiency, and reduced the milk SCC (only T250 vs. T0 sheep, on d 20), ROS and tended to reduce the milk levels of LPO (only T250 vs. T0 sheep on d 20). Also, MHB reduced the blood levels of neutrophils and ROS (only T250 vs. T0 sheep on d 20) and increased total protein and globulin levels. Thus, a microencapsulated blend of thymol, carvacrol, and cinnamaldehyde improved the productive performance and milk quality of sheep.

https://doi.org/10.1590/0001-3765202320201805

Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023
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Teixeira, Ricardo Alkmim

; Fagundes, Alexsandro Alves

; Baggio Junior, José Mário

; Oliveira, Júlio César de

; Medeiros, Paulo de Tarso Jorge

; Valdigem, Bruno Pereira

; Teno, Luiz Antônio Castilho

; Silva, Rodrigo Tavares

; Melo, Celso Salgado de

; Elias Neto, Jorge

; Moraes Júnior, Antonio Vitor

; Pedrosa, Anisio Alexandre Andrade

; Porto, Fernando Mello

; Brito Júnior, Hélio Lima de

; Souza, Thiago Gonçalves Schroder e

; Mateos, José Carlos Pachón

; Moraes, Luis Gustavo Belo de

; Forno, Alexander Romeno Janner Dal

; D’Avila, Andre Luiz Buchele

; Cavaco, Diogo Alberto de Magalhães

; Kuniyoshi, Ricardo Ryoshim

; Pimentel, Mauricio

; Camanho, Luiz Eduardo Montenegro

; Saad, Eduardo Benchimol

; Zimerman, Leandro Ioschpe

; Oliveira, Eduardo Bartholomay

; Scanavacca, Mauricio Ibrahim

; Martinelli Filho, Martino

; Lima, Carlos Eduardo Batista de

; Peixoto, Giselle de Lima

; Darrieux, Francisco Carlos da Costa

; Duarte, Jussara de Oliveira Pinheiro

; Galvão Filho, Silas dos Santos

; Costa, Eduardo Rodrigues Bento

; Mateo, Enrique Indalécio Pachón

; Melo, Sissy Lara De

; Rodrigues, Thiago da Rocha

; Rocha, Eduardo Arrais

; Hachul, Denise Tessariol

; Lorga Filho, Adalberto Menezes

; Nishioka, Silvana Angelina D’Orio

; Gadelha, Eduardo Barreto

; Costa, Roberto

; Andrade, Veridiana Silva de

; Torres, Gustavo Gomes

; Oliveira Neto, Nestor Rodrigues de

; Lucchese, Fernando Antonio

; Murad, Henrique

; Wanderley Neto, José

; Brofman, Paulo Roberto Slud

; Almeida, Rui M. S.

; Leal, João Carlos Ferreira

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 1 elocation e20220892

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

https://doi.org/10.36660/abc.20220892

10.

Handgrip strength as a diagnostic tool for frailty risk in elderly patients with moderate to severe asthma
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Figueiredo, Ricardo G

; Holguin, Fernando

; Pizzichini, Marcia

; Pinheiro, Gabriela P

; Arata, Vanessa

; Leal, Maisa F M

; Santana, Cinthia V N

; Cruz, Álvaro A

; Bessa Júnior, José

Jornal Brasileiro de Pneumologia

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2023, Volume 49 N. 3 elocation e20220465

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

ABSTRACT Objective: To evaluate handgrip strength (HGS) as a diagnostic tool for frailty risk in elderly patients with asthma, as well as to investigate the prevalence of frailty in this population. Methods: This was a cross-sectional study including 96 patients ≥ 60 years of age diagnosed with moderate to severe asthma and treated at a tertiary referral center in Brazil. We measured HGS using a calibrated hydraulic hand dynamometer. We used a frailty scale and the AUC to assess the diagnostic accuracy of the HGS test. Results: The median age of participants was 67 years. Most (78%) were women and non-White (91%) of low socioeconomic status. HGS identified those at risk for frailty, with an AUC of 71.6% (61.5-80.4%; p < 0.002), as well as a sensitivity of 73.58% and a specificity of 67.53%, on the basis of a cutoff of ≤ 19 kgf. Conclusions: HGS appears to be a simple, reliable tool for clinicians to determine frailty risk in older asthma patients in a point-of-care setting.

RESUMO Objetivo: Avaliar a força de preensão manual (FPM) como ferramenta diagnóstica de risco de fragilidade em pacientes idosos com asma e investigar a prevalência de fragilidade nessa população. Métodos: Estudo transversal com 96 pacientes com idade ≥ 60 anos e diagnóstico de asma moderada a grave, atendidos em um centro terciário de referência no Brasil. Medimos a FPM com um dinamômetro hidráulico manual calibrado. Usamos uma escala de fragilidade e a ASC para avaliar a precisão diagnóstica do teste de FPM. Resultados: A mediana da idade dos participantes foi de 67 anos. A maioria eram mulheres (78%) não brancas (91%) cujo nível socioeconômico era baixo. O ponto de corte de FPM ≤ 19 kgf identificou os participantes que apresentavam risco de fragilidade, com ASC = 71,6% (61,5-80,4%; p < 0,002), sensibilidade = 73,58% e especificidade = 67,53%. Conclusões: A FPM parece ser uma ferramenta simples e confiável para determinar, no próprio local de atendimento médico, o risco de fragilidade em pacientes idosos com asma.

https://doi.org/10.36416/1806-3756/e20220465

11.

ESTRESSE E AUTOEFICÁCIA EM PAIS DE CRIANÇAS COM PARALISIA CEREBRAL ATÉ 12 ANOS DE IDADE
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CUNHA, Katiane da Costa

; OLIVEIRA, Ana Karoline Brito de

; PONTES, Fernando Augusto Ramos

; RAMOS, Edson Marcos Leal Soares

; SOUZA, Priscilla Bellard Mendes de

; SILVA, Simone Souza da Costa

Revista Brasileira de Educação Especial

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2023, Volume 29 elocation e0116

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

ABSTRACT Cerebral palsy is a chronic encephalopathy that affects family functioning, altering everyone’s routine and well-being. The intense care routine can lead to stress and affect parental self-efficacy. Thus, the aim of this article was to evaluate the possible association between stress and self-efficacy in parents of children with cerebral palsy. Eighty-one parents of children up to 12 years old participated in the study. The sociodemographic inventory, the gross motor functional rating scale, the parental stress index and the self-efficacy scale were used. The Correspondence Analysis Technique was also used. High levels of self-efficacy were associated with low levels of stress in the domains of parental distress [2.33 (98.00)] and dysfunctional parent-child interaction [1.12 (73.54)]. High parental self-efficacy acts as a buffer against stressful events in parents of children with cerebral palsy.

RESUMO A paralisia cerebral é uma encefalopatia crônica, que afeta o funcionamento familiar, alterando a rotina e o bem-estar de todos. A intensa rotina de cuidados pode acarretar estresse e afetar a autoeficácia parental. Assim sendo, objetivou-se, neste artigo, avaliar a possível associação entre estresse e autoeficácia em pais de crianças com paralisia cerebral. Participaram do estudo 81 pais de crianças com até 12 anos de idade. Utilizaram-se o inventário sociodemográfico, a escala de classificação funcional motora grossa, o Índice de Estresse Parental e a Escala de autoeficácia. A Técnica de Análise de Correspondência também foi usada. Altos níveis de autoeficácia foram associados a baixos índices de estresse nos domínios sofrimento parental [2.33 (98.00)] e interação disfuncional pai e filho [1.12 (73.54)]. A autoeficácia parental elevada funciona como um amortecedor dos eventos geradores de estresse em pais de crianças com paralisia cerebral.

https://doi.org/10.1590/1980-54702023v29e0116

12.

The use of bedside echocardiography in the care of critically ill patients - a joint consensus document of the Associação de Medicina Intensiva Brasileira, Associação Brasileira de Medicina de Emergência and Sociedade Brasileira de Medicina Hospitalar. Part 2 - Technical aspects
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Pellegrini, José Augusto Santos

; Mendes, Ciro Leite

; Gottardo, Paulo César

; Feitosa, Khalil

; John, Josiane França

; Oliveira, Ana Cláudia Tonelli de

; Negri, Alexandre Jorge de Andrade

; Grumann, Ana Burigo

; Barros, Dalton de Souza

; Negri, Fátima Elizabeth Fonseca de Oliveira

; Macedo, Gérson Luiz de

; Neves, Júlio Leal Bandeira

; Rodrigues, Márcio da Silveira

; Spagnól, Marcio Fernando

; Ferez, Marcus Antonio

; Chalhub, Ricardo Ávila

; Cordioli, Ricardo Luiz

Critical Care Science

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2023, Volume 35 N. 2 Pages 117 - 146

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

ABSTRACT Echocardiography in critically ill patients has become essential in the evaluation of patients in different settings, such as the hospital. However, unlike for other matters related to the care of these patients, there are still no recommendations from national medical societies on the subject. The objective of this document was to organize and make available expert consensus opinions that may help to better incorporate echocardiography in the evaluation of critically ill patients. Thus, the Associação de Medicina Intensiva Brasileira, the Associação Brasileira de Medicina de Emergência, and the Sociedade Brasileira de Medicina Hospitalar formed a group of 17 physicians to formulate questions relevant to the topic and discuss the possibility of consensus for each of them. All questions were prepared using a five-point Likert scale. Consensus was defined a priori as at least 80% of the responses between one and two or between four and five. The consideration of the issues involved two rounds of voting and debate among all participants. The 27 questions prepared make up the present document and are divided into 4 major assessment areas: left ventricular function, right ventricular function, diagnosis of shock, and hemodynamics. At the end of the process, there were 17 positive (agreement) and 3 negative (disagreement) consensuses; another 7 questions remained without consensus. Although areas of uncertainty persist, this document brings together consensus opinions on several issues related to echocardiography in critically ill patients and may enhance its development in the national scenario.

RESUMO A ecocardiografia do paciente grave tem se tornado fundamental na avaliação de pacientes em diferentes cenários e ambientes hospitalares. Entretanto, ao contrário de outras áreas relativas ao cuidado com esses pacientes, ainda não existem recomendações de sociedades médicas nacionais acerca do assunto. O objetivo deste documento foi organizar e disponibilizar opiniões de consenso de especialistas que possam auxiliar a melhor incorporação dessa técnica na avaliação de pacientes graves. Dessa forma, a Associação de Medicina Intensiva Brasileira, a Associação Brasileira de Medicina de Emergência e a Sociedade Brasileira de Medicina Hospitalar compuseram um grupo de 17 médicos para formular questões pertinentes ao tópico e debater a possibilidade de consenso de especialistas para cada uma delas. Todas as questões foram elaboradas no formato de escala Likert de cinco pontos. Consenso foi definido, a priori, como um somatório de, ao menos, 80% das respostas entre um e dois ou entre quatro e cinco. A apreciação das questões envolveu dois ciclos de votação e debate entre todos os participantes. As 27 questões elaboradas compõem o presente documento e estão divididas em 4 grandes áreas de avaliação: da função ventricular esquerda; da função ventricular direita; diagnóstica dos choques e hemodinâmica. Ao fim do processo, houve 17 consensos positivos (concordância) e 3 negativos (discordância); outras 7 questões persistiram sem consenso. Embora persistam áreas de incerteza, este documento reúne opiniões de consenso para diversas questões relativas à ecocardiografia do paciente grave e pode potencializar seu desenvolvimento no cenário nacional.

https://doi.org/10.5935/2965-2774.20230310-en

13.

FONTES DE MATÉRIA ORGÂNICA PARA OS SEDIMENTOS SUPERFICIAIS DO ESTUÁRIO DO RIO ITAPICURU (BAHIA - BRASIL)
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Santana, Juliana de Souza

; Leal, Iasmim de Deus Gargur

; Queiroz, Antonio Fernando de Souza

; Assumpção, Henrique Cesar Pereira

; Souza, José Roberto Bispo de

; Zucchi, Maria do Rosário

; Albergaria-Barbosa, Ana Cecília Rizzatti de

Química Nova

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2023, Volume 46 N. 6 Pages 608 - 615

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

ORGANIC MATTER SOURCES TO THE SUPERFICIAL SEDIMENT OF THE ITAPICURU RIVER ESTUARY (BAHIA - BRAZIL). The present study evaluated the sources of organic matter (O.M.) in the Itapicuru River estuary (IRE), which is in an environmentally protected area surrounded by the Atlantic Rainforest in the northeast of Brazil. Eleven sediment samples were collected along the study area. Total organic carbon (TOC) and the δ13C values were determined using an elemental analyzer coupled with an isotope ratio mass spectrometer. The n-alkanes composition was evaluated through gas chromatography coupled to a flame ionization detector. TOC and total n-alkanes concentrations ranged, respectively, from not detected to 0.72%, and from lower the limit of detection to 5024 ng g-1. There was a significant concentration of n-C22 and n-C24 in some samples showing bacterial production and recycling of O.M. Values of δ13C ranged from -27.6 to -21.9‰. Carbon preference index, terrestrial-aquatic ratio, aquatic production index, average chain length, and the ratio between n-C29 and n-C31 values ranged, respectively, from 1.42 to 4.11; 2.82 to 9.40; 0.00 to 0.25; 27.7 to 29.9; and 0.27 to 0.43. These results show that concentrations of O.M. to IRE are low, and its main source is C3 plants, such as those from mangroves. There is also the contribution of macrophytes.

https://doi.org/10.21577/0100-4042.20230056

14.

Tumor necrosis factor α, and agonist and antagonists of cannabinoid receptor type 1 and type 2 alter the immunophenotype of stem cells from human exfoliated deciduous teeth
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Trevizani, Marizia

; Leal, Laís Lopardi

; Rettore, João Vitor Paes

; Macedo, Gilson Costa

; Alves, Caio César de Souza

; Castro, Sandra Bertelli Ribeiro de

; Carmo, Antônio Márcio Resende do

; Silva, Silvioney Augusto da

; Maranduba, Carlos Magno da Costa

; Silva, Fernando de Sá

einstein (São Paulo)

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2023, Volume 21 elocation eAO0405

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. Methods Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. Results The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. Conclusion Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules.

https://doi.org/10.31744/einstein_journal/2023ao0405

15.

Point-Of-Care Cardiac Ultrasound:is it time for anesthesiologists to embrace and achieve competence? PointOfCare Point Of Care Ultrasoundis Ultrasound is competence
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Papa, Fabio de V.

; Galhardo Jr, Carlos

; Pontes, João Paulo Jordão

; Alves, Rodrigo Leal

; Zamper, Raffael

; Salgado, Marcello

; da Costa, Luiz Guilherme Villares

; Lineburger, Eric Benedet

; dos Reis Falcão, Luiz Fernando

Brazilian Journal of Anesthesiology

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2023, Volume 73 N. 4 Pages 367 - 369

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.bjane.2023.06.001

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