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Cuidados de enfermagem promotores do conforto à pessoa em situação paliativa: protocolo de scoping review
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Ramos, Olga Alexandra Moura

; Monteiro de Sá, José Alberto Fernandes Traila

; Figuerola, Marta Millan

; Augusto, Maria Cristina Bompastor

; Gomes, Maria José Almendra Rodrigues

Revista Onconews

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dec 2023, N. 47 elocation e0162

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

Abstract Introduction: Comfort is sensitive to nursing care and results from satisfying the need for relief, tranquility, and transcendence in the physical, psycho-spiritual, social, and environmental dimensions. Objective: To map the available scientific evidence on nursing care that promotes comfort in palliative care. Inclusion criteria: Primary studies that report nursing care in promoting comfort to people in palliative care. Methods: Scoping review protocol according to the Joanna Briggs Institute recommendations. Published and unpublished studies, with a quantitative, qualitative, or mixed methods approach. Complete search in MEDLINE Complete, CINAHL Complete, Scopus, Web of Science, RCAAP and OpenGrey databases. Screening of studies performed by title and abstract, with subsequent analysis of the full text by two independent reviewers who will extract and categorize data according to content. Research protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/CN258). Conclusions: It is hoped to contribute to the clarification of concepts and to the definition of a theoretical framework that underpins the nursing intervention in the promotion of comfort to the person in a palliative situation.

Resumo Introdução: O conforto é sensível aos cuidados de enfermagem e resulta da satisfação da necessidade de alívio, tranquilidade e transcendência, nas dimensões física, psicoespiritual, social e ambiental. Objetivo: Mapear a evidência científica disponível sobre os cuidados de enfermagem que promovem o conforto na pessoa em situação paliativa. Critérios de inclusão: Estudos primários que relatem os cuidados de enfermagem na promoção do conforto à pessoa em situação paliativa. Métodos: Protocolo de scoping review segundo as recomendações do Joanna Briggs Institute. Estudos publicados e não publicados, com abordagem quantitativa, qualitativa ou de métodos mistos. Pesquisa completa nas bases de dados MEDLINE Complete, CINAHL Complete, Scopus, Web of Science, RCAAP e OpenGrey. Triagem dos estudos realizada pelo título e resumo, com posterior análise do texto integral por dois revisores independentes que farão a extração e categorização dos dados em função do conteúdo. Protocolo de pesquisa registado na Open Science Framework (DOI 10.17605/OSF.IO/CN258). Conclusões: Espera-se contribuir para a clarificação de conceitos e para a definição de um quadro teórico que fundamente a intervenção de enfermagem na promoção do conforto à pessoa em situação paliativa.

Resumen Introducción: El confort es sensible a los cuidados de enfermería y resulta de la satisfacción de la necesidad de alivio, tranquilidad y trascendencia, en las dimensiones física, psico-espiritual, social y ambiental. Objetivo: Mapear la evidencia científica disponible sobre los cuidados de enfermería que promuevem el confort em el entorno de los cuidados paliativos. Criterios de inclusión: Estudios primarios sobre cuidados de enfermería promotores del confort de la persona en situación paliativa. Métodos: Protocolo de revisión de alcance según las recomendaciones del Joanna Briggs Institute. Estudios publicados y no publicados, con enfoque cuantitativo, cualitativo o métodos mixtos. Búsqueda completa en las bases de datos MEDLINE Complete, CINAHL Complete, Scopus, Web of Science, RCAAP y OpenGrey. Cribado de los estudios realizado por título y resumen, com posterior análisis del texto completo por dos revisores independientes que extraerán y categorizarán los datos según el contenido. Protocolo de investigación registrado en el Open Science Framework (DOI 10.17605/OSF.IO/CN258). Conclusiones: Se espera contribuir a la clarificación de conceptos y a la definición de un marco teórico que sustente la intervención enfermera en la promoción del confort de la persona en situación paliativa.

https://doi.org/10.31877/on.2023.47.04

An online platform for COVID-19 diagnostic screening using a machine learning algorithm
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Souza Filho, Erito Marques de

; Tavares, Rodrigo de Souza

; Dembogurski, Bruno José

; Gagliano, Alice Helena Nora Pacheco

; Pacheco, Luiz Carlos de Oliveira

; Pacheco, Luiz Gabriel de Resende Nora

; Carmo, Filipe Braida do

; Alvim, Leandro Guimarães Marques

; Monteiro, Alexandra

Revista da Associação Médica Brasileira

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2023, Volume 69 N. 4 elocation e20221394

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: COVID-19 has brought emerging public health emergency and new challenges. It configures a complex panorama that has been requiring a set of coordinated actions and has innovation as one of its pillars. In particular, the use of digital tools plays an important role. In this context, this study presents a screening algorithm that uses a machine learning model to assess the probability of a diagnosis of COVID-19 based on clinical data. METHODS: This algorithm was made available for free on an online platform. The project was developed in three phases. First, an machine learning risk model was developed. Second, a system was developed that would allow the user to enter patient data. Finally, this platform was used in teleconsultations carried out during the pandemic period. RESULTS: The number of accesses during the period was 4,722. A total of 126 assistances were carried out from March 23, 2020, to June 16, 2020, and 107 satisfaction survey returns were received. The response rate to the questionnaires was 84.92%, and the ratings obtained regarding the satisfaction level were higher than 4.8 (on a 0–5 scale). The Net Promoter Score was 94.4. CONCLUSION: To the best of our knowledge, this is the first online application of its kind that presents a probabilistic assessment of COVID-19 using machine learning models exclusively based on the symptoms and clinical characteristics of users. The level of satisfaction was high. The integration of machine learning tools in telemedicine practice has great potential.

https://doi.org/10.1590/1806-9282.20221394

Sustainable composites of eco-friendly polyethylene reinforced with eggshells and bio-calcium carbonate
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Vieira, Kássia Peçanha

; Reichert, Alexandra Augusta

; Cholant, Gabriel Monteiro

; Marin, Dielen

; Beatrice, Cesar Augusto Gonçalves

; Oliveira, Amanda Dantas de

Polímeros

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2023, Volume 33 N. 3 elocation e20230026

Abstract: En | Text: En | PDF: En

Abstract This work aimed to obtain and analyze composite materials made from green polyethylene and calcium carbonate extracted from chicken eggshells. The shells were collected and prepared for later extraction of calcium carbonate. With the X-ray diffraction analysis it was possible to confirm that both the in natura reinforcement and the calcined one, have the same polymorph mineral (calcite). With regard to thermal behavior, compounds with in natura reinforcement showed greater mass loss due to the moisture contained in them. The results showed a significant increase in Young’s moduli of the composites compared to the pure polymer. The scanning electron microscopy showed good dispersion and adhesion between the reinforcement materials and matrix. In view of the results, eggshells have the potential to be used as fillers, where greater rigidity is required. Since these materials come from a waste material, with low cost, their use becomes even more viable.

https://doi.org/10.1590/0104-1428.20220108

Neoliberalism, Welfare crisis and Social Work in Italy: the analysis of the M’Imprendo Project
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Mustafá, Maria Alexandra da Silva Monteiro

Serviço Social & Sociedade

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dec 2022, N. 145 Pages 33 - 52

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

Resumo: Este artigo, resultado de pesquisa de pós-doutorado, buscou apreender as interconexões entre o Welfare e o Serviço Social italiano, e analisar os impactos da sua crise e do avanço do neoliberalismo nas políticas sociais, a partir do estudo do Projeto M’Imprendo. Identificou que existe uma cultura de direitos e de cidadania na Itália, herança do Welfare, e que tais impactos ameaçam a formação/prática do assistente social que tem um influxo da Sociologia e das Ciências Sociais no âmbito acadêmico.

Abstract: This article, the result of a Postdoctoral research, sought to understand the interconnections between Welfare and Italian Social Service and analyze the impacts of its crisis and the advance of neoliberalism in social policies, based on the study of the M’Imprendo Project. He identified that there is a culture of rights and citizenship in Italy, heritage of Welfare, and that such impacts threaten the training/practice of the social worker who has an influence of Sociology and Social Sciences in the academic sphere.

https://doi.org/10.1590/0101-6628.291

Neoliberalismo, crise do Welfare e Serviço Social na Itália: uma análise do Projeto M’Imprendo
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Mustafá, Maria Alexandra da Silva Monteiro

Serviço Social & Sociedade

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dec 2022, N. 145 Pages 12 - 32

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

https://doi.org/10.1590/0101-6628.290

Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil
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Cajueiro, Francisco Candido Monteiro

; Croti, Ulisses Alexandre

; Barufi, Alexandra Regina Siscar

; Bodini, André Luís de Andrade

; Postigo, Karolyne Barroca Sanches

; Marchi, Carlos Henrique De

; Santos, Fernando Cesar Gimenes Barbosa

; Beani, Lilian

; Borim, Bruna Cury

; Godoy, Moacir Fernandes

; Moscardini, Airton Camacho

Brazilian Journal of Cardiovascular Surgery

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jun 2022, Volume 37 N. 3 Pages 281 - 291

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Pediatric heart transplantation is the definitive therapy for children with end-stage heart failure. This paper describes our initial experience in pediatric heart transplantation in a tertiary center in Brazil Methods: This is a historical prospective descriptive cohort study based on a review of the medical records of children undergoing heart transplantation at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto. Variables were displayed as frequency, mean, or median. Statistical analysis and Kaplan-Meier actuarial curve were obtained with the aid of Microsoft® Excel® 2019 and STATSDirect version 3.3.5. Results: Between January 2010 and December 2020, ten children underwent bicaval orthotopic heart transplantation, 30% of which were under one year of age. Nine patients had end-stage heart failure (International Society for Heart and Lung Transplantation-Heart Failure D) and 50% of the recipients were transplanted under conditions of progressive clinical deterioration (Interagency Registry for Mechanically Assisted Circulatory Support ≤ 2). Forty percent of the recipients had a panel-reactive antibody > 20% on virtual crossmatch. In the postoperative period, 80% of patients required high dose of inotropic support (vasoactive-inotropic score > 10) for > 48 hours. The death-free survival rate at 131 months was 77.1±14.4%. Most patients (88.9%) in late follow-up had an episode of active cytomegalovirus infection. Cellular rejection, with or without clinical repercussion, was present in 44.4% of the patients. Conclusion: Pediatric heart transplantation produces acceptable and feasible outcomes as definitive therapy for children with end-stage heart failure.

https://doi.org/10.21470/1678-9741-2021-0483

Effect of Lippia grata essential oil as a feed additive on the performance of tambatinga juveniles
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COSTA, Thaisa Sales

; SILVA, Rafael Carvalho da

; PRETTO, Alexandra

; MONTEIRO, Odair dos Santos

; SIQUEIRA, Jefferson Costa de

; BALDISSEROTTO, Bernardo

; LOPES, Jane Mello

Acta Amazonica

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apr 2022, Volume 52 N. 2 Pages 122 - 130

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

RESUMO Lippia grata (previamente conhecida como Lippia gracillis) é uma planta aromática nativa do Brasil, com folhas ricas em óleos essenciais que possuem atividades biológicas significativas. Avaliamos o efeito do óleo essencial de L. grata (OELG) como aditivo alimentar sobre o crescimento, índices somáticos e parâmetros bioquímicos de juvenis (5,25 ± 0,26 g) de tambatinga, um hibrido obtido do cruzamento de tambaqui (Colossoma macropomum) com pirapitinga (Piaractus brachypomum) com grande importância econômica no norte e nordeste do Brazil. Foram avaliados quatro tratamentos dietéticos consistindo na suplementação com OELG em 0,0; 0,5; 1,0 e 2,0 mL kg-1 durante 60 dias. O rendimento de carcaça foi significativamente maior nos peixes alimentados com todas as dietas contendo OELG em comparação à dieta controle. Os animais do tratamento 0,5 mL kg-1 ganharam significativamente mais peso e apresentaram maior taxa de crescimento específico do que aqueles tratados com 1,0 e 2,0 mL kg-1 OELG, embora nenhum tenha diferido significativamente do controle. A taxa de conversão alimentar foi significativamente menor no tratamento 0,5 mL kg-1 do que no tratamento 1,0 mL kg-1. Comparada com as concentrações mais altas, a dieta contendo 0,5 mL kg-1 OELG aumentou o uso de glicogênio muscular, glicose e lactato para suprir as demandas energéticas, evitando o uso de proteína muscular. Nossos resultados sugerem que a suplementação dietética com OELG melhora significativamente o rendimento de carcaça de juvenis de tambatinga, mas concentrações acima de 0,5 mL kg-1 podem comprometer as taxas de crescimento e metabolismo de carboidratos desses peixes.

ABSTRACT Lippia grata (formerly known as Lippia gracillis) is an aromatic plant native to Brazil, with leaves rich in essential oils that possess significant biological activities. We evaluated the effect of essential oil of L. grata (EOLG) as a dietary additive on the growth, somatic indices, and biochemical parameters of juveniles (5.25 ± 0.26 g) of tambatinga, a hybrid fish obtained by crossing tambaqui (Colossoma macropomum) with pirapitinga (Piaractus brachypomum) of great economic importance in north and northeastern Brazil. We evaluated four dietary treatments, consisting of EOLG supplemented at 0.0, 0.5, 1.0, and 2.0 mL kg-1, over 60 days. Carcass yield was significantly higher in fish fed all EOLG diets compared to those fed the control diet (0.0 mL kg-1). Animals that received the 0.5 mL kg-1 treatment gained significantly more weight and showed a higher specific growth rate than those treated with 1.0 and 2.0 ml kg-1 EOLG, although none differed significantly from the control. The feed conversion rate was significantly lower in the 0.5 than in the 1.0 mL kg-1 treatment. Compared with higher concentrations, the diet containing 0.5 mL kg-1 EOLG increased the use of muscle glycogen, glucose, and lactate to meet energy demands, avoiding the use of muscle protein. Our results suggest that dietary supplementation with EOLG significantly improves carcass yield in tambatinga juveniles but that concentrations above 0.5 mL kg-1 may compromise growth rates and carbohydrate metabolism in this fish.

https://doi.org/10.1590/1809-4392202102442

Challenges in Telemedicine: Even When the Road is Hard, Never Give up
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Souza Filho, Erito Marques de

; Monteiro, Alexandra

International Journal of Cardiovascular Sciences

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mar 2022, Volume 35 N. 2 Pages 159 - 160

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20220014

A importância das “cores finas”: notas sobre pintores e os seus materiais de trabalho na pintura mural do Alentejo (séculos XVI-XIX)
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Monteiro, Patrícia Alexandra Rodrigues

Cadernos do Arquivo Municipal

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dec 2021, Volume ser2 N. 16 Pages 79 - 96

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

Resumo No Alentejo existe um conjunto de técnicas tradicionais decorativas (esgrafito, stucco, pintura mural) que utilizaram a cal e os pigmentos locais como base, formando um património artístico bastante expressivo. De entre todas, a pintura mural foi a que mais marcou a imagem desta região, exigindo hoje, cada vez mais, um olhar interdisciplinar. Neste contexto, a documentação histórica torna-se uma ferramenta essencial. Através da sua consulta, levantamento e sistematização é possível reunir novos dados sobre os protagonistas das campanhas murais, bem como os materiais que utilizavam. Estas informações serão auxiliares importantes no momento de se traçarem intervenções de conservação e restauro ajustadas a cada caso. No presente artigo apresentaremos exemplos de campanhas de pintura mural documentadas, onde foram identificadas referências a materiais e a pintores, alguns dos quais desconhecidos. Pretendemos, assim, contribuir para a caracterização do contexto laboral dos pintores entre o final do século XVI e o início do século XIX.

Abstract In Alentejo there is a set of traditional decorative techniques (esgrafito, stucco, mural painting) that used lime and local pigments as a base, forming a very expressive artistic heritage. Amongst all, mural painting was the one that most marked the image of this region, requiring an interdisciplinary look. In this context, the research, survey and systematization of historical documentation becomes an essential tool. Through it is possible to gather new data about the protagonists involved in the mural campaigns, as well as the materials they used. This information will be an important tool when designing conservation and restoration interventions, tailored to each case. In this article we will present examples of documented mural painting campaigns, where references to materials and painters have been identified, some of them unknown. Thus, we intend to contribute to the characterization of the work context of painters between late 16th century and the beginning of the 19th century.

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10.

Reflexões sobre o plágio e a fraude em estudos brasileiros
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Alencar, Gildiney Penaves de

; Monteiro, Geanlucas Mendes

; Carvalho, Alexandra Maria Almeida

Revista Bioética

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jul 2021, Volume 29 N. 3 Pages 641 - 647

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

Resumo Este estudo reflete sobre o plágio e a fraude na produção científica brasileira por meio de revisão integrativa de artigos publicados entre janeiro de 2009 e junho de 2019. As publicações foram buscadas nas bases DOAJ, Lilacs, PubMed, SciELO e Web of Science, com os descritores exatos “plagiarism”, “scientific misconduct”, “fraud” e “Brazil”. Com a rápida expansão da internet e o desenvolvimento tecnológico, os casos de má conduta na produção científica aumentaram, ocorrendo, por exemplo, adulteração, invenção ou reutilização de dados, múltiplas submissões, conflitos de autoria e de interesses, publicação “salame” (fracionada) e plágio. Entre as más condutas acadêmicas mais comuns estão a “cola” e o plágio, presentes nos mais diversos níveis de ensino, da educação básica à educação superior.

Abstract This integrative review reflects on plagiarism and fraud in Brazilian studies based on scientific production and academic attitude. Literature search of articles published between January 2009 and June 2019 was conducted in the DOAJ, LILACS, PubMed, SciELO and Web of Science databases, using the exact descriptors “Plagiarism,” “Scientific Misconduct,” “Fraud” and “Brazil.” The rapid expansion of the internet and technological development lead to increased cases of misconduct in scientific production, occurring, for example, tampering, fabrication or reuse of data, multiple submissions, conflicts of authorship and interests, salami publication (salami slicing) and plagiarism. Among the most common academic misconducts are the copying and plagiarism, present at all education levels, whether in primary or tertiary education.

Resumen Este estudio promueve una reflexión sobre el plagio y el fraude en estudios brasileños basados en la producción científica y la postura académica a través de una revisión integradora de artículos publicados entre enero de 2009 y junio de 2019. Se realizó una búsqueda en las bases de datos DOAJ, LILACS, PubMed, SciELO y Web. of Science, utilizando los descriptores exactos “Plagio”, “Mala conducta científica”, “Fraude” y “Brasil”. Con la rápida expansión de Internet y el desarrollo tecnológico, han aumentado los casos de mala conducta en la producción científica, ocurriendo, por ejemplo, adulteración, invención o reutilización de datos, múltiples presentaciones, conflictos de autoría e intereses, publicación “salami” (fraccional) y plagio. Entre las faltas académicas más comunes se encuentran el “pegamento” y el plagio, presentes en los más diversos estratos, ya sea en la Educación Básica o en la Educación Superior.

https://doi.org/10.1590/1983-80422021293499 113 downloads

11.

Chest computed tomography in COVID-19 pneumonia: a retrospective study of 155 patients at a university hospital in Rio de Janeiro, Brazil
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Mogami, Roberto

; Lopes, Agnaldo Jose

; Araújo Filho, Ronaldo Carvalho

; Almeida, Fernando Carlos Santos de

; Messeder, Alexandre Malta da Costa

; Koifman, Ana Celia Baptista

; Guimarães, Amanda Barbosa

; Monteiro, Alexandra

Radiologia Brasileira

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feb 2021, Volume 54 N. 1 Pages 1 - 8

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

Resumo Objetivo: Definir os critérios diagnósticos da COVID-19 na tomografia computadorizada (TC), estudar a concordância entre a TC e o PCR e determinar a associação da extensão do envolvimento parenquimatoso e ventilação mecânica com os achados tomográficos e características clínicas da amostra. Materiais e Métodos: Estudo de 155 pacientes com COVID-19 atendidos entre março e maio de 2020. Tentamos determinar se os achados da TC se correlacionavam com a idade e variáveis clínicas, bem como se a necessidade de ventilação mecânica se correlacionava com a extensão do envolvimento pulmonar. Resultados: A faixa etária dos pacientes com COVID-19 (54,8 anos) foi maior do que a dos pacientes sem a doença (45,5 anos) (p = 0,031). Opacidades em vidro fosco foram as alterações mais frequentes (88,6%; p = 0,0001). Bandas parenquimatosas (p = 0,013), ectasia brônquica (p = 0,046) e consolidações peribroncovasculares (p = 0,012) foram mais frequentes nos pacientes que necessitaram de ventilação mecânica. Pacientes com comorbidades apresentaram envolvimento parenquimatoso mais extenso (p = 0,023). A TC apresentou sensibilidade de 84,3%, especificidade de 36,7% e acurácia de 73,5% (p = 0,012). Conclusão: Os padrões de TC são úteis para o diagnóstico de COVID-19 e avaliação dos critérios de gravidade da doença. Pacientes com comorbidades estão associados a condições clínicas mais graves.

Abstract Objective: To define diagnostic criteria for coronavirus disease 2019 (COVID-19) on computed tomography (CT); to study the correlation between CT and polymerase chain reaction (PCR) testing for infection with severe acute respiratory syndrome coronavirus 2; and to determine whether the extent of parenchymal involvement and the need for mechanical ventilation are associated with the CT findings and clinical characteristics of patients with COVID-19. Materials and Methods: This was a retrospective study of 155 patients with COVID-19 treated between March and May 2020. We attempted to determine whether the CT findings correlated with age and clinical variables, as well as whether the need for mechanical ventilation correlated with the extent of the pulmonary involvement. Results: On average, the patients with COVID-19 were older than were those without (mean age, 54.8 years vs. 45.5 years; p = 0.031). The most common CT finding (seen in 88.6%) was ground-glass opacity, which correlated significantly with a diagnosis of COVID-19 (p = 0.0001). The CT findings that correlated most strongly with the need for mechanical ventilation were parenchymal bands (p = 0.013), bronchial ectasia (p = 0.046), and peribronchovascular consolidations (p = 0.012). The presence of one or more comorbidities correlated significantly with more extensive parenchymal involvement (p = 0.023). For the diagnosis of COVID-19, CT had a sensitivity of 84.3%, a specificity of 36.7%, and an accuracy of 73.5% (p = 0.012 vs. PCR). Conclusion: The patterns of CT findings are useful for the diagnosis of COVID-19 and the evaluation of disease severity criteria. The presence of any comorbidity is associated with greater severity of COVID-19.

https://doi.org/10.1590/0100-3984.2020.0133 2277 downloads

12.

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
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Marques, Heloisa Helena de Sousa

; Pereira, Maria Fernanda Badue

; Santos, Angélica Carreira dos

; Fink, Thais Toledo

; Paula, Camila Sanson Yoshino de

; Litvinov, Nadia

; Schvartsman, Claudio

; Delgado, Artur Figueiredo

; Gibelli, Maria Augusta Bento Cicaroni

; Carvalho, Werther Brunow de

; Odone Filho, Vicente

; Tannuri, Uenis

; Carneiro-Sampaio, Magda

; Grisi, Sandra

; Duarte, Alberto José da Silva

; Antonangelo, Leila

; Francisco, Rossana Pucineli Vieira

; Okay, Thelma Suely

; Batisttella, Linamara Rizzo

; Carvalho, Carlos Roberto Ribeiro de

; Brentani, Alexandra Valéria Maria

; Silva, Clovis Artur

; Eisencraft, Adriana Pasmanik

; Rossi Junior, Alfio

; Fante, Alice Lima

; Cora, Aline Pivetta

; Reis, Amelia Gorete A. de Costa

; Ferrer, Ana Paula Scoleze

; Andrade, Anarella Penha Meirelles de

; Watanabe, Andreia

; Gonçalves, Angelina Maria Freire

; Waetge, Aurora Rosaria Pagliara

; Silva, Camila Altenfelder

; Ceneviva, Carina

; Lazari, Carolina dos Santos

; Abellan, Deipara Monteiro

; Santos, Emilly Henrique dos

; Sabino, Ester Cerdeira

; Bianchini, Fabíola Roberta Marim

; Alcantara, Flávio Ferraz de Paes

; Ramos, Gabriel Frizzo

; Leal, Gabriela Nunes

; Rodriguez, Isadora Souza

; Pinho, João Renato Rebello

; Carneiro, Jorge David Avaizoglou

; Paz, Jose Albino

; Ferreira, Juliana Carvalho

; Ferranti, Juliana Ferreira

; Ferreira, Juliana de Oliveira Achili

; Framil, Juliana Valéria de Souza

; Silva, Katia Regina da

; Kanunfre, Kelly Aparecida

; Bastos, Karina Lucio de Medeiros

; Galleti, Karine Vusberg

; Cristofani, Lilian Maria

; Suzuki, Lisa

; Campos, Lucia Maria Arruda

; Perondi, Maria Beatriz de Moliterno

; Diniz, Maria de Fatima Rodrigues

; Fonseca, Maria Fernanda Mota

; Cordon, Mariana Nutti de Almeida

; Pissolato, Mariana

; Peres, Marina Silva

; Garanito, Marlene Pereira

; Imamura, Marta

; Dorna, Mayra de Barros

; Luglio, Michele

; Rocha, Mussya Cisotto

; Aikawa, Nadia Emi

; Degaspare, Natalia Viu

; Sakita, Neusa Keico

; Udsen, Nicole Lee

; Scudeller, Paula Gobi

; Gaiolla, Paula Vieira de Vincenzi

; Severini, Rafael da Silva Giannasi

; Rodrigues, Regina Maria

; Toma, Ricardo Katsuya

; Paula, Ricardo Iunis Citrangulo de

; Palmeira, Patricia

; Forsait, Silvana

; Farhat, Sylvia Costa Lima

; Sakano, Tânia Miyuki Shimoda

; Koch, Vera Hermina Kalika

; Cobello Junior, Vilson

Clinics

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2021, Volume 76 elocation e3488

Abstract: En | Text: En | PDF: En

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

https://doi.org/10.6061/clinics/2021/e3488

13.

Risk Factors for Urinary Incontinence in Pregnancy: A Case Control Study
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Caruso, Fernanda Borsatto

; Schreiner, Lucas

; Todescatto, Alexandra Damasio

; Crivelatti, Isabel

; Oliveira, Julia Monteiro de

Revista Brasileira de Ginecologia e Obstetrícia

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dec 2020, Volume 42 N. 12 Pages 787 - 792

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

Resumo Objetivo A incontinência urinária (IU) é um importante problema de saúde pública que pode trazer prejuízos àsmulheres emqualquer período da vida, inclusive durante o período gestacional. A IU durante a gravidez temsido estudada por ser capaz de reduzir a qualidade de vida e interferir em vários aspectos do binômio materno-fetal. O objetivo deste estudo foi determinar a prevalência de IU em gestantes nulíparas e identificar fatores de risco associados a essa população. Métodos Este é um estudo de caso-controle em que foram convidadas mulheres nulíparas entre 12 e 20 semanas de gravidez para participar do projeto. Elas foram submetidas a um questionário específico, diário miccional de 3 dias e avaliação uroginecológica, incluindo quantificação de prolapso de órgãos pélvicos (POP-Q), teste de esforço com volume residual e avaliação da musculatura do assoalho pélvico. Resultados Um total de 70 das 73 pacientes aceitaram participar do estudo, e a prevalência de incontinência urinária nessa população foi de 18,3%. O uso de tabaco foi identificado como fator de risco independente para a IU em gestantes (OR 8,0). Todos os outros fatores analisados não foram significativamente associados à perda urinária nessa população. Conclusão A incontinência urinária pode trazer prejuízos para pacientes durante o período da gestação. O tabagismo foi identificado como fator de risco para o desenvolvimento de IU emgestantes, o que denotamais ummotivo para encorajar as pacientes a abandonarem o hábito.

Abstract Objective Urinay incontinence (UI) is amajor public health problemthat can harm women in any period of life, including during the gestational period. Urinary incontinence during pregnancy has been studied because this condition can reduce the quality of life and interfere in several aspects of the maternal-fetal binomial. The aim of this study was to determine the prevalence of UI in nullipara pregnant women and to identify risk factors associated with UI in this population. Methods This is a case-control study in which we invited nullipara women between 12 and 20 weeks of pregnancy to participate in the research. They were asked to answer a specific questionnaire, write a 3-day bladder diary, and undergo a urogynecological evaluation including pelvic organ prolapse quantification (POP-Q), empty stress supine test (ESST), and pelvic floor muscle assessment. Results A total of 70 out of 73 patients accepted to participate in the study, and the prevalence of UI in this population was 18.3%. Tobacco use was identified as an independent risk factor for UI in pregnant women (odds ratio 8.0). All other factors analyzed were not significantly associated to UI in pregnancy. Conclusion Urinary incontinence can be a major problem in pregnancy.We identified the use of tobacco as a risk factor for developing UI in pregnancy, which provides an extra reason to encourage patients to quit smoking.

https://doi.org/10.1055/s-0040-1718951 1474 downloads

14.

Internal carotid pseudoaneurysm caused by migration of a coronary guidewire fragment: a case of a broken arrow
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Coelho, Nuno Henriques

; Monteiro, Pedro

; Augusto, Rita

; Pinto, Evelise

; Semião, Carolina

; Ribeiro, João

; Peixoto, João

; Fernandes, Luís

; Gouveia, Ricardo

; Martins, Victor

; Canedo, Alexandra

Angiologia e Cirurgia Vascular

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sep 2020, Volume 16 N. 3 Pages 191 - 194

Abstract: En | Text: En | PDF: En

Introduction: Guidewire fracture is a rare complication of percutaneous coronary intervention (PCI). Retained fragments can cause thrombosis, dissection, perforation of the vessel or embolize. When is impossible to withdraw or to trap the fragment during the procedure, management is debatable between surgical removal or conservative approach. When choosing to leave the fragment in place, the patient remains at risk for all of the aforementioned complications. Clinical Case: 65-year-old male patient submitted to PCI with stenting of distal right coronary artery in 2017. A proximal optimization technique was performed, with a guidewire placed in the posterior descending artery (PDA). After stenting, the protection guidewire became entrapped and after several retrieval attempts, it fractured. Wire fragment remained within the RCA and ascending aorta with a free mobile distal part in the beginning of the innominate artery. Multiple attempts went in vain for wire retrieval and a conservative approach was adopted. Two and a half years later, the patient felt a sudden chest pain and then collapsed. He was transferred to our Hospital for emergent surgery due to cardiac tamponade. Intra-operatively, cardiac surgeons found the guidewire perforating the posterior descending artery. When trying to pull it out, the guidewire fractured again. Post-intervention CTA revealed migration of the fragmented guidewire now it was entrapped in a tortuous initial portion of the right internal carotid artery and a small pseudoaneurysm was visible at the distal portion of the wire. Surgical approach was performed revealing the presence of the wire within the carotid medial wall, in a subintimal plane. The 7 cm fragment was successfully withdrawn, through a common carotid transverse incision. Pseudoaneurismectomy was performed and carotid artery bifurcation reconstruction with internal carotid artery re-implantation into the bifurcation, end-to-end anastomosis. The patient had an uneventful postoperative course. Conclusion: Although leaving the wire in place remains an option, coronary guidewire fractured fragments can be associated not only with immediate complications but also with potential adverse events in the long run.

230 downloads

15.

Telecardiology on the Diagnostic Support of Chest Pain in Twenty-Two Emergency Care Units (UPA 24h) in The State of Rio de Janeiro
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Farah, Simone

; Andréa, Bruno Rustum

; Silva, Rogério Casemiro da

; Monteiro, Alexandra

International Journal of Cardiovascular Sciences

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apr 2019, Volume 32 N. 2 Pages 158 - 162

Abstract: En | Text: En | PDF: En

Abstract Background: Telecardiology may be a useful support in diagnosis and management of chest pain. Objective: Evaluate the application of telecardiology to support the differential diagnosis of chest pain in patients admitted to Emergency Care Units. Method: Observational, retrospective and documental study of 5,816 patients admitted with supposedly cardiological chest pain in twenty two Emergency Care Units in the state of Rio de Janeiro. Data were tabulated and analyzed by Excel® software, using simple descriptive statistics, from the database of the Cardiology Consultancy Nucleus. Results: Diagnostic disagreement was found in 1,593 (27.39%) cases. Of these, 1,477 (92.72%) were diagnosed locally as non-ST-elevation myocardial infarction (non-STEMI), 74 (4.64%) as acute myocardial infarction with ST-segment elevation (STEMI), 40 (2.52%) as acute pulmonary edema (APE) and 2 (0.12%) as tachyarrhythmia. Intensive care referral was requested to 100% of these patients. After telecardiology, the diagnoses were: 385 (24.17%) unstable angina, 289 (18.14%) congestive heart failure, 212 (13.31%) APE, 174 (10.92%) STEMI, 152 (9.54%) hypertensive emergency, 113 (7.09%) acute chronic renal failure, 89 (5.59%) non-STEMI, 89 (5.59%) pneumonia, 39 (2.45%) sepsis, 26 (1.63 %) myopericarditis, 20 (1.26%) tachyarrhythmia and 5 (0.31%) orovalvar disease. The outcome after telecardiology was 1,178 discharges (73.94%), 338 (21.21%) referrals, 62 (3.90%) deaths and 15 (0.95%) unknown. Conclusion: Telecardiology was effective in chest pain diagnosis and management, optimizing hospital admission in the public health system.

https://doi.org/10.5935/2359-4802.20180099 733 downloads

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