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ABSTRACT Objective: To examine the associations between self-reported screen time and symptoms of stress, anxiety, and depression in adolescents. Methods: A cross-sectional study was conducted with 982 adolescents aged between 12 and 15 years, enrolled in public schools in Jacarezinho (PR), Brazil. Screen time was assessed by the question “Considering a typical day, how much time do you spend watching TV, playing videogame, using computer or smartphone?” The DASS-21 questionnaire (short form) was used to assess symptoms of depression, anxiety, and stress. Crude and adjusted analyses (age, sex, and maternal level of education) between screen time and mental disorders symptoms were performed using general linear regression models, with Poisson distribution, with significance level at p<0.05. Results: Higher depressive symptoms were observed in adolescents who reported screen time of 4–6 hours/day (PR 1.35, 95%CI 1.13–1.61) and ≥6 hours/day (PR 1.88, 95%CI 1.62–2.19), compared with their pairs with <2 hours/day. The same was observed for anxiety symptoms with screen time of 4–6 hours/day (PR 1.23, 95%CI 1.04–1.46) and ≥6 hours/day (PR 1.50, 95%CI 1.28–1.77); and stress, with 4–6 hours/day (PR 1.25, 95%CI 1.08–1.44) and ≥6 hours/day (PR 1.49, 95%CI 1.30–1.71), also compared with their pairs with <2 hours/day. Conclusions: Screen time was positively associated with depressive, anxiety, and stress symptoms in adolescents. Special attention should be given to those who spend more than four hours a day in front of a screen. Objective selfreported self Methods crosssectional cross sectional 98 1 years PR, PR , (PR) Brazil Considering TV videogame smartphone smartphone? DASS21 DASS 21 DASS-2 short form age, age (age sex education models distribution p005 p 0 05 p<0.05 Results 46 4 6 4– hoursday 135 35 1.35 95CI CI 95 1.13–1.61 113161 13 61 ≥ 188 88 1.88 1.62–2.19, 162219 1.62–2.19 62 2 19 1.62–2.19) < 123 23 1.23 1.04–1.46 104146 04 150 50 1.50 1.28–1.77 128177 28 77 1.28–1.77) 125 25 1.25 1.08–1.44 108144 08 44 149 49 1.49 1.30–1.71, 130171 1.30–1.71 30 71 1.30–1.71) Conclusions 9 DASS2 DASS- p00 p<0.0 3 1.3 1.13–1.6 11316 18 8 1.8 16221 1.62–2.1 1.2 1.04–1.4 10414 5 1.5 1.28–1.7 12817 7 1.08–1.4 10814 14 1.4 13017 1.30–1.7 p0 p<0. 1. 1.13–1. 1131 1622 1.62–2. 1.04–1. 1041 1.28–1. 1281 1.08–1. 1081 1301 1.30–1. p<0 1.13–1 113 162 1.62–2 1.04–1 104 1.28–1 128 1.08–1 108 130 1.30–1 p< 1.13– 11 16 1.62– 1.04– 10 1.28– 1.08– 1.30– 1.13 1.62 1.04 1.28 1.08 1.30 1.1 1.6 1.0

RESUMO Objetivo: Examinar a associação entre o tempo de tela autorreportado e os sintomas de estresse, ansiedade e depressão em adolescentes. Métodos: Foi realizado estudo com delineamento transversal com 982 adolescentes entre 12-15 anos, matriculados na rede pública de ensino da cidade de Jacarezinho (PR). Para mensurar o tempo de tela, os adolescentes responderam à pergunta: “Considerando um dia típico, quanto tempo você passa assistindo TV, jogando videogame, usando computador ou smartphone?”. O questionário DASS-21 (versão curta) foi utilizado para avaliar os sintomas de depressão, ansiedade e estresse. Análises brutas e ajustadas (idade, sexo e nível de escolaridade materna) entre tempo de tela e indicadores de saúde mental foram realizadas por meio do modelo de regressão linear generalizado, com distribuição de Poisson, adotando a significância de p<0,05. Resultados: Maiores sintomas depressivos foram observados em adolescentes com tempo de tela de 4–6 horas/dia (RP 1,35, IC95% 1,13–1,61) e ≥6 horas/dia (RP 1,88, IC95% 1,62–2,19) quando comparados com seus pares com ≤2 horas/dia. O mesmo foi observado para os sintomas de ansiedade com tempo de tela de 4–6 horas/dia (RP 1,23, IC95% 1,04–1,46) e ≥6 horas/dia (RP 1,50, IC95% 1,28–1,77); e estresse, com 4–6 horas/dia (RP 1,25, IC95% 1,08–1,44) e ≥6 horas/dia (RP 1,49, IC95% 1,30–1,71), também comparados com seus pares com ≤2 horas/dia. Conclusões: O tempo de tela foi associado positivamente com os sintomas de depressão, ansiedade e estresse em adolescentes. Atenção especial deve ser dada àqueles que passam mais de quatro horas por dia em frente a uma tela. Objetivo Métodos 98 1215 12 15 12-1 anos PR. PR . (PR) pergunta Considerando típico TV videogame smartphone. smartphone smartphone?” DASS21 DASS 21 DASS-2 versão curta idade, idade (idade materna generalizado Poisson p005 p 0 05 p<0,05 Resultados 46 4 6 4– horasdia RP 135 1 35 1,35 IC95 IC 1,13–1,61 113161 13 61 ≥ 188 88 1,88 1,62–2,19 162219 62 2 19 ≤ 123 23 1,23 1,04–1,46 104146 04 150 50 1,50 1,28–1,77 128177 28 77 1,28–1,77) 125 25 1,25 1,08–1,44 108144 08 44 149 49 1,49 1,30–1,71, 130171 1,30–1,71 , 30 71 1,30–1,71) Conclusões 9 121 12- (PR smartphone? DASS2 DASS- p00 p<0,0 3 1,3 IC9 1,13–1,6 11316 18 8 1,8 1,62–2,1 16221 1,2 1,04–1,4 10414 5 1,5 1,28–1,7 12817 7 1,08–1,4 10814 14 1,4 13017 1,30–1,7 p0 p<0, 1, 1,13–1, 1131 1,62–2, 1622 1,04–1, 1041 1,28–1, 1281 1,08–1, 1081 1301 1,30–1, p<0 1,13–1 113 1,62–2 162 1,04–1 104 1,28–1 128 1,08–1 108 130 1,30–1 p< 1,13– 11 1,62– 16 1,04– 10 1,28– 1,08– 1,30– 1,13 1,62 1,04 1,28 1,08 1,30 1,1 1,6 1,0

https://doi.org/10.1590/1984-0462/2025/43/2023250

Disease progression in Sanfilippo type B: Case series of Brazilian patients B
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Montenegro, Yorran Hardman Araújo

; Kubaski, Francyne

; Trapp, Franciele Barbosa

; Riegel-Giugliani, Mariluce

; Souza, Carolina Fischinger Moura de

; Ribeiro, Erlane Marques

; Lourenço, Charles Marques

; Cardoso-dos-Santos, Augusto César

; Ribeiro, Márcia Gonçalves

; Kim, Chong Ae

; Castro, Matheus Augusto Araújo

; Embiruçu, Emília Katiane

; Steiner, Carlos Eduardo

; Vairo, Filippo Pinto e

; Baldo, Guilherme

; Giugliani, Roberto

; Poswar, Fabiano de Oliveira

Genetics and Molecular Biology

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2024, Volume 47 Nº 1 elocation e20230285

Resumo: En | Texto: En | PDF: En

Abstract Mucopolysaccharidosis type IIIB (MPS IIIB) is caused by deficiency of alpha-N-acetylglucosaminidase, leading to storage of heparan sulphate. The disease is characterized by intellectual disability and hyperactivity, among other neurological and somatic features. Here we studied retrospective data from a total of 19 MPS IIIB patients from Brazil, aiming to evaluate disease progression. Mean age at diagnosis was 7.2 years. Speech delay was one of the first symptoms to be identified, around 2-3 years of age. Behavioral alterations include hyperactivity and aggressiveness, starting around age four. By the end of the first decade, patients lost acquired abilities such as speech and ability to walk. Furthermore, as disease progresses, respiratory, cardiovascular and joint abnormalities were found in more than 50% of the patients, along with organomegaly. Most common cause of death was respiratory problems. The disease progression was characterized in multiple systems, and hopefully these data will help the design of appropriate clinical trials and clinical management guidelines. alphaNacetylglucosaminidase, alphaNacetylglucosaminidase alpha N acetylglucosaminidase, acetylglucosaminidase alpha-N-acetylglucosaminidase sulphate features 1 Brazil 72 7 2 7. identified 23 3 2- aggressiveness four decade walk Furthermore progresses 50 organomegaly problems systems guidelines 5

https://doi.org/10.1590/1678-4685-gmb-2023-0285

Correlation of Diagnostic Components of Metabolic Syndrome with Electrocardiographic and Echocardiographic Alterations in Patients with Obesity
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Luz, Alan Souza da

; Ramos, João Gabriel da Costa

; Ribeiro, Carolina Heitmann Mares Azevedo

; Oliveira Júnior, Roberto Márcio de

; Siqueira Neto, Antônio Carmo da Costa

; Oliveira, Ralf Cardoso Mudesto

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20230165

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Metabolic syndrome (MS) and obesity are risk factors for cardiovascular diseases (CVD). However, the development of cardiovascular pathologies in obese individuals without MS is being investigated. Objective: To investigate whether there are similar electrocardiographic (ECG) and echocardiographic changes in individuals with obesity with and without MS. Methodology: A retrospective, descriptive cross-sectional study was carried out with obese patients at a university hospital in Belém, Pará, Brazil. Anthropometric, laboratory, ECG and echocardiographic data were evaluated in both populations. The chi-square test was used to describe the relationship between variables among groups; hypothesis tests with p < 0.05 were considered statistically significant values. Results: The study evaluated 100 individuals with obesity, 60 of whom had MS. The average age was 54 years, and the female sex was prevalent. Systolic blood pressure, HDL, and waist circumference were altered in both groups. Systemic arterial hypertension and low HDL demonstrated 4.27 times and 3.32 times greater likelihood of presenting changes in the ECG and echocardiogram for both groups. On the ECG, diffuse changes in ventricular repolarization were observed in both groups. On echocardiography, left ventricular diastolic dysfunction and left ventricular hypertrophy were present in both populations studied. Conclusion: Obese individuals without MS present a similar risk, requiring adequate attention to their cardiac health. Introduction (MS CVD. CVD . (CVD) However investigated Objective (ECG Methodology retrospective crosssectional cross sectional Belém Pará Brazil Anthropometric laboratory chisquare chi square groups 005 0 05 0.0 values Results 10 6 5 years prevalent pressure 427 4 27 4.2 332 3 32 3.3 echocardiography studied Conclusion health (CVD 00 0. 1 42 2 4. 33 3.

https://doi.org/10.36660/ijcs.20230165

Position statement of the Brazilian society of Rheumatology on mesna use as a preventive therapy for bladder disease in patients with systemic autoimmune diseases and systemic vasculitis under cyclophosphamide treatment
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de Souza, Alexandre Wagner S.

; Dantas, João Gabriel

; Montandon, Ana Carolina de Oliveira e Silva

; Calich, Ana Luísa

; Alverne, Andrea Rocha de Saboia Mont'

; Gasparin, Andrese Aline

; Bianchi, Dante

; Yuki, Emily Figueiredo Neves

; Sacilotto, Nathalia

; Reis Neto, Edgard Torres dos

; Monticielo, Odirlei André

; Pereira, Ivanio Alves

Advances in Rheumatology

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2024, Volume 64 elocation 41

Resumo: En | Texto: En | PDF: En

Abstract Objective To review current literature to support the use of mesna as a preventive therapy for hemorrhagic cystitis and bladder cancer in patients with systemic autoimmune diseases and systemic vasculitis treated with cyclophosphamide. Materials and methods The search for articles was conducted systematically through MEDLINE, LILACS, Cochrane Library, and Embase databases. Only articles in English were selected. For available records, titles and abstracts were selected independently by two investigators. Results Eighteen studies were selected for analysis. The known adverse effects of cyclophosphamide were hematological toxicity, infections, gonadal toxicity, teratogenicity, increased risk for malignancy and hemorrhagic cystitis. Long-term toxicity was highly dependent on cyclophosphamide cumulative dose. The risk of bladder cancer is especially higher in long-term exposure and with cumulative doses above 36 g. The risk remains high for years after drug discontinuation. Hemorrhagic cystitis is highly correlated with cumulative dose and its incidence ranges between 12 and 41%, but it seems to be lower with new regimens with reduced cyclophosphamide dose. No randomized controlled trials were found to analyze the use of mesna in systemic autoimmune rheumatic diseases and systemic vasculitis. Retrospective studies yielded conflicting results. Uncontrolled prospective studies with positive results were considered at high risk of bias. No evidence was found to support the use of mesna during the treatment with cyclophosphamide for autoimmune diseases or systemic vasculitis to prevent hemorrhagic cystitis and bladder cancer. In the scenarios of high cumulative cyclophosphamide dose (i.e., > 30 g), patients with restricted fluid intake, neurogenic bladder, therapy with oral anticoagulants, and chronic kidney disease, mesna could be considered. Conclusion The current evidence was found to be insufficient to support the routine use of mesna for the prophylaxis of hemorrhagic cystitis and bladder cancer in patients being treated for systemic autoimmune diseases and systemic vasculitis with cyclophosphamide. The use may be considered for selected cases. MEDLINE LILACS Library databases records investigators analysis infections teratogenicity Longterm Long term longterm long 3 g discontinuation 1 41 41% bias i.e., ie i e (i.e. g, , g) intake anticoagulants disease cases 4 i.e. (i.e i.e

https://doi.org/10.1186/s42358-024-00380-0

To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis B B2 positive outcomes
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Resende, Gustavo Gomes

; Saad, Carla Goncalves Schahin

; Marques, Claudia Diniz Lopes

; Ribeiro, Sandra Lúcia Euzébio

; Gavi, Maria Bernadete Renoldi de Oliveira

; Yazbek, Michel Alexandre

; Marinho, Adriana de Oliveira

; Menin, Rita de Cássia

; Ochtrop, Manuella Lima Gomes

; Soares, Andressa Miozzo

; Cavalcanti, Nara Gualberto

; Carneiro, Jamille Nascimento

; Werner de Castro, Glaucio Ricardo

; Fernandes, José Mauro Carneiro

; Souza, Elziane da Cruz Ribeiro E

; Alvarenga, Corina Quental de Menezes

; Vieira, Rejane Maria Rodrigues de Abreu

; Machado, Natalia Pereira

; Ximenes, Antônio Carlos

; Gazzeta, Morgana Ohira

; Albuquerque, Cleandro Pires de

; Skare, Thelma Larocca

; Keiserman, Mauro Waldemar

; Kohem, Charles Lubianca

; Benacon, Gabriel Sarkis

; Rocha, Vítor Florêncio Santos

; Lage, Ricardo da Cruz

; Malheiro, Olivio Brito

; Golebiovski, Rywka Tenenbaum Medeiros

; Oliveira, Thauana Luiza

; Duque, Ruben Horst

; Londe, Ana Carolina

; Pinheiro, Marcelo de Medeiros

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2024, Volume 64 elocation 33

Resumo: En | Texto: En | PDF: En

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±

https://doi.org/10.1186/s42358-024-00372-0

Retrato da inserção de terapeutas ocupacionais no Sistema Único de Assistência Social
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Basso, Ana Carolina de Souza

; Homem, Janette dos Santos

; Borba, Patrícia Leme de Oliveira

Cadernos Brasileiros de Terapia Ocupacional

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2024, Volume 32 elocation e3605

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Introduction Since 2005, Brazilian cities have been adapting to organize teams and services of the Unified Social Assistance System (SUAS), and since 2011, occupational therapy has been recognized as one of the professions that compose these teams and the management of SUAS. This study addresses how the category has been involved in this policy in the state of Rio de Janeiro. Objective To map the occupational therapists working at SUAS in this state and outline the characteristics of this inclusion. Methodology A descriptive, cross-sectional mapping study, using official data from the SUAS Census. Data were analyzed from a descriptive perspective, in dialogue with the National Social Assistance/Welfare Policy, the literature in the field of occupational therapy in social assistance, and under the framework of social occupational therapy. Results In the State of Rio de Janeiro, 142 occupational therapists work at SUAS, which is equivalent to 8.9% of the professionals in this state. This workforce is composed of women (89.4%) aged 41-50 years (34.5%), hired by Civil Society Organizations (93%), under the Consolidation of Labor Laws (CLT) regime (50%), with a weekly workload of 11-20 hours (40.9%), mainly inserted in Day Centers (71%), working with people with disabilities and older people. Conclusion The inclusion of occupational therapists in SUAS of Rio de Janeiro state occurs precariously, with low insertion in this state’s devices. It highlights the need for representative entities of the class to act in this public policy as a promoter of expanding job opportunities/public contests/employment, as well as to invest in debates about team compositions and the recognition of different fields of knowledge. 2005 , (SUAS) 2011 crosssectional cross sectional Census perspective AssistanceWelfare Welfare Policy assistance 14 89 8 9 8.9 89.4% 894 4 (89.4% 4150 41 50 41-5 34.5%, 345 34.5% 34 5 (34.5%) 93%, 93 93% (93%) CLT (CLT 50%, 50% (50%) 1120 11 20 11-2 40.9%, 409 40.9% 40 (40.9%) 71%, 71 71% (71%) precariously states s devices opportunitiespublic opportunities contestsemployment contests employment contests/employment knowledge 200 (SUAS 201 1 8. 89.4 (89.4 415 41- 34.5 3 (34.5% (93% (50% 112 2 11- 40.9 (40.9% 7 (71% 89. (89. 34. (34.5 (93 (50 40. (40.9 (71 (89 (34. (9 (5 (40. (7 (8 (34 ( (40 (3 (4

Resumo Introdução Desde 2005, as cidades brasileiras estão se adequando para organizar equipes e serviços do Sistema Único de Assistência Social (SUAS) e, a partir de 2011, a terapia ocupacional passou a ser reconhecida como uma das profissões que compõem tais equipes e a gestão do SUAS. Este estudo aborda como a categoria tem participado dessa política no estado do Rio de Janeiro. Objetivo Mapear as terapeutas ocupacionais que atuam no SUAS nesse estado e delinear as características dessa inserção. Metodologia Estudo de mapeamento, descritivo e transversal, utilizando informações oficiais do Censo SUAS. Os dados foram analisados a partir de uma perspectiva descritiva, em diálogo com a Política Nacional de Assistência Social, a literatura do campo da terapia ocupacional na assistência social e sob o referencial da terapia ocupacional social. Resultados No estado do Rio de Janeiro, 142 terapeutas ocupacionais atuam no SUAS, o equivalente a 8,9% das profissionais desse estado. Como retrato, obtivemos imagem formada por mulheres (89,4%) entre 41-50 anos de idade (34,5%), contratadas por Organizações da Sociedade Civil (93%), celetistas (50%), com carga horária semanal de 11-20 horas (40,9%), inseridas majoritariamente nos Centros-dia (71%), atuando com pessoas com deficiências e idosas. Conclusão A inserção de terapeutas ocupacionais no SUAS fluminense acontece de forma precarizada, com baixa inserção nos equipamentos estatais. Sinaliza-se a necessidade de as entidades representativas da classe atuarem nessa política pública enquanto promotora de ampliação de vagas/concursos/emprego, bem como investirem em debates sobre as composições das equipes e o reconhecimento dos diferentes campos de saber. 2005 (SUAS 2011 Janeiro mapeamento transversal descritiva 14 89 8 9 8,9 retrato 89,4% 894 4 (89,4% 4150 41 50 41-5 34,5%, 345 34,5% , 34 5 (34,5%) 93%, 93 93% (93%) 50%, 50% (50%) 1120 11 20 11-2 40,9%, 409 40,9% 40 (40,9%) Centrosdia Centros dia 71%, 71 71% (71%) idosas precarizada estatais Sinalizase Sinaliza vagasconcursosemprego vagas concursos emprego vagas/concursos/emprego saber 200 201 1 8, 89,4 (89,4 415 41- 34,5 3 (34,5% (93% (50% 112 2 11- 40,9 (40,9% 7 (71% 89, (89, 34, (34,5 (93 (50 40, (40,9 (71 (89 (34, (9 (5 (40, (7 (8 (34 ( (40 (3 (4

https://doi.org/10.1590/2526-8910.ctoao277036051

Obstacles in combating multidrug resistant tuberculosis in pediatric patients: a scope review patients
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Sobreira, Letícia Baltar

; Freitas, Paula de Souza Silva

; Nascimento, Luciana de Cassia Nunes

; Vieira, Anne Caroline Barbosa Cerqueira

; Sales, Carolina Maia Martins

; Pacheco, Alicia de Oliveira

; Rezende, Lucas Dalvi Armond

Revista Brasileira de Saúde Materno Infantil

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2024, Volume 24 elocation e20230082

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Objectives: to identify the scientific evidence on excessively resistant and multidrug resistant tuberculosis in pediatric patients. Methods: this is a scope review of the literature, with a guiding question: “What is the scientific evidence on multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis in pediatric patients?”. The research used the descriptors: “extensively drug-resistant tuberculosis” OR “multidrug-resistant tuberculosis” AND “pediatrics”. The research was carried out in a double-blind manner in the following databases of the Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific’s Institutional Repository for Information Sharing, Embase/Elsevier and International Clinical Trials Registry Platform, with a temporal cut-off from 2011 to 2021, sending a final synthesized sample of 18 articles, which evaluated the methodological content through the level of evidence. Results: the results show the lack of research with a high level of evidence related to MDR-TB in children, the lack of adequate dosage of second-line drugs for the pediatric population and the importance of drug sensitivity testing for the cases of treatment Conclusions: it was identified that the obstacles to MDR-TB treatment were concentrated in the lack of detailed protocols, safe drug dosages with a low side effect, and mainly in the social health determinants and disease process involving MDR-TB. Objectives patients Methods literature question What multidrugresistant MDRTB MDR TB (MDR-TB drugresistant . patients?” descriptors pediatrics. pediatrics “pediatrics” doubleblind double blind Online Pacifics Pacific s Sharing EmbaseElsevier Embase Elsevier Platform cutoff cut off 201 2021 1 articles Results children secondline second line Conclusions protocols effect MDRTB. TB. patients? “pediatrics 20 202 2

Resumo Objetivos: identificar as evidências científicas sobre tuberculose excessivamente resistente e multidroga resistente em pacientes pediátricos. Métodos: trata-se de uma revisão de escopo da literatura, tendo como questão norteadora: “Quais as evidências científicas sobre tuberculose multidroga-resistente (TB-MDR) e tuberculose extensivamente resistente em pacientes pediátricos?” A pesquisa usou os descritores: “tuberculose extensivamente resistente a medicamentos” OR “tuberculose resistente a múltiplos medicamentos” AND “pediatria”. A pesquisa foi realizada de modo duplo-cego nas bases de dados Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific’s Institutional Repository for Information Sharing, Embase/Elsevier e International Clinical Trials Registry Platform, com um corte temporal de 2011 a 2021, sendo a amostra final sintetizada de 18 artigos, nos quais avaliou-se o conteúdo metodológico por meio do nível de evidência. Resultados: os resultados mostraram a escassez de pesquisas de alto nível de evidência relacionadas à TB-MDR em crianças, ausência de posologia adequada das drogas de segunda linha para o público pediátrico e a importância do teste de sensibilidade a drogas para o tratamento dos casos. Conclusões: identificou-se que os obstáculos do tratamento TB-MDR se concentraram na ausência de protocolos detalhados, de dosagens medicamentosas seguras e com menor efeito colateral, e, principalmente, nos determinantes sociais do processo saúde e doença que envolvem a TB-MDR. Objetivos pediátricos Métodos tratase trata literatura norteadora Quais multidrogaresistente TBMDR TB MDR (TB-MDR pediátricos? descritores medicamentos pediatria. pediatria . “pediatria” duplocego duplo cego Online Pacifics Pacific s Sharing EmbaseElsevier Embase Elsevier Platform 201 2021 1 artigos avaliouse avaliou Resultados crianças casos Conclusões identificouse identificou detalhados colateral principalmente TBMDR. MDR. “pediatria 20 202 2

https://doi.org/10.1590/1806-9304202400000082-en

Nurses’ workload during the COVID-19 pandemic: potential for experiences of moral distress Nurses COVID19 COVID 19 COVID-1 pandemic COVID1 1 COVID-
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Santos, Thallison Carlos Campos

; Soares, Gabriela da Costa

; Lima, Kelly Cristina Oliveira de

; Souza, Beatriz Bolognani Cardoso de

; Velloso, Isabela Silva Câncio

; Caram, Carolina da Silva

Revista Brasileira de Enfermagem

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2024, Volume 77 Supl. 4 elocation e20230200

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

RESUMEN Objetivos: comprender las experiencias de angustia moral de los enfermeros relacionadas con la sobrecarga de trabajo durante la pandemia de COVID-19 en Brasil. Métodos: investigación cualitativa, cuya recolección de datos ocurrió a través de entrevistas individuales con 19 enfermeros que actuaron en la primera línea de COVID-19 en servicios de salud de la región Sudeste de Brasil. Los datos fueron analizados mediante análisis de contenido temático. Resultados: la sobrecarga de trabajo resultó ser una poderosa fuente de experiencias de sufrimiento moral por exceso de jornada durante la vacunación, doble jornada laboral, relaciones conflictivas por presiones de los directivos y la población y agotamiento físico y mental, lo que impidió al enfermero actuar según su criterio. Consideraciones Finales: la sobrecarga de trabajo de las enfermeras se refleja en la calidad de la atención al paciente e impide que las enfermeras actúen de acuerdo con sus principios morales, generando sufrimiento moral en las enfermeras. Objetivos COVID19 COVID COVID-1 Brasil Métodos cualitativa 1 temático Resultados vacunación laboral mental criterio Finales morales COVID1 COVID-

ABSTRACT Objectives: to understand nurses’ experiences of moral distress related to work overload during the COVID-19 pandemic in Brazil. Methods: qualitative research, whose data collection occurred through individual interviews with 19 nurses who worked on the front line of COVID-19 in health services in southeastern Brazil. Data were analyzed using thematic content analysis. Results: work overload proved to be a powerful source of experiences of moral distress due to excessive working hours during vaccination, double working hours, a troubled relationship due to pressure from managers and the population and physical and mental exhaustion, which prevented nurses from act according to their judgment. Final Considerations: nurses’ work overload reflects on quality patient care and prevents nurses from acting in accordance with their moral principles, generating moral distress in nurses. Objectives COVID19 COVID COVID-1 Brazil Methods research 1 analysis Results vaccination exhaustion judgment Considerations principles COVID1 COVID-

RESUMO Objetivos: compreender vivências de sofrimento moral de enfermeiros relacionadas à sobrecarga de trabalho durante a pandemia de COVID-19 no Brasil. Métodos: pesquisa qualitativa, cuja coleta de dados ocorreu através de entrevistas individuais com 19 enfermeiros que atuaram na linha de frente da COVID-19 em serviços de saúde da região Sudeste do Brasil. Os dados foram analisados mediante análise temática de conteúdo. Resultados: a sobrecarga de trabalho mostrou-se potente fonte para vivências de sofrimento moral devido à jornada de trabalho excessiva na vacinação, à dupla jornada de trabalho, à relação conturbada por pressão de gestores e população e ao esgotamento físico e mental, os quais impediam o enfermeiro de agir conforme o seu julgamento. Considerações Finais: a sobrecarga de trabalho dos enfermeiros reflete na assistência de qualidade ao paciente, e impede que os enfermeiros atuem conforme os seus princípios morais, gerando sofrimento moral nos enfermeiros. Objetivos COVID19 COVID COVID-1 Brasil Métodos qualitativa 1 conteúdo Resultados mostrouse mostrou se vacinação mental julgamento Finais paciente morais COVID1 COVID-

https://doi.org/10.1590/0034-7167-2023-0200

Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas Gerais
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Alves, Maria Luíza de Faria

; Souto, Deisiane Oliveira

; Romeros, Angélica Cristina Sousa Fonseca

; Magalhães, Elton Duarte Dantas

; Mendes, Larissa Gabrielle

; Ayupe, Kênnea Martins Almeida

; Chagas, Paula Silva de Carvalho

; Campos, Ana Carolina de

; Moreira, Rafaela Silva

; Toledo, Aline Martins de

; Camargos, Ana Cristina Resende

; Longo, Egmar

; Leite, Hércules Ribeiro

; Morais, Rosane Luzia de Souza

Revista Paulista de Pediatria

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2024, Volume 42 elocation e2023043

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To characterize the environmental factors of children and adolescents with Cerebral Palsy (CP) in the state of Minas Gerais (MG), Brazil. Methods: This is a cross-sectional study involving 164 caregivers of children/adolescents with CP, aged 1-14 years. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the participants’ functioning, and environmental factors were evaluated by an on-line questionnaire that examined products and technologies, physical environment, services, and systems. A descriptive analysis was performed using percentage and frequency. Results: Most participants had bilateral CP (66.9%) and 45% of them were spastic. Levels II and V of the GMFCS and MACS were the most frequent. About half (49.4%) used anticonvulsants, 27.4% underwent botulinum toxin application, and 29% went through orthopedic surgery in the lower limbs. Among the participants, 71.3% used orthoses in the lower limbs, and 51.8% used the public health care system. Most had access to physiotherapy (91.5%), but found difficulties to access interventions with other professionals, such as psychologists (28%) and nutritionists (37.8%). The school was the most frequently adapted environment (78%), and had the highest level of structural adaptation (42.7%). Conclusions: The results of this study suggest that the barriers to access health services and barriers to the physical environment may impact participation and social inclusion. Objective (CP MG, MG , (MG) Brazil Methods crosssectional cross sectional 16 childrenadolescents 114 1 14 1-1 years (GMFCS (MACS functioning online on line technologies systems frequency Results 66.9% 669 66 9 (66.9% 45 spastic frequent 49.4% 494 49 4 (49.4% anticonvulsants 274 27 27.4 application 29 limbs 713 71 3 71.3 518 51 8 51.8 system 91.5%, 915 91.5% 91 5 (91.5%) professionals 28% 28 (28% 37.8%. 378 37.8% . 37 (37.8%) 78%, 78 78% (78%) 42.7%. 427 42.7% 42 7 (42.7%) Conclusions inclusion (MG 11 1- 66.9 6 (66.9 49.4 (49.4 2 27. 71. 51. 91.5 (91.5% (28 37.8 (37.8% (78% 42.7 (42.7% 66. (66. 49. (49. 91. (91.5 (2 37. (37.8 (78 42. (42.7 (66 (49 (91. ( (37. (7 (42. (6 (4 (91 (37 (42 (9 (3

RESUMO Objetivo: Caracterizar os fatores ambientais de crianças e adolescentes com paralisia cerebral (PC) no estado de Minas Gerais (MG), Brasil. Métodos: Trata-se de um estudo transversal envolvendo 164 cuidadores de crianças/adolescentes com PC, na faixa etária de um a 14 anos. O Sistema de Classificação da Função Motora Grossa (GMFCS) e o Sistema de Classificação da Habilidade Manual (MACS) foram utilizados para classificar a funcionalidade dos participantes e os fatores ambientais foram avaliados por um questionário on-line que abordou produtos e tecnologias, ambiente físico, serviços e sistemas. Análises descritivas foram realizadas por meio de porcentagem e frequência. Resultados: A maioria dos participantes tinha PC bilateral (66,9%) e 45% deles eram espásticos. Os níveis II e V do GMFCS e MACS foram os mais frequentes. Cerca de metade (49,4%) fazia uso de anticonvulsivantes, 27,4% realizaram aplicação de toxina botulínica e 29% cirurgia ortopédica em membros inferiores. Utilizavam órteses em membros inferiores 71,3% e eram usuários do sistema público de saúde 51,8%. A maioria tinha acesso à fisioterapia (91,5%), mas dificuldade de acesso a intervenções com outros profissionais, como psicólogos (28%) e nutricionistas (37,8%). A escola foi o ambiente mais frequentado (78%) e também mais adaptado estruturalmente (42,7%). Conclusões: Os resultados deste estudo sugerem que barreiras de acesso aos serviços de saúde e barreiras no ambiente físico podem impactar a participação e inclusão social. Objetivo (PC MG, MG , (MG) Brasil Métodos Tratase Trata se 16 criançasadolescentes 1 anos (GMFCS (MACS online on line tecnologias sistemas frequência Resultados 66,9% 669 66 9 (66,9% 45 espásticos frequentes 49,4% 494 49 4 (49,4% anticonvulsivantes 274 27 27,4 29 713 71 3 71,3 518 51 8 51,8% 91,5%, 915 91,5% 91 5 (91,5%) profissionais 28% 28 (28% 37,8%. 378 37,8% . 37 (37,8%) 78% 78 (78% 42,7%. 427 42,7% 42 7 (42,7%) Conclusões social (MG 66,9 6 (66,9 49,4 (49,4 2 27, 71, 51,8 91,5 (91,5% (28 37,8 (37,8% (78 42,7 (42,7% 66, (66, 49, (49, 51, 91, (91,5 (2 37, (37,8 (7 42, (42,7 (66 (49 (91, ( (37, (42, (6 (4 (91 (37 (42 (9 (3

https://doi.org/10.1590/1984-0462/2024/42/2023043

10.

Prognostic value of programmed cell death ligand 1 (PD-L1) expression in patients with stage III non-small cell lung cancer under different treatment types: a retrospective study PDL1 PDL PD L1 L (PD-L1 nonsmall non small types (PD-L
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Castro, Nicoly Marques de

; Moura, Fernando

; Hada, Aline Lury

; Garcia, Diogo

; Victor, Elivane da Silva

; Schvartsman, Gustavo

; Carvalho, Leonardo

; Fernandes, Milena Lourenço Coleta

; Martins, Rodrigo de Souza

; Silva, Elaine Ferreira da

; Santos, Sarah Silva Mello Batista dos

; Taniwaki, Letícia

; Taranto, Patrícia

; Pontes, Janaina

; Beal, Juliana Rodrigues

; Dutra, Ana Carolina Pereira

; Oliveira Filho, João Bosco de

; Araujo, Sérgio Eduardo Alonso

; Usón Junior, Pedro Luiz Serrano

einstein (São Paulo)

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2024, Volume 22 elocation eAO0575

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective Currently programmed cell death protein 1 (PD-1) inhibitors in combination with other therapies are being evaluated to determine their efficacy in cancer treatment. However, the effect of PD-ligand (L) 1 expression on disease outcomes in stage III (EC III) non-small cell lung cancer is not completely understood. Therefore, this study aimed to assess the influence of PD-L1 expression on the outcomes of EC III non-small cell lung cancer. Methods This study was conducted on patients diagnosed with EC III non-small cell lung cancer who underwent treatment at a tertiary care hospital. PD-L1 expression was determined using immunohistochemical staining, all patients expressed PD-L1. Survival was estimated using the Kaplan-Meier method. Relationships between variables were assessed using Cox proportional regression models. Results A total of 49 patients (median age=69 years) with EC III non-small cell lung cancer and PD-L1 expression were evaluated. More than half of the patients were men, and most were regular smokers. The patients were treated with neoadjuvant chemotherapy, surgery, or sequential or combined chemotherapy and radiotherapy. The median progression-free survival of the entire cohort was 14.2 months, and the median overall survival was 20 months. There was no significant association between PD-L1 expression and disease progression, clinical characteristics, or overall survival. Conclusions PD-L1 expression was not correlated with EC III non-small cell lung cancer outcomes. Whether these findings differ from the association with immune checkpoint inhibitors remains to be addressed in future studies. PD1 PD (PD-1 However PDligand ligand L (L nonsmall non small understood Therefore PDL1 PDL L1 PD-L hospital staining PDL1. L1. KaplanMeier Kaplan Meier method models 4 age69 age 69 age=6 years men smokers surgery radiotherapy progressionfree progression free 142 14 2 14. months characteristics studies (PD- age6 6 age= (PD

https://doi.org/10.31744/einstein_journal/2024ao0575

11.

ELABORAÇÃO E VALIDAÇÃO DE UM PROTOCOLO DE PONTOS DE ACUPUNTURA AURICULAR PARA CEFALEIA
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Andrade, Kaue Batista

; Rodrigues, Carolina Amaral Oliveira

; Souza, Vitória Cristina Ferreira

; Teixeira, Wesley Silva

; Gusmão, Ricardo Otávio Maia

; Moura, Caroline de Castro

; Araújo, Diego Dias de

Cogitare Enfermagem

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2024, Volume 29 elocation e92862

Resumo: En Pt Es | Texto: En Pt Es | PDF: En | PDF: Pt | PDF: Es

ABSTRACT Objective: To develop and validate the content of an auricular acupuncture point protocol for the treatment of headaches. Method: A methodological study, carried out in June 2023 in Montes Claros, Minas Gerais, Brazil. It was structured in three stages: Planning (bibliographic survey and identification of the study variables); Construction of the instruments (characterization of the experts, point protocol and treatment regime); and Content validation in charge of 15 experts. In the data analysis, an absolute agreement percentage equal to or greater than 80% was used. Results: The auricular acupuncture protocol for the treatment of headaches that was validated by experts consisted of the following points: “Door of the Mind” (93.3%), Kidney (86.7%), Sympathetic (86.7%), Anxiety (86.7%), Subcortex (86.7%), Brainstem (86.7%), Frontal (86.7%), Occipital (86.7%), Temporal (86.7%) and Liver (80%). Conclusion: the auricular acupuncture protocol for the treatment of headaches was considered valid, which will allow its use in the clinical practice and research studies. Objective Method 202 Claros Gerais Brazil stages bibliographic variables variables) characterization regime regime) 1 analysis 80 used Results points Door Mind 93.3%, 933 93.3% , 93 3 (93.3%) 86.7%, 867 86.7% 86 7 (86.7% 80%. . (80%) Conclusion valid studies 20 8 93.3 9 (93.3% 86.7 (86.7 (80% 2 93. (93.3 86. (86. (80 (93. (86 (8 (93 ( (9

RESUMO Objetivo: Elaborar e validar o conteúdo de um protocolo de pontos de acupuntura auricular para o tratamento de cefaleia. Método: Estudo metodológico, realizado em junho de 2023, em Montes Claros, Minas Gerais, Brasil. Estruturando em três etapas: planejamento (levantamento bibliográfico e identificação das variáveis de estudo), construção dos instrumentos (caracterização dos experts, protocolo de pontos e regime de tratamento) e validação de conteúdo por 15 experts. Na análise de dados utilizou-se a porcentagem de concordância absoluta igual ou superior a 80%. Resultados: O protocolo de acupuntura auricular para o tratamento de cefaleia, validado pelos experts, foi composto pelos seguintes pontos: “Porta da Mente” (93,3%), Rim (86,7%), Simpático (86,7%), Ansiedade (86,7%), Subcórtex (86,7%), Tronco Cerebral (86,7%), Frontal (86,7%), Occipital (86,7%), Temporal (86,7%) e Fígado (80%). Conclusão: o protocolo de acupuntura auricular para o tratamento de cefaleia foi considerado válido, o que permitirá sua utilização na prática clínica e em pesquisas. Objetivo Método metodológico 2023 Claros Gerais Brasil etapas levantamento estudo, estudo , estudo) caracterização experts 1 utilizouse utilizou se 80 80% Resultados Porta Mente 93,3%, 933 93,3% 93 3 (93,3%) 86,7%, 867 86,7% 86 7 (86,7% . (80%) Conclusão válido pesquisas 202 8 93,3 9 (93,3% 86,7 (86,7 (80% 20 93, (93,3 86, (86, (80 2 (93, (86 (8 (93 ( (9

RESUMEN Objetivo: Elaborar y validar el contenido de un protocolo de puntos de acupuntura auricular para el tratamiento de la cefalea. Método: Estudio metodológico, realizado en junio de 2023, en Montes Claros, Minas Gerais, Brasil. Estructurado en tres etapas: planificación (relevamiento bibliográfico e identificación de variables de estudio), elaboración de instrumentos (caracterización de expertos, protocolo de puntos y régimen de tratamiento) y validación de contenido por 15 expertos. En el análisis de los datos se utilizó un porcentaje de concordancia absoluta igual o mayor al 80%. Resultados: El protocolo de acupuntura auricular para el tratamiento de la cefalea, validado por expertos, estuvo compuesto por los siguientes puntos: “Puerta de la Mente” (93,3%), Riñón (86,7%), Simpático (86,7%), Ansiedad (86,7%), Subcórtex (86,7%), Tronco Encefálico (86,7%), Frontal (86,7%), Occipital (86,7%), Temporal (86,7%) e Hígado (80%). Conclusión: Se consideró válido el protocolo de acupuntura auricular para el tratamiento de la cefalea, lo que permitirá su uso en la práctica clínica y en la investigación. Objetivo cefalea Método metodológico 2023 Claros Gerais Brasil etapas relevamiento estudio, estudio , estudio) caracterización expertos 1 80 80% Resultados Puerta Mente 93,3%, 933 93,3% 93 3 (93,3%) 86,7%, 867 86,7% 86 7 (86,7% . (80%) Conclusión investigación 202 8 93,3 9 (93,3% 86,7 (86,7 (80% 20 93, (93,3 86, (86, (80 2 (93, (86 (8 (93 ( (9

https://doi.org/10.1590/ce.v29i0.92862

12.

Analysis of intensive care unit admissions for older adults with femoral fractures: a retrospective cohort fractures
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Cobra, Carolina Rodrigues Mendes Nogueira

; Garcia, Paulo Carlos

; Passos, Isadora Castilho Moreira de Oliveira

; Rocha, Greiciane da Silva

; Nogueira, Lilia de Souza

Revista da Escola de Enfermagem da USP

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2024, Volume 58 elocation e20230398

Resumo: Es Pt En | Texto: Es Pt En | PDF: Es | PDF: Pt | PDF: En

RESUMEN Objetivo: Describir la serie histórica de internaciones, en la Unidad de Cuidados Intensivos, de ancianos con fractura de fémur, y verificar la asociación entre la edad y las características y tratamiento de la lesión, carga de trabajo de enfermería, gravedad y evolución clínica en la unidad. Método: Cohorte retrospectiva de 295 ancianos (edad ≥60 años) ingresados en la Unidad de Cuidados Intensivos de un hospital de São Paulo, entre 2013 y 2019, y que presentaron fractura de fémur como principal causa de hospitalización. Se analizaron variables relativas a características demográficas, causa y tipo de fractura, tratamiento realizado, gravedad, carga de trabajo de enfermería y evolución clínica de los pacientes. Se aplicaron las pruebas de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis y correlación de Pearson. Resultados: Hubo aumento de hospitalizaciones de ancianos en Unidad de Cuidados Intensivos desde 2017. Las pacientes del sexo femenino con fracturas de fémur distal que murieron en la Unidad de Cuidados Intensivos tuvieron mediana de edad significativamente (p < 0,05) más alta que los hombres, los pacientes con fracturas de diáfisis o de fémur proximal y los supervivientes. Conclusión: Los hallazgos del estudio resaltan información esencial para estructurar la atención de los ancianos con fracturas femorales que requieren tratamiento intensivo. Objetivo internaciones lesión unidad Método 29 60 ≥6 años Paulo 201 2019 hospitalización demográficas realizado ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis Pearson Resultados 2017 p 0,05 005 0 05 hombres supervivientes Conclusión intensivo 2 6 ≥ 20 0,0 00 0,

RESUMO Objetivos: Descrever a série histórica das internações, na Unidade de Terapia Intensiva, de idosos com fratura de fêmur, e verificar a associação entre idade e as características e tratamento da lesão, carga de trabalho de enfermagem, gravidade e evolução clínica na unidade. Método: Coorte retrospectiva de 295 idosos (idade ≥60 anos) admitidos na Unidade de Terapia Intensiva de hospital em São Paulo, entre 2013 e 2019, e que apresentaram fratura de fêmur como causa principal da internação. Variáveis sobre características demográficas, causa e tipo da fratura, tratamento realizado, gravidade, carga de trabalho de enfermagem e desfecho clínico dos pacientes foram analisadas. Os testes de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis e correlação de Pearson foram aplicados. Resultados: Houve aumento das internações de idosos na Unidade de Terapia Intensiva a partir de 2017. Pacientes do sexo feminino, com fratura distal de fêmur e que morreram na Unidade de Terapia Intensiva apresentaram significativamente (p < 0,05) maior mediana de idade do que homens, pacientes com fratura de diáfise ou proximal do fêmur e sobreviventes. Conclusão: Os achados do estudo evidenciam informações essenciais para estruturação dos cuidados ao idoso com fratura de fêmur que necessita de tratamento intensivo. Objetivos lesão unidade Método 29 60 ≥6 anos Paulo 201 2019 internação demográficas realizado analisadas ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis aplicados Resultados 2017 feminino p 0,05 005 0 05 homens sobreviventes Conclusão intensivo 2 6 ≥ 20 0,0 00 0,

ABSTRACT Objectives: To describe the historical series of admissions to the Intensive Care Unit of older adults with femoral fractures, and verify the association between age and injury characteristics and treatment, nursing workload, severity, and clinical evolution in the unit. Method: Retrospective cohort of 295 older adults (age ≥60 years) admitted to the Intensive Care Unit of a hospital in São Paulo, between 2013 and 2019, and who presented with a femur fracture as the main cause of hospitalization. Variables regarding demographic characteristics, cause, and type of fracture, treatment provided, severity, nursing workload, and medical outcome of patients were analyzed. The Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis tests and Pearson correlation were applied. Results: There was an increase in older adults admission to the Intensive Care Unit from 2017 on. Female patients with distal femur fractures who died in the Intensive Care Unit had significantly (p < 0.05) higher median age than men, patients with shaft or proximal femur fractures, and survivors. Conclusion: The study findings highlight essential information for structuring care for older adults with femoral fractures who require intensive care. Objectives workload severity unit Method 29 60 ≥6 years Paulo 201 2019 hospitalization provided analyzed ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk WilcoxonMannWhitney, WilcoxonMannWhitney Wilcoxon Mann Whitney, Whitney Wilcoxon-Mann-Whitney KruskalWallis Kruskal Wallis applied Results on p 0.05 005 0 05 men survivors Conclusion 2 6 ≥ 20 0.0 00 0.

https://doi.org/10.1590/1980-220x-reeusp-2023-0398en

13.

Late relapses in leprosy patients in Brazil: 10-year post-trial of uniform multidrug therapy (U-MDT/CT-BR) Brazil 10year year 10 posttrial post trial UMDT/CTBR UMDTCTBR U MDT/CT BR MDT CT (U-MDT/CT-BR 1 UMDT CTBR MDTCT
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Penna, Gerson Oliveira

; Pontes, Maria Araci de Andrade

; Talhari, Sinésio

; Goncalves, Heitor de Sá

; Talhari, Carolina

; Pessoa, Allen de Souza

; Pedroza, Valderiza

; Bührer-Sékula, Samira

; Stefani, Mariane Martins de Araujo

; Penna, Maria Lucia Fernandes

Brazilian Journal of Infectious Diseases

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2024, Volume 28 Nº 2 elocation 103745

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Leprosy is a neglected dermato-neurologic, infectious disease caused by Mycobacterium leprae or M. lepromatosis. Leprosy is treatable and curable by multidrug therapy/MDT, consisting of 12 months rifampicin, dapsone and clofazimine for multibacillary/MB patients and for 6 months for paucibacillary/PB patients. The relapse rate is considered a crucial treatment outcome. A randomized Controlled Clinical Trial (U-MDT/CT-BR) conducted from 2007‒2012 compared clinical outcomes in MB patients after 12 months regular MDT/R-MDT and 6 months uniform MDT/U-MDT in two highly endemic Brazilian areas. Objectives: To estimate the 10 years relapse rate of MB patients treated with 6 months U-MDT. Methods: The statistical analyses treated the data as a case-control study, sampled from the cohort generated for the randomized trial. Analyses estimated univariate odds ratio and applied logistic regression for multivariate analysis, controlling the confounding variables. Results: The overall relapse rate was 4.08 %: 4.95 % (16 out of 323) in the U-MDT group and 3.10 % (9 out of 290) in the regular/R-MDT group. The difference in relapse proportion between U-MDT and R-MDT groups was 1.85 %, not statistically significant (Odds Ratio = 1.63, 95 % CI 0.71 to 3.74). However, misdiagnosis of relapses, may have introduced bias, underestimating the force of the association represented by the odds ratio. Conclusions: The relapse estimate of 10 years follow-up study of the first randomized, controlled study on U-MDT/CT-BR was similar to the R-MDT group, supporting strong evidence that 6 months U-MDT for MB patients is an acceptable option to be adopted by leprosy endemic countries worldwide. Trial registration: ClinicalTrials.gov: NCT00669643. Background dermatoneurologic, dermatoneurologic dermato neurologic, neurologic dermato-neurologic M lepromatosis therapyMDT therapy MDT therapy/MDT 1 rifampicin multibacillaryMB multibacillary paucibacillaryPB paucibacillary PB outcome UMDT/CTBR UMDTCTBR U MDT/CT BR CT (U-MDT/CT-BR 20072012 2007 2012 2007‒201 MDT/RMDT MDTRMDT MDT/R R MDT/UMDT MDTUMDT MDT/U areas Objectives UMDT. UMDT MDT. Methods casecontrol case control trial analysis variables Results 408 4 08 4.0 495 4.9 16 (1 323 310 3 3.1 9 ( 290 regular/RMDT regularRMDT regular/R RMDT 185 85 1.8 Odds 163 63 1.63 071 0 71 0.7 3.74. 374 3.74 . 74 3.74) However relapses bias Conclusions followup follow up worldwide registration ClinicalTrials.gov ClinicalTrialsgov ClinicalTrials gov NCT00669643 NCT CTBR MDTCT 2007201 200 201 2007‒20 MDTR MDTU 40 4. 49 32 31 3. 29 regularR 18 8 1. 1.6 07 7 0. 37 3.7 NCT0066964 200720 20 2007‒2 2 NCT006696 20072 2007‒ NCT00669 NCT0066 NCT006 NCT00 NCT0

https://doi.org/10.1016/j.bjid.2024.103745

14.

Position paper of diagnosis and treatment of post-extubation laryngitis in children: a multidisciplinary expert-based opinion postextubation post extubation children expertbased expert based
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Pazinatto, Débora Bressan

; Maunsell, Rebecca

; Avelino, Melissa Ameloti Gomes

; Lubianca Neto, Jose Faibes

; Schweiger, Cláudia

; Caldas, Jamil Pedro de Siqueira

; Brandão, Marcelo Barciela

; Souza, Paula Pires de

; Peixoto, Fernanda Aparecida de Oliveira

; Ricachinevsky, Claudia Pires

; Silveira, Rita C.

; Andreolio, Cinara

; Miura, Carolina Sponchiado

; Volpe, Daniele da Silva Jordan

; Ferri, Walusa Assad Gonçalves

; Gavazzoni, Fabiano Bleggi

; João, Paulo Ramos David

; Possas, Silmara Aparecida

; Chone, Carlos Takahiro

Brazilian Journal of Otorhinolaryngology

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2024, Volume 90 Nº 3 elocation 101401

Resumo: En | Texto: En | PDF: En

Abstract Objectives To make recommendations on the diagnosis and treatment of post-extubation laryngitis (PEL) in children with or without other comorbidities. Methods A three-iterative modified Delphi method was applied. Specialists were recruited representing pediatric otolaryngologists, pediatric and neonatal intensivists. Questions and statements approached topics encompassing definition, diagnosis, endoscopic airway evaluation, risk factors, comorbidities, management, and follow-up. A consensus was defined as a supermajority >70%. Results Stridor was considered the most frequent symptom and airway endoscopy was recommended for definitive diagnosis. Gastroesophageal reflux and previous history of intubation were considered risk factors. Specific length of intubation did not achieve a consensus as a risk factor. Systemic corticosteroids should be part of the medical treatment and dexamethasone was the drug of choice. No consensus was achieved regarding dosage of corticosteroids, although endoscopic findings help defining dosage and length of treatment. Non-invasive ventilation, laryngeal rest, and use of comfort sedation scales were recommended. Indications for microlaryngoscopy and bronchoscopy under anesthesia were symptoms progression or failure to improve after the first 72-h of medical treatment post-extubation, after two failed extubations, and/or suspicion of severe lesions on flexible fiberoptic laryngoscopy. Conclusions Management of post-extubation laryngitis is challenging and can be facilitated by a multidisciplinary approach. Airway endoscopy is mandatory and impacts decision-making, although there is no consensus regarding dosage and length of treatment. postextubation post extubation PEL (PEL comorbidities threeiterative three iterative applied otolaryngologists intensivists definition evaluation factors management followup. followup follow up. up follow-up 70 >70% factor choice Noninvasive Non invasive ventilation rest 72h h 72 postextubation, extubation, extubations andor laryngoscopy approach decisionmaking, decisionmaking decision making, making decision-making 7 >70 >7 >

https://doi.org/10.1016/j.bjorl.2024.101401

15.

2023 Brazilian Society of Rheumatology guidelines for the treatment of systemic sclerosis 202 20 2
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Kayser, Cristiane

; Delgado, Sandra Maximiano de Oliveira

; Zimmermann, Adriana Fontes

; Horimoto, Alex Magno Coelho

; Del Rio, Ana Paula Toledo

; Müller, Carolina de Souza

; Camargo, Cintia Zumstein

; Lupo, Cristiano Michelini

; Moraes, Daniela Aparecida de

; Do Rosário E Souza, Eduardo José

; Santos, Flávia Patrícia Sena Teixeira

; Sekiyama, Juliana Yuri

; Lonzetti, Lilian Scussel

; Martins, Lucas Victória de Oliveira

; Bezerra, Mailze Campos

; Bredemeier, Markus

; Oliveira, Maria Carolina

; Salgado, Maria Cecília da Fonseca

; Miossi, Renata

; Fontenele, Sheila Márcia de Araújo

; Hax, Vanessa

; Dantas, Andrea Tavares

; Sampaio-Barros, Percival Degrava

Advances in Rheumatology

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2024, Volume 64 elocation 52

Resumo: En | Texto: En | PDF: En

Abstract Background Systemic sclerosis (SSc) is a rare chronic autoimmune disease with heterogeneous manifestations. In the last decade, several clinical trials have been conducted to evaluate new treatment options for SSc. The purpose of this work is to update the recommendations of the Brazilian Society of Rheumatology in light of the new evidence available for the pharmacological management of SSc. Methods A systematic review including randomized clinical trials (RCTs) for predefined questions that were elaborated according to the Patient/Population, Intervention, Comparison, and Outcomes (PICO) strategy was conducted. The rating of the available evidence was performed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. To become a recommendation, at least 75% agreement of the voting panel was needed. Results Six recommendations were elaborated regarding the pharmacological treatment of Raynaud’s phenomenon, the treatment (healing) and prevention of digital ulcers, skin involvement, interstitial lung disease (ILD) and gastrointestinal involvement in SSc patients based on results available from RCTs. New drugs, such as rituximab, were included as therapeutic options for skin involvement, and rituximab, tocilizumab and nintedanib were included as therapeutic options for ILD. Recommendations for the pharmacological treatment of scleroderma renal crisis and musculoskeletal involvement were elaborated based on the expert opinion of the voting panel, as no placebo-controlled RCTs were found. Conclusion These guidelines updated and incorporated new treatment options for the management of SSc based on evidence from the literature and expert opinion regarding SSc, providing support for decision-making in clinical practice. (SSc manifestations decade (RCTs PatientPopulation Patient Population Patient/Population Intervention Comparison PICO (PICO Assessment GRADE (GRADE methodology recommendation 75 needed Raynauds Raynaud s phenomenon healing (healing ulcers ILD (ILD drugs rituximab placebocontrolled placebo controlled found decisionmaking decision making practice 7

https://doi.org/10.1186/s42358-024-00392-w

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