Diseño de una base de datos para la Revista Cubana de Tecnología de la Salud

Introducción: la Revista Cubana de Tecnología de la Salud, requiere un sistema de base de datos para el tratamiento de la información concerniente a los diferentes procesos de la gestión editorial. Esto es necesario en la automatización y a la vez humanización de la recolección, organización, procesamiento y presentación de los datos relacionados con los indicadores de evaluación de la calidad, los bibliométricos y los referentes con la indexación, por citar ejemplos. Objetivo: diseñar una base de datos para la Revista Cubana de Tecnología de la Salud. Métodos: se realizó una investigación aplicada de innovación tecnológica, en la que diseñó una base de datos relacional. Se emplearon métodos a nivel teórico y empíricos; entre ellos la entrevista para obtener una descripción detallada de las necesidades de la revista, y la modelación en la representación a través de modelos lógicos y conceptuales del universo de discurso. Resultados: la base de datos se diseñó mediante el modelo Entidad-Relación. Se obtuvieron el diagrama de entidad-relación y el esquema relacional de la base de datos. Se aplicó la teoría de la normalización para eliminar las redundancias. Conclusiones: quedó descrito el proceso de diseño de la base de datos con la cual la Revista Cubana de Tecnología de la Salud, podrá gestionar los datos de una forma centralizada y eficaz, de manera que se puedan aplicar en la evaluación de la gestión editorial y el desarrollo de estudios bibliométricos de la producción científica de la revista.

Introduction: The Cuban Journal of Health Technology requires a database system for the treatment of information concerning the different editorial management processes. This is necessary in the automation process and, at the same time, in the humanization of the collection, organization, processing, and presentation of the data related to the quality evaluation and bibliometric indicators, as well as those related to the indexing, to cite some examples. Objective: To design a database for the Cuban Journal of Health Technology. Methods: An applied research on technological innovation was carried out, in which a relational database was designed. Theoretical and empirical methods were used; among them, we can mention the interview to obtain a detailed description of the needs of the journal, and the representation modeling through logical and conceptual models of the universe of discourse. Results: The database was designed using the Entity-Relationship model. The entity-relationship diagram and the relational schema of the database were obtained. Normalization theory was applied to eliminate redundancies. Conclusions: The design process of the database that will allow the Cuban Journal of Health Technology to manage data in a centralized and efficient way was described, so that it can be applied to the evaluation of the editorial management and the development of bibliometric studies of the scientific production of the journal.

Mapa microbiológico: software para los laboratorios de microbiología

Introducción: El mapa microbiológico permite conocer desde una situación infecciosa particular hasta la epidemiología de toda la institución en torno a las infecciones, así como las opciones terapéuticas. Objetivos: Crear una base de datos que analice los datos registrados mediante consultas y formularios a partir de criterios de búsqueda. Métodos: Se confeccionó una base de datos empleando Microsoft Access, y se organizó la información usando lenguajes de programación SQL y VBA mediante consultas y formularios. Resultados: Se obtuvieron tablas, consultas y formularios para proporcionar la información de acuerdo a las exigencias del laboratorio y el servicio que lo solicita. Conclusiones: El software ofrece una solución al acceso de la información de forma digital, rápida y certera, además de segura. El registro de los datos es el único proceder manual, con lo que se minimizan las jornadas dedicadas al desarrollo del informe final. Se sugiere el empleo del mapa microbiológico en Microsoft Access como herramienta en los laboratorios de microbiología.

Introduction: The microbiological map allows us to know from a particular infectious situation to the epidemiology of the entire institution regarding infections, as well as therapeutic options. Objectives: To create a database that groups the results of microorganisms isolated in the laboratory and their susceptibility (according to the antibiogram), capable of grouping queries and accounts based on search criteria. Methods: A database was created using Microsoft Access, and the information was organized using SQL and VBA programming languages, through queries and forms. Results: Tables, consultations and forms were obtained to provide information according to the requirements of the laboratory and the service that requests it. Conclusions: The software offers a solution to access information digitally, quickly, accurately, and safely. Data recording is the only manual procedure, thus minimizing the days dedicated to the development of the final report. The use of the microbiological map using Microsoft Access is suggested as a tool in microbiology laboratories.

Revisão por pares das estratégias de busca para revisões sistemáticas: o PRESS, histórico, tradução para o português e funcionalidade / Peer review of search strategies for systematic reviews: the PRESS, history, Portuguese translation and functionality / Revisión por pares de las estrategias de búsqueda para revisiones sistemáticas: el PRESS, historia, traducción al portugués y funcionalidad

O Peer Review of Electronic Search Strategies (PRESS) é um instrumento elaborado na Canadian Agency for Drugs & Technologies in Health (CADTH) para avaliar cada elemento das estratégias de busca em bases de dados eletrônicas que podem influenciar a base das evidências das revisões sistemáticas. Os autores obtiveram licença para traduzir o PRESS para o português. O objetivo é contribuir para disseminação, uso e posterior implementação do PRESS, especialmente entre os bibliotecários, consolidando uma prática de avaliação de estratégias de busca das revisões sistemáticas. A metodologia foi o relato de experiência. Para contextualizar, inicia-se com o histórico da construção do PRESS, seguido do processo da tradução e apresentação das funcionalidades de cada tabela. O resultado é a disponibilização da versão do PRESS em português na página da CADTH. Conclui-se que a tradução deve impactar positivamente na qualidade das estratégias de busca das revisões sistemáticas com participação de bibliotecários brasileiros

The Peer Review of Electronic Search Strategies (PRESS) is an instrument developed at the Canadian Agen-cy for Drugs & Technologies in Health (CADTH) to evaluate each element of search strategies in electronic databases that may influence the evidence base of systematic reviews. The authors obtained a license to translate the PRESS into Portuguese. The objective is to contribute to the dissemination, use and sub-sequent implementation of PRESS, especially among librarians, to consolidate the practice of evaluating search strategies for systematic reviews. The methodology used was the experience report. It begins with the history of the construction of PRESS, followed by the report of the translation process and the function-alities of each table. The result is the availability of the PRESS version in portuguese on the CADTH page. It is concluded that the translation should have a positive impact on the quality of search strategies for systematic reviews involving Brazilian librarians

El Peer Review of Electronic Search Strategies (PRESS) es un instrumento de la Canadian Agency for Drugs & Technologies in Health (CADTH) para evaluar cada elemento de las estrategias de búsqueda en bases de datos electrónicas que pueden influir en la base de evidencia de revisiones sistemáticas. Los autores obtu-vieron permiso para traducir PRESS al portugués. El objetivo es contribuir para difusión, uso e implemen-tación del PRESS, especialmente entre bibliotecarios, para consolidar la práctica de evaluar las estrategias de búsqueda de revisiones sistemáticas. La metodología utilizada fue relato de experiencias. Comienza con la historia de la construcción de PRESS, sigue el relato de la traducción, y de las funcionalidades de cada ta-bla. Como resultado el PRESS en portugués está en el sitio web de CADTH. Se concluye que esta traducción debe tener un impacto positivo en la calidad de las estrategias de búsqueda de revisiones sistemáticas que involucren bibliotecarios brasileños

Significado de la indexación de la Revista Peruana de Ginecología y Obstetricia a Scopus

La Revista Peruana de Ginecología y Obstetricia (RPGO) ha obtenido su inclusión en la importante base de datos Scopus. En una rápida recopilación de la publicación de la revista, se recuerda la dedicación editorial de sus seis editores, cuatro de los cuales acababan de presidir la Sociedad Peruana de Obstetricia y Ginecología (SPOG). Los momentos iniciales de trabajo editorial fueron realizados manualmente, en máquinas de escribir y visitando la imprenta continuamente, así como a los patrocinadores. El compromiso de los Comités Directivos de SPOG para financiar la publicación y distribución de los ejemplares permitió la gradual indexación a bases de datos locales, regionales e internacionales. Su internalización se amplió desde la publicación de la RPGO en el Open Journal Systems (OJS), sistema informático donde se publica los artículos con puntualidad, calidad, incluyendo sus características editoriales y la Información para los Autores. Ahora la publicación es solo virtual, en español e inglés, con visibilidad e impacto de los artículos desde el inicio de la RPGO en 1955. Con datos actualizados del OJS sobre la RPGO, el número de visitas mensuales a los resúmenes llegan hasta 10 mil y las descargas mensuales de artículos en formato PDF hasta más de 9 mil. Y, en el ámbito de revistas científicas de ginecoobstetricia de América Latina y España en Scopus, destaca el índice h de la RPGO por Google Scholar Metrics, como una de las mejores. Al presente, y frente a los desafíos futuros, la actividad de la RPGO ha sido fortalecida, estableciendo un equipo editorial y herramientas que permiten la ya iniciada profesionalización de los procesos de la actividad editorial.

The Peruvian Journal of Gynecology and Obstetrics (RPGO, for its acronym in Spanish) has obtained its inclusion in the important Scopus database. A quick review of the journal's publication recalls the editorial dedication of its six editors, four of whom had just recently chaired the Peruvian Society of Obstetrics and Gynecology (SPOG, for its acronym in Spanish). The initial editorial work was carried out manually, on typewriters and continuously visiting the printing press, as well as the sponsors. The commitment of the SPOG Steering Committees to finance the publication and distribution of the issues allowed the gradual indexing to local, regional and international databases. Its internalization was expanded since the publication of the RPGO in the Open Journal Systems (OJS), a computer system where articles are published with punctuality, quality, including their editorial characteristics and the Information for Authors. Now the publication is only virtual, in English and Spanish, with visibility and impact of the articles since the beginning of the RPGO in 1955. With updated OJS data on the RPGO, the number of monthly visits to the abstracts reaches up to 10 thousand and monthly downloads of articles in PDF format reach more than 9 thousand. And, in the field of obstetrics and gynecology scientific journals in Latin America and Spain in Scopus, the h index of the RPGO by Google Scholar Metrics stands out as one of the best. At present, and facing future challenges, the activity of the RPGO has been strengthened, establishing an editorial team and tools that allow the already initiated professionalization of the processes of the editorial activity.

Elaboración de una base de referencia de composición corporal pediátrica para la provincia de Mendoza (Argentina)

R E S U M E N El objetivo fue elaborar una base de datos de referencia para composición corporal de sujetos pediátricos en la provincia de Mendoza (Argentina). Se obtuvieron datos de I4 variables de composición corporal (densidad y composición mineral ósea; masa magra y blanda; índice de masa corporal y magra, entre otros) de 198 sujetos (96 mujeres) de 4 a 19 años. Los sujetos se clasificaron en ocho grupos bienales; aquellos en etapa de transición puberal fueron clasificados según los estadios de Tanner: Las medidas se obtuvieron mediante densitometría dual de rayos-X en un equipo Lunar Prodigy DF+I6206. Para el análisis estadístico se usó Prism 5.4 en MS Win 7. Los valores de las variables analizadas aumentaron con la edad. Los valores en hombres siguen una tendencia lineal mientras en mujeres es sigmoidea, excepto el índice de masa corporal. Pacientes con igual edad, pero mayor estadio de Tanner, mostraron valores superiores de los componentes corporales. Las mujeres maduraron más tempranamente. Se concluyó que valores de las variables analizadas aumentaron con la edad y en menor medida, con las etapas de Tanner Los cambios son más precoces en mujeres y siguen diferentes cursos temporales en ambos sexos.

The objective was to develop a reference database for body composition of pediatric subjects in the province of Mendoza (Argentina). Data on I4 body composition variables (bone mineral density and composition; lean and soft mass; lean and body mass index, among others) were obtained from I98 subjects (96 women) aged 4 to 19 years. Subjects were classified into eight biennial groups; those in the pubertal transition stage were classified according to the Tanner stages. Measurements were obtained by dual X-ray densitometry on a Lunar Prodigy DF+I6206 instrument. For the statistical analysis, Prism 5.4 in MS Win 7 was used. The values of the variables analyzed increased with age. The values i n men follow a linear trend while in women it is sigmoid, except for the body mass index. Patients with the same age, but higher Tanner stage, showed higher values of body components. Women matured earlier It was concluded that the values of the variables analyzed increased with age and, to a lesser extent, with the Tanner stages. The changes are earlier and follow different time courses in women than in men.

O objetivo foi desenvolver um banco de dados de referência para composição corporal de indivíduos pediátricos na província de Mendoza (Argentina). Dados sobre I4 variáveis de composição corporal (densidade e composição mineral óssea; massa magra e massa mole; índice de massa magra e corporal, entre outras) foram obtidos de I98 indivíduos (96 mulheres) com idades entre 4 e I9 anos. Os sujeitos foram classificados em oito grupos bienais; aqueles no estágio de transição puberal foram classificados de acordo com os estágios de Tanner As medições foram obtidas por densitometria por dupla emissão de raios-X em um instrumento Lunar Prodigy DF+I6206. Para a análise estatística foi utilizado o Prism 5.4 no MS Win 7. Os valores das variáveis analisadas aumentaram com a idade. Os valores nos homens seguem uma tendência linear enquanto nas mulheres é sigmóide, com exceção do índice de massa corporal. Pacientes com a mesma idade, mas estágio de Tanner mais alto, apresentaram valores mais elevados de componentes corporais. As mulheres amadureceram mais cedo. Concluiu-se que os valores das variáveis analisadas aumentaram com a idade e, em menor grau, com os estágios de Tanner As mudanças são mais precoces e seguem cursos de tempo diferentes nas mulheres do que nos homens.

Base de datos automatizada para el control de la literatura docente

Introducción: Actualmente se impone la automatización de los datos, lo que contribuye a ganar tiempo, mejorar el rendimiento y la escalabilidad de los procesos. Objetivo: crear una base de datos automatizada (BDA) para el control de la literatura docente, en la Filial de Ciencias Médicas de Nuevitas. Métodos: Se realizó un estudio de innovación tecnológica, en el período comprendido desde octubre de 2021 hasta enero de 2022; para la recolección de datos se utilizó una encuesta, que permitió el diagnóstico de la necesidad de crear el producto terminado e identificar criterios que aportaron información primaria. Como herramienta de diseño se utilizó el gestor de base de datos Microsoft Access. Se trabajó en dos etapas: la primera donde se hizo un estudio de los documentos concernientes a la literatura docente existentes en el almacén y la segunda en la cual se trabajó en el diseño lógico y físico de la BDA. Resultados: La factibilidad del producto fue valorada de adecuada por parte de los especialistas. Conclusiones: Se recomienda la validación del producto para determinar su confiabilidad, así como la utilización del producto terminado en otras instituciones de la educación médica superior.

Introduction: Currently, the need for data automation is an imposition that contributes to reducing time, as well as improving performance and process scalability. Objective: to create an automated database (BDA) for the control of teaching literature in the Nuevitas Medical Sciences Branch. Methods: A study of technological innovation was carried out from October 2021 to January 2022. The information was obtained by means of a survey, which allowed the diagnosis of the need to create the finished product and identify criteria that provided primary information. Microsoft Access database manager was used as design tool. The work was carried out in two stages: a first stage related to the study of the documents concerning the teaching literature existing in the warehouse; the second stage that involved the logical and physical design of the BDA. Results: The feasibility of the computer product was assessed as adequate by the specialists. Conclusions: The validation of the product is recommended to determine its reliability, as well as its use in other institutions of higher medical education.

Lactate acid level and prognosis of neonatal necrotizing enterocolitis: a retrospective cohort study based on pediatric-specific critical care database

Abstract Objective To investigate the relationship between lactate acid level and hospitalization mortality in neonatal necrotizing enterocolitis (NEC). Method Paediatric-specific critical care database collected clinical data from the intensive care unit of Children's Hospital Affiliated to Zhejiang University Medical College from 2010 to 2018. Clinical and laboratory examination information of NEC patients was collected and divided into the death group and discharge group to find out the risk factors affecting the prognosis through univariate and multivariate analysis. Results Among 104 NEC neonates, the admission age was 7.5 days and the weight was 2.03 kg. Comparing the death group with the discharge group, there were significant differences in therapeutic regimen, pH, serum albumin, total protein, creatinine and lactate acid. Multivariate and threshold effect analysis showed that lactate acid had a linear correlation with hospital mortality, and newborns who died in the hospital had much higher lactate levels than those who were discharged. The mortality of NEC newborns increased by 40-45% for every 1 mmol/L increase in lactate acid level. Conclusions There was a correlation between lactate acid level and hospital mortality in newborns with NEC, and lactate acid level was an important index to evaluate the prognosis of NEC.

The impact of patients with generalized anxiety disorder in the Brazilian Private Healthcare System: a claim database study with expert's perspective / O impacto de pacientes com transtorno de ansiedade generalizada no Sistema Único de Saúde: um estudo de base de sinistros com a perspectiva de especialistas

This study describes the healthcare resource use and costs associated with anxiety assessing claim database outcomes and expert opinion from the perspective of the Brazilian Private Healthcare System. A retrospective analysis of the Orizon database was conducted, containing claims data of anxiety patients reported in Private Healthcare Systems (2015-2017) according to the ICD-10 code (F40 or F41 and their subtypes). Further, a 3-hour online meeting brought together five anxiety and Health Insurance Companies experts to discuss their perspectives. The total cost of the 18,069 patients identified in the database was BRL 490 million: related to medical appointments (2%), exams (16%), emergency room (5%), and others (77%). The mean number of appointments was 5.1 in a 4-year period, performed by 61% of the patients. Approximately 2,595 visits were made to psychiatrists by 923 patients, and 95% underwent at least one examination (100.6 examinations per patient, on average). The identification of anxiety patients and their corresponding burden is challenging to estimate. The higher impact is related to the frequency of healthcare use before the diagnosis than the treatment itself. These outcomes may help plan and implement adequate healthcare programs for patients with anxiety.

Este estudo descreve o uso de recursos de saúde e os custos relacionados à ansiedade associando resultados de uma base de dados administrativa e opinião de especialistas na perspectiva do Sistema Privado de Saúde Brasileiro. Foi realizada uma análise retrospectiva da base de dados da Orizon de pacientes com ansiedade em atendimento hospitalizar ou ambulatorial no Sistema Privado de Saúde (2015 - 2017) com o código CID-10 (F40 ou F41 e os seus subtipos), adicionalmente promovemos uma reunião online de 3 horas com cinco especialistas em ansiedade e em seguros de saúde para discutir as suas perspectivas. O custo total dos 18.069 pacientes identificados no banco de dados foi de R$ 490 milhões, relacionados a consultas médicas (2%), exames (16%), pronto-socorro (5%) e outros (77%). A média de consultas foi de 5,1 em um período de 4 anos, realizadas por 61% dos pacientes. Aproximadamente 2.595 visitas foram feitas a psiquiatras por 923 pacientes, e 95% realizaram pelo menos um exame (média de 100,6 exames por paciente. É desafiador identificar e estimar o impacto da doença no Sistema Privado de Saúde Brasileiro. O impacto maior está relacionado à frequência de uso de serviços de saúde antes do diagnóstico, em comparação com o próprio tratamento. Esses resultados podem ajudar a planejar e implementar programas de saúde adequados para pacientes com ansiedade.

The impact of depression in the Brazilian private healthcare system: patient journey and economic burden study associating claim database and expert's opinion approach / O impacto da depressão no sistema de saúde privado brasileiro: estudo da jornada do paciente e da carga econômica associando banco de dados de sinistros e abordagem de opinião de especialistas

Objective: The study aimed to describe the profile and economic burden of patients with depression from the perspective of the Brazilian Private Healthcare System (PHS). Methods: A two-step methodological quantitative-qualitative research design was performed: retrospective descriptive analysis of the Orizon database of patients with at least one claim of depression (F33, F38, or F39) in PHS (2013-2019) and experienced physicians perspective from an expert meeting. Results: 1,802 patients fulfilling the eligibility criteria counted BRL 74,978 million across the 4-year period. Over this period, nearly 60% of patients had a medical appointment (6.6 appointments per patient, on average), 61% had a psychologist, 9.8% had a psychiatrist appointment, and an average of 115.2 exams and 8.7 emergency visits per patient were performed. According to the experts, the economic impact of depression is more significant when considering the indirect costs related to productivity loss and impairment in occupational and interpersonal functioning. Conclusion: Identifying and diagnosing patients with depression and their real burden is challenging; even with significant costs identified in the claim database analyses in the Brazilian PHS, the real impact must be higher if indirect costs are considered. The depressive disorder should be prioritized in the Brazilian PHS to establish more adequate health policies.

Objetivo: O estudo teve como objetivo descrever o perfil e a carga econômica de pacientes com depressão na perspectiva do Sistema Único de Saúde (SUS). Métodos: Foi realizado um projeto de pesquisa quantitativo-qualitativo metodológico em duas etapas: análise descritiva retrospectiva do banco de dados Orizon de pacientes com pelo menos uma alegação de depressão (F33, F38 ou F39) no PHS (2013- 2019) e perspectiva de médicos experientes de uma reunião de especialistas. Resultados: 1.802 pacientes que preencheram os critérios de elegibilidade totalizaram R$ 74,978 milhões no período de 4 anos. Nesse período, cerca de 60% dos pacientes tiveram consulta médica (6,6 consultas por paciente, em média), 61% tiveram psicólogo, 9,8% consulta com psiquiatra e foram realizados em média 115,2 exames e 8,7 atendimentos de emergência por paciente . Segundo os especialistas, o impacto econômico da depressão é mais significativo quando considerados os custos indiretos relacionados à perda de produtividade e prejuízo no funcionamento ocupacional e interpessoal. Conclusão: Identificar e diagnosticar pacientes com depressão e sua real carga é desafiador; mesmo com custos significativos identificados nas análises da base de sinistros do SUS brasileiro, o impacto real deve ser maior se considerados os custos indiretos. O transtorno depressivo deve ser priorizado na APS brasileira para o estabelecimento de políticas de saúde mais adequadas.

Web-tools for the genomic analysis of the 2022 Monkeypox virus global outbreak / Herramientas web para el análisis genómico del virus de la viruela símica durante el brote mundial de 2022

Abstract The resources and platforms available on the internet for collecting and sharing information and performing genomic sequence analysis have made it possible to follow closely the evolution the evolution of SARS-CoV-2. However, the current monkeypox outbreak in the world brings us back to the need to use these resources to appraise the extent of this outbreak. The objective of this work was an analysis of the information presented so far in the genomic database GISAID EpiPox™, using various tools available on the web. The results indicate that the monkeypox outbreak is referred as MPXV clade II B.1 lineage and sub-lineages, isolated from male patients mainly from the European and American continents. In the current scenario, the access to genomic sequences, epidemiological information, and tools available to the scientific community is of great importance for global public health in order to follow the evolution of pathogens.

Resumen Los recursos y plataformas disponibles en Internet para recopilar, compartir información y realizar análisis de secuencias genómicas han permitido seguir de cerca la evolución del SARS-CoV-2. El actual brote global de viruela del mono en el mundo, requiere de nuevo utilizar estos recursos para conocer el alcance de este brote. El objetivo de este trabajo fue un análisis de la información presentada hasta el momento en la base de datos genómica EpiPox™ de GISAID, utilizando diversas herramientas disponibles en la web. Los resultados indican que el brote de la viruela del mono o símica está referido al linaje y sub-linajes B.1 del clado II de MPXV, aislado principalmente de pacientes hombres de Europa y América. En el escenario actual, el acceso a las secuencias genómicas, la información epidemiológica, y las herramientas disponibles para la comunidad científica son de gran importancia para la salud pública mundial con el fin de seguir la evolución de los patógenos.

Adoption, implementation, definitions, and future of blockchain technology in ophthalmology

In this era of cutting-edge research and digitalization, artificial intelligence (AI) has rapidly penetrated all subspecialties, including ophthalmology. Managing AI data and analytics is cumbersome, and implementing blockchain technology has made this task less challenging. Blockchain technology is an advanced mechanism with a robust database that allows the unambiguous sharing of widespread information within a business model or network. The data is stored in blocks that are linked together in chains. Since its inception in 2008, blockchain technology has grown over the years, and its novel use in ophthalmology has been less well documented. This section on current ophthalmology discusses the novel use and future of blockchain technology for intraocular lens power calculation and refractive surgery workup, ophthalmic genetics, payment methods, international data documentation, retinal images, global myopia pandemic, virtual pharmacy, and drug compliance and treatment. The authors have also provided valuable insights into various terminologies and definitions used in blockchain technology.

Utilização de banco de dados policiais como perspectiva para redução do sub-registro da violência contra mulheres / Using police databases as a prospect to reduce under-recording of violence against women / Utilizar las bases de datos policiales como perspectiva para reducir el subregistro de la violencia contra las mujeres

Objetivo: buscou-se avaliar a concordância entre o Sistema de Informação de Agravo de Notificação (SINAN) e dados policiais para casos de violência física e sexual contra mulheres, bem como o perfil das mulheres agredidas, das agressões e dos agressores. Método: foi realizado estudo transversal com casos ocorridos em uma cidade de Minas Gerais, notificados no SINAN e/ou identificados na base policial, entre os anos de 2015 e 2016. Criou-se uma base consolidada, composta pelos casos elegíveis das duas fontes, tendo sido realizadas análises descritivas. Em uma base pareada contendo casos comuns aos dois bancos, foi realizada análise de concordância pelo teste Fleiss'Kappa. Resultados: 1.185 casos compuseram a base consolidada e 56 constituíram a base pareada. Houve sub-registro de 83,54% nos dados do SINAN, além de incompletude importante de informações. A base policial apresentou cerca de oito vezes maior captação. A concordância de informações foi elevada/moderada para sete de 11 características avaliadas para os casos comuns. Na base consolidada, as vítimas foram predominantemente negras, solteiras ou viúvas, com idade entre 18 e 39 anos. Os homens, especialmente (ex)parceiros e familiares, foram os principais agressores. Conclusão: o sub-registro e a incompletude de informações sobre violência contra mulher no SINAN é uma realidade que precisa ser tratada. O cruzamento com fontes de dados policiais é uma alternativa para melhorar a qualidade das informações, reduzindo o sub-registro. Apesar dos dados subestimados, percebeu-se que a violência física e doméstica, cometida por (ex)parceiro contra mulheres jovens e negras continua sendo prevalente, atentando para o fato que se deve manter foco de políticas públicas.(AU)

Objective: this study sought to evaluate the agreement between the Information System for Notifiable Health Problems (Sistema de Informação de Agravo de Notificação, SINAN) and Police data for cases of physical and sexual violence against women, as well as the profile of the assaulted women, the aggressions and the aggressors. Method: a cross-sectional study was conducted with cases in a city from Minas Gerais, notified to the SINAN and/or identified in the Police database between 2015 and 2016. A consolidated database was created, comprised by the eligible cases from both sources, with performance of descriptive analyses. An agreement analysis by means of the Fleiss Kappa test was performed in a paired database containing cases common to both databases. Results: a total of 1,185 cases comprised the consolidated database, whereas 56 were included in the paired one. There was 83.54% under-recording in the SINAN data, in addition to important information incompleteness. The Police database presented nearly eight times more recording of cases. Agreement of all the information was high/moderate for seven out of 11 characteristics evaluated for the common cases. In the consolidated databases, the victims were predominantly black-skinned, single or widowed, and aged between 18 and 39 years old. The main aggressors were men, mainly (former) partners and family members. Conclusion: under-recording and incompleteness of diverse information about violence against women in the SINAN is a reality that needs to be dealt with. Cross-referencing with Police data sources represent an alternative to improve quality of the information, reducing under-recording. Despite the underestimated data, it was noticed that physical and domestic violence, perpetrated by (former) partners against young and black-skinned women, continues to be prevalent, pointing to the fact that it should remain as the focus of public policies.(AU)

Objetivo: se buscó evaluar la concordancia entre el Sistema de Informação de Agravo de Notificação (SINAN) y los datos policiales para los casos de violencia física y sexual contra las mujeres, así como el perfil de las mujeres maltratadas, de las agresiones y agresores. Método...(AU)

The SickKids Caribbean Initiative to improve care for children with cancer and blood disorders / La iniciativa SickKids para el Caribe para mejorar la atención a pacientes pediátricos con cáncer o trastornos hematológicos / Iniciativa SickKids no Caribe: melhorar o atendimento a crianças com câncer e doenças hematológicas

ABSTRACT To improve pediatric hematology and oncology outcomes, there is a recognized potential for partnerships between low- and high-resource institutions within health care systems. The SickKids Caribbean Initiative is a partnership between health care professionals at the Hospital for Sick Children in Toronto, Canada, and seven Caribbean institutions across six countries (Bahamas, Barbados, Jamaica, Saint Lucia, Saint Vincent and the Grenadines, and Trinidad and Tobago). The primary aim of the SickKids Caribbean Initiative has been to improve the outcomes and the quality of life of children in the Caribbean aged <18 years who have cancer and blood disorders. This article describes five key activities undertaken within the SickKids Caribbean Initiative, including providing education and training, assisting with case consultations and diagnostic services, developing local oncology databases, engaging in advocacy and ensuring stakeholder engagement, and coordinating administration and project management.

RESUMEN Las colaboraciones de instituciones de recursos bajos y altos dentro de los sistemas de atención de salud tienen un potencial reconocido para mejorar las respuestas a los tratamientos hematológicos y oncológicos pediátricos. La iniciativa SickKids para el Caribe es una asociación entre profesionales de la salud del Hospital for Sick Children de Toronto (Canadá) y siete instituciones de seis países del Caribe (Bahamas, Barbados, Jamaica, Santa Lucía, San Vicente y las Granadinas y Trinidad y Tabago). El objetivo principal de la iniciativa SickKids para el Caribe ha sido mejorar la respuesta a los tratamientos y la calidad de vida de los menores de 18 años del Caribe con cáncer o trastornos hematológicos. En este artículo se describen cinco actividades clave emprendidas en el marco de la iniciativa SickKids para el Caribe, consistentes en impartir formación y capacitación, prestar asistencia en materia de consultas de pacientes y servicios de diagnóstico, crear bases de datos locales en el área de la oncología, participar en actividades de promoción y garantizar la participación de las partes interesadas, y coordinar la administración y gestión de proyectos.

RESUMO Há um potencial reconhecido para parcerias entre instituições com poucos e muitos recursos dentro dos sistemas de saúde para melhorar os resultados de hematologia e oncologia pediátricas. A iniciativa SickKids no Caribe é uma parceria entre profissionais de saúde do Hospital for Sick Children em Toronto, Canadá, e sete instituições em seis países do Caribe (Bahamas, Barbados, Jamaica, Santa Lúcia, São Vicente e Granadinas e Trinidad e Tobago). O objetivo principal da iniciativa SickKids no Caribe tem sido melhorar os desfechos e a qualidade de vida das crianças caribenhas com menos de 18 anos que têm câncer e doenças hematológicas. Este artigo descreve cinco atividades principais realizadas no âmbito da iniciativa SickKids no Caribe: oferecimento de educação e capacitação; assistência em consultas de casos e serviços diagnósticos; desenvolvimento de bancos de dados locais em oncologia; promoção da causa, assegurando o envolvimento das partes interessadas; e coordenação da administração e da gestão de projetos.

Use of Psychotropic Drugs during the COVID-19 pandemic in Minas Gerais, Brazil / Perfil de utilização de psicofármacos durante a pandemia de COVID-19 em Minas Gerais, Brasil

ABSTRACT Objective: To describe the profile of dispensation of mental health drugs by analyzing trends in use before and during the COVID-19 pandemic within the Unified Health System (Sistema Único de Saúde [SUS]). Methods: Pharmacoepidemiological study based on the retrospective analysis of records regarding the dispensation of psychotropic medicines in the SUS database in the state of Minas Gerais between 2018 and 2021, considering the periods before (2018-2019) and during the COVID-19 pandemic (2020-2021). A database with the records of dispensation of municipalities was created, and the consistency of releases was verified using the Analysis of Variance (ANOVA) test. Medicine consumption was measured in a defined daily dose (DDD) per 1,000 inhabitants/day for SUS, and the difference between periods was evaluated using Student's t-test. Results: During the COVID-19 pandemic, there was an increase in the consumption of psychotropic drugs in SUS-MG. The most consumed medicines were fluoxetine hydrochloride, diazepam and phenobarbital sodium (DDD=5.89; 3.42; 2.49) in the Basic Pharmaceutical Services Component(CBAF), and olanzapine, risperidone and quetiapine hemifumarate (DDD=0.80; 0.47; 0.38) in the Specialized Pharmaceutical Services Component (CEAF). The highest percentage increase in consumption was attributed to clonazepam (75.37%) and lithium carbonate (35.35%), in CBAF, and levetiracetam (3,000.00%) and memantine hydrochloride (340.0%) in CEAF. Conclusion: The change in the psychotropic drug dispensation profile during the COVID-19 pandemic highlights the need to produce more studies to complete, confirm or rule out this profile and monitor the use of psychotropic drugs by the population in the post-pandemic context.

RESUMO Objetivo: Descrever o perfil de dispensação de medicamentos da saúde mental analisando o uso antes e durante a pandemia de COVID-19 no âmbito do Sistema Único de Saúde (SUS). Métodos: Estudo farmacoepidemiológico a partir da análise retrospectiva dos registros de dispensação de psicofármacos na base de dados do SUS no estado de Minas Gerais (MG) nos períodos antes (2018-2019) e durante a pandemia de COVID-19 (2020-2021). Um banco de dados com os registros de dispensação dos municípios foi elaborado, sendo verificada a consistência de lançamento pelo teste de Análise de Variância (ANOVA). O consumo dos medicamentos foi mensurado em dose diária definida (DDD) por 1.000 habitantes/dia para o SUS, sendo a diferença entre os períodos avaliada pelo teste estatístico t de Student. Resultados: Durante a pandemia de COVID-19 houve aumento no consumo de psicofármacos no SUS-MG. Os medicamentos mais consumidos foram cloridrato fluoxetina, diazepam e fenobarbital sódico (DDD=5,89; 3,42; 2,49) no componente básico (CBAF), e olanzapina, risperidona e hemifumarato de quetiapina (DDD=0,80; 0,47; 0,38) no componente especializado da Assistência Farmacêutica (CEAF). Os maiores aumentos percentuais no consumo foram atribuídos ao clonazepam (75,37%) e carbonato de lítio (35,35%) no CBAF e levetiracetam (3.000,00%) e cloridrato de memantina (340,00%) no CEAF. Conclusão: A alteração do perfil de dispensação de psicotrópicos durante a pandemia de COVID-19 alerta quanto à necessidade de produção de mais estudos a fim de completar, confirmar ou afastar este perfil e monitorar o uso de psicofármacos pela população no contexto pós-pandêmico.

Resultados Imediatos após Múltiplos Enxertos Arteriais em Cirurgia de Revascularização Miocárdica no Estado de São Paulo: Estudo de Coorte / Immediate Results after Multiple Arterial Grafts in Coronary Artery Bypass Graft Surgery in the São Paulo State: Cross Cohort Study

Resumo Fundamento Os resultados a curto prazo após o uso de enxertos arteriais ainda suscitam questionamentos e dúvidas na sociedade médica. Objetivo Comparar os resultados imediatos de pacientes submetidos à cirurgia de revascularização do miocárdio com enxerto arterial único versus enxertos arteriais múltiplos. Métodos Estudo de coorte transversal no Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II). Os dados perioperatórios de 3122 pacientes foram agrupados pelo número de enxertos arteriais utilizados e seus desfechos foram comparados: reoperação, infecção profunda da ferida torácica (IPFT), acidente vascular cerebral, lesão renal aguda, intubação prolongada (>24 horas), tempo de internação curta (<6 dias), tempo de internação prolongada (>14 dias), morbidade e mortalidade. O Propensity Score Matching (PSM) correspondeu a 1062 pacientes, ajustado para o risco de mortalidade. Resultados Após PSM, o grupo enxerto arterial único apresentou pacientes com idade avançada, mais ex-fumantes, hipertensos, diabéticos, portadores de angina estável e infarto do miocárdio prévio. Nos enxertos arteriais múltiplos houve predomínio do sexo masculino, pneumonia recente e cirurgias de urgência. Após o procedimento, houve maior incidência de derrame pleural (p=0,042), pneumonia (p=0,01), reintubação (p=0,006), IPFT (p=0,007) e desbridamento esternal (p=0,015) no grupo de enxertos multiarteriais, porém, menor necessidade de hemotransfusão (p=0,005), infecções de extremidades (p=0,002) e menor tempo de internação (p=0,036). O uso bilateral da artéria torácica interna não foi relacionado ao aumento da taxa de IPFT, e sim a hemoglobina glicosilada >6,40% (p=0,048). Conclusão Pacientes submetidos a técnica multiarterial apresentaram maior incidência de complicações pulmonares e IPFT, sendo que a hemoglobina glicosilada ≥6,40% teve maior influência no resultado infeccioso do que a escolha dos enxertos.

Abstract Background The short-term results after using arterial grafts still raise questions and doubts for medical society. Objective To compare the immediate outcomes of patients undergoing single arterial graft versus multiple arterial grafts coronary artery bypass grafting surgery. Methods Cross-sectional cohort study in the São Paulo Registry of Cardiovascular Surgery II (REPLICCAR II). Perioperative data from 3122 patients were grouped by the number of arterial grafts used, and their outcomes were compared: reoperation, deep sternal wound infection (DSWI), stroke, acute kidney injury, prolonged intubation (>24 hours), short hospital stay (<6 days), prolonged hospital stay (>14 days), morbidity and mortality. Propensity Score Matching (PSM) matched 1062 patients, adjusted for the mortality risk. Results After PSM, the single arterial graft group showed patients with advanced age, more former smokers, hypertension, diabetes, stable angina, and previous myocardial infarction. In the multiple arterial grafts, there was a predominance of males, recent pneumonia, and urgent surgeries. After the procedure, there was a higher incidence of pleural effusion (p=0.042), pneumonia (p=0.01), reintubation (p=0.006), DSWI (p=0.007), and sternal debridement (p=0.015) in the multiple arterial grafts group, however, less need for blood transfusion (p=0.005), extremity infections (p=0.002) and shorter hospital stays (p=0.036). Bilateral use of the internal thoracic artery was not related to increased DSWI rate, but glycosylated hemoglobin >6.40% (p=0.048). Conclusion Patients undergoing the multiarterial technique had a higher incidence of pulmonary complications, and DSWI, where glycosylated hemoglobin ≥6.40%, had a greater influence on the infectious outcome than the choice of grafts.

Efficacy of chemoradiotherapy versus surgery in cervical esophageal cancer: a population-based competing risk analysis / 中华放射肿瘤学杂志

Objective:To evaluate the value of chemoradiotherapy and surgery in cervical esophageal cancer (CEC).Methods:Data of 459 patients with CEC from 2004 to 2017 were collected and retrospectively analyzed from the surveillance, epidemiology, and end results (SEER) database of National Cancer Institute (US). All patients were divided into the chemoradiotherapy group ( n=379) and surgery group ( n=80) according to the treatment methods. Survival analysis was performed by Kaplan-Meier method and survival curve was drawn. Multivariate survival analysis was conducted by Cox proportional hazards regression model. The death rate of different causes between two groups was calculated by cumulative incidence function (CIF). The differences of death rate between two groups were evaluated by Fine-Gray competing risk model. By analyzing the clinical characteristics and survival of CEC patients, the overall survival (OS) was compared between the surgery and chemoradiotherapy groups. Results:The 2- and 5-year survival rates in the chemoradiotherapy group were 43.1% and 22.4%, while those of the surgical group were 46.8% and 26.0%, respectively. No significant difference was observed in the OS between the chemoradiotherapy and surgery groups ( P=0.750). Cox multivariate analysis showed that treatment (surgery group vs. chemoradiotherapy group) was not an independent prognostic factor for OS. Based on the results of competing risk analysis, the risk of esophageal cancer-specific death in the chemoradiotherapy group was higher than that in the surgery group, and the difference was statistically significant between two groups ( P<0.001). The risk of other cause-specific death in the chemoradiotherapy group was lower than that in the surgery group ( P<0.001). The proportion of patients who died of oral, oropharyngeal, hypopharyngeal and laryngeal diseases in the surgery group was significantly higher than that in the chemoradiotherapy group(all P<0.001). Conclusions:No significant difference is observed in the OS of CEC patients treated with chemoradiotherapy or surgery. In the surgery group, the risk of esophageal cancer-specific death is lower, whereas the risk of other cause-specific death is higher compared with those in the chemoradiotherapy group.

Research progress on image standard database of artificial intelligence-assisted radiotherapy for lung cancer / 中华放射肿瘤学杂志

Lung cancer is the malignant tumor with the highest mortality rate in the world. Radiotherapy plays an important role in the comprehensive treatment of lung cancer. With the continuous advancement of radiotherapy technology and equipment, it has become one of the effective therapeutic options for lung cancer. In recent years, artificial intelligence technology has developed rapidly and has been widely applied in clinical practice, especially in the diagnosis and treatment of lung cancer imaging. The image database can be obtained by sorting and summarizing the images, which can be used in clinical work and scientific research. In this article, the application of artificial intelligence in lung cancer radiotherapy imaging and lung cancer imaging database was reviewed, aiming to provide reference for the construction of artificial intelligence radiotherapy imaging database for lung cancer.

Establishment and evaluation of early in-hospital death prediction model for patients with acute pancreatitis in intensive care unit / 中华危重病急救医学

Objective:To investigate the death risk prediction factors of acute pancreatitis (AP) patients in intensive care unit (ICU), and to establish a death prediction model and evaluate its efficacy.Methods:A retrospective cohort study was conducted using the data in the Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ). The clinical data of 285 AP patients admitted to the ICU in the database were collected, including age, gender, blood routine and blood biochemical indicators, comorbidities, simplified acute physiology score Ⅲ (SAPS Ⅲ) and hospital prognosis. By using univariate analysis, the differences in the clinical data of the patients were compared between the two groups. Binary multivariate Logistic regression analysis was used to screen out independent predictors of in-hospital death in AP patients. A death prediction model was established, and the nomogram was drawn. The receiver operator characteristic curve (ROC curve) was plotted, and the area under the ROC curve (AUC) was used to test the discrimination of the prediction model. In addition, the prediction model was compared with the SAPSⅢ score in predicting in-hospital death. The calibration ability of the prediction model was evaluated by the Hosmer-Lemeshow goodness of fit test, and a calibration map was drawn to show the calibration degree of the prediction model.Results:Among 285 patients with AP, 29 patients died in the hospital and 256 patients survived. Univariate analysis showed that the patients in the death group were older than those in the survival group (years old: 70±17 vs. 58±16), and had higher white blood cell count (WBC), total bilirubin (TBil), serum creatinine (SCr), blood urea nitrogen (BUN), red blood cell volume distribution width (RDW), proportion of congestive heart failure and SAPSⅢ score [WBC (×10 9/L): 18.5 (13.9, 24.3) vs. 13.2 (9.3, 17.9), TBil (μmol/L): 29.1 (15.4, 66.7) vs. 16.2 (10.3, 29.1), SCr (μmol/L): 114.9 (88.4, 300.6) vs. 79.6 (53.0, 114.9), BUN (mmol/L): 13.9 (9.3, 17.8) vs. 6.1 (3.7, 9.6), RDW: 0.152 (0.141, 0.165) vs. 0.141 (0.134, 0.150), congestive heart failure: 34.5% vs. 14.8%, SAPSⅢ score: 66 (52, 90) vs. 39 (30, 48), all P < 0.05]. Multivariate Logistic regression analysis showed that age [odds ratio ( OR) = 1.038, 95% confidence interval (95% CI) was 1.005-1.073], WBC ( OR = 1.103, 95% CI was 1.038-1.172), TBil ( OR = 1.247, 95% CI was 1.066-1.459), BUN ( OR = 1.034, 95% CI was 1.014-1.055) and RDW ( OR = 1.344, 95% CI was 1.024-1.764) were independent risk predictors of in-hospital death in patients with AP. Logistic regression model was established: Logit ( P) = 0.037×age+0.098×WBC+0.221×TBil+0.033×BUN+0.296×RDW-12.133. ROC curve analysis showed that the AUC of the Logistic regression model for predicting the in-hospital death of patients with AP was 0.870 (95% CI was 0.794-0.946), the sensitivity was 86.2%, and the specificity was 78.5%, indicating that the model had good predictive performance, and it was superior to the SAPSⅢ score [AUC was 0.831 (95% CI was 0.754-0.907), the sensitivity was 82.8%, and the specificity was 75.4%]. A nomogram model was established based on the result of multivariate Logistic regression analysis. The calibration map showed that the calibration curve of the nomogram model was very close to the standard curve, with the goodness of fit test: χ 2 = 6.986, P = 0.538, indicating that the consistency between the predicted death risk of the nomogram model and the actual occurrence risk was relatively high. Conclusions:The older the AP patient is, the higher the WBC, TBil, BUN, and RDW, and the greater the risk of hospital death. The death prediction Logistic regression model and nomogram model constructed based on the above indicators have good discrimination ability and high accuracy for high-risk patients with hospital death, which can accurately predict the probability of death in AP patients and provide a basis for prognosis judgment and clinical treatment of AP patients.

Development and validation of a prognostic model for patients with sepsis in intensive care unit / 中华危重病急救医学

Objective:To analyze the risk factors related to the prognosis of patients with sepsis in intensive care unit (ICU), construct a nomogram model, and verify its predictive efficacy.Methods:A retrospective cohort study was conducted using data from Medical Information Mart for Intensive Care-Ⅳ 0.4 [MIMIC-Ⅳ (version 2.0)]. The information of 6 500 patients with sepsis who meet the diagnostic criteria of Sepsis-3 were collected, including demography characteristics, complications, laboratory indicators within 24 hours after ICU admission, and final outcome. Using a simple random sampling method, the patients were divided into a training set and a validation set at a ratio of 7∶3. The restricted cubic spline (RCS) was used to explore whether there was a linear relationship between each variable and the prognosis, and the nonlinear variables were truncated into categorical variables. All variables were screened by LASSO regression and included in multivariate Cox regression analysis to analyze the death risk factors in ICU patients with sepsis, and construct a nomograph. The consistency index, calibration curve and receiver operator characteristic curve (ROC curve) were used to evaluate the prediction efficiency of nomogram model. The decision curve analysis (DCA) was used to validate the clinical value of the model and its impact on actual decision-making.Results:Among 6 500 patients with sepsis, 4 551 were in the training set and 1 949 were in the validation set. The 28-day, 90-day and 1-year mortality in the training set were 27.73% (1?262/4?551), 34.76% (1?582/4?551), and 42.98% (1?956/4?551), respectively, those in the validation set were 27.24% (531/1?949), 33.91% (661/1?949), and 42.23% (823/1?949), respectively. Both in training set and the validation set, compared with the final survival patients, the death patients were older, and had higher sequential organ failure assessment (SOFA) score and simplified acute physiology scoreⅡ (SAPSⅡ), more comorbidities, less urine output, and more use of vasoactive drugs, kidney replacement therapy, and mechanical ventilation. By RCS analysis, the variables with potential nonlinear correlation with the prognosis risk of septic patients were transformed into categorical variable. The variables screened by LASSO regression were enrolled in the multivariate Cox regression model. The results showed that age [hazard ratio ( HR) = 1.021, 95% confidence interval (95% CI) was 1.018-1.024], SOFA score ( HR = 1.020, 95% CI was 1.000-1.040), SAPSⅡ score > 44 ( HR = 1.480, 95% CI was 1.340-1.634), mean arterial pressure (MAP) ≤ 75 mmHg (1 mmHg ≈ 0.133 kPa; HR = 1.120, 95% CI was 1.026-1.222), respiratory rate (RR; HR = 1.044, 95% CI was 1.034-1.055), cerebrovascular disease ( HR = 1.620, 95% CI was 1.443-1.818), malignant tumor ( HR = 1.604, 95% CI was 1.447-1.778), severe liver disease ( HR = 1.330, 95% CI was 1.157-1.530), use of vasoactive drugs within 24 hours ( HR = 1.213, 95% CI was 1.101-1.336), arterial partial pressure of oxygen (PaO 2; HR = 0.999, 95% CI was 0.998-1.000), blood lactic acid (Lac; HR = 1.066, 95% CI was 1.053-1.079), blood urea nitrogen (BUN) > 8.9 mmol/L ( HR = 1.257, 95% CI was 1.144-1.381), total bilirubin (TBil; HR = 1.023, 95% CI was 1.015-1.031), and prothrombin time (PT) > 14.5 s ( HR = 1.232, 95% CI was 1.127-1.347) were associated with the death of ICU patients with sepsis (all P < 0.05). Based on the above factors, a nomogram model was constructed, and the model validation results showed that the consistency index was 0.730. The calibration curve showed a good consistency between the predicted results of the nomogram model and observed results in the training and validation sets. ROC curve analysis showed that the area under the ROC curve (AUC) predicted by the nomogram model in the training set and the validation set for 28-day, 90-day and 1-year death risk was 0.771 (95% CI was 0.756-0.786) and 0.761 (95% CI was 0.738-0.784), 0.777 (95% CI was 0.763-0.791) and 0.765 (95% CI was 0.744-0.787), 0.677 (95% CI was 0.648-0.707) and 0.685 (95% CI was 0.641-0.728), respectively. DCA analysis showed that the nomogram model had significant net benefits in predicting 28-day, 90-day, and 1-year death risk, verifying the clinical value of the model and its good impact on actual decision-making. Conclusions:The death risk factors related to ICU patients with sepsis include age, SOFA score, SAPSⅡ score > 44, MAP ≤ 75 mmHg, RR, cerebrovascular disease, malignant tumors, severe liver disease, use of vasoactive drugs within 24 hours, PaO 2, Lac, BUN, TBil, PT > 14.5 s. The nomogram model constructed based on this can predict the death risk of ICU patients with sepsis.