Who are the Solidarity Kitchen users? Study on inequalities to ensure food and nutritional security based on the experience of Sol Nascente community - Distrito Federal, Brazil / Quem são os usuários da Cozinha Solidária? Estudo sobre desigualdades na garantia da segurança alimentar e nutricional a partir da experiência da comunidade do Sol Nascente - Distrito Federal, Brasil

ABSTRACT Objective To review the demographic and socioeconomic profile of the Homeless Workers Movement's Solidarity Kitchen project users in the Sol Nascente Community, Federal District, Brazil. Methods Descriptive cross-sectional study. The interviews were conducted with adults, users of the solidarity kitchen, in August 2022, using a standardized questionnaire containing demographic, socioeconomic, housing and food consumption information. The outcome of the study was Frequent Use (picking up food at the solidarity kitchen five days/week). General and gender descriptive analyses were conducted, as well as a bivariate analysis based on the chi-square test (p<0.05). Results The sample was composed of 83 dark complexion women with a mean age of 39.6 years (SD=14.6). A total of 35 women (42.2%) had attended the first year of high school or over, and approximately 65.0% had a job and were paid up to one minimum wage. Most received social benefits and 81.9% were unemployed at the time of the survey. More than half of the respondents owned their own home and among those who did not, 64.0% paid rent. A total of 46.3% respondents had up to two daily meals. The prevalence of users who were considered Frequent Users was 61.0%. Women reported lower family income, greater dependence on aid, more unemployment, in addition to living with a greater number of people and having more people in the house who took food from the solidarity kitchen, all statistically significant differences. Conclusion The project Solidarity Kitchen essentially caters to dark complexion women with lower family income, who enhance the inequalities and inequities conditions in food security in the country.

RESUMO Objetivo Analisar o perfil demográfico e socioeconômico dos usuários do projeto Cozinha Solidária do Movimento dos Trabalhadores Sem Teto no Sol Nascente, Distrito Federal, Brasil. Métodos Estudo descritivo do tipo transversal. As entrevistas foram realizadas com adultos, usuários da cozinha solidária, em agosto de 2022, a partir de um questionário padronizado contendo informações demográficas e socioeconômicas, sobre moradia e alimentação. O desfecho do estudo foi considerado Consumo Frequente (pegar comida na cozinha solidária nos cinco dias da semana: sim/não). Foram conduzidas as análises descritivas geral e por sexo, e bivariadas a partir do Teste qui-quadrado (p<0,05). Resultados A amostra de 83 indivíduos foi composta predominantemente por mulheres, pretas e pardas, com idade média de 39,6 anos (DP=14,6). Onde 42,2% cursaram o 1º ano do ensino médio ou mais e aproximadamente 65% recebiam até um salário-mínimo. A maioria recebia benefício social e 81,9% estava desempregada no momento da entrevista. Mais da metade dos entrevistados possuíam casa própria e, entre os que não tinham, 64,0% pagavam aluguel. O número de refeições diárias foi de até duas para 46,3% dos entrevistados. A prevalência de usuários que tinham Consumo Frequente foi 61%. As mulheres relataram menor renda familiar, maior dependência de auxílios, maior desemprego, além de residirem com mais pessoas, os quais pegavam mais comida da cozinha solidária, sendo todas diferenças estatisticamente significativas. Conclusão O projeto atende essencialmente mulheres, pretas e com menor renda familiar, corroborando o panorama das desigualdades e iniquidades no acesso à alimentação no país.

Breast cancer survival after mammography dissemination in Brazil: a population-based analysis of 2,715 cases.

BACKGROUND: This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. METHODS: It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. RESULTS: Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p = 0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. CONCLUSIONS: In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.

Ações educativas na melhoria da comunicação entre profissionais de saúde: revisão integrativa / Educational actions to improve communication among health professionals: integrative review / Acciones educativas para mejorar la comunicación entre los profesionales de la salud: revisión inte-gradora

Objetivo: Mapear as ações educativas para a melhoria na comunicação entre profissionais de saúde. Método: Revisão integrativa entre junho e agosto de 2021. Incluídos artigos com texto completo, publicados entre 2016 e 2021, em português, inglês e espanhol. Excluídos resumos, editoriais, dissertações, teses e artigos que não incluíram a temática selecionada. Utilizou-se as bases de dados: Biblioteca Virtual em Saúde, Literatura Latino-americana e do Caribe em Ciências da Saúde, PubMed, Scientific Electronic Library Online, através dos descritores "Sistemas de comunicação no hospital", "Educação", "Pessoal de saúde". associados através dos operadores booleanos "AND" ou "OR". Os artigos foram organizados e analisados por similaridade de conteúdo. Resultados: Foram analisados 2 artigos e identificou-se duas categorias: "Simulação e desenvolvimento de habilidade de comunicação interdisciplinar" e "Desenvolvimento de programa eletrônico envolvendo a comunicação entre profissionais de saúde". Conclusão: Observou-se escassez de pesquisas relacionadas à temática. Sugere-se que novas investigações sejam realizadas no que diz respeito à comunicação entre profissionais (AU).

Objective: To map educational actions to improve communication between health professionals. Method: Integrative review between June and August 2021. Included full-text articles, published between 2016 and 2021, in Portuguese, English and Spanish. Abstracts, editorials, dissertations, theses and articles that did not include the selected theme were excluded. The following databases were used: Virtual Health Library, Latin American and Caribbean Health Sciences Literature, PubMed, Scientific Electronic Library Online, through the descriptors "Communication systems in the hospital", "Education", "Health personnel". associated through boolean operators "AND" or "OR". The articles were organized and analyzed by content similarity. Results: Two articles were analyzed and two categories were identified: "Simulation and development of interdisciplinary communication skills" and "Development of an electronic program involving communication between health professionals". Conclusion: There was a scarcity of research related to the theme. It is suggested that further investigations be carried out with regard to communication between professionals (AU).

Objetivo: Mapear acciones educativas para mejorar la comunicación entre los profesionales de la salud. Método: Revisión integradora entre junio y agosto de 2021. Incluye artículos de texto completo, publicados entre 2016 y 2021, en portugués, inglés y español. Se excluyeron resúmenes, editoriales, disertaciones, tesis y artículos que no incluyeran el tema seleccionado. Se utilizaron las siguientes bases de datos: Biblioteca Virtual en Salud, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, PubMed, Biblioteca Científica Electrónica en Línea, a través de los descriptores "Sistemas de comunicación en el hospital", "Educación", "Personal de salud". asociados a través de operadores booleanos "AND" o "OR". Los artículos fueron organizados y analizados por similitud de contenido. Resultados: Se analizaron dos artículos y se identificaron dos categorías: "Simulación y desarrollo de habilidades de comunicación interdisciplinarias" y "Desarrollo de un programa electrónico que involucra la comunicación entre profesionales de la salud". Conclusión: Hubo escasez de investigaciones relacionadas con el tema. Se sugiere que se lleven a cabo más investigaciones con respecto a la comunicación entre profesionales (AU).

The impact of vaccination on the evolution of COVID-19 in Portugal.

In this work we use simple mathematical models to study the impact of vaccination against COVID-19 in Portugal. First, we fit a SEIR type model without vaccination to the Portuguese data on confirmed cases of COVID-19 by the date of symptom onset, from the beginning of the epidemic until the 23rd January of 2021, to estimate changes in the transmission intensity. Then, by including vaccination in the model we develop different scenarios for the fade-out of the non pharmacological intervention (NPIs) as vaccine coverage increases in the population according to Portuguese vaccination goals. We include a feedback function to mimic the implementation and relaxation of NPIs, according to some disease incidence thresholds defined by the Portuguese health authorities.

"Hunger and rage (and the virus) are human things": reflections on solidarity in times of Covid-19 / "A fome e a raiva (e o vírus) é coisas dos home": reflexões sobre participação social em tempos de Covid-19

ABSTRACT Objective To identify and reflect about civil society's initiatives to curb hunger in connection with the Covid-19 pandemic in Brazil. Methods In order to identify society's initiatives to fight hunger, two independent systematic searches were conducted in the Google® search engine using the following keywords: "covid civil society initiatives" and "hunger pandemic solidarity campaign". Results Fourteen nationwide civil society-promoted initiatives were identified, that among their objectives aimed at fostering collective funding to purchase and distribute foods. Conclusion Brazilian society has been historically sensitive to the hunger problem and shows solidarity as a social value. Nevertheless, the State is legally bound to provide food, as a social right.

RESUMO Objetivo Mapear e refletir sobre as iniciativas da sociedade civil para o combate à fome no contexto da pandemia de Covid-19 no Brasil. Métodos Para identificar as iniciativas da sociedade para o combate à fome foram conduzidas duas buscas sistemáticas independentes na plataforma Google®, utilizando as palavras-chave: "iniciativas sociedade civil covid" e "fome pandemia campanha solidariedade". Resultados Foram localizadas quatorze iniciativas da sociedade civil de abrangência nacional que têm entre seus objetivos promover campanhas de financiamento coletivo para aquisição e distribuição de alimentos. Conclusão Historicamente, a sociedade brasileira é sensível ao tema do combate à fome e presta solidariedade como um valor social. Contudo, cabe ao Estado a obrigação legal do cumprimento da alimentação enquanto um direito de cidadania.

Autocompaixão e ações de promoção à saúde mental como moderadores da ansiedade entre idosos institucionalizados / Self-compassion and mental health promotion actions as moderators of anxiety among institutionalized older adults

Objetivou-se verificar a relação entre ansiedade, autocompaixão e ações de promoção à saúde mental de idosos residentes em Instituições de Longa Permanência. Estudo exploratório, transversal e quantitativo, realizado com 88 idosos residentes em seis instituições de cinco cidades do interior do Estado de São Paulo, entre 2016 e 2017, utilizando um questionário de caracterização dos participantes, o Mini exame do Estado Mental, o Inventário de Ansiedade de Beck e a Escala de Autocompaixão. Foram realizadas análises descritivas, correlacionais e de regressão linear múltipla pelos mínimos quadrados ordinários. Todos os cuidados éticos foram respeitados. Para cada um ponto de aumento nos escores de autocompaixão houve redução de 1,11% nos escores de ansiedade (p=0,005). Ações de promoção à saúde mental reduziram em 0,54% (p=0,043) os escores de ansiedade. Concluiu-se que a autocompaixão e as ações de promoção à saúde mental reduziram a ansiedade em idosos institucionalizados.

The objective of this study has been to verify the relationship between anxiety, self-compassion, and actions to promote mental health of older adults living in long-term facilities. This is an exploratory, cross-sectional, and quantitative study, carried out with 88 older adults living in six institutions in five cities in the state of São Paulo, Brazil, between 2016 and 2017, using a questionnaire to characterize the participants, the Mini-Mental State Examination, the Beck Anxiety Inventory, and the Self-Compassion Scale. Descriptive, correlational, and multiple linear regression analyses were performed using ordinary least squares. All ethical precautions were followed. For each point of increase in self-compassion scores, there was a 1.11% decrease in anxiety scores (p = 0.005). Actions to promote mental health reduced anxiety scores by 0.54% (p = 0.043). Thus, this study concludes that self-compassion and mental health promotion actions reduced anxiety in institutionalized older adults.

Microbiological evaluation of constructed wetlands and solar disinfection in wastewater treatment and reuse.

The objective of this study was to evaluate the removal of fecal indicator bacteria and select bacterial pathogens (total coliforms, Escherichia coli, Shigella spp., Salmonella spp. and Pseudomonas aeruginosa) in vertical flow constructed wetlands (VF-CWs) with earthworms and solar disinfection (SODIS) as post-treatment of effluent from a septic tank. There was no significant difference between them in removing bacteria using a VF-CW with earthworms (VF-CW W/E) and without earthworms (VF-CW N/E). Both VF-CWs did not completely remove pathogens; however, with the SODIS technology receiving the effluent from VF-CW W/E, for E. coli, Shigella spp., Salmonella spp. and P. aeruginosa, the values were reduced below the limit of detection and 4.3 log unit average reduction for total coliforms, with 6 h in SODIS.

Efeitos da fisioterapia na incontinência urinária feminina / Effects of physiotherapy on female urinary incontinence

A incontinência urinaria é definida como qualquer perda involuntária de urina, sendo o sexo feminino o mais atingido. É classificada em três tipos: de esforço, de urgência e mista. A fisioterapia no tratamento de incontinência urinária consiste na normalização do tônus dos músculos do assoalho pélvico, utilizando cinesioterapia e eletroestimulação transcutânea do nervo tibial posterior. OBJETIVO: Avaliar os efeitos da fisioterapia na incontinência urinária feminina. METODOLOGIA: Tratou-se de uma pesquisa clínica, longitudinal e prospectiva. Participaram do estudo 27 mulheres com idade média de 57,4 anos, com diagnóstico de incontinência urinária, encaminhadas para tratamento em Ambulatório de Fisioterapia Escola. As mesmas responderam um questionário de avaliação dos dados demográficos e clínicos e o questionário de qualidade de vida ICIQ-FS, antes e após intervenção fisioterapêutica por meio de cinesioterapia e eletroestimulação tibial posterior. RESULTADOS: A maioria das mulheres possuía incontinência urinária de esforço (55,6%), sendo que 33,3% (n=9) referiram perdas urinárias de 01 a 04 anos e 33,3 % (n=9) de 04 a 08 anos. A frequência de perdas urinárias antes do tratamento na maioria (55,6%) era diversas vezes ao dia e após o tratamento a maioria (55,6%) perdia uma vez por semana ou menos. Houve diminuição significativa na comparação do ICIQ Score antes e após o tratamento fisioterapêutico (p< 0.0001). CONCLUSÃO: A fisioterapia, por meio de cinesioterapia e eletroestimulação, é eficaz no tratamento da Incontinência Urinária feminina.

Urinary incontinence is defined as any involuntary loss of urine, with females being the most affected. It is classified into three types: stress urinary incontinence; urgency; and mixed. Physiotherapy in the treatment of urinary incontinence consists of normalization of the tone of the pelvic floor muscles, using kinesiotherapy and transcutaneous electrostimulation of the posterior tibial nerve. OBJECTIVE: To evaluate the effects of physiotherapy on female urinary incontinence. METHODOLOGY: It was a clinical, longitudinal and prospective study. The study included 27 women with a mean age of 57.4 years, diagnosed with urinary incontinence, referred for treatment at the School Physiotherapy Outpatient Clinic. They answered a questionnaire to assess demographic and clinical data and the ICIQ-FS quality of life questionnaire, before and after physiotherapeutic intervention through kinesiotherapy and posterior tibial electrostimulation. RESULTS: Most women had stress urinary incontinence (55.6%), and 33.3% (n=9) reported urinary losses from 01 to 04 years and 33.3% (n=9) from 04 to 08 years. The frequency of urinary losses before treatment in the majority (55.6%) was several times a day and after treatment the majority (55.6%) lost once a week or less. There was a significant decrease in the comparison of the ICIQ Score before and after physical therapy treatment (p< 0.0001). CONCLUSION: Physiotherapy, through kinesiotherapy and electrostimulation, is effective in the treatment of female urinary incontinence.

Modulation of phenolic and lipophilic compounds of olive fruits in response to combined drought and heat.

The awareness of the functional and nutraceutical properties of olives and olive oil bioactive constituents contributed to oliviculture recent increase. Olives' metabolism and nutritional quality are determined by how the olive-tree is coping to climate change-related episodes, which increasingly occur in the Mediterranean. We characterize the most relevant lipophilic and phenolic compounds of olives from Olea europaea cultivars [Cobrançosa, Cordovil de Castelo Branco and Cordovil de Serpa (C.Serpa)] exposed to drought + heat. Olives from the three cultivars presented a similar qualitative profile but differed in their relative richness. Cobrançosa olives are richer in organic acids, esters and carbohydrates, while C.Serpa olives have higher levels of phenolic compounds, particularly under control conditions. Drought + heat changed the quantitative profile of olives, in a way dependent on the cultivar, and C.Serpa olives showed the highest stress susceptibility. Climate change-related conditions stimulate the accumulation of relevant bioactive compounds in olives, contributing to increasing its nutritional value.

Educação popular e Extensão Universitária em Segurança Alimentar e Nutricional e Direito Humano à Alimentação Adequada e Saudável: um caminho metodológico possível / Popular Education and University Outreach in Food and Nutition Security and the Human Right to Adequate and Healty Food: a possible methodological path

Introdução: A temática da segurança alimentar e nutricional e do direito humano à alimentação adequada e saudável tornou-se uma questão política no Brasil, no período de 2003 a 2016. No entanto, a tarefa de manutenção de direitos sociais não estava concluída e hoje encontra-se politicamente ameaçada, demandando a conscientização e mobilização de segmentos da sociedade civil para a compreensão crítica da realidade e a retomada da construção de caminhos possíveis para a exigibilidade do direito e garantia da segurança alimentar e nutricional. Objetivo: Este trabalho buscou relatar a experiência e evidenciar as expressões pedagógicas dos princípios da educação popular ao longo do processo de ensino-aprendizagem da edição de 2018 do curso, realizado no município de Colinas do Sul, Goiás. Métodos: Na Universidade de Brasília, em 2018, instituiu-se um Programa de Extensão e Ação Continuada, o MultiplicaSAN. Dentre suas atividades, estava a realização de um curso de formação e promoção da cultura de direitos visando à formação da sociedade civil nas temáticas de segurança alimentar e nutricional e direito humano à alimentação adequada e saudável, utilizando como referência a pedagogia freireana e os princípios da Política de Educação Popular. Resultados: A experiência do projeto de extensão proporcionou aprofundamento sobre a educação popular, mostrando a riqueza da construção do conhecimento junto com uma comunidade de trabalhadoras. Conclusão: Revelou, ainda, o potencial transformador de um processo educativo pautado nos princípios da educação popular: amorosidade, dialogicidade, conscientização, construção do conhecimento, a partir da realidade concreta, transformação do mundo e sistematização do conhecimento na formação de educadoras e educandas. (AU)

Introduction: The theme of food and nutrition security and the human right to adequate and healthy food became a political issue in Brazil, from 2003 to 2016. However, the task of maintaining social rights was not completed and today it is politically threatened, demanding the awareness and mobilization of segments of civil society for an understanding of reality and the resumption of the construction of possible paths for the enforceability of the law and guarantee of food and nutritional security. Objective: This work sought to report the experience and highlight the pedagogical expressions of the principles of popular education throughout the teaching-learning process of the 2018 edition of the course, held in the municipality of Colinas do Sul, Goiás. Methods: At the University of Brasília, in 2018, an Outreach Program, MultiplicaSAN, was instituted. Among its activities, there was a course to promote the culture of rights aiming at the formation of civil society in the themes of food and nutritional security and the human right to adequate and healthy food, using Freire's pedagogy and the principles of Popular Education Policy. Results: The experience of the outreach program provided an in-depth look at popular education, showing the wealth of knowledge construction together with a community of female workers. Conclusion: It also revealed the transformative potential of an educational process based on the principles of popular education: lovingness, dialogicity, awareness, construction of knowledge, based on concrete reality, transformation of the world and systematization of knowledge in the teaching-learning process of educators and students. (AU)

Sustainable Sanitation Management Tool for Decision Making in Isolated Areas in Brazil.

There is a worldwide range of technical sanitation guidelines focusing on small or traditional and isolated communities for ecological alternatives at the household level. However, a computational tool (software) that has a database and connects these guidelines in a single reference for resource-oriented sanitation concept decision making is still lacking. In this regard, an easy-to-use tool was developed using a participatory approach for the decision-making process from a choice of technical solutions to a type of system management. The results obtained from a pilot study indicate that the proposed tool in this paper will help with the decision-making process to aid in not only choosing sustainable sanitation solutions, but also sustainable operation and maintenance options for the systems. When presenting and discussing the tool with research groups and technicians, the potential for participatory application was noticed. The proposed tool can be used in the elaboration of municipal sanitation plans, assisting local technicians and environmental licensing agencies, designers and engineering students, among others. The software can be applied with other management tools, such as 5W2H and Canvas business model.

Fatores de risco para dermatite associada à incontinência: uma revisão integrativa / Risk factors for dermatitis associated with incontinence: an integrating review / Factores de riesgo para dermatite asociada a la incontinencia: una revisión integral

OBJETIVO: Identificar, na literatura, as melhores evidências sobre os fatores de risco para o desenvolvimento da Dermatite Associada à Incontinência (DAI). MÉTODO: Foi realizada busca nas bases de dados da BVS e MEDLINE por meio da PUBMED, CINAHL e WEB OF SCIENCE. Foram identificadas 20 publicações potencialmente elegíveis para inclusão, selecionando-se 14 artigos que atenderam aos critérios de elegibilidade. Eles foram lidos e analisados. RESULTADOS: Os fatores de risco para DAI como idade, comorbidades, nutrição, oxigenação, perfusão, temperatura, incontinência fecal e/ou urinária, atrito mecânico, permeabilidade da pele, uso de determinadas estratégias de cuidado, capacidade cognitiva e avaliação da pele são determinantes para o surgimento da DAI. A monitorização da pele, constante, pela avaliação criteriosa do enfermeiro, é essencial. CONCLUSÃO: Para prevenir-se do problema, é necessária a identificação precoce de fatores de risco para evitar danos ao paciente, prevenção de agravos, favorecer o conforto, bem-estar, diminuir tempo de internação e custos hospitalares e aumentar a qualidade da assistência. Ressalta-se a escassez de literatura sobre a temática e a necessidade de estudos com alto nível de evidência

OBJECTIVE: To identify, in the literature, the best evidences on the risk factors for the development of Incontinence-Associated Dermatitis (IAD). METHOD: We performed searches on the VHL, MEDLINE databases through PUBMED, CINAHL and WEB OF SCIENCE. We identified twenty eligible publications and we selected 14 articles that met the inclusion criteria. We read and analyzed them. RESULTS: The risk factors for IAD are: age, comorbidities, nutrition, oxygenation, perfusion, temperature, fecal and / or urinary incontinence, mechanical friction, skin permeability, use of certain care strategies, cognitive ability and skin evaluation. These factors are determinant for the appearance of IAD. Constant skin monitoring by the careful nurse evaluation is essential. CONCLUSION: In order to prevent IAD, identifying risk factors early is necessary to avoid harm to the patient, to prevent injuries, to promote comfort, well-being, to reduce hospitalization time and hospital costs, and to increase the care quality. It is important to emphasize that there is lack of literature about this subject and its importance for studies with a high level of evidence

OBJETIVO: Identificar, en la literatura, las mejores evidencias sobre los factores de riesgo para el desarrollo de la Dermatitis Asociada a la Incontinencia (DAI). MÉTODO: Se realizó una búsqueda en las bases de datos de la BVS, MEDLINE a través de PUBMED, CINAHL y WEB OF SCIENCE. Se identificaron 20 publicaciones potencialmente elegibles para inclusión, siendo seleccionados 14 artículos que atendieron a los criterios de inclusión. Ellos fueron leídos y analizados. RESULTADOS: Los factores de riesgo de DAI como edad, comorbilidad, nutrición, oxigenación, perfusión, temperatura, incontinencia fecal y/o urinaria, fricción mecánica, permeabilidad de la piel, uso de determinadas estrategias de cuidado, capacidad cognitiva y evaluación de la piel son determinantes para el surgimiento de la DAI. La monitorización constante por la evaluación cuidadosa es esencial. CONCLUSIÓN: Para prevenir la DAI, es necesaria la identificación precoz de factores de riesgo para evitar daños al paciente, prevención de agravios, favorecer el confort, bienestar, disminuir el tiempo de internación y costos hospitalarios y aumentar la calidad de la asistencia. Se resalta la escasez de literatura sobre la temática y la necesidad de estudios con alto nivel de evidencia

Incontinence-associated dermatitis: a cohort study in critically ill patients. / Dermatite associada à incontinência: estudo de coorte em pacientes críticos.

OBJECTIVES: Estimate incidence, determine risk factors and propose a prediction model for the development of incontinence- associated dermatitis critically ill adult patients. METHOD: Concurrent cohort study with 157 critically ill patients. Data collection was daily performed between February and July 2015, at a public teaching hospital of Belo Horizonte, Minas Gerais. Data was entered in a database and subjected to descriptive, survival and multivariate analysis. RESULTS: An overall incidence of 20.4% was obtained. Nineteen (19) risk factors significantly associated with the disorder were found. The variables identified in the risk prediction model were male, trauma, use of hypnotics/sedatives, lactulose, nutritional support, loose stools and complaints of burning. CONCLUSION: The results showed that dermatitis is a common clinical finding in critically ill adult patients and requires special attention from the nursing staff.

The impact of rotavirus vaccination on emergency department visits and hospital admissions for acute diarrhea in children under 5 years.

INTRODUCTION:: Acute diarrheal disease is the second cause of death in children under 5 years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 hospital admissions per year and 4% of the deaths in children under 5 years. Rotavirus is the leading cause of severe acute diarrhea worldwide. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program. OBJECTIVES:: To analyze the impact of the RV1 on emergency department (ED) visits and hospital admissions for acute diarrhea. METHOD:: A retrospective ecologic study at the University Hospital, University of São Paulo. The study analyzed the pre-vaccine (2003-2005) and the post-vaccine (2007-2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under 5 years in an electronic registry system database and calculated the rates of ED visits and hospital admissions. The reduction rate was analyzed according to the following formula: reduction (%) = (1 - odds ratio) x 100. RESULTS:: The rates of ED visits for acute diarrhea was 85.8 and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95CI 4 to 9%, p<0.001). The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95CI 22 to 54%, p<0.001). CONCLUSION:: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea.

The impact of rotavirus vaccination on emergency department visits and hospital admissions for acute diarrhea in children under 5 years / Impacto da vacinação contra rotavírus nas consultas de pronto-socorro e internações por doença diarreica aguda em crianças menores de 5 anos de idade

Summary Introduction: Acute diarrheal disease is the second cause of death in children under 5 years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 hospital admissions per year and 4% of the deaths in children under 5 years. Rotavirus is the leading cause of severe acute diarrhea worldwide. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program. Objectives: To analyze the impact of the RV1 on emergency department (ED) visits and hospital admissions for acute diarrhea. Method: A retrospective ecologic study at the University Hospital, University of São Paulo. The study analyzed the pre-vaccine (2003–2005) and the post-vaccine (2007–2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under 5 years in an electronic registry system database and calculated the rates of ED visits and hospital admissions. The reduction rate was analyzed according to the following formula: reduction (%) = (1 - odds ratio) x 100. Results: The rates of ED visits for acute diarrhea was 85.8 and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95CI 4 to 9%, p<0.001). The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95CI 22 to 54%, p<0.001). Conclusion: The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea.

Resumo Introdução: a doença diarreica aguda é a segunda causa de morte em crianças abaixo de 5 anos de idade. No Brasil, entre 2003 e 2009, a diarreia aguda foi responsável por cerca de 100 mil internações por ano e por 4% das mortes em crianças abaixo de 5 anos de idade. O rotavírus é a principal etiologia de diarreia aguda grave. A vacina monovalente (RV1) contra o rotavírus foi introduzida em 2006. Objetivos: verificar o impacto da vacina monovalente contra rotavírus nas consultas de pronto-socorro e internações por doença diarreica aguda em crianças menores de 5 anos de idade. Método: foi realizado um estudo ecológico retrospectivo no Hospital Universitário da Universidade de São Paulo. O período foi dividido em pré-vacina (2003 a 2005) e pós-vacina (2007 a 2009). Foram incluídas todas as crianças abaixo de 5 anos que passaram em consulta no pronto-socorro. Foram obtidas as taxas de consultas no pronto-socorro e internações por doença diarreica aguda. A redução nas taxas foi obtida através da fórmula: redução (%) = (1 - odds ratio) x 100. Resultados: no período pré-vacina, a taxa de consultas por diarreia aguda foi de 85,8 consultas por 1.000 consultas gerais, enquanto no período pós-vacina a taxa de consultas por diarreia aguda foi 80,9 por 1.000, uma redução de 6% (IC95% 4-9, p<0,001). A taxa de internação por diarreia aguda era 40,8 internações por 1.000 e caiu para 24,9 por 1.000, redução de 40% (IC95% 22-54, p<0,001). Conclusão: após a introdução da vacina contra rotavírus houve uma redução de 6% nas consultas por diarreia aguda no pronto-socorro e de 40% nas internações por diarreia aguda.

Dermatite associada à incontinência: estudo de coorte em pacientes críticos / Dermatitis asociada con incontinencia: estudio de cohorte en pacientes críticos / Incontinence-associated dermatitis: a cohort study in critically ill patients

RESUMO Objetivos Estimar incidência, determinar fatores de risco e propor modelo de predição de risco para desenvolvimento de dermatite associada a incontinência em pacientes adultos críticos. Método Trata-se de um estudo de coorte concorrente realizado com 157 pacientes críticos. A coleta de dados foi conduzida diariamente entre fevereiro e julho de 2015 em hospital público e de ensino de Belo Horizonte, MG. Os dados foram lançados em banco de dados, submetidos a análise descritiva de sobrevida e multivariada. Resultados Obteve-se uma incidência global de 20,4%. Foram encontrados 19 fatores de risco que apresentaram associação significativa com o problema. As variáveis encontradas no modelo de predição de risco foram: sexo masculino, trauma, uso de hipnótico/sedativos, lactulona, suporte nutricional, fezes pastosas e queixa de ardência (local). Conclusão Os resultados mostraram que a dermatite é um achado clínico comum em pacientes adultos críticos e merece atenção especial para maior qualidade da assistência de enfermagem.

RESUMEN Objetivos Estimar incidencia, determinar factores de riesgo y proponer modelo de predicción de riesgo para el desarrollo de la dermatitis asociada a la incontinencia en pacientes adultos críticos. Método Se trata de un estudio de cohorte concurrente de 157 pacientes críticamente enfermos. La recolección de datos se realizó diariamente entre febrero y julio de 2015, en un hospital público y de enseñanza de Belo Horizonte-MG. Los datos se introdujeron en la base de datos, sometidos a análisis descriptivo, de supervivencia y multivariada. Resultados Se obtuvo una incidencia global del 20,4%. Se encontraron 19 factores de riesgo asociados significativamente con el problema. Las variables identificadas en el modelo de predicción de riesgo fueron: sexo masculino, trauma, uso de hipnóticos/sedantes, lactulona, soporte nutricional, heces sueltas y queja de ardor (local). Conclusión Los resultados mostraron que la dermatitis es un hallazgo clínico frecuente en pacientes adultos críticos y merece una atención especial para una mayor calidad de los cuidados de enfermería.

ABSTRACT Objectives Estimate incidence, determine risk factors and propose a prediction model for the development of incontinence- associated dermatitis critically ill adult patients. Method Concurrent cohort study with 157 critically ill patients. Data collection was daily performed between February and July 2015, at a public teaching hospital of Belo Horizonte, Minas Gerais. Data was entered in a database and subjected to descriptive, survival and multivariate analysis. Results An overall incidence of 20.4% was obtained. Nineteen (19) risk factors significantly associated with the disorder were found. The variables identified in the risk prediction model were male, trauma, use of hypnotics/sedatives, lactulose, nutritional support, loose stools and complaints of burning. Conclusion The results showed that dermatitis is a common clinical finding in critically ill adult patients and requires special attention from the nursing staff.

Tumoral chromoblastomycosis: a rare manifestation with typical complementary exams

Abstract: Chromoblastomycosis is a chronic subcutaneous fungal infection caused by traumatic implantation of dematiaceous fungi in the skin. The clinical presentation is usually a verrucous plaque lesion and the diagnosis is confirmed by the visualization of muriform bodies at direct examination or at the histologic study. This report describes a rare case of tumoral chromoblastomycosis confirmed by histologic study and whose agent was identified by culture and micromorphology.

Tumoral chromoblastomycosis: a rare manifestation with typical complementary exams.

Chromoblastomycosis is a chronic subcutaneous fungal infection caused by traumatic implantation of dematiaceous fungi in the skin. The clinical presentation is usually a verrucous plaque lesion and the diagnosis is confirmed by the visualization of muriform bodies at direct examination or at the histologic study. This report describes a rare case of tumoral chromoblastomycosis confirmed by histologic study and whose agent was identified by culture and micromorphology.

Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a pediatric emergency room.

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.

Impacto do uso da prova rápida para estreptococo beta-hemolítico do grupo A no diagnóstico e tratamento da faringotonsilite aguda em pronto-socorro de Pediatria / Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a Pediatric emergency room / Impacto del uso de la prueba rápida para estreptococos beta-hemolíticos del grupo A en el diagnóstico y tratamiento de la faringotonsilitis en emergencia de Pediatría

OBJETIVO: Avaliar o impacto da realização rotineira da prova rápida para pesquisa de estreptococo do grupo A no diagnóstico e tratamento da faringotonsilite aguda em crianças. MÉTODOS: Estudo prospectivo e observacional que contou com a utilização de protocolo de pesquisa estabelecido na Unidade de Emergência do Hospital Universitário da Universidade de São Paulo para o atendimento de crianças e adolescentes com faringotonsilite aguda. RESULTADOS: Com base na avaliação clínica, dos 650 pacientes estudados, antimicrobianos seriam prescritos para 389 indivíduos (59,8%) e, com o uso da pesquisa de estreptococo do grupo A, foram prescritos em 286 pacientes (44,0%). Das 261 crianças que não receberiam antibiótico pelo quadro clínico, 111 (42,5%) tiveram pesquisa de estreptococo do grupo A positiva. O diagnóstico baseado no quadro clínico apresentou sensibilidade de 61,1%, especificidade de 47,7%, valor preditivo positivo de 44,9% e valor preditivo negativo de 57,5%. CONCLUSÕES: O diagnóstico clínico da faringotonsilite estreptocócica mostrou baixa sensibilidade e especificidade. O uso rotineiro da prova rápida para pesquisa de estreptococo permitiu a redução do uso de antibióticos e a identificação de um grupo de risco para as complicações da infecção estreptocócica, pois 42,5% dos pacientes com prova rápida positiva não receberiam antibióticos, se levado em consideração apenas o diagnóstico clínico.

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.

OBJETIVO: Evaluar el impacto de la realización de rutina de la prueba rápida para investigación de estreptococos del grupo A en el diagnóstico y tratamiento de la faringotonsilitis aguda en niños. MÉTODOS: Estudio prospectivo y observacional que contó con el uso de protocolo de investigación establecido en la Unidad de Emergencia del Hospital Universitario de la USP para la atención a niños y adolescentes con faringotonsilitis aguda. RESULTADOS: Con base en la evaluación crítica, de los 650 pacientes estudiados, antimicrobianos serían prescritos a 389 individuos (59,8%) y, con el uso de la investigación de estreptococos del grupo A se los prescribieron a 286 pacientes (44,0%). De los 261 niños que no recibirían antibióticos por el cuadro clínico, 111 (42,5%) tuvieron investigación de estreptococos del grupo A positiva. El diagnóstico basado en el cuadro clínico presentó sensibilidad del 61,1%, especificidad del 47,7%, valor predictivo positivo del 44,9% y valor predictivo negativo del 57,5%, CONCLUSIONES: En este estudio, el diagnóstico clínico de la faringotonsilitis estreptocócica mostró baja sensibilidad y especificidad. El uso de rutina de la prueba rápida para investigación de estreptococos permitió la reducción del uso de antibióticos y la identificación de un grupo de riesgo para las complicaciones de la infección estreptocócica, pues el 42,5% de los pacientes con prueba rápida positiva no recibirían antibióticos si se llevara en consideración solamente el diagnóstico clínico.