Analysis of Key Factors for Evaluating Mucosal Adhesion Using Swine Buccal Tissue.

The assessment of the mucoadhesive properties peak mucoadhesive force (Fmax) and work of mucoadhesion (Wmuc) with texture analyzers is a common in vitro method for analyzing formulation capabilities. Challenges arise in selecting and standardizing experimental conditions due to various variables influencing mucoadhesion. This complexity hampers direct product performance comparisons. In our study, we explored factors (contact force and time, probe speed and mucin in artificial saliva) impacting a model formulation's mucoadhesive capacity. Using Omcilon-A®Orabase on porcine buccal mucosa, we systematically varied experimental conditions, employing a statistical approach (Central Composite Design - CCD). Three variables (contact force, contact time, probe speed) and their interactions were assessed for their impact on Fmax and Wmuc. Results showed that contact time and force positively affected Fmax, while only contact time influenced Wmuc. In the mucin artificial saliva test, a force of 0.5 N, time of 600 s, and speed of 1 mm/s yielded optimal Fmax (0.587 N) and Wmuc (0.468 N.s). These conditions serve as a reference for comparing mucoadhesive properties of formulations for topical oral use.

Obesity and the risk of multiple or severe frequent knee pain episodes: a 4-year follow-up of the ELSA-Brasil MSK cohort.

BACKGROUND/OBJECTIVE: Knee pain is an important health problem due to its high prevalence, negative impact on daily activities and quality of life, and societal burden. While the link between excess weight and knee pain has been well-documented in the literature, many studies are limited to patients with osteoarthritis or use cross-sectional data. This longitudinal study investigated whether overweight and obesity were associated with the frequency and severity of frequent knee pain (FKP) episodes over 4 years in civil servants enrolled in the ELSA-Brasil MSK cohort. METHODS: Knee pain was assessed during baseline face-to-face interviews (2012-2014) and four yearly telephone follow-ups (2015-2019). Disabling FKP episodes or those of moderate to very severe intensity were classified as severe. Multinomial logistic regression models adjusted for confounders were used to test for associations in two participant groups: those with knee pain at baseline (prognosis cohort) and those without knee pain (incidence cohort). RESULTS: A total of 2644 participants were included: 54.2% female, mean age 55.8 (SD 8.8) years. In the incidence cohort (n = 1896), obesity increased the risk of one (OR: 1.63; 95% CI 1.13-2.37) and multiple FKP episodes (OR: 2.61; 95% CI 1.71-3.97), as well as the risk of non-severe (OR: 1.72; 95% CI 1.04-2.84) and severe FKP episodes (OR: 2.10; 95% CI 1.50-2.95). In the prognosis cohort (n = 748), obesity increased the risk of multiple (OR: 2.54; 95% CI 1.60-4.05) and severe FKP episodes (OR: 2.31; 95% CI 1.49-3.59). Overweight presented the same trends but fell short of significance. CONCLUSIONS: These results provide further support that overweight and obesity are important contributors to the incidence and worsening of FKP, and that weight management must be prioritized in multidisciplinary knee pain prevention and treatment programs to reduce the burden of musculoskeletal disorders.

Procedimento online de incentivo à leitura em crianças com dificuldades escolares e seus responsáveis, durante a pandemia de COVID-19 / Online procedure to encourage reading in children with school difficulties and their guardians, during the COVID-19 pandemic

RESUMO A escola é o principal ambiente para a promoção formal da alfabetização e do letramento, os quais são portas para o mundo da leitura. Porém, com a ocorrência da pandemia do COVID-19, as atividades pedagógicas tiveram que ser suspensas ou adaptadas ao modelo remoto, acarretando prejuízos a todos os alunos, e principalmente àqueles que já apresentavam dificuldades escolares, especialmente as relacionadas à leitura. Sabe-se que a proficiência e o hábito de leitura são condições importantes para o desenvolvimento acadêmico geral. Estudos têm demonstrado que a aplicação de estratégias no contexto familiar e a utilização de plataformas digitais, com a finalidade de compartilhamento de leituras, são práticas favorecedoras do hábito leitor. Dessa forma, o presente estudo objetivou relatar as experiências da aplicação online de um procedimento de incentivo à leitura, em crianças com dificuldades escolares e seus respectivos responsáveis (seis díades), com a utilização de uma plataforma digital específica para compartilhamentos de leituras. Dentre os resultados obtidos estão: a mudança de comportamentos das crianças envolvidas para maior propensão a hábitos leitores, a mudança de atitudes diárias das mães no ambiente familiar para o incentivo à leitura, e a presença de comportamentos incentivadores por parte das mães, frente ao compartilhamento de leituras de seus filhos. As experiências relatadas mostraram-se promissoras e para maior consolidação dos achados, sugerem-se novos estudos com número amostral que permita análises estatísticas, estudos longitudinais e também com uma possível aplicação presencial ou híbrida do procedimento.

ABSTRACT School is the main environment for the formal promotion of literacy and it is the first step to the world of reading. However, with the occurrence of the COVID-19 pandemic, pedagogical activities had to be suspended or adapted to the remote model, causing harm to all students, and notably to those who already had school difficulties, especially those related to reading. Proficiency and the habit of reading are important conditions for academic development. Studies have shown that the application of strategies in the family context and the use of digital platforms, with the purpose of sharing readings, are practices that promote the reading habit. Therefore, the present study aimed to report the experiences of applying an online procedure to encourage reading in children with school difficulties and their respective guardians (six dyads), using a specific digital platform for sharing readings. The results obtained include a behavioral change in the children towards solid reading habits, a change in mothers' daily attitudes in the family environment towards encouraging reading, and mothers' encouraging behaviors when sharing their children's reading. The experiences reported were promising and, to further consolidate the findings, new studies are suggested with a sample size that allows statistical analyses, longitudinal studies and also with a possible face-to-face or hybrid application of the procedure.

Online procedure to encourage reading in children with school difficulties and their guardians, during the COVID-19 pandemic. / Procedimento online de incentivo à leitura em crianças com dificuldades escolares e seus responsáveis, durante a pandemia de COVID-19.

School is the main environment for the formal promotion of literacy and it is the first step to the world of reading. However, with the occurrence of the COVID-19 pandemic, pedagogical activities had to be suspended or adapted to the remote model, causing harm to all students, and notably to those who already had school difficulties, especially those related to reading. Proficiency and the habit of reading are important conditions for academic development. Studies have shown that the application of strategies in the family context and the use of digital platforms, with the purpose of sharing readings, are practices that promote the reading habit. Therefore, the present study aimed to report the experiences of applying an online procedure to encourage reading in children with school difficulties and their respective guardians (six dyads), using a specific digital platform for sharing readings. The results obtained include a behavioral change in the children towards solid reading habits, a change in mothers' daily attitudes in the family environment towards encouraging reading, and mothers' encouraging behaviors when sharing their children's reading. The experiences reported were promising and, to further consolidate the findings, new studies are suggested with a sample size that allows statistical analyses, longitudinal studies and also with a possible face-to-face or hybrid application of the procedure.

A escola é o principal ambiente para a promoção formal da alfabetização e do letramento, os quais são portas para o mundo da leitura. Porém, com a ocorrência da pandemia do COVID-19, as atividades pedagógicas tiveram que ser suspensas ou adaptadas ao modelo remoto, acarretando prejuízos a todos os alunos, e principalmente àqueles que já apresentavam dificuldades escolares, especialmente as relacionadas à leitura. Sabe-se que a proficiência e o hábito de leitura são condições importantes para o desenvolvimento acadêmico geral. Estudos têm demonstrado que a aplicação de estratégias no contexto familiar e a utilização de plataformas digitais, com a finalidade de compartilhamento de leituras, são práticas favorecedoras do hábito leitor. Dessa forma, o presente estudo objetivou relatar as experiências da aplicação online de um procedimento de incentivo à leitura, em crianças com dificuldades escolares e seus respectivos responsáveis (seis díades), com a utilização de uma plataforma digital específica para compartilhamentos de leituras. Dentre os resultados obtidos estão: a mudança de comportamentos das crianças envolvidas para maior propensão a hábitos leitores, a mudança de atitudes diárias das mães no ambiente familiar para o incentivo à leitura, e a presença de comportamentos incentivadores por parte das mães, frente ao compartilhamento de leituras de seus filhos. As experiências relatadas mostraram-se promissoras e para maior consolidação dos achados, sugerem-se novos estudos com número amostral que permita análises estatísticas, estudos longitudinais e também com uma possível aplicação presencial ou híbrida do procedimento.

Impact of intestinal colonization by Gram-negative bacteria on the incidence of bloodstream infections and lethality in critically ill neonates.

BACKGROUND: Early detection of antimicrobial-resistant microorganisms is crucial to prevent subsequent invasive infections and contain their spread in the Neonatal Intensive Care Unit (NICU). This study aims to investigate the association between intestinal colonization (IC) by Gram-negative bacteria and the risk of bloodstream infection (BSI) in critically ill neonates. METHODS: Data from the electronic medical records of 678 newborns admitted to a NICU Brazilian between 2018 and 2022 were retrospectively analyzed. Participants were monitored by the National Health Security Network. RESULTS: Among neonates, 6.9 % had IC (56.9 % attributed to Acinetobacter baumannii); of these, 19.1 % developed BSI (66.7 % by Staphylococcus spp.). Within the A. baumannii colonization, 34.5 % occurred during an outbreak in September 2021. Colonized individuals had a longer mean length of stay (49.3 ± 26.4 days) and higher mortality rate (12.8 %) compared to non-colonized individuals (22.2 ± 16.9 days; 6.7 %, respectively). Previous use of antimicrobials and invasive devices significantly increased the risk of colonization. Colonization by drug-resistant microorganisms, along with the occurrence of BSI, was associated with increased mortality and reduced survival time. CONCLUSIONS: IC contributed to the incidence of BSI, leading to more extended hospital stays and higher mortality rates. Its early detection proved to be essential to identify an outbreak and control the spread of resistant microorganisms within the NICU.

Domínios e facetas da qualidade de vida de pessoas idosas segundo a prática sexual / Domains and facets of the quality of life of olders adults according to sexual practice

A pesquisa objetivou comparar os domínios e facetas da qualidade de vida de idosos segundo a prática de relação sexual nos últimos seis meses. Estudo quantitativo, transversal e observacional realizado com 219 idosos de um município do Estado de Minas Gerais. Aplicaram-se os instrumentos WHOQoL-Bref e WHOQoL-Old para a coleta de dados referentes à qualidade de vida, e o teste Mann-Whitney (p < 0,05) para análise. Os domínios físico (p = 0,002), psicológico (p < 0,001) e relações sociais (p < 0,001), e as facetas atividades passadas, presentes e futuras (p = 0,013), participação social (p = 0,007) e intimidade (p = 0,018) estiveram associados à prática de relação sexual nos últimos seis meses, com maiores escores entre aqueles que referiram ser ativos sexualmente.

The objective of this study was to compare the domains and facets of quality of life of older adults, according to the practice of sexual intercourse in the last six months. Quantitative, cross-sectional and observational study, carried out with 219 elderly from a municipality in the State of Minas Gerais. The WHOQoL-Bref and WHOQoL-Old instruments were used to collect data regarding quality of life and the Mann-Whitney test (p < 0.05) for analysis. In the physical (p = 0.002), psychological (p < 0.001) and social relations (p < 0.001) domains, and in the facets past, present and future activities (p = 0.013), social participation (p = 0.007) and intimacy (p = 0.018) were associated with the practice of sexual intercourse in the last six months, with higher scores among those who reported being sexually active.

Breastfeeding lifespan control of growth, maintenance, and metabolism of small intestinal epithelium.

Gastrointestinal epithelial cells respond to milk-born molecules throughout breastfeeding, influencing growth, and development. The rapid renewal of the small intestine depends on the proliferation in the crypt that drives cell fates. We used early weaning model to investigate immediate and late effects of breastfeeding on proliferation, differentiation of jejunal epithelial cells. Wistar rats were either allowed to suckle (S) until 21 postnatal days or submitted to early weaning (EW) at 15 days. By comparing ages (18, 60, and 120 days), we found that EW decreased Ki67 indices and villi height at 18 and 60 days (p < 0.05), and at 120 days they were similar between diets. Proliferative reduction and augmented expression of Cdkn1b (p27 gene) were parallel. In the stem cell niche, EW increased the number and activity (Defa24) of Paneth cells at 18 and 60 days (p < 0.05), and Lgr5 and Ascl2 genes showed inverted responses between ages. Among target cells, EW decreased goblet cell number at 18 and 60 days (p < 0.05) and increased it at 120 days (p < 0.05), whereas enteroendocrine marker genes were differentially altered. EW reduced enterocytes density at 18 days (p < 0.05), and at 120 days this population was decreased (vs. 60 days). Among cell fate crypt-controlling genes, Notch and Atoh1 were the main targets of EW. Metabolically, intraperitoneal glucose tolerance was immediately reduced (18 days), being reverted until 120 days (p < 0.05). Currently, we showed that breastfeeding has a lifespan influence on intestinal mucosa and on its stem cell compartment. We suggest that, although jejunum absorptive function is granted after early weaning, the long lasting changes in gene expression might prime the mucosa with a different sensitivity to gut disorders that still have to be further explored.

A Novel Kinetic Modeling of Enzymatic Hydrolysis of Sugarcane Bagasse Pretreated by Hydrothermal and Organosolv Processes.

Lignocellulosic biomasses have a complex and compact structure, requiring physical and/or chemical pretreatments to produce glucose before hydrolysis. Mathematical modeling of enzymatic hydrolysis highlights the interactions between cellulases and cellulose, evaluating the factors contributing to reactor scale-up and conversion rates. Furthermore, this study evaluated the influence of two pretreatments (hydrothermal and organosolv) on the kinetics of enzymatic hydrolysis of sugarcane bagasse. The kinetic parameters of the model were estimated using the Pikaia genetic algorithm with data from the experimental profiles of cellulose, cellobiose, glucose, and xylose. The model considered the phenomenon of non-productive adsorption of cellulase on lignin and inhibition of cellulase by xylose. Moreover, it included the behavior of cellulase adsorption on the substrate throughout hydrolysis and kinetic equations for obtaining xylose from xylanase-catalyzed hydrolysis of xylan. The model for both pretreatments was experimentally validated with bagasse concentration at 10% w/v. The Plackett-Burman design identified 17 kinetic parameters as significant in the behavior of process variables. In this way, the modeling and parameter estimation methodology obtained a good fit from the experimental data and a more comprehensive model.

The rs1800469 T/T and rs1800470 C/C genotypes of the TGFB1 gene confer protection against diabetic retinopathy in a Southern Brazilian population.

The transforming growth factor beta 1 (TGFB1) is a pro-inflammatory cytokine that plays a key role in the mechanisms of angiogenesis and breakdown of the blood-retina barrier, which are implicated in the pathogenesis of diabetic retinopathy (DR). Polymorphisms in the TGFB1 gene have been associated with DR; however, results are still contradictory. Therefore, the aim of this study was to investigate the potential association between two TGFB1 polymorphisms and DR. This study included 992 patients with diabetes mellitus (DM): 546 patients with DR (cases) and 446 patients without DR and with ≥10 years of DM (controls). The TGFB1 rs1800469 and rs1800470 polymorphisms were genotyped by real-time PCR. Frequency of rs1800469 T/T genotype was higher in controls compared to DR cases (18.3% vs. 12.7%, P= 0.022). This genotype remained associated with protection for DR, adjusting for covariables (OR= 0.604; 95% CI 0.395 - 0.923; P= 0.020, recessive model). The rs1800470 C/C genotype was observed in 25.4% of the controls and 18.0% of the cases (P= 0.015); thus, being associated with protection against DR under the recessive model (OR= 0.589; 95% CI 0.405 - 0.857; P= 0.006), adjusting for covariables. In conclusion, the TGFB1 rs1800469 and rs1800470 polymorphisms are associated with protection against DR in DM patients from Southern Brazil.

Distribuição espacial de violência com idosos antes e durante a pandemia de covid-19 / Spatial distribution of violence against older adults before and during the covid-19 pandemic / Distribución espacial de la violencia hacia las personas mayores antes y durante la pandemia covid-19

RESUMO: Objetivo: analisar a distribuição espacial da violência contra a pessoa idosa na região Sul do Brasil antes e no primeiro ano de vigência da pandemia de COVID-19. Método: estudo ecológico que analisou as notificações de violência contra o idoso, entre 2019 e 2020, no Sul do Brasil. Foram calculadas as taxas bayesianas empíricas locais, o Índice de Autocorrelação Local de Moran e a análise de Getis Ord Gi. Resultados: houve redução da taxa suavizada de violência contra o idoso. As cidades alto-alto e hot-spot em 2019, se tornaram mais violentas em 2020; e as cidades com baixa prevalência, se tornaram menos violentas em 2020. As maiores taxas de letalidade por COVID-19 também foram naquelas cidades com maiores taxas de violência. Conclusão: os dados reforçam a complexidade da violência e seu agravamento pela pandemia. E contribuem com as tomadas de decisões na enfermagem, desatacando-se a necessidade de suscitar novas pesquisas sobre esta temática.

ABSTRACT Objective: to analyze the spatial distribution of violence against older adults in the Brazilian South region before and in the first year of the COVID-19 pandemic. Method: an ecological study that analyzed reports of violence against older adults between 2019 and 2020, in Southern Brazil. Local empirical Bayesian rates, Moran's Local Autocorrelation Index and Getis Ord Gi analysis were calculated. Results: there was a reduction in the smoothed rate of violence against older adults. The high-high and hot-spot cities in 2019 became more violent in 2020; and cities with low prevalence became less violent in 2020. The highest COVID-19 fatality rates were also in those cities with the highest violence rates. Conclusion: the data reinforces the complexity of violence and its worsening due to the pandemic. In addition, they contribute to decision-making in Nursing, highlighting the need to encourage new research studies on this theme.

RESUMEN Objetivo: analizar la distribución espacial de la violencia contra las personas mayores en la región sur de Brasil antes y durante el primer año de la pandemia de COVID-19. Método: estudio ecológico que analizó denuncias de violencia contra las personas mayores, entre 2019 y 2020, en la región sur de Brasil. Se calcularon las tasas bayesianas empíricas locales, el índice de autocorrelación local de Moran y el análisis Getis Ord Gi. Resultados: hubo reducción en la tasa suavizada de violencia contra las personas mayores. Las ciudades alto-alto y hotspot de 2019 se volvieron más violentas en 2020; y las ciudades con baja prevalencia se volvieron menos violentas en 2020. Las tasas de mortalidad por COVID-19 más altas también se registraron en las ciudades con mayores tasas de violencia. Conclusión: los datos confirman la complejidad de la violencia y el agravamiento debido a la pandemia; además contribuyen a la toma de decisiones en enfermería y destacan la necesidad de fomentar nuevas investigaciones sobre este tema.

Organosolv pretreatment for biorefineries: Current status, perspectives, and challenges.

Biorefineries integrate processes for the sustainable conversion of biomass into chemicals, materials, and bioenergy so that resources are optimized and effluents are minimized. Despite the vast potential of lignocellulosic biorefineries, their success depends heavily on effective, economically viable, and sustainable biomass fractionation. Although efficient, organosolv pretreatment still faces challenges that must be overcome for its widespread utilization, mainly related to solvent type and recycling, robustness regarding biomass type and integration of hemicellulose recovery and use. This review shows the recent advances and state-of-the-art of organosolv pretreatment, discussing the advances, such as the use of biobased solvents, whilst also shedding light on the perspectives of using the streams - cellulose, hemicellulose, and lignin - to produce biofuels and products of high added value. In addition, it presents an overview of the existing industrial implementations of organosolv processes and, lastly, shows the main scientific and industrial challenges and opportunities for this process.

Ascending Flaccid Paralysis Secondary to Hypokalemia in A Cancer Patient using Abiraterone - A Case Report.

BACKGROUND: Prostate cancer (PC) is the most common type of neoplasm in men and the fourth leading cause of mortality in Brazil. The prostate cancer refractory metastatic castration can be treated with abiraterone acetate (AA). CASE PRESENTATION: Its use has been associated with increased survival. However, there are also side effects associated with the use of this drug, such as severe electrolyte disturbances. CONCLUSION: The objective is to report the clinical case of a patient with castration-resistant metastatic prostate cancer who developed ascending flaccid paralysis secondary to severe hypokalemia, probably due to hyperaldosteronism secondary to the use of Abiraterone Acetate, despite the use of Prednisone.

Avaliação do conhecimento do enfermeiro sobre hemotransfusão em um hospital de referência em trauma / Evaluation of nurses knowledge about hemotransfusion in a trauma reference hospital

Os profissionais de enfermagem exercem um papel fundamental na segurança transfusional. A atuação da equipe de enfermagem não é limitada à apenas administrar os hemocomponentes, uma vez que tem a responsabilidade de prestar uma assistência livre de danos decorrentes de imperícia, negligência e imprudência. Portanto, esses profissionais devem ter conhecimento das boas práticas relacionadas ao ciclo produtivo do sangue e componentes, garantindo a qualidade dos processos e produtos, reduzindo os riscos sanitários e garantindo a segurança transfusional. Objetivo: Avaliar o conhecimento do enfermeiro sobre hemotransfusão, explorando os principais pontos da legislação que aborda o ciclo do sangue, enfatizando principalmente os conhecimentos necessários durante o ato transfusional. Materias e Métodos: Trata-se de um estudo exploratório, transversal, quantitativo, descritivo, realizado em um hospital de referência em urgência e trauma no estado de Goiás, sendo a coleta de dados estruturada por meio de questionário semi-estruturado, abordando os seguintes temas: legislação sobre o assunto, sistema ABO e Rh, bolsa de coleta, tempo de administração, reação adversa imediata e tardia. Resultados: A amostra foi constituída de 35 enfermeiros (n), que atuam na assistência direta ao paciente crítico nas quatro UTIs de um hospital de urgências de no estado de Goiás: 62,9% afirmam que nunca participaram de educação continuada sobre transfusão sanguínea, 68,6 % desconhecem a classificação das reações transfusionais quanto ao tempo de manifestação do quadro clínico. 37,1% apresentaram resposta satisfatória quanto a iniciar a transfusão de concentrado de hemácias de acordo com o percentual de perda volêmica no choque hemorrágico. Considerações finais: Os enfermeiros não têm os conhecimentos necessários para realizar de forma competente o ato transfusional, podendo comprometer a segurança do paciente e a qualidade do serviço de saúde. Parte das fragilidades podem estar relacionadas à formação acadêmica, já que, uma parcela considerável de profissionais relataram não ter cursado disciplina que abordasse a hemoterapia durante a graduação. Espera-se que esse trabalho possa contribuir com o conhecimento e desenvolvimento de estudos sobre a terapia transfusional e que possa servir de base para formulação de avaliação e treinamentos dos profissionais envolvidos na terapia transfusional

Nursing professionals play a key role in transfusion safety. The performance of the nursing team is not limited to just administering the blood components, since it has the responsibility to provide assistance free of damage resulting from malpractice, negligence and recklessness. Therefore, these professionals must be aware of good practices related to the production cycle of blood and components, ensuring the quality of processes and products, reducing health risks and ensuring transfusion safety. Objective: Evaluate nurses´knowledge about blood transfusion, exploring the main points of the legislation that addresses the blood cycle, emphasizing mainly the necessary knowledge during the transfusion act. Methodology: This is an exploratory, cross-sectional, quantitative, descriptive study, carried out in a reference hospital in emergency and trauma in the state of Goiás, with data collection structured through a semi-structured questionnaire, covering the following topics: legislation on the subject, ABO and RH system, collection bag, administration time, immediate and late adverse reaction. Results: The sample consisted of 35 nurses (n), who work in direct assistance to critical patients in the four ICUs of hospital de emergency in the state of Goiás: 62.9% claim that they have never participated in continuing education on blood transfusion, 68.6% are unaware of classification of transfusion reactions according to the time of manifestation of the clinical condition. 37.1% had a satisfactory response regarding initiating the transfusion of packed red blood cells according to the percentage of volume loss in hemorrhagic shock. Final considerations: Nurses do not have the necessary knowledge to competently perform the transfusion act, which may compromise patient safety and the quality of the health service. Part of the weaknesses may be related to academic training, since a considerable portion of professionals reported not having taken a course that addressed hemotherapy during graduation. It is hoped that this work can contribute to the knowledge and development of studies on transfussion therapy and that it can serve as a basis for the formulation of evaluation and training of professionals involved in transfusion therapy

Perfil epidemiológico de pacientes vítimas de trauma torácico em um hospital de urgência e trauma / Epidemiological profile of patients victims of thoracic trauma in an emergency and trauma hospital

O trauma é responsável por significativos impactos na sociedade. De acordo com dados da Organização Mundial de Saúde (OMS), mais de nove pessoas morrem por minuto, vítimas de trauma. Entre os principais tipos de trauma, o torácico representa na atualidade cerca de 25% dos mortos em politraumatizados, constituindo um problema complexo, tendo em vista os elevados índices de mortalidade e sequelas incapacitantes permanentes. Objetivo: Descrever o perfil epidemiológico dos pacientes atendidos em um hospital de urgências da região centro-oeste, vítimas de trauma torácico. Método: Estudo quantitativo, de caráter transversal e retrospectivo, realizado a partir de coleta de dados efetuada em prontuário eletrônico no período de março a maio de 2022. Resultados: Identificou-se 73 pacientes vítimas de trauma torácico, com maior acometimento de pessoas do sexo masculino, com idade entre 26 e 35 anos. Como causa mais frequente, se destacaram os acidentes motociclísticos, resultando principalmente em lesões do tipo hemopneumotórax. Conclusão: o perfil epidemiológico dos pacientes vítimas de trauma torácico foi representado com maior frequência pelo sexo masculino, com idade entre 26 a 35 anos, causados predominantemente por acidentes motociclísticos, resultando na maioria das vezes em lesões do tipo hemopneumotórax

Trauma is responsible for significant impacts on society. According to data from the World Health Organization (WHO), more than nine people die per minute victims of trauma. Among the main types of trauma, thoracic trauma currently represents about 25% of polytrauma deaths, constituting a complex problem, in view of the high rates of mortality and sequelae permanent disabling. Objective: To describe the epidemiological profile of patients treated at an emergency hospital in the Midwest region, victims of thoracic trauma. Method: Quantitative, cross-sectional and retrospective study carried out from data collection of electronic medical records in the period from March to May of 2022. Results: We identified 73 patients who were victims of chest trauma with higher affecting males aged between 26 and 35 years. As the most frequent cause motorcycle accidents stood out, resulting mainly in lesions of the hemopneumothorax type. Conclusion: the profile epidemiology of patients victims of thoracic trauma was represented with greater frequency by males, aged between 26 and 35 years, caused predominantly by motorcycle accidents, often resulting in hemopneumothorax lesions

Indicadores de infecção relacionados à assistência à saúde em um hospital de urgência e trauma / Indicators of infection related to health care in an emergency and trauma hospital

As infecções hospitalares caracterizam-se como um fator importante para a saúde pública, por tratar-se de infecções recorrentes, principalmente em unidades de terapia intensiva (UTI), que tem causando alta taxa de morbidade e mortalidade, consequentemente aumento no tempo de internação e nos custos associados à internação. O objetivo deste estudo é analisar os indicadores de infecção hospitalar na unidade de terapia intensiva e descrever a incidência das Infecções Relacionadas à Assistência à Saúde (IRAS) na UTI. Trata-se de um estudo transversal, descritivo, com abordagem quantitativa, realizado na UTI de um hospital de grande porte do estado de Goiás. Durante o período analisado, foram notificados 44 casos de IRAS pela SCIH e 1779 pacientes passaram pela unidade. A partir da análise das notificações nas Fichas Referência do SCIH no período de abril a junho de 2022, foi possível observar o registro de IRAS nos referentes meses do semestre na UTI II, com um número maior de ocorrências no mês de maio com 23 casos, e um menor número de casos em abril, com 10 casos notificados. Em relação aso indicadores a PAV destacou-se como o indicador mais prevalente e de grande relevância entre as IRAS notificadas a SCIH. Conclui-se que é extremamente necessário conhecer a importância e a efetividade que os indicadores possuem e como eles podem contribuir para desenvolver medidas eficazes de prevenção e controle de infecção, melhorando tanto a qualidade dos cuidados prestados quanto os custos e credibilidade do estabelecimento de saúde

Hospital infections are characterized as an important factor for public health, because they are recurrent infections, especially in intensive care units (ICU), which has caused a high morbidity and mortality rate, consequently an increase in hospitalization time and costs associated with hospitalization. OBJECTIVE: the objective of this study is to analyze the indicators of nosocomial infection in the intensive care unit and to describe the incidence of HAI in the ICU. This is a cross-sectional, descriptive study with a quantitative approach, conducted in the ICU of a large hospital in the state of Goiás. During the analyzed period, 44 cases of AIS were reported by SCIH and 1779 patients passed through the unit. From the analysis of the notifications in the SCIH Reference Forms from April to June 2022, it was possible to observe the record of IRAS in the referring months of the semester in ICU II, with a higher number of occurrences in The Month of May with 23 cases, and a smaller number of cases in April, with 10 cases reported. In relation to the indicators, VAP stood out as the most prevalent and relevant indicator among the HAI reported to SCIH. It is concluded that it is extremely necessary to know the importance and effectiveness that the indicators have and how they can contribute to develop effective measures for prevention and infection control, improving both the quality of care provided and the costs and credibility of the health establishment.

Fatores facilitadores e limitadores da atuação das enfermeiras no controle da COVID-19 na assistência ao parto / Factores facilitadores y limitantes para el papel del enfermero en el control de la COVID-19 en la atención del parto / Facilitating and limiting factors for nurses' role in controlling COVID-19 in childbirth care

Resumo Objetivo discutir os fatores facilitadores e limitadores da atuação das enfermeiras no controle da COVID-19 na assistência ao parto. Métodos estudo descritivo e qualitativo, com 20 enfermeiras obstétricas de serviços públicos do estado do Rio de Janeiro. Os dados foram coletados de maio a julho de 2021, por entrevistas semiestruturadas, e submetidos à análise de conteúdo temática. Resultados como fatores facilitadores, têm-se: instalações físicas e recursos que proporcionam o uso individualizado; implementação de protocolos; reorganização do uso de ambientes coletivos; e preferência por cuidados que não requerem instrumentos ou a presença contínua da enfermeira. Como limitadores, apontam-se: a alta demanda assistencial; acomodações restritas e ventilação inadequada; carência de recursos; resistência ao uso de máscara; dificuldades das enfermeiras em manter o distanciamento físico nos cuidados; e incremento de práticas intervencionistas entre determinados profissionais. Conclusões e implicações para a prática serviços que passaram por adequações nos ambientes, com recursos disponíveis, corresponsabilização acerca das medidas sanitárias e onde as enfermeiras obstétricas modificaram seu processo de cuidar, apresentam melhores condições para proteger a saúde e mitigar a transmissão da COVID-19, com atenção à ambiência, humanização e aos direitos das mulheres no parto.

Resumen Objetivo discutir los factores facilitadores y limitantes de la actuación de los enfermeros en el control de la COVID-19 en la atención al parto. Métodos estudio descriptivo y cualitativo, con 20 parteras de servicios públicos del estado de Río de Janeiro. Los datos fueron recolectados de mayo a julio de 2021, a través de entrevistas semiestructuradas, y sometidos a análisis de contenido temático. Resultados como factores facilitadores, se encuentran: instalaciones físicas y recursos que brindan un uso individualizado; implementación de protocolos; reorganización del uso de los entornos colectivos; y preferencia por cuidados que no requieran instrumental o la presencia continua de la enfermera. Como limitantes, se destacan: la alta demanda de atención; alojamiento restringido y ventilación inadecuada; falta de recursos; resistencia a usar mascarilla; dificultades de las enfermeras para mantener la distancia física en el cuidado; y el aumento de las prácticas intervencionistas entre determinados profesionales. Conclusiones e implicaciones para la práctica los servicios que sufrieron adaptaciones en los ambientes, con recursos disponibles, corresponsabilidad en las medidas sanitarias y donde las matronas modificaron su proceso de atención, presentan mejores condiciones para proteger la salud y mitigar la transmisión de la COVID-19, con atención al ambiente, la humanización y los derechos de la mujer durante el parto.

Abstract Objective to discuss the facilitating and limiting factors of nurses' performance in controlling COVID-19 in childbirth care. Methods a descriptive and qualitative study, with 20 nurse-midwives from public services in the state of Rio de Janeiro. Data were collected from May to July 2021, through semi-structured interviews, and submitted to thematic content analysis. Results as facilitating factors there are: physical installations and resources that provide individualized use; protocol implementation; reorganization of collective environment use; and preference for care that does not require instruments or nurses' continuous presence. As limiting factors, the following stand out: high demand for care; restricted accommodation and inadequate ventilation; lack of resources; resistance to wearing a mask; nurses' difficulty in maintaining physical distance in care; and increase in interventionist practices among certain professionals. Conclusions and implications for practice services that underwent adaptations in environments, with available resources, co-responsibility regarding sanitary measures and where nurse-midwives modified their care process, presented better conditions to protect health and mitigate COVID-19 transmission, with attention to environment, humanization and women's rights during childbirth.

Adaptação transcultural para o português brasileiro da Escala de Ruminação Relacionada ao Trabalho (B-WRRS) / Transcultural adaptation to Brazilian Portuguese of the Work-related rumination scale (B-WRRS)

Resumo Introdução A ruminação relacionada ao trabalho se refere aos pensamentos relativos aos diversos aspectos do trabalho que ocorrem nos períodos de folga. Objetivo Descrever o processo de adaptação transcultural da escala de ruminação relacionada ao trabalho para o contexto brasileiro (B-WRRS) e analisar suas propriedades psicométricas. Método Foi realizada a tradução, retrotradução e avaliação psicométrica inicial de uma escala composta por 15 itens e três dimensões, onde a B-WRRS foi testada em 173 trabalhadores de cargos administrativos de uma instituição pública. Para a avaliação da validade dimensional, iniciou-se com a análise fatorial confirmatória, tendo como base o modelo original proposto pelos autores da escala. Foi realizada também a análise fatorial exploratória, utilizando o Mplus. Resultados A adaptação da escala cumpriu as etapas de avaliação da equivalência conceitual, de itens, semântica e operacional, apresentando grande aceitabilidade e compreensão por parte dos respondentes. A avaliação da estrutura fatorial da B-WRRS corroborou a tridimensionalidade da escala. Conclusão Por ser simples e rápido, o preenchimento da B-WRRS se destaca como promissor para o uso no ambiente de trabalho. O processo de adaptação transcultural do instrumento não apresentou divergências conceituais nem semânticas. Entretanto, as diferenças observadas na composição das dimensões indicam a necessidade de novas avaliações psicométricas para estabelecer a equivalência funcional da B-WRRS.

Abstract Background The work-related rumination scale refers to thoughts related to various aspects of work that occur during periods of rest. Objective To describe the transcultural adaptation process of the work-related rumination scale to the Brazilian context (B-WRRS), and to analyze psychometric properties. Method Translation, back-translation, and initial psychometric evaluation of the scale, which comprised 15 items and 3 dimensions, were performed. B-WRRS was tested on a sample of 173 administrative staff at a public institution. To evaluate the dimensional validity, the confirmatory factor analysis was tested based on the original model proposed by the authors of the scale. Exploratory factor analysis was also performed using Mplus. Results The transcultural adaptation of the scale fulfilled the steps of assessment of conceptual, item, semantic, and operational equivalence, showing acceptability and understanding by the respondents. The evaluation of the factorial structure of B-WRRS corroborated the three-dimensionality of the scale. Conclusion The simple and quick filling of the scale highlights that the use of B-WRRS in the work environment is promising. The process of cross-cultural adaptation of the instrument did not present conceptual or semantic divergences. However, the differences observed in the composition of the dimensions indicate the need for new psychometric assessments to establish the functional equivalence of B-WRRS.

Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II.

BACKGROUND: Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. OBJECTIVE: The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. METHODS: Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. RESULTS: From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. CONCLUSIONS: Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.

ANTECEDENTES: Migrânea afeta um bilhão de pessoas em todo o mundo e mais de 30 milhões de brasileiros; além disso, é um distúrbio subdiagnosticado e subtratado. OBJETIVO: Sabe-se sobre a necessidade de difundir o conhecimento sobre o tratamento profilático da migrânea; por isso, a Sociedade Brasileira de Cefaleias (SBCe) nomeou um comitê de autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da migrânea episódica com base em artigos da literatura mundial, assim como da experiência pessoal. MéTODOS: As reuniões foram realizadas inteiramente online, com a participação de 12 grupos que revisaram e escreveram sobre as categorias farmacológicas dos medicamentos e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de medicamentos estudadas na parte II deste Consenso foram: anti-hipertensivos, inibidores seletivos de recaptação de serotonina, inibidores de recaptação de serotonina e noradrenalina, bloqueadores dos canais de cálcio, outros medicamentos e politerapia racional. RESULTADOS: Desta lista de medicamentos, apenas o candesartan foi estabelecido como eficaz no controle da migrânea episódica. Flunarizina, venlafaxina, duloxetina e pizotifeno foram definidos como provavelmente eficazes, enquanto lisinopril, enalapril, escitalopram, fluvoxamina, quetiapina, atorvastatina, sinvastatina, ciproheptadina e melatonina foram possivelmente eficazes na profilaxia da doença. CONCLUSõES: Apesar do esforço da comunidade científica em encontrar medicamentos realmente eficazes no tratamento da migrânea, dado o grande número de medicamentos testados para este fim, ainda dispomos de poucas opções terapêuticas.

Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I.

The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.

A Sociedade Brasileira de Cefaleia (SBCe) nomeou um Comitê de Autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da enxaqueca episódica com base em artigos da literatura mundial e da experiência pessoal. A enxaqueca é um distúrbio subdiagnosticado e subtratado que acomete um bilhão de pessoas no mundo e mais de 30 milhões de brasileiros. É conhecido na comunidade médica de neurologistas e, sobretudo, dos especialistas em cefaleia, a necessidade de se divulgar o conhecimento sobre o tratamento profilático da enxaqueca. Com esta finalidade, aliada às necessidades de atualizações de drogas e de se aumentar o conhecimento sobre a doença em si (frequência, intensidade, duração, impacto e talvez a progressão da enxaqueca), foi elaborado este Consenso, com metodologia totalmente on-line, por 12 grupos que revisaram e escreveram sobre as categorias farmacológicas das drogas e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de drogas estudadas para este Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais do antipeptídeo relacionado ao gene da calcitonina (peptídeo relacionado ao gene da calcitonina ­ anti-CGRP), betabloqueadores, anti-hipertensivos, inibidores dos canais de cálcio, outros antidepressivos (inibidores seletivos de recaptação de serotonina, ISRSs, e antidepressivos de ação dual), outras drogas, e politerapia. O tratamento hormonal, bem como anti-inflamatórios e triptanas em esquema de profilaxia mínima (miniprofilaxia), será abordado em um capítulo próprio. As classes de drogas estudadas na parte I do Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais anti-CGRP, e betabloqueadores.