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2.
BMC Geriatr ; 24(1): 10, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172673

RESUMO

BACKGROUND: The use of a reliable remote cognitive screening test for older adults is crucial for the diagnosis of cognitive impairment. This study aimed to translate and validate the audiovisual Montreal Cognitive Assessment (MoCA)for older adults in Brazil. METHODS: One hundred and fourteen older adults were recruited from the community and demographic, functional, mood, and cognitive data were collected. Participants were classified into two groups: cognitively healthy or mild cognitive impairment (MCI). Statistical analyses were performed in order to assess the validity of the test and the cutoff score. RESULTS: The psychometric properties of the audiovisual MoCA showed good convergent validity. The audiovisual MoCA was represented as a unifactorial adjusted model, the composite reliability value was acceptable and a cutoff point of ≥23 reached adequate sensitivity and specificity at 0.77 and 0.92, respectively. CONCLUSIONS: The translated audiovisual MoCA is a valid and reliable cognitive screening test that can be administered remotely in older adults in Brazil. The test demonstrated a great ability to discriminate older adults with MCI from cognitively healthy adults. Future studies should focus on validating the audiovisual MoCA using other target population groups in order to expand the use of this remote screening test.


Assuntos
Disfunção Cognitiva , Humanos , Idoso , Brasil/epidemiologia , Reprodutibilidade dos Testes , Testes de Estado Mental e Demência , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Testes Neuropsicológicos
3.
Front Med (Lausanne) ; 10: 1259055, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38046414

RESUMO

Background: Predicting the need for invasive mechanical ventilation (IMV) is important for the allocation of human and technological resources, improvement of surveillance, and use of effective therapeutic measures. This study aimed (i) to assess whether the ABC2-SPH score is able to predict the receipt of IMV in COVID-19 patients; (ii) to compare its performance with other existing scores; (iii) to perform score recalibration, and to assess whether recalibration improved prediction. Methods: Retrospective observational cohort, which included adult laboratory-confirmed COVID-19 patients admitted in 32 hospitals, from 14 Brazilian cities. This study was conducted in two stages: (i) for the assessment of the ABC2-SPH score and comparison with other available scores, patients hospitalized from July 31, 2020, to March 31, 2022, were included; (ii) for ABC2-SPH score recalibration and also comparison with other existing scores, patients admitted from January 1, 2021, to March 31, 2022, were enrolled. For both steps, the area under the receiving operator characteristic score (AUROC) was calculated for all scores, while a calibration plot was assessed only for the ABC2-SPH score. Comparisons between ABC2-SPH and the other scores followed the Delong Test recommendations. Logistic recalibration methods were used to improve results and adapt to the studied sample. Results: Overall, 9,350 patients were included in the study, the median age was 58.5 (IQR 47.0-69.0) years old, and 45.4% were women. Of those, 33.5% were admitted to the ICU, 25.2% received IMV, and 17.8% died. The ABC2-SPH score showed a significantly greater discriminatory capacity, than the CURB-65, STSS, and SUM scores, with potentialized results when we consider only patients younger than 80 years old (AUROC 0.714 [95% CI 0.698-0.731]). Thus, after the ABC2-SPH score recalibration, we observed improvements in calibration (slope = 1.135, intercept = 0.242) and overall performance (Brier score = 0.127). Conclusion: The ABC2-SPHr risk score demonstrated a good performance to predict the need for mechanical ventilation in COVID-19 hospitalized patients under 80 years of age.

4.
BMC Med ; 21(1): 207, 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37280651
5.
Front Med (Lausanne) ; 10: 1130218, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37153097

RESUMO

Objectives: To assess the ABC2-SPH score in predicting COVID-19 in-hospital mortality, during intensive care unit (ICU) admission, and to compare its performance with other scores (SOFA, SAPS-3, NEWS2, 4C Mortality Score, SOARS, CURB-65, modified CHA2DS2-VASc, and a novel severity score). Materials and methods: Consecutive patients (≥ 18 years) with laboratory-confirmed COVID-19 admitted to ICUs of 25 hospitals, located in 17 Brazilian cities, from October 2020 to March 2022, were included. Overall performance of the scores was evaluated using the Brier score. ABC2-SPH was used as the reference score, and comparisons between ABC2-SPH and the other scores were performed by using the Bonferroni method of correction. The primary outcome was in-hospital mortality. Results: ABC2-SPH had an area under the curve of 0.716 (95% CI 0.693-0.738), significantly higher than CURB-65, SOFA, NEWS2, SOARS, and modified CHA2DS2-VASc scores. There was no statistically significant difference between ABC2-SPH and SAPS-3, 4C Mortality Score, and the novel severity score. Conclusion: ABC2-SPH was superior to other risk scores, but it still did not demonstrate an excellent predictive ability for mortality in critically ill COVID-19 patients. Our results indicate the need to develop a new score, for this subset of patients.

6.
Int. j. cardiovasc. sci. (Impr.) ; 36: e20200312, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1430488

RESUMO

Abstract Background Dental anesthetic management in implantable cardioverter defibrillator (ICD) recipients with cardiac channelopathies (CCh) can be challenging due to the potential risk of life-threatening arrhythmias and appropriate ICD therapies during procedural time. Objectives The present study assessed the hypothesis that the use of local dental anesthesia with 2% lidocaine with 1:100,000 epinephrine or without a vasoconstrictor can be safe in selected ICD and CCh patients, not resulting in life-threatening events (LTE). Methods Restorative dental treatment under local dental anesthesia was made in two sessions, with a wash-out period of 7 days (cross-over trial), conducting with a 28h - Holter monitoring, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments in 3 time periods. Statistical analysis carried out the paired Student's t test and the Wilcoxon signed-rank test. In all cases, a significance level of 5% was adopted. All patients were in stable condition with no recent events before dental care. Results Twenty-four consecutive procedures were performed in 12 patients (9 women, 3 men) with CCh and ICD: 7 (58.3%) had long QT syndrome (LQTS), 4 (33.3%) Brugada syndrome (BrS), and 1 (8.3%) Catecholaminergic polymorphic ventricular tachycardia (CPVT). Holter analysis showed no increased heart rate (HR) or sustained arrhythmias. Blood pressure (BP), electrocardiographic changes and anxiety measurement showed no statistically significant differences. No LTE occurred during dental treatment, regardless of the type of anesthesia. Conclusion Lidocaine administration, with or without epinephrine, can be safely used in selected CCh-ICD patients without LTE. These preliminary findings need to be confirmed in a larger population with ICD and CCh.

7.
Cad. psicanal. (Rio J., 1980) ; 44(47): 119-132, jul.-dez. 2022.
Artigo em Português | Index Psicologia - Periódicos | ID: psi-72491

RESUMO

Este artigo nasce do desejo de analisar os enfrentamentos da construção de uma clínica psicanalítica em tempos pandêmicos. Pretende-se refletir acerca dos tensionamentos surgidos entre os atendimentos nas modalidades presencial e virtual, mas também sobre os novos arranjos do sofrimento e suas formas de nomeá-lo na clínica. Tendo como aporte as contribuições freudianas (FREUD, 1917[1915]/2010) e pós-freudianas, a tessitura da discussão caminhou no sentido de desenvolver uma reflexão acerca da relação dos sujeitos frente a perdas objetais, seja pela via do enlutamento, seja pela via melancólica, a partir de dois casos clínicos: a criança enlutada que se aventurou a migrar para a análise on-line e a adulta melancólica que só conseguiu permanecer no cenário presencial.(AU)


This article is born from the desire to analyze the confrontations of the construction of a psychoanalytic clinic in pandemic times. It is intended to reflect on the tensions that have arisen between the attendances in the face-to-face and virtual modalities, but also on the new arrangements of suffering and its ways of naming it in the clinic. With the contribution of Freudian (FREUD, 1917[1915]/2010) and post-Freudian contributions, the fabric of the discussion moved in the direction of developing a reflection on the relationship of the subjects in the face of object losses, either through mourning or through via melancholy, from two clinical cases: the bereaved child who ventured to migrate to online analysis and the melancholic adult who only managed to remain in the face-to-face setting.(AU)


Assuntos
Humanos , Psicanálise
8.
BMC Med ; 20(1): 324, 2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056335

RESUMO

BACKGROUND: Acute kidney injury (AKI) is frequently associated with COVID-19, and the need for kidney replacement therapy (KRT) is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting the need for KRT in hospitalised COVID-19 patients, and to assess the incidence of AKI and KRT requirement. METHODS: This study is part of a multicentre cohort, the Brazilian COVID-19 Registry. A total of 5212 adult COVID-19 patients were included between March/2020 and September/2020. Variable selection was performed using generalised additive models (GAM), and least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC-ROC). RESULTS: The median age of the model-derivation cohort was 59 (IQR 47-70) years, 54.5% were men, 34.3% required ICU admission, 20.9% evolved with AKI, 9.3% required KRT, and 15.1% died during hospitalisation. The temporal validation cohort had similar age, sex, ICU admission, AKI, required KRT distribution and in-hospital mortality. The geographic validation cohort had similar age and sex; however, this cohort had higher rates of ICU admission, AKI, need for KRT and in-hospital mortality. Four predictors of the need for KRT were identified using GAM: need for mechanical ventilation, male sex, higher creatinine at hospital presentation and diabetes. The MMCD score had excellent discrimination in derivation (AUROC 0.929, 95% CI 0.918-0.939) and validation (temporal AUROC 0.927, 95% CI 0.911-0.941; geographic AUROC 0.819, 95% CI 0.792-0.845) cohorts and good overall performance (Brier score: 0.057, 0.056 and 0.122, respectively). The score is implemented in a freely available online risk calculator ( https://www.mmcdscore.com/ ). CONCLUSIONS: The use of the MMCD score to predict the need for KRT may assist healthcare workers in identifying hospitalised COVID-19 patients who may require more intensive monitoring, and can be useful for resource allocation.


Assuntos
Injúria Renal Aguda , COVID-19 , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/terapia , Adulto , Idoso , COVID-19/terapia , Dextranos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mitomicina , Curva ROC , Terapia de Substituição Renal/efeitos adversos , Estudos Retrospectivos , Fatores de Risco
9.
Intern Emerg Med ; 17(8): 2299-2313, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36153772

RESUMO

The COVID-19 pandemic caused unprecedented pressure over health care systems worldwide. Hospital-level data that may influence the prognosis in COVID-19 patients still needs to be better investigated. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with in-hospital mortality in COVID-19 patients admitted to Brazilian institutions. This multicenter retrospective cohort study is part of the Brazilian COVID-19 Registry. We enrolled patients ≥ 18 years old with laboratory-confirmed COVID-19 admitted to the participating hospitals from March to September 2020. Patients' data were obtained through hospital records. Hospitals' data were collected through forms filled in loco and through open national databases. Generalized linear mixed models with logit link function were used for pooling mortality and to assess the association between hospital characteristics and mortality estimates. We built two models, one tested general hospital characteristics while the other tested ICU characteristics. All analyses were adjusted for the proportion of high-risk patients at admission. Thirty-one hospitals were included. The mean number of beds was 320.4 ± 186.6. These hospitals had eligible 6556 COVID-19 admissions during the study period. Estimated in-hospital mortality ranged from 9.0 to 48.0%. The first model included all 31 hospitals and showed that a private source of funding (ß = - 0.37; 95% CI - 0.71 to - 0.04; p = 0.029) and location in areas with a high gross domestic product (GDP) per capita (ß = - 0.40; 95% CI - 0.72 to - 0.08; p = 0.014) were independently associated with a lower mortality. The second model included 23 hospitals and showed that hospitals with an ICU work shift composed of more than 50% of intensivists (ß = - 0.59; 95% CI - 0.98 to - 0.20; p = 0.003) had lower mortality while hospitals with a higher proportion of less experienced medical professionals had higher mortality (ß = 0.40; 95% CI 0.11-0.68; p = 0.006). The impact of those association increased according to the proportion of high-risk patients at admission. In-hospital mortality varied significantly among Brazilian hospitals. Private-funded hospitals and those located in municipalities with a high GDP had a lower mortality. When analyzing ICU-specific characteristics, hospitals with more experienced ICU teams had a reduced mortality.


Assuntos
COVID-19 , Humanos , Adolescente , Pandemias , Brasil/epidemiologia , Estudos Retrospectivos , Unidades de Terapia Intensiva , Mortalidade Hospitalar , Estudos de Coortes , Hospitais Gerais , Sistema de Registros
10.
Int J Infect Dis ; 116: 319-327, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35065257

RESUMO

BACKGROUND: It is not clear whether previous thyroid diseases influence the course and outcomes of COVID-19. METHODS: The study is a part of a multicentric cohort of patients with confirmed COVID-19 diagnosis from 37 hospitals. Matching for age, sex, number of comorbidities, and hospital was performed for the paired analysis. RESULTS: Of 7,762 patients with COVID-19, 526 had previously diagnosed hypothyroidism and 526 were matched controls. The median age was 70 years, and 68.3% were females. The prevalence of comorbidities was similar, except for coronary and chronic kidney diseases that were higher in the hypothyroidism group (p=0.015 and p=0.001). D-dimer levels were lower in patients with hypothyroid (p=0.037). In-hospital management was similar, but hospital length-of-stay (p=0.029) and mechanical ventilation requirement (p=0.006) were lower for patients with hypothyroidism. There was a trend of lower in-hospital mortality in patients with hypothyroidism (22.1% vs 27.0%; p=0.062). CONCLUSION: Patients with hypothyroidism had a lower requirement of mechanical ventilation and showed a trend of lower in-hospital mortality. Therefore, hypothyroidism does not seem to be associated with a worse prognosis.


Assuntos
COVID-19 , Hipotireoidismo , Idoso , Teste para COVID-19 , Feminino , Mortalidade Hospitalar , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Prognóstico , Sistema de Registros , SARS-CoV-2
13.
Sci Rep ; 11(1): 20289, 2021 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645833

RESUMO

Chagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64-80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.


Assuntos
COVID-19/complicações , Doença de Chagas/patologia , Hospitalização/tendências , Idoso , Fibrilação Atrial , Brasil , Proteína C-Reativa/análise , COVID-19/patologia , Doença de Chagas/complicações , Doença de Chagas/virologia , Coinfecção , Diabetes Mellitus , Feminino , Mortalidade Hospitalar/tendências , Hospitalização/estatística & dados numéricos , Hospitais , Humanos , Hipertensão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/patogenicidade
14.
Int J Infect Dis ; 110: 281-308, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34311100

RESUMO

OBJECTIVES: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. METHODS: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. RESULTS: Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). CONCLUSIONS: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.


Assuntos
COVID-19 , Idoso , Mortalidade Hospitalar , Hospitalização , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
15.
Zoology (Jena) ; 141: 125782, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32502832

RESUMO

Haemulon steindachneri (Jordan and Gilbert) (Haemulidae), popularly known as "cocoroca-de-boca-larga", "latin-grunt" or "latin-burro", represents a species complex found on the Atlantic western coast and on the Pacific eastern coast, condition confirmed recently by molecular phylogenies. In the present study, DNA barcoding analysis recognizes two distinct clusters; the first includes Brazil and Caribbean, and the second is composed of Pacific specimens, with genetic distance of 7.4%, differentiated by 35 base pairs. In addition to the molecular evidence, our results show morphological differences that distinguish the Atlantic lineage from that of the Pacific: anal fin, usually, with eight rays (vs. generally nine rays in Pacific); 13-15 scales below the lateral line, rarely 12 (vs. 12 scales below the lateral line, rarely 13 in Pacific), posterior margin of the maxilla robust with a slightly angled end (vs. smaller maxilla with moderately convex extremity), and presence of a spot on the pre-operculum, broad and robust, with no definite shape (vs. narrow spot, with anterior extremity tuned and posterior straight, resembling a triangle in Pacific). Therefore, based on both molecular and morphological evidences, H. steindachneri is redescribed for the Pacific coast while a new species is described for the Atlantic coast.


Assuntos
Código de Barras de DNA Taxonômico , DNA/genética , Peixes/anatomia & histologia , Peixes/genética , Filogenia , Distribuição Animal , Animais , Peixes/classificação , Especificidade da Espécie
16.
Psicol. ciênc. prof ; 39(3,n.esp): 194-205, dez. 2019-maio 2020. graf
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1097350

RESUMO

Atualmente o Brasil se encontra em um cenário preocupante em termos de violações de direitos, sobretudo no que se refere às minorias sexuais. Tendo em vista que tal cenário produz intenso sofrimento, é importante que se construam espaços de pesquisa, discussão e reflexão que possam trazer maior densidade e visibilidade às problemáticas sociais que envolvam gênero e sexualidade. Neste sentido, este estudo, marcado pela perspectiva genealógica de Foucault, trata-se de uma pesquisa de revisão bibliográfica, cuja análise deu-se por meio de um estudo quantitativo, que foi construído a partir da análise das bases de dados SciELO, LILACS e Lattes. Tal análise teve por objetivo apontar como as temáticas relacionadas ao gênero e à sexualidade são abordadas nas produções das ciências humanas, especialmente na Psicologia. Diante dos resultados, constatou-se que a ciência psicológica não é uma das áreas mais envolvidas com o tema. No entanto, vale salientar que os estudos da Psicologia encontrados apontam para uma análise mais crítica e que aposta na produção dos sentidos, distanciando-se de uma perspectiva mais positivista...(AU)


Brazil is in a worrying scenario in terms of violations of rights, especially with regard to sexual minorities. Taking into account that this scenario produces intense suffering, it is important to construct spaces of data, discussion and reflection which relate to networks that evolve gender and sexuality. In this sense, this study, marked by the genealogical perspective of Foucault, is a bibliographical research, using a quantitative study, which was constructed from the analysis of the databases SciELO, LILACS and Lattes. This analysis sought to point out how gender and sexuality issues are approached in the humanities productions, especially in Psychology. It was found that the psychological science is not involved with this subject. However, it is worth mentioning that the studies of Psychology studied here point to a more critical analysis that defends the production of senses, distancing itself from a more positivist perspective...(AU)


Brasil se encuentra actualmente en un escenario preocupante en términos de violaciones de derechos, especialmente con respecto a las minorías sexuales. Dado que este escenario produce un sufrimiento intenso, es importante crear espacios para la investigación, el debate y la reflexión que puedan aportar mayor densidad y visibilidad a los problemas sociales relacionados con el género y la sexualidad. En este sentido, este estudio, marcado por la perspectiva genealógica de Foucault, es una investigación de revisión bibliográfica, cuyo análisis tuvo lugar a través de un estudio cuantitativo, que se construyó a partir del análisis de Scielo, Lilacs y Lattes. Este análisis tuvo como objetivo señalar cómo se abordan los temas relacionados con el género y la sexualidad en las producciones de las ciencias humanas, especialmente en Psicología. Dados los resultados, se descubrió que la ciencia psicológica no es una de las áreas más involucradas con el tema. Sin embargo, es digno de mención que los estudios de Psicología encontrados apunten hacia un análisis más crítico y que apuesten por la producción de los sentidos, alejándose de una perspectiva más positivista...(AU)


Assuntos
Humanos , Masculino , Feminino , Psicologia , Pesquisa , Sexualidade , Minorias Sexuais e de Gênero , Identidade de Gênero , Problemas Sociais , LILACS , Ciências Humanas
17.
Psicol. pesq ; 13(3): 48-72, set.-dez. 2019. ilus
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1098527

RESUMO

Buscando investigar práticas de cuidados de crianças com bebês em acolhimento institucional, conduziu-se estudo de caso exploratório e longitudinal acompanhando Ana, bebê com idade entre 10-12 meses. Por meio de videogravações semanais, em ambiente naturalístico, foram categorizados episódios de cuidado. Três categorias finais foram descritas: cuidados orientados por atenção; cuidados orientados por solicitude (criança atendeu à necessidade expressa do bebê) e; cuidados orientados por tensão (criança agiu frente a um risco ao bebê). Discutiu-se o caráter empático e pró-social destas práticas e seu potencial para promoção do desenvolvimento e aprendizagem das crianças acolhidas e formação da sua rede socioafetiva. Destacou-se, também, o papel mediador do adulto no planejamento do ambiente, da supervisão e da significação das ações das crianças nestes encontros.


Aiming to investigate care practices of children with babies in institutional care, an exploratory and longitudinal case study was conducted accompanying Ana, a baby aged between 10-12 months. Based on weekly video recordings made in a naturalistic environment, episodes of care were categorized. Three final categories were described: attention-oriented care; request-oriented care (the child met the infants' expressed needs); stress-oriented care (the child acted upon a risk to the baby). The empathic and pro-social character of those practices, their potential to promote foster children's development and learning, and the formation of their social-affective network were discussed. The mediating role of the adult in planning the environment, the supervision and the signification of the children's actions in these encounters was also highlighted.


Buscando investigar las prácticas de cuidado de bebés por los niños en instituciones de acogida, se realizó un estudio de caso exploratorio y longitudinal acompañando a Ana, una bebé de entre 10-12 meses de edad. Por medio de videograbaciones semanales, en un ambiente natural, se categorizaron los episodios de cuidado. Se describieron tres categorías finales: cuidados orientados por atención; cuidados orientados por solicitud (el niño atendió a la necesidad expresada por el bebé) y; cuidados orientados por tensión (el niño reaccionó frente a un riesgo para el bebé). Se discutió el carácter empático y pro social de estas prácticas y su potencial para la promoción del desarrollo y aprendizaje de los niños acogidos y la formación de su red socio afectiva. Se destacó también, el papel mediador del adulto en la planificación del ambiente, de la supervisión y significación de las acciones de los niños en estos encuentros.

18.
J Am Heart Assoc ; 8(15): e012361, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31319747

RESUMO

Background Brugada syndrome and long-QT syndrome may account for at least one third of unexplained sudden cardiac deaths. Dental care in patients with cardiac channelopathies is challenging because of the potential risk of life-threatening events. We hypothesized that the use of local dental anesthesia with lidocaine with and without epinephrine is safe and does not result in life-threatening arrhythmias in patients with channelopathies. Methods and Results We performed a randomized, double-blind pilot trial comparing the use of 2% lidocaine without a vasoconstrictor and with 1:100 000 epinephrine in 2 sessions of restorative dental treatment with a washout period of 7 days (crossover trial). Twenty-eight-hour Holter monitoring was performed, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments were also conducted at 3 time points. Fifty-six dental procedures were performed in 28 patients (18 women, 10 men) with cardiac channelopathies: 16 (57.1%) had long-QT syndrome, and 12 (42.9%) had Brugada syndrome; 11 (39.3%) of patients had an implantable defibrillator. The mean age was 45.9±15.9 years. The maximum heart rate increased after the use of epinephrine during the anesthesia period from 82.1 to 85.8 beats per minute (P=0.008). In patients with long-QT syndrome, the median corrected QT was higher, from 450.1 to 465.4 ms (P=0.009) at the end of anesthesia in patients in whom epinephrine was used. The other measurements showed no statistically significant differences. No life-threatening arrhythmias occurred during dental treatment. Conclusions The use of local dental anesthesia with lidocaine, regardless of the use of a vasoconstrictor, did not result in life-threatening arrhythmias and appears to be safe in stable patients with cardiac channelopathies. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03182777.


Assuntos
Anestésicos Locais/administração & dosagem , Síndrome de Brugada/fisiopatologia , Canalopatias/fisiopatologia , Contraindicações de Procedimentos , Assistência Odontológica/efeitos adversos , Epinefrina/administração & dosagem , Lidocaína/administração & dosagem , Síndrome do QT Longo/fisiopatologia , Vasoconstritores/administração & dosagem , Adolescente , Adulto , Idoso , Anestésicos Locais/efeitos adversos , Método Duplo-Cego , Epinefrina/efeitos adversos , Feminino , Humanos , Lidocaína/efeitos adversos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Vasoconstritores/efeitos adversos
19.
Psicol. ciênc. prof ; 39(spe3): e228573, 2019. graf
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1135827

RESUMO

Atualmente o Brasil se encontra em um cenário preocupante em termos de violações de direitos, sobretudo no que se refere às minorias sexuais. Tendo em vista que tal cenário produz intenso sofrimento, é importante que se construam espaços de pesquisa, discussão e reflexão que possam trazer maior densidade e visibilidade às problemáticas sociais que envolvam gênero e sexualidade. Neste sentido, este estudo, marcado pela perspectiva genealógica de Foucault, trata-se de uma pesquisa de revisão bibliográfica, cuja análise deu-se por meio de um estudo quantitativo, que foi construído a partir da análise das bases de dados SciELO, LILACS e Lattes. Tal análise teve por objetivo apontar como as temáticas relacionadas ao gênero e à sexualidade são abordadas nas produções das ciências humanas, especialmente na Psicologia. Diante dos resultados, constatou-se que a ciência psicológica não é uma das áreas mais envolvidas com o tema. No entanto, vale salientar que os estudos da Psicologia encontrados apontam para uma análise mais crítica e que aposta na produção dos sentidos, distanciando-se de uma perspectiva mais positivista.


Brazil is in a worrying scenario in terms of violations of rights, especially with regard to sexual minorities. Taking into account that this scenario produces intense suffering, it is important to construct spaces of data, discussion and reflection which relate to networks that evolve gender and sexuality. In this sense, this study, marked by the genealogical perspective of Foucault, is a bibliographical research, using a quantitative study, which was constructed from the analysis of the databases SciELO, LILACS and Lattes. This analysis sought to point out how gender and sexuality issues are approached in the humanities productions, especially in Psychology. It was found that the psychological science is not involved with this subject. However, it is worth mentioning that the studies of Psychology studied here point to a more critical analysis that defends the production of senses, distancing itself from a more positivist perspective.


Brasil se encuentra actualmente en un escenario preocupante en términos de violaciones de derechos, especialmente con respecto a las minorías sexuales. Dado que este escenario produce un sufrimiento intenso, es importante crear espacios para la investigación, el debate y la reflexión que puedan aportar mayor densidad y visibilidad a los problemas sociales relacionados con el género y la sexualidad. En este sentido, este estudio, marcado por la perspectiva genealógica de Foucault, es una investigación de revisión bibliográfica, cuyo análisis tuvo lugar a través de un estudio cuantitativo, que se construyó a partir del análisis de Scielo, Lilacs y Lattes. Este análisis tuvo como objetivo señalar cómo se abordan los temas relacionados con el género y la sexualidad en las producciones de las ciencias humanas, especialmente en Psicología. Dados los resultados, se descubrió que la ciencia psicológica no es una de las áreas más involucradas con el tema. Sin embargo, es digno de mención que los estudios de Psicología encontrados apunten hacia un análisis más crítico y que apuesten por la producción de los sentidos, alejándose de una perspectiva más positivista.

20.
Rev. polis psique ; 6(1): 98-112, jan. 2016.
Artigo em Português | LILACS | ID: lil-778201

RESUMO

O objetivo deste artigo é discutir o ato de pesquisar em ciências humanas, tendo como foco a produção escrita. Assim sendo, buscamos definir o que entendemos por escrever com o outro, a partir do pesquisar com. O que está em pauta é uma postura metodológica, que tem como referência a filosofia da linguagem de Mikhail Bakhtin, cujo fundamento é assumir o interlocutor da pesquisa como parceiro e coautor. O compromisso ético com o discurso do outro tem como premissa os conceitos de dialogismo e alteridade para iluminar o encontro com o outro no campo e, posteriormente, na escrita do texto. Esse modo de atuar instaura alguns questionamentos éticos, tal como a exigência do anonimato, e problematiza a forma como o consentimento livre e esclarecido é tratado na pesquisa. Em síntese, narrar uma pesquisa não é só registrar os acontecimentos, mas consiste em um trabalho político de afirmação de algumas verdades em detrimento de outras.


This article discusses the act of research in Human Sciences which focuses on the production of writing. Thus, starting from the conceptual foundation of researching with, we seek to define what we mean by writing with the other. What is at stake is a methodological approach which accepts the interlocutor of research as partner and co-author, an approach based on Mikhail Bakhtin’s philosophy of language. The ethical commitment to the other’s discourse is premised on the concepts of dialogism and alterity to illuminate the encounter with the other in the field and, subsequently, in the written text. This way of working poses ethical questions-such as conditions of anonymity-and problematizes the way in which consent is accorded and treated in the research. In short, relating research findings is not just about recording events. It consists in the affirmation of certain truths at the expense of others as political activity.


El propósito de este artículo es discutir el acto de investigar en Humanidades, enfocándose en la producción escrita. Por lo tanto, tratamos de definir qué entendemos por escribir con el otro, a partir del investigar con el. Lo que está en juego es una postura metodológica, que tiene referencia a la filosofía del lenguaje de Mikhail Bakhtin, que se fundamenta en asumir el interlocutor de la investigación como socio y coautor. El compromiso ético con el discurso del otro tiene como premisa los conceptos de dialogismo y de otredad para iluminar el encuentro con el otro en el campo y, posteriormente, en la escritura del texto. Este modo de actuar introduce algunas cuestiones éticas, tales como el requisito del anonimato, y discute la manera cómo se trata el consentimiento libre e informado en la encuesta. Así, narrar una búsqueda no es tan sólo el registro los acontecimientos, pero consiste en un trabajo político de la afirmación de algunas verdades, a costa de comprometer otras.


Assuntos
Pesquisa , Autoria , Metodologia como Assunto , Ética , Ciências Humanas
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