Application of ventilator-associated events (VAE) in ventilator-associated pneumonia (VAP) notified in Brazil (IMPACTO MR-PAV): a protocol for a cohort study.

INTRODUCTION: Certain criteria for ventilator-associated events (VAE) definition might influence the type of an event, its detection rate and consequently the resource expenditure in intensive care unit. The Impact of Infections by Antimicrobial-Resistant Microorganisms - Ventilator-Associated Pneumonia (IMPACTO MR-PAV) aims to evaluate the incidence and diagnostic accuracy of ventilator-associated pneumonia (VAP) using the current criteria for VAP surveillance in Brazil versus the VAE criteria defined by the US National Healthcare Safety Network-Center for Diseases Control and Prevention (CDC) criteria. METHODS AND ANALYSIS: The study will be conducted in around 15 centres across Brazil from October 2022 to December 2023. Trained healthcare professionals will collect data and compare the incidence of VAP using both the current criteria for VAP surveillance in Brazil and the VAE criteria defined by the CDC. The accuracy of the two criteria for identifying VAP will also be analysed. It will also characterise other events associated with mechanical ventilation (ventilator-associated condition, infection-related ventilator-associated complication) and adjudicate VAP reported to the Brazilian Health Regulatory Agency (ANVISA) using current epidemiological diagnostic criteria. ETHICS AND DISSEMINATION: This study was approved by the Institutional Review Board under the number 52354721.0.1001.0070. The study's primary outcome measure will be the incidence of VAP using the two different surveillance criteria, and the secondary outcome measures will be the accuracy of the two criteria for identifying VAP and the adjudication of VAP reported to ANVISA. The results will contribute to the improvement of VAP surveillance in Brazil and may have implications for other countries that use similar criteria. TRIAL REGISTRATION NUMBER: NCT05589727; Clinicaltrials.gov.

Avaliação do impacto da quimioterapia no consumo alimentar de mulheres com câncer de mama / Analyzing the impact of chemotherapy on food intake of women with breast cancer

Introdução: O câncer de mama está relacionado não só a fatores hormonais, raciais e genéticos, como também ao estilo de vida. A dieta, atividade física, peso corporal, e hormônios esteróides, podem aumentar o risco de desenvolvimento do câncer de mama. Por isso, recomenda-se a manutenção do balanço energético e prevenção da perda de peso durante a quimioterapia para obtenção de melhores resultados, possibilitando a promoção da qualidade de vida durante e após o tratamento. Poucos estudos relacionam hábitos alimentares e seu impacto em pessoas submetidas à quimioterapia. Objetivos: Analisar a ocorrência de mudança no consumo alimentar durante a quimioterapia, correlacionando-a com variáveis sócio-demográficas e incidência de efeitos gastrintestinais, além de destacar qual grupo de alimento apresentou alteração de consumo. Metodologia: No Departamento de Oncologia Clínica do Hospital A.C. Camargo, São Paulo, foram aferidos peso, altura e aplicados Questionários de Freqüência Alimentar (QFA) antes do inicio e após o término da quimioterapia isolada contendo antraciclina com intuito curativo em pacientes com câncer de mama. Resultados: Quarenta e uma pacientes participaram da primeira fase do estudo, destas 26 concluíram a segunda fase. Das participantes, 58% receberam orientação nutricional. Leites e derivados, estrogonofe, fígado, atum/sardinha, camarão, mamão papaia, suco de caju, suco de acerola, oleaginosas e macarrão/massas tiveram seu consumo aumentado durante o tratamento enquanto que alface/escarola tiveram seu consumo reduzido. Os grupos das carnes, pescados e ovos, e o dos doces, salgadinhos e guloseimas tiveram seu consumo aumentado. A perda de apetite foi associada ao consumo aumentado de carnes, pescados e ovos e a náusea foi associada ao consumo de pães, cereais, tubérculos e leguminosas.. Conclusão: As mudanças encontradas não foram relacionadas com o aumento do IMC e não houve correlação com as variáveis sócio-demográficas. Estes achados mostram que há alterações no hábito alimentar de pacientes em quimioterapia e estas merecem melhor avaliação em estudos futuros para identificar pacientes com risco de potenciais prejuízos em sua qualidade de vida.

Introduction: Breast cancer is related not only to hormonal, racial and genetic factors, but also to lifestyle. Diet, physical activity, body weight, and steroid hormones may increase the risk of developing breast cancer. Therefore, we recommend the maintenance of energy balance and prevention of weight loss during chemotherapy to achieve better results, enabling the promotion of quality of life during and after treatment. Few studies have linked dietary habits and their impact on people undergoing chemotherapy. Objectives: To analyze the occurrence of change in food intake during chemotherapy, correlating it with socio-demographic characteristics and incidence of gastrointestinal effects, and highlight what food group showed a change in consumption. Methodology: In the Department of Clinical Oncology, Hospital A.C. Camargo, São Paulo, were measured weight, height and implemented Food Frequency Questionnaires (FFQs) before the start and after completion of anthracycline-containing chemotherapy alone with curative intent in patients with breast cancer. Results: Forty-one patients participated in the first phase, these 26 completed the second phase. Of participants, 58% received nutritional counseling. Milk, dairy products, stroganoff, liver, tuna / sardines, shrimp, papaya, cashew apple juice, acerola juice, oil and noodles / pasta consumption had increased during the treatment while lettuce / endive had reduced their consumption. Groups of meat, fish and eggs, and candy, snacks and sweets consumption had increased. Loss of appetite was associated with increased consumption of meat, fish and eggs and nausea was associated with consumption of breads, cereals, tubers and legumes. Conclusion: The changes found were not related to increased BMI, and no correlation with the socio-demographic variables. These findings show that there are changes in dietary habits of patients receiving chemotherapy and they deserve better evaluation in future studies to identify patients at risk of potential losses in their quality of life.