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1.
Braz. j. biol ; 83: e253009, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339373

ABSTRACT

Abstract Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.


Resumo Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.


Subject(s)
Cucurbitaceae , Ethanol , Saccharomyces cerevisiae , Water , Biotransformation , Prospective Studies , Fermentation
2.
Arch. argent. pediatr ; 120(3): 167-173, junio 2022. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1368141

ABSTRACT

Objetivos. Describir el uso de la guía ecográfica en el cateterismo venoso central, comparando el número de intentos (1 versus 2 o más intentos), en relación con los catéteres insertados en vena yugular interna (VYI) versus vena femoral (VF). Material y métodos. Estudio descriptivo, prospectivo de catéteres venosos centrales (CVC) colocados mediante punción ecoguiada en pacientes de 1 mes a 18 años. Se realizó un modelo de regresión multivariado considerando el punto final primario, éxito a la primera punción en relación con el sitio de inserción (VYI versus VF) y variables predictoras de éxito. Resultados. Se colocaron 257 CVC, VYI 118 (45,9 %), VF 139 (54,1 %); 161 (62,7 %) insertados en la primera punción y 96 (37,3 %) requirieron más de una punción. Las inserciones en VYI fueron exitosas en la primera punción en 86 pacientes (53,5 %) y en VF fueron 75 (46,5 %) (p 0,0018; OR: 0,43 [IC95%: 0,24-0,76]). Hubo 21 (8,1 %) complicaciones inmediatas, 3 (1,86 %) se relacionaron con la primera punción, 18 (18,75 %) lo hicieron con más de una punción (p 0,0001 [IC95%: 3,36-45,68]). Las complicaciones graves, como neumotórax, fueron 4. Conclusiones. El cateterismo venoso guiado por ultrasonido demostró ser significativamente exitoso en el primer intento cuando el vaso de elección fue la VYI comparado con VF, especialmente en menores de 6 meses. Las complicaciones inmediatas fueron más frecuentes en los pacientes que requirieron más de una punción


Objectives. Describe ultrasound-guided central venous catheterization use comparing the number of attempts (1 versus 2 or more attempts) in relation to catheters placed in the internal jugular vein (IJV) versus the femoral vein (FV). Material and methods. Descriptive, prospective study of central venous catheters (CVCs) inserted via ultrasound-guided puncture in patients aged 1 month to 18 years. A multivariate regression model was done considering the primary endpoint, first puncture success in relation to the insertion site (IJV versus FV), and predictors of success. Results. A total of 257 CVCs were inserted: IJV 118 (45.9%), FV 139 (54.1%); 161 (62.7%) were inserted in the first attempt and 96 (37.3%) required more than 1 attempt. IJV insertions were successful with the first puncture in 86 patients (53.5%) and FV insertions, in 75 (46.5%) (p 0.0018; OR: 0.43 [95% CI: 0.24-0.76]). There were 21 (8.1%) immediate complications: 3 (1.86%) were related to the first puncture, 18 (18.75%), to more than 1 puncture (p 0.0001 [95% CI: 3.36-45.68]). There were 4 cases of severe complications, including pneumothorax. Conclusions. Ultrasound-guided venous catheterization demonstrated to be significantly successful in the first attempt when using the IJV versus FV, especially in infants younger than 6 months. Immediate complications occurred more frequently in patients requiring more than 1 puncture.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Catheterization, Central Venous/adverse effects , Epidemiology, Descriptive , Prospective Studies , Ultrasonography, Interventional , Intensive Care Units , Jugular Veins/diagnostic imaging
3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 21(1): 25-30, maio 05,2022. tab
Article in Portuguese | LILACS | ID: biblio-1370544

ABSTRACT

Objetivo: determinar a incidência, os fatores associados e o impacto das complicações pulmonares no pós-operatório de cirurgia cardíaca pediátrica. Metodologia: estudo de coorte, prospectivo, que incluiu lactentes e crianças submetidas à cirurgia cardíaca em um hospital pediátrico, no período de novembro de 2016 a julho de 2019. Foram coletados dados dos prontuários referentes ao sexo, idade, presença de outras malformações associadas, tipo de cardiopatia, ocorrência de complicações pulmonares, tempo de ventilação mecânica (VM) e de internamento na unidade de terapia intensiva (UTI) e óbito. Resultados: a amostra foi constituída por 111 lactentes e crianças, mediana da idade de 13 meses (7-32 meses), 54,1% do sexo feminino. Quanto ao tipo de cardiopatia, 80,2% foram cianogênicas. As complicações pulmonares ocorreram em 44,1% dos casos, sendo a mais frequente a atelectasia. A mediana do tempo de VM foi 8 horas (1-48h) e 45 (40,5%) permaneceram na VM por mais de 24h. A mediana do tempo de internamento na UTI foi de 7 dias (4-12dias). Evoluíram a óbito 7 (14,3%) pacientes. Conclusão: a amostra investigada apresentou incidência elevada de complicações pulmonares no pós-operatório de cirurgia cardíaca


Objective: to determine the incidence, associated factors and impact of pulmonary complications in the postoperative period of pediatric cardiac surgery. Methodology: prospective cohort study, which included infants and children undergoing cardiac surgery in a pediatric hospital, from November 2016 to July 2019. Data were collected from medical records regarding sex, age, presence of other associated malformations, type of heart disease, occurrence of pulmonary complications, duration of mechanical ventilation (MV) and admission to the intensive care unit (ICU) stay and death. Results: the sample consisted of 111 infants and children, median age 13 months (7-32 months), 54.1% female. As for the type of heart disease, 80.2% were acyanotic. Pulmonary complications occurred in 44.1% of cases, with atelectasis being the most frequent. The median time on mechanical ventilation (MV) was 8 hours (1-48h) and 45 (40.5%) remained on MV for more than 24h. The median length of stay in the ICU was 7 days (4-12 days). 7 (14.3%) patients died. Conclusion: the investigated sample had a high incidence of pulmonary complications in the postoperative period of cardiac surgery


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Thoracic Surgery , Intensive Care Units, Pediatric , Heart Defects, Congenital , Hospitals, Pediatric , Respiration, Artificial , Prospective Studies , Heart Diseases
4.
Prensa méd. argent ; 108(3): 113-119, 20220000.
Article in Spanish | LILACS, BINACIS | ID: biblio-1372907

ABSTRACT

Las infecciones urinarias complicadas, dentro de las cuales se encuentran las asociadas a catéteres, son un hallazgo frecuente de la práctica clínica. Las complicaciones infecciosas después de los procedimientos urológicos son una fuente importante de morbimortalidad y consumen múltiples recursos sanitarios. La colonización bacteriana en el catéter ureteral juega un papel esencial en la patogénesis de la infección, y el uso de profilaxis antimicrobiana en urología es controvertido. El objetivo de nuestro trabajo fue evaluar la utilidad de la profilaxis antibiótica en la extracción del catéter doble J


Complicated urinary infections, among which are those associated with catheters, are a frequent finding in clinical practice. Infectious complications after urological procedures are an important source of morbidity and mortality and consume multiple healthcare resources. Bacterial colonization in the ureteral catheter plays an essential role in the pathogenesis of infection, and the use of antimicrobial prophylaxis in urology is controversial. Te objective of our work was to evaluate the usefulness of antibiotic prophylaxis in the extraction of the double J catheter


Subject(s)
Humans , Adult , Middle Aged , Aged , Urinary Tract Infections/therapy , Chi-Square Distribution , Stents , Prospective Studies , Aftercare , Ureteroscopy , Antibiotic Prophylaxis , Cystoscopes , Nephrolithiasis/surgery , Urinary Catheters
5.
Prensa méd. argent ; 108(3): 120-125, 20220000. graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1373050

ABSTRACT

Introducción: El manejo inmediato del dolor postoperatorio es esencial para una comodidad y rehabilitación temprana del paciente Este estudio busca evaluar el efecto analgésico postoperatorio inmediato en cirugías de columna lumbosacra por vía posterior, como los efectos adversos con la administración de analgesia intratecal, usando Clonidina contra Morfina. Material y métodos: Es un estudio analítico de intervención, cuasi experimental, prospectivo, longitudinal, comparativo, doble ciego. Para comparar la eficacia de la analgesia intratecal post operatoria inmediata en cirugías de columna lumbosacra primarias por vía posterior y los efectos adversos. Los pacientes se distribuyeron en dos grupos previamente designados, a un grupo se le administro Clonidina 0.5 microgramos/kg/peso y a otro grupo Morfina 5 microgramos/Kg/Peso. intratecal, intraoperatorio. Resultados: Existió diferencia estadísticamente significativa con mejor manejo del dolor postoperatorio en las primeras horas y menor presencia de vómitos en el grupo de pacientes que se utilizó Clonidina intratecal. No existió diferencia estadísticamente significativa de ambas medicaciones intratecales en la valoración de otros efectos adversos. Discusión: El uso de la analgesia intratecal ha ido ganando relevancia en el tiempo y se fueron sumando estudios para ver la eficacia de diferentes medicamentos, diferentes dosis, menor presencia de efectos adversos. El estudio analiza estas variables buscando una mejor opción terapéutica. Tenemos a favor una muestra representativa a pesar de no ser aleatoria, estricto seguimiento, y análisis estadístico adecuado. Conclusión: La Clonidina intratecal es más efectiva para manejo del dolor post operatorio inmediato de cirugías de columna lumbosacra por vía posterior y con menor presencia de efectos adversos


Introduction: Immediate postoperative pain management is essential for the patient's greater comfort and early rehabilitation. Te goal of this study is to evaluate the immediate analgesic postoperative effect in posterior lumbosacral spine surgery, as well as the adverse effects of the administration of intrathecal analgesia, using Clonidine versus Morphine. Material and methods: An analytical, quasi-experimental, prospective, longitudinal, comparative, double-blinded intervention study was conducted to compare the efficacy of immediate postoperative intrathecal analgesia in primary posterior lumbosacral spine surgery, and the adverse effects. Te patients were divided into two previously designated groups. One group received Clonidine 0.5 microgramos/kg and the other group received Morphine 5 microgramos/kg. Intrathecal, intraoperative. Results: Tere was a statistically significant difference with better postoperative pain management in the first hours and less vomiting in the group of patients who received intrathecal Clonidine. Tere was no statistically significant difference between both intrathecal medications in the evaluation of other adverse effects. Discussion: Te use of intrathecal analgesia, has been on the rise over time and more studies have been conducted to see the efficacy of different drugs, different doses, with fewer adverse effects. Tis study to analyze these variables with a view to finding a better therapeutic option. Te advantage is having a representative if not random sample, strict follow-up, and appropriate statistical analysis Conclusion: Intrathecal Clonidine proved to be more effective in immediate postoperative pain management after posterior lumbosacral spine surgery and with fewer adverse effects


Subject(s)
Humans , Adult , Middle Aged , Aged , Pain, Postoperative/therapy , Pain Measurement , Analgesia, Epidural/methods , Double-Blind Method , Prospective Studies , Longitudinal Studies , Clonidine/administration & dosage , Aftercare , Non-Randomized Controlled Trials as Topic , Lumbosacral Region/surgery , Morphine/administration & dosage
6.
Arch. argent. pediatr ; 120(2): 106-: I-110, II, abril 2022. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1363696

ABSTRACT

Introducción. Los cambios en la rutina y en el entramado social que generó la pandemia por COVID-19 afectaron a los niños, niñas y adolescentes (NNyA). El objetivo de este trabajo fue conocer el estado de ánimo, las emociones y las conductas de los NNyA durante el aislamiento por COVID-19. Población y métodos . Estudio prospectivo, descriptivo y transversal. Se preguntó a los padres y/o cuidadores de niños de 3 a 15 años de edad, de la Ciudad Autónoma de Buenos Aires, cómo percibían el estado de ánimo, las conductas y las emociones de los NNyA durante el período de aislamiento. Resultados. Se incluyeron 1080 cuestionarios. El 81 % de los padres y/o cuidadores advirtió algún cambio en la salud emocional de los NNyA. El 76 % refirió que los niños de 3-5 años se mostraban aburridos, enojados y angustiados. Además, observaron un aumento de los episodios de llanto (52 %) y regresión a comportamientos ya superados (29 %). En el grupo de 6-11 años, el 43 % presentó dificultad en mantener la concentración. En 3 de cada 10 adolescentes, de 12 a 15 años de edad, los adultos percibieron abandono de actividades que antes disfrutaban, preocupación y tristeza. Conclusión. La pandemia de COVID-19 impactó en el estado de ánimo, las conductas y las emociones de los NNyA. Predominaron los sentimientos negativos, como aburrimiento, tristeza, angustia y preocupación.


Introduction. Changes in daily routine and social fabric resulting from the COVID-19 pandemic had an effect on children and adolescents. The objective of this study was to know the mood, emotions, and behaviors of children and adolescents during the COVID-19 lockdown. Population and methods. This was a prospective, descriptive, cross-sectional study. Parents and/or caregivers of children and adolescents aged 3-15 years in the Autonomous City of Buenos Aires were asked about their perceptions of the mood, behaviors, and emotions of children and adolescents during the lockdown. Results. A total of 1080 questionnaires were included. Results showed that 81% of parents and/or caregivers observed changes in children and adolescents emotional health; 76% referred that children aged 3-5 years were bored, angry, and upset. They also observed an increase in crying spells (52%) and regression to behaviors that had been outgrown (29%). In the 6-11-year-old group, 43% showed difficulty focusing. Adults noticed that 3 out of 10 adolescents aged 12-15 years discontinued activities they used to enjoy and were sad and worried. Conclusion. The COVID-19 pandemic impacted on the mood, behaviors, and emotions of children and adolescents. Negative feelings prevailed, such as boredom, sadness, anxiety, and worry.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , Communicable Disease Control , Prospective Studies , Emotions , Pandemics
7.
Arch. argent. pediatr ; 120(2): 118-121, abril 2022. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1363788

ABSTRACT

Se realizó un estudio observacional y prospectivo en el Hospital Garrahan, cuyos objetivos fueron conocer la portación asintomática del coronavirus de tipo 2 del síndrome respiratorio agudo grave (SARS-CoV-2, por su sigla en inglés) en niños oncológicos y/o en sus cuidadores al hospitalizarse para realizar quimioterapia, y describir el impacto en la continuación del tratamiento en aquellos con prueba positiva para SARS-CoV-2 o con síntomas compatibles con la infección por el virus durante la internación. Se incluyeron los pacientes con enfermedad oncohematológica y sus cuidadores, a quienes se les realizó una prueba de detección de SARS-CoV-2 por reacción en cadena de la polimerasa con transcripción inversa. Se analizaron 733 hospitalizaciones. La tasa de positividad para SARS-CoV-2 fue del 2,2 % (IC95%: 1,35-3,52). Todos los pacientes con prueba detectable completaron la quimioterapia. El 7,7 % de los pacientes presentó síntomas compatibles de caso sospechoso con prueba no detectable y el 77 % de ellos pudo continuar su tratamiento.


An observational, prospective study was carried out at Hospital Garrahan. Its objectives were to establishtherateofasymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children with cancer and/or their caregivers during hospitalization for chemotherapy, and describe the impact of ongoing treatment among those positive for SARS-CoV-2 or with symptoms compatible with infection during hospitalization. Patients with onco-hematological disease and their caregivers were included. A reverse transcription polymerase chain reaction for SARS-CoV-2 was done. A total of 733 hospitalizations were analyzed. The SARS-CoV-2 positivity rate was 2.2% (95% confidence interval: 1.35-3.52). All patients with a detectable test result completed chemotherapy. Also, 7.7% of patients developed symptoms compatible with a suspected case although they had an undetectable test result, and 77% of them were able to continue treatment.


Subject(s)
Humans , Child , COVID-19 , Neoplasms/drug therapy , Prospective Studies , Early Detection of Cancer , SARS-CoV-2 , Hospitalization
8.
Actual. SIDA. infectol ; 30(108): 7-16, 20220000. graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1363203

ABSTRACT

Las infecciones de piel y partes blandas (IPPB) en niños son una de las principales causas de prescripción de antimicrobianos. El objetivo del estudio fue describir las características clínicas y microbiológicas de las IPPB ambulatorias de niños asistidos en dos hospitales zonales. Se realizó un estudio prospectivo entre el 1/11/2017 y el 1/11/2018. Se incluyeron pacientes entre 1 mes y 15 años internados en dos hospitales. Se evaluó: edad, sexo, localidad, factores predisponentes, tipo de IPPB, muestras biológicas realizadas, aislamiento microbiológico, tratamiento empírico indicado y evolución del cuadro. Se realizó antibiograma y determinación genética. Se calculó chi2, IC95, OR; α=5%. N= 94. 58,7% masculinos. 12 pacientes <1 año, 85 >1 año (promedio de edad 4 años, 1-15). El 36% de Tandil y 63,8% de Florencio Varela. El 59,6% corresponden a IPPB purulentas. Se aislaron microorganismos en un 59,6%. Los aislamientos principales: SAMR (40,4%), SAMS (7,4%), S. agalactiae (2,1%) y S. pyogenes (2,1%). El 100% de SAMR son portadores de gen mecA y SCCmec tipo IV, sin multirresistencia. No hubo diferencia estadística entre los factores de riesgo evaluados para el desarrollo de IPPB por SAMR. El 52,1% de los niños recibió tratamiento antibiótico combinado, siendo la más indicada TMS-SMX + CLI en 36 eventos. (38,3%). La evolución fue favorable: no hubo diferencia significativa entre el subgrupo que se aisló SAMR y el que no se aisló SAMR; 91,9% (34/37) y 92,6% (50/54) correspondientemente (chi2: 0,01; p= 0,97 IC95: 0,26-3,88). El principal agente etiológico fue SAMRco, debiendo adecuar los tratamientos a este microorganismo.


Skin and soft tissue infections (SSIs) in children are one of the main causes of antimicrobial prescription. The aim of the study was to describe the clinical and microbiological characteristics of outpatient SSIs in children attended in two hospitals. A prospective study was conducted between 11/1/2017 and 11/1/2018. Patients between 1 month and 15 years old, hospitalized were included. We evaluated: age, sex, locality, predisposing factors, type of IPPB, biological samples taken, microbiological isolation, empirical treatment indicated and evolution of the condition. An antibiogram and genetic determination were performed. Chi2, CI95, OR; α=5% were calculated. N= 94. 58.7% male. 12 patients <1 year, 85 >1 year (mean age 4 years, 1-15). 36% were from Tandil and 63.8% from Florencio Varela. 59.6% corresponded to purulent SSIs. The diagnostic yield was 59.6%. Main isolates: MRSA (40.4%), MSSA (7.4%), S. agalactiae (2.1%) and S. pyogenes (2.1%). 100% of MRSA carried the mecA gene and SCCmec type IV, with no multidrug resistance. There was no statistical difference between the risk factors evaluated. 52.1% of children received combined antibiotic treatment, the most indicated being TMS-SMX + CLI in 36 events. (38,3%). Evolution was favorable: there was no significant difference between the subgroup that isolated MRSA and the subgroup that did not isolate MRSA; 91.9% (34/37) and 92.6% (50/54) respectively (chi2: 0.01; p= 0.97 CI95: 0.26-3.88). The main etiological agent was MRSA, and treatments should be adapted to this microorganism


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Skin Diseases/microbiology , Social Class , Staphylococcal Infections/microbiology , Hygiene/education , Prospective Studies , Risk Factors , Sanitary Profiles , Methicillin-Resistant Staphylococcus aureus , Anti-Infective Agents/administration & dosage
9.
Med. infant ; 29(1): 10-16, Marzo 2022. Tab, ilus
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1366813

ABSTRACT

El consentimiento informado es un proceso en el que un paciente libre y bien informado o sus representantes autorizan o no un procedimiento médico. Objetivos: El objetivo del estudio fue explorar el grado de satisfacción de padres de pacientes y profesionales con respecto al CI implementado en diferentes áreas del hospital. Métodos: Estudio observacional y descriptivo mediante encuesta anónima, a médicos y padres de pacientes atendidos en el hospital entre enero y julio de 2018. Resultados: Se obtuvieron 158 respuestas de profesionales y 139 de padres. Para el 50% de los padres el CI es un proceso para mejorar la calidad. El 81% de ellos consideró que recibió la información, la comprendieron y pudieron aclarar dudas. El 89% recibió la información del médico y el 59% en el lugar adecuado. De los profesionales, 57% consideró al CI como un proceso de información para mejorar la calidad. El 3% estimó que los padres comprenden la información siempre, el 66% consideró que el CI contiene la información suficiente y 13% le entregó una copia a la familia. Conclusiones: El grado de satisfacción de los padres en relación al CI es alto mientras que el de los profesionales es moderado. Hay que continuar trabajando en el proceso de comunicación entre ambos grupos (AU)


Informed consent is a process based on which a free and wellinformed patient or his/her representatives decide whether or not to authorize a medical procedure. Objectives: The aim of the study was to explore the degree of satisfaction of parents of patients and professionals regarding the IC implemented in different areas of the hospital. Methods: Observational and descriptive study using an anonymous survey of physicians and parents of patients treated at the hospital between January and July 2018. Results: the survey was responded by 158 physicians and 139 parents. Overall, 50% of the parents considered that the IC is part of a quality improvement process; 81% of them found they received adequate information, understood it, and were able to clarify doubts. Eighty-nine percent received the information from the physician and 59% in the appropriate area. Of the professionals, 57% considered the IC to be an information process to improve quality; 3% felt that parents always understand the information; 66% felt that the IC contains sufficient information; and 13% gave the family a copy. Conclusions: A degree of satisfaction with the IC was found in parents while it was moderate among physicians. It is necessary to continue working on the communication process between both groups (AU)


Subject(s)
Humans , Parents , Surveys and Questionnaires , Patient Satisfaction , Communication , Hospitals, Pediatric , Informed Consent , Medical Staff , Prospective Studies , Observational Study
10.
Med. infant ; 29(1): 23-29, Marzo 2022. Tab
Article in Spanish | LILACS | ID: biblio-1366940

ABSTRACT

Introducción: existen dos rutas para realizar el reemplazo de esófago (RE), la retroesternal (RRE) y la mediastinal posterior (RMP). El objetivo del estudio es comparar los pacientes que recibieron un ascenso gástrico parcial empleando estas dos rutas. Material y métodos: Se revisaron las historias clínicas de 51 pacientes con ascenso gástrico parcial, en 27 años en el Hospital Garrahan. Se utilizó la vía RRE en 25 casos y la RMP en 26. Fueron comparados los datos epidemiológicos de los grupos y las variables para valorar la dificultad del acto quirúrgico, evolución inmediata y alejada. El estudio es comparativo, retro-prospectivo y longitudinal. Resultados: las características generales de los pacientes fueron similares. Los que recibieron el ascenso gástrico por vía RMP presentaron una menor incidencia de dehiscencia (p=0,017), de enfermedad por reflujo gastroesofágico (ERGE) (p=0,001) y de dumping (p=0,0001). No hubo diferencias estadísticamente significativas entre los dos grupos al comparar la duración del procedimiento, días de internación total y en Unidad de Cuidados Intensivos (UCI), días de permanencia en asistencia respiratoria mecánica (ARM), inicio de alimentación oral y estenosis de la anastomosis. Se observó una tendencia clínicamente relevante, que no alcanzó significancia estadística en las complicaciones intraquirúrgicas y número de dilataciones postoperatorias. No hubo necrosis del ascenso. Fallecieron 2 pacientes. Conclusiones: considerando la menor incidencia de dehiscencia, ERGE y dumping reemplazados por RMP, elegimos a ésta como nuestra primera opción para el reemplazo esofágico en la infancia (AU)


Introduction: The two routes for esophageal replacement (ER) are retrosternal (RRE) and posterior mediastinal (PMR). The aim of the study was to compare patients who received a partial gastric pull-up using either of these two routes. Material and methods: The clinical records of 51 patients who underwent partial gastric pull-up over 27 years at the Garrahan Hospital were reviewed. The RRE route was used in 25 and the RMP in 26 cases. The epidemiological data of the groups and the variables to evaluate the complexity of the surgical procedure, and shortand long-term outcome were compared. A comparative, retroprospective, and longitudinal study was conducted. Results: the general characteristics of the patients were similar. Those who underwent gastric pull-up via PMR had a lower incidence of dehiscence (p=0.017), gastroesophageal reflux disease (GERD) (p=0.001), and dumping (p=0.0001). No statistically significant differences were found between the two groups when comparing the duration of the procedure, days of total hospital and intensive care unit (ICU) stay, days on mechanical ventilation (MV), initiation of oral feeding and stenosis of the anastomosis. A clinically relevant trend, which did not reach statistical significance, was observed in intraoperative complications and number of postoperative dilatations. There was no necrosis of the pull-up. Two patients died. Conclusions: considering the lower incidence of dehiscence, GERD, and dumping associated with PMR, this was our first choice for esophageal replacement in infancy (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Anastomosis, Surgical/methods , Esophagectomy/methods , Esophageal Atresia/surgery , Esophageal Atresia/chemically induced , Esophagoplasty/methods , Postoperative Complications , Comparative Study , Prospective Studies , Retrospective Studies , Longitudinal Studies , Treatment Outcome
11.
Ciênc. Saúde Colet ; 27(3): 1223-1236, mar. 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1364674

ABSTRACT

Resumo Analisou-se a associação entre mudanças autorreferidas nas condições de trabalho e a incidência de níveis recomendados de atividade física no tempo livre (AFTL) em professores da educação básica da rede pública. Trata-se de uma coorte prospectiva em que 298 professores da educação básica da rede pública de Londrina, Paraná, foram seguidos por 24 meses. A incidência de níveis recomendados de AFTL (≥150 minutos/semana) foi o desfecho do estudo. A análise incluiu modelos de regressão de Poisson ajustados, sempre tendo como grupo referência aqueles que tinham a pior condição de trabalho na linha de base e assim permaneceram no seguimento. A incidência de níveis recomendados de AFTL foi de 23,2%, sendo maior naqueles que se mantiveram com bom equilíbrio entre vida pessoal e profissional (RR=3,50; IC95%=1,26-9,72), passaram a ficar frequentemente desgastados no trabalho (RR=2,47; IC95%=1,10-5,56), passaram a ficar raramente desgastados no trabalho (RR=2,42; IC95%=1,09-5,36), mantiveram-se raramente desgastados no trabalho (RR=2,78; IC95%=1,30-5,95), passaram a raramente trabalhar demais (RR=2,69; IC95%=1,24-5,87) e mantiveram-se raramente trabalhando demais (RR=3,25; IC=1,46-7,26). Estes resultados indicam a importância da melhoria das condições de trabalho na promoção da AFTL.


Abstract The association between self-reported changes in working conditions and the incidence of recommended levels of leisure-time physical activity (LTPA) among middle and high school teachers of the public school network was analyzed. It is a prospective cohort in which 298 teachers from the public middle and high school network in Londrina, State of Paraná, were monitored for 24 months. The incidence of recommended LTPA levels (≥150 minutes/week) was the study outcome. The analysis included adjusted Poisson regression models, using those who had the worst working conditions in the baseline, and remained unchanged in the follow-up, as a reference group. The incidence of recommended levels of LTPA was 23.2%, being higher among those who maintained a good balance between their personal and professional lives (RR=3.50; 95%CI=1.26-9.72), frequently became exhausted at work (RR=2.47; 95%CI=1.10-5.56), infrequently became exhausted at work (RR=2.42; 95%CI=1.09-5.36), rarely became exhausted at work (RR=2.78; 95%CI=1.30-5.95), rarely began to work too hard (RR=2.69; 95%CI=1.24-5.87) and those who rarely needed to work too much (RR=3.25; 95%CI=1.46-7.26). These results indicate the importance of improving working conditions in the promotion of AFTL.


Subject(s)
Humans , School Teachers , Leisure Activities , Exercise , Prospective Studies , Cohort Studies
12.
J. bras. psiquiatr ; 71(1): 24-31, jan.-mar. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1365064

ABSTRACT

OBJETIVO: Investigar a relação entre a realização de testes para detectar COVID-19 e indícios de sofrimento psíquico, estresse e burnout entre profissionais de saúde da linha de frente da pandemia em um hospital geral. MÉTODOS: Estudo prospectivo de abordagem mista usando SRQ-20, PSS, OBI e entrevistas em profundidade em série de três entrevistas em 2020. RESULTADOS: Prevalências preocupantes de escores elevados de SRQ20, Burnout e Estresse Percebido ocorreram nas três entrevistas, e o registro de testes realizados foi crescente no período estudado, mas não houve associação entre desfechos e realização de testes para detectar COVID-19. Os temores de contrair a doença e de ser transmissor do vírus apareceram como os principais estressores para profissionais de saúde, mantidos apesar da realização de testes. CONCLUSÃO: Nesse grupo, testes realizados não se mostraram suficientes para modificar os efeitos psicossociais da atividade em linha de frente sobre profissionais de saúde.


OBJECTIVE: To investigate the relationship between the performance of tests to detect COVID-19 and signs of psychological distress, perceived stress and burnout among health professionals on the frontline of the pandemic in a general hospital. METHODS: Prospective mixed-approach study using SRQ-20, PSS, OBI and in-depth interviews in a series of 3 interviews throughout 2020. RESULTS: Worrying prevalences of high scores of SRQ20, Burnout and Perceived Stress occurred on the three interviews and the number of tests performed increased during the study period, but there was no association between outcomes and testing to detect COVID- 19. Fear of contracting the disease or being a transmitter of the virus appeared as the main stressors for health professionals, maintained despite testing. CONCLUSION: In this group, tests performed were not sufficient to modify the psychosocial effects of the front line activity on health professionals.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Burnout, Professional/psychology , Burnout, Professional/epidemiology , Health Personnel/psychology , Fear/psychology , Pandemics , COVID-19/transmission , Prevalence , Interviews as Topic , Prospective Studies , Psychological Distress , COVID-19 Testing , Hospitals, General
13.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 217-221, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1365360

ABSTRACT

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.


Subject(s)
Humans , Aged , Oral Health , Diabetes Mellitus/therapy , Quality of Life , China , Prospective Studies , Problem-Based Learning , Medicine, Chinese Traditional
14.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 256-260, Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365340

ABSTRACT

SUMMARY OBJECTIVE: The objective of this study was to analyze the relationship between the number of prenatal care visits and the occurrence of adverse perinatal outcomes in an average city in the state of Minas Gerais, Brazil. METHODS: This was a prospective and observational study. The variables analyzed were obtained through a questionnaire administered to postpartum women (between 1 and 48 h postpartum) and information contained in prenatal cards. The pregnant women were classified into three groups: Group I, <3 prenatal care visits; Group II, 3-5 prenatal care visits; and Group III, ≥6 prenatal care visits. RESULTS: Group I had a lower median weight (57.0 vs. 64.0 kg, p<0.001), body mass index (22.1 vs. 24.3 kg/m2, p<0.001), and weight gain (9.0 vs. 12 kg, p=0.002) than Group III. The prevalence of admission to the neonatal intensive care unit (11.6 vs. 4.2%, p=0.02) and the newborn mortality rate within the first 72 h of life (2.3 vs. 0%, p<0.001) were higher in Group I than in Group III. Group II had a higher prevalence of admission to the adult intensive care unit (5.7 vs. 0.6%, p<0.001) and a higher newborn mortality rate within the first 72 h of life (1.6% vs. 0%, p<0.001) than Group III. CONCLUSIONS: Having ≥6 prenatal care visits was associated with lower rates of admission to the neonatal and adult intensive care unit, as well as a lower newborn mortality rate within the first 72 h of life.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Prenatal Care , Pregnancy Outcome/epidemiology , Weight Gain , Prospective Studies , Postpartum Period
15.
J. pediatr. (Rio J.) ; 98(1): 60-68, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360552

ABSTRACT

Abstract Objective: This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017. Methods: It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05. Results: Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017. Conclusion: Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature.


Subject(s)
Humans , Child , Adolescent , Sedentary Behavior , Screen Time , Prospective Studies , Follow-Up Studies , Longitudinal Studies
16.
Säo Paulo med. j ; 140(2): 182-187, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1366042

ABSTRACT

Abstract BACKGROUND: Prevention of recurrence of stroke depends on recognition of the underlying mechanism of ischemia. OBJECTIVE: To screen patients who were hospitalized with diagnosis of acute ischemic stroke in terms of atrial fibrillation (AF) with repeated Holter electrocardiography recordings. DESIGN AND SETTING: Prospective study conducted at Konya Education and Research Hospital, Turkey. METHODS: Patients with a diagnosis of acute ischemic stroke, without atrial fibrillation on electrocardiography (ECG), were evaluated. Their age, gender, histories of previous ischemic attack, occurrences of paroxysmal atrial fibrillation (PAF) and other risks were assessed during the first week after acute ischemic stroke and one month thereafter. ECG recordings were obtained from 130 patients through 24-hour ambulatory Holter. Patients without PAF attack during the first Holter were re-evaluated. RESULTS: PAF was detected through the first Holter in 33 (25.4%) out of 130 acute ischemic stroke patients. A second Holter was planned for 97 patients: 53 (54.6%) of them could not attend due to COVID-19 pandemic; while 44 (45.3%) patients had the second Holter and, among these, 4 (9.1%) had PAF. The only parameter associated with PAF was older age. Four (10.8%) of the 37 patients with PAF had also symptomatic carotid stenosis. CONCLUSIONS: Detecting the presence of PAF by screening patients with no AF in the ECG through Holter ECG examinations is valuable in terms of changing the course of the treatment. It should be kept in mind that the possibility of accompanying PAF cannot be ruled out in the presence of other factors that pose a risk of stroke.


Subject(s)
Humans , Atrial Fibrillation/complications , Atrial Fibrillation/epidemiology , Stroke/complications , Ischemic Stroke , COVID-19 , Prospective Studies , Risk Factors , Electrocardiography, Ambulatory/adverse effects , Pandemics
17.
Arq. neuropsiquiatr ; 80(2): 112-116, Feb. 2022. graf
Article in English | LILACS | ID: biblio-1364362

ABSTRACT

ABSTRACT Background: There is a high demand for stroke patient data in the public health systems of middle and low-income countries. Objective: To develop a stroke databank for integrating clinical or functional data and benchmarks from stroke patients. Methods: This was an observational, cross-sectional, prospective study. A tool was developed to collect all clinical data during hospitalizations due to stroke, using an electronic editor of structured forms that was integrated with electronic medical records. Validation of fields in the electronic editor was programmed using a structured query language (SQL). To store the results from SQL, a virtual table was created and programmed to update daily. To develop an interface between the data and user, the Embarcadero Delphi software and the DevExpress component were used to generate the information displayed on the screen. The data were extracted from the fields of the form and also from cross-referencing of other information from the computerized system, including patients who were admitted to the stroke unit. Results: The database was created and integrated with the hospital electronic system, thus allowing daily data collection. Quality indicators (benchmarks) were created in the database for the system to track and perform decision-making in conjunction with healthcare service managers, which resulted in improved processes and patient care after a stroke. An intelligent portal was created, in which the information referring to the patients was accessible. Conclusions: Based on semi-automated data collection, it was possible to create a dynamic and optimized Brazilian stroke databank.


RESUMO Antecedentes: Há alta demanda de dados de pacientes com acidente vascular cerebral (AVC) nos sistemas de saúde de países de baixa e média renda. Objetivo: Desenvolver um banco de dados de AVC para integrar dados clínicos ou funcionais e indicadores de qualidade de pacientes com AVC. Métodos: Estudo observacional, transversal e prospectivo. Foi desenvolvida uma ferramenta para coletar dados clínicos durante as internações por AVC por meio de um editor eletrônico de formulários estruturados integrado ao prontuário eletrônico. A validação dos campos no editor eletrônico foi programada em linguagem de consulta estruturada (SQL). Para armazenar os resultados da SQL, uma tabela virtual foi criada e programada para atualização diária. Para desenvolver interface entre os dados e o usuário, foram utilizados o software Embarcadero Delphi e o componente DevExpress para gerar informações apresentadas na tela. Os dados foram extraídos dos campos do formulário e também do cruzamento de outras informações do sistema informatizado, incluindo pacientes internados na unidade de AVC. Resultados: O banco de dados foi criado e integrado ao sistema eletrônico do hospital, permitindo coleta diária de dados. Indicadores de qualidade foram criados no banco de dados para que o sistema acompanhasse e realizasse a tomada de decisão com os gestores dos serviços de saúde, resultando em melhoria no processo e no atendimento ao paciente após AVC. Foi criado um portal inteligente, no qual eram registradas as informações referentes aos pacientes. Conclusões: Com a coleta de dados semiautomática, foi possível criar um banco de dados de AVC dinâmico e otimizado em unidade de AVC no Brasil.


Subject(s)
Humans , Stroke , Electronic Health Records , Brazil , Cross-Sectional Studies , Data Collection , Prospective Studies
19.
Int. braz. j. urol ; 48(1): 131-156, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356297

ABSTRACT

ABSTRACT Purpose: Sperm DNA fragmentation (SDF) and seminal oxidative stress are emerging measurable factors in male factor infertility, which interventions could potentially reduce. We evaluated (i) the impact of lifestyle changes combined with oral antioxidant intake on sperm DNA fragmentation index (DFI) and static oxidation-reduction potential (sORP), and (ii) the correlation between DFI and sORP. Materials and Methods: We conducted a prospective study involving 93 infertile males with a history of failed IVF/ICSI. Ten healthy male volunteers served as controls. Semen analysis was carried out according to 2010 WHO manual, whereas seminal sORP was measured using the MiOXSYS platform. SDF was assessed by sperm chromatin structure assay. Participants with DFI >15% underwent a three-month lifestyle intervention program, primarily based on diet and exercise, combined with oral antioxidant therapy using multivitamins, coenzyme Q10, omega-3, and oligo-elements. We assessed changes in semen parameters, DFI, and sORP, and compared DFI results to those of volunteers obtained two weeks apart. Spearman rank correlation tests were computed for sORP and DFI results. Results: Thirty-eight (40.8%) patients had DFI >15%, of whom 31 participated in the intervention program. A significant decrease in median DFI from 25.8% to 18.0% was seen after the intervention (P <0.0001). The mean DFI decrease was 7.2% (95% CI: 4.8-9.5%; P <0.0001), whereas it was 0.42% (95%CI; -4.8 to 5.6%) in volunteers (P <0.00001). No differences were observed in sperm parameters and sORP. Based on paired sORP and DFI data from 86 patients, no correlation was observed between sORP and DFI values (rho=0.03). Conclusion: A 3-month lifestyle intervention program combined with antioxidant therapy reduced DFI in infertile men with elevated SDF and a history of failed IVF/ICSI. A personalized lifestyle and antioxidant intervention could improve fertility of subfertile couples through a reduction in DFI, albeit controlled trials evaluating reproductive outcomes are needed before firm conclusions can be made. Trial registration number and date: clinicaltrials.gov NCT03898752, April 2, 2019.


Subject(s)
Humans , Male , Infertility, Male/drug therapy , Antioxidants/metabolism , Antioxidants/therapeutic use , Spermatozoa , Fertilization in Vitro , Pilot Projects , Prospective Studies , Oxidative Stress , DNA Fragmentation , Life Style
20.
Int. braz. j. urol ; 48(1): 54-66, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356296

ABSTRACT

ABSTRACT Introduction: The therapeutic role of pelvic lymph node dissection (PLND) in prostate cancer (PCa) is unknown due to absence of randomized trials. Objective: to present a critical review on the therapeutic benefits of PLND in high risk localized PCa patients. Materials and Methods: A search of the literature on PLND was performed using PubMed, Cochrane, and Medline database. Articles obtained regarding diagnostic imaging and sentinel lymph node dissection, PLND extension, impact of PLND on survival, PLND in node positive "only" disease and PLND surgical risks were critically reviewed. Results: High-risk PCa commonly develops metastases. In these patients, the possibility of presenting lymph node disease is high. Thus, extended PLND during radical prostatectomy may be recommended in selected patients with localized high-risk PCa for both accurate staging and therapeutic intent. Although recent advances in detecting patients with lymph node involvement (LNI) with novel imaging and sentinel node dissection, extended PLND continues to be the most accurate method to stage lymph node disease, which may be related to the number of nodes removed. However, extended PLND increases surgical time, with potential impact on perioperative complications, hospital length of stay, rehospitalization and healthcare costs. Controversy persists on its therapeutic benefit, particularly in patients with high node burden. Conclusion: The impact of PLND on biochemical recurrence and PCa survival is unclear yet. Selection of patients may benefit from extended PLND but the challenge remains to identify them accurately. Only prospective randomized study would answer the precise role of PLND in high-risk pelvis confined PCa patients.


Subject(s)
Humans , Male , Prostatic Neoplasms/surgery , Lymph Node Excision , Pelvis , Prostatectomy , Prospective Studies , Lymph Nodes/surgery
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