Assessing the level of evidence of presented studies at the Brazilian Congress of Coloproctology

Introduction: Scientific studies in Brazil grew around 10.7% compared to previous years. However, the level of quality of evidence has been decreasing. The aim in our study is to examine the meeting abstracts of the Brazilian congress of coloproctology and analyze the level of evidence in trends and variables. Methods: A descriptive bibliometric study, working with secondary data to review scientific abstracts in the annals of the coloproctology congress from 2015 to 2019. Results: A total of 1756 abstracts of the Brazilian Congress of Coloproctology were analyzed for 5 years (2015-2019). There was a higher trend of abstracts presented with lower levels of evidence (level of evidence 5: 52.3% and 3: 30%), being the majority composed of case reports (49.4%) and retrospective studies (30.4%). The last two years analyzed (2018: 55.2% and 2019: 59.3%) had a predominance above average of case reports. From 2017 to 2019 there was a significant decrease in the number of level 2 evidence studies (18.10%,11.80% and 5.50%), while the number of studies with level 5 evidence showed an increase (45.60%, 56.60% and 61.40%). Statistical analysis occurred in only 17%, with an important decrease for the last two years (2018: 13.6%; 2019: 12.1%). Conclusions: Although the data of this study is from the Brazilian coloproctology point of view, they are important for the global scientific community, as they allow a quantitative evaluation of the relative contribution from the level of evidence of Brazilian coloproctology researchers to the scientific scenario. (AU)

Discrepancies of abstracts presented in coloproctology congresses and later publish as full manuscripts: a Brazilian perspective

Introduction: The purpose of this retrospective bibliometric study was to assess the discrepancies between coloproctology surgery meeting abstracts and subsequent full-length manuscript publications. Methods: Abstracts presented at the Brazilian Congress of Coloproctology Surgery from 2015 to 2019 were compared with matching manuscript publications. Discrepancies between the abstract and therefore the subsequent manuscript were categorized as major (changes within the purpose, methods, study design, sample size, statistical analysis, results, and conclusions) and minor (changes within the title, authorship, and number of female authors) variations. Results: The conversion rate of abstracts in published manuscripts was 6,9% (121 abstracts). There were inconsistencies between the study title (66,1%), authorship (69,5%), study design (3,3%), sample size (39,2%), statistical analysis (24,8%), results (25,6%), and conclusions (12,4%) of manuscripts compared with their corresponding meeting abstracts. Conclusion: As changes occur before manuscript publication of coloproctology surgery meeting abstracts, caution should be exercised in referencing abstracts or altering surgical practices based on abstracts content. (AU)

An American and Brazilian perspective on abstracts presented in coloproctology conferences converted into published manuscripts

Introduction: The presentation of abstracts in a congress is an important step for the dissemination of scientific information. The American Congress of Coloproctology is promoted by the American Society of Colon & Rectal Surgeons (ASCRS), and it is the largest in number of participants within the specialty, followed by the Brazilian Congress of Coloproctology. The present study aims to evaluate variables related to the quality of the scientific production of the abstracts presented in these two events and their conversion rate to published manuscripts. Materials and Methods: The present bibliometric study assesses secondary data from the review of abstracts presented in these 2 important conferences in 2016, followed by a research of the publications from these congress presentations. Results: The total number of abstracts evaluated was 854. The rate of articles containing statistical analyses was of 73.7% in the American congress, and of 34.1% in the Brazilian congress. Multicentric studies were more prevalent in the American congress (23.1%). Regarding study design, the most common were case reports in the Brazilian (44.8%) congress and retrospective studies in the American congress (67.7%). As for the works presented, the rate of conversion into full manuscripts in the American congress was of 24.2% compared with 10.6% in the Brazilian congress. Most papers from the American congress (93.7%) have citations compared with 68.6% of the other event evaluated. Conclusion: The scientific performance demonstrated by the conversion rate of abstracts into publications is below ideal, mainly in relation to the Brazilian meeting; yet, there were significant differences between the two events in terms of the profile of the presentations and several variables analyzed. (AU)

Bibliometric analysis and conversion rate of abstracts presented at the Brazilian Congress of Coloproctology into publication of full articles / Análise bibliométrica e taxa de conversão de resumos apresentados no Congresso Brasileiro de Coloproctologia em publicação de artigos completos

ABSTRACT Introduction: the presentation of research at a congress is an interesting means for scientific dissemination, but only with publication in an indexed journal does the data become accessible and disseminated. The conversion rate in published articles of abstracts presented at congresses is an indicator to assess the scientific quality of those events. The aim of this study is to evaluate bibliometric characteristics of abstracts presented at the Brazilian Congress of Coloproctology and to determine the factors that affect publication rates. Methods: Retrospective evaluation of all abstracts presented at the Brazilian Congresses of Coloproctology from 2015 to 2019. Multiple databases were analyzed to estimate the conversion rate of the presented papers, as well as variables associated with the conversion of abstracts into full manuscripts through bivariate analysis and multivariate variables of these predictors. Results: 1756 abstracts were analyzed. Most studies are retrospective, series or case reports, and even personal experience. The conversion rate was 6.9%. The presence of statistical analysis was twice as high for published abstracts as for unpublished ones. Conclusion: the data presented demonstrate a low scientific productivity of the specialty, since the research carried out is, for the most part, not published as complete manuscripts. The predictors of publication of abstracts were: multicenter studies, studies with statistical analysis, study designs with a higher level of evidence and studies awarded by the congress.

RESUMO Introdução: a apresentação de pesquisas em um congresso é meio interessante para disseminação científica, porém apenas com a publicação em revista indexada é que os dados se tornam acessíveis e disseminados. A taxa de conversão em artigos publicados de resumos apresentados em congressos é um indicador para avaliar a qualidade científica de seus eventos. O objetivo deste estudo é avaliar características bibliométricas dos resumos apresentados no Congresso Brasileiro de Coloproctologia e determinar os fatores que afetam as taxas de publicação. Métodos: avaliação retrospectiva de todos os resumos apresentados nos Congressos Brasileiros de Coloproctologia dos anos de 2015 a 2019. Análise de múltiplas bases de dados para estimar a taxa de conversão dos trabalhos apresentados, assim como variáveis associadas à conversão dos resumos em manuscritos completos através de análises bivariadas e multivariadas desses preditores. Resultados: foram analisados 1756 resumos. A maioria dos estudos são retrospectivos, séries ou relatos de casos e até experiência pessoal. A taxa de conversão foi de 6,9%. A presença de análise estatística foi o dobro para os resumos publicados frente aos não publicados. Conclusão: os dados apresentados demonstram uma baixa produtividade científica da especialidade, já que as pesquisas realizadas não são publicadas, em sua maioria, como manuscritos completos. Os fatores preditores de publicação dos resumos foram: estudos multicêntricos, estudos contendo análise estatística, desenhos de estudo de maior nível de evidência e estudos premiados pelo congresso.

Burnout at the hospital: Healthcare workers coping with COVID-19 stress / Burnout no hospital: enfrentamento do estresse da COVID-19 por trabalhadores da saúde

Objective The first wave of COVID-19 was challenging for healthcare workers. This study analyzed the ways of coping with stress at a university hospital. Method A Sociodemographic Characterization, Risk and Exposure Assessment, Burnout Assessment Tool (BAT-23), and COVID-19 Coping Scale were responded online by 181 professionals. Results The sample was composed mainly of women, white, married, physicians, with one job. Over 80% of the sample were at high exposure and risk for infection, with 17.1% having tested positive. The most reported stressors were risks of transmitting the disease, being hospitalized, and being separated from loved ones; 11% presented the risk of/probable burnout, with exhaustion and emotional impairment. They presented adaptive coping strategies, such as problem-solving and information-seeking, with a negative correlation between adaptive coping and burnout. Being a physician with maladaptive coping, in psychiatric care, and having religious beliefs were predictors of burnout. Conclusion Promoting adaptive coping may improve the mental health of these workers.

Objetivo A primeira onda da COVID-19 foi desafiadora para os profissionais de saúde. Este estudo analisou o enfrentamento do estresse em um hospital universitário. Método De forma online, 181 profissionais responderam: Caracterização Sociodemográfica, Avaliação do Risco e Exposição, Burnout Assessment Tool (BAT-23) e Escala de Coping da COVID-19. Resultados A amostra foi composta principalmente por mulheres, caucasianos, casados, médicos, com um emprego. Tiveram alta exposição e risco à infecção mais de 80% da amostra, com 17,1% positivos. Os estressores mais relatados foram: riscos de transmitir a doença, ser hospitalizado e separado de pessoas queridas; 11% apresentaram risco/provável de burnout, com exaustão e prejuízo emocional. Apresentaram estratégias mais adaptativas, como Resolução de Problemas e Busca de Informações, havendo uma correlação negativa entre coping adaptativo e burnout. Ser médico, com coping mal adaptativo, em atendimento psiquiátrico e ter crença religiosa foram preditores de burnout. Conclusão Promover um coping adaptativo poderá melhorar a saúde mental desses trabalhadores.

Pandemia no Hospital: Cartilha para Enfrentamento do Estresse / PANDEMIA EN EL HOSPITAL: CARTILLA PARA EL ENFRENTAMIENTO DEL ESTRÉS / Pandemic at the hospital: Booklet for coping with stress

Healthcare workers have been under intense stress in the coronavirus disease 2019 (Covid-19) pandemic when they faced situations that threatened or challenged their basic psychological needs for autonomy, competence, and relatedness, and they may present mental health problems. Seeking to help these pro-fessionals in the hospital context, this article presents the theoretical bases and procedures for the devel-opment of a psychoeducational booklet for coping with stress. An integrative literature review and an online survey with 141 healthcare workers from hospitals in Brazil, Colombia, Peru, and Argentina were carried out to identify the main stressors and coping strategies. This material was organized according to the motivational theory of coping into charts with recommendations on what to do and avoid and boards for alternative communication. The booklet was evaluated by 17 expert health judges, obtaining good correlation coefficients for relevance content (.98) and for clarity of language (.92). With a Spanish version, its application possibilities are expanded.

Profissionais de saúde estiveram sob estresse intenso na pandemia da coronavirus disease 2019 (Covid-19) ao enfrentarem situações que ameaçaram ou desafiaram suas necessidades psicológicas básicas de auto-nomia, competência e relacionamento, podendo apresentar problemas de saúde mental. Procurando au-xiliar esses profissionais no contexto hospitalar, este artigo apresenta as bases teóricas e o procedimento de elaboração de uma cartilha psicoeducacional para o enfrentamento do estresse. Realizou-se uma revi-são integrativa da literatura e um levantamento on-line com 141 profissionais de saúde em hospitais do Brasil, da Colômbia, do Peru e da Argentina, para identificação dos principais estressores e estratégias de enfrentamento. Esse material foi organizado pela teoria motivacional do coping em quadros, com reco-mendações sobre o que fazer e evitar, e quadros para comunicação alternativa. A cartilha foi avaliada por 17 juízes especialistas em saúde, obtendo-se bons coeficientes de correlação para relevância do conteúdo (0,98) e clareza de linguagem (0,92). Com versão em espanhol, ampliam-se suas possibilidades de aplicação.

Los profesionales de la salud han estado bajo un estrés intenso en la pandemia del coronavirus disease 2019 (Covid-19), cuando enfrentaron situaciones que amenazaban o desafiaban sus necesidades psicológicas básicas de autonomía, competencia y relaciones, y pueden presentar problemas de salud mental. Buscando ayudar a estos profesionales en el contexto hospitalario, este artículo presenta las bases teóricas y el pro-cedimiento para la elaboración de una cartilla psicoeducativa para el afrontamiento del estrés. Se realizó una revisión integradora de la literatura y una encuesta online con 141 profesionales de la salud en los hospitales de Brasil, Colombia, Perú y Argentina, para identificar los principales estresores y estrategias de afrontamiento. Este material se organizó de acuerdo con la teoría motivacional del afrontamiento en ta-blas con recomendaciones sobre qué hacer y evitar, y tableros de comunicación alternativa. La cartilla fue evaluada por 17 expertos en salud, obteniendo buenos coeficientes de correlación para la relevancia del contenido (0,98) y la claridad del lenguaje (0,92). Con una versión en español, se amplían sus posibilidades de aplicación.

Comparative analysis of late results of cervical esophagogastric anastomosis by manual and mechanical suture in patients submitted to esophageal mucosectomy through advanced megaesophagus / Análise comparativa dos resultados em longo prazo da anastomose esofagogástrica cervical pela sutura manual e mecânica em pacientes submetidos à mucosectomia esofágica por megaesôfago avançado

ABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis in megaesophagus treatment. Methods: Were included 92 patients diagnosed with advanced megaesophagus with clinical conditions to undergo the surgery. All underwent esophageal mucosectomy, performing anastomosis of the esophagus stump with the gastric tube at the cervical level. In order to make this anastomosis, the patients were divided into two groups: group A (n=53) with circular mechanical suture, lateral end; group B (n=39) with manual suture in two sides, lateral end. In the postoperative period, an early evaluation was performed, analyzing local and systemic complications and late (average 5.6 y) analyzing deglutition. Results: Early evaluation: a) dehiscence of esophagogastric anastomosis n=5 (9.4%) in group A vs. n=9 (23.0%) in group B (p=0.0418); b) stenosis of esophagogastric anastomosis n=8 (15.1%) in group A vs. n=15 (38.4%) in group B (p=0.0105.); c) pulmonary infection n=5 (9.4%) in group A vs. n=3 (7.6%) in group B (p=1.0000.); d) pleural effusion n=5 (9.4%) in group A vs. n=6 (15.4%) in group B (p<0.518). Late evaluation showed that 86.4-96% of the patients presented the criteria 4 and 5 from SAEED, expressing effective swallowing mechanisms without showing significant differences among the groups. Conclusion: Cervical esophagogastric anastomosis by means of mechanical suture is more proper than the manual with lower incidence of local complications and, in the long-term evaluation, regular deglutition was acquired in both suture techniques in equal quality.

RESUMO Racional: Das anastomoses do trato gastrointestinal, as do esôfago têm especial interesse devido às varias peculiaridades anatômicas e mesmo sistêmicas. Objetivo: Avaliar retrospectivamente os resultados comparando a sutura mecânica e manual na anastomose esofagogástrica cervical no tratamento do megaesôfago. Métodos: Foram estudados 92 pacientes com diagnóstico de megaesôfago avançado com condições clínicas de serem submetidos à operação. Todos foram submetidos à mucosectomia esofágica, sendo realizada anastomose do coto esofágico com o tubo gástrico no nível cervical. Para a realização desta anastomose, foram divididos em dois grupos: grupo A (n=53) com sutura mecânica circular terminolateral; grupo B (n=39) com sutura manual em dois planos terminolateral. No período pós-operatório foi realizada avaliação precoce, com análise das complicações locais e sistêmicas, e tardia (média 5,6 anos) com análise da deglutição. Resultados: Avaliação precoce: a) deiscência da anastomose esofagogástrica, n=5 (9,4%) no grupo A vs. n=9 (23,0%) no grupo B (p=0.0418); b) estenose da anastomose esofagogástrica n=8 (15,1%) no grupo A vs. n=15 (38,4%) no grupo B (p=0.0105); c) infecção pulmonar n=5 (9,4%) no grupo A vs. n=3 (7,6%) no grupo B (p=1.000); d) derrame pleural n=5 (9,4%) no grupo A vs. n=6 (15,4%) no grupo B (p<0.518). A avaliação tardia demonstrou que 86,4 a 96,0% dos pacientes apresentaram critérios 4 e 5 de SAEED, demonstrando deglutição efetiva e sem diferença significante entre os grupos. Conclusão: A anastomose esofagogástrica pela sutura mecânica é mais adequada que a manual com pequena incidência de complicações locais e, na avaliação em longo prazo, a deglutição demonstrou ser adequada em ambos os grupos e com qualidade semelhante.

Banho de clorexidina para prevenção de colonização e infecção por micro-organismos multirresistentes na unidade de transplante de células tronco e hematopoiéticas / Chlorhexidine daily bath for prevention multiresistant microorganisms (MR) colonization and infection in Hematopoietic Stem Cell Transplant (HSCT) unit in a nine years period

Introdução: Infecções relacionadas à assistência de saúde (IRAS) representam hoje um dos principais desafios da qualidade do cuidado do paciente, principalmente em pacientes submetido a transplante de células tronco e hematopoiéticas (TCTH) O banho diário com a clorexidina (CHG) degermante a 2% tem sido proposto principalmente em unidades de terapia intensivas (UTIs) para diminuir a colonização bacteriana do paciente e assim diminuir IRAS. O objetivo deste estudo foi avaliar o impacto do banho com CHG degermante a 2% em unidade de internação de TCTH na incidência de infecção e colonização por patógenos multirresistentes e ainda avaliar seu impacto na sensibilidade das bactérias ao antisséptico. Métodos: Foi realizado um estudo quasi-experimental, com duração de 9 anos, com início em janeiro/2005 até dezembro/2013. A intervenção foi iniciada em agosto de 2009, sendo que os períodos pré e pós-intervenção tiveram duração de 4,5 anos. As taxas de IRAS, infecção por gram-negativos multirresistentes e infecção e colonização por enterococo resistente a vancomicina (VRE) foram avaliadas através de série temporal, para estudar o impacto da intervenção. As concentrações inibitórias mínimas (CIM) das bactérias para a CHG com e sem o inibidor de bomba de efluxo (CCCP) foram avaliadas nos dois períodos. Os genes de resistência a CHG foram estudados por meio da PCR e a clonalidade dos isolados por eletroforese em campo pulsátil. Resultados: Foi observada redução significativa na incidência de infecção e colonização de VRE na unidade no período pós-intervenção (p: 0,001). Essa taxa permaneceu estável em outras UTIs clínicas do hospital. Contudo as taxas de infecção por Gram negativos multirresistentes aumentou nos últimos anos na unidade. Não ocorreu diminuição na taxa de IRAS na unidade. As CIMs testadas de CHG aumentaram nas amostras de VRE e K. pneumoniae após o período de exposição ao antisséptico, com queda importante da CIM após o uso do CCCP...

Background and objectives: Daily skin cleansing with 2% chlorhexidine gluconate (CHG) in patients in intensive care unit is associated with reduction in incidence of multiresistant microorganisms (MR). Data in Hematological Steam Cell Transplant (HSCT), however, is scarce, and studies addressing the impact of this intervention in this population are needed. The aim of this study was to evaluate the effectiveness of daily bathing with CHG in reducing infection and colonization by MR (vancomycin resistance Enterococcus -VRE, P. aeruginosa, A. baumannii and K. pneumoniae) in HSCT patients and also evaluated the antiseptic susceptibility comparing pre and post intervention period. Methods: We perform a 9 year pre and post interventional study. In August 2009, was implemented daily bathing with CHG, replacing regular soap in all patients in a 12 beds HSCT ward, located in a tertiary reference hospital in Sao Paulo/Brazil. The goal of the intervention was decreasing MR prevalence in the unit. Therefore we evaluated the incidence-density (ID=cases/1000 patient days) of MR colonization and infection in periods of 4.5 years before and 4.5 years after intervention. Minimum inhibitory concentration (MIC) values were tested for CHG using Muller-Hinton agar dilution in MR strains isolated pre and post intervention period. The behavior of the strains after introduction of an efflux pump inhibitor (CCCP) was also assessed to study the importance of this resistance mechanism in relation to CHG. Statistical analyzes were performed using time-series analyses in ARIMA model, and SPSS program was used. P < 0.05 was considered statistically significant. Results: A significant reduction in infection and colonization VRE incidence was observed in post-intervention period (p 0.001). The opposite occurred with gran-negative infection and colonization rates, which had increased in recent years at the unit (p < 0.001). Rates of blood stream infection (BSI)...