Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

ObjectivesTo 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 methodsConsecutive 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.ResultsABC2-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.ConclusionABC2-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

DESMAME PRECOCE E SUAS CAUSAS: EXPERIÊNCIA NA ATENÇÃO BÁSICA DE CAMPINA GRANDE-PB Doi: http://dx.doi.org/10.5892/ruvrd.v11i2.146155

O Desmame precoce continua presente na sociedade e caracteriza-se pela introdução de outros alimentos ou líquidos durante o período de amamentação exclusiva. Este estudo objetivou descrever os fatores que levam ao desmame precoce. Tratou-se de uma pesquisa de campo de natureza exploratória, descritiva e quantitativa. A população estudada foi composta por 74 puérperas cujos filhos eram menores de 01 ano, por sua vez a amostra foi composta por 68 mulheres. Constatou-se que 45,4% das mães estavam na faixa etária entre 20 a 24 anos, 77,3% eram solteiras; 36,4% tinham baixa escolaridade e 63,6% não exerciam nenhuma atividade remunerada. A maioria das mães (50%) amamentou por menos de um mês. Dentre os motivos de desmame precoce 18,2% das mães não tinham leite suficiente; 18,2% dos bebês recusaram o peito; 9,1% das mães não tinham mamilos favoráveis para amamentação e 9,1% apresentaram problemas nas mamas, vale ressaltar que 45,4% destas relataram outros motivos. É fundamental o investimento na promoção do aleitamento materno exclusivo, especialmente em comunidades menos privilegiadas sócio-economicamente ao longo do ciclo gravídico-puerperal potencializando a relação salutar no binômio mãe-filho

Desmame precoce e suas causas: Experiência na atenção básica de campina grande-pb

O Desmame precoce continua presente na sociedade e caracteriza-se pela introdução de outros alimentos ou líquidos durante o período de amamentação exclusiva. Este estudo objetivou descrever os fatores que levam ao desmame precoce. Tratou-se de uma pesquisa de campo de natureza exploratória, descritiva e quantitativa. A população estudada foi composta por 74 puérperas cujos filhos eram menores de 01 ano, por sua vez a amostra foi composta por 68 mulheres. Constatou-se que 45,4% das mães estavam na faixa etária entre 20 a 24 anos, 77,3% eram solteiras; 36,4% tinham baixa escolaridade e 63,6% não exerciam nenhuma atividade remunerada. A maioria das mães (50%) amamentou por menos de um mês. Dentre os motivos de desmame precoce 18,2% das mães não tinham leite suficiente; 18,2% dos bebês recusaram o peito; 9,1% das mães não tinham mamilos favoráveis para amamentação e 9,1% apresentaram problemas nas mamas, vale ressaltar que 45,4% destas relataram outros motivos. É fundamental o investimento na promoção do aleitamento materno exclusivo, especialmente em comunidades menos privilegiadas sócio-economicamente ao longo do ciclo gravídico-puerperal potencializando a relação salutar no binômio mãe-filho

IMPLICAÇÕES DA VIOLÊNCIA NA INFÂNCIA E ADOLESCÊNCIAdoi: http://dx.doi.org/10.5892/ruvrd.v12i1.1415

No Brasil as questões históricas e culturais são os principais fatores atrelados a naturalização e banalização da violência, vitimizando principalmente as crianças e adolescentes. Trata-se de uma revisão sistemática desenvolvida a partir da extração secundária de dados colhidos na Biblioteca Virtual em Saúde (BVS) no mês de novembro de 2012, a qual teve por objetivo investigar as implicações da violência na infância e adolescência. Os resultados encontrados apontam agravos a saúde física, evidenciada por lesões que vão desde escoriações leves, hematomas, lacerações, queimaduras, até acometimentos graves como as fraturas em várias áreas do corpo, inclusive na cabeça, e comprometimento neurológico, além da necessidade de longos períodos de internação decorrente dessas lesões. Ficaram evidentes também os agravos de ordem psicológica percebidos pelo desencadeamento de distúrbios de ansiedade, medo, comportamento agressivo, retraído, antissocial ou depressivo, problemas de atenção e dificuldade de relacionamento. Assim, diante do exposto, é notória a importância do profissional do setor da saúde pelo possível olhar holístico atribuído ao tema, em especial o enfermeiro (a) especialista na área de saúde da criança, considerando sua atuação e atenção voltadas especialmente ao público infantil, posto que o reconhecimento do evento violento faz parte das atribuições técnicas deste (a) durante a consulta de enfermagem.

Implicações da violência na infância e adolescência

No Brasil as questões históricas e culturais são os principais fatores atrelados a naturalização e banalização da violência, vitimizando principalmente as crianças e adolescentes. Trata-se de uma revisão sistemática desenvolvida a partir da extração secundária de dados colhidos na Biblioteca Virtual em Saúde (BVS) no mês de novembro de 2012, a qual teve por objetivo investigar as implicações da violência na infância e adolescência. Os resultados encontrados apontam agravos a saúde física, evidenciada por lesões que vão desde escoriações leves, hematomas, lacerações, queimaduras, até acometimentos graves como as fraturas em várias áreas do corpo, inclusive na cabeça, e comprometimento neurológico, além da necessidade de longos períodos de internação decorrente dessas lesões. Ficaram evidentes também os agravos de ordem psicológica percebidos pelo desencadeamento de distúrbios de ansiedade, medo, comportamento agressivo, retraído, antissocial ou depressivo, problemas de atenção e dificuldade de relacionamento. Assim, diante do exposto, é notória a importância do profissional do setor da saúde pelo possível olhar holístico atribuído ao tema, em especial o enfermeiro (a) especialista na área de saúde da criança, considerando sua atuação e atenção voltadas especialmente ao público infantil, posto que o reconhecimento do evento violento faz parte das atribuições técnicas deste (a) durante a consulta de enfermagem.

Crotalus durissus venom: biological effects and relevant applications

Snakes have an important biological role in the ecological chain, as well as in scientific researches performed with the venoms produced by them, since the enzyme-protein fractions these substances possess have been studied as pharmacological tools for the discovery of new therapies. Snakes of the genus Crotalus have gained significant relevance in the scientific field, since the venom produced by these reptiles has been the target of researchers in a few decades, due to the composition and the effects that these substances can produce. In Brazil, a single species represents the genus, which is Crotalus durissus. This review demonstrates that even with the advancement in scientific research on the composition, role and application of the venom produced by the subspecies of Crotalus durissus snake, it is necessary to further study their fractions and their action potential, which also demonstrates the how rich are these active components in different fields of biomedicine

Direct antiviral therapy for treatment of hepatitis C: A real-world study from Brazil

Introduction and objectives: Direct antiviral agents (DAAs) including sofosbuvir (SOF), daclatasvir (DCV), simeprevir (SIM) and ombitasvir, paritaprevir and dasabuvir were introduced 2015 in Brazil for treatment of hepatitis C virus (HCV) infection. The aims of this study were to assess effectiveness and safety of HCV treatment with DAA in real-life world in a highly admixed population from Brazil. Materials and methods: All Brazilian reference centers for HCV treatment were invited to take part in a web-based registry, prospectively conducted by the Brazilian Society of Hepatology, to assess outcomes of HCV treatment in Brazil with DAAs. Data to be collected included demographics, disease severity and comorbidities, genotype (GT), viral load, DAA regimens, treatment side effects and sustained virological response (SVR). Results: 3939 patients (60% males, mean age 58 ± 10 years) throughout the country were evaluated. Most had advanced fibrosis or cirrhosis, GT1 and were treated with SOF/DCV or SOF/SIM. Overall SVR rates were higher than 95%. Subjects with decompensated cirrhosis, GT2 and GT3 have lower SVR rates of 85%, 90% and 91%, respectively. Cirrhosis and decompensated cirrhosis in GT1 and male sex and decompensated cirrhosis in GT3 were significantly associated with no SVR. Adverse events (AD) and serious AD occurred in 18% and 5% of those subjects, respectively, but less than 1% of patients required treatment discontinuation. Conclusion: SOF-based DAA regimens are effective and safe in the heterogeneous highly admixed Brazilian population and could remain an option for HCV treatment at least in low-income countries

Table_2_Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit.docx

ObjectivesTo 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 methodsConsecutive 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.ResultsABC2-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.ConclusionABC2-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.</p

Table_3_Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit.docx

ObjectivesTo 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 methodsConsecutive 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.ResultsABC2-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.ConclusionABC2-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.</p

Table_1_Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit.docx

ObjectivesTo 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 methodsConsecutive 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.ResultsABC2-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.ConclusionABC2-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.</p