I Diretrizes do Grupo de Estudos em Cardiogeriatria da Sociedade Brasileira de Cardiologia

O idoso apresenta características próprias na manifestação das doenças, na resposta à terapêutica e no efeito colateral dos medicamentos. Constitui um grupo de maior risco para o aparecimento das doenças degenerativas, em geral, e cardiovasculares, em particular, além de apresentar maior número de comorbidades

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Avaliação da qualidade bromatologica de duas cultivares de sorgo, Sorghum bicolor L. Moench, submetidas à adubação fosfatada e fungos micorrizicos

The work was developed at the Greenhouse of the University of Agronomy of Pombal - FAP, in Pombal – Paraiba. It had as objective to evaluate the quality the chemical composition of two cultivate of sorgo, submitted to the phosphate fertilization and micorrhizal fungi. The treatments were 0, 30mg dm3 of P and 30mg dm3 of P + micorrhizas, maybe disposed in blocks to the in outline factorial (2 x 3), with 4 repetitions. After 50 days, of sowing the plants were collected and the texts of were determined of N, P, PB, MS, FDA and FDN of the aerial part. In agreement with it analyzes of the variance for N of the PA, there was not interaction among the factors, however the largest averages were obtained in the treatments that received 30 mg dm-3 of P and 30 mg dm-3 of P more micorrhizas. Already for variable P and MS of the PA, happened interaction between the factors and the largest accumulation of P was verified in the treatment 30 mg dm-3 of P more micorrhizas of cultivating 304 hybrid, already the largest accumulation of MS happened in the treatment 30 mg dm-3 of P more micorrhizas in to cultivate GRF-IPA-730-1011. For PB there was difference between the treatments and the largest averages they were also obtained in the treatment with 30 mg dm-3 of P more micorrhizas. For variable FDA, happened significant (P ≤ 0,05), not having difference among the treatments. For variable FDN, happened significant difference just the cultivate, the largest averages were obtained in to cultivate 304 hybrid (P0 ≤ 0,01).O trabalho foi desenvolvido na casa de vegetação da Faculdade de Agronomia de pombal – FAP, no mesmo município e teve como objetivo avaliar a qualidade bromatologica de duas cultivar de sorgo, submetidos à adubação fosfatada e fungos micorrizicos. Os tratamentos foram 0, 30mg dm3 de P e 30mg dm3 de P + micorrizas, dispostos em blocos ao acaso em esquema fatorial (2 x 3), com 4 repetições. Após 50 dias da semeadura as plantas foram coletadas e determinaram-se os teores de N, P, PB, MS, FDA e FDN da parte aérea. De acordo com a analise de variância para N da PA, não houve interação entre os fatores, no entanto as maiores médias foram obtidas nos tratamentos que receberam 30 mg dm- 3 de P e 30 mg dm- 3 de P mais micorrizas. Já para as variáveis P e MS da PA, ocorreu interação entre os fatores e o maior acúmulo de P verificou-se no tratamento 30 mg dm- 3 de P mais micorrizas da cultivar 304 hibrido, já o maior acúmulo de MS ocorreu no tratamento 30 mg dm- 3 de P mais micorrizas na cultivar GRF-IPA-730-1011. Para PB houve diferença entre os tratamentos e as maiores médias também foram obtidas no tratamento com 30 mg dm- 3 de P mais micorrizas. Para a variável FDA, ocorreu significativa (P≤0,05), não havendo diferença entre os tratamentos. Para a variável FDN, ocorreu diferença significativa apenas entre as cultivares, as maiores médias foram obtidas na cultivar 304 hibrido (P≤0,01).El trabajo fue desarrollado en la casa de vegetação de la Facultad de Agronomia de pombal – FAP, en el mismo municipio y tuvo cómo objetivo evaluar la calidad bromatologica de dos cultivar de sorgo, sometidos a la adubação fosfatada y fungos micorrizicos. Los tratamientos fueron 0, 30mg dm3 de P y 30mg dm3 de P + micorrizas, dispuestos en bloques al acaso en esquema factorial (2 x 3), con 4 repeticiones. Después de 50 días de la semeadura las plantas fueron recolectadas y se determinaron los teores de N, P, PB, MS, FDA y FDN de la parte aérea. De acuerdo con a analice de variância para N de la PA, no hube interacción entre los factores, sin embargo las mayores medias fueron obtenidas en los tratamientos que recibieron 30 mg dm-3 de P y 30 mg dm-3 de P más micorrizas. Ya para las variabais P y MS de la PA, ocurrió interacción entre los factores y el mayor acúmulo de P se verificó en el tratamiento 30 mg dm-3 de P más micorrizas de la cultivar 304 hibrido, ya el mayor acúmulo de MS ocurrió en el tratamiento 30 mg dm-3 de P más micorrizas en la cultivar GRF-IPA-730-1011. Para PB hube diferencia entre los tratamientos y las mayores medias también fueron obtenidas en el tratamiento con 30 mg dm-3 de P más micorrizas. Para la variável FDA, ocurrió significativa (P≤0,05), no habiendo diferencia entre los tratamientos. Para la variável FDN, ocurrió diferencia significativa sólo entre las cultivares, las mayores medias fueron obtenidas en la cultivar 304 hibrido (P≤0,01)

AVALIAÇÃO DA QUALIDADE BROMATOLOGICA DE DUAS CULTIVARES DE SORGO (Sorghum bicolor L. Moench), SUBMETIDAS À ADUBAÇÃO FOSFATADA E FUNGOS MICORRIZICOS

O trabalho foi desenvolvido na casa de vegetação da Faculdade de Agronomia de pombal – FAP, no mesmo município e teve como objetivo avaliar a qualidade bromatologica de duas cultivar de sorgo, submetidos à adubação fosfatada e fungos micorrizicos. Os tratamentos foram 0, 30mg dm3 de P e 30mg dm3 de P + micorrizas, dispostos em blocos ao acaso em esquema fatorial (2 x 3), com 4 repetições. Após 50 dias da semeadura as plantas foram coletadas e determinaram-se os teores de N, P, PB, MS, FDA e FDN da parte aérea. De acordo com a analise de variância para N da PA, não houve interação entre os fatores, no entanto as maiores médias foram obtidas nos tratamentos que receberam 30 mg dm- ³ de P e 30 mg dm- ³ de P mais micorrizas. Já para as variáveis P e MS da PA, ocorreu interação entre os fatores e o maior acúmulo de P verificou-se no tratamento 30 mg dm- ³ de P mais micorrizas da cultivar 304 hibrido, já o maior acúmulo de MS ocorreu no tratamento 30 mg dm- ³ de P mais micorrizas na cultivar GRF-IPA-730-1011. Para PB houve diferença entre os tratamentos e as maiores médias também foram obtidas no tratamento com 30 mg dm- ³ de P mais micorrizas. Para a variável FDA, ocorreu significativa (P≤0,05), não havendo diferença entre os tratamentos. Para a variável FDN, ocorreu diferença significativa apenas entre as cultivares, as maiores médias foram obtidas na cultivar 304 hibrido (P≤0,01)