EXCESSIVE DAYTIME SLEEPNESSAND CARDIOMETABOLIC RISK FACTORS IN CHILDREN AND TEENAGERS WITH OVERWEIGHT

Introdução: atualmente, é observada tendência exacerbada para sonolência diurna excessivaem crianças e adolescentes com excesso de peso. A obesidade e os distúrbios do sono, têmefeito conjunto nas doenças cardiovasculares e no diabetes mellitus. Objetivo: avaliar aprevalência de sonolência diurna excessiva e sua associação com fatores de riscocardiometabólicos. Método: estudo de corte transversal realizado em serviço público, referênciaem atendimento a crianças e adolescentes com excesso de peso no período de junho de 2011a março de 2013, em Campina Grande/PB. A amostra foi composta por 140 crianças e adolescentesde cinco a 18 anos. Foi realizada antropometria, aferida a pressão arterial, aplicado questionáriosobre hábitos do sono, Escala de Sonolência de Epworth e realizados exames laboratoriais(perfil lipídico, glicemia, insulina, HOMA-RI, hemoglobia glicada, proteína C-reativa ultrassensívele leptina). Os dados foram analisados pelo SPSS (v.17), através dos testes do Qui-quadrado, devariância e da correlação de Pearson, com nível de significância de 5%. Resultados: A prevalênciade sonolência diurna excessiva foi de 19,3% e foi maior nas meninas. naqueles com SDE foiobservado maior percentual de alteração nos níveis de LDL, HbA1c e PCR-u, porém sem significânciaestatística. Conclusões: a presença de sonolência na amostra estudada foi prevalente e a aquelescom esta condição apresentaram resultados metabólicos menos favoráveis.Introduction: Currently, an exacerbated trend for excessive daytime sleepiness in overweightchildren and adolescents has been observed. Obesity and sleep disorders have a combinedeffect on cardiovascular diseases and diabetes mellitus. The aim of the study was to evaluatethe prevalence of excessive daytime sleepiness and its association with cardiometabolic riskfactors. Method: Cross-sectional study carried out in a public service, which is reference servicefor overweight children and adolescents in the period from June 2011 to March 2013 in CampinaGrande / PB. The sample consisted of 140 children and adolescents aged from five to 18 years.Anthropometry and blood pressure measures were performed and a questionnaire on sleephabits and Epworth Sleepiness Scale were applied. Laboratory tests were also conducted (lipidprofile, blood glucose levels, insulin, HOMA-IR, glycated hemoglobin, ultrasensitive C-reactiveprotein and leptin). Data were analyzed using SPSS software (v.17), through the chi-squaretest, ANOVA and Pearson’s correlation, with significance level of 5%. Results: the prevalence ofexcessive daytime sleepiness was 19.3% and it was higher among girls. In those with excessivedaytime sleepiness was observed the highest percentage change in LDL levels, HbA1c and CRPu,but without statistical significance. Conclusions: the presence of sleepiness were prevalentin this sample, and those with this condition showed less favorable metabolic results

Entendendo a agitação psicomotora na sociedade brasileira: revisão de literatura

Introduction: Psychomotor agitation is a characteristic feature characterized by intense arousal, involving both psychological and motor aspects. This condition can manifest in various ways and is often associated with various mental and neurological disorders. Methodology: This literature review employed a systematic approach to identify relevant studies on psychomotor engineering in hospital settings in Brazil. The descriptors used were Psychomotor Agitation, Psychomotor Hyperactivity, Brazil, Hospitals, Psychiatric. The search was conducted in the PUBMED database, using the search filter for the last 10 years. Result: In the context of non-pharmacological management of the agitated patient, recommendations emphasize the importance of following a line of interventions, prioritizing less invasive measures before resorting to more coercive approaches. The process begins with directing the patient to a secure environment, providing a fundamental basis for improvement management. Conclusion: Psychomotor improvement is a symptom that can significantly impact a person's quality of life. Understanding the underlying causes and implementing an appropriate therapeutic approach are essential for the effective management of this state. The support of mental health professionals is crucial to assist in both the assessment and treatment of this complex condition.Introdução: A agitação psicomotora é uma característica que se caracteriza por uma intensa intensa, envolvendo tanto aspectos psicológicos quanto motores. Esta condição pode se manifestar de várias maneiras e está frequentemente associada a diversos transtornos mentais e neurológicos. Metodologia: Esta revisão bibliográfica utilizou uma abordagem sistemática para identificar estudos relevantes sobre engenharia psicomotora em contextos hospitalares no Brasil. Os descritores utilizados foram Psychomotor Agitation, Psychomotor Hyperactivity, Brazil, Hospitals, Psychiatric. A busca foi conduzida na base de dados PUBMED, utilizando o filtro de pesquisa nos últimos 10 anos. Resultado: No contexto do manejo não farmacológico do paciente agitado, as recomendações ressaltam a importância de seguir uma linha de intervenções, priorizando medidas menos invasivas antes de recorrer a abordagens mais coercitivas. O processo inicia com o encaminhamento do paciente para um ambiente protegido, proporcionando uma base fundamental para a gestão da melhoria. Conclusão: A melhoria psicomotora é um sintoma que pode impactar significativamente a qualidade de vida de uma pessoa. A compreensão das causas subjacentes e a implementação de uma abordagem terapêutica adequada são essenciais para o manejo eficaz desse estado. O suporte de profissionais de saúde mental é fundamental para auxiliar tanto na avaliação quanto no tratamento dessa condição complexa

Dexmedetomidina versus outros sedativos na prevenção de Delirium nos adultos em ventilação mecânica

Delirium é uma síndrome neurocognitiva aguda relativamente comum e grave que se caracteriza por desatenção, consciência alterada, disfunção cognitiva e curso flutuante, e pode levar à mortalidade, declínio funcional, institucionalização e demência, com maior incidência nos pacientes mais velhos. Pacientes hospitalizados na Unidade de Terapia Intensiva (UTI) e em uso de ventilação mecânica (VM), quando sedados em excesso, possuem maior duração de permanência na UTI, aumento da duração da VM, maior incidência de delirium e mortalidade. Estudos apontam que a dexmedetomidina reduz a incidência de delirium em pacientes adultos hospitalizados na UTI e em uso de ventilação mecânica quando comparada com outros sedativos. Desse modo, o objetivo do estudo é comparar a dexmedetomidina e outros sedativos na prevenção de delirium nos adultos em ventilação mecânica. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que, quando comparado com outros sedativos gabaminérgicos, como os benzodiazepínicos e o propofol, a dexmedetomidina diminui significativamente a incidência de delirium nos pacientes adultos em ventilação mecânica na UTI, com melhora da capacidade de despertar do paciente, preservação do desempenho cognitivo e redução do risco de depressão respiratória. Desse modo, pesquisas futuras sobre as propriedades farmacológicas da dexmedetomidina podem ajudar a determinar se esta droga possui propriedades neuroprotetoras intrínsecas, sendo assim, tal descoberta facilitaria o desenvolvimento de análogos com menos efeitos colaterais cardiorrespiratórios, tendo em vista seu efeito hemodinâmico, com bradicardia e possível hipotensão associadas

Impact of a Virtual Clinic in a Paediatric Cardiology Network on Northeast Brazil

Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects. Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis. Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients. Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals

A telemedicine network for remote paediatric cardiology services in north-east Brazil

PROBLEM: Providing health care for children with congenital heart diseases remains a major challenge in low- and middle-income countries. APPROACH: In October 2011, the Government of Paraíba, Brazil, established a paediatric cardiology network in partnership with the nongovernmental organization Círculo do Coração. A cardiology team supervised all network activities, using the Internet to keep in contact with remote health facilities. The network developed protocols for screening heart defects. Echocardiograms were performed by physicians under direct online supervision of a cardiologist; alternatively, a video recording of the examination was subsequently reviewed by a cardiologist. Cardiovascular surgeons came to a paediatric hospital in the state capital once a week to perform heart surgeries. LOCAL SETTING: Until 2011, the State of Paraíba had no structured programme to care for children with heart disease. This often resulted in missed or late diagnosis, with adverse health consequences for the children. RELEVANT CHANGES: From 2012 to 2014, 73 751 babies were screened for heart defects and 857 abnormalities were identified. Detection of congenital heart diseases increased from 4.09 to 11.62 per 1000 live births (P < 0.001). Over 6000 consultations and echocardiograms were supervised via the Internet. Time to diagnosis, transfers and hospital stays were greatly reduced. A total of 330 operations were carried out with 6.7% (22/330) mortality. LESSONS LEARNT: Access to an echocardiography machine with remote supervision by a cardiologist improves the detection of congenital heart disease by neonatologists; virtual outpatient clinics facilitate clinical management; the use of Internet technology with simple screening techniques allows resources to be allocated more efficiently

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data