Terminalidade de vida: bioética e humanização em saúde

A visão dos profissionais de saúde frente à terminalidade da vida é uma das realidades mais difíceis com as quais estes se deparam, pois, apesar dos melhores esforços, alguns pacientes virão a óbito. O objetivo do presente estudo é identificar e descrever, por meio da literatura científica, os aspectos da promoção de saúde e da Bioética, no que diz respeito à humanização do atendimento aos sujeitos em terminalidade de vida, frente aos familiares e profissionais de saúde envolvidos. A metodologia baseouse em uma revisão de literatura através de pesquisa e seleção de textos a partir de bases de dados, proporcionando o conhecimento acerca dos diferentes conceitos utilizados na humanização dos profissionais de saúde com relação à terminalidade de vida e questões bioéticas, a fim de buscar suprir as grandes dificuldades que os profissionais de saúde têm em lidar com os doentes terminais e como devem ser tratados, uma vez que o bem estar físico e emocional deve ser o foco das atenções.The view of health professionals opposite of life terminality is one of the most difficult situations which they have to face, because, despite best efforts, some patients will come to death. The purpose of this study is to identify and describe, through scientific literature, the aspects of promoting health and bioethics, with respect to the humanization of care in life-terminal-patients, and also how to deal with the family and health professionals involved. The methodology was based on a literature review using the search and selection of texts from databases, providing knowledge about different concepts used in humanization of health professionals regarding to life terminality and bioethical issues, in order to redress the great difficulties that health professionals have in dealing with the terminally ill and how they should be treated once the physical and emotional well being should be the focus

Relationship between power condition, agility, and speed performance among young roller hockey elite players

Purpose. The study was intended to describe the correlations between speed performance (11 m, 22 m, and 33 m) and agility test in skates with determinants of muscular power (squat jump, countermovement jump) in young Portuguese roller hockey athletes involved in a regional selection. Methods. A cross-sectional study was conducted among 10 male roller hockey players with mean (? SD) age of 14.20 (0.57) years, involved in the Portuguese national competition of under-15, making part of the final Oporto district selection of players to participate in inter-regional selections competition. Their mean (? SD) weight, height, body mass index, and sum of the skinfolds were 58.62 (8.78) kg, 165.72 (8.45) cm, 21.26 (1.52) kg/m2, 51.80 (14.91) mm, respectively. Furthermore, it strength was measured with squat jump and countermovement jump; sprinting time at 11 m, 22 m, and 33 m was determined, as well as time in an agility t-test, conducted in roller skating. Spearman correlation coefficients were calculated to test the associations. Results. Significant inverse correlations between vertical jumps, a practical method of power training monitoring, and linear velocity in skating (countermovement jump vs. speed, ?0.78) were found. Despite the increasing complexity of the agility test, a moderate inverse correlation with strength was observed, too (?0.48). Conclusions. Lower limbs explosive strength turned out a strong predictor of skating linear speed and agility among young roller hockey players, providing a simple evaluation tool of important determinants of performance.D915-7373-ED16 | Cesar LeaoN/

A retrospective analysis of oral and maxillofacial lesions in children and adolescents reported in two different services

Most epidemiological studies involving oral and maxillofacial lesions assess only data from histopathological analysis. This may lead to a poor notification of diseases whose diagnosis is predominantly clinical. Aim: To evaluate and to compare the freque

Predicting the distribution of canine leishmaniasis in western Europe based on environmental variables.

The domestic dog is the reservoir host of Leishmania infantum, the causative agent of zoonotic visceral leishmaniasis endemic in Mediterranean Europe. Targeted control requires predictive risk maps of canine leishmaniasis (CanL), which are now explored. We databased 2187 published and unpublished surveys of CanL in southern Europe. A total of 947 western surveys met inclusion criteria for analysis, including serological identification of infection (504, 369 dogs tested 1971-2006). Seroprevalence was 23 2% overall (median 10%). Logistic regression models within a GIS framework identified the main environmental predictors of CanL seroprevalence in Portugal, Spain, France and Italy, or in France alone. A 10-fold cross-validation approach determined model capacity to predict point-values of seroprevalence and the correct seroprevalence class (20%). Both the four-country and France-only models performed reasonably well for predicting correctly the 20% seroprevalence classes (AUC >0 70). However, the France-only model performed much better for France than the four-country model. The four-country model adequately predicted regions of CanL emergence in northern Italy (<5% seroprevalence). Both models poorly predicted intermediate point seroprevalences (5-20%) within regional foci, because surveys were biased towards known rural foci and Mediterranean bioclimates. Our recommendations for standardizing surveys would permit higher-resolution risk mapping

Oral and maxillofacial lesions in older individuals and associated factors : a retrospective analysis of cases retrieved in two different services

Studies on the oral and maxillofacial lesions (OMLs) in older people usually assess data of laboratory services and data from oral medicine clinic have been poorly described. The aim of this study was to describe and to compare OMLs in older individuals considering two data sources, besides to assess associated factors with the three most frequent lesions. A retrospective study was conducted with individuals aged 60 years or older. Data of individuals and lesions reported in both services were collected. Univariate analysis was used to test the association between the occurrence of the lesion and the independent variables. The level of significance was set at 5%. A total of 1,695 (37.3%) records were from the Oral Medicine clinic and 2,848 (62.7%) from the Laboratory service. Inflammatory/reactive lesion group was the most frequent in both services (40.4% in Oral Medicine Clinic and in 44.2% Laboratory). The second and third groups of lesions in the Oral Medicine clinic were infectious diseases (18.5%), and variations of normality (10.8%), while in the laboratorial service were the malignant neoplasms (17.6%) and potentially malignant disorders (13.3%). Differences between services regarding the frequency of lesion groups occurred (p<0.05), except for pigmented (p=0.054) and infectious (p=0.054) groups. Females (OR: 2.08; CI: 1.81?2.39) and individuals who wore a removable prosthesis (OR: 3.99; CI: 2.83?5.62) were also likely to have inflammatory fibrous hyperplasia. Old?old individuals (OR: 1.70; CI: 1.30?2.21), male (OR: 3.63; CI: 3.00?4.39), smoking (OR: 6.05; CI: 4.84?7.56) or alcohol use (OR: 3.95; CI: 3.12?5.01) were likely to have squamous cell carcinoma. The results showed different frequencies of OMLs in older individuals according to the data sources and age group. The findings are important to direct public policies for this age group

What is the preferred concentration of ethanolamine oleate for sclerotherapy of oral vascular anomalies?

This study compared three different concentrations of EO (1.25%, 2.5% and 5%) for the treatment of oral vascular anomalies (OVAs). This was a retrospective comparative analysis of patients with OVAs treated with EO. Anomalies smaller than 20 mm were included. The patients were treated with 1.25% (G1), 2.5% (G2), and 5% (G3) and clinical data were obtained. The number of sessions, the final volume and dose of EO were statistically analyzed to verify effectiveness and safety of the treatment. The different concentrations of EO were compared considering the number of sessions, the final volume and total dose of EO. Analysis of covariance (ANCOVA) was used to evaluate the influence of covariates on the outcomes. A p-value < 0.05 was considered significant. Nineteen women and 11 men with a median age of 54 years were included. The OVAs were most frequent in the lip (n=14) and cheek (n=9). All lesions exhibited complete clinical healing within 28 days. Patients of G3 required fewer sessions than those of G2 (p=0.017), a lower final volume compared to the other groups (p<0.001), and a lower total dose than G1 (p<0.001). Patients of G1 used a lower total dose than G2 (p=0.003). The concentration of 5% EO performed better than 1.25% and 2.5% for sclerotherapy of OVAs measuring up to 20 mm. This preliminary result should be the preferred concentration of EO to provide an effective and safe treatment of OVAs

Explanation-by-Example Based on Item Response Theory

Intelligent systems that use Machine Learning classification algorithms are increasingly common in everyday society. However, many systems use black-box models that do not have characteristics that allow for self-explanation of their predictions. This situation leads researchers in the field and society to the following question: How can I trust the prediction of a model I cannot understand? In this sense, XAI emerges as a field of AI that aims to create techniques capable of explaining the decisions of the classifier to the end-user. As a result, several techniques have emerged, such as Explanation-by-Example, which has a few initiatives consolidated by the community currently working with XAI. This research explores the Item Response Theory (IRT) as a tool to explaining the models and measuring the level of reliability of the Explanation-by-Example approach. To this end, four datasets with different levels of complexity were used, and the Random Forest model was used as a hypothesis test. From the test set, 83.8% of the errors are from instances in which the IRT points out the model as unreliable.Comment: 15 pages, 5 figures, 3 tables, submitted for the BRACIS'22 conferenc

Development of a sequential injection system for the determination of nitrite and nitrate in waters with different salinity: Application to estuaries in NW Portugal

In this work, a sequential injection methodology for monitoring nitrite and nitrate in estuarine waters without any previous treatment is described. The developed system was applied to the measurement of nitrite and nitrate in estuarine waters of three rivers in the NW Portugal, allowing an automatic, fast (ca 60 h 1) and precise method (relative standard deviation lower than 2%). The procedure was based on the reaction between nitrite, sulfanilamide and N-(1-naphthyl)-ethylenediamine dihydrochloride (N1NED), whereas the determination of nitrate resulted from its reduction to nitrite, using an in-line cadmium column, followed by the same reaction. The samples were collected in three locations for each river (Douro, C avado and Ave) covering the lower, middle and upper section of the estuaries. Despite the presence of a salinity gradient, this parameter showed no interference in the accuracy of the determinations. The results obtained for the described method for nitrite were statistically comparable to those obtained by the reference procedure. For the determination of nitrate, recovery tests confirmed that the sequential injection methodology provided good quality results.info:eu-repo/semantics/publishedVersio

Molecular epidemiology of hiv-1 infected migrants followed up in Portugal: Trends between 2001-2017

Migration is associated with HIV-1 vulnerability. Objectives: To identify long-term trends in HIV-1 molecular epidemiology and antiretroviral drug resistance (ARV) among migrants followed up in Portugal Methods: 5177 patients were included between 2001 and 2017. Rega, Scuel, Comet, and jPHMM algorithms were used for subtyping. Transmitted drug resistance (TDR) and Acquired drug resistance (ADR) were defined as the presence of surveillance drug resistance mutations (SDRMs) and as mutations of the IAS-USA 2015 algorithm, respectively. Statistical analyses were performed. Results: HIV-1 subtypes infecting migrants were consistent with the ones prevailing in their countries of origin. Over time, overall TDR significantly increased and specifically for Non-nucleoside reverse transcriptase inhibitor (NNRTIs) andNucleoside reverse transcriptase inhibitor (NRTIs). TDR was higher in patients from Mozambique. Country of origin Mozambique and subtype B were independently associated with TDR. Overall, ADR significantly decreased over time and specifically for NRTIs and Protease Inhibitors (PIs). Age, subtype B, and viral load were independently associated with ADR. Conclusions: HIV-1 molecular epidemiology in migrants suggests high levels of connectivity with their country of origin. The increasing levels of TDR in migrants could indicate an increase also in their countries of origin, where more efficient surveillance should occur. © 2020 by the authors

The Facet of Human Impact: Solenopsis invicta Buren, 1972 Spreading around the Atlantic Forest

The present investigation deals with some aspects of the diversity of fire ants (Hymenoptera: Formicidae) in their native range. The Red Imported Fire Ant Solenopsis invicta is native to the tropical and subtropical inland territories of South America. In Brazil, it mainly occurs around the Pantanal region and across the Paraguay river, a region composed of grasslands which are seasonally flooded. Recent studies have evidenced this fire ant species is gradually spreading to other regions of Brazil. In the present investigation, we surveyed the molecular diversity of S. invicta populations across fragments of Atlantic Forest in Sao Paulo, Brazil, using mtDNA COI haplotypes. Fire ant nests were sampled along the highways lining the northern and southern slope sides of the mountain range Serra do Mar, SP, Brazil. Four haplotypes were identified (H1-H4), which were assessed for similarity to deposited records by other authors, revealing that the haplotypes H1 and H2 are likely of foreign origin through recent reintroduction via a marine port to the south of the Serra do Mar mountain range. On the other hand, the haplotypes H3 and H4, predominating among the inland samples from the northern side of the mountain range, were most similar to previous records from more central regions of Brazil. Haplotypes clustered into distinct supergroups, further pointing to the occurrence of two separate expansion waves of S. invicta in the region. We suggest the obtained pattern indicates the mountain range may function as a geographical barrier deferring gene flow