Vídeo educativo sobre a medida da pressão arterial: impacto no conhecimento de estudantes de enfermagem / Educational video on blood pressure measurement: impact on nursing students' knowledge

Avaliar o impacto de um vídeo educativo no conhecimento de estudantes de enfermagem sobre o procedimento da medida indireta da pressão arterial utilizando aparelho oscilométrico. Estudo quase-experimental, quantitativo, do tipo antes e depois, realizado com 42 estudantes de enfermagem, por meio do Google Forms. Um instrumento foi utilizado para avaliar o conhecimento teórico dos estudantes, antes e após a apresentação de um vídeo educativo sobre a temática.  As variáveis analisadas foram: preparo do paciente e do ambiente, cuidados com o manguito, manutenção dos equipamentos e procedimento. As respostas dos estudantes foram classificadas como “Correta”, “Parcialmente Correta” e “Incorreta”. Os dados foram analisados através docálculo de frequências absolutas e relativas. Os estudantes demonstraram melhora no conhecimento sobre o intervalo de tempo entre as medidas da pressão arterial (81%) e a escolha do manguito (33,3%). O vídeo educativo teve impacto positivo no conhecimento dos estudantes

Síndrome de Pendred causada por mutação em homozigoze no gene SLC26A4 em uma família brasileira consangüínea

ABSTRACTPendred Syndrome (PS) is an autossomal recessive disorder characterized by sensorineural deafness, goiter and iodide organification defect. The hearing loss is associated with inner ear abnormalities, ranging from an isolated enlarged vestibular aqueduct (EVA) to a typical coclear dysplasia. Mutations in the gene that encodes pendrin (SLC26A4), a chloride/iodide transporter, have been shown to be associated with PS. We describe the clinical and molecular characteristics of a large consanguineous family harboring a mutation in the SLC26A4 gene. The proband was a 26-year-old deaf Brazilian woman who presented a bulky multinodular goiter and hypothyroidism since puberty. Five other siblings were deaf: one brother had a similar phenotype, three siblings also had goiters but normal thyroid function tests, and one brother had only a subtle thyroid enlargement. Other 4 siblings had no thyroid or hearing disorder. Parents were first degree cousins and had normal hearing. The mother was healthy, except for subclinical hypothyroidism; the father was deceased. A perchlorate test in the proband showed a discharge of 21% of the incorporated iodide 2h after the administration of 1g of KClO4. Audiological examinations showed profound hearing loss in all deaf subjects; CT and MRI of the temporal bones showed EVA in all of them. Genomic DNA was isolated from whole blood, from the 6 affected and 4 unaffected siblings, the mother and control. The coding region of the PDS gene (exons 2-21), including exon/intron boundaries, were amplified by PCR and sequenced. A single base-pair (T) deletion at position 1197 of exon 10 was detected in homozygous state in the 6 deaf siblings. The mother and 2 unaffected siblings were heterozygous for this mutation, which has been described by Everett et al. The 1197delT mutation is predicted to result in a frameshift and a truncated protein. The existence of PS phenocopies and intrafamilial phenotypic variability are well documented. The definite diagnosis requires molecular analysis. Our study illustrates the value and challenges of mutational analysis in selected patients with PS. __________________________________________________________________________________ RESUMOA syndrome de Pendred (SP) é uma doença autossômica recessiva caracterizada por surdez neurossensorial, bócio e defeito de organificação do iodo. A perda auditiva está associada a anormalidades do ouvido interno, desde a dilatação isolada do aqueduto vestibular (DAV) até uma típica displasia coclear. Mutações no gene que codifica a pendrina (SLC26A4), um transportador de cloreto/iodeto, têm sido associadas à SP. Descrevemos as características clínicas e moleculares de uma grande família consangüínea portadora de uma mutação no gene SLC26A4. O caso-índice era uma paciente do sexo feminino, brasileira, 26 anos, portadora de surdez congênita, que apresentava um volumoso bócio multinodular e hipotireoidismo desde a puberdade. Outros cinco irmãos eram surdos: um irmão tinha fenotipo semelhante, três também tinham bócio, porém com função tiroideana normal e um irmão tinha apenas um discreto aumento da tiróide. Outros quatro irmãos não apresentavam alteração tiroideana ou auditiva. Os pais eram primos de primeiro grau e tinham audição normal. A mãe era saudável, exceto por hipotireoidismo subclínico; o pai era falecido. O teste do perclorato no caso-índice revelou a liberação de 21% do iodo incorporado duas horas após a administração de 1 g de KClO4. Os exames audiológicos mostraram perda auditiva profunda em todos os indivíduos afetados; TC e RMN dos ossos temporais mostraram DAV em todos eles. O DNA genômico foi isolado do sangue total dos seis irmãos afetados e dos quatro não-afetados, da mãe e do controle. A região codificante do gene PDS (éxons 2-21), incluindo as junções éxon/íntron, foram amplificadas por PCR e seqüenciadas. Foi detectada a deleção de uma base (T) na posição 1197 do éxon 10, em homozigoze, nos seis irmãos afetados. A mãe e dois irmãos não-afetados eram heterozigotos para a mutação, que foi descrita inicialmente por Everett e cols. A mutação 1197delT provavelmente resulta em um erro de fase de leitura (frameshift) e em uma proteína truncada. A existência de fenocópias da SP e a variabilidade fenotípica intrafamiliar são bem conhecidas. O diagnóstico definitivo requer análise molecular. O presente estudo ilustra o valor e os desafios da análise mutacional em pacientes selecionados com SP

MORTALITY TREND FROM CARDIAC ISCHEMIC DISEASES IN THE FEDERAL DISTRICT FROM 2010 TO 2018

Esse estudo avaliou a tendência de mortalidade por Doenças Isquêmicas Cardíacas no Distrito Federal, conforme as variáveis faixa etária, sexo e distribuição geográfica por Região Administrativa do estado. Foi realizado estudo ecológico do tipo séries temporais, entre 2010 e 2018. No período estudado, foram contabilizados 7.645 óbitos para o desfecho, uma média de idade de 70,3 anos (±14,1 anos), com mediana de 72 anos. A maioria dos indivíduos encontrava-se na faixa etária maior ou igual a 60 anos (77,3%), era sexo masculino (57,9%), possuía de um a três anos de estudo (30,8%), era solteiro, viúvo ou divorciado (55%) e de raça/cor branca (53,2%). Em suma, identificou-se a tendência crescente de mortalidade geral e para pessoas do sexo masculino devido a Doenças Isquêmicas Cardíacas e estacionária para as faixas etárias investigadas.This study evaluated the trend of mortality due to Cardiac Ischemic Diseases in the Federal District according to the variables age group, gender, and geographic distribution by Administrative Region of the state. An ecological study of the time series was conducted between 2010 and 2018. In the period studied, 7,645 deaths were recorded for the outcome, mean age of 70.3 years (±14.1 years), with a median of 72 years. Most individuals were in the age group greater than or equal to 60 years (77.3%), were male (57.9%), had one to three years of schooling (30.8%), were single, widowed or divorced (55%) and white race/color (53.2%). In a total, the growing trend of mortality in general   and for males due to Cardiac and stationary Ischemic   Diseases was identified for the age groups investigated

TENDÊNCIA DE MORTALIDADE POR DOENÇAS ISQUÊMICAS CARDÍACAS NO DISTRITO FEDERAL DE 2010 A 2018

This study evaluated the trend of mortality due to Cardiac Ischemic Diseases in the Federal District according to the variables age group, gender, and geographic distribution by Administrative Region of the state. An ecological study of the time series was conducted between 2010 and 2018. In the period studied, 7,645 deaths were recorded for the outcome, mean age of 70.3 years (±14.1 years), with a median of 72 years. Most individuals were in the age group greater than or equal to 60 years (77.3%), were male (57.9%), had one to three years of schooling (30.8%), were single, widowed or divorced (55%) and white race/color (53.2%). In a total, the growing trend of mortality in general   and for males due to Cardiac and stationary Ischemic   Diseases was identified for the age groups investigated.Esse estudo avaliou a tendência de mortalidade por Doenças Isquêmicas Cardíacas no Distrito Federal, conforme as variáveis faixa etária, sexo e distribuição geográfica por Região Administrativa do estado. Foi realizado estudo ecológico do tipo séries temporais, entre 2010 e 2018. No período estudado, foram contabilizados 7.645 óbitos para o desfecho, uma média de idade de 70,3 anos (±14,1 anos), com mediana de 72 anos. A maioria dos indivíduos encontrava-se na faixa etária maior ou igual a 60 anos (77,3%), era sexo masculino (57,9%), possuía de um a três anos de estudo (30,8%), era solteiro, viúvo ou divorciado (55%) e de raça/cor branca (53,2%). Em suma, identificou-se a tendência crescente de mortalidade geral e para pessoas do sexo masculino devido a Doenças Isquêmicas Cardíacas e estacionária para as faixas etárias investigadas

COVID-19 outcomes in people living with HIV: Peering through the waves

Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group

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 un derstanding 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,5–7 vast areas of the tropics remain understudied.8–11 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 underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities 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 or ganism 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 ne glected 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 lostinfo:eu-repo/semantics/publishedVersio

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