Contributos para a redução de erros de medicação em pediatria: prescrição electrónica e participação da farmácia

Erros de medicação são um qualquer acontecimento prevenível que pode causar dano no doente quando os medicamentos se encontram sob a responsabilidade dos profissionais de saúde e podem ocorrer em todo o circuito do medicamento. Afectando todos os doentes, apresentam uma maior incidência e gravidade nos doentes pediátricos pelas suas características fisiológicas e comportamentais próprias desta fase do desenvolvimento. Grande parte destes erros podem ser evitados. Um dos elementos que mais tem contribuído para a redução dos erros de medicação em pediatria tem sido a introdução nos hospitais de sistemas de prescrição electrónica (Computerized Prescription Order Entry - CPOE) que, em associação com um maior envolvimento da farmácia no circuito do medicamento, permite uma redução da ocorrência de erros até 81,3%. Objectivo do estudo: verificar, através de uma revisão da literatura, o contributo da utilização da prescrição electrónica em complemento com outras acções desenvolvidas pela farmácia hospitalar na redução de erros de medicação em unidades pediátricas de cuidados intensivos e de emergência

Acute ischemic preconditioning does not influence high-intensity intermittent exercise performance

This study evaluated the acute effect of ischemic preconditioning (IPC) on a high-intensity intermittent exercise performance and physiological indicators in amateur soccer players. Thirteen players (21.5 ± 2 yrs) attended three trials separated by 3–5 days in a counterbalanced randomized cross-over design: IPC (4 × 5-min occlusion 220 mmHg/reperfusion 0 mmHg) in each thigh; SHAM (similar to the IPC protocol but “occlusion” at 20 mmHg) and control (seated during the same time of IPC). After 6-min of each trial (IPC, SHAM or control), the players performed the YoYo Intermittent Endurance Test level 2 (YoYoIE2). The distance covered in the YoYoIE2 (IPC 867 ± 205 m; SHAM 873 ± 212 m; control 921 ± 206 m) was not different among trials (p = 0.10), furthermore, lactate concentration and rate of perceived exertion did not differ (P > 0.05) among protocols. There were also no significant differences in either mean heart rate (HR) or peak HR (p > 0.05) for both IPC and SHAM compared to control. Therefore, we conclude that acute IPC does not influence high-intensity intermittent exercise performance in amateur soccer players and that rate of perceived exertion, heart rate and lactate do not differ between the intervention IPC, SHAM and control

Comparison of High-Volume and High-Intensity Upper Body Resistance Training on Acute Neuromuscular Performance and Ratings of Perceived Exertion

International Journal of Exercise Science 13(1): 723-733, 2020. The assessment of neuromuscular fatigue is important for minimizing the risks of nonfunctional overreaching, and monitoring training loads has rapidly grown in recent years. The objective of the study was to compare the acute upper body performance and rating of perceived exertion (RPE) responses to high-volume (HV) and high-intensity (HI) resistance-training loads. Sixteen young resistance-trained men (4 repetition maximum [RM] bench press = 105.8 ± 15.9 kg) were divided into two groups of eight subjects each that performed a HI (3 sets of 4RM with 180 s of rest), and a HV (4 sets of 12RM with 90 s of rest) training sessions. Session RPE was obtained 30 min Post. The medicine-ball throw (MBT) performance was measured at pre, and 10 min post. Training volume load (movements × load), and intensity (volume load ÷ movements) were calculated. Volume load was significantly higher for HV (10890 ± 1241 kg) than HI (2718 ± 413 kg) protocol (p \u3c 0.001). Intensity was significantly higher for HI (100.7 ± 15.3 kg) than HV (75.6 ± 8.6 kg) protocol (p = 0.002). MBT performance was significantly reduced from pre- to post- HV (p \u3c 0.001; Δ = −11%), but not in HI (p = 0.15; Δ = −5%). RPE was significantly higher Post-HI (9.9 ± 0.4) than Post HV (8.9 ± 0.8) (p = 0.01). We conclude that higher volume loads induce greater upper body neuromuscular fatigue in young resistance-trained men. Session RPE may reflect training intensity, but not the performance impairments

Tensor-Based Methods for Blind Spatial Signature Estimation in Multidimensional Sensor Arrays

The estimation of spatial signatures and spatial frequencies is crucial for several practical applications such as radar, sonar, and wireless communications. In this paper, we propose two generalized iterative estimation algorithms to the case in which a multidimensional (R-D) sensor array is used at the receiver. The first tensor-based algorithm is an R-D blind spatial signature estimator that operates in scenarios where the source’s covariance matrix is nondiagonal and unknown. The second tensor-based algorithm is formulated for the case in which the sources are uncorrelated and exploits the dual-symmetry of the covariance tensor. Additionally, a new tensor-based formulation is proposed for an L-shaped array configuration. Simulation results show that our proposed schemes outperform the state-of-the-art matrix-based and tensor-based techniques

Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO. Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency. Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions.info:eu-repo/semantics/publishedVersio

Fraqueza muscular adquirida na UTI (ICU-AW): efeitos sistêmicos da eletroestimulação neuromuscular

Com os avanços tecnológicos alcançados atualmente na terapia intensiva e maior sobrevida dos pacientes, outros desafios têm surgido para os profissionais de saúde. Dentre alguns, destaca-se a fraqueza muscular adquirida na UTI (ICU-AW), caracterizada por paresia esquelética e respiratória dos músculos promovendo aumento nastaxas de mortalidade e comprometimento da qualidade de vida. Sua incidência varia de 30% a 60% e tem na síndrome da resposta inflamatória sistêmica (SIRS) e na disfunção de múltiplos órgãos (DMO) sua principal etiologia. Outros fatores de risco como a hiperglicemia,o uso de bloqueadores neuromusculares e sedativos, a imobilidade e a própria ventilação mecânica estão entre os mais comuns. Entre as medidas de combate à ICU-AW, está o conceito de mobilização precoce, bem como despertar diário e controle estreito da glicemia. Nesse contexto, a eletroestimulação muscular apresenta-se como recurso de grande valia. Sua principal vantagem está no fato de poder ser empreendida independentemente da cooperação do paciente, epor ser capaz de gerar respostas musculares eficientes, bem como resultados satisfatórios na preservação da massa muscular, condicionamento físico e funcionalidade dos que usam essa ferramenta. Desfechos interessantes têm sido observados em diversos perfis de pacientes, como os de doença pulmonar obstrutiva crônica (DPOC)e traumatismo raquimedular (TRM). No paciente crítico, seu uso tem mostrado redução nos tempos de ventilação mecânica (VM), internação na UTI e maior funcionalidade dos pacientes. A relevância dos efeitos sistêmicos e metabólicos provenientes da eletroestimulação neuromuscular (ENM) tem sido a base para os estudos nos pacientes críticos. Portanto, a ICU-AW é uma realidade no cenário da terapia intensiva e sua prevenção tem dado margem à aparição de novas propostas e ferramentas na prevenção dessas complicações