EVIDENCIA ADICIONAL DE VALIDEZ DE LA ESCALA DE ANSIEDAD POR CORONAVIRUS (CAS) EN UNA MUESTRA DE MUJERES BRASILEÑAS

Em 2020, a Organização Mundial da Saúde (OMS) declarou a pandemia da COVID-19 e trabalhadores ajustaram as atividades laborais para a forma remota. O excesso de informações sobre a COVID-19 e a intensa exposição a situações de sofrimentos podem provocar o aumento da ansiedade. Diante disso, urge identificar grupos de alto risco de impactos psicológicos, tais como as mulheres, a fim de direcionar tratamentos. Logo, objetivou-se buscar evidências adicionais de validade da escala, consistência interna e correlação com outras variáveis, da Coronavirus Anxiety Scale (CAS-BR) em mulheres brasileiras. As correlações foram verificadas entre a ansiedade frente à COVID-19 e o estresse percebido, mesurado pela Escala de Estresse Percebido, e a resiliência, avaliada pela Escala Breve de Coping Resiliente. Participaram deste estudo 203 mulheres brasileiras com idades entre 23 e 59 anos, majoritariamente da região sudeste (61,1% de Minas Gerais, 17,7% do Rio de Janeiro). Realizou-se a análise fatorial confirmatória, através da modelagem de equações estruturais, utilizando-se o software MPLUS. A escala apresentou bons índices de ajustes (x² =12,909 (5); CFI =0,997 TLI = 0.994; RMSEA = 0,088). As cargas fatoriais foram excelentes e variaram de 0,84 a 0,91, enquanto a consistência interna do instrumento avaliada pelo Alfa de Cronbach foi de 0,91. Conclui-se que a escala tem propriedades psicométricas adequadas e sugere-se o seu uso para avaliar os níveis de ansiedade frente ao coronavírus de mulheres no território brasileiro.In 2020, the World Health Organization (WHO) declared the COVID-19 pandemic and workers adjusted their work activities to the remote form. Excessive information about COVID-19 and intense exposure to situations of suffering can lead to increased anxiety. Therefore, it is urgent to identify groups at high risk of psychological impacts, such as women, in order to target treatments. Therefore, the objective was to seek additional evidence of scale validity, internal consistency and correlation with other variables of the Coronavirus Anxiety Scale (CAS-BR) in the Brazilian mothers. Correlations were verified between anxiety regarding COVID-19 and perceived stress, measured by the Perceived Stress Scale, and resilience, assessed by the Brief Resilient Coping Scale. 203 Brazilian women aged between 23 and 59 years, mostly from the Southeast region (61.1% from Minas Gerais, 17.7% from Rio de Janeiro) participated in this study. Confirmatory factor analysis was carried out through structural equation modeling, using the MPLUS software. The scale showed good fit indices (x² =12.909 (5); CFI =0.997 TLI = 0.994; RMSEA = 0.088). The factor loading were excellent and ranged from 0.84 to 0.91, while the instrument's internal consistency assessed by Cronbach's alpha was 0.91. It is concluded that the scale has adequate psychometric properties, and its use is suggested to assess the levels of anxiety regarding the coronavirus of women in Brazilian territory.En 2020, la Organización Mundial de la Salud (OMS) declaró la pandemia de COVID-19 y los trabajadores ajustaron sus actividades laborales a la forma remota. La información excesiva sobre COVID-19 y la exposición intensa a situaciones de sufrimiento pueden provocar un aumento de la ansiedad. Por lo tanto, es urgente identificar a los grupos con alto riesgo de impactos psicológicos, como las mujeres, para orientar los tratamientos. Por lo tanto, el objetivo fue buscar evidencia adicional de validez de escala, consistencia interna y correlación con otras variables de la Escala de Ansiedad por Coronavirus (CAS-BR) en madres brasileñas. Se verificaron correlaciones entre la ansiedad respecto al COVID-19 y el estrés percibido, medido por la Escala de Estrés Percibido, y la resiliencia, evaluada por la Escala Breve de Afrontamiento Resiliente. Participaron en este estudio un total de 203 mujeres brasileñas de entre 23 y 59 años, en su mayoría de la región Sudeste (61,1% de Minas Gerais, 17,7% de Rio de Janeiro). El análisis factorial confirmatorio se realizó mediante el modelado de ecuaciones estructurales, utilizando el software MPLUS. La escala mostró índices de buen ajuste (x² = 12,909 (5); CFI = 0,997 TLI = 0,994; RMSEA = 0,088). Las cargas factoriales fueron excelentes y variaron de 0,84 a 0,91, mientras que la consistencia interna del instrumento evaluada por el alfa de Cronbach fue de 0,91. Se concluye que la escala tiene propiedades psicométricas adecuadas y se sugiere su uso para evaluar los niveles de ansiedad ante el coronavirus de mujeres en territorio brasileño

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

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 &lt; 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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

RESIDUAL ROOT BURIAL IN PATIENT WITH A HISTORICAL OF HEAD AND NECK CANCER: CASE REPORT

Radiotherapy reduces the tissue vascularization potential. Therefore, tooth extraction in irradiated patients has a high risk of osteoradionecrosis. This case report described endodontic treatment followed by residual root burial of two mandibular teeth in a patient undergoing radiotherapy. A 60-year-old female patient underwent radiotherapy in 2018 for the treatment of oropharyngeal squamous cell carcinoma. Teeth 43 and 44 had extensive coronal destruction and indication for tooth extraction. Anesthesia, rubber dam isolation, access to the root canals, negotiation and patency with a #15 K-file (Dentsply) were performed. After electronic odontometry, mechanical preparation was performed with R50 instrument of the Reciproc system (VDW) and irrigation with ultrasonic-activated 2.5% sodium hypochlorite solution.&nbsp; Calcium hydroxide was used as intracanal dressing. After 15 days, the intracanal dressing was removed, and final irrigation with 17% EDTA and 2.5% sodium hypochlorite solution was performed.&nbsp; The root canals were dried with absorbent paper points.&nbsp; Root canal obturation was performed by the lateral condensation technique with epoxy resin-based cement (AH Plus, Dentsply). The entrance of the root canals was sealed with composite resin and residual root burial was performed for subsequent rehabilitation with a lower complete denture. After 12 months of follow-up, the patient was asymptomatic and the periapical region did not present areas of bone rarefaction. Endodontic treatment was successful and it should be indicated in patients undergoing radiotherapy in order to avoid tooth extraction and the development of osteoradionecrosis

ATLANTIC BIRD TRAITS: a data set of bird morphological traits from the Atlantic forests of South America

Scientists have long been trying to understand why the Neotropical region holds the highest diversity of birds on Earth. Recently, there has been increased interest in morphological variation between and within species, and in how climate, topography, and anthropogenic pressures may explain and affect phenotypic variation. Because morphological data are not always available for many species at the local or regional scale, we are limited in our understanding of intra- and interspecies spatial morphological variation. Here, we present the ATLANTIC BIRD TRAITS, a data set that includes measurements of up to 44 morphological traits in 67,197 bird records from 2,790 populations distributed throughout the Atlantic forests of South America. This data set comprises information, compiled over two centuries (1820–2018), for 711 bird species, which represent 80% of all known bird diversity in the Atlantic Forest. Among the most commonly reported traits are sex (n = 65,717), age (n = 63,852), body mass (n = 58,768), flight molt presence (n = 44,941), molt presence (n = 44,847), body molt presence (n = 44,606), tail length (n = 43,005), reproductive stage (n = 42,588), bill length (n = 37,409), body length (n = 28,394), right wing length (n = 21,950), tarsus length (n = 20,342), and wing length (n = 18,071). The most frequently recorded species are Chiroxiphia caudata (n = 1,837), Turdus albicollis (n = 1,658), Trichothraupis melanops (n = 1,468), Turdus leucomelas (n = 1,436), and Basileuterus culicivorus (n = 1,384). The species recorded in the greatest number of sampling localities are Basileuterus culicivorus (n = 243), Trichothraupis melanops (n = 242), Chiroxiphia caudata (n = 210), Platyrinchus mystaceus (n = 208), and Turdus rufiventris (n = 191). ATLANTIC BIRD TRAITS (ABT) is the most comprehensive data set on measurements of bird morphological traits found in a biodiversity hotspot; it provides data for basic and applied research at multiple scales, from individual to community, and from the local to the macroecological perspectives. No copyright or proprietary restrictions are associated with the use of this data set. Please cite this data paper when the data are used in publications or teaching and educational activities. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ