Principais complicações apresentadas por pacientes diagnosticados com COVID-19: revisão integrativa

It was aimed to highlight and identify the main complications after infection by COVID-19 reported in the scientific literature. It is an integrative review of the literature. To achieve scientific production on the chosen theme, the Virtual Health Library (BVS) and the Databases: Medical Literature Analysis and Retrieval System Online (Medline), Latin American and Caribbean in the Caribbean in the search was used as a search. Health Sciences (Lilacs) and Pubmed. A total of 30 articles was obtained. After application of the inclusion and exclusion, reading and analysis criteria of the studies, 10 articles were reached for the construction of this review. Studies showed cardiovascular, renal, neurological, respiratory, liver, hematological, metabolic, functional and psychological complications. These include: ischemic injury of myocardial, pericarditis, renal failure, hematuria, proteinuria, stroke, yearsia, bronchopneumonia, bronchial mucosal edema, alterations in liver enzymes, venous thromboembolism, metabolic disorders, functional and psychological impairment. It is concluded that COVID-19 has high relevance during the appearance and development of its complications. We do not yet know how long these complications can reach patients if sequelae are temporary or definitive. Thus, the Unified Health System is prepared to continue watching these individuals.Objetivou-se evidenciar e identificar as principais complicações pós infecção pela COVID-19 relatadas na literatura científica. Trata-se de uma revisão Integrativa da literatura. Para alcançar a produção científica sobre a temática escolhida, utilizou-se como fonte de busca a Biblioteca Virtual em Saúde (BVS) e as bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e PubMed. Obteve-se uma totalidade de 30 artigos. Após aplicação dos critérios de inclusão e exclusão, leitura e análise dos estudos, chegou-se ao número de 10 artigos para a construção da presente revisão. Os estudos evidenciaram complicações  cardiovasculares, renais, neurológicas, respiratórias, hepáticas, hematológica, metabólicas, funcionais e psicológicas. Dentre elas, destacam-se: lesão isquêmica do miocárdio, pericardite, insuficiência renal, hematúria, proteinúria, acidente vascular cerebral, anosmia, broncopneumonia, edema de mucosa brônquica, alterações na enzimas hepáticas, tromboembolismo venoso, disfunções metabólicas, comprometimento funcional e psicológico. Conclui-se que a COVID-19 possui alta relevância durante o aparecimento e desenvolvimento de suas complicações. Ainda  não sabemos após quanto tempo  essas complicações podem atingir os pacientes, se as sequelas são temporárias ou definitivas. Assim, o  Sistema Único de Saúde precisa está preparado para continuar assistindo estes indivíduos

Vivência de enfermeiros em unidade de terapia intensiva destinada a pacientes com COVID-19: relato de experiência

The aim was to report the performance of nurses in Adult Intensive Care Units at this time of pandemic. This is an experience report, of a descriptive type, with a qualitative approach, based on the experience of nurses, in the current moment of pandemic, in relation to time, the research is delimited from the practices and assistance of these professionals in a Health Unit. Exclusive Intensive Care for patients diagnosed with COVID-19, from February to July 2021. Continuing and continuing education in health is essential for the quality of care provided in the care of patients with SARS-CoV-2. Maintaining a communication relationship between the multidisciplinary teams is very important in view of the experienced scenario. The pandemic scenario has a framework of great challenges for the entire population, referring to nursing professionals, care actions, care practices, training, remodeling of work management. However, the preparation of professionals with knowledge about: the new disease COVID-19, critically ill patients and the use of new technologies is notorious, as well as providing a suitable workplace.Objetivou-se relatar a atuação de enfermeiros de Unidades de Terapia Intensiva Adulto neste momento de pandemia. Trata-se de um relato de experiência, do tipo descritivo, com abordagem qualitativa, baseado na experiência de enfermeiros, no atual momento de pandemia, em relação ao tempo, a pesquisa delimita-se a partir das práticas e assistência destes profissionais em Unidade de Terapia Intensiva exclusiva para pacientes diagnosticados com COVID-19, período de fevereiro a julho do ano de 2021. A educação continuada e permanente em saúde é imprescindível para qualidade da assistência prestada no atendimento ao paciente com SARS-CoV-2. Manter entre as equipes multiprofissionais uma relação de comunicação é muito importante diante do cenário experienciado. O cenário pandêmico tem um marco de grandes desafios para toda população, referente aos profissionais de enfermagem, as ações de cuidado, das práticas assistenciais, treinamentos, remodelação da gestão de trabalho. Contudo é notório a preparação dos profissionais com conhecimentos sobre:  a nova doença COVID-19, pacientes críticos e o uso das novas tecnologias como também proporcionar um local de trabalho adequado

Vivência de enfermeiros em unidade de terapia intensiva destinada a pacientes com COVID-19: relato de experiência

The aim was to report the performance of nurses in Adult Intensive Care Units at this time of pandemic. This is an experience report, of a descriptive type, with a qualitative approach, based on the experience of nurses, in the current moment of pandemic, in relation to time, the research is delimited from the practices and assistance of these professionals in a Health Unit. Exclusive Intensive Care for patients diagnosed with COVID-19, from February to July 2021. Continuing and continuing education in health is essential for the quality of care provided in the care of patients with SARS-CoV-2. Maintaining a communication relationship between the multidisciplinary teams is very important in view of the experienced scenario. The pandemic scenario has a framework of great challenges for the entire population, referring to nursing professionals, care actions, care practices, training, remodeling of work management. However, the preparation of professionals with knowledge about: the new disease COVID-19, critically ill patients and the use of new technologies is notorious, as well as providing a suitable workplace.Objetivou-se relatar a atuação de enfermeiros de Unidades de Terapia Intensiva Adulto neste momento de pandemia. Trata-se de um relato de experiência, do tipo descritivo, com abordagem qualitativa, baseado na experiência de enfermeiros, no atual momento de pandemia, em relação ao tempo, a pesquisa delimita-se a partir das práticas e assistência destes profissionais em Unidade de Terapia Intensiva exclusiva para pacientes diagnosticados com COVID-19, período de fevereiro a julho do ano de 2021. A educação continuada e permanente em saúde é imprescindível para qualidade da assistência prestada no atendimento ao paciente com SARS-CoV-2. Manter entre as equipes multiprofissionais uma relação de comunicação é muito importante diante do cenário experienciado. O cenário pandêmico tem um marco de grandes desafios para toda população, referente aos profissionais de enfermagem, as ações de cuidado, das práticas assistenciais, treinamentos, remodelação da gestão de trabalho. Contudo é notório a preparação dos profissionais com conhecimentos sobre:  a nova doença COVID-19, pacientes críticos e o uso das novas tecnologias como também proporcionar um local de trabalho adequado

The inventory of geological heritage of the state of São Paulo, Brazil: Methodological basis, results and perspectives

An inventory of geological sites based on solid and clear criteria is a first step for any geoconservation strategy. This paper describes the method used in the geoheritage inventory of the State of São Paulo, Brazil, and presents its main results. This inventory developed by the geoscientific community aimed to identify geosites with scientific value in the whole state, using a systematic approach. All 142 geosites representative of 11 geological frameworks were characterised and quantitatively evaluated according to their scientific value and risk of degradation, in order to establish priorities for their future management. An online database of the inventory is under construction, which will be available to be easily consulted and updated by the geoscientific community. All data were made available to the State Geological Institute as the backbone for the implementation of a future state geoconservation strategy.The authors acknowledge the Science Without Borders Programme, Process 075/2012, which supported this study and the São Paulo Research Foundation (FAPESP), Process 2011/17261-6. We also thanks C. Mazoca for his help with maps and figures.info:eu-repo/semantics/acceptedVersio

Higher Protein Intake Does Not Improve Lean Mass Gain When Compared with RDA Recommendation in Postmenopausal Women Following Resistance Exercise Protocol: A Randomized Clinical Trial

The aim of this study was to evaluate the effect of a higher protein intake on lean body mass (LBM) gain in postmenopausal women practicing resistance exercise and compare it to the Recommended Dietary Allowance (RDA) recommendation. Twenty-three postmenopausal women (63.2 ± 7.8 years) were randomized into two groups. The group with higher protein intake (n = 11) (HP) received a dietary plan with ~1.2 g·kg−1·day−1 of protein, while the normal protein (NP) group (n = 12) was instructed to ingest ~0.8 g·kg−1·day−1 of protein (RDA recommendation). Both groups performed the same resistance training protocol, 3 times a week, with progression of the number of sets (from 1 to 6 sets) and 8–12 repetitions. The intervention occurred over 10 weeks. Body composition evaluation was performed by dual-energy X-ray absorptiometry. The diet was evaluated by nine 24-h food recall summaries over the course of the study. During the intervention period, the HP group presented a higher protein (1.18 ± 0.3 vs. 0.87 ± 0.2 g·kg−1·day−1, p = 0.008) and leucine (6.0 ± 1.4 vs. 4.3 ± 0.9 g/day, p < 0.001) intake than the NP group, respectively. At the end of the intervention, there were increases in LBM both in HP (37.1 ± 6.2 to 38.4 ± 6.5 kg, p = 0.004) and in NP (37.6 ± 6.2 to 38.8 ± 6.4 kg, p < 0.001), with no differences between the groups (p = 0.572). In conclusion, increased protein intake did not promote higher LBM gain when compared to RDA recommendation in postmenopausal women performing resistance exercise during 10 weeks. This trial was registered at ClinicalTrials.gov as NCT03024125

Importância da avaliação bioquímica mensal na triagem de pacientes com desnutrição em hemodiálise

INTRODUÇÃO: A desnutrição é uma complicação frequente nos pacientes em hemodiálise, sendo o diagnóstico precoce importante para reduzir as taxas de morbidade e mortalidade do tratamento. OBJETIVO: Investigar a utilidade dos exames bioquímicos mensais realizados na hemodiálise para triagem de pacientes com desnutrição. MÉTODOS: O diagnóstico nutricional de 252 pacientes foi feito através da avaliação objetiva e subjetiva global, classificando-os em desnutridos e não desnutridos. Paralelamente, durante 4 meses consecutivos, as concentrates de creatinina, fósforo, ureia pré-e pósdiálise e o Kt/V foram registradas para cálculo das médias. Após análise dessas variáveis através da curva ROC, calculouse a sensibilidade e a especificidade na identificação dos pacientes com desnutrição. RESULTADOS: Na curva ROC, a área sob a curva para a ureia foi de 0,683, para o fósforo 0,71, para o Kt/V 0,724 e para a creatinina 0,765. Para valores de ureia < 90 mg/dL; fósforo < 4,2 mg/dL; Kt/V > 1,6 e creatinina < 6,5 mg/dL, a especificidade variou entre 80% e 88% e a sensibilidade entre 26 % e 51% . O valor preditivo negativo variou entre 90% e 92% e o valor preditivo positivo entre 23% e 32%. A associação de dois ou mais desses índices não modificou de forma significante esses valores. CONCLUSÕES: Nossos resultados sugerem que valores de ureia < 90 mg/dL, creatinina < 6,5 mg/dL, fósforo < 4,2 mg/dL e Kt/V > 1,6 podem ser utilizados para triagem de pacientes com desnutrição

Moderate Increase in Protein Intake Promotes a Small Additional Improvement in Functional Capacity, But Not in Muscle Strength and Lean Mass Quality, in Postmenopausal Women Following Resistance Exercise: A Randomized Clinical Trial

The aim of this study was to evaluate the effect of a moderate increase in protein intake on muscle strength, functional capacity and lean mass quality improvements in postmenopausal women following resistance exercise. Forty-seven postmenopausal women were randomized in two groups: Normal protein (NP, n = 25), who received a dietary plan containing ~0.8 g protein&middot;kg&minus;1&middot;d&minus;1 (recommended dietary allowance&mdash;RDA recommendations); and higher protein (HP, n = 22), which a moderate increase in protein intake was recommended (~1.2 g protein&middot;kg&minus;1&middot;d&minus;1). Resistance training was performed for 10 weeks, three times/week. Muscle strength (handgrip strength and one repetition maximum test&mdash;1-RM), functional capacity and lean mass (LM) quality (muscle strength to lean mass ratio) were evaluated. Dietary intake was assessed by nine 24 h food recalls. After intervention, both groups increased similarly the leg extension 1-RM and handgrip strength. Regarding functional capacity tests, both groups increased the balance test score (SPPB) and 10 m walk test speed, with no differences between the groups. In addition, an increase in speed to perform the 6 min and 400 m walk tests was observed over the time, with an additional improvement in the HP group (time &times; group interaction; p = 0.007 and p = 0.004, respectively). About LM quality, leg extension 1-RM/leg LM improved over the time in both groups (p = 0.050), with no time &times; group interaction. All these significant changes had a low effect size. In conclusion, a moderate increase in protein intake promoted a small additional improvement in functional capacity, but it did not induce a greater increase in strength and LM quality after 10 weeks of resistance exercise in postmenopausal women. This trial was registered at ClinicalTrials.gov as NCT03024125

A Low-protein Diet During Pregnancy Prevents Modifications In Intercellular Communication Proteins In Rat Islets.

Gap junctions between β-cells participate in the precise regulation of insulin secretion. Adherens junctions and their associated proteins are required for the formation, function and structural maintenance of gap junctions. Increases in the number of the gap junctions between β-cells and enhanced glucose-stimulated insulin secretion are observed during pregnancy. In contrast, protein restriction produces structural and functional alterations that result in poor insulin secretion in response to glucose. We investigated whether protein restriction during pregnancy affects the expression of mRNA and proteins involved in gap and adherens junctions in pancreatic islets. An isoenergetic low-protein diet (6% protein) was fed to non-pregnant or pregnant rats from day 1-15 of pregnancy, and rats fed an isocaloric normal-protein diet (17% protein) were used as controls. The low-protein diet reduced the levels of connexin 36 and β-catenin protein in pancreatic islets. In rats fed the control diet, pregnancy increased the levels of phospho-[Ser(279/282)]-connexin 43, and it decreased the levels of connexin 36, β-catenin and beta-actin mRNA as well as the levels of connexin 36 and β-catenin protein in islets. The low-protein diet during pregnancy did not alter these mRNA and protein levels, but avoided the increase of levels of phospho-[Ser(279/282)]-connexin 43 in islets. Insulin secretion in response to 8.3 mmol/L glucose was higher in pregnant rats than in non-pregnant rats, independently of the nutritional status. Short-term protein restriction during pregnancy prevented the Cx43 phosphorylation, but this event did not interfer in the insulin secretion.48