Network management in acute stroke care: integrative literature review

O objetivo deste artigo é analisar as publicações científicas sobre a gestão em rede no atendimento ao paciente com acidente vascular cerebral agudo, considerando as tecnologias implantadas e suas consequências para a atuação da equipe. Foi feita uma revisão integrativa de literatura, operacionalizada nas seguintes bases de dados: PubMed/Medline, Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde e no Índice Bibliográfico Espanhol de Ciências da Saúde, de 2008 a 2022, com sintaxe de palavras-chave para cada base. A análise dos dados foi realizada por meio da similaridade de conteúdo, sendo posteriormente elaboradas as categorias. Foram selecionados 46 artigos para análise, um nacional e os demais publicados em periódicos estrangeiros. Ressaltam-se as tecnologias empregadas para ampliar a gestão em rede na atenção ao paciente com Acidente Vascular Cerebral isquêmico agudo, como a conexão entre serviços por fluxos e protocolos, por meio da regionalização, da telemedicina e de plataforma de smartphone, com a ampliação das funções da equipe intervencionista móvel, ou por elementos integradores, como a prénotificação hospitalar.This article aims to analyze the scientific publications on network management in the care of patients with acute stroke, considering the technologies implemented and their consequences for the team’s performance. An integrative literature review was carried out, operationalized in the databases: PubMed/MEDLINE, Scopus, Latin American and Caribbean Literature in Health Sciences, and Spanish Bibliographical Index of Health Sciences, from 2008 to 2022, with keyword syntax keys for each base. Data analysis was carried out by similarity of content, and categories were subsequently elaborated. A total of 46 articles were selected for analysis, one national and the others published in foreign journals. The technologies employed to expand network management in the care of patients with acute ischemic stroke are highlighted, such as the connection between services by flows and protocols, by regionalization, telemedicine, and smartphone platform, with the expansion of functions of the mobile interventional team or by integrating elements, such as hospital pre-notification

CARACTERIZAÇÃO DO ATENDIMENTO DO SERVIÇO DE ATENDIMENTO MÓVEL DE URGÊNCIA (SAMU) ÀS EMERGÊNCIAS CLÍNICAS

RESUMO Objetivo: caracterizar os atendimentos clínicos realizados pelo SAMU de Salvador. Metodologia: trata-se de estudo descritivo, exploratório e transversal cuja amostra foi composta de 465 fichas de atendimentos clínicos realizados pelo SAMU, na cidade de Salvador na Bahia. Os dados foram obtidos por meio de instrumento de coleta de dados e a análise descritiva realizada com o software SPSS, no qual foram processadas frequências relativas e absolutas. Resultados: os usuários atendidos se caracterizaram por serem homens (49,9%) com média de idade de 54 anos [desvio-padrão (DP)=21)]. Os agravos neurológicos (36,1%), cardiológicos (14,4%) e respiratórios (12,9%) foram prevalentes. Unidades de suporte básico foram as mais acionadas (63,7%) e tiveram como principal desfecho o atendimento no local e remoção para um hospital de referência (21,7%), no entanto, recursos como oxigenoterapia e punção venosa não foram utilizados na maior parte dos atendimentos. A média de tempo entre a abertura da ocorrência e saída da base foi de 22 minutos (DP= 20). O tempo resposta teve média de 39 minutos (DP= 25) e a duração total média da ocorrência foi de duas horas (DP= 1:23). Conclusão: os atendimentos clínicos realizados pelo SAMU ocorrem prevalentemente com homens e por agravos neurológicos. Identificou-se discordância entre a necessidade dos pacientes e o envio de recursos, mediante a avaliação da equipe. Os tempos implicados no atendimento pré-hospitalar são elevados

Impacto do tratamento profilático no manejo da Asma

Asma é uma doença prevalente e que, se não tratada, apresenta elevada morbidade. É comumente diagnosticada na infância e necessita de cuidados para manejo e controle. O presente trabalho avaliou o perfil dos pacientes asmáticos que necessitam de atendimento em serviço de urgência, o impacto da educação em asma quanto ao manejo da pré-crise e uso de profilaxia em relação à internação e busca de atendimento de urgência devido a essa doença. Trata-se de estudo descritivo, realizado a partir de uma amostra de conveniência, abrangendo crianças e adolescentes de 2 a 14 anos, com diagnóstico de asma, recrutados no pronto atendimento do Hospital Municipal Odilon Behrens no período de janeiro a agosto de 2022. Aplicou-se um questionário aos pais e responsáveis desses pacientes acerca do manejo da pré-crise, uso de medicação profilática, internações prévias e sinais de procura ao serviço de urgência. Quando não se utiliza medicação de profilaxia a necessidade de internação aumenta 69,6% e a necessidade de admissão em CTI aumenta 92,8%. Enquanto que com uso de profilaxia, a admissão em CTI cai para 42,8%. Concluiu-se que há um desfecho desfavorável nos que não utilizaram ou souberam manusear a medicação profilática

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

New Lager Brewery Strains obtained by crossing techniques using cachaça (Brazilian Spirit) yeasts

The development of hybrids has been an effective approach to generate novel yeast strains with optimal technological profile for use in beer production. This study describes the generation of a new yeast strain for lager beer production by direct mating between two Saccharomyces cerevisiae strains isolated from cachaça distilleries: one that was strongly flocculent, and the other with higher production of acetate esters. The first step in this procedure was to analyze the sporulation ability and reproductive cycle of strains belonging to a specific collection of yeasts isolated from cachaça fermen- tation vats. Most strains showed high rates of sporulation, spore viability, and homothal- lic behavior. In order to obtain new yeast strains with desirable properties useful for la- ger beer production, we compare haploid-to-haploid and diploid-to-diploid mating procedures. Moreover, an assessment of parental phenotype traits showed that the seg- regant diploid C2-1d generated from a diploid-to-diploid mating experiment showed good fermentation performance at low temperature, high flocculation capacity, and de- sirable production of acetate esters that was significantly better than that of one type la- ger strain. Therefore, strain C2-1d might be an important candidate for the production of lager beer, with distinct fruit traces and originating using a non-genetically modified organism (GMO) approach. Recent work has suggested the utilization of hybridization techniques for the generation of novel non-genetically modified brewing yeast strains with combined properties not commonly found in a unique yeast strain. We have observed remarkable traits, especially low temperature tolerance, maltotriose utilization, flocculation ability, and production of volatile aroma compounds, among a collection of Saccharomyces cerevisiae strains isolated from cachaça distilleries, which allow their utilization in the production of beer. The significance of our research is in the use of breeding/hybridization techniques to generate yeast strains that would be appropriate for producing new lager beers by exploring the capacity of cachaça yeast strains to flocculate and to ferment maltose at low temperature, with the concomitant production of flavoring compounds

Neotropical xenarthrans: a dataset of occurrence of xenarthran species in the Neotropics.

International audienceXenarthrans—anteaters, sloths, and armadillos—have essential functions forecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosys-tem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts withdomestic dogs, these species have been threatened locally, regionally, or even across their fulldistribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths.Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae(3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data onDasypus pilo-sus(Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized,but new genetic studies have revealed that the group is represented by seven species. In thisdata paper, we compiled a total of 42,528 records of 31 species, represented by occurrence andquantitative data, totaling 24,847 unique georeferenced records. The geographic range is fromthe southern United States, Mexico, and Caribbean countries at the northern portion of theNeotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regardinganteaters,Myrmecophaga tridactylahas the most records (n=5,941), andCyclopessp. havethe fewest (n=240). The armadillo species with the most data isDasypus novemcinctus(n=11,588), and the fewest data are recorded forCalyptophractus retusus(n=33). Withregard to sloth species,Bradypus variegatushas the most records (n=962), andBradypus pyg-maeushas the fewest (n=12). Our main objective with Neotropical Xenarthrans is to makeoccurrence and quantitative data available to facilitate more ecological research, particularly ifwe integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, andNeotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure,habitat loss, fragmentation effects, species invasion, and climate change effects will be possiblewith the Neotropical Xenarthrans data set. Please cite this data paper when using its data inpublications. We also request that researchers and teachers inform us of how they are usingthese data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data