Reflexões acerca da proposta pedagógica de Londrina para a educação física

Anais do II Seminário Seminário Estadual PIBID do Paraná: tecendo saberes / organizado por Dulcyene Maria Ribeiro e Catarina Costa Fernandes — Foz do Iguaçu: Unioeste; Unila, 2014Este trabalho teve como objetivo analisar os conteúdos da Proposta Pedagógica da Educação Física adotada pelos professores da Rede Municipal De Ensino de Londrina, mais especificamente aqueles sugeridos para a Educação Infantil, refletindo e discutindo sobre os conteúdos abordados no primeiro bimestre do ano corrente de acordo com o planejamento anual do professor. O estudo foi realizado por meio de uma pesquisa em conjunto com os estudantes do PIBID, com o professor supervisor e orientador. A partir das aulas que assistimos e das pesquisas sobre o conteúdo, tentamos pontuar a o que falta na proposta e ajudar a explicar um conteúdo desta. Concluímos que a proposta é um avanço para a área da Educação Física, pois distribui seus conteúdos propondo que os alunos reflitam sobre eles, mas apesar disso, ainda apresenta uma falta em sua estruturação quanto a um esclarecimento dos conteúdos, por isso o seu processo de reformulação não deve para

Composição da fumaça produzida pelo bisturi elétrico: revisão integrativa da literatura

OBJETIVO Identificar a composição da fumaça produzida pelo uso do bisturi elétrico durante o ato cirúrgico. MÉTODO Revisão integrativa na qual a busca dos estudos primários foi realizada nas bases de dados US National Library of Medicine National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature e Literatura Latino-Americana e do Caribe em Ciências da Saúde, abrangendo estudos publicados entre 2004 e 2014. RESULTADOS A amostra final foi composta por 14 estudos, agrupados em três categorias, hidrocarbonetos policíclicos aromáticos, compostos voláteis e compostos orgânicos voláteis. CONCLUSÃO Há evidências científicas de que a fumaça do bisturi elétrico possui compostos voláteis tóxicos, cancerígenos e mutagênicos, e sua inalação constitui-se em riscos químicos potenciais à saúde dos trabalhadores que estão envolvidos no ato cirúrgico.OBJECTIVE To identify the composition of the smoke produced by electrocautery use during surgery. METHOD Integrative review with search for primary studies conducted in the databases of the US National Library of Medicine National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences, covering the studies published between 2004 and 2014. RESULTS The final sample consisted of 14 studies grouped into three categories, namely; polycyclic aromatic hydrocarbons, volatile compounds and volatile organic compounds. CONCLUSION There is scientific evidence that electrocautery smoke has volatile toxic, carcinogenic and mutagenic compounds, and its inhalation constitutes a potential chemical risk to the health of workers involved in surgeries.OBJETIVO Identificar la composición del humo producido por el empleo del bisturí eléctrico durante el acto quirúrgico. MÉTODO Revisión integradora en la que la búsqueda de los estudios primarios fue llevada a cabo en las bases de datos US National Library of Medicine National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature y Literatura Latinoamericana y del Caribe en Ciencias de la Salud, abarcando estudios publicados entre 2004 y 2014. RESULTADOS La muestra estuvo compuesta de 14 estudios, agrupados en tres categorías: hidrocarburos policíclicos aromáticos, compuestos volátiles y compuestos orgánicos volátiles. CONCLUSIÓN Hay evidencias científicas de que el humo del bisturí eléctrico tiene compuestos volátiles tóxicos, cancerígenos y mutagénicos, y su inhalación se constituye en riesgos químicos potenciales a la salud de los trabajadores que están involucrados en el acto quirúrgico

Hidrocarburos policíclicos aromáticos producidos por el humo del electrocauterio y uso de equipamientos de protección individual

Objective: analyze the concentration of polycyclic aromatic hydrocarbons in electrocautery smoke in operating rooms and the use of personal protective equipment by the intraoperative team when exposed to hydrocarbons. Method: exploratory and cross-sectional field research conducted in a surgery center. Gases were collected by a vacuum suction pump from a sample of 50 abdominal surgeries in which an electrocautery was used. A form was applied to identify the use of personal protective equipment. Gases were analyzed using chromatography. Descriptive statistics and Spearman's test were used to treat data. Results: there were 17 (34%) cholecystectomies with an average duration of 136 minutes, while the average time of electrocautery usage was 3.6 minutes. Airborne hydrocarbons were detected in operating rooms in 100% of the surgeries. Naphthalene was detected in 48 (96.0%) surgeries and phenanthrene in 49 (98.0%). The average concentration of these compounds was 0.0061 mg/m3 and a strong correlation (0.761) was found between them. The intraoperative teams did not use respirator masks such as the N95. Conclusion: electrocautery smoke produces gases that are harmful to the health of the intraoperative team, which is a concern considering the low adherence to the use of personal protective equipment.Objetivo: analizar las concentraciones de hidrocarburos policíclicos aromáticos provenientes del humo del electrocauterio en salas quirúrgicas y el uso de equipamientos de protección individual por parte del equipo intraoperatorio, cuando expuestos a los hidrocarburos. Método: investigación de campo, exploratoria y transversal realizada en un centro quirúrgico. En la muestra, compuesta por 50 cirugías abdominales con uso de electrocauterio, los gases fueron recolectados con una bomba de succión de vacío. Se aplicó un formulario para identificar el uso de los equipamientos de protección. Se realizó la lectura de los gases por medio de cromatografía. Los datos fueron analizados con la estadística descriptiva y el test de Spearman. Resultados: 17 (34%) fueron colecistectomías con tiempo medio quirúrgico de 136 minutos y tiempo medio de uso del electrocauterio de 3,6 minutos. Fueron detectados hidrocarburos en el aire de las salas de operación en 100% de las cirugías. Se detectó el naftaleno en 48 (96,0%) cirugías y el fenantreno en 49 (98,0%). Las concentraciones promedio de esos compuestos fueron de 0,0061 mg/m3. Hubo correlación (0,761) fuerte entre estos compuestos. El equipo intraoperatorio no utilizó máscaras respiratorias, como la N95. Conclusión: el humo del electrocauterio produce gases perjudiciales para la salud del equipo intraoperatorio que se encuentra expuesto debido a la baja adhesión al uso de equipamientos de protección individual, tornando preocupante esta exposición.Objetivos: analisar as concentrações de hidrocarbonetos policíclicos aromáticos provenientes da fumaça do eletrocautério em salas cirúrgicas e o uso de equipamentos de proteção individual pela equipe intraoperatória quando expostos aos hidrocarbonetos. Método: pesquisa de campo, exploratória e transversal realizada em um centro cirúrgico. Na amostra composta por 50 cirurgias abdominais com uso de eletrocautério, os gases foram coletados por bomba de sucção a vácuo. Um formulário foi aplicado para identificar o uso dos equipamentos de proteção. Realizou-se a leitura dos gases por cromatografia. Os dados foram analisados por estatística descritiva e teste de Spearman. Resultados: 17 (34%) foram as colecistectomias com tempo médio cirúrgico de 136 minutos e tempo médio de uso do eletrocautério de 3,6 minutos. Hidrocarbonetos foram detectados no ar das salas operatórias em 100% dos atos cirúrgicos. Detectou-se o naftaleno em 48 (96,0%) cirurgias e o fenantreno em 49 (98,0%). As concentrações médias desses compostos foram de 0,0061 mg/m3. Houve correlação (0,761) forte entre estes compostos. A equipe intraoperatória não utilizou máscaras respiratórias, como a N95. Conclusão: a fumaça do eletrocautério produz gases prejudiciais à saúde da equipe intraoperatória exposta e diante da baixa adesão ao uso de equipamentos de proteção individual, tornando-se preocupante esta exposição

Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study.

BACKGROUND: A Zika virus epidemic emerged in northeast Brazil in 2015 and was followed by a striking increase in congenital microcephaly cases, triggering a declaration of an international public health emergency. This is the final report of the first case-control study evaluating the potential causes of microcephaly: congenital Zika virus infection, vaccines, and larvicides. The published preliminary report suggested a strong association between microcephaly and congenital Zika virus infection. METHODS: We did a case-control study in eight public maternity hospitals in Recife, Brazil. Cases were neonates born with microcephaly, defined as a head circumference of 2 SD below the mean. Two controls without microcephaly were matched to each case by expected date of delivery and area of residence. We tested the serum of cases and controls and the CSF of cases for detection of Zika virus genomes with quantitative RT-PCR and for detection of IgM antibodies with capture-IgM ELISA. We also tested maternal serum with plaque reduction neutralisation assays for Zika and dengue viruses. We estimated matched crude and adjusted odds ratios with exact conditional logistic regression to determine the association between microcephaly and Zika virus infection. FINDINGS: We screened neonates born between Jan 15 and Nov 30, 2016, and prospectively recruited 91 cases and 173 controls. In 32 (35%) cases, congenital Zika virus infection was confirmed by laboratory tests and no controls had confirmed Zika virus infections. 69 (83%) of 83 cases with known birthweight were small for gestational age, compared with eight (5%) of 173 controls. The overall matched odds ratio was 73·1 (95% CI 13·0-∞) for microcephaly and Zika virus infection after adjustments. Neither vaccination during pregnancy or use of the larvicide pyriproxyfen was associated with microcephaly. Results of laboratory tests for Zika virus and brain imaging results were available for 79 (87%) cases; within these cases, ten were positive for Zika virus and had cerebral abnormalities, 13 were positive for Zika infection but had no cerebral abnormalities, and 11 were negative for Zika virus but had cerebral abnormalities. INTERPRETATION: The association between microcephaly and congenital Zika virus infection was confirmed. We provide evidence of the absence of an effect of other potential factors, such as exposure to pyriproxyfen or vaccines (tetanus, diphtheria, and acellular pertussis, measles and rubella, or measles, mumps, and rubella) during pregnancy, confirming the findings of an ecological study of pyriproxyfen in Pernambuco and previous studies on the safety of Tdap vaccine administration during pregnancy. FUNDING: Brazilian Ministry of Health, Pan American Health Organization, and Enhancing Research Activity in Epidemic Situations

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt