A inclusão da tecnologia móvel em prontuários de consultórios obstétricos

A equipe médica obstétrica tem necessitado de equipamentos que agilizem suas consultas e suas anotações específicas de cada paciente e seu quadro evolutivo gestacional, estas anotações são os prontuários médicos. Essa necessidade surgiu devido à procura de médicos obstetras que fazem o acompanhamento de gestantes, onde toda informação coletada nesta fase é crucial para um parto sem complicações, seja este normal ou cesário. Palavras-Chaves: Prontuário Obstétrico, Pré-Natal, PDA obstétrico

Attitudes towards Vaccinations in a National Italian Cohort of Patients with Inflammatory Bowel Disease

Background: The vaccination status of patients with inflammatory bowel disease (IBD) should be investigated before starting any treatment, and patients should eventually be vaccinated against vaccine-preventable diseases (VPDs). Patients with IBD may have suboptimal vaccination rates. The aim of this study was to evaluate the vaccination coverage, attitude towards vaccinations, and determinants among an Italian cohort of patients with IBD.Methods: AMICI, the Italian IBD patients' association, sent an anonymous web-based questionnaire in February 2021. Previous vaccination status and patients' attitudes towards vaccinations were recorded. We examined the factors influencing their attitudes using crude and adjusted odds ratios (adjORs) with 95% confidence intervals (CIs).Results: Among the 4039 patients invited, 1252 patients (including 729 women, median age 47.7 [37-58]) completed the questionnaire, with a response rate of 25.3%. Respondents declared being vaccinated against tetanus (74.1%), flu (67.7%; last season), MMR (43.3%), HBV (37.1%), pneumococcus (29.1%), meningitis (20%), HAV (16%), VZV (15.3%), and HPV (7.6%). Complete vaccination history was not remembered by 20.7% of the patients. One thousand one hundred and twelve (88.8%) expressed a positive attitude towards vaccination, 91 (7.3%) were indifferent, and 49 (3.9%) reported being opposed to vaccinations. The belief of a possible return of VPDs with a decline in vaccination coverage rates was the factor most strongly related to a positive attitude towards vaccinations (adjOR 5.67, 95% CI 3.45-9.30, p-value < 0.001).Conclusions: A low vaccination rate against some VPDs was found among a national cohort of patients with IBD, despite a generally positive attitude towards vaccinations

O Museu de Telecomunicações de Pelotas: a trajetória de um projeto

O Museu de Telecomunicações UFPEL - CEFET, Pelotas, tem como seu objetivo principal estabelecer o diálogo entre o passado e o presente, ou seja, uma proposta museológica centrada no processo histórico das telecomunicações e as novas tecnologias do presente. O museu, concebido como um espaço onde história e tecnologia andam juntas, é portanto um espaço da curiosidade, pesquisa e aprendizado

Mandibular Reconstruction with Bridging Customized Plate after Ablative Surgery for ONJ: A Multi-Centric Case Series

Purpose: Computer-aided methods for mandibular reconstruction have improved both functional and morphological results in patients who underwent segmental mandibular resection. The purpose of this study is to evaluate the overlaying of virtual planning in terms of measures of the Computer Assisted Design/Computer Assisted Manufacturing CAD/CAM plate for mandibular reconstruction in patients who are ineligible for the insertion of reconstructing the titanium plate supported by fibular free flap, due to their poor health status, or in the presence of specific contraindications to autologous bone flap harvest. Materials and methods: The retrospective study performed analyzed the results of nine patients. The patients were treated at the Maxillofacial Surgery Unit of Policlinico S. Orsola of Bologna, Italy, and Policlinico San Marco, Catania, Italy, from April 2016 to June 2021. Superimposition between planning and post operative Computed Tomography CT scan was performed to assess the accuracy. Results: All reconstructive procedures were carried out successfully. No microsurgery-related complications occurred. In two cases, we had plate misplacement, and in one case, plate exposure that led to plate removal. The average accuracy of the series assessed after CT superimposition, as previously described, was 0.95 mm. Conclusions: Considering that microvascular bone transfer is a high-risk procedure in BRONJ patients, we can conclude that the positioning of a customized bridging mandibular prosthesis (CBMP), whether or not it is associated with a microvascular soft tissue transfer, is a safe technique in terms of surgical outcome and feasibility

Safety of boneless reconstruction of the mandible with a CAD/CAM designed titanium device: The replica cohort study

Objective: We evaluated the safety of REPLICA, a CAD/CAM-designed patient-specific titanium mandible, in patients with mandibular defects not suitable for reconstruction with traditional techniques. Patients and methods: We performed a cohort study with a composite primary outcome assigned at the end of a 1- year follow-up. The outcome was assigned in the presence of all the following: 1) absence of intraoral or skin extrusion of REPLICA; 2) decrease or cessation of oral pain; 3) stability or increase in mouth opening; 4) resumption of oral feeding without the need of nasogastric tube; 5) absence of fracture at multidetector computer tomography (MDCT); 6) absence of displacement (MDCT); 7) absence of screw loosening (MDCT). The secondary outcome was the patient-reported QOL at 6 months of follow-up as detected by the EORTC QLQ-C30 and QLQ- H&N35 questionnaires. Results: Between March 2012 and June 2017, 18 consecutive patients, with a median (IQR) age of 67 (65;74) underwent reconstruction of mandibular defects with REPLICA at our Unit. The primary outcome was reached by 14 of the 18 patients. QOL data were available for 15 patients at the 6-month follow-up, showing a good profile of general and disease-specific QOL. Conclusion: REPLICA offered a safe solution at 1-year for the treatment of mandibular defects not suitable for reconstruction with traditional techniques, and was associated with subjective well-being and satisfaction. Further studies are needed to assess the full range of indications of REPLICA

MEASUREMENT AND SENSING OF COVER CROP GROWTH AND NITROGEN CREDITS IN CONSERVATION AGRICULTURE

We studied cover crops in maize-based cropping systems in the agricultural plain areas of Northern Italy (Lombardia region), to: quantify the growth of winter cover crops, nitrogen uptake, weed control capacity, and nitrogen credits for maize; to test the possibility of sensing cover crop biomass and nitrogen (N) concentration using aerial images, and to estimate N concentration using near-infrared spectroscopy (NIRS); and to quantify cover crop cultivation costs. We set up six experiments to compare different cover crop species in rotation with maize. The experiments started in September 2017 and ended in August 2019. Cover crop growth in autumn was rapid for white mustard, tillage radish and black oat (which accumulated 1.5–3.0 t DM/ha until November), while legume cover crops (Egyptian clover, hairy vetch and purple vetch) had a lower crop growth rate (reaching 0.5–1.5 t DM/ha). Therefore, non-legume cover crops controlled weeds better compared to legume cover crops. Nitrogen uptake in autumn was highest for white mustard, tillage radish and hairy vetch (77-125 kg N/ha). Rye and black oat were intermediate, while Egyptian clover and purple vetch were lowest (35 kg N/ha). Rye and hairy vetch survived winter, while white mustard was always destroyed by winter frosts. We did not observe relevant effects of cover crops on maize yield and N uptake. In one experiment, we also established relationships between vegetation indices (NDVI, Normalised Difference Vegetation Index; and CIg, Chlorophyll Index) obtained with a multispectral digital camera carried by an Unmanned Aerial Vehicle and cover crop biomass and nitrogen concentration. Increasing biomass above about 1 and 2 t DM/ha for NDVI and CIg, respectively, did not correspond to increasing values of the indices, thus reducing their predictive capacity. A new index (calculated using measured crop height) improved the predictions of cover crop biomass substantially (R2 = 0.64–0.86). Cover crop nitrogen concentration was poorly predicted by the vegetation indices. We finally scanned cover crops with two NIR instruments, and used the spectra for chemometric elaborations (Partial Least Squares regression). Predictions of N concentrations on spectra of fresh materials were rather poor, while dried and ground samples provided better results (R2 = 0.86 for the bench instrument, and 0.70 for the portable instrument). Locally Weighted Regression further improved the R2 (0.90 and 0.84, respectively). Cultivation costs ranged between 112 €/ha for white mustard (a winter killed species that does not require termination and has a low seed cost) and 208 €/ha for rye (winter-hardy, with more expensive seed)

Cover crop dopo il mais, scegliere la giusta strategia

Le cover crop graminacee e brassicacee hanno mostrato un buon potenziale relativamente alla crescita autunnale, all’assorbimento di azoto e al controllo delle erbe infestanti. Per quelle leguminose, invece, il tasso di crescita in autunno è stato modesto, compensato da un’importante crescita in primavera solo per la veccia villos

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31â127 anaesthetic procedures in 30â874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0â5·5) with an incidence of respiratory critical events of 3·1% (2·9â3·3). Cardiovascular instability occurred in 1·9% (1·7â2·1), with an immediate poor outcome in 5·4% (3·7â7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10â000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86â0·90; p<0·0001), medical history, and physical condition (1·60, 1·40â1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981â0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97â0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia. Funding European Society of Anaesthesiology

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6.35 years (SD 4.50) were included. The incidence of perioperative severe critical events was 5.2% (95% CI 5.0-5.5) with an incidence of respiratory critical events of 3.1% (2.9-3.3). Cardiovascular instability occurred in 1.9% (1.7-2.1), with an immediate poor outcome in 5.4% (3.7-7.5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0.88, 95% CI 0.86-0.90; p<0.0001), medical history, and physical condition (1.60, 1.40-1.82; p<0.0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0.99, 0.981-0.997; p<0.0048 for respiratory critical events, and 0.98, 0.97-0.99; p=0.0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia