Análise de incidência de infecção de sítio cirúrgico em cirurgias oncológicas do aparelho digestivo no Hospital Geral de Fortaleza

Model of Study: This is a study characterized as retrospective, analytical and quantitative approach with non-experimental research design. Objective: Analyze patients undergoing cancer surgery of the objetive tract in Hospital Geral de Fortaleza for the appearance of surgical site infection (SSI) and suggest preventive measures. Material and Methods: Underwent cancer surgery of the digestive tract 196 individuals in the period from 10/01/2011 to 09/30/2012 and analyzed the possible risk factors related to the patient, to the surgical procedure and the incision. Results: Showed up 26 cases of infection, with an overall SSI prevalence of 13,26%. The following variables showed significant association of risk: duration of procedure, duration of preoperative hospitalization, comorbidities, smoking, alcohol consumption, use of drains and bladder catheterization. Conclusion: The risk factors indicated in this study describe a group of individuals with increased risk of SSI, in which prevention protocols should be rigorously applied.Modelo do Estudo: Trata-se de um estudo caracterizado como retrospectivo, analítico, com abordagem quantitativa, com delineamento de pesquisa não experimental. Objetivo: Analisar os pacientes submetidos à cirurgia oncológica do aparelho digestivo no Hospital Geral de Fortaleza quanto ao aparecimento de infecção de sítio cirúrgico (ISC) e sugerir medidas de prevenção. Material e Métodos: Foram submetidos à cirurgia oncológica do aparelho digestório 196 indivíduos, no período de 01/10/2011 a 30/09/2012, e, analisados os possíveis fatores de risco, ligados ao paciente, ao procedimento cirúrgico e à incisão. Resultados: evidenciou-se 26 casos de infecção, com uma prevalência global de ISC de 13,26%. As seguintes variáveis apresentaram associação relevante de risco: duração do procedimento, tempo de internação pré-operatório, comorbidades, tabagismo, etilismo, uso de drenos e sondagem vesical. Conclusão: Os fatores de risco apontados neste estudo descrevem um grupo de indivíduos com maior risco de ISC, nos quais os protocolos de prevenção devem ser aplicados rigorosamente

Amicus curiae on the request for an advisory opinion concerning the figure of the political judgment or impeachment presented by the Inter-American Commission on Human Rights

O presente trabalho diz respeito à solicitação de Opinião Consultiva feita pela Comissão Interamericana de Direitos Humanos (CIDH) acerca dos julgamentos políticos e impeachment, de modo a fomentar e ampliar o debate sobre o tema. Nesse sentido, o Núcleo Constitucionalismo e Democracia, que integra o Centro de Estudos da Constituição (CCONS), do Programa de Pós-Graduação em Direito da Universidade Federal do Paraná (UFPR), e o Departamento de Direito Constitucional da Universidade Externado da Colômbia, ingressaram, em conjunto, como amicus curiae, e apresentaram esta opinião diante da Comissão Interamericana com o propósito de colaborar, teórica e praticamente, com o Sistema Interamericano de Direitos Humanos (SIDH). Na primeira parte do trabalho faz-se uma série de observações sobre a consulta formulada pela CIDH, inclusive quanto às próprias regras e estrutura do procedimento da função consultiva. Na segunda parte, faz-se referência ao papel e legitimidade dos tribunais internacionais e, concretamente, da Corte Interamericana de Direitos Humanos (Corte IDH), na proteção da democracia e dos direitos políticos. Na terceira parte, responde-se ao objeto central da consulta, sobre as garantias judiciais e a legalidade nos processos de impeachment e julgamentos políticos contra presidentes democraticamente eleitos. Finalmente, na quarta parte, alerta-se a Corte IDH sobre a importância de se especificar o alcance do artigo 23 da Convenção Americana de Direitos Humanos (CADH) em relação aos diferentes fenômenos que ocorrem nos Estados Partes da CADH. O objetivo do trabalho é oferecer à Corte IDH uma visão completa do conteúdo e de problemas concretos que surgem da solicitação de uma opinião consultiva tal como essa, formulada pela CIDH, como também um pronunciamento sobre o contexto jurídico e fático que rodeia este procedimento.This work concerns the request for an Advisory Opinion made by the Inter-American Commission on Human Rights (IACHR) on political judgments and impeachment, in order to encourage and broaden the debate on the subject. In this sense, the Núcleo Constitucionalismo e Democracia (Constitutionalism and Democracy Nucleus), which integrates the Centro de Estudos da Constituição (Center for Constitutional Studies – CCONS) of the Federal University of Paraná (UFPR) Law’s LL.M and Ph.D Program, and the Constitutional Law Department of the Externado University of Colombia, have joined together as amicus curiae and presented their view before the Inter-American Commission, aiming to collaborate, theoretically and practically, with the Inter-American System of Human Rights (IASHR). The first part of this report presents comments on the consultation formulated by the IACHR, including the rules and structure of the advisory procedure itself. The second part deals with the role and legitimacy of international courts and tribunals – specifically, the Inter-American Court of Human Rights (IACHR) – for the protection of democracy and political rights. The third part refers to the core object of the consultation – on judicial guarantees and legality in impeachment proceedings and political trials against democratically elected presidents. Finally, in the fourth part, the Inter-American Court is warned about the importance of specifying the scope of Article 23 of the American Convention on Human Rights (ACHR) in relation to the different phenomena occurring in the States that have ratified it. The objective of this work is to provide the Inter-American Court with a complete view of the content and concrete problems that arise from the request for an advisory opinion such as that formulated by the IACHR, as well as with a statement on the legal and factual context surrounding this procedure

Evidence confirms an anthropic origin of Amazonian Dark Earths.

Arising from: Silva et al. Nature Communications https://doi.org/10.1038/s41467-020-20184-2 (2021

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Evaluation of variables responsible for hospital mortality in patients with rheumatic heart disease undergoing double valve replacement

Objective: To describe the hospital mortality and associated clinical and echocardiographic variables in patients with rheumatic disease who underwent double valve replacement surgery. Methods: This is a cross sectional descriptive study of mortality, performed in a referral hospital in Salvador, Bahia. Records from patients with rheumatic disease who underwent double valve replacement surgery during the years 2007-2011 were analyzed. Results: The studied sample comprises 104 patients and 60 (57.7%) were male. The mean age was 38.04±14.45. Sixty five bioprostheses and 38 mechanical prostheses were used in these patients at the time of surgery. There were statistically significant differences between the two groups, when we analyzed the following variables: the mean age (36.30±13.03 vs. 45.35±17.8 years-old, P=0.011), mean hemoglobin (11.10±2.19 vs. 9.22±2.26 g/dL, P=0.002), mean hematocrit (34.22±5.86 vs. 28.44±6.62%, P<0.001). New York Heart Association functional class III and IV (NYHA) (P=0.022) was statistically associated with mortality. Conclusion: We concluded that the mean hemoglobin/hematocrit level and the NYHA functional class was the major variables associated to the mortality among these patients. Based on these data one may concern about the patient best moment for surgery and the patient hemoglobin level

Prevalência de anemia e insuficiência renal em portadores de insuficiência cardíaca não-hospitalizados

FUNDAMENTOS: Insuficiência cardíaca (IC) é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR) são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de julho de 2003 a novembro de 2006. Anemia foi definida como níveis de hemoglobina abaixo de 13 mg/dl para homens e de 12 mg/dl para mulheres. A função renal foi avaliada por meio da taxa de filtração glomerular (TFG), calculada pela fórmula simplificada do estudo MDRD (Modification of Diet in Renal Disease). RESULTADOS: Dos trezentos e quarenta e cinco pacientes incluídos neste estudo, 26,4% (n = 91) tinham anemia e 29,6% tinham insuficiência renal moderada a grave (TFG < 60 ml/min). A associação entre anemia e maior prevalência de insuficiência renal foi estatisticamente significante (41,8% vs. 25,2%; p = 0,005). Os pacientes em classe funcional III e IV apresentaram maior incidência de anemia (39,0% vs. 19,4%; p <0,001) e insuficiência renal (38,2% vs. 24,8%; p = 0,007). Não foi observada associação entre anemia ou insuficiência renal e história de hipertensão, diabetes, função sistólica ou etiologia de insuficiência cardíaca. CONCLUSÃO: A prevalência de anemia e insuficiência renal foi elevada nessa população e foi associada com a gravidade da insuficiência cardíaca (classes funcionais III e IV)