Fatores prognósticos associados ao SAPS 3 e APACHE II em pacientes idosos admitidos em unidade de terapia intensiva

Study design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from July 2016 to June 2017. The primary independent variables analyzed were: presence of stress hyperglycemia, the need for invasive mechanical ventilation (IMV), acute renal failure, level of consciousness and use of vasopressors. The outcomes studied were death and hospital discharge. Results: ICU and hospital mortality were 17.8% and 29.8%, respectively. The multivariate analysis of factors associated with hospital death not contemplated in the obtaining of SAPS 3 demonstrated that IMV, Chronic Obstructive Pulmonary Disease (COPD) and Mean Arterial Pressure (MAP) <70 mmHg improved the prediction of mortality. The Hosmer-Lemeshow test (p=0.472) and area under ROC curve=0.80 (CI95%:0.731-0.872) confirmed, respectively, an appropriate calibration and acceptable-to-excellent discriminatory power for this model. IMV and COPD were also factors associated with the APACHE II score in prediction of mortality with appropriated calibration (p=0.471) and acceptable-to-excellent discriminatory power (area under ROC curve=0.80 [CI95%:0.730-0.868]). Conclusion: IMV, COPD, and MAP <70 mmHg were associated with SAPS3 and APACHE II to predict mortality in elderly admitted to ICU.Modelo de estudo: estudo descritivo, coorte prospectiva. Objetivos: identificar os fatores de risco associados ao escore SAPS 3 e APACHE II para melhorar a predição de mortalidade em idosos internados em unidade de terapia intensiva (UTI). Metodologia: estudo de coorte com 174 idosos internados em UTI no período de julho de 2016 a junho de 2017. As principais variáveis ​​independentes analisadas foram: presença de hiperglicemia de estresse, necessidade de ventilação mecânica invasiva (VMI), insuficiência renal aguda, nível de consciência e uso de vasopressores. Os desfechos estudados foram morte e alta hospitalar. Resultados: A mortalidade na UTI e hospitalar foi de 17,8% e 29,8%, respectivamente. A análise multivariada de fatores associados à morte hospitalar não contemplada na obtenção do SAPS 3 demonstrou que a VMI, Doença Pulmonar Obstrutiva Crônica (DPOC) e Pressão Arterial Média (PAM) <70 mmHg melhoraram a predição de mortalidade. O teste de Hosmer-Lemeshow (p = 0,472) e a área sob curva ROC = 0,80 (IC95%: 0,731-0,872) confirmaram, respectivamente, calibração adequada e poder discriminatório aceitável a excelente para este modelo. VMI e DPOC também foram fatores associados ao escore APACHE II na predição de mortalidade com calibração adequada (p = 0,471) e poder discriminatório aceitável-a-excelente (área sob curva ROC = 0,80 [IC95%: 0,730-0,868]). Conclusão: VMI, DPOC e PAM <70 mmHg foram associados ao SAPS3 e ao APACHE II para predizer mortalidade em idosos internados em UTI.&nbsp

Sustainable practices in a higher education institution: an approach to implementation difficulties in the Garanhuns academic unit of the Federal rural University of Pernambuco

Higher Education Public Institutions can be understood as major consumers of goods and services, in the case of Brazil. To lessen the negative impacts of their activities, these entities have a primary role in the dissemination and implementation of sustainable ideas in their administrative routines. Thus, this study investigated the main difficulties faced by public actors in adopting sustainable practices in their administrative routines. The case study methodology was used as methodological strategy, and the research was classified as descriptive, applied in nature and of qualitative approach. The unit of analysis chosen was the Garanhuns Academic Unit of the Federal Rural University of Pernambuco (UAG/UFRPE).For data collection, semi-structured interviews were conducted with 12 servants representatives of strategic sectors of UAG/UFRPE. The data collected through the interviews were analyzed using content analysis. The results showed that the main difficulties in adopting sustainable practices in the workplace were administrative, budgetary and cultural, with the most critical obstacles being the lack of knowledge and training factors on sustainable actions and the scarcity of effective institutional policies. From these results, it is concluded that it is necessary to overcome these difficulties to implement effective sustainable management in the Unit

Macrofauna de áreas recuperadas após extração de seixo na região Amazônica / Soil macrofauna of recovered areas after gravel extraction in the Amazon region

A exploração mineral gera expressivas consequências ambientais, porém ainda são poucos os estudos visando à recuperação de áreas degradadas por mineração. Assim, o objetivo da pesquisa foi avaliar o efeito do uso da técnica de revegetação na macrofauna do solo em área degradada após extração de seixo na região amazônica. O experimento foi realizado em área de extração de seixo em Capitão Poço – PA. O delineamento experimental usado foi em blocos ao acaso, em parcelas subdivididas. As parcelas foram constituídas de dois tratamentos – calagem + escarificação (CC) e sem calagem e sem escarificação (SC). As subparcelas foram compostas de cinco tratamentos: 1) plantio de mudas de sete espécies + 500 kgde serrapilheira; 2) plantio de mudas de sete espécies + 50 g planta-1 de NPK + 200 g planta-1 de cama aviária; 3) plantio de mudas de sete espécies + 50 g planta-1 de NPK + 200 g planta-1 de cama aviária + plantio de duas linhas de feijão-caupi entre as linhas das sete espécies; 4) plantio de mudas de sete espécies + 50 g planta-1 de NPK + 200 g planta-1 de cama aviária +500 kg de topsoil e 5) regeneração natural. Em geral, a macrofauna do solo construído apresentou comportamento diferenciado, sendo mais abundantes os grupos taxonômicos Formicidae e Oligochaeta, A maior diversidade de grupos taxonômicos foi observada no solo sob floresta secundária. A técnica de revegetação do solo construído proporcionou o aumento da densidade da macrofauna invertebrada aos 16 meses de experimento

Ecos committee from Pernambuco – Brazil: a study on the sustainability actions of participating institutions

This article seeks to analyze the importance of socio-environmental actions as tools for structuring sustainability management in the public sphere, with a view to fulfilling corporate responsibility, based on the Ecos Committee from Pernambuco-Brazil. To carry out this study, a bibliographical and documental research was carried out, where scientific articles, resolutions and other bases of formal documents were raised for a wider understanding of the theme in focus. Then,we conducted a survey of the actions put into practice by the Ecos Committee between 2015 and 2017. Confronting their planning with this survey, it was possible to analyze its strategic alignment, confronting theory and practice. The main results point to the existence of feasible public initiatives that endorse sustainability ramifications denoting potential for replication in other organizations, since the Ecos Committee from Pernambuco appears to fulfill its role.Further research initiatives are also presented

Labor relations as an indicator of social responsibility in the perception of employees at the Serra Talhada academic unit of the Federal rural University of Pernambuco

The emergence of the concept of sustainable development and social and environmental responsibility in organizations has evolved over time, from a view focused on the economic and legal aspects to a new stance of organizations that includes responsibility in labor relations or the social aspect. In this context of change, both private and public organizations have made efforts to contemplate labor relations in their daily practices and in the decisionmaking process. Public institutions, and within them, Higher Education Institutions (HEI),play a fundamental role in this aspect as a driving force in changing proactive behaviors in relation to their collaborators, in addition to having a training role externally, citizens or future entrepreneurs who have a more humane background and are committed to the quality of life in the work place. In this sense, this study aims to investigate the social responsibility practices contemplated in the management of the Serra Talhada Academic Unit of the Federal Rural University of Pernambuco (UAST/UFRPE), from management and operational practices related to labor relations, besides knowing the perception of the servers about suchpractices. The research adopted a qualitative and quantitative approach and is configured forbeing applied and descriptive in nature. For data collection, questionnaires were used. As a result, it was possible to highlight the concern with the issue of labor relations by the institution since it is formally inserted in it’s management, even if in an embryonic way. However, the perception of the staff differs as to the institutional position regarding socialissues, especially regarding labor relations, suggesting the need for better dissemination of existing actions in UAST

The Heart and COVID-19: What Cardiologists Need to Know

In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes

Implicações da radiação na saúde dos profissionais que utilizam a fluoroscopia na prática diária: Implications of radiation on the health of professionals who use the fluoroscopy in daily practice

O presente estudo tem como objetivo analisar as implicações da radiação na saúde dos profissionais que utilizam o arco cirúrgico na prática diária. Neste estudo foi realizada uma revisão sistemática da literatura. Para seleção das publicações foram considerados como critérios de inclusão estar disponível em formato completo, publicado nos últimos cinco anos (2018-2022), escritas em língua portuguesa e inglesa. E como critérios de exclusão foram considerados estar foram do tema de pesquisa, ser revisão de literatura e repetido na base de dados. Os critérios de inclusão e exclusão foram considerados como meio de validade metodológica. Concluiu-se a partir desse estudo que apesar de baixos níveis de radiação emitidos por arco cirúrgico, os riscos ainda são significativos, verificando-se a necessidade de conscientização dos profissionais de saúde sobre a proteção necessária para mitigação das implicações, principalmente, entre os menos experientes.&nbsp

O Coração e a COVID-19: O que o Cardiologista Precisa Saber

Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos