A força do futebol europeu na mídia impressa do Brasil: análise dos cadernos de esportes do Correio Braziliense e da Folha de S. Paulo

Este trabalho de conclusão de curso tem como objetivo analisar reportagens sobre a final da Liga dos Campeões da Europa, publicadas durante os anos de 2013 a 2017 nos cadernos de esportes do Correio Braziliense e da Folha de S. Paulo. Foram analisadas as edições do dia da final da competição europeia, bem como o conteúdo do dia seguinte dos jornais em análise. Também foi feita uma reflexão sobre as possíveis diferenças na produção de conteúdo, palavras escolhidas e expressões vinculadas, em relação às reportagens sobre a final da Liga dos Campeões da Europa e das matérias sobre as mesmas escolhas para os conteúdos do Campeonato Brasileiro. A intenção deste estudo foi identificar e analisar a linguagem dos textos publicados, por meio de elementos constitutivos da reportagem, tais como adjetivos, advérbios e expressões que podem enaltecer a disputa europeia, ao passo que, eventualmente, podem ser demeritórias para o futebol nacional, o que poderia, em tese, influenciar quem consome o produto jornalístico

Transferência do Conhecimento de Suporte Básico de Vida para Leigos e Profissionais de Saúde: uma Revisão Integrativa

O objetivo do trabalho foi identificar as publicações sobre o conhecimento a respeito da reanimação cardiopulmonar, a formação dos autores, a metodologia utilizada, o ano de prevalência e suas recomendações. Trata-se de uma revisão integrativa da literatura, na qual se buscou artigos nas bases de dados SciELO e no Portal de Periódicos CAPES. Levantou-se 40 artigos e depois de aplicados critérios de inclusão e exclusão a amostragem final foi de 21 publicações entre 2008 e 2018. Apurou-se que a maior parte dos artigos foi publicada em 2016, prevalecendo autores que possuem formação acadêmica em Enfermagem. Os artigos utilizaram mais de estudos descritivos e transversais. Em relação às recomendações, as principais foram quanto à importância de treinamentos para leigos sobre o Suporte Básico de Vida e o uso de Desfibrilador Externo Automático. No que diz respeito aos profissionais de saúde, sugere-se a aplicação de educação continuada para assegurar a atualização do saber e aprimoramento profissional. Para o profissional enfermeiro é fundamental o conhecimento e reconhecimento sobre a Parada Cardiorrespiratória, e as publicações tendem a aumentar após as atualizações periódicas da American Heart Association, não importando a metodologia utilizada. Portanto, a principal recomendação diz respeito à necessidade de manter treinamentos periódicos regulares para a população leiga e profissionais de saúde acerca do Suporte Básico de Vida

Effects of dietary protein and phosphorus restriction on the progression of early renal failure

Effects of dietary protein and phosphorus restriction on the progression of early renal failure. Three groups of patients with chronic renal failure were studied. Group 1 comprised 25 patients with a mean serum creatinine of 2.18mg/dl and a mean arterial pressure of 117mm Hg. Group 2 had 20 patients with a mean serum creatinine of 4.24mg/dl and a mean arterial pressure of 119mm Hg. All these patients were kept for 18 to 76 months on a diet containing about 40 kcal/kg, 0.6 g/kg of protein, 700mg of phosphorus, and 1,000 to 1,500mg of calcium (orally supplemented). Group 3 comprised 30 patients with a mean serum creatinine of 2.28mg/dl and a mean arterial pressure of 116mm Hg. They had followed no specific dietary regimen for 3 to 72 months, and their dietary calorie, protein, phosphorus, and calcium intakes averaged 35 kcal/kg, 70 g, 900mg, and 800mg, respectively. The plots of reciprocal creatinine against time gave slopes of -0.0008 and -0.0010 in patients in groups 1 and 2, and a slope of -0.020 in group 3 patients. The slopes of both groups 1 and 2 were statistically different (analysis of variance and “F” test, P < 0.01) from that of group 3. No evidence of progressive protein and phosphorus depletion was observed in groups 1 and 2 patients. We conclude that a moderate dietary restriction of protein and phosphorus is an acceptable and effective regimen for delaying progression of functional deterioration in early renal failure.Effet de la restriction protéique et phosphorée alimentaire sur la progression de l'insuffisance rénale débutante. Trois groupes de malades ayant une insuffisance rénale chronique ont été étudiés. Le groupe 1 comprenait 25 malades ayant une créatinine sérique moyenne de 2,18mg/dl et une pression artérielle moyenne de 117mm Hg. Le groupe 2 comportait 20 malades ayant une créatinine sérique moyenne de 4,24mg/dl et une pression artérielle moyenne de 119mm Hg. Tous ces malades ont été soumis pendant 18 à 76 mois à un régime contenant environ 40 kcal/kg, 0,6kg de protéines, 700mg de phosphore, et 1000 à 1500mg de calcium (par supplémentation orale). Le groupe 3 comprenait 30 malades ayant une créatinine sérique moyenne de 2,28mg/dl et une pression artérielle moyenne de 116mm Hg. Ils n'avaient pas suivi de régime alimentaire spécifique pendant 3 à 72 mois, et leurs apports alimentaires caloriques, protéiques, phosphorés et calciques étaient en moyenne de 35 kcal/kg, 70 g, 900mg, et 800mg, respectivement. Les courbes de créatinine en fonction du temps ont donné des pentes de -0,0008 et de -0,0010 chez les malades des groupes 1 et 2, et une pente de -0,020 chez ceux de groupe 3. Des pentes des groupes 1 et 2 différaient statistiquement (analyse de variance et test de “F”, P < 0,01) de ceux du groupe 3. Il n'a pas été observé de preuve de déplétion progressive en protéines et en phosphore chez les malades des groupes 1 et 2. Nous concluons qu'une restriction alimentaire modérée en protéines et en phosphore est un régime acceptable et efficace pour retarder la progression de la détérioration fonctionnelle au cours de l'insuffisance rénale précoce

Acervo de livros para formação dos profissionais de saúde em cuidados paliativos: revisão integrativa

Cuidados paliativos devem ser abordados na formação dos profissionais de saúde devido à grande necessidade atual, tanto para pessoas no fim da vida, quanto para pessoas com doenças crônicas não transmissíveis, sendo imprescindível os livros editados para estudo sobre o tema. O objetivo geral deste estudo foi identificar os livros disponíveis sobre cuidados paliativos no acervo físico da biblioteca de uma universidade da região central do Estado de São Paulo que são utilizados pelos seguintes cursos da saúde: Enfermagem, Medicina, Psicologia, Fisioterapia, Nutrição, e Educação Física, apontando características relevantes dessas obras.. A metodologia foi a revisão integrativa das obras encontradas no acervo físico da biblioteca da universidade. Como resultados foram encontrados 40 livros, porém aplicados os critérios de exclusão e inclusão resultaram em 13 livros. Os livros datam de 2000 a 2013, sendo a maioria publicada entre 2005 a 2008. Os organizadores em sua maioria são médicos, seguidos por enfermeiros tendo teólogos e nutricionista também como autores. A importância dos cuidados paliativos está em garantir ao paciente bem-estar físico, emocional, biológico, fisiológico, social, familiar e espiritual.  As recomendações principais são quanto aos locais destinados aos cuidados paliativos, à capacitação de profissionais, à filosofia, ética e religiosidade, à família, à comunicação, à sedação, à higiene e conforto, à importância da assistência multiprofissional. Levantou-se que 24 livros foram publicados nos últimos 5 anos e que não estão disponíveis no acervo da biblioteca

Contraception in chronic kidney disease: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

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A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology

Kidney transplantation (KT) is often considered to be the method best able to restore fertility in a woman with chronic kidney disease (CKD). However, pregnancies in KT are not devoid of risks (in particular prematurity, small for gestational age babies, and the hypertensive disorders of pregnancy). An ideal profile of the potential KT mother includes “normal” or “good” kidney function (usually defined as glomerular filtration rate, GFR ≥ 60 ml/min), scant or no proteinuria (usually defined as below 500 mg/dl), normal or well controlled blood pressure (one drug only and no sign of end-organ damage), no recent acute rejection, good compliance and low-dose immunosuppression, without the use of potentially teratogen drugs (mycophenolic acid and m-Tor inhibitors) and an interval of at least 1–2 years after transplantation. In this setting, there is little if any risk of worsening of the kidney function. Less is known about how to manage “non-ideal” situations, such as a pregnancy a short time after KT, or one in the context of hypertension or a failing kidney. The aim of this position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology is to review the literature and discuss what is known about the clinical management of CKD after KT, with particular attention to women who start a pregnancy in non-ideal conditions. While the experience in such cases is limited, the risks of worsening the renal function are probably higher in cases with markedly reduced kidney function, and in the presence of proteinuria. Well-controlled hypertension alone seems less relevant for outcomes, even if its effect is probably multiplicative if combined with low GFR and proteinuria. As in other settings of kidney disease, superimposed preeclampsia (PE) is differently defined and this impairs calculating its real incidence. No specific difference between non-teratogen immunosuppressive drugs has been shown, but calcineurin inhibitors have been associated with foetal growth restriction and low birth weight. The clinical choices in cases at high risk for malformations or kidney function impairment (pregnancies under mycophenolic acid or with severe kidney-function impairment) require merging clinical and ethical approaches in which, beside the mother and child dyad, the grafted kidney is a crucial “third element”

Diagnostic accuracy of ultrasound dilution access blood flow measurement in detecting stenosis and predicting thrombosis in native forearm arteriovenous fistulae for hemodialysis.

BACKGROUND: Vascular access surveillance by ultrasound dilution blood flow rate (Qa) measurement is widely recommended; however, optimal criteria for detecting stenosis and predicting thrombosis in arteriovenous fistulae (AVFs) are still not clearly defined. METHODS: In a blinded trial, we evaluated the accuracy of single Qa measurement, Qa adjusted for mean arterial pressure (Qa/MAP), and decrease in Qa over time (dQa) in detecting stenosis and predicting thrombosis in an unselected population of 120 hemodialysis subjects with native forearm AVFs (91 AVFs, located at the wrist; 29 AVFs, located at the midforearm). All AVFs underwent fistulography, which identified greater than 50% stenosis in 54 cases. RESULTS: Receiver operating characteristic curve analysis showed that dQa, Qa, and Qa/MAP have a high stenosis discriminative ability with similar areas under the curve (AUCs), ie, 0.961 +/- 0.025, 0.946 +/- 0.021, and 0.912 +/- 0.032, respectively. In the population as a whole, optimal thresholds for stenosis were Qa less than 750 mL/min alone and in combination with dQa greater than 25% (efficiency, 90%); however, the best threshold depended on anastomotic site; it was Qa less than 750 mL/min for an AVF at the wrist and Qa less than 1,000 mL/min for an AVF in the midforearm. Qa was the best predictor of incipient thrombosis (AUC, 0.981 +/- 0.013) with an optimal threshold at less than 300 mL/min (efficiency, 94%). Pooled intra-assay and interassay variation coefficients were 8.2% for MAP, 7.9% for Qa, and 11.2% for Qa/MAP. CONCLUSION: Our study shows that ultrasound dilution Qa measurement is a reproducible and highly accurate tool for detecting stenosis and predicting thrombosis in forearm AVFs. Neither Qa/MAP nor dQa improve the diagnostic performance of Qa alone, although its combination with dQa increases the test's sensitivity for stenosis

A prospective controlled trial on effect of percutaneous transluminal angioplast on functioning arteriovenous fistulae survival

Balloon angioplasty (PTA) is an established treatment modality for stenosis in dysfunctional arteriovenous fistulae (AVF), although most studies showing efficacy have been retrospective, uncontrolled, and nonrandomized. In addition, it is unknown whether correction of stenosis not associated with significant hemodynamic, functional, and clinical abnormality may improve survival in AVF. This study was a prospective controlled open trial to evaluate whether prophylactic PTA of stenosis not associated with access dysfunction improves survival in native, virgin, radiocephalic forearm AVF. Sixty-two stenotic, functioning AVF, i.e., able to provide adequate dialysis, were enrolled in the study: 30 were allocated to control and 32 to PTA. End points of the study were either AVF thrombosis or surgical revision due to reduction in delivered dialysis dose. Kaplan-Meier analysis showed that PTA improved AVF functional failure-free survival rates (P = 0.012) with a fourfold increase in median survival and a 2.87-fold decrease in risk of failure. Cox proportional hazard model identified PTA as the only variable associated with outcome (P = 0.012). PTA induced an increase in access blood flow rate (Qa) by 323 (236 to 445) ml/min (P < 0.001), suggesting that improved AVF survival is the result of increased Qa. PTA was also associated with a significant decrease in access-related morbidity by approximately halving the risk of hospitalization, central venous catheterization, and thrombectomy (P < 0.05). This study shows that prophylactic PTA of stenosis in functioning forearm AVF improves access survival and decreases access-related morbidity, supporting the usefulness of preventive correction of stenosis before the development of access dysfunction. It also strongly supports surveillance program for early detection of stenosis