Internações em UTI por causas obstétricas

The objective was to analyze the admission of women of childbearing age to an Obstetric Intensive Care Unit. A cross-sectional, documentary and retrospective study was carried out in an Obstetric Intensive Care Unit, located in Fortaleza/Ceará, with women of childbearing age admitted to the unit in 2016. Data were collected from 106 medical records that met the inclusion criteria during the month of April 2017, using a semi-structured form, and analyzed by means of descriptive statistics. The majority of the women were between 20 and 29 years old, common-law married, with complete secondary education, primiparous, had initiated prenatal care in the first trimester of pregnancy, and attended 4 to 6 consultations. Among the direct obstetric causes (61.1%), the most frequent were Eclampsia (34.4%), HELLP syndrome (15.1%) and Severe preeclampsia (11%). The indirect obstetric causes (38.9%) included Renal insufficiency (13.5%), Acute lung edema (11.5%) and Heart disease (9.6%). Data revealed a fragile health care for women within the pregnant-puerperal cycle.Su objetivo es analizar los ingresos de mujeres en edad fértil en una Unidad de Cuidados Intensivos Obstétrica. Estudio transversal, documental y retrospectivo, realizado en una Unidad de Cuidados Intensivos Obstétrica, ubicada en Fortaleza / Ceará, con la presencia de mujeres en edad fértil admitidas en la unidad en el año 2016. Los datos fueron recolectados de los registros que atendieron a los criterios de inclusión. Durante el mes de abril de 2017, mediante un formulario semiestructurado y analizado por medio de estadística descriptiva, siendo incluidos 106 registros. La mayoría de las mujeres tenía un grupo de edad entre 20 y 29 años, pardas, en unión estable, con enseñanza media completa, primíperas, con inicio del prenatal en el primer trimestre gestacional, con 4 a 6 consultas. Entre las causas obstétricas directas (61,1%) las principales fueron Eclampsia (34,4%), Síndrome de Hellp (15,1%) y Pre-eclampsia grave (11%) y para las causas obstétricas indirectas (38,9 (%), Se observan las siguientes: Insuficiencia renal (13,5%), Edema agudo de pulmón (11,5%) y Cardiopatía (9,6%). Los datos revelan una línea tenue en lo que concierne a la atención a la salud de las mujeres dentro del ciclo gravídico-puerperal.Objetivou-se analisar as internações de mulheres em idade fértil em uma Unidade de Terapia Intensiva Obstétrica. Estudo transversal, documental e retrospectivo, realizado em uma Unidade de Terapia Intensiva Obstétrica, localizada em Fortaleza/Ceará, com a presença de mulheres em idade fértil admitidas na unidade no ano de 2016. Os dados foram coletados dos prontuários que atenderam aos critérios de inclusão, durante o mês de abril de 2017, mediante um formulário semiestruturado e analisados por meio de estatística descritiva, sendo incluídos 106 prontuários. A maioria das mulheres tinham faixa etária entre 20 a 29 anos, pardas, em união estável, com ensino médio completo, primíperas, com início do pré-natal no 1º trimestre gestacional, com 4 a 6 consultas. Dentre as causas obstétricas diretas (61,1%) as principais foram Eclâmpsia (34,4%), Síndrome de Hellp (15,1%) e Pré-eclâmpsia grave (11%) e para as causas obstétricas indiretas (38,9%) destacam-se Insuficiência renal (13,5%), Edema agudo de pulmão (11,5%) e Cardiopatia (9,6%). Os dados revelam uma linha ténue no que concerne a atenção a saúde da mulheres dentro do ciclo gravídico-puerperal

eHealth promoting stoma self-care for people with an elimination ostomy: focus group study

Background: The construction of an elimination stoma has a physical, psychological, and social impact on the person. The development of stoma self-care competence contributes to the adaptation to a new health condition and improvement of quality of life. eHealth refers to everything associated with information and communication technology and health care, including telemedicine, mobile health, and health informatics. The use of eHealth platforms by the person with an ostomy, as a digital application that includes websites and mobile phone apps, can bring scientific knowledge and well-informed practices to individuals, families, and communities. It also allows functionalities that enable the person to describe and identify early signs and symptoms and precursors of complications and to be guided to an adequate health response for their problems. Objective: This study aimed to define the most relevant content and features to promote ostomy self-care integrated into an eHealth platform as a digital app or website to be used by patients for self-management of stoma care. Methods: We developed a descriptive, exploratory study with a qualitative approach using the focus group methodology, which was oriented to reach a consensus of at least 80%. A convenience sample of 7 participants consisting of stomatherapy nurses was used. The focus group discussion was recorded, and field notes were taken. The focus group meeting was fully transcribed, and a qualitative analysis was performed. The research question was: Which content and features for ostomy self-care promotion should be integrated into an eHealth platform as a digital app or website? Results: An eHealth platform, which can be a smartphone app or website, for people with ostomy should provide content aimed at promoting self-care, namely in the field of knowledge and self-monitoring, as well as the possibility of interacting with a stomatherapy care nurse. Conclusions: The stomatherapy nurse has a decisive role in promoting adaptation to life with a stoma, namely through the promotion of stoma self-care. Technological evolution has emerged as a useful tool to enhance nursing interventions and promote self-care competence. The development of an eHealth platform aimed at promoting ostomy self-care should include the capabilities for telehealth and help with decision-making regarding self-monitoring and seeking differentiated care.info:eu-repo/semantics/publishedVersio

Are structurally modified galactomannan derivatives biologically active?

Galactomannans are versatile macromolecules with broad industrial potential. The influence of changes in the chemical structures and respective bioactivities of these polysaccharides have been extensively studied. The derivatives obtained by sulfation, complexation, and phosphorylation are the most studied biological properties in galactomannans. The derivatives obtained have shown several pharmacological activities such as antiviral, antimicrobial, anticoagulant, fibrinolytic, chemopreventive, anticancer, antioxidant, chondroprotective, analgesic, immunomodulatory, and antileishmanial. Considering the relevance of these studies, we aim to provide an overview of studies that apply galactomannan modification or derivatization strategies to improve their properties for applications in the biomedical area. We identified the success of most modified galactomannans for pharmacological purposes. However, some studies found loss of bioactivity of the original polysaccharide after chemical changes to its original structures.info:eu-repo/semantics/publishedVersio

Chia seed mucilage (Salvia hispanica L.): An emerging biopolymer for industrial application

Biopolymers are widely distributed in nature and have a wide variety of biological properties and applications. Chia (Salvia hispanica L.) is an herbaceous plant that belongs to the Lamiaceae family, which when in contact with water exude the fraction of soluble fiber in the form of mucilage. In view of the above, this study aims to provide an overview of the characteristics and applications of chia mucilage that make it a biopolymer of industrial interest. The data collection was carried out in the databases: SciELO (Scientific Electronic Library Online), Science Direct, MDPI, Wiley Online Library, Springer and Periodical capes using the following descriptors: “Chia Seed Mucilage”, “Technological Properties”, “Biological Activities”, and “Applications” in alone and in association. After the critical analysis of the selected articles, it was possible to conclude that the chia mucilage has numerous and unique physical-chemical, chemical and technological properties. Applications in the food field are among the most used in view of the industrial perspective. However, the infinite potential that this biomaterial has for the pharmaceutical and agricultural industries is undeniable

Mucilagem de sementes de chia (Salvia hispanica L.): um biopolímero emergente para aplicação industrial

Biopolymers are widely distributed in nature and have a wide variety of biological properties and applications. Chia (Salvia hispanica L.) is an herbaceous plant that belongs to the Lamiaceae family, which when in contact with water exude the fraction of soluble fiber in the form of mucilage. In view of the above, this study aims to provide an overview of the characteristics and applications of chia mucilage that make it a biopolymer of industrial interest. The data collection was carried out in the databases: SciELO (Scientific Electronic Library Online), Science Direct, MDPI, Wiley Online Library, Springer and Periodical capes using the following descriptors: “Chia Seed Mucilage”, “Technological Properties”, “Biological Activities”, and “Applications” in alone and in association. After the critical analysis of the selected articles, it was possible to conclude that the chia mucilage has numerous and unique physical-chemical, chemical and technological properties. Applications in the food field are among the most used in view of the industrial perspective. However, the infinite potential that this biomaterial has for the pharmaceutical and agricultural industries is undeniable.Os biopolímeros são amplamente distribuídos na natureza e possuem uma ampla variedade de propriedades biológicas e aplicações. A chia (Salvia hispanica L.) é uma planta herbácea pertencente à família Lamiaceae, que quando em contato com a água exala a fração de fibra solúvel na forma de mucilagem. Diante do exposto, este estudo tem como objetivo fornecer um panorama sobre as características e aplicações da mucilagem da chia que a tornam um biopolímero de interesse industrial. A coleta de dados foi realizada nas bases de dados: SciELO (Scientific Electronic Library Online), Science Direct, MDPI, Wiley Online Library, Springer e Periodical capes utilizando os seguintes descritores: “Chia Seed Mucilage”, “Technological Properties”, “Biological Activities ”, e “Aplicações” isoladamente e em associação. Após a análise crítica dos artigos selecionados, foi possível concluir que a mucilagem da chia possui inúmeras e únicas propriedades físico-químicas, químicas e tecnológicas. As aplicações na área de alimentos estão entre as mais utilizadas do ponto de vista industrial. No entanto, é inegável o potencial infinito que este biomaterial tem para as indústrias farmacêutica e agrícola.info:eu-repo/semantics/publishedVersio

Endoscopic Biliary Darinage (EBD) versus Percutaneous Transhepatic Biliary Drainage (PTBD) for biliary drainage in patients with Perihilar Cholangiocarcinoma (PCCA): A systematic review and meta-analysis

Biliary drainage for Perihilar Cholangiocarcinoma (PCCA) can be performed either by endoscopic retrograde cholangiopancreatography or Percutaneous Transhepatic Biliary Drainage (PTBD). To date there is no consensus about which method is preferred. Taking that into account, the aim of this study is to compare Endoscopic Biliary Drainage (EBD) versus percutaneous transhepatic biliary drainage in patients with perihilar cholangiocarcinoma through a systematic review and metanalysis. A comprehensive search of multiple electronic databases was performed. Evaluated outcomes included technical success, clinical success, post drainage complications (cholangitis, pancreatitis, bleeding, and major complications), crossover, hospital length stay, and seeding metastases. Data extracted from the studies were used to calculate Mean Differences (MD). Seventeen studies were included, with a total of 2284 patients (EBD = 1239, PTBD = 1045). Considering resectable PCCA, the PTBD group demonstrated lower rates of crossover (RD = 0.29; 95% CI 0.07‒0.51; p = 0.009 I² = 90%), post-drainage complications (RD = 0.20; 95% CI 0.06‒0.33; p < 0.0001; I² = 78%), and post-drainage pancreatitis (RD = 0.10; 95% CI 0.05‒0.16; p < 0.0001; I² = 64%). The EBD group presented reduced length of hospital stay (RD = -2.89; 95% CI -3.35 ‒ -2,43; p < 0.00001; I² = 42%). Considering palliative PCCA, the PTBD group demonstrated a higher clinical success (RD = -0.19; 95% CI -0.27 ‒ -0.11; p < 0.00001; I² = 0%) and less post-drainage cholangitis (RD = 0.08; 95% CI 0.01‒0.15; p = 0.02; I² = 48%) when compared to the EBD group. There was no statistical difference between the groups regarding: technical success, post-drainage bleeding, major post-drainage complications, and seeding metastases

Sepse: correlação dos achados laboratoriais e taxa de sobrevida de animais: Sepsis: correlation of laboratory findings and animal survival rate

A sepse tem se tornando um dos maiores desafios na medicina veterinária. A sepse é definida como uma disfunção orgânica decorrente de uma inadequada resposta imunológica frente a um agente infeccioso, ameaçando a vida do animal. O objetivo deste trabalho foi verificar a ocorrência das doenças de maior frequência que levaram os animais a sepse nos atendimentos realizados no Hospital Veterinário (HV) da Universidade Vila Velha (UVV), em Vila Velha/ Espírito Santo, Brasil, observando as alterações laboratoriais relacionadas à sepse e correlacionando com a expectativa de vida desses animais. Através de um estudo retrospectivo, houve o levantamento dos casos atendidos no período de agosto a dezembro de 2019. Os dados foram tabulados, e, analisados por software, utilizando nível de significância de 5%. As principais doenças que conduziram a sepse foram em ordem de frequência a erliquiose, piometra e gastroenterites; além disso, foi observado que os fatores influenciadores na sobrevida destes animais foram alteração nos valores de leucócitos totais (p=0,042) e a presença de azotemia (ureia p <0,001 e creatinina p=0,003). Demonstrou-se assim, a importância dos achados laboratoriais em conjunto com as alterações clínicas, permitindo agilidade na identificação de um quadro em curso de síndrome da resposta inflamatória (SRIS)/Sepse

Manejo de infecção pós-operatória decorrente de ressecção cirúrgica de ameloblastoma unicístico: relato de caso / Management of post-operative infection due to surgical resection of unicistic ameloblastoma: case report

O ameloblastoma é o tumor de origem epitelial odontogênica de maior relevância e mais comum entre os tumores epiteliais odontogênicos. Baseados nos achados clinico radiográficos existem três tipos padrões: sólido/multicísticos, unicísticos e periférico/extraósseos, o tipo unicístico é mais frequentemente observado em pacientes mais jovens, com cerca de 50% dos casos diagnosticados durante a segunda década de vida. Sua predileção de desenvolvimento é a região posterior da mandíbula, seguida da região de parassínfise, na maxila encontra-se geralmente na região de molar, podendo se estender-se para o seio maxilar, cavidade nasal ou base do crânio. Embora seja raro o ameloblastoma pode sofrer malignização, expressando-se de dois modos: ameloblastoma maligno e carcinoma ameloblástico. O tratamento varia desde conservador ao agressivo, no entanto é necessário identificar o tipo e subtipo do ameloblastoma, pois cada um apresenta um comportamento biológico diferente ditando assim a decisão terapêutica e o prognóstico. Os métodos conservadores incluem: descompressão, marsupialização, enucleação, curetagem e tratamento físico-químico com ozoto líquido ou solução de Carnoy, já a abordagem agressiva consistem em ressecção marginal, ressecção segmentar e em bloco, com ambos os métodos apresentando vantagens, desvantagens e variadas taxas de recorrência. O presente trabalho tem como objetivo relatar um caso clínico com infecção pós-operatória como complicação de tratamento cirúrgico de ameloblastoma unicístico tipo mural

Endoscopic Ultrasound-Guided Fine Needle Aspiration and Endoscopic Retrograde Cholangiopancreatography-Based Tissue Sampling in Suspected Malignant Biliary Strictures: A Meta-Analysis of Same-Session Procedures

Background/Aims: The diagnosis of biliary strictures can be challenging. There are no systematic reviews studying same-session endoscopic retrograde cholangiopancreatography (ERCP)-based tissue sampling and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of biliary strictures. Methods: A systematic review was conducted on studies analyzing same-session EUS and ERCP for tissue diagnosis of suspected malignant biliary strictures. The primary outcome was the accuracy of each method individually compared to the two methods combined. The secondary outcome was the accuracy of each method in pancreatic and biliary etiologies. In the meta-analysis, we used Forest plots, summary receiver operating characteristic curves, and estimates of the area under the curve for intention-to-treat analysis. Results: Of the 12,132 articles identified, six were included, resulting in a total of 497 patients analyzed. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and accuracy of the association between the two methods were: 86%, 98%, 12.50, 0.17, and 96.5%, respectively. For the individual analysis, the sensitivity, specificity and accuracy of EUS-FNA were 76%, 100%, and 94.5%, respectively; for ERCP-based tissue sampling, the sensitivity, specificity, and accuracy were 58%, 98%, and 78.1%, respectively. For pancreatic lesions, EUS-FNA was superior to ERCP-based tissue sampling. However, for biliary lesions, both methods had similar sensitivities. Conclusions: Same-session EUS-FNA and ERCP-based tissue sampling is superior to either method alone in the diagnosis of suspected malignant biliary strictures. Considering these results, combination sampling should be performed when possible

Correlação entre achados imagenológicos e histopatológicos de lesões não palpáveis de mama em pacientes atendidos em hospital de referência da Amazônia / Correlation between imaging and histopathological findings of non-palpable breast lesions in patients seen at a referral hospital in the Amazônia

Objetivo: Apresentar a correlação de achados em exames de imagem com a classificação de BIRADS® e os resultados histológicos de lesões não palpáveis, de pacientes em um hospital de referência em diagnóstico e tratamento do câncer na cidade de Manaus-AM. Métodos: Trata-se de um estudo retrospectivo, observacional e transversal, realizado por meio de revisão de prontuários médicos da Fundação do Centro de Controle de Oncologia do Estado do Amazonas (FCECON) na cidade de Manaus de pacientes atendidas de janeiro a outubro de 2018.  Resultados: A amostra foi composta por 48 pacientes. 100% das lesões nas categorias I e II eram lesões malignas, apesar do exame de imagem sugerir lesões benignas. Das lesões categoria III, aproximadamente 33% eram malignas e 67% benignas. Das lesões categoria IV, 57,5% eram malignas, já nas de categoria V, as lesões malignas representaram 77,8%. Conclusão: O rastreamento utilizando mamografia ou ultrassonografia com classificação BI-RADS® se mostrou um método seguro para investigar lesões suspeitas não-palpáveis de mama e em nosso serviço as taxas de malignidade por categoria foram compatíveis com as encontradas na literatura