Factores biopsicosociales que interfieren en la rehabilitación de víctimas de quemaduras: revisión integradora de la literatura

This study aimed to identify the biopsychosocial factors that influence the rehabilitation of burn victims, through an integrative literature review, from January 1987 to January 2007. Articles were searched in databases Scielo, Pubmed and Lilacs, resulting in 982 articles, of which 45 were selected, after the analysis and categorization processes. Most studies were descriptive and qualitative. The most frequently associated factors to the rehabilitation process were: mental health state before the accident, coping strategies and family support, besides the severity of the burn and the total body surface area burned. The quality of the selected studies, most classified as evidence level VI, shows the scarce production of strong evidences in this knowledge area, which needs more investment, considering the important implications of the sequelae of burns in the social reintegration of these people.Este estudo teve como objetivo identificar os fatores biopsicossociais que influenciam a reabilitação de vítimas de queimadura, por meio de revisão integrativa de literatura, no período de janeiro de 1987 a janeiro de 2007. A partir da busca dos artigos nas bases de dados SciELO, PubMed e LILACS, obtiveram-se 982 artigos, dos quais 45 foram selecionados. A maior parte dos estudos era do tipo descritivo e qualitativo. Os fatores mais frequentemente associados ao processo de reabilitação foram: estado de saúde mental prévio ao acidente, estratégias de enfrentamento e apoio da família, além da gravidade da queimadura e da superfície corporal queimada. A qualidade dos estudos, na maioria classificados com nível de evidência VI, chama a atenção para a escassa produção de evidências fortes nessa área do conhecimento, necessitando maiores investimentos, considerando-se as importantes implicações das sequelas da queimadura na reintegração social dessas pessoas.Este estudio tuvo como objetivo identificar los factores biopsicosociales que influyen en la rehabilitación de víctimas de quemaduras, por medio de una revisión integradora de la literatura, en el período de enero de 1.987 a enero de 2.007. A partir de la búsqueda de los artículos en las bases de datos Scielo, Pubmed y Lilacs, se obtuvieron 982 artículos, de los cuales 45 fueron seleccionados. La mayor parte de los estudios era del tipo descriptivo y cualitativo. Los factores más frecuentemente asociados al proceso de rehabilitación fueron: estado de salud mental previo al accidente, estrategias de enfrentamiento y apoyo de la familia, además de la gravedad de la quemadura y de la superficie corporal quemada. La calidad de los estudios, en la mayoría clasificados con nivel de evidencia VI, llaman la atención para la escasa producción de evidencias fuertes en esta área del conocimiento, que necesita mayores inversiones, considerando las importantes implicaciones de las secuelas de la quemadura en la reintegración social de esas personas

Consulta de vigilância juvenil e infantil - 15 meses

Poster apresentado nas III Jornadas Científicas Universitárias e Politécnicas da Egas Moniz, Monte de Caparica, 01-02-2023N/

A queimadura e a experiência do familiar frente ao processo de hospitalização

Hospital admission due to burning is usually fast and unpredictable. There may be different reactions to trauma according to the phase experienced by the patient and his/her family. This study aimed at describing the impact of the hospitalization of burnt patients on family dynamics. The Calgary Family Assessment Model was applied using semi-structured interviews and direct observation of family members. The following phases were considered for data analysis: reading the material and data reduction, data presentation, conclusion presentation, and verification. The findings showed that family members experience a crisis period that affects their physical and emotional status, relationships, daily routine, management of financial resources, and work. All of these aspects change the family dynamics, contributing for the maintenance of a crisis-adjustment-stability cycle during the entire treatmentLa hospitalización como consecuencia de quemaduras ocurre de forma rápida e imprevisible. Las reacciones frente al trauma pueden ser diferentes, dependiendo de la fase en que se encuentren el paciente y la familia. Con el objetivo de describir el impacto de la quemadura y de la consiguiente hospitalización sobre la dinámica familiar, se utilizó el Modelo de Calgary de Evaluación de Familias en 21 familiares de pacientes quemados. Se realizaron evaluaciones semi-estructuradas y observación directa. El análisis de los datos siguió las etapas de: reducción de los datos, presentación, elaboración de las conclusiones y verificación. Los resultados mostraron que los familiares viven un período de crisis reflejado en el estado físico y emocional, en las relaciones y en la rutina. Estos aspectos alteran la dinámica familiar y contribuyen a que ocurra el ciclo crisis-adaptaciónestabilización, que persiste durante el tratamiento.A hospitalização decorrente de queimaduras acontece de forma rápida e imprevisível. As reações frente ao trauma podem ser diferentes dependendo da fase que se encontram o paciente e família. Com o objetivo de descrever o impacto da queimadura e hospitalização sobre a dinâmica familiar, utilizou-se o Modelo Calgary de Avaliação de Famílias com 21 familiares de pacientes queimados. Foram realizadas entrevistas semi-estruturadas e observação direta. A análise dos dados foi conduzida considerando-se as seguintes etapas: redução dos dados, apresentação, delineamento das conclusões e verificação. Os resultados mostraram que os familiares vivenciam um período de crise com reflexo sobre o estado físico e emocional, relacionamentos e rotina. Esses aspectos alteram a dinâmica familiar e contribuem para a ocorrência do ciclo crise-adaptação-estabilização, que persiste durante o tratamento

The distribution of wall shear stress downstream of a change in roughness

In the present work, six different experimental techniques are used to characterize the non-equilibrium flow downstream of a rough-to-smooth step change in surface roughness. Over the rough surface, wall shear stress results obtained through the form drag and the Reynolds stress methods are shown to be mutually consistent. Over the smooth surface, reference wall shear stress data is obtained through two optical methods: linear velocity profiles obtained through laser-Doppler anemometry and a sensor surface, the diverging fringe Doppler sensor. The work shows that the two most commonly used methods to determine the wall shear stress, the log-law gradient method and the Reynolds shear stress method, are completely inappropriate in the developing flow region. Preston tubes, on the other hand, are shown to perform well in the region of a non-equilibrium flow.Indisponível

Dermatomiosite juvenil, manifestações clínicas e condutas médicas: relato de caso / Juvenile dermatomyositis, clinical manifestations and medical management: case report

O presente artigo visou relatar o caso clínico de uma paciente, sabidamente portadora do anticorpo anti-Ro e de alterações enzimáticas musculares, que foi encaminhada por uma Unidade de Pronto Atendimento (UPA) a um hospital público devido à refratariedade à terapêutica instituída na unidade. Posteriormente, procedeu-se a internação desta em enfermaria de reumatologia. Trata-se, portanto, de um estudo descritivo, do tipo relato de caso, que visou discorrer sobre as principais observações constatadas durante a permanência da paciente no centro terciário de atenção à saúde. Para tanto, foram analisados os documentos sobre suas evoluções diárias, bem como os resultados de exames laboratoriais e de imagens realizados por ela. A paciente evoluiu com características clínicas típicas e, por vezes, patognomônicas de dermatomiosite juvenil (DMJ), como fraqueza muscular proximal e simétrica, heliotrópio, pápulas de Gottron, sinal do “V” do decote e vasculites, além de intercorrências como manifestações gastrointestinais. A abordagem farmacológica, ajustada às alterações diárias em seu quadro clínico, permitiram melhor prognóstico e estabilização da agudização da doença. 

Detection of diploid males in a natural colony of the cleptobiotic bee Lestrimelitta sp (Hymenoptera, Apidae)

When working at quantifying the genome size of stingless bees, it was observed that males of Lestrimelitta sp possessed the same amount of nuclear DNA as the females. Thus, we used flow cytometry (FCM) and cytogenetic analysis to confirm the ploidy of these individuals. The males analyzed proved to be diploid, since, through cytometric analysis, it was demonstrated that the mean genome size of both males and females was the same (C = 0.463 pg), and, furthermore, cytogenetic analysis demonstrated that both had 2n = 28 chromosomes

Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

BACKGROUND: Smear negative pulmonary tuberculosis (SNPT) accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. METHODS: The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. RESULTS: It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. CONCLUSION: The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe

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