RIO DE JANEIRO: DA CIDADE INSALUBRE À VERSALHES TROPICAL

Na segunda metade do século XIX, foram apresentadas propostas de modificação do espaço urbano do Rio de Janeiro, em função dos discursos dos viajantes, médicos e engenheiros que criticavam as condições sanitárias da cidade, e seu aspecto identificado com a escravidão. Essas reformas, inspiradas nos ideais de progresso e civilização, estabeleciam como paradigmas os modelos urbanísticos europeus, em especial da França. Esses projetos visavam à modernização urbana, de acordo com os esforços de higienização, de combate a epidemias e de controle social, culminando nas reformas Pereira Passos que modificaram significativamente a cidade. Palavras chave: Rio de Janeiro - reformas urbanas – Pereira Passo

Monitoring COVID-19 and Influenza: The Added Value of a Severe Acute Respiratory Infection Surveillance System in Portugal

Background: Severe acute respiratory infections (SARI) surveillance is recommended to assess the severity of respiratory infections disease. In 2021, the National Institute of Health Doutor Ricardo Jorge, in collaboration with two general hospitals, implemented a SARI sentinel surveillance system based on electronic health registries. We describe its application in the 2021/2022 season and compare the evolution of SARI cases with the COVID-19 and influenza activity in two regions of Portugal. Methods: The main outcome of interest was the weekly incidence of patients hospitalized due to SARI, reported within the surveillance system. SARI cases were defined as patients containing ICD-10 codes for influenza-like illness, cardiovascular diagnosis, respiratory diagnosis, and respiratory infection in their primary admission diagnosis. Independent variables included weekly COVID-19 and influenza incidence in the North and Lisbon and Tagus Valley regions. Pearson and cross-correlations between SARI cases, COVID-19 incidence and influenza incidence were estimated. Results: A high correlation between SARI cases or hospitalizations due to respiratory infection and COVID-19 incidence was obtained (ρ = 0.78 and ρ = 0.82, respectively). SARI cases detected the COVID-19 epidemic peak a week earlier. A weak correlation was observed between SARI and influenza cases (ρ = -0.20). However, if restricted to hospitalizations due to cardiovascular diagnosis, a moderate correlation was observed (ρ = 0.37). Moreover, hospitalizations due to cardiovascular diagnosis detected the increase of influenza epidemic activity a week earlier. Conclusion: In the 2021/2022 season, the Portuguese SARI sentinel surveillance system pilot was able to early detect the COVID-19 epidemic peak and the increase of influenza activity. Although cardiovascular manifestations associated with influenza infection are known, more seasons of surveillance are needed, to confirm the potential use of cardiovascular hospitalizations as an indicator of influenza activity.The data of the study were originally collected as part of the project “Establishing Severe Acute Respiratory Infections (SARI) surveillance and performing hospital-based COVID-19 transmission studies,” and the “Vaccine Effectiveness, Burden, and Impact Studies (VEBIS) of COVID-19 and Influenza,” funded by the European Centre for Disease Prevention and Control through a service contract with Epiconcept (ECD.11236 and Amendment Nos. 1 ECD.11810 and ECDC/2021/016).info:eu-repo/semantics/publishedVersio

the added value of a severe acute respiratory infection surveillance system in Portugal

Publisher Copyright: Copyright © 2023 Ana Rita Torres et al.Background. Severe acute respiratory infections (SARI) surveillance is recommended to assess the severity of respiratory infections disease. In 2021, the National Institute of Health Doutor Ricardo Jorge, in collaboration with two general hospitals, implemented a SARI sentinel surveillance system based on electronic health registries. We describe its application in the 2021/2022 season and compare the evolution of SARI cases with the COVID-19 and influenza activity in two regions of Portugal. Methods. The main outcome of interest was the weekly incidence of patients hospitalized due to SARI, reported within the surveillance system. SARI cases were defined as patients containing ICD-10 codes for influenza-like illness, cardiovascular diagnosis, respiratory diagnosis, and respiratory infection in their primary admission diagnosis. Independent variables included weekly COVID-19 and influenza incidence in the North and Lisbon and Tagus Valley regions. Pearson and cross-correlations between SARI cases, COVID-19 incidence and influenza incidence were estimated. Results. A high correlation between SARI cases or hospitalizations due to respiratory infection and COVID-19 incidence was obtained (ρ = 0.78 and ρ = 0.82, respectively). SARI cases detected the COVID-19 epidemic peak a week earlier. A weak correlation was observed between SARI and influenza cases (ρ = −0.20). However, if restricted to hospitalizations due to cardiovascular diagnosis, a moderate correlation was observed (ρ = 0.37). Moreover, hospitalizations due to cardiovascular diagnosis detected the increase of influenza epidemic activity a week earlier. Conclusion. In the 2021/2022 season, the Portuguese SARI sentinel surveillance system pilot was able to early detect the COVID-19 epidemic peak and the increase of influenza activity. Although cardiovascular manifestations associated with influenza infection are known, more seasons of surveillance are needed, to confirm the potential use of cardiovascular hospitalizations as an indicator of influenza activity.publishersversionpublishe

Incidence of postoperative residual neuromuscular blockade: a multicenter, observational study in Portugal (INSPIRE 2)

Background: Although the use of neuromuscular blocking agents (NMBAs) optimizes surgical conditions and facilitates tracheal intubation, it can lead to residual neuromuscular blockade (RNMB), with postoperative complications. This study aimed to assess RNMB incidence and management in Portugal. Methods: Prospective observational study of patients admitted for elective surgery requiring general anesthesia with nondepolarizing NMBAs between July 2018 and July 2019 at 10 Portuguese hospitals. The primary endpoint was the proportion of patients arriving at postanesthesia care unit (PACU) with a TOF ratio ,0.9. Results: A total of 366 patients were included, with a median age of 59 years, and 89.1% classified as ASA II or III. Rocuronium was the most used NMBA (99.5%). A total of 96.2% of patients received a reversal agent, 96.6% of which sugammadex and 3.4% neostigmine. Twenty patients displayed a TOF ratio ,0.9 at PACU arrival, representing an RNMB incidence of 5.5% (95% CI, 3.1%–7.8%). Only two patients displayed a TOF ratio ,0.7. RNMB incidence was 16.7% with neostigmine and 5.3% with sugammadex (P 5 .114). In patients with intraoperative neuromuscular blockade (NMB) monitoring, RNMB incidence was 5% (95% CI, 2%–8%), which varied significantly according to the type of monitoring (P 5 .018). Incidence of adverse events was 3.3% (2 severe and 10 moderate). Conclusions: The reported overall incidence of 5.5% is numerically lower than results from similar observational studies. An appropriate pharmacological neuromuscular reversal strategy, guided by quantitative neuromuscular monitoring, has the potential to achieve even better results, converting RNMB from an unusual to a very rare or even inexistent event.info:eu-repo/semantics/publishedVersio

Reporting an experience : recovering and recording residues of teaching laboratories of Chemical Institute of the Federal University of Rio Grande do Sul.

An experience aiming to promote a residue interchange and recovery between the teaching laboratories of the Chemistry Institute of this University is described. At the present, several residues interchange have already appeared as advantageous. To make the work easier, a software has been developed in order to keep a record of all the residues generated by the teaching laboratories. Standard labels have been developed for the residues in order to organize them. The software and the label design are described

PARESIA HIPOCALÊMICA PÓS-EPISÓDIO DIARREICO E DIAGNÓSTICOS DIFERENCIAIS: RELATO DE CASO PARESIS HYPOKALEMIC (POST EPISODE OF DIARRHEA) AND DIFFERENTIAL DIAGNOSIS: CASE REPORT

ResumoObjetivo: Descrever um caso de perda de mobilidade em decorrência de episódio diarreico com desitratação e hipocalemia, enumerando os diagnósticos diferenciais que poderiam ser pesquisados. Descrição do caso: Paciente com quadro de gastroenterite aguda que se apresentou com desidratação importante e hipocalemia, evoluindo com perda de força de membros inferiores. Por meio de revisão da literatura, discutimos os principais diagnósticos diferenciais relacionados ao caso, destacando-os quanto à sua importância clínica durante a investigação e abordagem terapêutica adequada. Considerações finais: Enfatiza-se com este relato que um episódio de gastroenterite aguda pode estar associado a várias outras consequências clínicas, como importante paresia de membros. Portanto, é importante uma adequada avaliação clínica e propedêutica do paciente, além de sempre elencar diagnósticos diferenciais como possíveis agentes desencadeantes de sintomas atípicos, como perda de força nos membros inferiores. Palavras-chave:Diarreia. Desidratação. Paresia AbstractObjective: To describe a case presenting with loss of mobility due to severe diarrheal episodes with dehydration and hypokalemia, as well as to list the differential diagnoses to be investigated in those cases. Case description: Patient with acute gastroenteritis presenting with severe dehydration and hypokalemia, evolving with lower limbs loss of strength. Through a review of the literature, we discuss the main differential diagnoses related to the case, highlighting them according to their clinical importance during the investigation and appropriate therapeutic approach. Final considerations: We emphasize with this case report that an episode of acute gastroenteritis may be associated with several other clinical presentation, such as lower limbs paresis. Therefore, an adequate clinical and propaedeutic evaluation is important, as well as always distinguishing differential diagnoses as possible triggers for atypical symptoms, such as loss of strength in the lower limbs. Keyword:Diarrhea. Dehydration. Paresis

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Contracepção hormonal e lesões cervicais pelo Papilomavírus Humano: uma revisão de literatura / Hormonal contraception and cervical injuries by Human Papillomavirus: a literature review

Introdução: A infecção pelo papilomavírus humano (HPV) é a doença sexualmente transmissível (DST) mais comum, afetando 50% da população mundial. Estima-se que entre 75 e 80% da de indivíduos sexualmente ativos adquirirão algum subtipo de HPV ao longo da vida. No Brasil, a taxa de prevalência de HPV varia de 13,7 a 54,3%, de acordo com a população e as regiões estudadas. Assim, este artigo tem como objetivo analisar a associação entre os hormônios contracepção e o aparecimento de lesões induzidas por HPV em o colo uterino. Metodologia: O presente estudo foi elaborado por meio de uma pesquisa bibliográfica, realizada eletronicamente, procurando registros sobre o desenvolvimento de lesões induzidas por HPV em colo uterino e hormônios de contracepção. Objetivando com isso identificar através da literatura a associação entre os hormônios de contracepção e o aparecimento de lesões induzidas por HPV em colo uterino. Para a realização do mesmo foram analisados artigos publicados em revistas científicas, utilizando as bases de dados da BVS (Biblioteca Virtual da Saúde), como: Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) e Scielo (Scientific Electronic Library Online). Resultados: Após a seleção, restaram nove artigos para a discussão. Podemos observar os artigos escolhidos no quadro, composto pelos autores, título, metodologia, resultados e conclusão que cada um encontrou. Em seguida foi realizada uma discussão acerca destes artigos. Conclusão: Muitos estudos relataram que os mecanismos envolvidos na persistência e incidência de lesões de HPV estão longe de ser esclarecidas, e que novas estudos são necessários para elucidar melhores abordagens em relação ao tipo de contracepção, via de administração e doses hormonal que não estão associadas a lesões induzidas por HPV