Angioplastia Coronária: adversdades e possibilidades na assistência de enfermagem / Coronary Angioplasty: adversities and possibilities in nursing assistance

Objetivo: Relatar as adversidades e desafios e possiblidades da assistência de enfermagem em pacientes submetidos a angioplastia coronária. Metodologia: revisão integrativa de literatura, onde a busca pelos artigos foi realizada no período de janeiro de 2020 á novembro de 2020 na Biblioteca Virtual de Saúde junto à base de dados, SCIELO, LILACS, MEDLINE, BDENF. Resultados evidenciaram que o enfoque dado pelos autores refere-se a temas pesquisados onde abordam a assistência de enfermagem e suas adversidades e suas possiblidades em assistência voltado para angioplastia coronariana. Conclui-se que o tema escolhido é diferenciado e vem merecendo atenção por parte de pesquisadores, pois se observa um número crescente de estudos sobre a temática. Desse modo, é necessário que as instituições forneçam aos profissionais, cursos de qualificação e aperfeiçoamento, com a finalidade de minimizar eventuais erros onde possam causar danos físicos e emocional nesses pacientes e em seus familiares

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Legislação ambiental do Brasil e do Estado do Maranhão: vislumbrando as queimadas como tematica necessária/ Environmental legislation in Brazil and in the State of Maranhão: glimpsing the burning as a necessary theme

A educação ambiental auxilia na compreensão do ambiente, nos conflitos entre sociedade e natureza, tomando um caráter de educação crítica voltada para cidadania. O presente artigo tem por objetivo traçar um panorama quantitativo e qualitativo de leis que regulamentam a preservação do meio ambiente e o trato com a Educação Ambiental no Brasil, Maranhão e no município de Codó/MA, pontuando principalmente questões sobre as queimadas. Para tanto, adotou-se como metodologia a pesquisa documental, onde por meio de levantamento em sites oficiais do governo federal, estadual e municipal identificou-se e selecionou-se a legislação ambiental para um estudo exploratório. Os resultados mostraram que o cenário nacional conta hoje com números satisfatórios de leis que se destinam à temática do Meio Ambiente e Educação Ambiental. Das legislações analisadas destacamos quatorze na área ambiental e dez orientadas para Educação Ambiental onde também inserem a temática das queimadas. Ressalta-se que essas leis orientam para a proteção a direitos fundamentais, como por exemplo, o direito ao ambiente natural equilibrado

Myocardial scars correlate with eletrocardiographic changes in chronic Trypanosoma cruzi infection for dogs treated with Benznidazole.

objectives The cardiac form of Chagas disease is evidenced by a progressive cardiac inflammation that leads to myocarditis, fibrosis and electrocardiographic (ECG) conduction abnormalities. Considering these characteristics, the aim of this study was to prospectively evaluate the early ECG changes in dogs that were experimentally inoculated with Benznidazole (Bz)-susceptibly (Berenice-78) and Bz-resistant (VL-10, and AAS) Trypanosoma cruzi strains and, later, evaluate the efficacy of Bz treatment for preventing these ECG alterations. methods Electrocardiographic changes of treated and untreated animals were prospectively evaluated for up to 270 days after infection, at which point collagen (right atrium) quantification was performed. results All infected dogs had a high intensity of heart fibrosis (4616.00 ± 1715.82 collagen ⁄ 74931 lm2 in dogs infected with Berenice-78 strain, 5839.2 ± 1423.49 collagen ⁄ 74931 lm2 in infected by AAS and 6294.40 ± 896.04 collagen ⁄ 74931 lm2 in animals infected with VL-10 strain), while 78.57% of all infected dogs showed ECG alterations. Bz Therapy reduced or prevented fibrosis in Bz-susceptible Berenice-78 (2813.00 ± 607.13 collagen ⁄ 74931 lm2) and Bz-resistant AAS strains (4024 ± 1272.44 collagen ⁄ 74931 lm2), coincident with only 10% de ECG alterations at 270 days. However, in those animals infected with a Bz-resistant VL-10 strain, specific treatment did not alter collagen deposition (6749.5 ± 1596.35 collagen ⁄ 74931 lm2) and there was first atrioventricular block and chamber overload at 120 and 270 days after infection, with 75% abnormal ECG exams. conclusions These findings indicate that an effective antiparasitic treatment in the early stage of Chagas disease can lead to a significant reduction in the frequency and severity of the parasite-induced cardiac disease, even if parasites are not completely eliminated

Analisando as pesquisas em educação especial no Brasil Analysing research in special education in Brazil

Nosso objetivo foi examinar a articulação lógica entre o problema e a proposição teórico-metodológica das produções na área da Educação Especial, focando os seus pressupostos epistemológicos. Nos fundamentamos nos pressupostos das tendências empírico-analítica, fenomenológica-hermenêutica, crítico-dialética e do paradigma da complexidade. O procedimento adotado foi interpretar todas as dissertações/teses produzidas nos Programas de Pós-Graduação em Educação e Educação Especial do Brasil, que versam sobre Educação Especial, produzidas nos anos de 2001, 2002 e 2003, disponíveis no banco de teses da CAPES. Encontramos as tendências empírica, fenomenológica e dialética. Os equívocos encontrados foram a não inserção da pesquisa entre as produções na área; ausência de criticidade; não posicionamento numa determinada concepção de educação; construção teórica fundamentada em concepções diferentes; falta de coerência nos pressupostos teórico-metodológicos; não explicitação metodológica; não descrição dos procedimentos éticos; e má elaboração dos resumos. Concluímos pela necessidade da melhoria das dissertações/teses para que possamos avançar na produção de conhecimento na área da Educação Especial.<br>Our objective was to analyze the logical articulation between the problem and the theoretical-methodological proposal of studies in the field of Special Education, focusing on the epistemological issues. We based our study on the empiric-analytical tendencies, phenomenology-hermeneutic, critical-dialectical and the complexity paradigm. The procedure that was adopted was interpreting all dissertations/thesis produced in Post-Graduate programs in Education and Special Education in Brazil, which focus on Special Education, produced in 2001, 2002 and 2003, available online at CAPES' thesis database. We found empirical, phenomenological and dialectic tendencies. The errors encountered included the failure to include the research among the productions in the field; lack of critical approach; lack of making explicit what educational conception the study was based on; theoretical construction based on different conceptions; lack of coherence in the theoretical-methodological proposals; lack of methodological specification; absence of ethical procedural descriptions; and poorly written abstracts. We came to the conclusion that improvements in theses /dissertations are necessary so as to continually move forward in the production of knowledge in the field of Special Education

Núcleos de Ensino da Unesp: artigos 2013: volume 2: metodologias de ensino e a apropriação de conhecimento pelos alunos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP