Costurando tradições: Praça Bento Silvério

TCC (graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. ArquiteturaTCC sem resumo

O PAPEL DA ENFERMAGEM NA ASSISTÊNCIA À PARTURIENTE QUE SOFRE VIOLÊNCIA OBSTÉTRICA: revisão narrativa

Obstetric violence is characterized by aggressions suffered by the pregnant woman during the prenatal, delivery or postpartum period. In this context, the nurse plays a very important role in promoting a safe delivery, and its presence is essential when thinking about a humanized delivery. Nurses are the professionals trained in reception, generating well-being and comfort at the time of delivery. Aiming at approaching the theme, the general objective of this work was to verify how nurses are helped in cases of obstetric violence against women. As secondary objectives, one must understand what violence against women is, conceptualize obstetric violence and understand how nurses can help in this context. For this purpose, a narrative literature review was used as a methodological process, using Google Scholar, Latin American and Caribbean Literature on Health Sciences (LILACS) and the Scientific Electronic Library Online (SCIELO) virtual library on materials that addressed the topic.La violencia obstétrica se caracteriza por las agresiones que sufre la mujer embarazada durante el período prenatal, parto o posparto. En este contexto, la enfermera juega un papel muy importante en la promoción de un parto seguro, y su presencia es esencial cuando se piensa en un parto humanizado. Las enfermeras son los profesionales capacitados en recepción, generando bienestar y confort al momento del parto. Con el objetivo de abordar el tema, el objetivo general de este trabajo fue verificar cómo se ayuda a las enfermeras en casos de violencia obstétrica contra las mujeres. Como objetivos secundarios, uno debe entender qué es la violencia contra las mujeres, conceptualizar la violencia obstétrica y entender cómo las enfermeras pueden ayudar en este contexto. Para ello, se utilizó como proceso metodológico una revisión narrativa de la literatura, utilizando Google Scholar, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y la biblioteca virtual de la Biblioteca Científica Electrónica en Línea (SCIELO) sobre materiales que abordaban el tema.A violência obstétrica é caracterizada por agressões sofridas pela gestante no decorrer do pré-natal, parto ou pós-parto. Nesse contexto o enfermeiro desempenha um papel de suma relevância na promoção de um parto seguro, sendo primordial a presença deste quando se pensa em um parto humanizado. São os enfermeiros os profissionais capacitados no acolhimento, gerando um bem-estar e conforto na hora do parto. Visando a abordagem do tema, o objetivo geral deste trabalho foi verificar como se dá o auxílio do enfermeiro em casos de violência obstétrica contra a mulher. Como objetivos secundários, têm-se de entender o que é a violência contra a mulher, conceituar a violência obstétrica e entender como o enfermeiro pode auxiliar nesse contexto. Para tanto, usou-se como processo metodológico a pesquisa de revisão bibliográfica narrativa, com busca no Google Acadêmico, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e na biblioteca virtual Scientific Eletronic Library Online (SCIELO)sobre materiais que abordassem a temática

Medicamentos na insuficiência cardíaca: revisão bibliográfica: Medications in heart failure: a literature review

Introdução: Os objetivos do manejo da insuficiência cardíaca são reduzir a morbidade e a mortalidade.  O gerenciamento inclui o gerenciamento da causa da IC (por exemplo, doença arterial coronariana) e o gerenciamento de condições associadas (por exemplo, diabetes). Os pacientes requerem acompanhamento seriado para avaliar o estado clínico, apoiar o autogerenciamento, incluindo o uso adequado de medicamentos, avaliar a resposta à terapia e avaliar a necessidade potencial de mudanças no manejo. Objetivos: O objetivo desse estudo é revisar sobre o manejo farmacológico das insuficiências cardíacas, sejam elas de fração de ejeção preservada, levemente reduzida ou reduzida. Métodos: Os bancos de dados Pubmed e UpToDate, além de diretrizes foram pesquisados eletronicamente os descritores insuficiência cardíaca; tratamento; insuficiência cardíaca sistólica nos idiomas inglês e português, utilizando as publicações dos últimos 05 anos. Discussão e Conclusão: A insuficiência cardíaca de fração levemente reduzida é tratada de forma semelhante à de fração de ejeção reduzida. Sendo assim, a terapia inicial é geralmente terapia diurética, um bloqueador do sistema angiotensina e um betabloqueador. Já a terapia secundária consiste em um antagonista do receptor mineralocorticóide e um inibidor do cotransportador 2 de sódio-glicose.  Já a insuficiência cardíaca de fração preservada tende a ter os inibidores do cotransporte 2 de sódio-glicose e o antagonista do receptor mineralocorticóide como tratamento de primeira linha

Perspectivas Futuras em Terapias Imunomoduladoras para Psoríase uma análise abrangente

This scientific review provides a comprehensive and up-to-date analysis on Future Perspectives in Immunomodulatory Therapies for Psoriasis. Given the complexity and variability of this dermatological condition, it becomes crucial to thoroughly examine the available therapeutic approaches for a more effective understanding of this clinical challenge. Psoriasis, with its diverse clinical presentations, demands a holistic evaluation of available therapies, ranging from IL-23 inhibitors to lifestyle interventions, offering a complete overview of the current landscape. Not only does it highlight the diversity of available therapeutic approaches, but the review also emphasizes the crucial importance of personalization and early intervention. Recognizing the different manifestations of psoriasis and individual patient responses, the study underscores how therapeutic strategies tailored to the specific characteristics of each individual are essential to optimize outcomes. This personalization not only takes into account the uniqueness of each patient but also underscores the need for an integrative and multifaceted approach to psoriasis treatment. By exploring the latest findings and developments in this field, this study goes beyond consolidating existing information, aiming to foster a critical reflection on current therapeutic practices in psoriasis. In doing so, it provides valuable insights for healthcare professionals, researchers, and patients, fostering a deeper understanding of therapeutic strategies and contributing to the ongoing improvement of the quality of life for individuals with psoriasis.Esta revisão científica proporciona uma análise abrangente e atualizada sobre as Perspectivas Futuras em Terapias Imunomoduladoras para Psoríase. Diante da complexidade e variabilidade dessa condição dermatológica, torna-se crucial examinar detalhadamente as abordagens terapêuticas disponíveis para uma compreensão mais eficaz desse desafio clínico. A psoríase, com sua diversidade de apresentações clínicas, demanda uma avaliação holística das terapias disponíveis, desde os inibidores de IL-23 até intervenções no estilo de vida, oferecendo um panorama completo do cenário atual. Não apenas se destaca a diversidade de abordagens terapêuticas disponíveis, mas a revisão enfatiza a importância crucial da personalização e da intervenção precoce. Reconhecendo as diferentes manifestações da psoríase e as respostas individuais dos pacientes, o estudo ressalta como estratégias terapêuticas adaptadas às características específicas de cada indivíduo são essenciais para otimizar os resultados. Essa personalização não apenas leva em conta a singularidade de cada paciente, mas também sublinha a necessidade de uma abordagem integrativa e multifacetada para o tratamento da psoríase. Ao explorar as últimas descobertas e desenvolvimentos nessa área, este estudo vai além da consolidação de informações existentes, buscando promover uma reflexão crítica sobre as práticas terapêuticas atuais em psoríase. Ao fazê-lo, oferece insights valiosos para profissionais de saúde, pesquisadores e pacientes, fomentando uma compreensão mais profunda das estratégias terapêuticas e contribuindo para a contínua melhoria da qualidade de vida dos indivíduos com psoríase

Bronquiolite Viral Aguda: Um Panorama Completo da Definição, Epidemiologia, Fisiopatologia, Sintomas, Tratamento e Desfecho

Introduction:  Acute Viral Bronchiolitis (AVB) is a common viral respiratory infection in childhood, primarily affecting infants under 2 years of age. Predominantly caused by the Respiratory Syncytial Virus (RSV) in up to 90% of cases, AVB results in inflammation and obstruction of the smaller airways, manifesting as cough, wheezing, and respiratory difficulty. The disease is particularly dangerous for premature infants, children with congenital heart diseases, or immunodeficiencies, with up to 30% requiring hospitalization, significantly impacting healthcare systems and the quality of life of families. Method: An integrative literature review was conducted in June 2024 using databases such as PubMed/Medline and SciELO. The descriptors "bronchiolitis," "respiratory infection," "virus," and "infant" were combined with the boolean operators "AND" and "OR". Inclusion criteria involved research from 2004 to 2024 in English, Portuguese, and Spanish. Case reports, duplicate articles, or non-pertinent studies were excluded. Eighteen scientific articles and chapters from the "Tratado de Pediatria" by the Brazilian Society of Pediatrics (2017) were analyzed. Results: Bronchiolitis is defined as inflammation of the bronchioles, with guidelines varying between the American Academy of Pediatrics and European directives. It affects over one-third of children in their first two years of life, with up to 10% hospitalized. RSV is responsible for up to 75% of cases, followed by rhinovirus and other respiratory viruses. Bronchiolitis shows seasonality, with risk factors such as age under 6 weeks, prematurity, immunodeficiency, and congenital heart disease. It is characterized by inflammation, increased mucus production, necrosis, and airway edema. RSV, transmitted through inhalation of infected particles, causes epithelial necrosis and airway obstruction, leading to hyperinflation and atelectasis. Studies suggest an association between RSV infection and increased incidence of asthma in subsequent years. Initial symptoms include upper respiratory infection, progressing to respiratory difficulty, wheezing, tachycardia, and tachypnea. Severe cases require hospitalization. Differential diagnosis is essential, distinguishing from asthma, bacterial pneumonia, and other conditions. Treatment is predominantly supportive, with hydration and monitoring for warning signs. In 2013, the monoclonal antibody palivizumab was approved for prophylaxis in high-risk groups. Hypertonic saline nebulization showed efficacy in mild to moderate cases. The indiscriminate use of corticosteroids and bronchodilators is not recommended. Conclusion: AVB is a prevalent condition significant for pediatric hospitalizations, with RSV as the primary etiologic agent. Treatment is mainly supportive, with specific prophylaxis for high-risk groups. The review highlights the importance of appropriate clinical approaches and prevention for effective AVB management. Introdução:  A Bronquiolite Viral Aguda (BVA) é uma infecção respiratória viral comum na infância, afetando principalmente lactentes menores de 2 anos. Causada majoritariamente pelo Vírus Sincicial Respiratório (VSR) em até 90% dos casos, a BVA resulta em inflamação e obstrução das vias aéreas menores, manifestando-se por tosse, sibilância e dificuldade respiratória. A doença é especialmente perigosa para prematuros, crianças com doenças cardíacas congênitas ou imunodeficiências, com até 30% necessitando de hospitalização, impactando significativamente os sistemas de saúde e a qualidade de vida das famílias. Método: Realizou-se uma revisão integrativa da literatura em junho de 2024, utilizando bases de dados como PubMed/Medline e SciELO. Os descritores "bronquiolite", "infecção respiratória", "vírus" e "lactente" foram combinados com operadores booleanos "AND" e "OR". Critérios de inclusão envolveram pesquisas de 2004 a 2024, nos idiomas inglês, português e espanhol. Excluíram-se relatos de caso, artigos duplicados ou não pertinentes. Foram analisados 18 artigos científicos e capítulos do "Tratado de Pediatria" da Sociedade Brasileira de Pediatria (2017). Resultados: A bronquiolite é definida como inflamação dos bronquíolos, com diretrizes variando entre a Academia Americana de Pediatria e as europeias. Afeta mais de um terço das crianças nos primeiros dois anos de vida, com até 10% hospitalizadas. O VSR é responsável por até 75% dos casos, seguido por rinovírus e outros vírus respiratórios. A bronquiolite exibe sazonalidade, com fatores de risco como idade menor de 6 semanas, prematuridade, imunodeficiência e cardiopatia congênita. Caracteriza-se por inflamação, aumento de muco, necrose e edema das vias aéreas. O VSR, transmitido por inalação de partículas infectadas, provoca necrose epitelial e obstrução das vias aéreas, levando a hiperinsuflação e atelectasia. Estudos sugerem associação entre infecção por VSR e aumento da incidência de asma em anos posteriores.Inicia-se com sintomas de infecção das vias aéreas superiores, evoluindo para dificuldade respiratória, sibilos, taquicardia e taquipneia. Casos graves necessitam de hospitalização. Diagnóstico diferencial é essencial, diferenciando-se de asma, pneumonia bacteriana e outras condições. O tratamento é predominantemente de suporte, com hidratação e monitoramento dos sinais de alerta. Em 2013, o uso do anticorpo monoclonal palivizumabe foi aprovado para profilaxia em grupos de risco. A solução salina hipertônica por nebulização mostrou eficácia em casos leves a moderados. O uso indiscriminado de corticóides e broncodilatadores não é recomendado. Conclusão: A BVA é uma condição prevalente e significativa para internações pediátricas, com o VSR como principal agente etiológico. O tratamento é majoritariamente de suporte, com profilaxia específica para grupos de risco. A revisão destaca a importância de abordagens clínicas adequadas e prevenção para manejo eficaz da BVA

Endothelial biomarkers in critically-ill COVID-19 patients: potential predictors of the need for dialysis

Introduction: To evaluate the function of vascular biomarkers to predict need for hemodialysis in critically-ill patients with COVID-19. Methods: This is a prospective study with 58 critically-ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, Syndecan-1, Angiopoietin-1 and Angiopoeitin-2 were quantified on intensive care unit (ICU) admission. Results: There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with need for hemodialysis. Vascular biomarkers (VCAM-1, Syndecan-1, angiopoetin-2/ anogiopoetin-1 ratio) were predictors of death and their cut-off values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 [O.R. 1.13 (C.I. 95%: 1.01 - 1.27); p= 0.034] and Ang-2/Ang-1 ratio [O.R. 4.87 (C.I.95%: 1.732 - 13.719); p= 0.003] were associated with need for dialysis. Conclusion: Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict need for hemodialysis in critically-ill COVID-19 patients

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic