Is arthrodesis still a good indication for non-inflammatory arthrosis of the wrist?

AbstractObjectiveThe aim of this study was to objectively and subjectively evaluate wrist function after total arthrodesis, among patients with sequelae of non-inflammatory arthritis who were treated with rigid internal fixation using a DCP plate.MethodsThirty-two patients with sequelae of non-inflammatory degenerative arthritis were treated using total arthrodesis of the wrist. Of these, two patients were treated with Kirschner wires and four discontinued the treatment, thus leaving 26 patients. The indication for arthrodesis of the wrist was the presence of intracarpal pathological conditions: eight wrists presented sequelae from fractures of the distal radius; 13 had sequelae from fractures of the scaphoid; and five had sequelae from Kienbock's disease. The cases were evaluated using the visual analogue scale (VAS), the muscle strength test, the Jebsen–Taylor functional test and the Buck-Gramcko test.ResultsIt was observed that there were no significant differences at the level of 5%, in the variables of grip strength, VAS, Jebsen–Taylor functional test or Buck-Gramcko/Lohmann test, between the pathological conditions.ConclusionTotal arthrodesis of the wrist using a plate in the dorsal region was shown to be a safe and efficient technique for patients with different types of pathological arthrosis of the wrist, since it did not cause any important functional incapacity and brought great pain relief

A percepção de futuros administradores sobre o trabalho de pessoas com deficiência (PcDs): inclusão ou benevolência?

The objective of the present study was to analyze the perception of undergraduates in administration about the work potential of people with disabilities (PcDs). A descriptive survey, with a quantitative approach, and data collection was done through the Carvalho-Freitas and Marques (2010) Inventory of Conceptions of Disability in Work Situations (ICD-ST) applied to 217 undergraduate students in Management. The data were treated through descriptive analysis and correlation (Pearson’s coefficient). The results show a perception that PCDs can perform well in the workplace, provided they have the necessary conditions, besides contributing positively to the image of the organization and being more involved. On the other hand, the greater the perception of performance, the more a concept based on normality assumptions is evidenced. Thus, it can be concluded that the respondents’ perception meets the assumptions of inclusion, however, the moderate and positive correlation between performance and normality factors indicates that the “deviation” from normality, caused by disability, is still seen as low productivity generator.O objetivo do presente estudo foi analisar qual a percepção de graduandos em administração sobre as potencialidades de trabalho de pessoas com deficiência (PcDs). Realizou-se uma pesquisa descritiva, do tipo survey, com abordagem quantitativa, e coleta de dados por meio do Inventário de Concepções de Deficiência em Situações de Trabalho (ICD-ST) de Carvalho-Freitas e Marques (2010) aplicado a 217 graduandos em Administração. Os dados foram tratados por meio de análises descritivas e correlação (Coeficiente de Pearson). Os resultados obtidos mostram uma percepção de que PcDs podem ter bom desempenho no trabalho, desde que possuam as condições necessárias, além de contribuir positivamente para a imagem da organização e serem mais comprometidos. Por outro lado, quanto maior a percepção de desempenho mais se evidencia uma concepção baseada em pressupostos de normalidade. Assim, pode-se concluir que a percepção dos respondentes vem ao encontro de pressupostos de inclusão, contudo, a correlação moderada e positiva entre os fatores de desempenho e normalidade sinaliza que o “desvio” da normalidade, causado pela deficiência, ainda é visto como gerador de baixa produtividade

INCIDÊNCIA DE INFECÇÕES DE SÍTIO CIRÚRGICO EM CIRURGIAS LIMPAS EM CLÍNICAS CIRÚRGICAS DE UM HOSPITAL ONCOLÓGICO DA REGIÃO NORTE

ABSTRACT Surgical Site Infection (SSI) is characterized as a post-surgical complication that occurs at the incision site, resulting from clinical aspects of the patient and/or incorrect handling of techniques that ensure the safety of procedures, increasing the probability of complications in surgeries classified as clean. This study aimed to determine the incidence of surgical site infection in breast, cardiac and thoracic surgeries in an oncology hospital in the North Region, highlighting the predisposing conditions and the etiological agents involved in the emergence of infections. This is an exploratory research with a quantitative, retrospective approach, carried out with 2,811 patients, in the period 2013-2020. The study found that 17 (0.6%) patients had infections, 13 (76.47%) were female and 4 (23.52%) were male. Escherichia coli and Staphylococcus Coagulase Negative (17.65%) were the most reported etiologic agents in SSI. The surgical wound was the main risk factor for SSI (33.33%).  Therefore, the article seeks to provide up-to-date knowledge about SSI-related risk factors to help with control interventions in hospitals. KEYWORDS: Cross Infection. Epidemiology. Surgery.RESUMEN La Infección del Sitio Quirúrgico (ISQ) se caracteriza como una complicación posquirúrgica que se presenta en el sitio de la incisión, resultante de aspectos clínicos del paciente y / o manejo incorrecto de técnicas que garantizan la seguridad de los procedimientos, aumentando la probabilidad de complicaciones en cirugías clasificadas tan limpio. Este estudio tuvo como objetivo determinar la incidencia de infección del sitio quirúrgico en cirugías de mama, cardíaca y torácica en un hospital de oncología de la Región Norte, destacando las condiciones predisponentes y los agentes etiológicos involucrados en la aparición de infecciones. Se trata de una investigación exploratoria con abordaje cuantitativo, retrospectivo, realizada con 2.811 pacientes, en el período 2013-2020. El estudio encontró que 17 (0,6%) pacientes tenían infecciones, 13 (76,47%) eran mujeres y 4 (23,52%) eran hombres. Escherichia coli y Staphylococcus Coagulase Negative (17,65%) fueron los agentes etiológicos más notificados en la ISQ. La herida quirúrgica fue el principal factor de riesgo de ISQ (33,33%). Por lo tanto, el artículo busca proporcionar conocimientos actualizados sobre los factores de riesgo relacionados con la ISQ para ayudar con las intervenciones de control en los hospitales. Palabras-clave: Infección nosocomial. Epidemiología. Cirugías.A Infecção de Sítio Cirúrgico (ISC) é caracterizada como uma complicação pós-cirúrgica que ocorre no local da incisão, decorrente de aspectos clínicos do paciente e/ou do manejo incorreto das técnicas que garantem a segurança dos procedimentos, elevando a probabilidade de intercorrências em cirurgias classificadas como limpas. Este trabalho teve como objetivo determinar a incidência de infecção de sítio cirúrgico em cirurgias de mastologia, cardíaca e torácica de um hospital oncológico da Região Norte, destacando as condições predisponentes e os agentes etiológicos envolvidos no surgimento das infecções. Trata-se de uma pesquisa exploratória com abordagem quantitativa, retrospectiva, realizada com 2.811 pacientes, no período de 2013-2020. O estudo constatou que 17 (0,6%) pacientes apresentaram infecções, sendo 13 (76,47%) do sexo feminino e 4 (23,52%) do sexo masculino. Escherichia coli e Staphylococcus Coagulase Negativo (17,65%) foram os agentes etiológicos mais notificados nas ISC. A ferida operatória foi o principal fator de risco para a ISC (33,33%). Portanto, o artigo procura prover conhecimento atualizado sobre os fatores de risco relacionados à ISC para ajudar nas intervenções de controle nos hospitais. Palavras-chave: Infecção Hospitalar. Epidemiologia. Cirurgias

Long-term Landsat-based monthly burned area dataset for the Brazilian biomes using Deep Learning

Fire is a significant agent of landscape transformation on Earth, and a dynamic and ephemeral process that is challenging to map. Difficulties include the seasonality of native vegetation in areas affected by fire, the high levels of spectral heterogeneity due to the spatial and temporal variability of the burned areas, distinct persistence of the fire signal, increase in cloud and smoke cover surrounding burned areas, and difficulty in detecting understory fire signals. To produce a large-scale time-series of burned area, a robust number of observations and a more efficient sampling strategy is needed. In order to overcome these challenges, we used a novel strategy based on a machine-learning algorithm to map monthly burned areas from 1985 to 2020 using Landsat-based annual quality mosaics retrieved from minimum NBR values. The annual mosaics integrated year-round observations of burned and unburned spectral data (i.e., RED, NIR, SWIR-1, and SWIR-2), and used them to train a Deep Neural Network model, which resulted in annual maps of areas burned by land use type for all six Brazilian biomes. The annual dataset was used to retrieve the frequency of the burned area, while the date on which the minimum NBR was captured in a year, was used to reconstruct 36 years of monthly burned area. Results of this effort indicated that 19.6% (1.6 million km2) of the Brazilian territory was burned from 1985 to 2020, with 61% of this area burned at least once. Most of the burning (83%) occurred between July and October. The Amazon and Cerrado, together, accounted for 85% of the area burned at least once in Brazil. Native vegetation was the land cover most affected by fire, representing 65% of the burned area, while the remaining 35% burned in areas dominated by anthropogenic land uses, mainly pasture. This novel dataset is crucial for understanding the spatial and long-term temporal dynamics of fire regimes that are fundamental for designing appropriate public policies for reducing and controlling fires in Brazil

Utilização de tóros mandibular para reconstrução de seio maxilar: revisão de literatura

O tóros mandibular é uma exostose óssea benigna, de crescimento lento que se desenvolve geralmente ao longo da superfície lingual da mandíbula, de ocorrência não rara porém assintomática, que na maioria das vezes se passa despercebida. O objetivo deste trabalho foi foi realizar uma revisão de literatura sobre o uso de tóros mandibular como fonte doadora de enxerto autógeno em procedimento de reconstrução do seio maxilar para reabilitação implantossuportada. Os resultados mostraram que os enxertos autógenos para as reconstruções ósseas na implantodontia têm um papel fundamental, pois é o material com as melhores propriedades biológicas para estes procedimentos de enxertia. Entretanto, a necessidade de um acesso cirúrgico à área doadora para a coleta do material acarreta maior morbidade para o procedimento. Por outro lado, pacientes que apresentam exostoses ósseas com indicação de remoção são ótimos candidatos para utilização do osso removido como enxerto em reconstruções ósseas para fins de reabilitação implantossuportada

Wild dogs at stake: deforestation threatens the only Amazon endemic canid, the short-eared dog (Atelocynus microtis)

The persistent high deforestation rate and fragmentation of the Amazon forests are the main threats to their biodiversity. To anticipate and mitigate these threats, it is important to understand and predict how species respond to the rapidly changing landscape. The short-eared dog Atelocynus microtis is the only Amazon-endemic canid and one of the most understudied wild dogs worldwide. We investigated short-eared dog habitat associations on two spatial scales. First, we used the largest record database ever compiled for short-eared dogs in combination with species distribution models to map species habitat suitability, estimate its distribution range and predict shifts in species distribution in response to predicted deforestation across the entire Amazon (regional scale). Second, we used systematic camera trap surveys and occupancy models to investigate how forest cover and forest fragmentation affect the space use of this species in the Southern Brazilian Amazon (local scale). Species distribution models suggested that the short-eared dog potentially occurs over an extensive and continuous area, through most of the Amazon region south of the Amazon River. However, approximately 30% of the short-eared dog's current distribution is expected to be lost or suffer sharp declines in habitat suitability by 2027 (within three generations) due to forest loss. This proportion might reach 40% of the species distribution in unprotected areas and exceed 60% in some interfluves (i.e. portions of land separated by large rivers) of the Amazon basin. Our local-scale analysis indicated that the presence of forest positively affected short-eared dog space use, while the density of forest edges had a negative effect. Beyond shedding light on the ecology of the short-eared dog and refining its distribution range, our results stress that forest loss poses a serious threat to the conservation of the species in a short time frame. Hence, we propose a re-assessment of the short-eared dog's current IUCN Red List status (Near Threatened) based on findings presented here. Our study exemplifies how data can be integrated across sources and modelling procedures to improve our knowledge of relatively understudied species

Panorama das Intervenções Coronárias Percutâneas em Oclusões Totais Crônicas em Centros Participantes do LATAM CTO Registry no Brasil

Background: Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries. Objectives: To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil. Methods: Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months. Results: Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%. Conclusions: CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centersinfo:eu-repo/semantics/publishedVersio

Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control

Tendência Temporal no Implante Percutâneo de Bioprótese Aórtica: Análise de 10 Anos do Registro TAVIDOR

Resumo Fundamento O implante percutâneo de bioprótese valvar aórtica (TAVI) consolidou-se como opção terapêutica da estenose aórtica de grau importante. Dados sobre as características evolutivas dos procedimentos e dos resultados obtidos com a técnica ao longo da última década, em escala nacional, são desconhecidos. Objetivos Analisar a tendência temporal referente ao perfil demográfico, características dos procedimentos e desfechos hospitalares de pacientes submetidos a TAVI na Rede D’Or São Luiz. Métodos Registro observacional envolvendo 29 instituições nacionais. Comparou-se características dos procedimentos realizados de 2012 a 2017 (Grupo 1) e de 2018 a 2023 (Grupo 2). Foram considerados significantes os resultados com valor de p 8%. Foi mais frequente o emprego de anestesia geral, monitorização ecocardiográfica transesofágica e via de acesso por dissecção. Maior taxa de sucesso do procedimento (95,4% versus 89,5%; p = 0,018) foi aferida em implantes efetivados a partir de 2018, assim como menor mortalidade (3,9% versus 11,6%; p = 0,004) e necessidade de marcapasso definitivo (8,5% versus 17,9%; p = 0,008). Conclusões A análise temporal de 10 anos do Registro TAVIDOR demonstra uma queda na complexidade clínica dos pacientes. Além disso, o avanço para técnicas de implante minimalistas, somadas à evolução tecnológica dos dispositivos, podem ter contribuído para desfechos favoráveis dentre aqueles cujo implante ocorreu no último quinquênio

Clareza, concisão e coesão: princípios e métricas de legibilidade aplicados ao texto de pós-graduandos em Ciência da Informação

Introdução: a barreira da língua dificulta publicar em inglês mesmo quando há mérito científico, pois o problema começa em português, na dificuldade em escrever como a ciência requer. Qual o impacto da aplicação de princípios de clareza, concisão e coesão na extensão e legibilidade de textos científicos? Esta pesquisa objetivou verificar esse impacto ao comparar extensão e indicadores de legibilidade antes e após a aplicação dos princípios. Método: vinte e cinco estudantes de pós-graduação em Ciência da Informação anotaram um texto científico próprio e o de três colegas, em revisão por pares duplo-cega, indicando problemas de estilo de quatro tipos: palavra desnecessária, distância sujeito-verbo excessiva, nominalização excessiva e contextualização tardia. Cada autor reelaborou seu próprio texto para resolver os problemas anotados. Os textos originais e reelaborados foram comparados em extensão e escore de facilidade de leitura de Flesch. Textos originais e reelaborados da literatura também foram mensurados como referência. Resultados: Todos os textos diminuíram em extensão após reelaborados, embora tenha havido mais atenção a problemas gramaticais do que aos quatro problemas de estilo. Houve 13 aumentos, duas manutenções e 10 diminuições nos escores de legibilidade. Esse resultado é compatível com o estudo-referência com textos da literatura. Conclusão: a aplicação dos princípios de legibilidade diminui a extensão e, em acordo com a literatura, tem impacto duvidoso no escore de legibilidade. Resta investigar a traduzibilidade comparada para verificar o pressuposto de que aplicar os princípios é "escrever em inglês em português".Introduction: The language barrier makes it difficult to publish in English, even when there is scientific merit, as the problem starts in Portuguese, in the difficulty of following scientific writing principles. What is the impact of applying principles of clarity, conciseness, and cohesion in the extension and readability of scientific texts? This research aimed to verify this impact when comparing extension and readability indicators before and after applying those principles. Method: Twenty-five Information Science graduate students annotated their own scientific text and that of three colleagues, in a double-blind review, indicating writing style problems of four types: unnecessary word, excessive subject-verb distance, excessive nominalization, and late contextualization. Each author then reworked their own text to solve the problems. The original and reworked texts were compared in length and Flesch Reading Ease score. Original and reworked texts from the literature were also compared, as a reference. Results: All texts were shortened after rework, although annotations were directed most to grammatical problems than to the four style problems. There were 13 increases, 2 maintenance, and 10 decreases in the readability scores. This result is compatible with the benchmark study with texts from the literature. Conclusions: Applying readability principles improves conciseness but, in accordance with the literature, has a dubious impact on the readability score. Compared translatability remains an open research topic, to verify the assumption that applying the principles equates to "write in English in Portuguese"