DENGUE HEMORRÁGICA

A dengue é uma arbovirose, de origem na África no final do séc XIX, caracterizada por ser um problema de saúde pública. Pandêmica no mundo, tal doença tem caráter sazonal e é transmitida por artrópodes. A doença costuma ter curso benigno, todavia as complicações podem ser fatais ao portador. As complicações da dengue são choque da dengue hemorrágica e febre da dengue hemorrágica. Ainda que manifestações como edema e hemorragia sejam bem descritas na literatura médica é certo que muitos parâmetros da fisiopatologia da dengue não sejam totalmente conhecidos e apresentem controvérsias apresentadas recentemente. Logo, deseja-se acrescentar dados que contribuam para o avanço do conhecimento sobre o assunto, correlacionando aspectos fisiopatológicos, histológicos e epidemiológicos dos dados analisados nos necropsiados bem como presentes na biblioteca médica hodierna. O presente estudo valerá de necropsia de sete falecidos no método de Virschow, bem como de posterior análise de lâminas coradas. A necropsia clínica contribui pra confirmação dos casos suspeitos e explica melhor os mecanismos patogênicos da doença. Em nosso meio os principais diagnósticos diferenciais em necropsia de dengue hemorrágica são hantavirose e HN1. Pelo feitio desse procedimento, e sendo comparados os achados com a literatura, uma maior compreensão da doença será obtida. Em tal fato encontra-se a validade deste estudo

AVALIAÇÃO DA EXPRESSÃO DE MARCADORES IMUNOLÓGICOS NA FEBRE HEMORRÁGICA DA DENGUE / DENGUE HEMORRHAGIC FEVER: IMMUNOHISTOCHEMICAL ASPECTS

Introdução: A dengue é uma arbovirose pandêmica de caráter sazonal, com evolução predominantemente benigna, emboracomplicações possam ocorrer. As complicações da dengue são: Síndrome do Choque da Dengue e Febre Hemorrágica da Dengue.Os parâmetros da fisiopatologia da dengue não são totalmente conhecidos, havendo discordância entre os estudiososquanto as várias hipóteses relacionadas à fisiopatologia da Febre Hemorrágica da Dengue. Objetivo: Avaliar a expressão demarcadores imunológicos (CD8, CD20, CD56 e CD38) no baço e pulmão de pacientes com Febre Hemorrágica da Dengue. Métodos:Foi realizado um estudo observacional, descritivo, do tipo série de casos, durante os anos 2014 e 2016. Foram avaliados 7+ casos através de blocos de parafina de derivados necropsiados. Resultados: Foram encontradas células CD8 no pulmão, dessa+ forma explicitando seu papel na fisiopatologia da FHD. O mesmo não se aplica para as células CD56 no baço considerando queos achados foram inconclusivos. No que se refere ao CD38, ressaltou-se a variação de expressão do marcador de acordo comidade e morbidades concomitantes. Conclusão: Foram encontrados diversos marcadores no baço e pulmão dos pacientes comFebre Hemorrágica da Dengue (CD8, CD20, CD56 e CD38). A maioria destes marcadores estiveram presentes com mais frequênciano baço do que no pulmão.Palavras-chave: Imuno-histoquímica. Febre Hemorrágica da Dengue. Fisiopatologia.AbstractIntroduction: Dengue is a pandemic arboviral disease with seasonal character, with predominantly benign evolution, althoughcomplications can occur. The dengue complications are Dengue Shock Syndrome and Dengue Hemorrhagic Fever. The parametersof dengue's pathophysiology are not completely understood, having disagreement among experts as various hypothesesrelated to the pathophysiology of Dengue Hemorrhagic Fever. Objective: This study aimed to evaluate the expression of immunologicalmarkers (CD8, CD20, CD56 and CD38) in the spleen and lung of patients with Dengue Hemorrhagic Fever. Method: Itwas performed an observational and descriptive study of case series, during the years 2014 and 2016. The 7 cases were evaluatedby paraffin blocks of necropsied derivatives. Results: Were found CD8 + cells in the lung, explaining their role in thepathophysiology of DHF. The same does not apply to CD56 + cells in the spleen whereas the findings were inconclusive. RegardingCD38, the variation of marker expression according to age and concomitant morbidities was emphasized. Conclusion:Several markers were found in the spleen and lung of patients with DHF (CD8, CD20, CD56 and CD38). Most of these markerswere present on a larger scale in the spleen than in the lung.Keywords: Immunohistochemistry. Hemorrhagic Dengue Fever. Pathophysiology

Repercussões Respiratórias no Pós – Operatório de Câncer de Mama

Introduction: Cancer is defined as a disorderly proliferation of cells that can spread and invade tissues and/or organs throughout the body, when a genetic mutation occurs, the deoxyribonucleic acid (DNA) undergoes an erroneous change of orders on how to multiply, classified as cancer cells, named according to their multiplication speed and ability to spread to other tissues. Objective: Check the respiratory repercussions in the postoperative period of breast câncer. Method: This is a descriptive, cross-sectional study with quantitative analysis, carried out with 20 female individuals in the postoperative period of breast cancer who were undergoing treatment at a Specialty Outpatient Clinic in Montes Claros - Minas Gerais. The instruments used were the MRC scale, which assesses the level of dyspnea during physical activity, cirtometry, which assesses chest expansion, and a manovacuometer, which measures respiratory muscle strength. Results: The average age of the participants was 50.40 ± 5.50, it was observed that 90.0% of the participants feel short of breath only during intense exercises, according to the MRC scale, in the cirtometry all the subjects showed a reduction in expandability thoracic. A significant decrease in respiratory muscle strength was observed, the average percentage achieved in forced inspiration was 86.77% and in forced expiration its average percentage was 71.75%. Conclusion: It is concluded that patients with breast cancer who underwent a surgical procedure may have respiratory changes, that is, the population studied showed changes in muscle strength and changes in expansion, but there was no association between the level of chest expansion and type of surgery.Introdução: O câncer é definido como uma proliferação de células desordenadas que pode se espalhar e invadir tecidos e/ou órgãos por todo o corpo, quando ocorre uma mutação genética. Objetivo: Verificar as repercussões respiratórias no pós-operatório do câncer de mama. Método: Trata-se de um estudo de caráter descritivo, corte transversal e análise quantitativa, realizado com 20 indivíduos do sexo feminino no pós-operatório do câncer de mama que estavam em tratamento em um Ambulatório de Especialidade em Montes Claros - Minas Gerais. Os instrumentos utilizados foram a escala de MRC que avalia o nível de dispneia durante atividade física, cirtometria que avalia a expansibilidade torácica e manovacuômetro que mensura a força muscular respiratória. Resultados: A idade média das participantes foi de 50,40 ± 5,50, observou-se que 90,0% das participantes sente falta de ar só durante exercícios intensos, segundo a escala de MRC, na cirtometria todos os sujeitos apresentaram redução da expansibilidade torácica. Foi observado uma diminuição significativa na força muscular respiratória, a média percentual alcançada na inspiração forçada foi de 86,77% e na expiração forçada sua média percentual foi de 71,75%. Conclusão: Conclui-se que pacientes portadoras de CA de mama que foram submetidas a um procedimento cirúrgico podem apresentar alterações respiratórias, ou seja, a população estudada apresentou alteração de força muscular e alteração da expansibilidade, porém não houve associação entre nível de expansibilidade torácica e tipo de cirurgia. &nbsp

O câncer e a criança: um impacto familiar

The aim of this work is a bibliographic review concerning the children living with cancer and their family, in order to identify the themes that have been already studied and to understand the impact on the family during the phases of childhood cancer. The information acquisition was based on documents from the Ministry of Health and on scientific studies available on the following databases: the Google Scholar, the Health virtual Library, the Scielo, the CAPES Journals, the MEDLINE, the LILACS and the Cochrane. The choice of the documents and journals was mainly justified by its link with the childhood health theme. The systematic of the studies research covered the period from 1999 to 2015. The keywords used for the research’s strategy were: childhood health, childhood cancer, family caregivers and grief. The results were presented in three themes: childhood cancer impact on the family, adaptation process of the family facing the sickness and the mourning regarding the death of the sick child. The review enabled to identify the need for special follow-up of the person, which is in direct contact with the child, usually the mother, since the moment of the diagnostic, until after the death.O objetivo desse estudo é revisar a literatura relativa à criança com câncer e sua família, a fim de identificar temas que têm sido pesquisados, e compreender o impacto causado na família durante as fases do câncer infantil. O levantamento de dados foi embasado em documentos do Ministério da Saúde e em trabalhos científicos disponibilizados no Google Acadêmico, Biblioteca virtual da Saúde, Scielo, Periodicos Capes, MEDLINE, LILACS e Cochrane. A escolha dos documentos e periódicos se deu pela sua relação com os temas Saúde da criança. A busca sistematizada de trabalhos abrangeram o período de 1999 a 2015. A estratégia de busca desse referencial utilizou as seguintes palavras-chave: Saúde da Criança, Câncer Infantil, Cuidadores Familiares e Luto. Os resultados foram apresentados em três temas: impacto do câncer infantil na familiar; processo de adaptação da família diante da doença e o luto diante da morte da criança. A revisão demonstrou que uma necessidade de acompanhamento especial a pessoa em contato direto com a criança, geralmente a mãe, desde o momento do diagnostico, e até após a morte

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake