Profile of ostomy patients: integrative review of the literature

Uma análise acerca do perfil de estomizados, através de estudos multicêntricos que retratem as características específicas desses pacientes, contribui para o atendimento de suas reais necessidades e para o direcionamento de políticas públicas e de saúde para melhoria da qualidade de vida dessa clientela. Este estudo objetiva investigar a produção científica acerca do perfil de pacientes estomizados, no período de 2004 a 2012. Trata-se de uma revisão integrativa da literatura realizada por meio de busca eletrônica nas bases: Lilacs, Scielo, Bdenf e na Revista Estima, por tratar-se de um periódico especializado da Sociedade Brasileira de Estomaterapia. Fizeram parte da amostra dez artigos que contemplaram os critérios de inclusão. Identificou-se que todos os estudos foram realizados no Brasil, em estados e regiões diversas e a grande maioria por enfermeiros. O perfil sociodemográfico e epidemiológico dos estomizados mostra prevalência do sexo feminino, com predomínio de adultos e idosos, o câncer colorretal como principal causa para realização do estoma, e a colostomia como tipo de estomia predominante. Verifica-se que o foco desta temática ainda apresenta uma produção científica incipiente, com estudos pontuais, pouco abrangentes e baixa regularidade. Sugere-se que sejam realizados novos estudos para subsidiar uma melhor qualificação da assistência ao usuário.Mediante el análisis sobre el perfil de ostomía en los estudios multicéntricos que describen las características específicas de estos pacientes ostomizados, se contribuye a la satisfacción de sus necesidades reales y la focalización de las políticas públicas y de salud para mejorar la calidad de vida de los mismos. Este estudio tiene como objetivo investigar el perfil científico de los pacientes ostomizados en el período 2004-2012. Se trata de una revisión integradora de la literatura realizada por una búsqueda electrónica en las bases de datos: Lilacs, scielo, Bdenf y la revista estima, porque es una revista especializada de la Sociedad Brasileña de Estomaterapia. La muestra estuvo conformada por diez artículos que contemplan los criterios de inclusión. Todos los estudios se llevaron a cabo en Brasil en diversos estados y regiones y la gran mayoría de las enfermeras. La prevalencia sociodemográfica y epidemiológica de los pacientes ostomizados muestra predominio femenino de adultos mayores, el cáncer colorrectal es la causa principal para la realización del estoma y colostomía como el tipo predominante de ostomía. Parece que el enfoque de este tema sigue aún en un período de relativa a infancia científica, con estudios de escasa y baja regularidad. Se sugiere que otros estudios se llevaron a cabo con la finalidad de apoyar un mejor cuidado de la salud del usuario.An analysis on the profile of ostomy, multicenter studies that portray the specific characteristics of these patients, contributes to meeting their real needs and the targeting of public policies and health to improve the quality of life for these clients. This study aims to investigate the scientific profile about ostomy patients in the period 2004-2012. It is an integrative literature review performed by an electronic search in databases: Lilacs, Scielo, and Bdenf Magazine estimated, because it is a specialized journal of the Brazilian Society of Stomatherapy. The sample consisted of ten articles which contemplated the inclusion criteria. It was found that all studies were conducted in Brazil in various states and regions and the vast majority of nurses. The sociodemographic and epidemiological prevalence of ostomy shows female predominance of older adults, colorectal cancer as the main cause for the realization of the stoma and colostomy as the predominant type of ostomy. It appears that the focus of this issue is still of scientific infancy, with specific studies, little comprehensive and low regularity. It is suggested that further studies be conducted to support improved health care user

Correlation between Bipolar Affective Disorder and Suicide Reviewing by the Risk Factors: a Systematic Review

Background: Because there are several reports associations between affective (AD) and bipolar disorder (BD) and suicide, the research develops a discussion of risk factors that inflence the occurrence of suicide attempts in patients with BD.Objectives: To relate risk factors present in patients with bipolar disorder who committed suicide or some suicide attempt.Methods: A survey was made in Scopus with the keyword "bipolar" and the terms "suicide" and "attempted"and "risk factors" from Medical Subject Headings (MeSH). We use only Scopus as the data source, and the statistical information available in tables and graphs provided from this source.Results: Frequently the AD and BD were associated with suicide occurrence in the studies included in this review. They identifid the main risk factors for suicide the previous suicide attempt and hopelessness. The main risk factors for nonfatal suicidal behavior included family history of suicide, early onset of bipolar disorder, extent of depressive symptoms, increasing severity of affective episodes, the presence of mixed affective states, rapid cycling, comorbid Axis I disorders, and abuse of alcohol or drugs. The suicide rate in this disorder reaches three times compared with other mental illnesses, and there are several risk factors: 3:1 ratio of suicide in men compared to women, but in females a greater number of attempts are observed. 25% of persons consume alcohol prior to suicidal attempt. The studies relate these factors and show how they can pose a risk to the carrier of the disorder. There are other risk factor for BD discussed on this review.Conclusions: It is inferred that the factors related to the risk of suicide in patients with bipolar disorder are important to enable the development of strategies designed to identify a possible suicidal ideation, prevention and control of these deaths. These elements are well characterized and defied in the studies

Síntese e caracterização de catalisadores SnO2.Nb suportado em argila maranhense

  O desenvolvimento de catalisadores eficientes e de baixo custo tem sido o foco de diferentes pesquisas e, nesse contexto, as argilas se destacam como matéria prima natural para serem empregadas como suportes catalíticos. Neste sentido, este trabalho teve como objetivo sintetizar e caracterizar materiais a base de estanho e nióbio suportados em argila maranhense. Os óxidos de estanho e nióbio foram sintetizados sobre a superfície da argila pelo método dos precursores poliméricos. Os catalisadores obtidos foram caracterizados por meio de difração de raios X (DRX), espectroscopia na região do Infravermelho (IV), microscopia eletrônica de varredura (MEV), fisissorção de nitrogênio (BET) e espectroscopia dispersiva de raios X (EDS). Os resultados mostraram que o ataque ácido contribuiu para o aumento da área superficial específica do argilomineral natural, passando de 83,53 m2 g-1 para 155,2 m2 g-1. No entanto, a deposição do óxido de nióbio sobre o argilomineral acarretou uma diminuição significativa em sua área superficial específica, passado a 14,68 m2 g-1. A ativação com ácido nítrico promoveu a lixiviação de alguns metais, aumentando a quantidade relativa de sílica presente na amostra. Nas análises por DRX e infravermelho pode-se identificar a presença do nióbio e estanho na matriz de argila. Por fim, verificou-se que processo de síntese adotado foi eficiente para preparação do catalisador suportado (SnO2.Nb/argila).Palavras-chave: Argila maranhense, catalisadores suportados, método dos precursores poliméricos, Nb, SnO2

Diagnosing congenital toxoplasmosis: where are we? A systematic review

Purpose: Compile information on laboratory methods for diagnosis of congenital toxoplasmosis, considering the tests conducted since the gestational stage until the child period. Methods:A systematic review of 01.01.2006 to 31.12.2013 was held by VHL (Virtual Health Library). The search was performed with the descriptors ''toxoplasmosis†and “diagnosis. The selected articles were indexed in MEDLINE. The information pertinent to the study was selected, categorized and analyzed. Of the 186 articles found, 41 met the eligibility criteria. Results: Laboratory tests are based on the presence of antibodies IgM and IgG anti-Toxoplasma gondii, in this sense it is important to correctly interpret serology, because the detection of specific antibodies is often delayed by the presence of maternal IgG or late production of specific antibodies in newborns. Molecular techniques (PCR) have emerged as alternative due to its higher sensitivity and specificity in diagnosing instruments, given the ability to detect parasite DNA and non-dependence of the immune response of the patient, such as serological tests.Conclusions: The need for early treatment of congenital toxoplasmosis in order to avoid sequelae justifies the search for more sensitive and specific laboratory tests in early detection of the parasite. Theintegration among the different levels of care in the public health system is essential for obtaining effective control of toxoplasmosis in pregnant women.Â

Plagiarism as another ethical issue in scientific research

The excessive demand for publications results in high plagiarism and duplicate numbers by scientists who take over existing texts into new publications. In addition to serious ethical problems, this practice hinders the generation of original material. In order to reduce the problem, softwares such as eTBLAST are being used to detect plagiarism and repeated papers. Despite the persistence of fraudsters, these tools have helped to reduce these problems; however, the ideal solution would be the basic ethical establishment principles. Therefore, plagiarism has always been a foible that could lead to fraudulent and dishonorable development of science

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

A todo pano: contribuition for study process of consolidation of the porto de Santos as maritime way of the capitania de São Paulo (1788-1822)

Entre o final do século XVIII e as primeiras décadas do século XIX a capitania de São Paulo vivenciou grandes transformações na sua estrutura produtiva, o que repercutiu diretamente na vida material e na composição social de sua população. Esse processo teve como eixo a agricultura mercantil desenvolvida nas terras do planalto. Apesar da produção de vários gêneros, o açúcar foi a mercadoria predominante. O comércio pelos diversos caminhos de São Paulo encontrou nas capitanias adjacentes mercados consumidores para os produtos paulistas. Na sua face marítima, os gêneros agrícolas navegaram por grande parte da costa da América portuguesa, América espanhola, atingindo algumas partes do ultramar. Na praça e porto da vila de Santos encontraram condições adequadas para sua comercialização, como a proximidade geográfica entre as terras agricultáveis e o litoral, as bases físicas privilegiadas do complexo portuário e a existência de um grupo de comerciantes com condições suficientes para a consecução de suas atividades e relações estabelecidas em vários outros portos da costa. As férteis terras de serra acima e o melhor porto da marinha encontraram no velho Caminho do Mar a ligação que necessitavam para ampliar as relações existentes desde os primórdios da colonização, contribuindo, dessa forma, para colocar a capitania de São Paulo num novo patamar no conjunto da América portuguesa. O presente trabalho visa a analisar esse processo de consolidação do porto de Santos como via marítima da capitania de São Paulo entre o final do século XVIII e as primeiras décadas do século XIX.Between the end of the 18th century and the first decades of the 19th century the capitania de São Paulo experienced major transformations in its productive structure, which reflected directly in the economic life and social composition of its population. This process took as central the market developed in agriculture lands of the plateau. Despite the production of various genres, the sugar was the predominant goods. Trade by various views of São Paulo found in adjacent capitanias consumer markets for the paulistas products. On the maritime face, the agricultural genres sailed for much of the coast of Portuguese and Spanish America country, reaching some parts of theoverseas. In the praça and the vila do porto de Santos found suitable conditions for their marketing, such as geographical proximity between the arable land and the coast, the privileged port complex physical bases and the existence of a group of merchants with sufficient conditions for the achievement of its activities and relations established in various other ports on the coast. The fertile lands of the serra acima above and the best port of the marinha found the old Caminho do Mar link that needed to expandexisting relations since the early days of colonization, contributing, therefore, to put the capitania de São Paulo on a new level in the set of Portuguese America Country. The present work aims to analyze this process of consolidation of the porto de Santos as maritime way of the capitania de São Paulo between the end of the 18th century and the first decades of the 19th century

A todo pano: contribuition for study process of consolidation of the porto de Santos as maritime way of the capitania de São Paulo (1788-1822)

Entre o final do século XVIII e as primeiras décadas do século XIX a capitania de São Paulo vivenciou grandes transformações na sua estrutura produtiva, o que repercutiu diretamente na vida material e na composição social de sua população. Esse processo teve como eixo a agricultura mercantil desenvolvida nas terras do planalto. Apesar da produção de vários gêneros, o açúcar foi a mercadoria predominante. O comércio pelos diversos caminhos de São Paulo encontrou nas capitanias adjacentes mercados consumidores para os produtos paulistas. Na sua face marítima, os gêneros agrícolas navegaram por grande parte da costa da América portuguesa, América espanhola, atingindo algumas partes do ultramar. Na praça e porto da vila de Santos encontraram condições adequadas para sua comercialização, como a proximidade geográfica entre as terras agricultáveis e o litoral, as bases físicas privilegiadas do complexo portuário e a existência de um grupo de comerciantes com condições suficientes para a consecução de suas atividades e relações estabelecidas em vários outros portos da costa. As férteis terras de serra acima e o melhor porto da marinha encontraram no velho Caminho do Mar a ligação que necessitavam para ampliar as relações existentes desde os primórdios da colonização, contribuindo, dessa forma, para colocar a capitania de São Paulo num novo patamar no conjunto da América portuguesa. O presente trabalho visa a analisar esse processo de consolidação do porto de Santos como via marítima da capitania de São Paulo entre o final do século XVIII e as primeiras décadas do século XIX.Between the end of the 18th century and the first decades of the 19th century the capitania de São Paulo experienced major transformations in its productive structure, which reflected directly in the economic life and social composition of its population. This process took as central the market developed in agriculture lands of the plateau. Despite the production of various genres, the sugar was the predominant goods. Trade by various views of São Paulo found in adjacent capitanias consumer markets for the paulistas products. On the maritime face, the agricultural genres sailed for much of the coast of Portuguese and Spanish America country, reaching some parts of theoverseas. In the praça and the vila do porto de Santos found suitable conditions for their marketing, such as geographical proximity between the arable land and the coast, the privileged port complex physical bases and the existence of a group of merchants with sufficient conditions for the achievement of its activities and relations established in various other ports on the coast. The fertile lands of the serra acima above and the best port of the marinha found the old Caminho do Mar link that needed to expandexisting relations since the early days of colonization, contributing, therefore, to put the capitania de São Paulo on a new level in the set of Portuguese America Country. The present work aims to analyze this process of consolidation of the porto de Santos as maritime way of the capitania de São Paulo between the end of the 18th century and the first decades of the 19th century