Validade preditiva do Protocolo de Classificação de Risco de Manchester: avaliação da evolução dos pacientes admitidos em um pronto atendimento

OBJECTIVE: to assess the predictive validity of the Manchester Triage System implemented in a municipal hospital in Belo Horizonte, MG, Brazil. METHOD: cohort prospective and analytical study. The sample of 300 patients was stratified by color groups. The outcome measured was the scores, obtained by patients in each classification group in the Therapeutic Intervention Scoring System - 28, 24 hours after admission to the emergency department. RESULTS: A total of 172 (57%) patients were men and the average age of all patients was 57.3 years old. The median score concerning the severity of their conditions was 6.5 points in the yellow group, 11.5 in the orange group, and 22 points in the red group. Statistically significant differences were found among the three groups (pOBJETIVO: evaluar la validez predictiva del protocolo de clasificación de riesgo de Manchester implantado en un hospital municipal de Belo Horizonte, Minas Gerais. MÉTODO: estudio de cohorte prospectivo y analítico. La muestra estratificada por colores de la clasificación fue de 300 pacientes. El final evaluado fue la puntuación por el Therapeutic Intervention Scoring System - 28, lograda por los pacientes en cada grupo de clasificación después de 24 horas de la admisión en el servicio de urgencia. RESULTADOS: entre los pacientes, 172 eran hombres (57%); la media de edad de los pacientes evaluados fue de 57,3 años. La mediana de puntuación del índice de gravedad en el grupo amarillo fue 6,5 puntos; en el grupo naranja, 11,5 puntos y, en el grupo rojo, 22 puntos, habiendo diferencia estadística significante entre los tres grupos (pOBJETIVO: avaliar a validade preditiva do protocolo de classificação de risco de Manchester, implantado em um hospital municipal de Belo Horizonte, Minas Gerais. MÉTODO: trata-se de estudo de coorte prospectivo e analítico A amostra estratificada por cores da classificação foi de 300 pacientes. O desfecho avaliado foi a pontuação pelo Therapeutic Intervention Scoring System - 28, obtida pelos pacientes em cada grupo de classificação, após 24 horas da admissão no serviço de urgência. RESULTADOS: entre os pacientes, 172 eram homens (57%) e a média de idade dos pacientes avaliados foi de 57,3 anos. A mediana de pontuação do índice de gravidade no grupo amarelo foi de 6,5 pontos; no grupo laranja, 11,5 pontos e, no grupo vermelho, 22 pontos, havendo diferença estatística significante entre os três grupos (

Visual sparklings by VJs. Poesy of clichés?

This paper discusses the visual ad-libbing of VJs and their strategy to build metanarratives by reiterating clichéd images. These images depict commonplace television scenes, stereotyped behaviors and images used for urban signaling. The poetics thus derived — a concept propounded by Paul Valéry — reconfigures the redundancy of such icons. Due to the juxtaposition of frames and the temporal sequencing of meaning-laden images, semantic and visual shocks are established which promote the resignification of the cliché. In other words, singular audiovisual expressions are built through repetition and shock

Predicting pre-triage waiting time in a maternity emergency room through data mining

An unsuitable patient flow as well as prolonged waiting lists in the emergency room of a maternity unit, regarding gynecology and obstetrics care, can affect the mother and child’s health, leading to adverse events and consequences regarding their safety and satisfaction. Predicting the patients’ waiting time in the emergency room is a means to avoid this problem. This study aims to predict the pre-triage waiting time in the emergency care of gynecology and obstetrics of Centro Materno Infantil do Norte (CMIN), the maternal and perinatal care unit of Centro Hospitalar of Oporto, situated in the north of Portugal. Data mining techniques were induced using information collected from the information systems and technologies available in CMIN. The models developed presented good results reaching accuracy and specificity values of approximately 74% and 94%, respectively. Additionally, the number of patients and triage professionals working in the emergency room, as well as some temporal variables were identified as direct enhancers to the pre-triage waiting time. The imp lementation of the attained knowledge in the decision support system and business intelligence platform, deployed in CMIN, leads to the optimization of the patient flow through the emergency room and improving the quality of services

Multidrug-Resistant Salmonella enterica Serovar Rissen Clusters Detected in Azores Archipelago, Portugal

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31950026/Gastrointestinal infections caused by nontyphoidal Salmonella (NTS) remain one of the main causes of foodborne illness worldwide. Within the multiple existing Salmonella enterica serovars, the serovar Rissen is rarely reported, particularly as a cause of human salmonellosis. Between 2015 and 2017, the Portuguese National Reference Laboratory of Gastrointestinal Infections observed an increase in the number of clinical cases caused by multidrug-resistant (MDR) S. enterica serovar Rissen, particularly from the Azores archipelago. In the present study, we analyzed by whole genome sequencing (WGS) all clinical, animal, food, and environmental isolates received up to 2017 in the Portuguese Reference Laboratories. As such, through a wgMLST-based gene-by-gene analysis, we aimed to identify potential epidemiological clusters linking clinical and samples from multiple sources, while gaining insight into the genetic diversity of S. enterica serovar Rissen. We also investigated the genetic basis driving the observed multidrug resistance. By integrating 60 novel genomes with all publicly available serovar Rissen genomes, we observed a low degree of genetic diversity within this serovar. Nevertheless, the majority of Portuguese isolates showed high degree of genetic relatedness and a potential link to pork production. An in-depth analysis of these isolates revealed the existence of two major clusters from the Azores archipelago composed of MDR isolates, most of which were resistant to at least five antimicrobials. Considering the well-known spread of MDR between gastrointestinal bacteria, the identification of MDR circulating clones should constitute an alert to public health authorities. Finally, this study constitutes the starting point for the implementation of the "One Health" approach for Salmonella surveillance in Portugal.This work was partially funded by the GenomePT project (POCI-01-0145- FEDER-022184), supported by COMPETE 2020–Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), and Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and by the Fundação para a Ciência e a Tecnologia (FCT)info:eu-repo/semantics/publishedVersio

A chemical study of yoghurt produced under isostatic pressure during storage

Yoghurt fermented under sub-lethal high pressure (10, 20, 30 and 40 MPa at 43 °C), and afterward placed under refrigeration (4 °C for 23 days) was studied and compared with yoghurt fermented at atmospheric pressure (0.1 MPa). For a deeper analysis, metabolite fingerprinting by nuclear magnetic resonance (NMR), sugars and organic acids assessment by high performance liquid chromatography (HPLC), total fatty acids (TFA) determination and quantification by gas chromatography with a flame ionization detector (GC-FID) were performed. Metabolomic analyses revealed that only 2,3-butanediol, acetoin, diacetyl and formate vary with the increase of pressure and probable relation with pressure influenced diacetyl reductase, acetoin reductase and acetolactate decarboxylase. Yoghurts fermented at 40 MPa had the lowest content in lactose (39.7 % of total sugar reduction) and the less content in TFA (56.1 %). Further research is of interest to understand more about fermentation processes under sub-lethal high pressure.info:eu-repo/semantics/publishedVersio

O uso de azeite de dendê na fortificação de alimentos

O objetivo do trabalho foi incluir o azeite de dendê como fonte de vitamina A em alimentos de consumo habitual da população brasileira e avaliar sua estabilidade e aceitação. Foram desenvolvidas as preparações: sequilho salgado, sequilho doce e biscoito de polvilho em suas formulações originais e as acrescidas de azeite de dendê. A vitamina A foi determinada pela quantificação de β caroteno presente nas amostras do azeite de dendê e nas preparações. Para a análise sensorial, utilizou-se o teste afetivo de aceitabilidade. As preparações desenvolvidas tiveram como parâmetro as originais para posterior análise. Com relação ao teor de vitamina A, todos os produtos com dendê tiveram concentrações significativas deste nutriente quando comparados aos biscoitos sem dendê. Pela análise sensorial, os produtos apresentaram aceitabilidade no atributo aceitação global. O azeite de dendê se manteve como fonte de vitamina A quando utilizado como ingrediente de preparações, mesmo se submetido a um processamento térmico, e mostrou ser uma boa fonte complementar deste nutriente. Assim, o azeite de dendê pode ser utilizado no enriquecimento de alimentos pela sua contribuição em retinol visando o controle da hipovitaminose A

TENDÊNCIA TEMPORAL DO ALEITAMENTO MATERNO NO MUNICÍPIO DE MACAÉ/RIO DE JANEIRO

Objetivo: Realizar análise descritiva da situação do aleitamento materno em crianças menores de quatro meses do município de Macaé/ RJ. Métodos: Estudo epidemiológico descritivo, retrospectivo, utilizando o Sistema de Informação da Atenção Básica (SIAB), disponível no sítio eletrônico do Departamento de Informática do Sistema Único de Saúde (DATASUS). Foram utilizadas as seguintes variáveis: crianças menores de 4 meses em aleitamento materno misto e crianças menores de 4 meses em aleitamento materno exclusivo, residentes no município de Macaé, no período de 2005 a 2015. O recorte temporal escolhido foram os últimos 10 anos consolidados no DATASUS. Resultados: O número de crianças cadastradas e amamentadas no município durante o período estudado mostra que, em todos os anos, o percentual se manteve estável para todas as variáveis estudadas. A prática de AME sofreu pouca variação com o menor percentual observado de 68% em 2011 e com um valor máximo de 75%, em 2013. O percentual de aleitamento misto se manteve entre 24% e 29%, enquanto o percentual de crianças não amamentadas ficou entre 1% a 3%. Conclusões: Existem evidências suficientes para afirmar que o apoio à amamentação é necessário para aumentar a duração e a exclusividade da amamentação, garantindo múltiplas vantagens à saúde de recém-nascidos a termo e pré-termo, crianças, mães e sociedade em geral

Resistive training reduces inflammation in skeletal muscle and improves the peripheral insulin sensitivity in obese rats induced by hyperlipidic diet

OBJETIVO: Investigar em ratos obesos o efeito da prática de exercício resistido sobre a sensibilidade à insulina e sobre a expressão de citocinas pró-inflamatórias e de transportador de glicose em músculo solear. MATERIAIS E MÉTODOS: Ratos Wistar alimentados com dieta hiperlipídica (grupos obesos) foram submetidos ao protocolo de exercício tipo jump squat. A sensibilidade à insulina e a expressão gênica de Tnf-α, SOCS3 e GLUT4 foram comparadas entre os grupos obesos sedentários (OS) e exercitados (OE) e controles sedentários (CS) e exercitados (CE). RESULTADOS: A sensibilidade à insulina estava reduzida no grupo OS e elevada no OE. Os conteúdos de RNAm de Tnf-α e de SOCS3 estavam aumentados no músculo esquelético do grupo OS e reduzidos no OE. O conteúdo proteico e de RNAm de GLUT4 não diferiu entre os grupos. CONCLUSÃO: O exercício resistido reverte o quadro de resistência à insulina periférica e de inflamação no músculo esquelético de obesos induzidos por dieta.OBJECTIVE: To determine if resistive exercise protocol can modulate Tnf-α, SOCS3 and glucose transporter GLUT4 genes expression in skeletal muscle, and peripheral insulin sensitivity in obese rats induced by hyperlipidic diet. MATERIALS AND METHODS: Wistar obese rats induced by hyperlipidic diet were subjected a resistive exercise protocol as jump squat. Insulin sensitivity and mRNA content of Tnf-α, SOCS3 and GLUT4 were assayed and compared among the groups: obese sedentary (OS) and exercised (OE), control sedentary (CS) and exercised (CE). RESULTS: The mRNA content of Tnf-α and SOCS3 has increased in skeletal muscle from OS and has decreased in OE group. The protein and GLUT4 mRNA contents were correlated but they did not change among the groups. Peripheral insulin sensitivity has increased in the OE compared to OS group. CONCLUSION: The resistive exercise reverses the peripheral insulin resistance and the inflammatory state in skeletal muscle from diet-induced obese rats

Building up an Open Data Plan for a public Research and Development organization and the challenge of an Open Agricultural Science

In keeping with the Open Data Policy of the Federal Executive Branch and the Law on Access to Information, the Brazilian Agricultural Research Corporation (Embrapa) has initiated discussions on the construction of its Open Data Plan – a planning tool for implementation and rationalization of open data publishing processes in public organizations. This paper aims to report the general strategy that was established for this purpose and the challenges that have been encountered in the preliminary stages of its implementation. As the opening of data by research institutions in Brazil is still in its infancy, Embrapa’s experience is expected to contribute to similar initiatives from other organizations

Predicting triage waiting time in maternity emergency care by means of data mining

Healthcare organizations often benefit from information technologies as well as embedded decision support systems, which improve the quality of services and help preventing complications and adverse events. In Centro Materno Infantil do Norte (CMIN), the maternal and perinatal care unit of Centro Hospitalar of Oporto (CHP), an intelligent pre-triage system is implemented, aiming to prioritize patients in need of gynaecology and obstetrics care in two classes: urgent and consultation. The system is designed to evade emergency problems such as incorrect triage outcomes and extensive triage waiting times. The current study intends to improve the triage system, and therefore, optimize the patient workflow through the emergency room, by predicting the triage waiting time comprised between the patient triage and their medical admission. For this purpose, data mining (DM) techniques are induced in selected information provided by the information technologies implemented in CMIN. The DM models achieved accuracy values of approximately 94% with a five range target distribution, which not only allow obtaining confident prediction models, but also identify the variables that stand as direct inducers to the triage waiting times.Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/00319/201