Protagonismo de acadêmicos da saúde na produção de equipamentos de proteção individual durante a pandemia da COVID-19: relato de experiência

The COVID-19 pandemic caused one of the biggest health crises of the 21st century. In the first half of 2020, the world experienced a lack of Personal Protective Equipment (PPE). In Acre, students from the Federal University of Acre mobilized and created the Episcovid-19 project. The aim of this work is to describe the production of PPE, distribution in health units, as well as the motivation of those involved in the process. This is a qualitative and quantitative study of the type of experience report carried out through semi-structured interviews. In 6 months, more than 120,000 PPE, including aprons, clips and face shields, were produced and distributed in various health units in Acre, covering several frontline health professionals and municipalities in the state. The EPISCOVID-19 project surpassed all the initially planned goals, which were 5,000 pieces of equipment, producing more than 125,000 PPE. The importance of the social responsibility of public universities in Brazil is highlighted, which contributed in different ways to society during the COVID-19 Pandemic, mainly through the University Extension axis, having a significant role in articulation with civil society entities in the fight and SARS-CoV-2 prevention.A Pandemia da COVID-19 provocou uma das maiores crises sanitárias do Século XXI. No primeiro semestre de 2020, o mundo vivenciou a falta de Equipamentos de Proteção Individuais (EPIs). No Acre, alunos da Universidade Federal do Acre se mobilizaram e criaram o projeto Episcovid-19. O objetivo deste trabalho é descrever a produção dos EPIs, a distribuição nas unidades de saúde, bem como a motivação dos envolvidos no processo. Trata-se de um estudo quali-quantitativo do tipo relato de experiência realizado por meio de entrevistas semiestruturadas. Em 6 meses, mais de 120 mil EPIs, entre aventais, clips e protetores faciais foram produzidos e distribuídos em várias unidades de saúde acreanas, contemplando diversos profissionais de saúde da linha de frente e municípios do estado. O projeto EPISCOVID-19 superou todas as metas previstas inicialmente que eram de 5 mil equipamentos, produzindo mais de 125 mil EPIs. Destaca-se a importância da responsabilidade social das universidades públicas do Brasil, as quais contribuíram de diversas formas à sociedade durante a Pandemia da COVID-19, principalmente pelo eixo de Extensão Universitária, tendo um papel significativo de articulação com entidades da sociedade civil no combate e prevenção ao SARS-CoV-2

Protagonismo de acadêmicos da saúde na produção de equipamentos de proteção individual durante a pandemia da COVID-19: relato de experiência

The COVID-19 pandemic caused one of the biggest health crises of the 21st century. In the first half of 2020, the world experienced a lack of Personal Protective Equipment (PPE). In Acre, students from the Federal University of Acre mobilized and created the Episcovid-19 project. The aim of this work is to describe the production of PPE, distribution in health units, as well as the motivation of those involved in the process. This is a qualitative and quantitative study of the type of experience report carried out through semi-structured interviews. In 6 months, more than 120,000 PPE, including aprons, clips and face shields, were produced and distributed in various health units in Acre, covering several frontline health professionals and municipalities in the state. The EPISCOVID-19 project surpassed all the initially planned goals, which were 5,000 pieces of equipment, producing more than 125,000 PPE. The importance of the social responsibility of public universities in Brazil is highlighted, which contributed in different ways to society during the COVID-19 Pandemic, mainly through the University Extension axis, having a significant role in articulation with civil society entities in the fight and SARS-CoV-2 prevention.A Pandemia da COVID-19 provocou uma das maiores crises sanitárias do Século XXI. No primeiro semestre de 2020, o mundo vivenciou a falta de Equipamentos de Proteção Individuais (EPIs). No Acre, alunos da Universidade Federal do Acre se mobilizaram e criaram o projeto Episcovid-19. O objetivo deste trabalho é descrever a produção dos EPIs, a distribuição nas unidades de saúde, bem como a motivação dos envolvidos no processo. Trata-se de um estudo quali-quantitativo do tipo relato de experiência realizado por meio de entrevistas semiestruturadas. Em 6 meses, mais de 120 mil EPIs, entre aventais, clips e protetores faciais foram produzidos e distribuídos em várias unidades de saúde acreanas, contemplando diversos profissionais de saúde da linha de frente e municípios do estado. O projeto EPISCOVID-19 superou todas as metas previstas inicialmente que eram de 5 mil equipamentos, produzindo mais de 125 mil EPIs. Destaca-se a importância da responsabilidade social das universidades públicas do Brasil, as quais contribuíram de diversas formas à sociedade durante a Pandemia da COVID-19, principalmente pelo eixo de Extensão Universitária, tendo um papel significativo de articulação com entidades da sociedade civil no combate e prevenção ao SARS-CoV-2

REVISÃO INTEGRATIVA SOBRE O PAPEL DO ENFERMEIRO NO PÓS-TRANSPLANTE RENAL

El objetivo fue identificar el papel del enfermero en el postransplante renal, evidenciando los principales cuidados a esa clientela. Para tanto, fue realizada revisión integrativa en septiembre de 2013, teniendo como fuente los acervos de cuatro bases de datos, usando los descriptores: Trasplante Renal, Asistencia de enfermería (procesos, intervenciones) y Postrasplante. Fueron identificados 110 artículos de los cuales 13 cumplieron los criterios de inclusión y fueron clasificados en tres categorías: Coordinación de Enfermería; Asistencia de Enfermería; y Educación en Salud. La literatura apunta la abrangencia e importancia de la actuación de la enfermería en la coordinación, asistencia en curto y largo plazo, enseñanza e investigación. La Sistematización de la Asistencia de Enfermería mostró ser de gran utilidad para subsidiar las intervenciones de enfermería y mejorar las respuestas clínicas. Así, son necesarios más estudios sobre la temática, principalmente acerca del aspecto educacional de la actuación de enfermería.The objective was to identify the role of nurses in post-renal transplant, showing the main care for these patients. For this, an integrative review was conducted in September 2013, with four databases as sources, using the key words: Renal Transplant, Nursing care (processes, interventions) and Post Transplant. 110 articles were identified, of which 13 met the inclusion criteria and were divided into three categories: Coordination of Nursing; Nursing Assistance; and Health Education. The literature points to the scope and importance of nursing coordination, care in the short and long-term, teaching and research. Nursing Care Systematization proved to be very useful to support nursing interventions and improve clinical outcomes. Thus, further studies on the subject are needed, especially on the educational aspect of nursing performance.O objetivo foi identificar o papel do enfermeiro no pós-transplante renal, evidenciando os principais cuidados a essa clientela. Para tanto, foi realizada revisão integrativa em setembro de 2013, tendo como fonte quatro bases de dados, usando os descritores: Transplante Renal, Assistência de enfermagem (processos, intervenções) e Pós-Transplante. Foram identificados 110 artigos dos quais 13 cumpriram os critérios de inclusão e foram separados em três categorias: Coordenação de Enfermagem; Assistência de Enfermagem; e Educação em Saúde. A literatura aponta a abrangência e importância da atuação da enfermagem na coordenação, assistência a cur to e longo prazo, ensino e pesquisa. A Sistematização da Assistência de Enfermagem mostrou ser de grande utilidade para subsidiar as intervenções de enfermagem e melhorar as respostas clínicas. Assim, são necessários mais estudos sobre a temática, principalmente sobre o aspecto educacional da atuação de enfermagem

Risk factors for death in patients with non-infectious adverse events

Objetive: to identify risk factors for death in patients who have suffered non-infectious adverse events. Method: a retrospective cohort study with patients who had non-infectious Adverse Events (AE) in an Intensive Care Unit. The Kaplan Meier method was used to estimate the conditional probability of death (log-rank test 95%) and the risk factors associated with death through the Cox regression. Results: patients over 50 years old presented a risk 1.57 times higher for death; individuals affected by infection/sepsis presented almost 3 times the risk. Patients with a Simplified Acute Physiology Score III (SAPS3) greater than 60 points had four times higher risk for death, while those with a Charlson scale greater than 1 point had approximately two times higher risk. The variable number of adverse events was shown as a protection factor reducing the risk of death by up to 78%. Conclusion: patients who had suffered an adverse event and who were more than 50 years of age, with infection/sepsis, greater severity, i.e., SAPS 3>;30 and Charlson>;1, presented higher risk of death. However, the greater number of AEs did not contributed to the increased risk of death.Objetivo: identificar los factores de riesgo para óbito en pacientes que sufrieron eventos adversos no infecciosos. Método: estudio de cohorte retrospectivo con pacientes que sufrieron Eventos Adversos (EA) no infecciosos en una Unidad de Terapia Intensiva. Fue utilizado el método de Kaplan Meier para estimar la probabilidad condicional del óbito (test log-rank 95%) y los factores de riesgo asociados al óbito por medio de la regresión de Cox. Resultados: pacientes con más de 50 años presentaron un riesgo de 1,57 veces, individuos acometidos por infección/sepsis presentaron casi 3 veces el riesgo. Los pacientes con Simplified Acute Physiology Score III(SAPS3) superior a 60 puntos tuvieron 4 veces mayor riesgo, mientras los que poseían escala de Charlson superior a 1 punto presentaron, aproximadamente, 2 veces mayor riesgo. La variable número de eventos adversos se mostró como factor de protección reduciendo el riesgo de óbito en hasta 78%. Conclusión: pacientes que sufrieron evento adverso y que tienen más de 50 años de edad, con infección/sepsis, mayor gravedad, o sea, SAPS 3>;30 y Charlson >;1, presentaron mayor riesgo de óbito, sin embargo el mayor número de EA no contribuyó para el aumento del riesgo de óbito.Objetivo: identificar os fatores de risco para óbito em pacientes que sofreram eventos adversos não infecciosos. Método: estudo de coorte retrospectivo com pacientes que sofreram Eventos Adversos (EA) não infecciosos em uma Unidade de Terapia Intensiva. Foi utilizado o método de Kaplan Meier para estimar a probabilidade condicional do óbito (teste log-rank 95%) e os fatores de risco associados ao óbito por meio da regressão de Cox. Resultados: pacientes acima de 50 anos apresentaram um risco de 1,57 vezes, indivíduos acometidos por infecção/sepse apresentaram quase 3 vezes o risco. Os pacientes com Simplified Acute Physiology Score III (SAPS3) superior a 60 pontos tiveram 4 vezes maior risco, enquanto os que possuíam escala de Charlson superior a 1 ponto apresentaram, aproximadamente, 2 vezes maior risco. A variável número de eventos adversos se mostrou como fator de proteção reduzindo o risco de óbito em até 78%. Conclusão: pacientes que sofreram evento adverso e que têm mais de 50 anos de idade, com infecção/sepse, maior gravidade, ou seja, SAPS 3>;30 e Charlson >;1, apresentaram maior risco de óbito, no entanto o maior número de EA não contribuiu para o aumento do risco de óbito

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

Background\ud To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated.\ud \ud Methods\ud This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years).\ud \ud Results\ud Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ≥ 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001).\ud \ud Conclusions\ud A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.We thank Mrs. Karianne Aroeira Davidson, Mrs. Anna Maria Ferreira, Mrs. Elisangela Santos and Sandro Sperandei for their technical assistance.This work was supported by grants from Farmanguinhos/Fundação Oswaldo Cruz/National Health Ministry, the Brazilian Diabetes Society, Fundação do Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico do Brasil