O impacto da ventilação não-invasiva no treinamento físico em pacientes com doença pulmonar obstrutiva crônica moderada a grave

OBJECTIVE: To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways (BiPAP®) in patients with chronic obstructive pulmonary disease. METHODS: Eighteen patients with FEV1 = 34 ± 8% of predicted values, mean age of 68 ± 9 years were randomly distributed into 2 groups, one group performing physical training on a treadmill and the other group performing physical training associated with BiPAP® (physical training+B), for 30 minutes, 3 times a week for 12 weeks. The training velocity was based on a test of cardiopulmonary force performed pre- and postintervention, which registered the values for heart rate, systolic blood pressure, diastolic blood pressure, peripheral oxygen saturation, blood lactate, sensation of dyspnea, respiratory muscle strength, and analysis of gases expired such as oxygen consumption and the production of carbon dioxide. RESULTS: For both groups, there was a significant improvement in dyspnea and peripheral oxygen saturation at identical levels of physical exercise, in distance walked during the physical training, and in respiratory muscle strength (P < 0.05). Only the physical training+B group had a significant improvement in heart rate, systolic blood pressure, and oxygen consumption after training (P < 0.05). Significant reductions of blood lactate were observed at identical levels of exercise in physical training+B when compared to isolated physical training (from 1.3 ± 0.7 mMol/L versus 2.5 ± 0.9 mMol/L, (P < 0.05), respectively). CONCLUSION: Physical training associated with BiPAP® enhanced the oxidative muscular capacity and could be an adjunctive recourse for physical rehabilitation in patients with chronic obstructive pulmonary disease.OBJETIVO: Avaliar a influência do treinamento físico, com e sem ventilação não invasiva com dois níveis de pressão nas vias aéreas (BiPAP®), em pacientes com doença pulmonar obstrutiva crônica. MÉTODOS: Dezoito pacientes com VEF1=34±8% do previsto, idade média de 68±9 anos, foram randomicamente distribuídos em dois grupos, um grupo realizando treinamento físico em esteira e outro grupo realizando treinamento físico associado ao BiPAP® (treinamento físico+B), durante 30 minutos, 3 vezes por semana, por 12 semanas. A velocidade do treinamento foi baseada no teste cardiopulmonar realizado pré e pós-intervenção, com registro dos valores de freqüência cardíaca, pressão arterial sistólica, pressão arterial diastólica, saturação periférica de oxigênio, lactato sanguíneo, sensação de dispnéia, força muscular respiratória e análise de gases expirados como consumo de oxigênio, produção de dióxido de carbono. RESULTADOS: Em ambos os grupos houve melhora significativa na dispnéia e saturação periférica de oxigênio no mesmo nível de esforço, na distância percorrida no teste cardiopulmonar e na força muscular respiratória (

Relationship between Malocclusion, Bullying, and Quality of Life in Students from Low Social Development Area: A Cross-Sectional Study

Objective:&nbsp;To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas.&nbsp;Material and Methods:&nbsp;This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one’s oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren\u27s Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years.&nbsp;Results:&nbsp;No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life.&nbsp;Conclusion:&nbsp;There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student\u27s quality of life

Relationship between Malocclusion, Bullying, and Quality of Life in Students from Low Social Development Area: A Cross-Sectional Study

Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one’s oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life

Indicações da fototerapia em recém-nascidos com icterícia / Indications for phototherapy in newborns with jaundice

A fototerapia é um método eficaz, não invasivo de alto impacto, sem restrições enquanto a sua utilização independente da idade gestacional, comorbidades ou nível de pigmentação cutânea, tratamento utilizado para redução de bilirrubina usado devido a sua alta eficiência e ausência de efeitos adversos. Analisar as evidências científicas publicadas sobre as indicações da fototerapia em recém–nascidos com icterícia. Trata de uma revisão bibliográfica do método revisão integrativa de literatura, realizado no período compreendido entre os meses de janeiro a abril de 2021. A busca efetuou-se, através da BVS, utilizando as bases de dados LILACS, MEDLINE, e por meio do SCIELO. Aderindo-se através dos descritores/palavras chaves: “Fototerapia”, “Icterícia Neonatal”, “Terapêutica”, “Diagnóstico”, “Cuidados de Enfermagem”, combinados entre si com o operador booleano “AND”. Os profissionais da equipe de enfermagem são responsáveis pelo recebimento e preparação do recém-nascido para a terapêutica, bem como, preparam os aparelhos que serão usados para a fototerapia, como os focos de luz, as incubadoras, entre outros. Evidenciou-se que a fototerapia é utilizada como forma de tratamento mais eficaz no controle da hiperbilirrubinemia. Sendo indicada nas doenças hemolíticas ou não, incompatibilidade fator Rh e grupo ABO. Embora seja frequente o uso da técnica em neonatos, deve-se enquanto profissionais se atentar aos sinais e sintomas, como também os fatores de risco no manejo da técnica, intervir elaborando uma rotina para o controle e manutenção dos equipamentos, observando criteriosamente o tipo de aparelhos utilizados e se atentar a distância ideal das lâmpadas sob o RN, avaliando sempre possíveis complicações durante o tratamento

High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19 : first results of ReumaCoV Brasil registry

Objectives To evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19. Methods Analysis of the first 8 weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as eligible for the study. Results 334 participants were enrolled, a majority of them women, with a median age of 45 years; systemic lupus erythematosus (32.9%) was the most frequent IMRD. Emergency care was required in 160 patients, 33.0% were hospitalised, 15.0% were admitted to the ICU and 10.5% underwent mechanical ventilation; 28 patients (8.4%) died. In the multivariate adjustment model for emergency care, diabetes (prevalence ratio, PR 1.38; 95% CI 1.11 to 1.73; p=0.004), kidney disease (PR 1.36; 95% CI 1.05 to 1.77; p=0.020), oral glucocorticoids (GC) (PR 1.49; 95% CI 1.21 to 1.85; p50 years (PR 1.89; 95% CI 1.26 to 2.85; p=0.002), no use of tumour necrosis factor inhibitor (TNFi) (PR 2.51;95% CI 1.16 to 5.45; p=0.004) and methylprednisolone pulse therapy (PR 2.50; 95% CI 1.59 to 3.92; p<0.001); for ICU admission, oral GC (PR 2.24; 95% CI 1.36 to 3.71; p<0.001) and pulse therapy with methylprednisolone (PR 1.65; 95% CI 1.00 to 2.68; p<0.043); the two variables associated with death were pulse therapy with methylprednisolone or cyclophosphamide (PR 2.86; 95% CI 1.59 to 5.14; p<0.018). Conclusions Age >50 years and immunosuppression with GC and cyclophosphamide were associated with unfavourable outcomes of COVID-19. Treatment with TNFi may have been protective, perhaps leading to the COVID-19 inflammatory process

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD)

OBJECTIVE: To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways (BiPAP®) in patients with chronic obstructive pulmonary disease. METHODS: Eighteen patients with FEV1 = 34 ± 8% of predicted values, mean age of 68 ± 9 years were randomly distributed into 2 groups, one group performing physical training on a treadmill and the other group performing physical training associated with BiPAP® (physical training+B), for 30 minutes, 3 times a week for 12 weeks. The training velocity was based on a test of cardiopulmonary force performed pre- and postintervention, which registered the values for heart rate, systolic blood pressure, diastolic blood pressure, peripheral oxygen saturation, blood lactate, sensation of dyspnea, respiratory muscle strength, and analysis of gases expired such as oxygen consumption and the production of carbon dioxide. RESULTS: For both groups, there was a significant improvement in dyspnea and peripheral oxygen saturation at identical levels of physical exercise, in distance walked during the physical training, and in respiratory muscle strength (P OBJETIVO: Avaliar a influência do treinamento físico, com e sem ventilação não invasiva com dois níveis de pressão nas vias aéreas (BiPAP®), em pacientes com doença pulmonar obstrutiva crônica. MÉTODOS: Dezoito pacientes com VEF1=34±8% do previsto, idade média de 68±9 anos, foram randomicamente distribuídos em dois grupos, um grupo realizando treinamento físico em esteira e outro grupo realizando treinamento físico associado ao BiPAP® (treinamento físico+B), durante 30 minutos, 3 vezes por semana, por 12 semanas. A velocidade do treinamento foi baseada no teste cardiopulmonar realizado pré e pós-intervenção, com registro dos valores de freqüência cardíaca, pressão arterial sistólica, pressão arterial diastólica, saturação periférica de oxigênio, lactato sanguíneo, sensação de dispnéia, força muscular respiratória e análise de gases expirados como consumo de oxigênio, produção de dióxido de carbono. RESULTADOS: Em ambos os grupos houve melhora significativa na dispnéia e saturação periférica de oxigênio no mesmo nível de esforço, na distância percorrida no teste cardiopulmonar e na força muscular respiratória (p<0,05). Somente o grupo treinamento físico+B teve melhora significativa de freqüência cardíaca, pressão arterial sistólica e consumo de oxigênio após treinamento (p<0,05). Além disso, significativa redução do lactato sanguíneo foi observada para o mesmo nível de exercício no grupo treinamento físico+B quando comparado com treinamento físico isolado (1,3±0,7 e 2,5±0,9mMol/L, p<0,05, respectivamente). CONCLUSÃO: O treinamento físico associado com BiPAP® aumenta a capacidade muscular oxidativa, e pode ser um recurso coadjuvante da reabilitação física de pacientes com doença pulmonar obstrutiva crônica

Educação em saúde: Uma ferramenta para a prevenção e controle de parasitoses

A educação em saúde é uma prática que estimula mudanças de hábitos, melhoria da qualidade de vida e diminuição da morbimortalidade. O presente trabalho trata-se de uma revisão integrativa com o objetivo de avaliar a educação em saúde como instrumento eficiente no controle e prevenção de parasitoses. Para nortear este estudo utilizamos o seguinte questionamento: A educação em saúde tem sido uma ferramenta eficiente no controle e prevenção de doenças parasitárias? Foi realizada uma seleção de artigos utilizando os Descritores em Ciências da Saúde (DeCS): Educação em saúde, Doenças parasitárias, Parasitic diseases e Health education junto àbase de dados Lilacs, Medline e Scielo. Foram identificados nove artigos que atenderam a proposta do estudo e os resultados encontrados apontam para eficacia da educação em saúde na prevenção de parasitoses, devendo essa atividade ser contínua. Portanto, a educação em saúde é uma importante aliada quando se visa romper com modelos hegemônicos e convencionais de saúde que já demonstraram ser apenas paliativos