O impacto da ultrassonografia no atendimento multidisciplinar na UTI

Introduction: The introduction of ultrasound in the Intensive Care Unit (ICU) represents a significant milestone, fostering substantial advancements in multidisciplinary practice and positively influencing the management of various critical conditions. The application of pulmonary ultrasound, in particular, emerges as a versatile and essential tool, directly impacting the quality of care provided. Methodology: A bibliographic search was conducted on the PUBMED platform, utilizing specific Mesh descriptors: Ultrasonography, Intensive Care Units, Patient Care Team. The search period spanned from 2013 to 2021, encompassing a total of 33 articles. Results: The application of ultrasound in the ICU has proven to be an extremely relevant tool for multidisciplinary care. Pulmonary ultrasound, when employed by intensivists, not only provides a precise assessment of the mentioned conditions but also plays a fundamental role in rapid decision-making and treatment optimization. Conclusion: Ultrasound emerges as a transformative tool in the ICU, shaping multidisciplinary practice and ushering in an era of more advanced and patient-centered intensive care. Its crucial role in swift decision-making and treatment optimization reinforces its position as an indispensable element in the toolkit of healthcare professionals in both the present and future ICU settings.Introdução: A introdução da ultrassonografia na Unidade de Terapia Intensiva (UTI) representa um marco significativo, promovendo avanços substanciais na prática multidisciplinar e influenciando positivamente o manejo de diversas condições críticas. A aplicação da ultrassonografia pulmonar, em particular, surge como uma ferramenta versátil e essencial, impactando diretamente a qualidade do atendimento prestado. Metodologia: A pesquisa bibliográfica foi conduzida na plataforma PUBMED, utilizando descritores Mesh específicos: Ultrasonography, Intensive Care Units, Patient Care Team. O período de busca abrangeu os anos de 2013 a 2021, totalizando 33 artigos. Resultado: Aplicação da ultrassonografia na UTI tem se mostrado uma ferramenta de extrema relevância para o atendimento multidisciplinar. A ultrassonografia pulmonar, quando utilizada pelos intensivistas, não apenas oferece uma avaliação precisa das condições mencionadas, mas também desempenha um papel fundamental na rápida tomada de decisões e na otimização do tratamento. Conclusão: A ultrassonografia emerge como uma ferramenta transformadora na UTI, moldando a prática multidisciplinar e promovendo uma era de cuidados intensivos mais avançados e centrados no paciente. Seu papel crucial na rápida tomada de decisões e na otimização do tratamento reforça sua posição como um elemento indispensável na caixa de ferramentas dos profissionais de saúde nas UTIs do presente e do futuro

Nascidos vivos com fenda palatina e labial: estudo epidemiológico

Introduction: Cleft lip and palate is a congenital malformation resulting from the inadequate fusion of bony structures during embryonic development. The etiology is multifactorial, involving genetic and environmental factors. Methodology: This study constitutes a descriptive epidemiological analysis focusing on the investigation of cases of live births with cleft lip and palate in Brazil. Data collection will be conducted through the Live Birth Information System (SINASC) during the period from 2017 to 2021. Results: The gender distribution of live births with cleft lip and palate indicates a male predominance in the sample, representing approximately 58.49% (n=4,390) of the total. Meanwhile, the percentage of female individuals is approximately 41.01% (n=3,078). The category "Unknown" has a very small representation, accounting for only 0.51% (n=38) of the sample. Conclusion: It is observed that live births with cleft lip and palate should not be overlooked. There is a significant number of cases each year, necessitating further related studies to provide solutions in society that directly benefit those affected.Introdução: A fenda labial e palatina é uma malformação congênita resultante da não fusão das estruturas ósseas adequadas durante o desenvolvimento embrionário. A etiologia é multifatorial, envolvendo fatores genéticos e ambientais. Metodologia: Este estudo constitui uma análise epidemiológica descritiva com enfoque na investigação dos casos de nascidos vivos com fenda labial e palatina no Brasil. A coleta de dados será realizada por meio do Sistema de Informações sobre Nascidos Vivos (SINASC) durante o período de 2017 a 2021. Resultado: A distribuição de gênero dos nascidos vivos com fenda labial e palatina indica que há uma maioria masculina na amostra, representando cerca de 58,49%  (n= 4.390) do total. Enquanto isso, a porcentagem de pessoas do sexo feminino é de aproximadamente 41,01% (n = 3.078) A categoria "Ignorado" tem uma representação muito pequena, com apenas 0,51% (n = 38) da amostra. Conclusão: Observa-se que os nascidos vivos com fenda labial e palatina não devem ser negligenciados. Há uma quantidade significativa de nascidos por ano, sendo indispensável mais estudos relacionados, a fim de trazer soluções na sociedade que beneficiem diretamente os acometidos

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age >= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients >= 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those >= 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups

Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI -Group I (BMI < 50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI > 60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 & PLUSMN; 24.4 Kgs and 43.03 & PLUSMN; 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively.The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = < 0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients