Telemedicine as a Health Promotion Tool: A Multidisciplinary Vision

Telemedicine is a resource that contributes to improving the quality of medical care, reducing the time between diagnosis and therapy, and helping extend specialised and quality medical services to remote or poor locations. Teledermatology and Telecardiology encompass the application of telecommunication and computer technologies in dermatological and cardiological practice. The aim of this paper was to report the integration of a multidisciplinary health team providing remote assistance for diagnosis and management of dermatological and cardiovascular diseases, wherein second opinion was given to teams treating patients with difficulty in travelling to face-to-face consultations. Details were referred to the Hospital São Lucas, using a process provided by the MicroG eHealth platform, and specialists issued expert second opinions on each case. In this sense, teledermatology and telecardiology reports served as a tool to assist the general practitioner and family physician in deciding whether or not to refer patients to a specialist service

Experiência de Telecardiologia no Hospital São José de Palmares Do Sul em 2016 / Telecardiology experience in São José de Palmares do Sul Hospital in 2016

Introdução: A Telemedicina é o ramo da Medicina que permite a assistência remota a comunidades que não possuem cuidados de saúde especializados. Dentre as especialidades médicas, a cardiologia pode ser considerada um dos mais importantes campos de aplicação da telemedicina. O objetivo da pesquisa é relatar a experiência de atendimentos de telecardiologia no Hospital São José de Palmares do Sul, com base em dados obtidos dos atendimentos clínicos gerais realizados por estudantes de medicina da PUCRS em conjunto com cardiologistas do serviço de teleconsultoria do Hospital São Lucas. Metodologia: Os atendimentos da telecardiologia ocorreram no Hospital São José de Palmares do Sul. Os materiais utilizados foram eletrocardiógrafo e computador. Os pacientes foram triados e receberam exame clínico por estudantes de medicina da PUCRS, sendo em seguida encaminhados para realização do ECG. Os resultados dos ECGs foram registrados no sistema de telessaúde eHealth Platform Online. Médicos cardiologistas do Hospital São Lucas da PUCRS (HSL) receberam acesso aos dados dos pacientes via sistema de telessaúde, fornecendo hipóteses diagnósticas e sugestões de manejo para os médicos do Hospital São José de Palmares do Sul. A partir dos dados clínicos e alterações no ECG coletados foram realizadas comparações com as diversas variáveis encontradas e descritos os resultados. Resultados: Dentre as queixas mais apresentadas durante o exame clínico realizado pelos estudantes de medicina da PUCRS, 17 pacientes relataram dor no peito (53%), 10 dispneia (31%), 4 palpitação (13%), 3 cansaço (9%), 2 ansiedade (6%), 1 taquicardia (3%), 1 bradicardia (3%). Dos 32 pacientes, 2 não realizaram ECG (6%) e 6 não tiveram alteração no ECG (19%). Foi observada alteração no exame de ECG pelos cardiologistas em 24 pacientes (75%). Conclusão: A telecardiologia pode melhorar o processo de tomada de decisão dos clínicos gerais, evitar hospitalizações desnecessárias, reduzir o tempo pré-tratamento em emergências cardíacas, racionalizar os custos da saúde e promover o atendimento domiciliar

Relato de experiência sobre consulta de enfermagem realizada por acadêmicos como estratégia de promoção de saúde / Experience report on the nursing consultation performed by students as a health promotion strategy

Objetivo: Apresentar as experiências e as atividades vividas por acadêmicos de enfermagem sob supervisão de um professor, compartilhando aspectos teóricos e práticos do momento vivido pelos autores neste singular ambiente de assistência de enfermagem como forma de promoção em saúde para prevenção de diabetes mellitus e hipertensão arterial sistêmica. Métodos: Trata-se de um relato de experiência, com característica qualitativa a partir de métodos descritivos e observacionais. Foi realizada uma ação educativa pelos acadêmicos de enfermagem juntamente de um professor, com 93 participantes, em um Centro Universitário localizado na cidade de Niterói/RJ, em maio de 2022. Criou-se um instrumento para aplicação na consulta de enfermagem. Resultados e discussão: A realização das consultas de enfermagem oportunizou o amadurecimento profissional dos graduandos, visto que estes exerceram o raciocínio clínico ao pôr em prática seus conhecimentos teóricos e assistenciais previamente adquiridos no curso. Além disso, o público assistido ressaltou a importância do acolhimento recebido nas consultas, sendo um diferencial na prática do autocuidado. Conclusão: Os acadêmicos identificaram a potencialidade do enfermeiro diante do seu papel como educador em saúde. Diante disso, sugere-se construir consultórios de enfermagem nas universidades ao entender a sua importância na formação do profissional enfermeiro, oportunizando vivências práticas ricas em aprendizado ao reconhecer a realidade do aumento das doenças crônicas não transmissíveis no país

Missões de teledermatologia em Palmares Do Sul / Teledermatology missions in Palmares Do Sul

Introdução: A Telemedicina abrange o uso de telecomunicações e informática na área da saúde; dessa forma, permite assistência médica remota a pacientes, leva agilidade à consulta com especialistas, reduz gastos no cuidado terapêutico e traz benefício e conforto à população. A Teledermatologia, ramo da telemedicina, insere-se, nesse contexto, como adjuvante no cuidado à população, por facilitar o contato com médicos especialistas e por possibilitar o diagnóstico e tratamento precoce de afecções de pele. O presente trabalho tem como objetivo apresentar a experiência de atendimentos de teledermatologia, realizados por meio de Missões promovidas pela Liga Acadêmica de Telessaúde da PUCRS (LITESA), no Hospital São José, localizado na cidade de Palmares do Sul, Rio Grande do Sul.Metodologia: Os teleatendimentos de dermatologia ocorreram no Hospital São José de Palmares do Sul, onde as consultas foram realizadas por estudantes de medicina da PUCRS, integrantes da LITESA - após treinamento prévio realizado pela liga - que identificaram, examinaram, descreveram e fotografaram as lesões de pele, às quais foram armazenadas na eHealth Platform - Online. Os dados clínicos e fotografias das alterações cutâneas ficaram  disponíveis para posterior avaliação diagnóstica e parecer de orientação terapêutica por dermatologistas do Hospital São Lucas (HSL) da PUCRS.Resultados: Foram avaliados 33 pacientes (24% homens, 76% mulheres; média 37 anos de idade). As queixas dermatológicas mais frequentes foram de prurido, secreção, descamação e dor. Já as características das lesões de pele fotografadas foram, em sua maioria, do tipo mácula, seguido por lesões papulosas, pustulosas e eritemato-descamativas.Conclusão: As teleconsultas dermatológicas se tornaram uma possibilidade para auxiliar locais com falta de profissionais especializados e podem ser uma ferramenta legítima para reduzir o tempo de espera dos pacientes por atendimento dermatológico. Assim, a teledermatologia tem o potencial de levar o acesso, para uma determinada população, a atendimentos especializados, reduzir custos de saúde pública e melhorar a qualidade dos atendimentos clínicos gerais

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements