Diagnosis and treatment of late jaundice in late preterm and term newborns: An integrative literature review / Diagnóstico e tratamento da icterícia tardia em recém-nascidos prematuros tardios e a termo: Uma revisão integrativa de literatura

Although it is a common clinical condition in neonatology, jaundice must have an adequate diagnosis and an on-time treatment since the excess of bilirubin can lead to the development of kernicterus – that, in rare cases, can lead to neonatal death. This study aimed to identify which diagnostic methods and treatment of late jaundice in late preterm and term show greater relevance, efficacy, and safety. An integrative review was performed through SciELO, Pubmed, and Bireme databases, of publications between 2015 and 2020, using the descriptors "neonatal jaundice", "neonatal hyperbilirubinemia", "neonatal jaundice" and "neonatal hyperbilirubinemia".  After the articles extraction, they were stratified in a dataset, from which 17 articles that deal with the diagnosis and / or treatment of late preterm newborns and / or suitable for gestational age were selected and arranged in narrative and charts. It was possible to establish that although serum bilirubin testing is widely used, extracorporeal methods are a good option in the diagnosis of jaundice, with good accuracy, for which phototherapy is the main treatment. There are effective, safe, and low-cost alternatives for the diagnosis and treatment of neonatal jaundice, that work by minimizing the risks of complications

Hanseníase em menores de 15 anos: expressão da magnitude e da força da transmissão recente, no estado do Pará, 2006 a 2015 / Leprosy in children under 15 years of age: expression of the magnitude and strength of recent transmission, in Pará state, 2006 to 2015

A hanseníase é uma doença infectocontagiosa, curável, contudo, com grande potencial para gerar incapacidade física. Conhecer o impacto da hanseníase em menores de 15 anos permite estimar o nível de transmissão, a intensidade da endemia e avaliar a efetividade dos serviços de saúde em combater essa enfermidade, que é mais prevalente em populações pobres e representa um crescente problema de saúde no estado do Pará. O objetivo deste estudo foi estudar a distribuição geográfica da hanseníase em menores de 15 anos, na Região Metropolitana de Belém, estado do Pará. Estudo quantitativo, com desenho de estudo ecológico, dos casos notificados de hanseníase, em menores de 15 anos de idade, abrangendo o período de 2006 a 2015. Foram calculados indicadores epidemiológicos e utilizou-se o software livre com código-fonte aberto QGis 2.18 para a construção dos mapas. Dos 675 casos, havia predomínio das formas paucibacilares e maior frequência da forma clínica dimorfa. A evolução da taxa média, padronizada, de detecção da hanseníase em menores de 15 anos, apontou muito hiperendemicidade nos municípios de Castanhal, que tinha cobertura populacional da Estratégia Saúde da Família consolidada, e de Marituba, com cobertura intermediária. A magnitude da endemia, a força da morbidade e a tendência da doença, apontadas pelos indicadores de acompanhamento epidemiológico, permaneceram elevadas e a cobertura da Estratégia Saúde da Família, embora consolidada na maioria dos municípios, não se distribuiu de forma homogênea a garantir cobertura universal aos territórios. Esses resultados contribuem para a análise da distribuição geográfica da hanseníase, importante para a identificação de áreas para alocação de recursos, visando controle e redução da doença. 

Hanseníase em menores de 15 anos de idade e cobertura da Estratégia Saúde da Família, Belém, estado do Pará/ Leprosy in children under 15 years of age and coverage of the Family Health Strategy, Belém, Pará state

Objetivo: Analisar a distribuição da hanseníase em menores de 15 anos, no município de Belém, estado do Pará, no período de 2005 a 2014 e correlacionar com a cobertura da Estratégia de Saúde da Família (ESF) do município. Metodologia: Pesquisa quantitativa com desenho de estudo descritivo, transversal, realizado no município de Belém, estado do Pará. A população estudada foi constituída pelos casos de hanseníase em menores de 15 anos de idade, residentes no município de Belém, investigados e notificados pela Secretaria Municipal de Saúde, no Sistema de Informação e de Agravos de Notificação (SINAN). Resultados: A maior ocorrência foi no sexo masculino (54,57%) e na cor parda (67,47%). A faixa etária mais acometida foi a de 10 a 14 anos. Houve predomínio das formas tuberculoide e dimorfa. A taxa de detecção apresentou tendência de queda, porém, apesar dessa queda, a detecção encontrada ainda é considerada muito alta pelos parâmetros utilizados pelo Ministério da Saúde. Foram três o número de bairros classificados como hiperendêmicos, sendo um deles com cobertura da Estratégia Saúde da Família (ESF) entre 25,18% a 45,91%. Conclusão: A situação identificada proporciona visibilidade das áreas geográficas de maior vulnerabilidade, quer por apresentarem elevadas taxas de detecção, quer por não apresentarem cobertura de ESF adequada, direcionando o planejamento de forma mais assertiva, com implementação de estratégias direcionadas à população com maior risco para o adoecimento

Evaluation of the impact of vegetable oils on the germination of lettuce seeds (Lactuca sativa L.)

Vegetable oils were widely used for food production at different levels: domestic, commercial or industrial. Due to the improper discharge of its remainings in the sewage system, they becom potentially polluting for water resources and can cause many problems to wastewater treatment plants operation, provoking efficiency loss and increasing operational costs. The objective of this work was to evaluate the impact of four vegetable oils (soy, corn, canola and sunflower) on germination and development of lettuce seeds (Lactuca sativa L.). The experimental design had 7 treatments for the test group (oils) and 1 control group. The control group was composed of 4 mL deionized water. At the end of 120 h (5 days), the following parameters were evaluated: number of germinated seeds and length of rootlets. It was verified a negative effect on the germination rate and root growth as a function of the increase of the doses. Starting the dose with 0.1 mL of oil, was observed inhibition in rate of germination and root growth. All the oils studied were equally impacting to the parameters of seed germination and root growth of lettuce seeds

práticas artísticas no ensino básico e secundário

A inclusão, a desmaterialização, a difusão das práticas artísticas para novos campos mais além das manualidades, as novas abordagens não formais pelos museus, trouxeram desafios acrescidos à educação artística. O panorama de pesquisa pelos investigadores é cada vez mais exigente e as propostas apresentam abordagens ao Museu sem lugar, ao emtrosamento cultural das pedagogias criticas, a aproximação às identidades, à complexidade da hibridação dos média, à ameaça dos cortes políticos nas esferas de decisão ou à crescente urbanização dos imaginários culturais contemporâneos.info:eu-repo/semantics/publishedVersio

COMPLICAÇÕES E MANEJO DO ACRETISMO PLACENTÁRIO: UMA REVISÃO INTEGRATIVA

Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introdução: O acretismo placentário é uma condição obstétrica grave e complexa que está se tornando mais comum devido ao aumento das cesarianas e outras intervenções uterinas. Esta condição ocorre quando a placenta adere anormalmente ao músculo uterino, variando em gravidade como placenta acreta, increta e percreta. Ela pode causar complicações sérias, como hemorragias intensas e a necessidade de histerectomia. O diagnóstico precoce, feito por ultrassonografia e ressonância magnética, é crucial para um manejo adequado. O aumento da incidência está ligado a fatores de risco como cesarianas anteriores, multiparidade, idade materna avançada e histórico de curetagem uterina. Metodologia: Foram selecionados dez artigos científicos relevantes, publicados em português, inglês e espanhol, encontrados em bases de dados como PubMed, SciELO e Google Scholar, usando termos como "acretismo placentário", "diagnóstico", "manejo clínico" e "complicações". Incluíram-se estudos originais, revisões sistemáticas e relatos de casos sobre o diagnóstico, manejo e complicações do acretismo placentário, excluindo estudos com populações não humanas, artigos sem texto completo e publicações anteriores a 2010. Resultados: A revisão integrativa resultou na seleção de dez artigos científicos relevantes que abordam o manejo e as complicações do acretismo placentário. Os principais temas incluem diagnóstico, manejo clínico e tratamento, com ênfase na conduta médica e da equipe multiprofissional. As complicações mais frequentes identificadas foram hemorragia pós-parto, necessidade de histerectomia e lesões a outros órgãos. A introdução de equipes multidisciplinares e novas técnicas cirúrgicas mostrou-se eficaz na redução da morbidade materna. Conclusões: A criação de equipes especializadas mostrou-se eficaz na redução da morbidade materna em casos graves. As principais complicações, como hemorragia pós-parto e necessidade de histerectomia, podem ser melhor gerenciadas com planejamento adequado e intervenções oportunas. Ferramentas diagnósticas, como ultrassonografia e ressonância magnética, são essenciais para a detecção precoce. A implementação de protocolos e novas técnicas cirúrgicas também se mostrou promissora. No entanto, há necessidade de mais estudos com amostras maiores para consolidar as evidências e aprimorar as estratégias de manejo dessa condição complexa

práticas artísticas no ensino básico e secundário

info:eu-repo/semantics/publishedVersio

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed