Análise das variáveis relacionadas ao tempo de permanência da UTI pediátrica de um Câncer center em São Paulo: Analysis of variables related to length of stay in the pediatric ICU of a Cancer center in Sao Paulo

Objetivo: Analisar algumas variáveis relacionadas ao tempo de permanência na Unidade de Terapia Intensiva Pediátrica (UTIP) de um câncer center em São Paulo. Métodos: Estudo descritivo de corte transversal retrospectivo de pacientes internados em um hospital oncológico em São Paulo, entre 2015 e 2020. As informações foram coletadas dos prontuários eletrônicos dos pacientes. Resultados: Foram internados na UTIP 580 pacientes, 51,7% eram do sexo feminino com mediana de permanência de cinco dias, 42,5% tinham a idade de 0 a 5 anos, 54,1% das admissões no hospital foram pelo SUS com mediana de cinco dias de internação, 23,6% dos pacientes tinham tumor hematológico e permaneciam internados 6,5 dias, 9,4% dos pacientes foram a óbito e permaneciam internados 18,1 dias e 0,6% foram a óbito com menos de 24 horas. Houve reinternação em 9,1% dos pacientes com média de permanência de 15,6 dias e reinternação em menos de 24 horas em 1,8%. Das internações 58,6% eram internação clínica com média de permanência de 7,8 dias, 8,7% tinham como procedência o setor de hemodinâmica ou externo com permanência de sete dias. O tempo de permanência quanto a causa da internação respiratória (11%) e cardiovascular (32,5%) foram de cinco e quatro dias respectivamente. Na comparação do tempo de permanência com o PIM II houve fraca relação entre as variáveis com o valor de 1,4 dias. Não houve influência significativa no tempo de permanência na UTIP em relação ao gênero, idade, tipo de entrada (se SUS ou convênio/particular), tipo de tumor, tipo de internação (clínica ou cirúrgica), procedência e o PIM II.  Conclusão: As variáveis que influenciaram no tempo de permanência foram a causa da internação, reinternação e óbito. Destacou-se a escassez de estudos nas populações oncológicas pediátricas e instrumentos que quantifiquem melhor a mortalidade dessa população. Objetivo: Analisar algumas variáveis relacionadas ao tempo de permanência na Unidade de Terapia Intensiva Pediátrica (UTIP) de um câncer center em São Paulo. Métodos: Estudo descritivo de corte transversal retrospectivo de pacientes internados em um hospital oncológico em São Paulo, entre 2015 e 2020. As informações foram coletadas dos prontuários eletrônicos dos pacientes. Resultados: Foram internados na UTIP 580 pacientes, 51,7% eram do sexo feminino com mediana de permanência de cinco dias, 42,5% tinham a idade de 0 a 5 anos, 54,1% das admissões no hospital foram pelo SUS com mediana de cinco dias de internação, 23,6% dos pacientes tinham tumor hematológico e permaneciam internados 6,5 dias, 9,4% dos pacientes foram a óbito e permaneciam internados 18,1 dias e 0,6% foram a óbito com menos de 24 horas. Houve reinternação em 9,1% dos pacientes com média de permanência de 15,6 dias e reinternação em menos de 24 horas em 1,8%. Das internações 58,6% eram internação clínica com média de permanência de 7,8 dias, 8,7% tinham como procedência o setor de hemodinâmica ou externo com permanência de sete dias. O tempo de permanência quanto a causa da internação respiratória (11%) e cardiovascular (32,5%) foram de cinco e quatro dias respectivamente. Na comparação do tempo de permanência com o PIM II houve fraca relação entre as variáveis com o valor de 1,4 dias. Não houve influência significativa no tempo de permanência na UTIP em relação ao gênero, idade, tipo de entrada (se SUS ou convênio/particular), tipo de tumor, tipo de internação (clínica ou cirúrgica), procedência e o PIM II.  Conclusão: As variáveis que influenciaram no tempo de permanência foram a causa da internação, reinternação e óbito. Destacou-se a escassez de estudos nas populações oncológicas pediátricas e instrumentos que quantifiquem melhor a mortalidade dessa população

Analno-vulvarna atrezija i ageneza kokcigealnih kralježaka u puleta - prikaz slučaja

Anal-vulvar atresia and agenesis of the coccygeal vertebrae is a rare condition that has never been reported before in donkeys, and only a single case in sheep. In this light, we sought to describe the surgical approach and postoperative care of a newborn donkey with this congenital abnormality. A female donkey was treated that was less than 24 hours old, weighing 15 kg, with increased perineal volume and the absence of an anus. The diagnosis was made by clinical examination, which also found an absence of the vulva and coccygeal vertebrae. A surgical approach followed using anoplasty and temporary fixation of a plastic probe, and a urethra attached to the skin. The postoperative period was followed by daily cleansing, antibiotic, anti-inflammatory and analgesic therapy, and removal of the plastic tube at 10 days. The early diagnosis and treatment enabled complete success and the animal’s recovery.Analno-vulvarna atrezija i ageneza kokcigealnih kralježaka rijetko je stanje koje dosad nije opisano u magaraca, naime opisano je samo u jednom slučaju u ovce. Upravo smo zbog toga nastojali opisati kirurški pristup i poslijeoperacijsku njegu u novorođenog puleta s ovom kongenitalnom abnormalnošću. Riječ je o ženki, staroj manje od 24 sata, tjelesne mase 15 kg, s povećanim perinealnim volumenom i bez anusa. Dijagnoza je postavljena na temelju kliničkog pregleda koji je otkrio i odsutnost vulve i kokcigealnih kralježaka. Uslijedio je kirurški zahvat s anoplastikom i privremenim postavljanjem plastične sonde i uretre pričvršćene za kožu. Poslijeoperacijski je period uključio dnevno čišćenje, antibiotičku, protuupalnu i analgetičku terapiju te uklanjanje plastične cijevi nakon deset dana. Rana dijagnoza i liječenje omogućili su potpun uspjeh u oporavku životinje

Moderators of ayahuasca’s biological antidepressant action

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy

Image_1_Moderators of ayahuasca’s biological antidepressant action.pdf

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy.</p

Table_1_Moderators of ayahuasca’s biological antidepressant action.pdf

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy.</p

Table_4_Moderators of ayahuasca’s biological antidepressant action.pdf

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy.</p

Table_3_Moderators of ayahuasca’s biological antidepressant action.pdf

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy.</p

Table_2_Moderators of ayahuasca’s biological antidepressant action.pdf

IntroductionThe understanding of biological responses to psychedelics with antidepressant potential is imperative. Here we report how a set of acute parameters, namely emotional (depressive symptoms), cognitive (psychedelic experience), and physiological (salivary cortisol), recorded during an ayahuasca dosing session, modulated serum brain-derived neurotrophic factor (BDNF), serum cortisol (SC), serum interleukin 6 (IL-6), plasma C-reactive protein (CRP), and salivary cortisol awakening response (CAR).MethodsResults were analyzed 2 days after the psychedelic intervention (ayahuasca) versus placebo in both patients with treatment-resistant depression and healthy volunteers. These measures were assessed as part of a randomized double-blinded, placebo-controlled trial (n = 72).ResultsResults revealed that larger reductions of depressive symptoms during the dosing session significantly moderated higher levels of SC in patients. Whereas lesser changes in salivary cortisol levels during the ayahuasca intervention were related to higher BDNF levels in patients with a larger clinical response in the reduction in depressive symptoms. No moderator was found for patient’s CAR, IL-6, and CRP responses to ayahuasca and for all biomarker responses to ayahuasca in healthy controls and in the placebo group.DiscussionIn summary, some specific emotional and physiological parameters during experimental ayahuasca session were revealed as critical moderators of the improvement of major depression biomarkers, mainly BDNF and SC two days after ayahuasca intake. These findings contribute to paving the way for future studies investigating the biological antidepressant response to psychedelic therapy.</p