VENTAJAS Y DESVENTAJAS DESPUÉS DE LA IMPLEMENTACIÓN DE SISTEMAS INTEGRADOS DE GESTIÓN EMPRESARIAL (ERP) EN LAS EMPRESAS – UNA REVISIÓN DE LA LITERATURA

A competitividade no ambiente empresarial requer implementar os Sistemas Integrados de Gestão Empresarial, denominados ERP em empresas. O trabalho tem o objetivo de apresentar as vantagens e as desvantagens proporcionadas pós-implementação dos sistemas ERP em empresas. Foi realizada revisão bibliográfica a partir do levantamento de estudos de caso utilizando o ERP no ambiente empresarial. A maior parte dos desafios da implementação desse sistema surge do uso inadequado do software, logo, é importante destacar a necessidade de um profissional bem treinado para que possa fazer a utilização da maneira mais eficiente possível. Conclui-se que os sistemas ERP proporcionam diversos benefícios para as empresas que os implementam. Uma das vantagens é que por serem softwares não são estáticos, eles se tornam totalmente adaptáveis a qualquer situação imposta pelo ambiente empresarial.Competitiveness in the business environment requires the implementation of Integrated Business Management Systems, called ERP in companies. The aim of this work is to present the advantages and disadvantages provided after the implementation of ERP systems in companies. A bibliographic review was carried out from the survey of case studies using the ERP in the business environment. Most of the challenges of implementing this system arise from the inappropriate use of the software, therefore, it is important to highlight the need for a well- trained professional so that he can use it in the most efficient way possible.  It is concluded that ERP systems provide several benefits for the companies that implement them. One of the advantages is that because they are not static software, they become totally adaptable to any situation imposed by the business environment.A competitividade no ambiente empresarial requer implementar os Sistemas Integrados de Gestão Empresarial, denominados ERP em empresas. O trabalho tem o objetivo de apresentar as vantagens e as desvantagens proporcionadas pós-implementação dos sistemas ERP em empresas. Foi realizada revisão bibliográfica a partir do levantamento de estudos de caso utilizando o ERP no ambiente empresarial. A maior parte dos desafios da implementação desse sistema surge do uso inadequado do software, logo, é importante destacar a necessidade de um profissional bem treinado para que possa fazer a utilização da maneira mais eficiente possível. Conclui-se que os sistemas ERP proporcionam diversos benefícios para as empresas que os implementam. Uma das vantagens é que por serem softwares não são estáticos, eles se tornam totalmente adaptáveis a qualquer situação imposta pelo ambiente empresarial.La competitividad en el entorno empresarial requiere implementar los Sistemas Integrados de Gestión Empresarial, denominados ERP en las empresas. El trabajo tiene como objetivo presentar las ventajas y desventajas proporcionadas después de la implementación de sistemas ERP en las empresas. Se realizó una revisión de la literatura basada en una encuesta de estudios de casos utilizando ERP en el entorno empresarial. La mayoría de los desafíos de implementar este sistema surgen del uso inadecuado del software, por lo que es importante resaltar la necesidad de un profesional bien capacitado para que pueda hacer el uso de la manera más eficiente posible. Se concluye que los sistemas ERP proporcionan varios beneficios a las empresas que los implementan. Una de las ventajas es que al ser software no son estáticos, se vuelven totalmente adaptables a cualquier situación impuesta por el entorno empresarial

Dor, Dort e doenças cardiovasculares em profissionais do SAMU 192 de Porto Alegre/RS

Objetivo: identificar a prevalência de dor musculoesquelética, distúrbios osteomusculares relacionadas ao trabalho (Dort), doenças cardiovasculares (DCV) e fatores associados em profissionais do SAMU 192 em Porto Alegre/RS. Métodos: 113 trabalhadores (37% da equipe do SAMU de Porto Alegre) responderam a um questionário de hábitos relacionados ao trabalho, riscos ocupacionais e aparecimento de DCV e Dort. A análise estatística foi realizada com tabelas de frequência, teste qui-quadrado e razões de prevalência – intervalo de confiança de 95% (IC 95%) – por meio de análise multivariável (modelo de regressão de Poisson), com α=0,05. Resultados: Todos os participantes estavam na condição de sobrepeso e apresentavam alta prevalência de dor (92,9%) e Dort (50,4%) e baixa prevalência de DCV (8,8%). A idade contribuiu para o aumento no risco de aparecimento da dor. Os fatores associados ao aparecimento da Dort foram exposição a frio, calor e vibrações, esforço físico, ausência de pausa nas atividades, profissão, regime de trabalho e estresse. A ligação entre os fatores associados e DCV não foi possível devido à baixa prevalência de DCV entre os trabalhadores. Conclusão: os profissionais do SAMU apresentaram alta prevalência de dor e Dort e baixa prevalência de DCV.Objective: To determine the prevalence of musculoskeletal pain, Cumulative Trauma Disorders (CTD) and cardiovascular disease (CVD) and identify the associated factors in the emergency professionals of Porto Alegre/RS. Methods: 113 workers (37% of SAMU 192 Porto Alegre/RS) answered a questionnaire about work-related habits, occupational risks and the onset of CTD and CVD. Statistical analysis was performed using frequency tables, chi-square test and prevalence ratios (95%) through multivariate analysis (Poisson’s regression model). Considering α=0.05. Results: All participants were in the overweight condition and showed high prevalence of pain (92.9%) and CTD (50.4%), and low CVD prevalence (8.8%). Age acted as a risk for pain. Factors associated with CTD were exposure to cold and heat, exposure to vibrations, physical exertion, no breaks in between activities, occupation, working hours and stress. The association between risk and CVD was not possible due to the low prevalence of CVD among workers. Conclusion: SAMU 192 professionals of Porto Alegre/RS showed high prevalence of pain and CTD, and low prevalence of CVD

Sites of Anesthetic Block of the Lateral and Medial Palmar Metacarpal Nerves in Equines of Indeterminate Breed

Background: Local anesthesia blockage at equines claudication diagnosis besides favoring the beginning of the therapy and relieving patient’s pain, it allows the identification of the specific affected region and its origin, however, if it is done incorrectly (by improper volume of anesthetics application and/or mistakenly nerve identification due to the lack of anatomic referential) it may cause inflammation, infection or even tissue necrosis. The aim was describing anatomically lateral and medial palmar metacarpal nerves in equines to improve diagnostic anesthetic block techniques on four metacarpophalangeal articulation joints of the specie.Materials, Methods & Results: A number of 20 thoracic limbs from 10 equines of indeterminate breed were used to be fixated in 10% phormaldehyde and with a marked arterial system by water solution of red dyed latex. The structures were identified by dissection, and their denomination bases on Nomina Anatomica Veterinaria (N.A.V.) by the International Committee on Veterinary Gross Anatomical Nomenclature. The study had been approved by the Board of Ethics in Animal Use of the University Center of Patos de Minas (UNIPAM), protocol n° 18/17. The lateral and medial palmar metacarpal nerves have been observed in all of the specimens originated from the deep branch of lateral palmar nerve, immediately distal to the intercarpal articulation. After its origin, the first nerve stretched ipsilaterally from the common trunk, whilst the second nerve positioned counter-lateral manner after superficially crossing the interosseus muscle. Both penetrated at the level of the mid third of the referred muscle and the metacarpal bone III and, assumed respectively a parallel medial position to the metacarpal bone IV and lateral to the metacarpal II, being intimately associated to the palmar face of the metacarpal bone III. Distally, those nerves emerged from a palmar position to a lateral and medial to the distal extremity of the metacarpal bones, corresponding and adjacent to the metacarpophalangeal articulation palmar recession, where they had finally ramified to partially innervate the associated articular capsule and the subcutaneous tissue of the region.Discussion: The lateral and medial palmar metacarpal nerves present similar origin and disposition to the above described, however, besides largely mentioned in literature, we point out here as recommended by N.A.V., no use of terms like axial and abaxial as position indicators for equine. As a part of block anesthetic diagnosis of four metacarpophalangeal articulation points, it is hereby suggested for the studied nerves desensitization, should be palpated the distal extremities of the metacarpal bones IV and II. After the identification, using thumb located from the extremity at proximal direction way, introduce the needle bilaterally for 1.5 cm downright between the above mentioned metacarpal bones and the interosseus muscle, being these latter and the flexor muscle tendons drawn in the palmar direction. Thus, it becomes valid to affirm that the technique of four-point diagnostic anesthetic block of the metacarpophalangeal articulation has been perfected for equines, and that it will limit the chances of false results on account of misplaced puncturing of nearby structures, such as, for example, the synovial recesses, mentioned as the location of the utmost gravity, hence septic synovitis may come in play

Quality assessment of a large multi-center flow cytometric dataset of acute myeloid leukemia patients—A EuroFlow study

Flowcytometric analysis allows for detailed identification and characterization of large numbers of cells in blood, bone marrow, and other body fluids and tissue samples and therefore contributes to the diagnostics of hematological malignancies. Novel data analysis tools allow for multidimensional analysis and comparison of patient samples with reference databases of normal, reactive, and/or leukemia/lymphoma patient samples. Building such reference databases requires strict quality assessment (QA) procedures. Here, we compiled a dataset and developed a QA methodology of the EuroFlow Acute Myeloid Leukemia (AML) database, based on the eight-color EuroFlow AML panel consisting of six different antibody combinations, including four backbone markers. In total, 1142 AML cases and 42 normal bone marrow samples were included in this analysis. QA was performed on 803 AML cases using multidimensional analysis of backbone markers, as well as tube-specific markers, and data were compared using classical analysis employing median and peak expression values. Validation of the QA procedure was performed by re-analysis of >300 cases and by running an independent cohort of 339 AML cases. Initial evaluation of the final cohort confirmed specific immunophenotypic patterns in AML subgroups; the dataset therefore can reliably be used for more detailed exploration of the immunophenotypic variability of AML. Our data show the potential pitfalls and provide possible solutions for constructing large flowcytometric databases. In addition, the provided approach may facilitate the building of other databases and thereby support the development of novel tools for (semi)automated QA and subsequent data analysis.The EuroFlow Consortium received support from the FP6-2004-LIFESCIHEALTH-5 program of the European Commission (grant LSHB-CT-2006-018708) as a Specific Targeted Research Project (STREP). The EuroFlow Consortium is part of the European Scientific Foundation for Hemato Oncology (ESLHO), a Scientific Working Group (SWG) of the European Hematology Association (EHA). S.M. was supported by Acción Estratégica en Salud (AES) (Grant PI21_01115) and the grant of CIBERONC of the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain and FONDOS FEDER (no. CB16/12/00400)

Immunophenotypic Analysis of Acute Megakaryoblastic Leukemia: A EuroFlow Study

Acute megakaryoblastic leukemia (AMKL) is a rare and heterogeneous subtype of acute myeloid leukemia (AML). We evaluated the immunophenotypic profile of 72 AMKL and 114 non-AMKL AML patients using the EuroFlow AML panel. Univariate and multivariate/multidimensional analyses were performed to identify most relevant markers contributing to the diagnosis of AMKL. AMKL patients were subdivided into transient abnormal myelopoiesis (TAM), myeloid leukemia associated with Down syndrome (ML-DS), AML—not otherwise specified with megakaryocytic differentiation (NOS-AMKL), and AMKL—other patients (AML patients with other WHO classification but with flowcytometric features of megakaryocytic differentiation). Flowcytometric analysis showed good discrimination between AMKL and non-AMKL patients based on differential expression of, in particular, CD42a.CD61, CD41, CD42b, HLADR, CD15 and CD13. Combining CD42a.CD61 (positive) and CD13 (negative) resulted in a sensitivity of 71% and a specificity of 99%. Within AMKL patients, TAM and ML-DS patients showed higher frequencies of immature CD34+/CD117+ leukemic cells as compared to NOS-AMKL and AMKL-Other patients. In addition, ML-DS patients showed a significantly higher expression of CD33, CD11b, CD38 and CD7 as compared to the other three subgroups, allowing for good distinction of these patients. Overall, our data show that the EuroFlow AML panel allows for straightforward diagnosis of AMKL and that ML-DS is associated with a unique immunophenotypic profile.The EuroFlow Consortium received support from the FP6-2004-LIFESCIHEALTH-5 program of the European Commission (grant LSHB-CT-2006-018708) as Specific Targeted Research Project (STREP). The EuroFlow Consortium is part of the European Scientific Foundation for HematoOncology (ESLHO), a Scientific Working Group (SWG) of the European Hematology Association (EHA). The work of C.E.P. and E.S.C. was partially supported by FAPERJ (Grant E26/200.840/2021- CNE; E26/210.379/2018 and E26/110.105/2014); CAPES-PROEX; and CNPq (Grant 306258/2019-6 and 303765/2018-6). M.N. and E.M. were supported by the Ministry of Health of the Czech Republic, grant number NU20J-07-00028. S.M. was supported by Acción Estratégica en Salud (AES) (Grant PI21_01115) and the grant of CIBERONC of the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain and FONDOS FEDER (no. CB16/12/00400)

A National Wide Collaborative Study

INTRODUCTION: Even though the risk of COVID-19 in pregnancy may be increased, large-scale studies are needed to better understand the impact of the infection in this population. The aim of this study is to describe obstetric complications and the rate of vertical transmission in pregnant women with SARS-CoV-2 infection. MATERIAL AND METHODS: Detected cases of SARS-CoV-2 infection in pregnancy were registered in Portuguese hospitals by obstetricians. Epidemiological, pregnancy and childbirth data were collected. RESULTS: There were 630 positive cases in 23 Portuguese maternity hospitals, most at term (87.9%) and asymptomatic (62.9%). The most frequent maternal comorbidity was obesity. The rates of preterm birth and small-to-gestational-age were 12.1% and 9.9%, respectively. In the third trimester, 2.9% of pregnant women required respiratory support. There were eight cases (1.5%) of fetal death, including two cases of vertical transmission. There were five cases of postpartum respiratory degradation, but no maternal deaths were recorded. The caesarean section rate was higher in the first than in the second wave (68.5% vs 31.5%). RT-PCR SARS-CoV-2 positivity among newborns was 1.3%. CONCLUSION: SARS-Cov-2 infection in pregnancy may carry increased risks for both pregnant women and the fetuses. Individualized surveillance and the prophylaxis of this population with vaccination. is recommended in these cases.publishersversionepub_ahead_of_prin