Análise de diferentes métodos de avaliação do estado nutricional de pacientes em hemodiálise

Introdução: O paciente em diálise deve ser avaliado nutricionalmente e monitorado periodicamente desde o início do tratamento dialítico, possibilitando melhores propostas de intervenções e adequações dietéticas eficazes. Objetivo: Comparar estado nutricional de pacientes com Doença Renal Crônica em hemodiálise, classificados entre desnutridos e não desnutridos, por diferentes parâmetros clínicos, antropométricos, laboratoriais e verificar o nível de concordância dessas formas avaliativas. Materiais e Métodos: Estudo transversal, realizado em 2010, com 90 pacientes de uma clínica de diálise em Belo Horizonte/MG. Foram coletados dados pessoais, socioeconômicos, nutricionais, clínicos, bioquímicos e antropométricos. Resultados e Discussão: Houve variação de 12,2% a 86,7% de indivíduos desnutridos conforme diferentes parâmetros avaliativos. Nas análises antropométricas, homens apresentaram pregas cutâneas menores que mulheres. Quanto à circunferência muscular do braço, quase 40% apresentaram classificação de desnutrição, sendo aproximadamente 30% destes do sexo masculino. Os valores médios Índice de Massa Corporal encontraram-se dentro da classificação de normalidade. Quanto à ingestão calórica e ingestão protéica, as proporções de pacientes com ingestão inferior ao desejado foram de 86,7% e 57,8% respectivamente. A média dos valores de albumina foi de 3,9g/dL e a classificação de desnutrição variou entre 25,6% e 50% dependendo da referência utilizada. Conclusões: A grande variação de classificação dos pacientes como desnutridos obtida, sugere a necessidade de padronização de rotinas, observação e acompanhamento cautelosos das referências e a necessidade de comitês de avaliação para determinação de novos pontos de corte para melhor classificação nutricional desta população.Cómo citar este artículo: Ribeiro M, Araújo ML, Cunha L, Ribeiro D, Pena G. Análise de diferentes métodos de avaliação do estado nutricional de pacientes em hemodiálise. Rev Cuid. 2015; 6(1): 932-40. http://dx.doi.org/10.15649/cuidarte.v6i1.16

EPIDEMIOLOGIA, COMPLICAÇÕES E FATORES ASSOCIADOS À DOENÇA CRÍTICA CRÔNICA EM PACIENTES HOSPITALIZADOS POR TRAUMA EM UNIDADE DE TERAPIA INTENSIVA

A doença crítica crônica (DCC) descreve pacientes que sobreviveram ao episódio inicial de doença crítica, mas que permanecem dependentes da unidade de terapia intensiva (UTI) por períodos prolongados ou pelo resto de suas vidas. O presente estudo objetivou caracterizar pacientes traumatizados e hospitalizados na Unidade de Terapia Intensiva com Doença Crítica Crônica. Foram coletados dados de internações por trauma UTI no interior do Paraná de 2013 a 2016, dessa maneira, foi traçado o perfil epidemiológico e realizado associações e comparação dos grupos analisados (total de pacientes traumatizados hospitalizados em UTI em comparação com os pacientes traumatizados que desenvolveram DCC). Notou-se que dos 417 indivíduos traumatizados investigados, 41 (9,8%) foram classificados com DCC, além disso, o sexo masculino, menor índice de comorbidades, maior gravidade do trauma e ferimentos contusos estiveram relacionados ao desenvolvimento da DCC. Os pacientes com DCC apresentaram complicações cirúrgicas (87,8%), e 41,5% evoluíram a óbito. Portanto, os DCC permanecem por longo período na UTI (com uma média de 19,88 dias), os quais necessitam de cuidados intensivos de enfermagem e da equipe multiprofissional

Comparison between lysine and paracetamol for post tooth extraction pain control

BACKGROUND AND OBJECTIVES: Tooth extraction is practiced since the early days of mankind to surgically solve dental problems. However, as any surgical procedure, it promotes an inflammatory reaction with clinical presentation of pain. Several drugs have been used to minimize postoperative discomfort; however there is still no established protocol for its control. This study aimed at evaluating the analgesic effect of lysine and paracetamol to control post tooth extraction pain. METHOD: Double blind randomized study with 40 patients seen by the Surgical Outpatient Setting I, Dentistry Department, Federal University of Sergipe (DOD/UFS), who needed alveolar extractions in different hemiarcades using lysine (125 mg) three times a day or paracetamol (750 mg) four times a day, both during three postoperative days. Pain was evaluated at 24 and 48 hours with the visual analog scale. Data were submitted to Student's t and Friedman statistical tests. RESULTS: There have been no statistically significant differences in age, gender and pain intensity. CONCLUSION: Both lysine and paracetamol were effective to control post tooth extraction pain.A exodontia é praticada desde os primórdios da humanidade como forma de resolver cirurgicamente os problemas dentários. Porém, como todo procedimento cirúrgico, ela promove um processo inflamatório reacional que se apresenta clinicamente com dor. Muitos fármacos têm sido usados no intuito de minimizar o desconforto pós-operatório, porém um protocolo para o seu controle ainda não está estabelecido. Este estudo teve como objetivo avaliar o efeito analgésico do clonixinato de lisina e paracetamol no controle de dor pós-exodontia. Estudo duplamente encoberto e randomizado com 40 pacientes atendidos no Ambulatório de Cirurgia I no Departamento de Odontologia da Universidade Federal de Sergipe (DOD/UFS) que necessitaram de extrações por via alveolar em hemiarcadas diferentes utilizando clonixinato de lisina (125 mg) três vezes ao dia ou paracetamol (750 mg) quatro vezes ao dia, ambos por três dias no pós-operatório. A dor foi avaliada nas primeiras 24 e 48h com o uso da escala analógica visual. Os dados foram submetidos aos testes estatísticos t de Student e de Friedman. Não houve diferenças estatisticamente significantes entre idade, em relação aos gêneros e em relação à intensidade da dor. Tanto o clonixinato de lisina como o paracetamol foi eficaz para o controle da dor pós-exodontia134356359Tooth extraction is practiced since the early days of mankind to surgically solve dental problems. However, as any surgical procedure, it promotes an inflammatory reaction with clinical presentation of pain. Several drugs have been used to minimize postoperative discomfort; however there is still no established protocol for its control. This study aimed at evaluating the analgesic effect of lysine and paracetamol to control post tooth extraction pain. Double blind randomized study with 40 patients seen by the Surgical Outpatient Setting I, Dentistry Department, Federal University of Sergipe (DOD/UFS), who needed alveolar extractions in different hemiarcades using lysine (125 mg) three times a day or paracetamol (750 mg) four times a day, both during three postoperative days. Pain was evaluated at 24 and 48 hours with the visual analog scale. Data were submitted to Student's t and Friedman statistical tests. There have been no statistically significant differences in age, gender and pain intensity. Both lysine and paracetamol were effective to control post tooth extraction pai

Fatores de risco para a ocorrência de acidentes em laboratórios de ensino e pesquisa em uma universidade brasileira (2012)

O estudo teve o objetivo de analisar os principais fatores associados à ocorrência de acidentes envolvendo agentes biológicos, materiais perfurocortantes ou compostos químicos em laboratórios de ensino e pesquisa de uma universidade brasileira. Trata-se de estudo transversal e analítico, com aplicação de questionário a 271 indivíduos que desenvolviam atividades laboratoriais em três unidades acadêmicas da Universidade Federal de Minas Gerais em 2012. A triagem de características potencialmente associadas à ocorrência de acidentes foi realizada por testes estatísticos univariados. A verificação dos principais fatores de risco ou proteção para a ocorrência de acidentes foi feita por modelos de análise multivariada (

Epidemiological determinants of Chrysomya (Diptera: calliphoridae) infestation in layer farms of Minas Gerais, Brazil

Aspects related to the epidemiology of Diptera belonging to genus Chrysomya were studied in order to determine predisposing factors for their occurrence in commercial laying hens farms from the state of Minas Gerais, Brazil. An observational, analytical and sectional survey was conducted to verify the main epidemiological determinants of infestations by Chrysomya spp. Forty-three farms were visited in 2012 and these 13 (30,23%) were infested by Chrysomya putoria, 4 (9,30%) by Chrysomya megacephala and 2 (4,65%) by Chrysomya albiceps and in 2 farms (4,65%) was not possible to identify the species of Chrysomya. The epidemiological determinants for the occurrence of infestations by Chrysomya spp. were investigated using multiple logistic regression models. Housing clustering type and its conditions were important factors involved in epidemiology of these species (OR=5.05, 95% CI = 2.66 to 9.58, p = 0.000). It was also observed that the increase of the humidity of manure leads to increase chances of infestations (OR = 1.81, 95% CI = 1.36 to 2.40, p = 0.000). The presence of the beetle “lesser mealworm” (Alphitobius diaperinus) (OR = 0.15, 95% CI = 0.067 to 0.36, p = 0.000) was characterized as a protective factor against infestations, probably due to predation behavior of the beetle. Some regions of the state were characterized as lower risk areas for Chrysomya spp. infestation as compared to other regions. Management measures, such as constant monitoring of water leaks on manure, adequate composting of dead poultry and periodic removal of manure could assist in decreasing the presence of Chrysomya spp. inside the laying houses

The effect of benznidazole dose among the efficacy outcome in the murine animal model. A quantitative integration of the literature.

Despite more than 100 years since it was firstly described Chagas disease, only two drugs are available to treat Chagas disease: Nifurtimox launched by Bayer in 1965 and benznidazole launched by Roche in 1971. Drug discovery initiatives have been looking for new compounds as an alternative to these old drugs. Although new platforms have been used with the latest technologies, a critical step on that process still relies on the in vivo model. Unfortunately, to date, available animal models have limited predictive value and there is no standardization. With the aim to better understand the role of benznidazole, the current standard of care of Chagas disease, we performed this review. We intend to analyze the influence of the experimental design of the most used animal model, the murine model, in the assessment of the efficacy endpoint

Epidemiological Characterization and Risk Assessment Associated with the Presence of Diptera Order in Laying Poultry Farms

Background: Health aspects of flocks of laying chickens, such as the occurrence of infestations by parasites and poultry pests, influence significantly the productivity indicators. In recent years, Brazilian poultry has gone through a scientific and technological evolution which resulted in high density poultry hens in the laying sheds and an increase of the occurrence of ectoparasites such as Diptera. The presence of these flies have caused negative impacts for poultry farming, since these may be responsible for the increase of stress and disease emergence and, in addition, reduction of productivity. In this context, the control of synanthropic Diptera is one of the challenges of the poultry farmers and professionals of this area. This study was carried to assess and characterize the risks for the presence of flies in chicken houses of laying farms in the state of Minas Gerais.Materials, Methods & Results: Was used a secondary database and adapted for this study, with information from 402 chicken houses of 42 laying hens commercial properties. The variables used to compose the correspondence model were selected through chi-square tests (P ≤ 0.05). A risk index was built to the presence of flies from variables considered as risk factors for these ectoparasites. In addition, a study of the spatial analysis was carried to evaluate the intensity of chicken houses of poultry farms with the presence of flies. For this, a Kernel map was produced using the QGIZ 2.18.1 software, georreferencing the regions of state of Minas Gerais that have these ectoparasites. It was observed the presence of flies in 253 chicken houses evaluated, which corresponds to a frequency of 62.9%, with the most present flies were Chrysomya spp. 37.3%, M. domestica 34.3%, Fannia spp. 16% and Stomoxys spp. 14%. The graph of the correspondence analysis produced for the epidemiological characterization of the presence of flies presented an accumulated chi-square value of 56.05%. There was an association of the risk index with removal interval and the humidity of the manure and with the type of installation of chicken houses. Farms with chicken houses that create their birds on the ground present a lower risk for the presence of Diptera. In addition, when the removal of the manure is performed manually and is not done periodically, the presence of flies in the chicken houses is observed. It was verified that clusters located in the messoregion south/southwest of Minas Gerais and between the west and metropolitan mesoregion of Belo Horizonte with chicken houses that have the presence of flies.Discussion: The accumulation and permanence of manure can occur in less technical farms that have laying hens kept in confinement with high densities. In the case of Diptera, the greater the interval of removal of the manure below cages, the greater the risk for their presence, combined with the high densities of the birds that contribute to a faster accumulation of manure. The humidity of the manure is another important factor for the development of flies. The risk is high when chicken feces are liquefied, due to the fact that larvaes of flies need a moist substrate for survival. These results provide knowledge about the epidemiology of flies, in addition to demonstrate the profile of laying farms in the state of Minas Gerais. The implementation of certain management measures and the investment in technification of the chicken houses could reduce the risks of possible infestations in the flocks, besides the negative effects resulting from this ectoparasitism

Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR)

Objective The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging staging guidelines for vulvar cancer and to propose standardised MRI protocols and reporting. Methods The guidelines recommended from the ESUR in this article resulted from a questionnaire analysis regarding imaging staging of vulvar cancer that was answered by all members of the Female Pelvic Imaging Working Group. Only the answers with an agreement equal to or more than 80% were considered. Additionally, the literature was reviewed to complement and further support our conclusions. Results The critical review of the literature and consensus obtained among experts allows for recommendations regarding imaging staging guidelines, patient preparation, MRI protocol, and a structured MRI report. Conclusions Standardising image acquisition techniques and MRI interpretation reduces ambiguity and ultimately improves the contribution of radiology to the staging and management of patients with vulvar cancer. Moreover, structured reporting assists with the communication of clinically relevant information to the referring physician

A aventura crítica da semiótica

The critical adventure of semiotics courses through the main theses about semiotics and communication that have been discussed during the first stage of the research Critical Semiotics: Towards a theory of materialities in communication. In it, the Semiotics and Communication Cultures Research Group (GPESC) discussed the potentialities and limits of a communicational perspective not only based on the founding works of semiotic research (Saussure, Peirce) and developed in its structuralist models (Jakobson, Barthes, Hjelmslev, Lotman), but also revisited by ideas that deconstructed structuralism through the postulates of this very structuralism (Derrida, Kristeva, Deleuze, Guattari). The paper presents this suggestion by means of ten deconstructions related to concepts and theoretical problems which are key to the debate around the materialities of communication: semiotics, communication, materialities, presence, phenomenon, representamen, mediums, sign and significant, structure and system. In so doing, it suggests a move from materialities towards the immanence of a micropolitical and post- human communication.A aventura crítica da semiótica percorre as principais teses sobre a semiótica e a comunicação conforme trabalhadas na primeira etapa da pesquisa Semiótica Crítica, denominada Por uma teoria das materialidades na comunicação. Nela, o Grupo de Pesquisa Semiótica e Culturas da Comunicação procurou discutir as potencialidades e limites de uma perspectiva comunicacional não somente fundamentada nos trabalhos fundadores da semiótica (Saussure, Peirce) e desenvolvida em seus modelos estruturalistas (como em Jakobson, Barthes, Hjelmslev e Lotman), mas também revisitada pelos textos que operaram uma desconstrução do estruturalismo pelo interior dos postulados deste próprio estruturalismo (Derrida, Kristeva, Deleuze, Guattari). O artigo apresenta esta proposta pelos modos como a pesquisa trabalhou com dez desconstruções ligadas a conceitos e problemas teóricos centrais ao debate das materialidades da comunicação: semiótica, comunicação, materialidades, presença, fenômeno, representâmen, meios, signo e significante, estrutura e sistema, sugerindo uma passagem das materialidades à imanência de uma comunicação micropolítica e pós-humana

Manejo Agudo do Estado Hiperglicêmico Hiperosmolar: Intervenções de Emergência e Perspectivas

This article aims to analyze current clinical practices in the management of hyperosmolar hyperglycemic state (HHS) in emergency settings. HHS is a severe endocrinological emergency that primarily occurs in patients with uncontrolled type 2 diabetes mellitus, characterized by extreme hyperglycemia, plasma hyperosmolarity, and severe dehydration without significant ketoacidosis. The condition develops insidiously over days or weeks and can lead to severe neurological manifestations such as lethargy, mental confusion, seizures, and coma. It is often triggered by factors such as infections, inadequate medication use, trauma, or concomitant diseases that increase the production of counter-regulatory hormones. The methodology used was a descriptive and qualitative bibliographic review, analyzing studies published between 2004 and 2024, in Portuguese and English. The databases consulted were PubMed, Scielo, and Google Scholar. The analysis focused on the triggering factors of HHS, the effectiveness of emergency interventions, protocols for correcting hyperglycemia and electrolyte disturbances, and the role of endocrinological follow-up in preventing recurrent episodes. The results indicate that proper management of HHS involves aggressive fluid therapy, careful insulin administration, and rigorous monitoring of glycemic and electrolyte levels. Recent advances include the use of continuous glucose monitoring and the application of standardized treatment protocols that significantly improve clinical outcomes. Studies show that implementing such protocols can reduce hospitalization time and mortality associated with HHS. The conclusion highlights the importance of a systematic and evidence-based approach to managing HHS. Early diagnosis and emergency interventions, such as fluid replacement and intensive glycemic control, are essential to stabilize the patient and prevent severe complications such as renal failure and neurological dysfunction. Continued research in this area is crucial to improving treatment strategies, ensuring the safety and efficacy of procedures, and enhancing the quality of life for patients.Este artigo tem como objetivo geral analisar as práticas clínicas atuais no manejo do estado hiperglicêmico hiperosmolar (EHH) em ambientes de emergência. O EHH é uma emergência endocrinológica grave que ocorre principalmente em pacientes com diabetes mellitus tipo 2 não controlada, caracterizada por hiperglicemia extrema, hiperosmolaridade plasmática e desidratação acentuada, sem cetoacidose significativa. A condição desenvolve-se de forma insidiosa ao longo de dias ou semanas e pode levar a manifestações neurológicas graves, como letargia, confusão mental, convulsões e coma. É frequentemente desencadeada por fatores como infecções, uso inadequado de medicamentos, trauma ou doenças concomitantes que aumentam a produção de hormônios contra-reguladores. A metodologia utilizada foi uma revisão bibliográfica descritiva e qualitativa, analisando estudos publicados entre 2004 e 2024, em português e inglês. As bases de dados consultadas foram PubMed, Scielo e Google Scholar. A análise focou nos fatores desencadeantes do EHH, eficácia das intervenções emergenciais, protocolos de correção de hiperglicemia e distúrbios eletrolíticos, e o papel do acompanhamento endocrinológico na prevenção de episódios recorrentes. Os resultados indicam que o manejo adequado do EHH envolve fluidoterapia agressiva, administração criteriosa de insulina e monitoramento rigoroso dos níveis glicêmicos e eletrolíticos. Avanços recentes incluem a utilização de monitoramento contínuo da glicose e a aplicação de protocolos de tratamento padronizados que melhoram significativamente os resultados clínicos. Estudos mostram que a implementação de tais protocolos pode reduzir o tempo de internação e a mortalidade associada ao EHH. A conclusão destaca a importância de uma abordagem sistemática e baseada em evidências no manejo do EHH. O diagnóstico precoce e intervenções emergenciais, como reposição de fluidos e controle glicêmico intensivo, são essenciais para estabilizar o paciente e prevenir complicações severas, como falência renal e disfunção neurológica. A continuidade das pesquisas nesta área é crucial para aprimorar as estratégias de tratamento, garantir a segurança e eficácia dos procedimentos, e melhorar a qualidade de vida dos pacientes