Avaliação preliminar da abordagem da Síndrome de Abstinência Neonatal por opióides na Unidade de Terapia Intensiva da Maternidade Odete Valadares em Belo Horizonte

Introduction: In order to treat pain and psychomotor agitation, which are common symptoms in Neonatal Intensive Care Units (NICU), sedatives/opioid analgesics are used. However, its prolonged use, mainly in the continuous base, can provoke the Neonatal Abstinence Syndrome (NAS). Objectives: Evaluate the approach of NAS by opioids in newborns (NB) admitted in a NICU of Odete Valadares Maternity (OVM) in Belo Horizonte. Methods: Analysis of the medical records from the OVM pharmacy of the NB who have used methadone in between June 2013 to July 2014, additionally with diagnosis or risk of abstinence by opioids, confirmed clinically by the Finnegan scoring system. Results: All of the NB who have received methadone during the study time were evaluated. From the total of 17 NB, 6 were eliminated as they have been transferred to other services or evolved towards death, making it impossible to complete the data analysis. From 11 NB included, 7 were premature with gestational age under 28 weeks. There was a prevalence of the male gender (72,7%). All the infants received fentanyl continuously, which period of use was 37 days in average in the preterm NB, whereas being 25 days in the mature NB. The time spent to reach the control dose of methadone, meaning the sufficient dosage to avoid abstinence symptoms (Finnegan score < 8 in 3 consecutive evaluations) was in average 6 days and the time for drug suspension ranged from 10 to 159 days. From 11 NB, 8 presented signs of abstinence after the beginning of methadone with the need of dose adjustment. Conclusion: The study allowed a preliminary evaluation of the NAS protocol along with the use of methadone in the service where it was held. There was a relation between the use of methadone and continuous sedation, which duration was prolonged in the NB of male gender and premature ones. Although a more detailed approach should be accomplished, considering the amount of ventilated NB in the period (256 NB), the number of NB with possible abstinence was relatively small (6.6%), which may mean a judicious use of opioids in this population.Introdução: Para tratar a dor e a agitação psicomotora,sintomas comuns em unidades de cuidados intensivos neonatais,são utilizados sedativos/analgésicos opióides. Contudo, seu usoprolongado, principalmente na forma contínua, pode provocar aSíndrome de Abstinência Neonatal (SAN). Objetivo: Avaliar aabordagem da Síndrome de Abstinência Neonatal por opióidesem recém nascidos (RN) internados na unidade neonatal daMaternidade Odete Valadares em Belo Horizonte. Métodos:Análise dos prontuários de RN que usaram metadona no períodode junho de 2013 a junho de 2014, a partir do levantamento feitona Farmácia da unidade, portanto com diagnóstico ou risco deabstinência por opióide, confirmada clinicamente pela escalade Finnegan. Resultados: Foram avaliados todos os RN que,no período de estudo, receberam metadona. Do total de 17 RN,6 foram eliminados pois receberam alta para outros serviçosou evoluíram para óbito, impossibilitando a análise completados dados. Dos 11 RN incluídos, 7 foram prematuros, comidade gestacional inferior a 28 semanas. Houve prevalênciado sexo masculino (72,7%). Todos os RN receberam fentanilcontinuamente, cujo período de uso foi, em média, 37 dias nosRN prematuros e 25 dias nos RN a termo. O tempo gasto para quese atingisse a dose controle da metadona, ou seja, dose suficientepata evitar os sintomas de abstinência (Escala de Finnegan <8 em3 avaliações consecutivas), em média, foi de 6 dias e o tempopara suspensão da mesma variou de 10 a 159 dias. Dos 11 RNacompanhados, 8 apresentaram sinais de abstinência após o inícioda metadona com necessidade de ajuste da mesma. Conclusão:O estudo permitiu uma avaliação preliminar do protocolo deabordagem da SAN e do uso da metadona no serviço em questão.Houve relação do uso da metadona com a sedação contínua, cujaduração foi prolongada nestes RN, com o gênero masculino e coma prematuridade. Considerando o número total de RN ventiladosno período (256 RN), o número de RN com possível S.A.Nfoi relativamente pequeno (6.6%), podendo significar um usocriterioso de opióides nesta população, embora uma abordagemmais detalhada deva ser realizada

Aspectos polêmicos da execução civil

Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à lei de Direitos Autorais, não disponibilizamos a obra na íntegra. STJ00092872 347.952(81) L242a (2012

Optimized Surge Arrester Allocation Based on Genetic Algorithm and ATP Simulation in Electric Distribution Systems

The efficient protection of electric power distribution networks against lightning discharges is a crucial problem for distribution electric utilities. To solve this problem, the great challenge is to find a solution for the installation of surge arresters at specific points in the electrical grid and in a sufficient quantity that can ensure an adequate level of equipment protection and be within the utility’s budget. As a solution to this problem of using ATP (Alternative Transient Program), this paper presents a methodology for optimized surge arrester allocation based on genetic algorithm (GA), with a fitness function that maximizes the number of protected equipment according to the financial availability for investment in surge arresters. As ATP may demand too much processing time when running large distribution grids, an innovative procedure is implemented to obtain an overvoltage severity description of the grid and select only the most critical electric nodes for the incidence of lightning discharges, in the GA allocation procedure. The results obtained for the IEEE-123 bus electric feeder indicate a great reduction of flashover occurrence, thus increasing the equipment protection level

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data