Evolução dos óbitos por neoplasias malignas de pele nas regiões sul e sudeste do brasil: aplicação da metodologia de box-jenkins

Nos conjuntos de dados cujas observações encontram-se ordenadas em instantes de tempo, indica-se a análise de séries temporais. Técnica que permite identificar padrões de sazonalidade, tendência, ciclos e mudanças de nível, sendo possível gerar modelos explicativos capazes de descrever o comportamento da sequência de observações, obtendo previsões acerca da série analisada. Esta pesquisa aplicou a metodologia de Box- Jenkins nas séries de óbitos por neoplasias malignas de pele entre o período de 1996 e 2014, ocorridos nas regiões Sul e Sudeste do Brasil, afim de identificar padrões, gerar modelos explicativos e obter previsões. Evidenciaram-se algumas características como presença de tendência crescente, ausência de sazonalidade e comportamento não estacionário nas séries de óbitos. A metodologia de Box-Jenkins demonstrou boa qualidade de predição para as séries da região Sul e Sudeste as quais apresentaram, os modelos ARIMA (4,1,0) com constante e ARIMA (0,1,1) com constante como modelos melhores ajustados aos dados. Concluiu-se que os óbitos por neoplasias malignas de pele nas regiões Sul foram explicados apenas por componentes AR e a região Sudeste por componentes MA, ambas com componente de integração

Pseudomonas aeruginosa Isolated from the Environment of a Veterinary Academic Hospital in Brazil - Resistance Profile

Background: The presence of resistant and potentially virulent bacterial strains in a veterinary hospital environment is a neglected problem.  Pseudomonas aeruginosa is an opportunistic microorganism present and circulating in the veterinary hospital environment, of clinical importance and zooanthroponotic transmission of P. aeruginosa has also been reported. The aim of this study was to characterize the population of P. aeruginosa present in a veterinary hospital environment by evaluating their resistance profile and biofilm production.Materials, Methods & Results: A total of 306 samples were collected from the veterinary hospital environment (swabs from consultation tables, surgical tables, door handles, hospitalization cages, stethoscopes, thermometers, and muzzles). The isolates were biochemically identified as belonging to the species Pseudomonas aeruginosa through nitrate to nitrite reduction, motility and oxidase test, growth at 42°C, pigment production, and alkalinization of acetamide. Antimicrobial resistance was tested using the minimum inhibitory concentration (MIC) test. Twenty seven isolates of P. aeruginosa were obtained, with a frequency of 8.8%. The detection of beta-lactamase production and biofilm formation genes by polymerase chain reaction (PCR). Two multidrug resistant (MDR) and 3 single-drug resistant (SDR) strains of P. aeruginosa were identified. Furthermore, it was observed that the strains carried genes related to beta-lactamase production (TEM and CTX-M group 25) and biofilm production (pelA, pslA, ppyR).Discussion: Pseudomonas aeruginosa is considered a major cause of opportunistic hospital infections, as it causes significant morbidity and mortality in immunosuppressed individuals, both in animals and in humans. Veterinary hospitals can harbor microorganisms that cause infections, as well as multiresistant agents. Normally, these environments have a large circulation of people and animals, which particularly enables a facilitated dissemination of these resistant microorganisms. Recently, the World Health Organization (WHO) listed carbapenem-resistant P. aeruginosa as one of 3 bacterial species in critical need for the development of new antibiotics to treat their infections. The data found in this work strengthen the knowledge on the antimicrobial resistance capacity that P. aeruginosa exhibits. The presence of 3 multiresistant strains further highlights the advanced stage of resistance of this bacterial species. The characterization of strains of this species in a veterinary hospital environment is crucial for the control of this population circulating in this environment, and the consequent adoption of more effective measures aimed at controlling its proliferation. The study of this bacterial species in a veterinary hospital environment has a direct impact on human health, due to the mechanisms of resistance and genetic variability that can occur between infections in different animal species and in humans. In view of that, professionals working in veterinary hospitals should be aware of the importance of controlling these microorganisms. Correct measures must be taken to sanitize the environment and utensils between animal care sessions, besides frequent hand washing by all employees and the use of protective equipment such as masks and gloves. The presence of potentially biofilm-producing MDR and SDR strains indicates the free circulation of these bacteria in the veterinary hospital environment. Thus, as a potentially pathogenic microorganism to humans and animals, containment measures must be taken to prevent this possible transmission.Keywords: bacteria, antimicrobial resistance, multidrug resistant, beta-lactamase, biofilm, veterinary care

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Evolução do estado nutricional de pacientes com AIDS atendidos em um ambulatório de Nutrição

Nutritional evolution of patients with AIDS treated in an nutritional clinicIntroduction and Aim: An improper diet affects health, quality of life and response to treatment of the patient. Thus, the study aimed to evaluate the nutritional status of patients with AIDS outpatients Nutrition. Materials and methods: A retrospective study using secondary data. Records of patients treated between 2005 and 2010 were analyzed. Evolution of nutritional status and the risk of developing metabolic complications of abdominal fat associated with waist circumference (WC) were analyzed in relation to age, sex, number of queries, and time of treatment, medication use, CD4 count, viral load and physical exercise on the first and last visit. Results, Discussion and Conclusion: Most patients (70 %) maintained their nutritional status and did not alter the risk related to CC. Most that have improved nutritional status, physical exercises practiced, had CD4 counts greater than 500 and detectable viral load. Patients who started treatment with worse nutritional and immune status with increased risk of subsequent immunological deterioration decreased the risk related to the CC. The results suggest that reducing the weight and CC may be associated with the degree of immune deterioration and viral load in these patients. The majority of patients followed kept the nutritional status, immune status and the degree of risk related to CC.Introdução e objetivo: Uma alimentação inadequada afeta a saúde, a qualidade de vida e a resposta ao tratamento do paciente. Assim, estudo teve por objetivo avaliar a evolução do estado nutricional dos pacientes com AIDS atendidos em um ambulatório de Nutrição. Materiais e Métodos: Estudo retrospectivo com dados secundários. Foram analisados prontuários de pacientes atendidos entre 2005 e 2010. A evolução do estado nutricional e do risco de desenvolver complicações metabólicas decorrentes da deposição de gordura abdominal relacionado à circunferência da cintura (CC) foram analisadas em relação à idade, sexo, número de consultas, tempo de tratamento, medicação utilizada, contagem de CD4, carga viral e à prática de exercício físico na primeira e última consulta. Resultados, Discussão e conclusão: A maioria dos pacientes (70%) manteve seu estado nutricional e não alterou o risco relacionado à CC. A maioria dos que melhoraram o estado nutricional, praticava exercícios físicos, apresentava contagem de CD4 superior a 500 e carga viral detectável. Já pacientes que iniciaram o tratamento nutricional com pior estado imunológico e com maior risco de deterioração imunológica subsequente apresentaram redução do risco relacionado à CC. Os resultados encontrados sugerem que a redução do peso e da CC pode estar associada ao grau de deterioração imunológica e à carga viral desses pacientes. A maioria dos pacientes acompanhados manteve o estado nutricional, o estado imunológico e o grau de risco relacionado a CC.

Evolução do estado nutricional de pacientes com AIDS atendidos em um ambulatório de Nutrição

Introdução e objetivo: Uma alimentação inadequada afeta a saúde, a qualidade de vida e a resposta ao tratamento do paciente. Assim, estudo teve por objetivo avaliar a evolução do estado nutricional dos pacientes com AIDS atendidos em um ambulatório de Nutrição. Materiais e Métodos: Estudo retrospectivo com dados secundários. Foram analisados prontuários de pacientes atendidos entre 2005 e 2010. A evolução do estado nutricional e do risco de desenvolver complicações metabólicas decorrentes da deposição de gordura abdominal relacionado à circunferência da cintura (CC) foram analisadas em relação à idade, sexo, número de consultas, tempo de tratamento, medicação utilizada, contagem de CD4, carga viral e à prática de exercício físico na primeira e última consulta. Resultados, Discussão e conclusão: A maioria dos pacientes (70%) manteve seu estado nutricional e não alterou o risco relacionado à CC. A maioria dos que melhoraram o estado nutricional, praticava exercícios físicos, apresentava contagem de CD4 superior a 500 e carga viral detectável. Já pacientes que iniciaram o tratamento nutricional com pior estado imunológico e com maior risco de deterioração imunológica subsequente apresentaram redução do risco relacionado à CC. Os resultados encontrados sugerem que a redução do peso e da CC pode estar associada ao grau de deterioração imunológica e à carga viral desses pacientes. A maioria dos pacientes acompanhados manteve o estado nutricional, o estado imunológico e o grau de risco relacionado a CC. ABSTRACTNutritional evolution of patients with AIDS treated in an nutritional clinicIntroduction and Aim: An improper diet affects health, quality of life and response to treatment of the patient. Thus, the study aimed to evaluate the nutritional status of patients with AIDS outpatients Nutrition. Materials and methods: A retrospective study using secondary data. Records of patients treated between 2005 and 2010 were analyzed. Evolution of nutritional status and the risk of developing metabolic complications of abdominal fat associated with waist circumference (WC) were analyzed in relation to age, sex, number of queries, and time of treatment, medication use, CD4 count, viral load and physical exercise on the first and last visit. Results, Discussion and Conclusion: Most patients (70 %) maintained their nutritional status and did not alter the risk related to CC. Most that have improved nutritional status, physical exercises practiced, had CD4 counts greater than 500 and detectable viral load. Patients who started treatment with worse nutritional and immune status with increased risk of subsequent immunological deterioration decreased the risk related to the CC. The results suggest that reducing the weight and CC may be associated with the degree of immune deterioration and viral load in these patients. The majority of patients followed kept the nutritional status, immune status and the degree of risk related to CC