1
|
Nakagawa NK, Oliveira KMG, Lockey A, Semeraro F, Aikawa P, Macchione M, Carvalho-Oliveira R, Gouvêa GB, Boaventura AP, Maiworm AI, Calderaro M, Hajjar LA, Motta EV, Souza HP, de André CDS, Silva LFF, Polastri TF, Timerman S, Carmona MJC, Böttiger BW. Effectiveness of the 40-Minute Handmade Manikin Program to Teach Hands-on Cardiopulmonary Resuscitation at School Communities. Am J Cardiol 2021; 139:126-130. [PMID: 33007308 DOI: 10.1016/j.amjcard.2020.09.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 01/18/2023]
Abstract
Bystander training in cardiopulmonary resuscitation (CPR) is crucial to improve the victims' survival and quality of life after sudden cardiac arrest. This observational study aimed to determine the success rate of 2 different programs of CPR training for children, adolescents, and adults in school communities. We assessed the development and acquisition of the following CPR skills: checking local safety, assessing victim's responsiveness, calling for help, assessing victim's breathing, and performing chest compression (hands and straight arms placement on the chest, compression velocity, depth, and chest release) using a 40-minute program with handmade manikins or the 120-minute program using intermediate-fidelity manikins. There were 1,630 learners (mean age 16 years, 38% male) in the 40-minute program, and 347 learners (mean age 27 years, 32% male) in the 120-minute program. The lowest successful pass rate of learners that developed CPR skills was 89.4% in the 40-minute program and 84.5% in the 120-minute program. The chances of success increased with age in the same program (compression rate and depth). The success rate also increased with the more extended and intermediate-cost program at the same age (assessing victim's responsiveness, calling for help, and assessing the victim's respiration). In conclusion, a 40-minute and cheaper (low-cost handmade manikin) CPR program was adequate to develop and acquire the overall CPR skills for ≥89% at school communities, independently of gender. However, some individual CPR skills can be further improved with increasing age and using the longer and intermediate-cost program.
Collapse
Affiliation(s)
- Naomi K Nakagawa
- Physiotherapy, Communication Science and Speech Therapy and Occupational Therapy Department, LIM54, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil.
| | - Katia M G Oliveira
- Physiotherapy, Communication Science and Speech Therapy and Occupational Therapy Department, LIM54, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Andrew Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, United Kingdom
| | | | - Priscila Aikawa
- Department of Physiological Sciences, Federal University of Rio Grande, Rio Grande do Sul, Brazil
| | | | | | - Gabriela B Gouvêa
- Physiotherapy, Communication Science and Speech Therapy and Occupational Therapy Department, LIM54, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | | | | | - Marcelo Calderaro
- Neurology Department, Hospital das Clínicas FMUSP, Sao Paulo, Brazil
| | | | - Eduardo V Motta
- Gynecology and Obstetrics Department, FMUSP, Sao Paulo, Brazil
| | | | - Carmen D S de André
- Institute of Mathematics and Statistics, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Thatiane F Polastri
- Medical Training Simulation Laboratory, Institute of Cardiology, FMUSP, Sao Paulo, Brazil
| | - Sergio Timerman
- Medical Training Simulation Laboratory, Institute of Cardiology, FMUSP, Sao Paulo, Brazil
| | | | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
2
|
Abstract
BACKGROUND evaluate the results of Pap smear in women attended at a gynecology preventive ambulatory (University of São Paulo Medical School Clinical Hospital). METHODS 6821 women were submitted to a medical interview, clinical and gynecologic exam. Cervical and vaginal cytology (Pap smear) were analyzed according to the Papanicolaou method and classification. All women were grouped according to their age into three categories:under 40 years old, between 41 and 60 years and over 60 years. RESULTS most of them, and mainly the younger ones, had been submitted to a previous Pap smear in a period shorter than 1 year (44.2%). The majority of women recognized the usefulness of the exam and knew its interval; the group that best knew its importance and interval was the one with ages between 41 and 60 years, while most women over 60 years did not know both its importance and interval. Cytological material was considered insufficient for analysis in 15,1% and inadequate in 1.1%, and for those with adequate material results were classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%). Distribution of cervical intraepithelial neoplasia (CIN) were similar in the three groups. The main microbiologic findings was Gardnerella sp. (8,6%) and Human papillomavirus (HPV) incidence was significantly lower among women over 60 years. CONCLUSION Cytological diagnoses of neoplastic modifications were performed in 2,2% and Gardnerella sp. was the most prevalent microbiologic agent. Distribution of HPV showed a decrease with age. Older women had lower knowledge on the importance of regular Pap smear examination.
Collapse
Affiliation(s)
- E V Motta
- Divisão de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
| | | | | | | | | |
Collapse
|
3
|
Carvalho FM, Carvalho JP, Motta EV, Souen J. Müllerian adenosarcoma of the uterus with sarcomatous overgrowth following tamoxifen treatment for breast cancer. Rev Hosp Clin Fac Med Sao Paulo 2000; 55:17-20. [PMID: 10881074 DOI: 10.1590/s0041-87812000000100004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Müllerian adenosarcoma with sarcomatous overgrowth presented by a 52-year-old female patient after adjuvant tamoxifen treatment for breast carcinoma is described. The diagnosis was made on histological basis after curettage and complementary total hysterectomy with bilateral salpingo-oophorectomy. The immunohistochemical study showed high expression of estrogen receptors in the epithelial component of the lesion and irregularly positive findings in the stroma. The proliferative activity evaluated by Ki-67 immunoexpression was higher in the stroma than the epithelium. Some of the stromal cells showed rhabdomyoblastic differentiation. The association of tamoxifen use and development of mesenchymal neoplasms is discussed.
Collapse
Affiliation(s)
- F M Carvalho
- Department of Gynecology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil
| | | | | | | |
Collapse
|