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de Souza DM, Guedes DMB, Boska GDA, Miranda NC, Rossato LM. Drawing attention? Going through judgments regarding child and adolescent suicide attempts in emergency rooms from a professional perspective. Rev Esc Enferm USP 2024; 57:e20230281. [PMID: 38358116 PMCID: PMC10868373 DOI: 10.1590/1980-220x-reeusp-2023-0281en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/14/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE To understand the perceptions of the multidisciplinary team of an emergency department regarding the care of children and adolescents who have attempted suicide. METHOD An exploratory-descriptive, qualitative study, in light of the Symbolic Interactionism theoretical framework. Thirteen professionals from the multidisciplinary team from two emergency rooms (children and adults) of a secondary hospital in São Paulo participated. Data were collected between August and September 2018 using semi-structured interviews, analyzed using thematic content analysis complemented by the IRAMUTEQ® software. RESULTS Two central categories emerged: Multidisciplinary team perceptions regarding attempted suicide care; and Multidisciplinary team perceptions regarding the possibilities for improving attempted suicide care. From these, professional perceptions of care, risk factors, emotional reactions, limitations of emergency rooms and strategies for improving practice were observed. CONCLUSION Professionals perceived suicide attempt care from a biomedical and reductionist perspective, with an approach marked by stigma, judgment and lack of preparation.
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Affiliation(s)
- Danton Matheus de Souza
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
| | - Danila Maria Batista Guedes
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
| | - Gabriella de Andrade Boska
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Departamento de Assistência e Orientação Profissional, Rio Grande do Sul, RS, Brazil
| | | | - Lisabelle Mariano Rossato
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Kanno DT, Mattos RLMD, Siqueira RM, Pereira JA, Campos FG, Martinez CAR. IMPACT OF THE COVID-19 PANDEMIC ON THE EMERGENCY SURGICAL TREATMENT OF COLORECTAL CANCER. Arq Bras Cir Dig 2024; 36:e1793. [PMID: 38324854 PMCID: PMC10841527 DOI: 10.1590/0102-672020230075e1793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 10/10/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) is the most common malignancy of the gastrointestinal tract and the third most common type of cancer worldwide. The COVID-19 pandemic, during the years 2020 and 2022, increased the difficulties in offering adequate early diagnosis and treatment to CRC patients worldwide. During this period, it was only possible to treat patients who evolved with complications, mainly intestinal obstruction and perforation. AIMS To assess the impact of the COVID-19 pandemic on the treatment of patients with CRC. METHODS A review of data from a total of 112 patients undergoing emergency surgical treatment due to complications of CRC was carried out. Of these, 78 patients underwent emergency surgery during the COVID-19 pandemic (2020/2021), and 34 were treated before the pandemic (2018/2019). Ethnic aspects, clinical symptoms, laboratory tests, histopathological variables, intra and postoperative complications, and 90-day postoperative follow-up were compared between the two groups. RESULTS Between the years 2018 and 2019, 79.4% (27/34) of patients had intestinal obstruction, while 20.6% (7/34) had intestinal perforation. During the period of the COVID-19 pandemic (2020/2021), 1.3% (1/78) of patients underwent surgery due to gastrointestinal bleeding, 6.4% (5/78) due to intestinal perforation, and 92.3% (72/78) due to intestinal obstruction. No statistically significant differences were recorded between the two groups in ethnic aspects, laboratory tests, type of complications, number of lymph nodes resected, compromised lymph nodes, TNM staging, pre or intraoperative complications, length of stay, readmission, or mortality rate. When considering postoperative tumor staging, among patients operated on in 2018/2019, 44.1% were classified as stage III and 38.2% as stage IV, while during the pandemic period, 28.2% presented stage III and 51.3% stage IV, also without a statistically significant difference between the two periods. Patients operated on during the pandemic had higher rates of vascular, lymphatic and perineural invasion. CONCLUSIONS The COVID-19 pandemic increased the rate of complications related to CRC when comparing patients treated before and during the pandemic. Furthermore, it had a negative impact on histopathological variables, causing worse oncological prognoses in patients undergoing emergency surgery.
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Affiliation(s)
- Danilo Toshio Kanno
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
| | | | - Rayama Moreira Siqueira
- Universidade Estadual de Campinas, Department of Surgery, Postgraduate Program in Surgical Sciences - Campinas (SP), Brazil
| | - José Aires Pereira
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
| | | | - Carlos Augusto Real Martinez
- Universidade São Francisco, Postgraduate Program in Health Sciences - Bragança Paulista (SP), Brazil
- Universidade Estadual de Campinas, Department of Surgery - Campinas (SP), Brazil
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Ramos MB, Rech MM, Telles JPM, Moraes WM, Teixeira MJ, Figueiredo EG. Repercussions of the Emergency neurological life support on scientific literature: a bibliometric study. Arq Neuropsiquiatr 2024; 82:1-10. [PMID: 38272043 PMCID: PMC10810700 DOI: 10.1055/s-0043-1777110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/12/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND In 2012, the Neurocritical Care Society launched a compilation of protocols regarding the core issues that should be addressed within the first hours of neurological emergencies - the Emergency neurological life support (ENLS). OBJECTIVE We aim to evaluate this repercussion through a bibliometric analysis. METHODS We searched Scopus on October 2022 for articles mentioning ENLS. The following variables were obtained: number of citations; number of citations per year; number of publications per year; year of publication; research type; research subtype; country of corresponding author and its income category and world region; journal of publication and its 5-year impact factor (IF); and section where ENLS appeared. RESULTS After applying eligibility criteria, we retrieved 421 articles, published from 2012 to 2022. The mean number of citations per article was 17.46 (95% Confidence Interval (CI) = 8.20-26.72), while the mean number of citations per year per article was 4.05 (95% CI = 2.50-5.61). The mean destiny journal 5-year IF was 5.141 (95% CI = 4.189-6.093). The majority of articles were secondary research (57.48%; n = 242/421) of which most were narrative reviews (71.90%; n = 174/242). High-Income countries were the most prominent (80.05%; n = 337/421 articles). There were no papers from low-income countries. There were no trials or systematic reviews from middle-income countries. CONCLUSION Although still low, the number of publications mentioning ENLS is increasing. Articles were mainly published in journals of intensive care medicine, neurology, neurosurgery, and emergency medicine. Most articles were published by authors from high-income countries. The majority of papers were secondary research, with narrative review as the most frequent subtype.
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Affiliation(s)
- Miguel Bertelli Ramos
- Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brazil.
| | - Matheus Machado Rech
- Universidade de Caxias do Sul, Faculdade de Medicina, Departamento de Neurocirurgia, Caxias do Sul RS, Brazil.
| | - João Paulo Mota Telles
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
| | - Willian Medeiros Moraes
- Hospital Nossa Senhora da Conceição, Departamento de Medicina Interna, Porto Alegre RS, Brazil.
| | - Manoel Jacobsen Teixeira
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
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de Lima MF, Meschial WC, Cecilio HPM, Coimbra JAH, Zago MGC, de Castro VC, Uema RTB, Higarashi IH. Workshop on pediatric trauma care: low-cost simulation. Rev Bras Enferm 2023; 76Suppl 4:e20210485. [PMID: 38088706 PMCID: PMC10704668 DOI: 10.1590/0034-7167-2021-0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/24/2022] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE to assess nursing students' and nurses' knowledge, satisfaction and self-confidence after a theoretical workshop on emergency care for traumatized children and clinical simulation. METHODS a quasi-experimental study, carried out with nursing students and nurses residing at a public university in southern Brazil. A workshop on pediatric trauma care was created and a mannequin was created for simulations. A knowledge pre-test and post-test and the Student Satisfaction and Self-Confidence in Learning instrument were applied to measure satisfaction and self-confidence in learning. For analysis, descriptive statistics and the Wilcoxon test were used to compare means before and after intervention. RESULTS the difference between misses and hits was statistically significant (p<0.005), demonstrating an increase in participants' knowledge after the workshop. Satisfaction and self-confidence were demonstrated in the instrument's high scores. CONCLUSIONS the effectiveness of the workshop in teaching-learning emergency care for pediatric trauma was demonstrated.
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Gobetti JSC, Zraik MB, Afornali CB, Goveia CHM, Naufel Junior CR, Coelho GA, Nunes SGB, Simm EB. Comparative analysis of the trauma care profile before and during the COVID-19 pandemic: a cross-sectional study in a tertiary university hospital. Rev Col Bras Cir 2023; 50:e20233449. [PMID: 36921134 PMCID: PMC10519697 DOI: 10.1590/0100-6991e-20233449-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/24/2022] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES to evaluate the profile of emergency care of trauma patients at Hospital Universitário Evangélico Mackenzie (HUEM) during the period of restrictive measures due to COVID-19 (03/13/2021 to 04/05/2021), and compare to the same period at the beginning of the pandemic, in 2020, and before the pandemic, in 2019. METHODS quantitative and descriptive observational cross-sectional study. The final sample of 8,338 was analyzed in terms of date, gender, age and service responsible for providing care; the traumas were analyzed according to the etiology and conduct of the treatment and outcome. RESULTS there was a percentage increase in non-traumatic emergency care during the pandemic, and the medical clinic held a third of admissions in 2021. There was a reduction in trauma care, since in 2019 traumas were responsible for 44.9% of admissions and by 23.5% in 2021. There was a significant difference in the proportion between the attendance of men and women, and the percentage of men victims of trauma was higher than in the pre-pandemic periods. There was a reduction in absolute numbers, with statistical significance, in traffic accidents, falls from the same level, burns, general blunt trauma and sports and leisure trauma. The proportion of conservative treatments with hospital discharge reduced. There was a significant difference in the number of deaths, decreasing in 2020 but increasing in 2021. CONCLUSION there was a reduction in trauma care during the pandemic, but the profile remained the adult male victim of a traffic accident. More severe traumas were admitted, resulting in an increase in surgical treatment, hospitalizations and deaths.
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Affiliation(s)
| | - Mariam Bleibel Zraik
- - Faculdade Evangélica Mackenzie do Paraná, Curso de Medicina - Curitiba - PR - Brasil
| | | | | | - Carlos Roberto Naufel Junior
- - Faculdade Evangélica Mackenzie do Paraná, Curso de Medicina - Curitiba - PR - Brasil
- - Hospital Universitário Evangélico Mackenzie, Pronto-socorro - Curitiba - PR - Brasil
| | - Guilherme Andrade Coelho
- - Faculdade Evangélica Mackenzie do Paraná, Curso de Medicina - Curitiba - PR - Brasil
- - Hospital Universitário Evangélico Mackenzie, Pronto-socorro - Curitiba - PR - Brasil
| | - Suelen Geisemara Barcelar Nunes
- - Faculdade Evangélica Mackenzie do Paraná, Curso de Medicina - Curitiba - PR - Brasil
- - Hospital Universitário Evangélico Mackenzie, Pronto-socorro - Curitiba - PR - Brasil
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Leite KFDS, Faria MGBFD, Andrade RLDP, Sousa KDLD, Santos SRD, Ferreira KS, Rezende CEMD, Neto OMP, Monroe AA. Effect of implementing care protocols on acute ischemic stroke outcomes: a systematic review. Arq Neuropsiquiatr 2023; 81:173-185. [PMID: 36948202 PMCID: PMC10033200 DOI: 10.1055/s-0042-1759578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/13/2022] [Indexed: 03/24/2023]
Abstract
BACKGROUND Implementing stroke care protocols has intended to provide better care quality, favor early functional recovery, and achieving long-term results for the rehabilitation of the patient. OBJECTIVE To analyze the effect of implementing care protocols on the outcomes of acute ischemic stroke. METHODS Primary studies published from 2011 to 2020 and which met the following criteria were included: population should be people with acute ischemic stroke; studies should present results on the outcomes of using protocols in the therapeutic approach to acute ischemic stroke. The bibliographic search was carried out in June 2020 in 7 databases. The article selection was conducted by two independent reviewers and the results were narratively synthesized. RESULTS A total of 11,226 publications were retrieved in the databases, of which 30 were included in the study. After implementing the protocol, 70.8% of the publications found an increase in the rate of performing reperfusion therapy, such as thrombolysis and thrombectomy; 45.5% identified an improvement in the clinical prognosis of the patient; and 25.0% of the studies identified a decrease in the length of hospital stay. Out of 19 studies that addressed the rate of symptomatic intracranial hemorrhage, 2 (10.5%) identified a decrease. A decrease in mortality was mentioned in 3 (25.0%) articles out of 12 that evaluated this outcome. CONCLUSIONS We have identified the importance of implementing protocols in increasing the performance of reperfusion therapies, and a good functional outcome with improved prognosis after discharge. However, there is still a need to invest in reducing post-thrombolysis complications and mortality.
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Affiliation(s)
- Karina Fonseca de Souza Leite
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
| | - Mariana Gaspar Botelho Funari de Faria
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
| | - Rubia Laine de Paula Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
| | - Keila Diane Lima de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
| | - Samuel Ribeiro dos Santos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
| | - Kamila Santos Ferreira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.
| | - Carlos Eduardo Menezes de Rezende
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
- Ministério da Saúde, Agência Nacional de Saúde Suplementar, Brasília DF, Brazil.
| | - Octavio Marques Pontes Neto
- Universidade de São Paulo, Faculdade de Medicina de Ribeirao Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
| | - Aline Aparecida Monroe
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto SP, Brazil.
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Tobase L, Peres HHC, Polastri TF, Cardoso SH, Souza DR, Almeida DG, Timerman S. The Use of the Borg Rating of Perceived Exertion Scale in Cardiopulmonary Resuscitation. Arq Bras Cardiol 2022; 120:e20220240. [PMID: 36629602 PMCID: PMC9833294 DOI: 10.36660/abc.20220240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND A cardiopulmonary arrest is a critical event whose survival rate is related to the quality of resuscitation maneuvers combined with the use of technology. It is important to understand the perception of fatigue during this procedure, aiming to improve the effectiveness of compressions to increase the chances of survival. OBJECTIVES To apply the Borg rating of perceived exertion scale (Borg scale) to analyze the exertion perceived by nurses during cardiopulmonary resuscitation maneuvers using a feedback device. METHODS Experimental study with a randomized distribution of nurses in a teaching hospital. Perceived exertion during simulated cardiopulmonary resuscitation with/without a feedback device was assessed using the Borg scale. The statistical significance level of 5% was adopted. RESULTS 69 nurses working in critical and non-critical adult care units were included. Perceived exertion and heart rate were lower in the intervention group (p<0.001), influenced by the feedback device, with no significant difference between critical and non-critical units. CONCLUSIONS The Borg scale proved to be adequate for the proposed objectives. The feedback device contributed to lower exertion and heart rate reduction during resuscitation maneuvers. The low cost and ease of application favor its use during training and real-time resuscitation attempts to assess performance using a feedback device to reduce exertion and perception of fatigue. It allows reflection on the intervening factors and resources that can influence the quality of resuscitation attempts and the chances of survival.
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Affiliation(s)
- Lucia Tobase
- Centro Universitário São CamiloSão PauloSPBrasilCentro Universitário São Camilo, São Paulo, SP – Brasil
| | - Heloisa Helena Ciqueto Peres
- Escola de EnfermagemUniversidade de São PauloDepartamento de Orientação ProfissionalSão PauloSPBrasilEscola de Enfermagem da Universidade de São Paulo – Departamento de Orientação Profissional, São Paulo, SP – Brasil
| | - Thatiane Facholi Polastri
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP – Brasil
| | - Sandra Helena Cardoso
- Escola de EnfermagemUniversidade de São PauloDepartamento de Orientação ProfissionalSão PauloSPBrasilEscola de Enfermagem da Universidade de São Paulo – Departamento de Orientação Profissional, São Paulo, SP – Brasil
| | - Dhieizom Rodrigo Souza
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP – Brasil
| | | | - Sergio Timerman
- Universidade de São PauloInstituto do CoraçãoSão PauloSPBrasilUniversidade de São Paulo Instituto do Coração, São Paulo, SP – Brasil
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Castro GRA, Zwierzikowski TA, Lemes JGDAS, Yuki VMG, Gouveia KO, Roginski-Guetter C. Clinical-epidemiological changes in patients with non-traumatic acute abdomen during the COVID-19 pandemic: a retrospective study. Rev Col Bras Cir 2022; 49:e20223303. [PMID: 36228198 PMCID: PMC10578844 DOI: 10.1590/0100-6991e-20223303-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/05/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE we intend to demonstrate the clinical alterations and the postoperative evolution in patients with acute abdomen non-traumatic in conservative or surgical treatment during the pandemic compared to a similar period in the last year. METHOD a single-center retrospective study, including patients who received clinical-surgical treatment at Hospital do Trabalhador diagnosed with acute abdomen between March and August 2020 and a similar period in 2019.Variables studied ranged from demographic data to indices of social isolation. RESULTS 515 patients were included, 291 received treatment in a pre-pandemic period and 224 during. There was not statistical difference in relation to comorbidities (p=0.0685), time to diagnosis and seeking medical help. No statistical differences were observed in terms of days of hospitalization (p = 0.4738) and ICU need (p=0.2320). Regarding in-hospital deaths, there was statistical relevance in the age above 60 years (p=0.002) and there were more deaths during the pandemic period (p=0.032). However, when we analyze the factors associated with the number of days until diagnosis by a physician, there was no statistical difference. CONCLUSION the analyzed data showed that the pandemic period and age over 60 years were the variables that increased the odds ratio for the in-hospital death outcome. However, the length of stay, days in intensive care unit and postoperative surgical complications showed no significant difference.
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Campos RT, Martiniano LVM, Lirio AKS, Souza KEDA, Rose N, Dias JMM, Cardoso ACA, Farhat SC, Silva CA. Nonsexual violence against children and adolescents: a study in a Latin American tertiary and university hospital. Rev Paul Pediatr 2022; 40:e2021101. [PMID: 35544904 PMCID: PMC9095060 DOI: 10.1590/1984-0462/2022/40/2021101in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/08/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The objective of this study was to assess interpersonal nonsexual violence against children and adolescents in a tertiary university hospital. METHODS A cross-sectional study was performed in 240 patients under nonsexual violence situation for 15 consecutive years. Data analyses included demographic data, hospital referral site, type and author of nonsexual violence, legal referral, laboratorial and imaging examinations, and outcomes. RESULTS Nonsexual violence situation was diagnosed in 240 (0.1%) of 295,993 patients for 15 years: 148 (61.7%) in children and 92 (38.3%) in adolescents. Out of 240, the most frequent types of violence were negligence in 156 (65.0%), physical 62 (25.8%), psychological/emotional aggression 52 (21.7%), Munchausen by proxy syndrome 4 (1.7%), and bullying/cyberbullying in 3 (1.3%). Out of 123, the most common pediatric chronic conditions were chronic kidney disease 24 (19.5%), human immunodeficiency virus 14 (11.4%), prematurity 9 (7.3%), cerebral palsy 8 (6.5%), and asthma 8 (6.5%). Further comparison between children versus adolescent under nonsexual violence situation revealed significant difference between the hospital referral sites. The frequency of patients under violence referred from outpatient clinics was significantly reduced in children versus adolescents (27.7 vs. 62%), whereas emergency department was higher in the former group (57.4 vs. 25.0%; p<0.001). All types of violence situations and pediatric chronic conditions were similar in both groups (p>0.05). CONCLUSIONS Nonsexual violence against our pediatric population was rarely diagnosed in a tertiary hospital, mainly negligence, physical, and psychological/emotional aggression. Approximately two-thirds of violence diagnosis occurred in children, referred mainly by the emergency department. In contrast, approximately one-third of violence diagnosis occurred in adolescents, referred mostly by outpatient clinics.
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Affiliation(s)
| | | | | | | | - Natalia Rose
- Universidade de São Paulo, São Paulo, SP, Brazil
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Gama CS, Backman C, Oliveira AC. Impact of surgical checklist and its completion on complications and mortality in urgent colorectal procedures. Rev Col Bras Cir 2022; 49:e20213031. [PMID: 35239845 PMCID: PMC10578841 DOI: 10.1590/0100-6991e-20213031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/24/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to assess the impact of using a surgical checklist and its completion on complications such as surgical site infection (SSI), reoperation, readmission, and mortality in patients subjected to urgent colorectal procedures, as well as the reasons for non adherence to this instrument in this scenario, in a university hospital in Ottawa, Canada. METHODS this is a retrospective, epidemiological study. We collected data from an electronic database containing information on patients undergoing urgent colorectal operations, and analyzed the occurrence of SSI, reoperation, readmission, and death in a 30 day period, as well as the completion of the checklist. We conducted a descriptive statistical analysis and logistic regression. RESULTS we included 5,145 records, of which 5,083 (98.8%) had complete checklists. As for the outcomes evaluated, cases with complete checklists displayed higher SSI rate, 9.1% vs. 6.5% (p=0.466), lower reoperation rate, 5% vs.11.3% (p=0.023), lower readmission rates, 7.2% vs. 11.3% (p=0.209), and lower mortality, 3.0% vs. 6.5% (p=0.108) than cases with incomplete ones. CONCLUSION there was a high level of checklist completion and a larger number of the outcomes in the reduced percentage of incomplete checklists found, demonstrating the impact of its utilization on the safety of patients undergoing urgent operations.
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Affiliation(s)
- Camila Sarmento Gama
- - Prefeitura de Belo Horizonte, Secretaria Municipal de Saúde - Belo Horizonte - MG - Brasil
| | - Chantal Backman
- - University of Ottawa, School of Nursing - Ottawa - Ontario - Canadá
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Pilatti M, Theodorovitz VC, Hille D, Sevignani G, Ferreira HC, Vieira MA, Calice-Silva V, de França PHC. Urgent vs. planned peritoneal dialysis initiation: complications and outcomes in the first year of therapy. J Bras Nefrol 2022; 44:482-489. [PMID: 35385569 PMCID: PMC9838670 DOI: 10.1590/2175-8239-jbn-2021-0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/04/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Urgent-start peritoneal dialysis (US-PD) has been proposed as a safe modality of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients with an indication for emergency dialysis initiation. We aimed to compare the characteristics, 30-day complications, and clinical outcomes of US-PD and planned peritoneal dialysis (Plan-PD) patients over the first year of therapy. METHODS This was a single-center retrospective study that included incident adult patients followed for up to one year. US-PD was considered when incident patients started therapy within 7 days after Tenckhoff catheter implantation. Plan-PD group consisted of patients who started therapy after the breaking period (15 days). Mechanical and infectious complications were compared 30 days from PD initiation. Hospitalization and technique failure during the first 12 months on PD were assessed by Kaplan-Meier curves and the determinants were calculated by Cox regression models. RESULTS All patients starting PD between October/2016 and November/2019 who fulfilled the inclusion criteria were analyzed. We evaluated 137 patients (70 in the US-PD x 67 Plan-PD). The main complications in the first 30 days were catheter tip migration (7.5% Plan-PD x 4.3% US-PD - p= 0.49) and leakage (4.5% Plan-PD x 5.7% US-PD - p=0.74). Most catheters were placed using the Seldinger technique. The main cause of dropout was death in US-PD patients (15.7%) and transfer to HD in Plan-PD patients (13.4%). The occurrence of complications in the first 30 days was the only risk factor for dropout (OR = 2.9; 95% CI 1.1-7.5, p = 0.03). Hospitalization rates and technique survival were similar in both groups. CONCLUSION The lack of significant differences in patients' outcomes between groups reinforces that PD is a safe and applicable dialysis method in patients who need immediate dialysis.
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Affiliation(s)
- Murilo Pilatti
- Universidade da Região de Joinville, Programa de Pós-Graduação em
Saúde e Meio Ambiente, Joinville, SC, Brasil.,Fundação Pró-Rim, Joinville, SC, Brasil
| | | | - Daniela Hille
- Universidade da Região de Joinville, Programa de Pós-Graduação em
Saúde e Meio Ambiente, Joinville, SC, Brasil
| | | | - Helen Caroline Ferreira
- Universidade da Região de Joinville, Programa de Pós-Graduação em
Saúde e Meio Ambiente, Joinville, SC, Brasil.,Fundação Pró-Rim, Joinville, SC, Brasil
| | | | - Viviane Calice-Silva
- Universidade da Região de Joinville, Programa de Pós-Graduação em
Saúde e Meio Ambiente, Joinville, SC, Brasil.,Fundação Pró-Rim, Joinville, SC, Brasil
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Parreira JG, DE-Godoy LGL, DE-Campos T, Lucarelli-Antunes PDES, DE-Oliveira-E-Silva LG, Santos HG, Luna RA, Portari Filho PE, Assef JC. Management of acute appendicitis during the COVID-19 pandemic: Views of two Brazilian surgical societies. Rev Col Bras Cir 2021; 48:e20202717. [PMID: 34644740 PMCID: PMC10683416 DOI: 10.1590/0100-6991e-20202717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/19/2021] [Indexed: 12/26/2022] Open
Abstract
Acute appendicitis (AA) is a frequent cause of abdominal pain requiring surgical treatment. During the COVID-19 pandemic, surgical societies considered other therapeutic options due to uncertainties in the evolution of the disease. The purpose of this study is to assess the treatment of AA by members of two Brazilian surgical societies in this period. A common questionnaire was sent in 2020. There were 382 responses. Most surgeons had more than 15 years of profession (68.3%) and treated more than five cases per month (44.8%). About 72.5% would indicate chest CT to investigate COVID-19 in patients with AA. For those patients sustaining uncomplicated AA, without COVID-19, 60.2% would indicate laparoscopic appendectomy (VLA), followed by open appendectomy (OA) (31.7%) and non-operative management (NOM) (1.3%). For those with mild COVID-19, OA was suggested by 51.0%, followed by VLA (29.6%) and NOM (6.0%). For those with severe COVID-19, OA was proposed by 35.3%, followed by NOM (19.9%) and VLA (18.6%). For patients with periappendiceal abscesses, without COVID-19, VLA was suggested by 54.2%, followed by OA (33.2%) and NOM (4.4%). For those with mild COVID-19, OA was proposed in 49.5%, followed by VLA (29.3%) and NOM (8.9%). In those with severe COVID-19, OA was proposed in 36.6%, followed by NOM (25.1%) and VLA (17.3%). This information, based on two recognized Brazilian surgical societies, can help the surgeon to select the best approach individually.
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Affiliation(s)
- José Gustavo Parreira
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil
| | | | - Tercio DE-Campos
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil
| | | | | | - Heitor Gavião Santos
- - UniCETREx, Curso de Videocirurgia - Brasília - DF - Brasil
- - Hospital São Lucas, Departamento de Cirurgia - Brasília - DF - Brasil
| | - Renato Abrantes Luna
- - Escola de Medicina e Cirurgia da UNIRIO, Disciplina de Cirurgia - Rio de Janeiro - RJ - Brasil
- - Hospital Federal do Estado do Rio de Janeiro, Serviço de Cirurgia Geral - Rio de Janeiro - RJ - Brasil
| | - Pedro Eder Portari Filho
- - Hospital dos Servidores do Estado do Rio de Janeiro, Departamento de Cirurgia Geral - Rio de Janeiro - RJ - Brasil
| | - Jose Cesar Assef
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil
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Pereira SDS, Fornés-Vives J, Unda-Rojas SG, Pereira-Junior GA, Juruena MF, Cardoso L. Confirmatory factorial analysis of the Maslach Burnout Inventory - Human Services Survey in health professionals in emergency services. Rev Lat Am Enfermagem 2021; 29:e3386. [PMID: 33439946 PMCID: PMC7798392 DOI: 10.1590/1518-8345.3320.3386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/04/2020] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to confirm the factorial validity of the Maslach Burnout Inventory - Human Services Survey version in a sample of health professionals from the emergency services. METHOD a quantitative, exploratory, descriptive and analytical study. Two hundred and eighty-two health professionals participated in the study. For data collection, a sociodemographic questionnaire and the Maslach Burnout Inventory were used. The psychometric sensitivity for the MBI-HSS items was estimated by measures of central tendency, variability and the distribution shape. Internal consistency was estimated using Cronbach's alpha coefficient and the adequacy of the sample was verified using the Kaiser-Meyer-Olkin (KMO) index. As indexes for assessing the quality of fit of the model, the chi-square ratio by the degrees of freedom (χ2/DoF), the comparative fit index (CFI), the goodness of fit index (GFI), the Tucker Lewis index (TLI) and the root mean square error of approximation (RMSEA) were considered. To test data fit, the maximum likelihood method was used. RESULTS the three-factor structure of the Maslach Burnout Inventory was confirmed. Items 9, 12, 15 and 16 had a factorial weight below what was considered appropriate and were removed from the model. The second order hierarchical model with the aforementioned modifications presented an adequate adjustment to the data and can be considered the best and most parsimonious model tested according to the information theory indexes. The internal consistency of the instrument's factors was recalculated considering the exclusion of the items and the three factors were considered adequate. CONCLUSION the results obtained show that the Maslach Burnout Inventory is a reliable and factorially valid instrument for measuring the burnout syndrome in emergency service professionals in Brazil.
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Affiliation(s)
| | - Joana Fornés-Vives
- Universitat de les lles Balears, Departamento de Enfermería y Fisioterapia, Palma de Mallorca, Illes Balears, Spain
| | - Sara Guadalupe Unda-Rojas
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Zaragoza, Ciudad de México, CDMX, Mexico
| | | | | | - Lucilene Cardoso
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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