bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Unstable Per-trochanteric Fracture in Old Patient by Primary Prosthetic Replacement
Authors: El-Azab Mostafa Mohamed Ahmed , Salah Eldeen Abd Elhamed Yousef  , Mahmoud Mohamed El Said
Published: April 2023

Background: Peritrochanteric fractures are frequent of the proximal femur and represents about half of all proximal femur fractures. They are associated with disability, mainly in elder patients. Its management aiming to achieve immediate ambulation and to regain the pre-operative ambulation.

Aim and objectives; to evaluate and assess the functional and radiological outcomes of primary prosthetic replacement in old age cases of unstable per-trochanteric femur fractures,

Subjects and methods: The current work was an interrupted time series clinical trial (quasi experimental), included 15 patients suffering from unstable per-trochanteric fracture presented to us within a week of sustaining injury. They were clinically assessed and checked for fitness for surgery. Then and after surgery, they were followed by for functional outcome by Harris Hip Scale and any complications were recorded.

Results: Patients age ranged between 61 and 94 years. Females were more affected than males (80.0% vs 20.0%). Associated comorbidities were hypertension, diabetes and both conditions among 33.3%, 6.7% and 33.3%, successively. Falling was the commonest mode of injury (60.0%), and the left side was more affected than the right (60.0% vs 40.0%). Associated injuries were 1(6.7%) fracture surgical neck hummers, 1(6.7%) contralateral both bone leg fracture, 1(6.7%) had fracture mid shaft ulna. Regarding outcome, all cases were free from postoperative complications. However, blood loss was reported among 11(73.3%). Twelve (80%) patients had an excellent, 2 (13.3%) had good and 1(6.7%) had fair functional outcome. There was significant association between functional outcome and patients, gender, associated comorbid medical conditions, mode of trauma, side of trauma, or blood loss.

Conclusion: Primary prosthetic replacement is a valid surgical option in management of unstable trochanteric fractures in elderly. The main advantages are the safety, effectiveness and early full weight bearing.
Suture Button Fixation for Treatment of Acute Distal Tibiofibular Syndesmotic Injury
Authors: Ahmed Fouad Serag El-Deen  , Fathy Hamza Salama  , Mohamed Abdallah Hassan
Published: April 2023

Introduction and Aim: Ankle fractures are common fractures encountered by the orthopedic surgeons in their daily clinical practice. The syndesmosis complex stabilizes the mortis by securing the fibula into the fibular notch. The current work aimed to evaluate the outcome of suture button fixation for treatment of distal tibiofibular syndesmotic injuries.

Patients and methods: This was a quasi-experimental study. It included twenty patients with distal tibiofibular syndesmotic injury. They were operated upon by suture button fixation at Al-Azhar University Hospital (New Damietta) and were assessed clinically and radiologically directly and followed up over four months after surgery.

Results: Patient’s age ranged from 25-54 years with the mean value of 39±7.3 years.  Female patients were 15 (75%). The left side was 14(70%) affected in patients, while the right 6 patients (30%). The functional outcomes were 95% excellent and 5% good. There was no post-operative complication except one case complicated with superficial infection and another case complicated with wound dehiscent. All cases were operated on the same day of fracture except two cases presented by severe edema and skin bullae and the operation was delay one week until the edema subsided. Time to full weight bearing ranged 5 to 6 weeks.

Conclusion: The suture button technique is considered a viable alternative option to replace screw fixation for syndesmosis injuries. It normalizes the distal tibiofibular syndesmosis that remains normal throughout the follow up duration.
Hypertrophic Obstructive Cardiomyopathy Repair with Coronary Artery Bypass Surgery: A Case Report
Authors: Mahmud Khalil  , Elsokkary Ismail N. , Wael Sayed
Published: April 2023

Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a cardiac condition of an abnormal interventricular septum (IVS) thickening. It is due to an autosomal dominant mutation in sarcomeric protein genes. It had many phenotypes with different distribution of myocardial hypertrophy. Septal myectomy remains the treatment of choice for hypertrophic obstructive cardiomyopathy resistant to medical therapy. However, controversy exist regarding standard treatment option(s).
Description of the Case: Here we described a case of 47-year-old patient admitted with diagnosis of acute coronary syndrome, with typical chest pain of angina class II, shortness of breath class-II (NYHA), smoker on regular renal hemodialysis.  Echocardiography showed HOCM, IVS thickening, normal Left ventricle global systolic function and mild to moderate eccentric regurge. Coronary angiography revealed normal left main with total (LAD) proximal occlusion, proximal and mid (LCX) (50%) occlusion, first (OM) mid (90%) lesion, (RCA) dominant with non-flow limiting lesions. He was submitted to open heart surgery with four grafts, sub-valvular myomectomy, and successful myomectomy. Distal anastomosis was done first then myomectomy then proximal anastomosis. Patient extubated after (9) hours with stable hemodynamics and complete neurological condition, with accepted drains output. He gradually weaned from inotropic support and chest drains removed on 3rd postoperative day. All lines and pacemakers were removed, the wound was dry with stable sternum and improvement of all symptoms. Then discharged home after 9 days of hospital stay on medical treatment. Postoperative echocardiography showed significant improvement.  
Conclusion: Surgical treatment is the standard option in treatment of HOCM to improve symptoms.
Left Ventricular Functions Assessment by Speckle Tracking in Comparison with The Two-Dimensional (2D) Echocardiography in Patients with Fragmented QRS
Authors: Al-Azzony Ahmed Mohamed Ahmed , Attia Mohamed Adel , Nagib Khaled Ebrahim , Gad Ayman Ahmed
Published: April 2023

Background and Aim: Fragmented QRS (fQRS) are electrocardiographic signals reflecting altered ventricular conduction around regions of a myocardial scar and/or ischemia. However, it could be presented in normal healthy individuals. But, its incidence and its role in prediction of cardiac disease is not yet addressed. This study aiming to assess the left ventricular (LV) functions in patients with apparent normal LV functions with fQRS using two-dimensional (2D) speckle tracking echocardiography.
Patients and Methods:  This cross-sectional study take place from March to October 2020. Fifty non cardiac patients who undergo preoperative cardiac assessment of non-cardiac surgery at cardiology department were included. All subjects are submitted to full history taking, complete general and local examinations, twelve lead ECG searching for fQRS complex and exclude ischemia and arrhythmia, and transthoracic echocardiography to assess LV functions as described previously.
Results:  36% fQRS complex was in anterior lead, 50% were in Inferior lead and only 14 % was in Lateral lead. Mean EF was 58.9 ± 5.8%, ranging from 55 to 65, FS was 26.7±1.9%, with range of 24 to 40%. LVEDD 4.5±0.7cm, LVESD was 3.3±0.4cm, Intraventricular septum was 10.1±0,6 mm and Posterior wall thickness 9.6±07 mm. Left ventricular longitudinal strain in 2 chamber apical view was 16.4±3.3%, 4 chamber apical view was 16.7±3%, apical long axis view was 17.7±3.5% and average LV GLS was 18.1±2.9%. There were 15 cases abnormal LV diastolic function according to E/e` ratio and 9 cases according to LV-GLS. There was statistically significant different between assessment of LV function by 2D echocardiography and speckle tracking.
Conclusion: The presence of fQRS on standard electrocardiography in apparently healthy people with preserved EF is associated with some sort of subclinical LV dysfunction and two-dimensional speckle tracking is more accurate and sensitive than two-dimensional echocardiography in detection of those patients.
El impacto de los videojuegos de aventura en el aprendizaje de lenguas extranjeras y las percepciones de los alumnos.
Authors: Briones Cueva Danilo Giovanny , Pallaroso Espinoza Carmen Yovisnita , Cangas Pilamunga Estefania Maribel
Published: April 2023

La investigación se basa en el estudio de replicación Hao-Jan y Ting-Yu, (2013) cuyo objetivo principal es examinar cada uno de los efectos que conlleva la implementación de un videojuego comercial de aventura en el aprendizaje del lenguaje extranjero. Se analizan las percepciones del proceso de aprendizaje que mantienen los estudiantes de décimo EGB en una Institución Educativa de la ciudad de Quito. El videojuego proporciona información netamente útil en beneficio de los alumnos en diversas áreas de aprendizaje, así como mejoras en la comprensión auditiva, habilidades de lectura, enriquecimiento del léxico y especialmente, aporta gran motivación hacia el aprendizaje de un idioma extranjero como el inglés. En este estudio se empleó un enfoque de tipo cuasi experimental, considerando la variable independiente videojuegos de aventura, y a la gamificación en el aprendizaje de lenguas extranjeras como dependiente. Por otra parte, se utilizó como instrumento de recolección de datos a una prueba de diagnóstico académico de manera previa y posterior a la aplicación del estudio. La investigación concluye en que existen diferencias significativas entre las calificaciones medias de dichos grupos experimentales, además con la prueba de rendimiento académico denominada Torrance del pensamiento creativo se evidencia el apoyo del grupo superior a la gamificación.
Treatment options for synchronous lung and esophagus tumors: A difficult decision to make
Authors: Büyükkarabacak Yasemin , Gökhan Pirzirenli Mehmet , Gurz Selçuk , Taslak Ayşen , Sullu Yurdanur , Çelik Burçin , Başoğlu Ahmet
Published: April 2023

Synchronous lung and esophageal carcinomas are rare clinical entities. Curative resection with lymph node dissection is the most optimal treatment approach for both tumors. However, due to the high potential risk of postoperative complications, the right approach is to make a patient-specific decision via a multidisciplinary approach at all stages. In this article, we present three cases of synchronous lung and esophageal tumors treated with different approaches due to their specific circumstances and discuss their pre-, intra-, and postoperative stages.
Effects of intraoperative fluid therapy on intensive care process, morbidity, and mortality after lung transplantation
Authors: Yiğit Özay Hülya , Yazıcıoğlu Alkın , Bindal Mustafa , Şahin Furkan , Yekeler Erdal , Turan Sema
Published: April 2023

Background: This study aims to evaluate the effect of intraoperative fluid therapy on intensive care process and first 90-day morbidity and mortality in patients undergoing lung transplantation.

Methods: Between March 2013 and December 2020, a total of 77 patients (64 males, 13 females; mean age: 47.6±13.0 years; range, 19 to 67 years) who underwent lung transplantation were retrospectively analyzed. The patients were divided into two groups according to the amount of fluid given intraoperatively: Group 1 (<15 mL/kg-1/h-1) and Group 2 (>15 mL/kg-1/h-1). Demographic, clinical, intra- and postoperative data of the patients were recorded.

Results: Less than 15 mL/kg-1/h-1 f luid w as a dministered t o 75.3% (n=58) of the patients (Group 1) and 24.7% (n=19) were administered more than 15 mL/kg-1/h-1 (Group 2). In t erms of native disease, the rate of diagnosis of chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis was higher in Group 1, and the rate of other diagnoses was higher in Group 2 (p<0.01). The ratio of women in Group 2 was higher (p<0.05), while the body mass index values were significantly lower in this group (p<0.01). The erythrocyte, fresh frozen plasma, platelet, crystalloid and total fluid given in Group 2 were significantly higher (p<0.001). Inotropic/vasopressor agent use rates and extracorporeal membrane oxygenation requirement were significantly higher in Group 2 (p<0.01). Primary graft dysfunction, gastrointestinal complications, and mortality rates were also significantly higher in Group 2 (p<0.05).

Conclusion: The increased intraoperative fluid volume in lung transplantation is associated with primary graft dysfunction, gastrointestinal complications, and mortality rates.
Assessment of the factors that affect fast-track or early extubation following pediatric cardiac surgery
Authors: Özalp Şerife , Dilek Özcanoğlu Hatice , Öztürk Erkut , Sağlam Selin , Ali Kahraman İncila , Berra Tan Zümrüt , Yıldız Okan , Gümüş Özcan Funda , Can Hatemi Ali
Published: April 2023

Background: This study aims to evaluate the early extubation rate and the factors affecting early extubation in pediatric patients undergoing cardiac surgery.

Methods: Between August 1st, 2020 and December 1st, 2021, a total of 528 pediatric patients (264 males, 264 females; median age: 4 months; range, 2 days to 24 months) who were followed in the pediatric cardiac intensive care unit after congenital heart surgery were retrospectively analyzed. Demographic and clinical characteristics of the patients including operation and intensive care data were obtained from the medical records. Patients included in the study were categorized into three groups as the group of patients who were extubated in the operating room (fast-track extubation), the group of patients who were extubated in the first 6 h of the operation (early extubation), the group of patients who were extubated after the postoperative 6 h or the group of patients who were not extubated or died (delayed extubation).

Results: Sixty-eight (12.9%) cases had fast-tract extubation, 124 (23.6%) cases had early extubation, and 335 (63.6%) cases had delayed extubation. The median age of the patients in the delayed extubation group was three months, which was significantly lower than those of the other groups (p<0.05). Reintubation rates were 1.5% in the fast-tract extubation group, 2.5% in early extubation group, and 9% in delayed extubation group (p<0.05). The median intensive care unit stay was 3, 5, and 10 days, respectively (p<0.05). Length of hospitalization was significantly higher in the delayed extubation group compared to the other groups (p<0.05). Neonatal age group, Risk Adjustment for Congenital Heart Surgery 1 score >4, Society of Thoracic Surgeons- European Association for Cardio-Thoracic Surgery mortality category >3, cardiopulmonary bypass time >100/min, vasoactive inotrope score >8, acute kidney injury >2, and low weight were found to be independent risk factors for delayed extubation.

Conclusion: Fast-track and early extubation can be successfully applied with low reintubation rates in selected cases with congenital heart surgery. Age, body weight, presence of genetic syndrome, operational risk category, and procedure time may affect the extubation time.
Tips and tricks about surgeon-modified fenestrated stent grafting for celiac truncus
Authors: Zafer İşcan Hakkı , Boran Tümer Naim , Levent Mavioğlu Hayrettin
Published: April 2023

Currently, thoracic endovascular aortic repair is usually the first-line treatment option for descending aortic pathologies. Supra-aortic or visceral branches sometimes involve assistive thoracic endovascular aortic repair techniques; hybrid procedures or intentional coverage may be performed during the procedure to achieve a sufficient proximal or distal landing zone. Most surgeons may agree on selective coverage of celiac truncus, but revascularization is preferred to reduce the risk of ischemic complications. Herein, we present the first successful surgeonmodified fenestrated stent graft procedure for celiac truncus in a patient with Crawford type V descending aortic aneurysm in Türkiye.
Predictors and outcomes of gastrointestinal complications after cardiac surgery: A systematic review and meta-analysis
Authors: Mert Duman Zihni , Bayram Muhammed , Timur Barış , Can Kaplan Mustafa , Aksu Timuçin
Published: April 2023

Background:In this systematic review, we aimed to examine the risk factors and surgical outcomes of gastrointestinal complications using the meta-analysis techniques.

Methods:Studies involving patients with and without gastrointestinal complications after cardiac surgery were electronically searched using the PubMed database, Cochrane Library and Scopus database, between January 2000 and May 2022. Some studies on gastrointestinal complications examined only single gastrointestinal complication (only intestinal ischemia, only gastrointestinal bleeding or only liver failure). Studies evaluating at least three different gastrointestinal complications were included in the meta-analysis to reduce the heterogeneity. Cohort series that did not compare outcomes of patients with and without gastrointestinal complications, studies conducted in a country"s health system databases, review articles, small case series (<10 patients) were excluded from the meta-analysis.

Results:Twenty-five studies (8 prospective and 17 retrospective) with 116,105 patients were included in the meta-analysis. The pooled incidence of gastrointestinal complications was 2.51%. Patients with gastrointestinal complications were older (mean difference [MD]=4.88 [95% confidence interval [CI]: 2.85-6.92]; p<0.001) and had longer cardiopulmonary bypass times (MD=17.7 [95% CI: 4.81-30.5]; p=0.007). In-hospital mortality occurred in 423 of 1,640 (25.8%) patients with gastrointestinal complications. In-hospital mortality was 11.8 times higher in patients with gastrointestinal complications (odds ratio [OR]=11.8 [95% CI: 9.5-14.8]; p<0.001).

Conclusion:The development of gastrointestinal complications after cardiac surgery is more commonly seen in patients with comorbidities. In-hospital mortality after cardiac surgery is 11.8 times higher in patients with gastrointestinal complications than in patients without.
Cerebral effects of different prime solutions used during cardiopulmonary bypass
Authors: Sayın Kart Jülide , Toraman Fevzi
Published: April 2023

Background: This study aims to compare the cerebral, hemodynamic, and metabolic effects of different prime solutions used in patients undergoing coronary artery bypass grafting.

Methods: Between May 2013 and May 2014, a total of 30 patients (25 males, 5 females; mean age: 59.5±9 years; range, 42 to 78 years) who were schedule for elective isolated coronary artery bypass grafting were included in this prospective study. The patients were randomized into three groups: Group 1 (n=10) (ringer"s lactate [RL]), Group 2 (n=10) (6% hydroxyethyl starch [HES] 130/0.4), and Group 3 (n=10) (RL + 6% HES 130/0.4). Hemodynamic parameters, arterial blood gas analyses, hemoglobin, hematocrit, cerebral regional oxygen saturation, urine output and fluid balance were recorded preoperatively, before and after anesthesia, 10 min after the transition to extracorporeal circulation, while weaning from extracorporeal circulation, and at the end of surgery. Preoperatively and on postoperative Day 5, neuron-specific enolase enzyme and S-100 ? protein were assessed. On Day 5 and Week 3 postoperatively, the Standardized Mini-Mental Test was administered to the patients.

Results: The serum neuron-specific enolase enzyme and S-100 ? protein levels of the patients were within physiological limits, and there were no clinical findings suggestive of cerebral damage, or changes in the Standardized Mini-Mental Test scores in any of the patients. There was a decrease of more than 20% of the baseline value of cerebral regional oxygen saturation in a total of four patients, one in Group 1 and three in Group 3. No significant difference was observed among the groups in terms of the other parameters.

Conclusion: The prime solution content has no effect on the development of cerebral damage after cardiopulmonary bypass, and the main factor in preventing the development of cerebral damage was the preservation of cerebral perfusion, which can be achieved by monitoring cerebral perfusion in these patients.
AS IMPLICAÇÕES DA PANDEMIA NAS POLÍTICAS PÚBLICAS EDUCACIONAIS
Authors: Bastos Milton Nilson Vasconcelos , De Sousa Alex Sandro Dias , Neves Ednaldo Ferreira , Da Costa Matheus Gomes
Published: April 2023

A presente pesquisa aborda sobre as políticas públicas em  educação no contexto pandêmico. E, partindo deste pressuposto, tem-se como objetivo geral compreender as implicações da pandemia nas políticas públicas educacionais. Trata-se de uma pesquisa bibliográfica de natureza descritiva e de cunho qualitativo. Sendo assim, o papel das políticas públicas passa em suas possíveis intervenções para minimizar os desafios, ainda mais nesse contexto pandêmico, ou seja, viabilizar a garantia de direitos básicos e contribuir na transformação da realidade escolar e do processo de ensino aprendizagem. Considerando a relevância de aprofundar a temática ora proposta neste estudo, esta pesquisa justifica-se por apresentar uma proposta de análise de novas abordagens críticas e teóricas a respeito das políticas públicas em educação, problematizando, por sua vez, se tal instrumento tem, de fato, o caráter resolutivo a que se propõe, refletindo, assim, sua relevância sua relevância no período pandêmico. Portanto, os resultados deste estudo evidenciam que as implicações foram diversas, dado a complexidade do contexto pandêmico e das políticas públicas educacionais, como aumento das desigualdades educacionais e consequentemente social, desafios que requerem debates e reflexões constantes, comprometidas, descentralizadas, críticas, inclusivas e democráticas em relação à educação. Por isso, estratégias que objetivam tais políticas são significativas na construção social dos sujeitos e no acesso e qualidade do ensino.
PENGGUNAAN MEDIA SOSIAL INSTAGRAM SEBAGAI MEDIA PROMOSI PERPUSTAKAAN DI PUSAT PERPUSTAKAAN DAN LITERASI PERTANIAN (PUSTAKA) (Studi pada Instagram @pustaka.kementan)
Authors: Suwandi Nabhilla Adzra , Anwar Rully Khairul , Rodiah Saleha
Published: April 2023

Promosi perpustakaan merupakan hal yang penting dilakukan untuk mengenalkan serta menginformasi masyarakat luas. Pemanfaatan media sosial untuk media promosi merupakan salah satu upaya yang telah dilakukan. Penelitian ini bertujuan untuk mengkaji lebih mendalam terkait dengan Penggunaan Media Sosial Instagram Sebagai Media Promosi Perpustakaan Di Pusat Perpustakaan Dan Literasi Pertanian (PUSTAKA). Metode yang digunakan dalam penelitian ini yaitu penelitian kualitatif dengan menggunakan pendekatan studi kasus. Subjek dalam penelitian ini adalah pihak yang peneliti tentukan berdasarkan teknik purposive sampling. Analisis data pada penelitian ini merujuk pada model Miles dan Huberman yang terdiri dari tiga tahapan, yaitu: Reduksi data (Data Reduction), Penyajian data (Data Display) dan Menarik Kesimpulan/ Verifikasi. Hasil dari penelitian ini menunjukan bahwa Penggunaan media sosial Instagram sebagai media promosi di Pusat Perpustakaan dan Literasi Pertanian (PUSTAKA) sudah berjalan cukup baik. Analisis menggunakan teori AIDA (Attention, Interest, Desire dan Action) diperoleh bahwa promosi yang dilakukan PUSTAKA sudah cukup baik. Konten baik foto ataupun video, judul dan caption sudah cukup menarik dan informatif. Konten yang disajikan juga mendorong keinginan dari para pengikut untuk dapat memanfaatkan berbagai layanan, fasilitas dan juga koleksi yang dimiliki PUSTAKA. Promosi melalui konten yang disajikan ini juga mendorong keingianan mereka untuk berkunjung secara langsung ke PUSTAKA.
Prevenção de incapacidades na hanseníase: palmilhas acomodativas para pés neuropáticos e adaptação de calçados
Authors: Gonçalves Soraya Diniz , Paula Cecilia Gonçalves de , Paula Clara Gonçalves de
Published: April 2023

A hanseníase é uma doença infectocontagiosa, de evolução lenta, provocada pelo Mycobacterium leprae, ou bacilo de Hansen, que se manifesta, essencialmente, por meio de sinais e sintomas dermatoneurológicos: lesões de pele e de nervos periféricos, principalmente nos olhos, mãos e pés1,2 .
Conhecimento sobre primeiros socorros de estudantes em uma escola pública
Authors: Cruz Neto Manoel Samuel , Miranda Suellen Oliveira da Silva , Negrão Renata de Jesus da Silva , Oliveira Isis Mendes de , Vilhena Andrezza Ozela , Vieira Flávia Nunes , Melo Suenny Leal , Rodrigues Bianca Morena de Sousa , Martins Maíra Freire , Lima Elis Pinho de , Silva Maycom Carvalho , Oliveira Euzébio
Published: April 2023

Introdução: A segurança no espaço escolar em todos os aspectos, ambiente físico, emocional e psicológico, é importante e interfere na vida de crianças e adolescentes, é no ambiente escolar que esses indivíduos passam um terço do seu dia, e estão suscetíveis a situações de urgência e emergência. Este estudo, visa conhecer as percepções de estudantes sobre noções de primeiros socorros em situações de urgência e emergência em uma escola pública. Método: Trata-se de uma pesquisa qualitativa com abordagem descritiva, foi desenvolvida em uma escola pública situada no município de Belém, Estado Pará. A análise do estudo seguiu a teoria de Bardin. Resultados e Discussão: A amostra foi composta por 15 estudantes, sendo oito do gênero feminino e sete do gênero masculino, entre a faixa etária de 12 a 16 anos. Verificou-se que a maioria dos participantes apresentavam desconhecimento sobre o assunto e/ou uma noção equivocada de como agir diante dessa emergência o que poderia causar uma piora do quadro da vítima, acarretando assim insegurança e inércia diante se situações como emergências por traumas, automedicação, crise convulsiva e infarto agudo do miocárdio. Conclusão: Levando-se em consideração o despreparo e a falta de conhecimento dos alunos diante as situações de primeiros socorros, é necessário que ocorram mudanças na grade curricular para oferecer aos estudantes maiores esclarecimentos, e assim agir com segurança diante de uma ocorrência de urgência e emergência. Tendo em vista que os alunos poderão prestar esse atendimento a vítima, também poderão ser intermediários desse conhecimento para seus familiares.
O programa saúde na escola como promotor de educação sexual e autocuidado em crianças e adolescentes
Authors: Saretta Catarina Spohr , Welfer Rafael Borislav Beal , Lazaretto Marina Pitagoras
Published: April 2023

A sexualidade está presente na vida de todos os seres humanos e que se manifesta de formas variadas nos diferentes ciclos de vida. Na infância, pode se expressar por meio de curiosidades, questionamentos, exploração do próprio corpo e reconhecimento das diferenças sexuais entre as pessoas (MAIA, 2014). Sendo assim, conhecer e entender os processos que envolvem a sexualidade torna-se essencial para desenvolver, plenamente, saúde física e mental.
A implementação de metodologias ativas em treinamentos para profissionais enfermeiros do Hospital Federal da Lagoa em tempos de COVID-19: uma estratégia para a educação permanente em saúde
Authors: Duarte Isabelly Mariano , Ferreira Fernanda Santana , Gonzaga Arthur Pedro Alves , Freitas Vera Lúcia , Pinto Ana Cristina Silva
Published: April 2023

Introdução: A utilização de metodologias ativas como uma estratégia para a educação permanente em saúde no Hospital Federal da Lagoa. Objetivos: O presente trabalho tem como objetivo apresentar um estudo sobre a implementação de metodologias ativas para Enfermeiros do Hospital Federal da Lagoa e coletar suas percepções sobre a utilização deste tipo de metodologia por meio de um questionário. Métodos: Trata-se de uma pesquisa quali-quantitativa, elaborada entre os meses de outubro de 2020 e fevereiro de 2022, realizada através de um questionário contendo questões mistas (objetivas e dissertativas). A partir do questionário foram realizadas um constructo das informações coletadas que deram base aos resultados e discussão. Resultados: Observou-se uma uniformidade de opiniões acerca das respostas obtidas no questionário onde estas foram positivas acerca da implementação de metodologias ativas de ensino em treinamentos implementados. Conclusão: Durante a pesquisa pôde-se perceber que as metodologias ativas são um excelente método de facilitação e interação do processo de ensino-aprendizagem e relações interpessoais, mas apesar de muitas evidências positivas sobre a utilização de metodologias ativas, assim como qualquer inovação, ainda é encontrada certa dificuldade na implementação, este fato se dá pelo emprego de metodologias ativas requererem a ruptura de paradigmas. Portanto, para que se se obtenha sucesso com a utilização desse tipo de metodologia é necessário comprometimento por parte das instituições e dos profissionais envolvidos nesse processo.
Popularização da difusão de novas técnicas de intervenção em vítimas de parada cardiorrespiratória
Authors: Santos Rafael de Carvalho dos , Cavichio Aline Figueira carneiro da Silva , Matias Geane Conceição , Martins Maria Helena Rosendo , Duda Mirella Fonseca Ribeiro , Silva Rayssa Vercosa Martins da
Published: April 2023

Trata-se de uma pesquisa quantitativa e exploratória realizada por meio de uma revisão da literatura e coleta de dados realizado através de um questionário passado nas turmas do curso técnico em enfermagem do colégio Bezerra de Araújo. Foi realizado uma divisão e coletado dados das turmas que se encontravam no início do curso, das turmas que estavam na metade do curso e das turmas concluintes. Esta divisão se fez importante para a definição do conhecimento sobre a temática nos diversos períodos do curso de formação de técnicos em enfermagem. Para atingir os objetivos propostos foi realizado um levantamento do material na Biblioteca Virtual de Saúde - BVS, utilizando os seguintes descritores: Parada Cardiorrespiratória; Paramédicos de emergência e Preparação para situações de emergências. Após o levantamento do material foram feitas as leituras e seleção de artigos científicos entre 2000 a 2020, os critérios de inclusão foram idioma português, qualquer período de publicação, incluindo-se citações gratuitas. Conclui se que os alunos não estão aptos, em termos de identificação dessa situação de emergência específica e que levar o conhecimento aos alunos é de fundamental importância, pois a identificação e prestação dos primeiros socorros poderão salvar muitas vidas, inclusive de seus parentes e pessoas ao seu redor.
Experiências do serviço do controle de infecções hospitalares voltados ao incentivo à higienização das mãos: um relato de experiência
Authors: Souza Brenda Ramos de , Ribeiro Ana Carolina Almeida , Pereira Lígia dos Reis , Souza Ana Carolina Silva de , Alencar Juliane Lima , Carmo Thalita Gomes do
Published: April 2023

Objetivo: relatar experiências de um Serviço de Controle de Infecções Hospitalares (SCIH) voltadas ao desenvolvimento de ações e sensibilização para a importância da HM de forma adequada. Métodos:Trata-se de um relato de experiência, realizado entre os meses de maio a agosto de 2022 com base nas ações da equipe do SCIH desenvolvidas no Hospital Regional Dr.Abelardo Santos localizado no estado do Pará. Para realização da intervenção baseou-se na metodologia do arco de Marguerez que consiste em 5 etapas: observação da realidade, elaboração de pontos-chaves, teorização, hipóteses de solução e aplicação da realidade. Resultados: o conjunto de ações desenvolvidas conseguiram sensibilizar as lideranças para a importância da higienização das mãos, houve melhora discreta das taxas de adesão à higienização das mãos nas unidades de internação e unidades de terapia intensiva neonatal onde ocorreram as intervenções, aliada ao processo de sensibilização das equipes de apoio, ademais, as outras ações visaram divulgar o protocolo para toda equipe assistencial. Considerações finais: mesmo diante da dificuldade de manter taxas elevadas de adesão à higienização das mãos e sustentá-las, é possível aliar estratégias adaptadas a cada realidade com base na estratégia multimodal para alcançar boas metas desta prática, vale ressaltar que dentro deste processo a educação em saúde é a principal aliada para o envolvimento profissional e o compromisso nas ações, fazendo-se necessário mais estudos para investigação da influência destas estratégias na boa adesão à prática de higienização das mãos.
Correlatos das quedas em pessoas idosas do Amazonas, Brasil
Authors: Borges Silvia , Gouveia Élvio Rúbio Quintal , Jurema Jefferson
Published: April 2023

Objetivos: (1) Investigar o grau de associação entre as quedas e fatores modificáveis (i.e., equilíbrio, o nível de atividade física, e fatores de risco para a saúde) e não modificáveis (i.e., idade e género), e (2) Investigar a associação entre os fatores modificáveis e as quedas depois de controlados a idade e o gênero. Métodos: Este estudo enquadra-se no projeto “Saúde, Estilo de Vida e Aptidão em Adultos e Adultos Idosos do Amazonas (SEVAAI)”. Esta investigação, com um delineamento transversal, 701 idosos, 268 homens e 433 mulheres, entre os 60 aos 92,8 anos de idade, residentes em três municípios do estado do Amazonas: Apuí, Fonte Boa e Manaus. A atividade física, a qualidade de vida e as variáveis sociodemográficas de saúde foram avaliadas através de questionários validados para a população brasileira (entrevistas face-to-face). Resultados: Verificamos que a ocorrência de quedas na população estudada estava correlacionada significativamente e positivamente com os fatores de risco para a saúde. A idade não apresentou diferenças significativas entre os idosos com quedas (70,35 anos) e idosos sem quedas (70,37 anos) e que menores níveis de atividade física e menores scores da escala da FAB estavam relacionados com a idade. A análise revelou que depois de controlados por fatores de risco não modificáveis (i.e., a idade e género), apenas duas variáveis predizem a ocorrência de quedas: os fatores de risco para saúde (β = .17, p < .001) comparativamente ao score da escala de Fullerton (β = –.11, p < .005). Conclusão: Os participantes que não reportaram quedas apresentaram menos fatores de risco para a saúde, um nível de atividade física superior e melhores scores na escala de Fullerton comparativamente aos participantes que reportaram quedas. Este estudo apresenta um modelo explicativo das quedas apenas em 5%, isto significa que existem outros fatores de risco a se considerar e que devem ser incorporados na avaliação. Mais estudos são absolutamente necessários para identificar outros fatores de risco de queda
Risk Management in Upstream Oil and Gas Businesses in Tanzania
Authors:   University of Dar es Salaam, Richard Evelyn , Paschal William ,   University of Dar es Salaam
Published: April 2023

This study gives an account of major risks faced by Tanzania's upstream oil and gas businesses and how they are managed. The study employs the agency and risk management theories coupled with a triangulation data collection. The data was collected from eight businesses using questionnaires, complemented by interviews and was analyzed using descriptive and content analyses. The study observed regulatory changes, fluctuation in global oil prices, government bureaucracy, corruption and government interference as high risks facing upstream oil and gas businesses. Expert consultation, experience, workshops, stakeholder analysis and brainstorming are the most used risk identification techniques. To manage these risks, businesses familiarise themselves with government guidelines, invest to understand government bureaucracy and cut down some operations. For efficient risk management, the study recommends that oil and gas businesses use techniques that are more relevant to the local environment. The results support the agency and risk management theories.
Resistencia antimicrobiana en unidades de cuidados intensivos
Authors: Rivero Morey Rodolfo Javier , Rivero Morey Jeisy , Fernández García Lourdes María , Martínez Oquendo Ariadna
Published: April 2023

Introducción: la resistencia antimicrobiana es un fenómeno global que afecta a los individuos y atenta contra la recuperación de pacientes en estado grave. Objetivo: determinar el grado de resistencia antimicrobiana de los microorganismos que se aíslan en las Unidades de Cuidados Intensivos. Diseño metodológico: observacional descriptivo de corte transversal sobre una serie de microorganismos aislados en muestras biológicas procedentes de las Unidades de Cuidados Intensivos del Hospital “Dr. Gustavo Aldereguía Lima” de Cienfuegos, durante el año 2018. El universo fue de 620 gérmenes. Se analizaron variables como microorganismo, muestra biológica y antimicrobiano. Se realizó el procesamiento estadístico a partir del SPSS 21.0 para mejor representación de los resultados. Resultados: Acinetobacter baumannii fue el germen más aislado (24,1%). Se evidenció una resistencia marcada a la ampicilina, cefazolina, cefuroxima y ceftazidima, con porcentajes superiores al 50%; dentro de los medicamentos más efectivos, resaltaron linezolid y vancomicina para gram positivos. Conclusiones: existen microorganismos resistentes y multirresistentes circulando en las terapias del hospital, su vigilancia debe ser prioritaria, los gérmenes más frecuentes fueron Acinetobacter baumannii, Staphylococcus coagulasa negativo, Klebsiella pneumoniae, entre otros. Las bacterias mostraron una resistencia marcada a la ampicilina, cefazolina, cefuroxima, ceftazidima; y sensibilidad a linezolid y vancomicina.
Caracterización clinica y epidemiologica de los pacientes ingresados en la unidad de cuidados intensivos para COVID-19 del Hospital Gustavo Aldereguía Lima de la provincia Cienfuegos
Authors: Sobrino-Jiménez Daniela Sobeida , Rodríguez-Monteagudo Pavel , Machado-Rangel Rachelis Rosalind
Published: April 2023

Introducción: la presentación clínica de la COVID-19 es variable, desde formas ligeras hasta graves. Se ha informado que el 25,9 % de los pacientes requieren admisión en unidades de cuidados intensivos. La predicción de sobrevida resulta vital, al permitir definir criterios de ingreso a las UCI, racionalizar la atención médica según el grado de necesidad y distribuir los recursos sanitarios eficientemente. Objetivo: Caracterizar clínica epidemiológicamente a los pacientes ingresados en la UCI Covid del Hospital “Gustavo Aldereguía Lima”, de la provincia Cienfuegos. Métodos: estudio observacional y descriptivo, con un universo de 232 pacientes ingresados durante el periodo comprendido entre el 17 de agosto y el 15 de noviembre, se utilizaron métodos teóricos, empíricos y estadísticos. Resultados: El 85,7% de los pacientes empezó con complicaciones que requerían ingreso en UCI entre el día 10 y 20 luego del inicio de los síntomas. Predominó la utilización de VAM en un 33,6% de los pacientes como 2da complicación más frecuente. Conclusiones: La COVID-19 ha demostrado tanto por su incidencia, como por su evolución a la gravedad y letalidad ser la enfermedad pandémica más relevante en el país y la provincia en el año 2021, sobretodo en el período estudiado por los investigadores. Consideramos que el manejo de los pacientes fue adecuado y ajustado a los protocolos nacionales. Sugerimos profundizar en los estudios tanto observacionales como experimentales que aporten nuevos conocimientos alrededor de esta enfermedad, así como generalizarlos en otras unidades de terapia intensiva que traten a pacientes de COVID-19.
Caracterización epidemiológica y complicaciones obstétricas de gestantes con diagnóstico de COVID-19
Authors: Specht González Aleanne , Casas Núñez Yuniel Enrique , Meriño Pompa Yunior , Naranjo Vázquez Sulanys Yainet , Johnson Quiñones Mirtha
Published: April 2023

Introducción: la pandemia de la covid-19 ha afectado a todo tipo de personas en el mundo, las mujeres embarazadas no han sido la excepción.Objetivo: describir las características epidemiológicas y complicaciones obstétricas en gestantes con diagnóstico de COVID-19 del Hospital Fe del Valle Ramos, en el período del 2 de marzo al 23 de abril del 2021.Métodos: se realizó un estudio descriptivo y transversal, con una muestra de 11 gestantes con RT-PCR positivo y negativo. Se estudiaron características epidemiológicas, antecedentes patológicos personales y las complicaciones obstétricas. Resultados: La edad promedio fue de 22 años; el 100% de las que resultaron positivas presentaron como comorbilidades más frecuentes como el asma e hipertensión arterial con un 25 %; de las negativas ninguna presentó alguna comorbilidad. Los síntomas más frecuentes fueron fiebre (27 %); tos, cefalea, dolor de garganta y falta de aire con 18 % respectivamente. Conclusiones: La COVID -19 se presentó de forma leve. Las complicaciones más frecuentes fueron la prematuridad e incremento en los partos por cesáreas. No existió neumonía ni muertes.
Predictores de bajo gasto cardiaco postquirúrgico en pacientes sometidos a cirugía de revascularización miocárdica
Authors: González-Velazquez Víctor Ernesto , Alfonso-Izquierdo Adrian , Pedraza-Rodríguez Elys María , Fuentes-Herrera Leonel , Fajardo-Egozcue Ignacio
Published: April 2023

Introducción: El conocimiento de factores predictores de complicaciones graves es de gran importancia, pues permite realizar una evaluación preoperatoria objetiva de los pacientes.Objetivo: Determinar los componentes de variables predictivas de bajo gasto cardiaco postquirúrgico (BGCp) en pacientes sometidos a cirugía de revascularización miocárdica en el Hospital Cardiocentro “Ernesto Che Guevara”.Método: Se realizó un estudio observacional analítico de cohorte retrospectivo; la población de estudio estuvo constituida por todos los pacientes sometidos a cirugía de revascularización miocárdica con diagnóstico operatorio de enfermedad multivasos entre 2017 y 2018 (N=107) y la muestra coincidió con esta. Se realizó un Análisis factorial donde se determinaron componentes predictivos compuestos por triadas de variables asociadas entre sí por coeficiente de correlación de Pearson. Se realizó un Regresión Logística Binaria y se construyeron curvas de supervivencia para BGCp con el método de Kaplan-Meier. Se trabajó con una confiabilidad del 95%.Resultados: El análisis factorial identificó 5 componentes predictivos, 3 de ellos tuvieron poco valor predictivo y 2 demostraron predecir el BGCp, p≤0,05; OR (IC95%): 5,305 (3,564-7,686) y OR (IC95%):5,752 (2,658-8,658), los cuales estaban compuestos por las variables variables que incuían antecedente de padecer Enfermedad renal crónica, Euroscore ≥4 puntos, índice leucoglucémico ≥1813,7, Tiempo de circulación extracorpórea ≥ 120 min y la Clasificación de la NYHA ≥ III.Conclusiones: Se determinaron como componentes predictores de BGCp agrupaciones de variables que incuían antecedente de padecer enfermedad renal crónica, Euroscore ≥4 puntos, índice leucoglucémico ≥1813,7, tiempo de circulación extracorpórea ≥ 120 min y la clasificación de la NYHA ≥ III. La identificación de dichas variables favorecería una mejor evaluación preoperatoria.
Nutrición en el paciente grave. La importancia de la terapia nutricional
Authors: Domínguez Veloso Magela , Rodríguez Alvarez Leslie Mariam
Published: April 2023

Introducción: El soporte nutricional en el paciente crítico es de vital importancia por su impacto en la morbimortalidad, estancia y preservación de la masa tisular entre otros. Se debe garantizar un soporte nutricional a todos los pacientes críticos idealmente por la vía más eficaz. Objetivos: Ofrecer las pautas para el cuidado nutricional óptimo a los pacientes críticos Identificar pacientes en riesgo de mala nutrición energético nutrimental, definir los requerimientos de energía, proteínas y micronutrientes para mantener un estado nutricional y metabólico óptimo en pacientes críticos y establecer una vigilancia seriada del efecto y la eficacia del apoyo nutricional. Método: Se realizó una revisión bibliográfica a través de la consulta de 23 referencias bibliográficas, 75 % de ellas pertenecientes a los últimos 5 años, todo ello en el período de 15 al 24 de febrero de 2022. Resultados: Con esta revisión bibliográfica se logró ahondar y trazar metas con respecto a mejorar la nutrición de los pacientes críticos a través de métodos más eficaces y con una mayor responsabilidad. Conclusiones: La terapia nutricional tiene una importancia crucial para nuestra capacidad de manejar enfermedades en general e infecciones, cirugías y traumatismo, en particular. El objeto de la terapia nutricional en estos pacientes es de mantener o mejorar el estado nutricional y evitar y tratar la malnutrición al mantener el tejido corporal, activar las reservas de proteínas plasmáticas y prevenir la deficiencia de macro y micronutrientes.
Intact Mass Analysis–Based Multi-Attribute Methods (iMAMs) for Characterization of Biopharmaceuticals
Authors: Rathore Anurag S. , Auclair Jared , Kumar Sunil
Published: April 2023

Multi-attribute methods (MAMs) are becoming increasingly popular for their ability to analyze multiple critical quality attributes (CQA) in a single workflow. This capability becomes particularly attractive for a product class such as monoclonal antibodies, which are large and complex, and have many CQAs that need to be monitored and controlled during their manufacturing so as to deliver consistent product quality. In an earlier installment, we discussed the role of liquid chromatography and mass spectrometry in MAMs. In this article, we focus on intact mass analysis–based multi-attribute methods (iMAMs), a suitable alternative that can complement standard MAMs or be used when there is a need for rapid turnaround and monitoring of only a limited number of CQAs. Multiple case studies are presented to elucidate this concept.
A Study on the Redesignation of Competitive Products among Small and Medium Businesses in the Unmanned Security Industry
Authors:   The Korean Society of Private Security, Kim Hyun-Ho , Ahn Hwang-Kwon , Yoo Min-Hyuk
Published: April 2023

The unmanned security market has been in a monopoly situation for 10 years, with the three major conglomerates accounting for nearly 90% of the monopoly standard of 70%, which is judged by the Fair Trade Commission. The Ministry of SMEs and Startups recognized this monopoly phenomenon and designated the unmanned security business as a competitive product among SMEs in 2019. However, the Public Procurement Service and the National Police Agency raised problems, and in three years, the unmanned security business was designated as a competitive product among small and medium-sized enterprises. Due to the nature of the unmanned security industry, small and medium-sized unmanned security companies that invested in facilities and facilities at the expense of maintaining and improving the same level of quality and service as large companies have been designated as competitors among small and medium-sized businesses. The re-designation of competitive products among small and medium-sized businesses in the unmanned security industry is a matter of survival of small and medium-sized unmanned security companies. This not only contributes to national policies that value SMEs and small business owners, but also improves the economic status of SMEs and the balanced development of the national economy by equally giving them economic opportunities and encouraging independent economic activities. Therefore, this study proposed an alternative to re-designate unmanned security business as a competitive product among SMEs by substantially solving the problem that unmanned security businesses were excluded from the competitive product among SMEs.