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BACKGROUND: This article is part of a special series designed to help health professionals in the process of developing a research project and writing a manuscript. The research question is the keystone in this process, and represents the first step of every research project. However, its importance is frequently neglected. OBJECTIVE: To highlight important considerations in the development and formulation of a research idea, with the purpose of identifying main guiding elements, in order to prevent errors in one of the most important stages of an experiment. METHODS: The authors performed a non-systematic literature review (PubMed.gov - U.S. National Library of Medicine/National Institute of Health) to retrieve papers that addressed the main steps to build a research question. RESULTS: The construction process includes the conception of the research idea, seeking an appropriate environment and resources, performing a literature review, then crafting and refining the research question, while being aware of potential challenges and pitfalls that may be encountered. The FINER and PICOT criteria can be useful tools in this process. CONCLUSION: It is essential to invest time, energy, and resources in the construction of the research question prior to detailing the study design, thus supporting the further development of the research project on a solid initial foundation.

Abstract Background Hypotension during dialysis arises from vasomotor tone alterations and hypovolemia, with disrupted counterregulatory mechanisms in acute kidney injury (AKI) patients. This study investigated the predictive value of preload dependency, assessed by the passive leg raising (PLR) test, and arterial tone, measured by dynamic elastance (Eadyn), for intradialytic hypotension (IDH). Methods In this prospective observational study conducted in a tertiary hospital ICU, hemodynamic parameters were collected from critically ill AKI patients undergoing intermittent hemodialysis using the FloTrac/Vigileo system. Baseline measurements were recorded before KRT initiation, including the PLR test and Eadyn calculation. IDH was defined as mean arterial pressure (MAP)

Randomized clinical trials are considered the gold standard for studies with dietary interventions, which is mainly due to the fact that they can establish causal relationships between food exposure and body composition measures or biomarkers. The aim of this study was to describe the details of a double-blind, randomized, clinical trial protocol to identify, characterize and evaluate the effects of human dietary exposure to pesticide residues in food. Specific aspects of planning (development of a research question, determination of objectives, selection of participants, randomization and blinding) and performance (recruitment of participants, measures to improve adherence, data collection, follow-up and evaluation of results) are addressed in this study. The study design proved effective in characterizing dietary patterns with foods originating from both conventional and organic agriculture. A total of 148 individuals were recruited for the study. The conventional group was represented by 47 % of the sample and the organic group was represented by 53 %. The practice of evidence-based nutrition has demanded that trials be well designed and systematically performed in the field of clinical nutrition. Therefore, this clinical trial emphasizes the importance of improving studies with toxicological nutrition that assess sources of exposure through food. • This double-blind, randomized clinical trial details the protocol for identifying, characterizing, and evaluating the effects of dietary exposure to pesticide residues. • The protocol demonstrates that well-designed and systematically conducted trials emphasize the importance of robust methodologies in evidence-based nutrition. • In the face of the global climate crisis, this clinical trial underscores the importance of enhancing studies in toxicological nutrition, particularly those evaluating sources of exposure through food, to better understand the dietary impacts on health.

Introdução: Durante a pandemia de Covid-19, o home office foi de suma importância para a continuidade das funções laborais e manutenção econômica domiciliar. Todavia, essa prática parece ser capaz de influenciar consideravelmente a vida da população. Objetivo: Avaliar a associação entre a realização de home office durante a pandemia de Covid-19 e desfechos de saúde, em dois municípios do Sul do Brasil. Métodos: Estudo transversal, de base populacional, realizado entre 2020 e 2021, em Criciúma (Santa Catarina) e Rio Grande (Rio Grande do Sul). Indivíduos com 18 anos ou mais de idade, residentes na área urbana, foram elegíveis para o estudo. O processo amostral ocorreu em duas etapas, com a seleção aleatória dos setores censitários e dos domicílios. A variável de exposição foi realização de home office durante a pandemia. Os desfechos estudados foram: sono, atividade física, peso corporal, consumo alimentar, tabagismo e ingestão de álcool. Resultados: Foram estudados 2.170 indivíduos. A prevalência de home office foi de 7,7%, sendo maior em indivíduos com até 49 anos (p

Point-of-care ultrasonography (POCUS) is gaining heightened significance in critical care settings as it allows for quick decision-making at the bedside. While computerized tomography is still considered the standard imaging modality for many diseases, the risks and delays associated with transferring a critically ill patient out of the intensive care unit (ICU) have prompted physicians to explore alternative tools. Ultrasound guidance has increased the safety of invasive procedures in the ICU, such as the placement of vascular catheters and drainage of collections. Ultrasonography is now seen as an extension of the clinical examination, providing quick answers for rapidly deteriorating patients in the ICU. The field of nephrology is increasingly acknowledging the value of diagnostic point-of-care ultrasound (POCUS). By employing multi-organ POCUS, nephrologists can address specific queries that arise during the diagnosis and treatment of patients with acute kidney injury. This approach aids in ruling out hydronephrosis and offers immediate information on hemodynamics, thereby consolidating patient data and facilitating the development of personalized treatment strategies.

Abstract Alternative cosmological models have been proposed to alleviate the tensions reported in the concordance cosmological model, or to explain the current accelerated phase of the universe. One way to distinguish between General Relativity and modified gravity models is using current astronomical data to measure the growth index $$\gamma $$ γ , a parameter related to the growth of matter perturbations, which behaves differently in different metric theories. We propose a model independent methodology for determining $$\gamma $$ γ , where our analyses combine diverse cosmological data sets, namely $$\{ f(z_i) \}$$ { f ( z i ) } , $$\{ [f\sigma _8](z_i) \}$$ { [ f σ 8 ] ( z i ) } , and $$\{ H(z_i) \}$$ { H ( z i ) } , and use Gaussian Processes, a non-parametric approach suitable to reconstruct functions. This methodology is a new consistency test for $$\gamma $$ γ constant. Our results show that, for the redshift interval $$0< z < 1$$ 0 < z < 1 , $$\gamma $$ γ is consistent with the constant value $$\gamma = 0.55$$ γ = 0.55 , expected in General Relativity theory, within $$2 \sigma $$ 2 σ confidence level (CL). Moreover, we find $$\gamma (z=0)$$ γ ( z = 0 ) = 0.311 $$\pm 0.144 $$ ± 0.144 and $$\gamma (z=0) = 0.609 \pm 0.200$$ γ ( z = 0 ) = 0.609 ± 0.200 for the reconstructions using the $$\{ f(z_i) \}$$ { f ( z i ) } and $$\{ [f\sigma _8](z_i) \}$$ { [ f σ 8 ] ( z i ) } data sets, respectively, values that also agree at a 2 $$\sigma $$ σ CL with $$\gamma = 0.55$$ γ = 0.55 . Our methodology and analyses can be considered as an alternative approach in light of the current discussion in the literature that suggests a possible evidence for the growth index evolution.

Objetivo: analisar as percepções das enfermeiras sobre o serviço de Acolhimento e Classificação de Risco de uma maternidade pública. Método: estudo descritivo, desenvolvido em uma maternidade do Estado da Bahia, onde sete enfermeiras do serviço de acolhimento e classificação de risco foram entrevistadas entre fevereiro e março de 2023. Foi elaborado um corpus textual processado pelo software Iramuteq que possibilitou a de análise da Classificação Hierárquica Descendente associada à Análise Temática na perspectiva de Bardin. Resultados: foram conformadas cinco classes e definidas quatro categorias: As dificuldades em trabalhar com classificação de risco; Principais queixas/sintomas atendidos no serviço; Importância percebida do acolhimento e classificação de risco e a responsabilização da gestão para o bom desempenho do serviço; e, Condutas das enfermeiras centradas em tecnologias leves e na necessidade de (re)avaliação pelo médico. Conclusão: as enfermeiras entendem a importância e a responsabilidade do papel executado dentro do serviço e apontam questões importantes quanto ao modelo de atenção à saúde, como a necessidade de valorização da enfermagem obstétrica. O estudo pode contribuir para a melhoria da assistência à saúde prestada por enfermeiras no acolhimento e classificação de risco e fomentar políticas públicas voltadas para a melhoria da atenção à saúde da mulher grávida.

RESUMO: As Metodologias Ativas (MAs) são um conjunto de alternativas pedagógicas que visam facilitar a aprendizagem dos estudantes e/ou proporcionar uma educação crítica e problematizadora da realidade a partir do redirecionamento do estudante para o centro do processo de construção do conhecimento. Realizamos uma pesquisa bibliográfica em artigos científicos sobre o tema “Metodologias Ativas”, selecionados no Portal de periódicos da CAPES. O intuito deste estudo é apresentar uma caracterização geral das MAs identificadas na literatura, considerando uma análise sobre as definições de MAs utilizadas pelos autores, a identificação dos principais referenciais teóricos e epistemológicos empregados para fundamentar essas metodologias, e uma análise das diferentes metodologias consideradas na literatura como MAs. Nesse contexto, chegamos a uma definição de metodologias ativas, que faz parte deste artigo. Nossos resultados apontam que houve um crescimento nas pesquisas sobre MAs nos últimos anos, prevalecendo pesquisas na área da Saúde, e que alguns artigos estão fundamentados nas ideias de teóricos consolidados como Freire, Dewey, Piaget e Ausubel. Identificamos uma diversidade de metodologias ativas diferentes dentre as 24 metodologias consideradas como ativas pelos autores presentes na nossa amostra. De modo geral, as metodologias ativas apresentam como características em comum a ideia/definição de protagonismo do estudante e a educação numa perspectiva crítica.

Objective: To investigate the trends of research on niobium (Nb) in dentistry to determine its use in dental materials. Material and Methods: Electronic searches were carried out in six databases. Studies that evaluated niobium alloys in dentistry in vitro, in situ, and in vivo (humans and animals) were included. Data on publication year, authors, country, journal, study design, application area, niobium alloy, study approach, assay type and results (positive, negative and null compared to controls) were grouped and analyzed in VantagePoint™ and Excel. Descriptive analyses of frequency, cross-tables and co-occurrence matrices were performed. Results: After screening, 315 studies published between 1977 and 2021 were included, with an increase in publications between 2011 and 2021 (n=209; 66.3%). “Doi, H” was the top author (n=9; 2.8%), and Brazil was the most productive country (n=70; 22.2%). “Dental Materials” was the major contributing journal (n=24; 7.6%), and most studies were carried out in vitro (n=266; 84.4%), under implant surfaces (n=162; 51.4%), followed by dental prostheses (n=77; 24.4%) and restorative materials (n=27; 8.6%). The most common niobium was a ternary alloy (n=147; 46.7%), which was mainly tested in vitro via structural characterization or material improvement (n=131; 41.6%). Mechanical assays (n=114; 36.2%) were the most prevalent. Positive effects of niobium were found in 264 articles (83.8%), and negative effects were found in 13 articles (4.1%). Conclusion: The number of studies on niobium has increased over time, resulting in improvements in the mechanical properties of materials used in dental practice.

Plant growth models, derived from reliable databases, enable development of software for recommending cultural practices, harvest predictions, and enhancing productivity. This study aimed to create, refine, and simulate reference models for pineapple growth and development, adapting them based on nitrogen supply per plant and plant density per hectare. We utilized a field test database with periodic assessments of root, stem, leaf, fruit, and stem diameter fresh and dry weight, along with climate data from meteorological stations in or near the experimental areas. These growth models were developed, considering significant correlations and high correlation coefficients, using both simple non-destructive (stem diameter) and destructive (fresh or dry weight of D leaf) plant evaluations, either separately or in combination. The resulting models can provide estimated predictions for pineapple growth, adaptable to varying plant populations and nitrogen fertilization rates (measured in grams of N per plant)

ABSTRACT Objective: We aimed to analyze the frequency of adherence to social distancing and individual protection measures of adult and older populations in two cities in southern Brazil and to characterize the sociodemographic aspects of these individuals. Methods: This cross-sectional, population-based study was conducted in the cities of Rio Grande, RS, and Criciúma, SC, Brazil. The outcome measure was the frequency of adherence to social distancing measures. Fisher's exact test (5% significance) was used to calculate the differences in prevalence according to exposure variables. Results: Among the 2,170 participants over the age of 18, the prevalence of adherence to social distancing was 18.5%. Adherence was significantly higher among women; older adults; single, divorced, or widowed people with a low educational level; people of lower socioeconomic status; and people affected by multiple chronic diseases. Conclusion: Approximately one in five respondents adhered to measures of social distancing, and adherence was more prevalent among the risk groups.

With the rise of the Internet of Things (IoT), social networks, and mobile devices, vast amounts of mobility data are continuously generated. These data encompass diverse location information from various sources, including smart vehicles, sensors, wearables, and social media platforms. By leveraging these data, we explore the semantic enrichment of trajectory components related to moving objects and locations, bringing the so-called multiple-aspects trajectories and relative privacy issues. Privacy risk analysis is crucial for the earlier detection of privacy problems, particularly when dealing with semantically enriched trajectories. In this study, we introduced the TrajectGuard privacy risk assessment framework. TrajectGuard, an extension of PRUDEnce, achieved significant results by formulating and assessing the privacy risk of multiple-aspects trajectories under several proposed attacks. The framework introduced a nuanced risk evaluation using AspectGuard and conducted fair privacy assessments on anonymized datasets using AnonimoGuard. Its adaptability and versatility make TrajectGuard a valuable tool for preserving data privacy with multiple-aspects.

Abstract Background/objectives The primary aim of this study was to evaluate the prevalence of autoimmune diseases (AIDs) and its associated factors in an admixed Brazilian population of patients with type 1 diabetes (T1D). The secondary one was to determine the relationship between AIDs and the occurrence of diabetes-related chronic complications (DRCC). Methods This cross-sectional, nationwide survey was conducted in 13 public clinics in 11 Brazilian cities. Overall, 1,760 patients were included; 967 females (55.9%), 932 (54%) Caucasians, aged 29.9 ± 11.9 years, age at diagnosis 14.8 ± 8.9 years, diabetes duration 15.5 ± 9.3 years and 12.2 ± 3.8 years of school attendance. AIDs were retrieved from medical records or self-report and stratified as follows: absence of AIDs, only autoimmune thyroid disease (AITD), and other AIDs including the combination with AITD (hyper or hypothyroidism). Results The prevalence of AIDs was 19.5% being AITDs (16.1%), the most frequently found. A higher prevalence of hypertension, dyslipidemia and overweight or obesity was found in patients who had exclusively AITDs. A higher prevalence of diabetic retinopathy (DR) was observed in patients with AITDs and patients with other AIDs in combination with AITDs. Chronic kidney disease (CKD) was more prevalent in patients with only AITDs. Lower levels of HbA1C, were observed in patients with isolated AITDs or with other AIDs, regardless of the presence of AITD. Hierarchical multivariate analysis, showed that AIDs were associated with female gender, older age, and longer diabetes duration, self-reported color-race (White and Brown), geographic region (Brazilian North/Northeast region) and higher anti-TPO levels (≥ 35 UI/ml). Conclusions In conclusion, Brazilian patients with T1D, belonging to a highly ethnically admixed population, had an important prevalence of AIDs, mostly AITDs, that was associated with female gender, self-reported color-race, older age and longer diabetes duration. Moreover, these patients also had a higher prevalence of DRCC. Even though we highlight the importance of investigating the presence of AIDs at diagnosis and at regular intervals, it is unclear whether screening and early detection of additional AIDs may improve the clinical outcomes in individuals with T1D. Future prospective studies are necessary to establish the interplay between T1D, AIDs and DRCC.

Abstract Background Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. Objectives The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. Design A systematic review and meta-analysis was conducted. Method Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. Results Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. Conclusions Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. Prospero registration CRD42021236155.

Apresentação do Dossiê "As intelectualidades negras na compreensão do Brasil"

Introductionhe challenge was to provide comprehensive health resources to a remote and underserved population living in the Brazil-Colombia-Peru border, amid the most disruptive global crisis of the century.MethodsIn August 2021, Fundação Oswaldo Cruz Amazonia (FIOCRUZ Amazônia) and partner collaborators implemented an overarching provisional program for SARS-CoV-2 detection and lineages characterization, training of laboratory personnel and healthcare providers, donation of diagnostic supplies and personal protective equipment, and COVID-19 vaccination. The expedition was conducted at the Port of Tabatinga, a busy terminal with an intense flux of people arriving and departing in boats of all sizes, located in the Amazon River basin. Local government, non-profit organizations, private companies, and other stakeholders supported the intervention.ResultsThe expedition was accomplished in a convergence point, where migrant workers, traders, army personnel, people living in urban areas, and people from small villages living in riversides and indigenous territories are in close and frequent contact, with widespread cross-border movement. Using a boat as a provisional lab and storage facility, the intervention provided clinical and laboratory monitoring for 891 participants; vaccination for 536 individuals; personal protective equipment for 200 healthcare providers; diagnostic supplies for 1,000 COVID-19 rapid tests; training for 42 community health agents on personal protection, rapid test execution, and pulse oximeter management; and hands-on training for four lab technicians on molecular diagnosis.DiscussionOur experience demonstrates that multilateral initiatives can counterweigh the scarcity of health resources in underserved regions. Moreover, provisional programs can have a long-lasting effect if investments are also provided for local capacity building.

A doença respiratória aguda causada pelo novo coronavírus de 2019 (COVID-19) é uma das maiores ameaças à saúde pública do último século. Em junho de 2020, foi aberto em Curitiba (Paraná, Brasil) um hospital exclusivo para atendimentos a pacientes com COVID-19 que atendeu 4116 pacientes até setembro de 2021. Nesse contexto, os desafios encontrados pela Assistência Farmacêutica foram da escassez de medicamentos e materiais médico-hospitalares à imprevisibilidade de consumo dos insumos. Diversas estratégias foram implementadas no enfrentamento destes obstáculos, como o monitoramento dos itens em falta, medidas de controle para diminuição de consumo de insumos, protocolos de substituição, criação de cotas de materiais por unidade de internação, dispensação de kits e análise minuciosa das prescrições. Assim, este relato descreve as estratégias utilizadas para contornar os desafios encontrados na pandemia da COVID-19, para ser útil a outros profissionais da área que se defrontem com um cenário epidemiológico semelhante.

This study examines the integration of epistemological principles into road infrastructure risk management, emphasizing the need for adaptive strategies in the face of inherent climate uncertainties, particularly flash floods. A systematic review of peer-reviewed articles, industry reports, and case studies from the past two decades was conducted, focusing on the application of epistemological approaches within the infrastructure sector. The research employs a mixed methods approach. Quantitatively, the risk of pavement failure is measured by analyzing the relationship between pavement serviceability rates and Intensity–Duration–Frequency (IDF) data in areas frequently affected by flash floods. For example, rainfall intensities during flood events on the BR-324 highway in Brazil were significantly higher than monthly averages, with maximum values reaching 235.73 mm for a 5 min duration over a 50-year return period. These intensities showed an increase of approximately 15% over 5 to 10 years and 8% over 50 to 75 years. Qualitatively, traditional risk management methods are combined with epistemological concepts. This integrated approach fosters reflective practice, encourages the use of both quantitative and qualitative data, promotes a dynamic management environment, and supports sustainable development goals by aligning risk management with environmental and social sustainability. This study finds that incorporating epistemological insights can lead to more fluid and continuously improving risk management practices in construction, design, and maintenance. It concludes with a call for future research to explore the integration of emerging technologies such as artificial intelligence to further refine these approaches and more effectively manage complexity and uncertainty.

A solar position sensor is an essential optoelectronic device used to monitor the sun’s position in solar tracking systems. In closed-loop systems, this sensor is responsible for providing feedback signals to the control system, allowing motor adjustments to optimize the angle of incidence and minimize positioning errors. The accuracy required for solar tracking systems varies depending on the specific photovoltaic concentration. In the case of the concentrator photovoltaic (CPV), it is normally essential to track the sun with a position error of less than ±0.6°. To achieve such precision, a proposed sensor configuration composed of low-cost embedded electronics and multifiber optical cable is subjected to characterization through a series of measurements covering range, sensitivity, and resolution. These measurements are performed in controlled indoor environments as well as outdoor conditions. The results obtained exhibit a resolution of 2.6×10−3 degrees when the sensor is illuminated within its designated field of view of ±0.1°, particularly in external conditions. Considering the performance demonstrated by the proposed solar position sensor, coupled with its straightforward modeling and assembly compared to position sensors documented in the literature, it emerges as a promising candidate for integration into solar tracking systems.

We characterized 3 autochthonous dengue virus serotype 3 cases and 1 imported case from 2 states in the North and South Regions of Brazil, 15 years after Brazil's last outbreak involving this serotype. We also identified a new Asian lineage recently introduced into the Americas, raising concerns about future outbreaks.

O presente estudo objetivou avaliar a associação do consumo de alimentos in natura ou minimamente processados e de Alimentos Ultraprocessados (AUP) com a saúde mental durante a pandemia de Covid-19. Trata-se de um estudo transversal, realizado com dados de duas pesquisas de base populacional conduzidas em Criciúma (SC) e Rio Grande (RS) entre 2020 e 2021. Os participantes foram indivíduos com 18 anos ou mais de idade, residentes na área urbana. A variável independente foi a frequência de consumo de alimentos in natura ou minimamente processados e de AUP. Sintomas depressivos e estresse percebidos foram os desfechos. Para avaliar as associações foram realizadas análises brutas utilizando-se teste Qui-quadrado de Pearson (nível de significância de 5%) e análises ajustadas utilizando-se regressão de Poisson. Foram estudados 2.170 indivíduos. Na análise bruta, tanto o consumo de alimentos in natura ou minimamente processados quanto o consumo de AUP foram associados aos sintomas depressivos e estresse. Após análise ajustada, indivíduos pertencentes aos maiores tercis de consumo de alimentos in natura ou minimamente processados tiveram prevalências 37% e 28% menores de sintomas depressivos e 29% e 26% menores de estresse, comparados àqueles com menor consumo. Indivíduos com maior consumo de alimentos ultraprocessados apresentaram prevalência 35% maior de sintomas depressivos quando comparados àqueles com menor consumo. Isso destaca a importância da atuação intersetorial e interdisciplinar entre nutrição e saúde mental, especialmente após a pandemia de Covid-19.

Introdução: Os gastos com saúde na população idosa, com fatores de risco para doenças cardiovasculares, geram grande preocupação para os sistemas de saúde em nível mundial, afinal, há uma relação direta entre o envelhecimento populacional e o impacto econômico. Os serviços farmacêuticos podem reduzir custos do tratamento, o que favorece o estudo das avaliações econômicas. Apesar disso, os indicadores utilizados para avaliar desfechos econômicos em pacientes com doenças de risco cardiovasculares e quais serviços são considerados mais propensos à redução de gastos em saúde não são conhecidos. Objetivos: Identificar indicadores de custos em saúde do atendimento farmacêutico ambulatorial de pacientes com doenças crônicas que contribuem para o risco cardiovascular. Material e Método: Foi realizada uma revisão de escopo para mapear a literatura existente e fornecer uma visão geral dos indicadores de custo e medidas de resultados disponíveis. As seguintes bases de dados foram consultadas: Cochrane Library, LILACS, PubMed, SCOPUS, EMBASE e Web of Science, com a seguinte combinação de descritores em inglês: Geriatric Assessment; Economic Evaluation; Pharmaceutical Services; Diabetes; Dyslipidemia; High Blood Pressure. Resultados: Foram incluídos 13 artigos, todos os estudos foram publicados em inglês e 77% dos estudos foram realizados nos Estados Unidos. A maioria foi específica para pacientes com diabetes mellitus. Nesta revisão, cinco estudos relataram que durante os atendimentos foram identificados e resolvidos problemas relacionados a medicamentos (PRM), seis fizeram acompanhamento farmacoterapêutico e dois realizaram a educação em saúde. Além disso, os indicadores financeiros encontrados nesta revisão foram: custos com medicamentos; custos com exames; custos com internações; visitas de emergência ou pronto-socorro; custo de atendimento médico do paciente por ano; custo de cirurgia; salários farmacêuticos e ligações telefônicas. Os indicadores não financeiros encontrados nesta revisão foram: adesão a medicamento; redução de hemoglobina glicada; redução da pressão arterial; redução nos níveis de colesterol LDL; número de consultas ambulatoriais; número de internações; número de visitas à emergência; recomendações farmacêuticas aceitas; satisfação do paciente; identificação e resolução de PRM; número de exames laboratoriais; visitas a diversas especialidades médicas devido a complicações no tratamento. Vale ressaltar que cinco estudos avaliaram a intervenção do farmacêutico clínico relacionada à redução de custos, variando de U$3,00 por paciente a U$852,00 quando a durou um ano. Quando a intervenção ocorreu ao longo de seis meses com economia média de custos de U$91,01 por paciente. Em outro estudo o custo anual médio total por paciente foi reduzido de US$8.667,03 para US$56.665,02. Discussão e Conclusões: A redução de custos foi associada às intervenções e os principais indicadores estão relacionados aos serviços farmacêuticos de maior complexidade, que é o acompanhamento farmacoterapêutico.

Objetivo: realizar tradução, adaptação cultural e validação de conteúdo e aparência do instrumento Practice Standards for Nurses Providing Pediatric Cancer Care in Atlantic Canada para o português do Brasil. Método: trata-se de um estudo de tradução, adaptação cultural e validação de conteúdo e aparência de instrumento. Participaram 8 profissionais no comitê de juízes. Resultados: houve a necessidade de adequar a semântica e correções gramaticais com a versão aprovada pela Associação Canadense de Enfermeiros em Oncologia. Adotou-se o Índice de Validade de Conteúdo. Foram realizadas três rodadas para atingir o Índice de Validade de Conteúdo ≥0,8 em 100% dos itens: primeira 233 itens (96%), segunda 9 itens (90%), terceira rodada 1 item. No pré-teste obteve-se 100% de compreensão. Conclusão: a versão traduzida do instrumento original está adequada para utilização no Brasil. Descritores: Enfermagem. Competência Profissional. Oncologia. Enfermagem Pediátrica. Estudo de Validação.

ABSTRACT Purpose: To evaluate inflammatory response in critical bone injuries after implantation of the biomaterial composed of hydroxyapatite (HA)/poly (lactic-coglycolic acid) (PLGA)/BLEED. Methods: Forty-eight male Wistar rats (280 ± 20 grams) were divided into two groups: control group (CG), in which the animals do not receive any type of treatment; and biomaterial group (BG), in which the animals received the HA/PLGA/BLEED scaffold. Critical bone injury was induced in the medial region of the skull calotte with the aid of a trephine drill 8 mm in diameter. The biomaterial was implanted in the form of 1.5-mm thick scaffolds. Serum and calotte were collected at one, three and seven days. Results: Biomaterial had a significant effect on the morphological structure of the bone, accelerating osteoblast activation within three days, without causing exacerbated systemic inflammation. In addition, quantitative real-time polymerase chain reaction (qRT-PCR) analysis showed that BG induced upregulation of osteogenic genes such as runt-related transcription factor 2, and stimulated genes of inflammatory pathways such as tumor necrosis factor-α, on the first day without overexpressing genes related to bone matrix degradation, such as tissue inhibitor of metalloproteinases-1 and matrix metalloproteinase-9. Conclusions: The HA/PLGA/BLEED® association can be used as a bone graft to aid bone repair, as it is capable of modulating expression of important genes at this stage of the repair process.

Biodiesel is a renewable fuel produced from vegetable oils and animal fats transesterification. However, due to its chemical characteristics, it is susceptible to oxidation causing losses to its manufacturers and users. In this work a series of salicylates were synthesized and employed as secondary antioxidants in biodiesel B100. The accelerated oxidation tests were carried out against copper and iron. The biodiesel oxidation degree was followed by the acidity index. Among the synthesized compounds, isopropyl salicylate was able to inhibit the oxidation process by 55% when induced by copper and 52% when it was induced by iron after 8 hours exposure. The commercial antioxidant TBHQ was used as a positive control presenting lower inhibition values than isopropyl salicylate. It should be noted that salicylates are accessible molecules in just one reaction step, high yields and low cost, these being desirable characteristics for the biodiesel industry.

Objective Purpose: To assess the influence of sleep disorders on temporal and jaw pain in the morning in adults and elderly people. Methods: Population-based study with representative individuals aged 18 years or over. Individuals were selected using a multistage sampling procedure. The outcomes of morning jaw pain and morning temporal pain were assessed. Sleep bruxism, obstructive sleep apnea, and sleep quality were evaluated as exposure variables. Adjusted analysis was conducted using Poisson regression. All analysis was sex stratified. Results: 820 individuals were studied. Female with sleep bruxism were 1.37 times more likely to have morning temporal pain (p=0.041). Male and female with bruxism had a prevalence 160% and 97%, respectively, higher of morning jaw pain (male: p=0.003; female: p

Abstract Zika virus (ZIKV) is an arbovirus from the Flaviviridae family and Flavivirus genus. Neurological events have been associated with ZIKV-infected individuals, such as Guillain-Barré syndrome, an autoimmune acute neuropathy that causes nerve demyelination and can induce paralysis. With the increase of ZIKV infection incidence in 2015, malformation and microcephaly cases in newborns have grown considerably, which suggested congenital transmission. Therefore, the development of an effective vaccine against ZIKV became an urgent need. Live attenuated vaccines present some theoretical risks for administration in pregnant women. Thus, we developed an in silico multiepitope vaccine against ZIKV. All structural and non-structural proteins were investigated using immunoinformatics tools designed for the prediction of CD4 + and CD8 + T cell epitopes. We selected 13 CD8 + and 12 CD4 + T cell epitopes considering parameters such as binding affinity to HLA class I and II molecules, promiscuity based on the number of different HLA alleles that bind to the epitopes, and immunogenicity. ZIKV Envelope protein domain III (EDIII) was added to the vaccine construct, creating a hybrid protein domain-multiepitope vaccine. Three high scoring continuous and two discontinuous B cell epitopes were found in EDIII. Aiming to increase the candidate vaccine antigenicity even further, we tested secondary and tertiary structures and physicochemical parameters of the vaccine conjugated to four different protein adjuvants: flagellin, 50S ribosomal protein L7/L12, heparin-binding hemagglutinin, or RS09 synthetic peptide. The addition of the flagellin adjuvant increased the vaccine's predicted antigenicity. In silico predictions revealed that the protein is a probable antigen, non-allergenic and predicted to be stable. The vaccine’s average population coverage is estimated to be 87.86%, which indicates it can be administered worldwide. Peripheral Blood Mononuclear Cells (PBMC) of individuals with previous ZIKV infection were tested for cytokine production in response to the pool of CD4 and CD8 ZIKV peptide selected. CD4 + and CD8 + T cells showed significant production of IFN-γ upon stimulation and IL-2 production was also detected by CD8 + T cells, which indicated the potential of our peptides to be recognized by specific T cells and induce immune response. In conclusion, we developed an in silico universal vaccine predicted to induce broad and high-coverage cellular and humoral immune responses against ZIKV, which can be a good candidate for posterior in vivo validation.

Abstract The antioxidants used in the food industry are essential to inhibit the formation of free radicals, preserving the existing properties in the different matrices. However, the insecurity of the synthetic antioxidants regarding human health propels search for natural substrates with potential antioxidant activity as an alternative to synthetic compounds. In this way, the work had as objective obtaining extracts from the seed pomace of the Hevea brasiliensis (rubber tree), relating the contents of flavonoids and total phenols in the application as an antioxidant. The methodology consisted of the extraction using four solvents, varying extractive methods, time, and seed concentrations. The antioxidant activity in vitro was evaluated by capturing the DPPH (2,2-diphenyl-1-picryl-hydrazil) radical. The optimized results demonstrate that the aqueous extracts produced in the Soxhlet in the concentrations of 85 g L−1 and retention time of 4 h reached 37.73 ± 1.69% in the antioxidant tests of the free radical DPPH capture, 1405.15 mg EAC 100 g−1 in the quantification of phenolic compounds and 223.34 mg 100 g−1 of total flavonoids. Thus, this work may contribute to the realization of studies and future research for characterization and identification concerning which phenolic compounds and flavonoids attribute the antioxidant characteristic to the extracts produced, enabling the discovery of products with high added value in the production chain. In addition, because the water used as a solvent showed greater antioxidant potential between the extracts, the non-toxic and environmentally friendly character is highlighted, allowing a wide variety of applications in the food industry.

Objetive: This systematic review aimed to evaluate whether the use of HA could be considered an effective treatment approach for the restoration of papillary defects. Material and methods: This study was registered on the PROSPERO. A systematic search was performed on five electronic databases for articles published up to May 2022. The meta-analysis was performed using the R program. The risk of bias and quality was assessed using the RoB 2.0 and National Institutes of Health, respectively. Results: Eighteen studies were included with a total of 213 participants with 696 interdental papillary defects. All included studies reported promising results on the reconstruction of the deficient interdental papilla after injection of HA. Single-arm meta-analysis indicated a proportion of 47% (confidence interval [CI]:35–59%) of sites evaluated with complete interdental papilla reconstruction (100% of reconstruction). Partial interdental papilla reconstruction (range from: 2.1% to 96% reconstruction) was reported by 49% (CI:40–59%) of sites evaluated. Five studies evaluated patient-reported outcome measures. An increased satisfaction was observed after the injection of HA without significant pain after the evaluation periods. Randomized controlled trials (RCT) studies presented a low and unclear risk of bias, while uncontrolled studies were classified as having good quality. Conclusion: The short-term analysis indicated that the injection of HA for the treatment of papillary defects is considered a feasible treatment achieving esthetic satisfactory results with minimum pain. However, further well-conducted RCT studies with standardized parameters and long-term follow-up should be recommended.

This study estimated the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in urban cleaning and solid waste management workers during the transmission of the Omicron variant in one of the poorest regions of Brazil (the state of Sergipe). Nasopharyngeal swabs were collected from 494 workers, and the presence of SARS-CoV-2 RNA was tested by quantitative reverse-transcriptase polymerase chain reaction. Data on socio-demographic characteristics, comorbidities, vaccination status, mask use, and use of public transport to commute to the workplace were collected. The prevalence with a 95% confidence interval (CI) was calculated from the proportion of SARS-CoV-2 positive cases among the total number of individuals tested. The prevalence ratio (PR) with a 95% CI was the measure of association used to evaluate the relationship between SARS-CoV-2 infection and the exposure variables. The prevalence of SARS-CoV-2 infection was 22.5% (95% CI, 19.0 to 26.4). Individuals under the age of 40 had a higher prevalence of infection (PR, 1.53; 95% CI, 1.03 to 2.30) as well as those who did not believe in the protective effect of vaccines (PR, 1.78; 95% CI, 1.05 to 2.89). Our results indicate the need for better guidance on preventive measures against coronavirus disease 2019 among urban cleaning and solid waste management workers.

Resenha de: PEREIRA, Leonardo Affonso de Miranda. A cidade que dança: clubes e bailes negros no Rio de Janeiros (1881-1933). Campinas: Editora da Unicamp; Rio de Janeiro: EdUERJ, 2020. 360 p.

Abstract Pharmacist-physician collaboration is a strategy for optimizing patient care and improving health outcomes. Nevertheless, there is a lack of information in Brazil about collaborative practices among these professionals. The aim of this study was to measure collaborative attitude of pharmacists and physicians who were working together in a teaching hospital. A cross-sectional study was conducted from June 2018 to January 2019 with pharmacists and physicians working in a teaching hospital in Northeastern Brazil. These professionals were invited to provide responses to the Brazilian version of the “Scale of Attitudes Towards Pharmacist-Physician Collaboration” (SATP2C); their scores ranged between 16 and 64 points. The software Epi Info TM (version 3.5.4) was used for data analysis, and data were expressed in means. Forty-four professionals participated in this study. The mean age was 33.5 (DP = 7.1) years. More than half of participants were male (n = 25, 56.8%). The means from the SATP2C for pharmacists and physicians were 54.20 and 50.91, respectively, indicating good collaborative attitudes. There was no statistical difference between the mean scores of pharmacists and physicians. Participants showed a predisposition for collaborative teamwork. Future studies should focus on understanding the process by which collaboration translates into clinical practice.

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

ABSTRACT Objective To analyze in the scientific literature the effects of massage on pain relief in newborns submitted to puncture. Method Systematic review with meta-analysis performed in October 2020, using PubMed, Web of Science, CINAHL, Scopus, Cochrane and Gale databases. Studies without time frame were included, which used massage as the main technique for relieving neonatal pain during puncture. Data were extracted using standardized forms and the synthesis of results occurred in a descriptive way. Results From the 12 studies included, massage was effective in pain relief in 83.3% of the studies. The comparative meta-analysis of massage versus routine care that assessed duration of crying obtained a statistically significant result (p = 0.0002; 95% CI -85.51 to -27.09). Conclusion Massage contributes to neonatal pain relief by reducing pain score and reducing crying time in newborns submitted to puncture.

Background: Despite some advances in the discovery of novel therapies, smoke inhalation injury remains a difficult to treat critical health issue due to its physiopathological complexity. Natural products, such as d-limonene (LIM), are becoming an important potential source of new treatments in many health problems. LIM has been shown to have antioxidant, anti-inflammatory and protective effects in respect of several diseases, including respiratory conditions. Objective: The aim of this study was to evaluate the effects of inhaled LIM on acute smoke-induced lung injury in rats. Methods: Thirty minutes after smoke inhalation, adult male Wistar rats were treated with vehicle or LIM (0.01 mg/kg) for 30 min. Blood samples, and the liver, lungs, and trachea were collected for analysis. Results: The results showed that LIM minimized the injuries, reducing oxidative and inflammatory damage by improving catalase (CAT) (p

Urbanization is an important source of air pollutants that can compromise human health. In developing countries, such as Brazil, most cities do not have air quality monitoring stations. Assessing air quality through plant species has gained recognized prominence, as they are sessile organisms and sensitive to environmental changes. Pollen abortion assay in Tradescantia pallida is a fast and low-cost bioassay that can be implemented in passive biomonitoring scenarios. The present study aimed to use the pollen abortion assay in T. pallida to assess air quality in the municipality of Rio Grande, RS, Brazil and the possible relationship with vehicular flow. A relation was found between the highest rate of pollen abortion and the sites where there was greater vehicular flow and ozone levels, while at the control point, the lowest rate of pollen abortion among the others was found, corroborating the hypothesis that air pollution together with high levels of ozone from vehicles, impair plant pollination.

Resumo Fundamento De acordo com o pensamento diagnóstico tradicional, indivíduos muito idosos estão mais predispostos a desenvolver sintomas atípicos em síndromes coronarianas agudas. Objetivo Testar a hipótese de que indivíduos muito idosos estão mais predispostos a manifestações de dor torácica atípica devido à doença arterial coronariana obstrutiva (DAC). Métodos O Registro de dor torácica inclui pacientes internados com dor torácica aguda. Primeiramente, foi construído o índice de tipicidade dessa manifestação clínica: a soma de 12 características de sintomas (8 sintomas típicos e 4 sintomas atípicos). No subgrupo de pacientes com etiologia coronariana, o índice de tipicidade foi comparado entre octogenários e não octogenários. A significância estatística foi definida por p

ABSTRACT BACKGROUND: The prevalence of congenital abnormalities in general populations is approximately 3-5%. One of the most important applications of obstetric ultrasound is in detection of fetal structural defects. OBJECTIVE: To assess fetal structural anomalies diagnosed using ultrasound in the three trimesters of pregnancy. DESIGN AND SETTING: Retrospective cohort study at the Mário Palmério University Hospital of the University of Uberaba (Universidade de Uberaba, UNIUBE), from March 2014 to December 2016. METHODS: Ultrasound data at gestational weeks 11-13 + 6, 20-24 and 32-36 were recorded to identify fetal anomalies in each trimester and in the postnatal period. The primary outcome measurements were sensitivity, specificity, positive predictive value and negative predictive value for detection of fetal anomalies and their prevalence. RESULTS: The prevalence of anomalies detected using ultrasound was 2.95% in the prenatal period and 7.24% in the postnatal period. The fetal anomalies most frequently diagnosed using ultrasound in the three trimesters were genitourinary tract anomalies, with a prevalence of 27.8%. Cardiac anomalies were diagnosed more often in the postnatal period, accounting for 51.0% of all cases. High specificity, negative predictive value and accuracy of ultrasound were observed in all three trimesters of pregnancy. CONCLUSION: Ultrasound is safe and has utility for detecting fetal anomalies that are associated with high rates of morbidity and mortality. However, the low sensitivity of ultrasound for detecting fetal anomalies in unselected populations limits its utility for providing reassurance to examiners and to pregnant women with normal results.

Myelomeningocele (MMC) or open spina bifida is a neural tube defect which consists of a cleft in the vertebral column and a correspondent defect in the skin, causing the meninges and the spinal cord to be exposed. Despite some recommendations for nutrient supplementation during pregnancy, MMC remains very prevalent, especially in poor regions. MMC causes paralysis, urinary and gastrointestinal dysfunction, motor and neurological deficits, hydrocephalus and hindbrain herniation. Until 1997, the only way to repair this defect was performing surgery right after birth. In 2011, MOMS trial revealed a positive impact of prenatal surgery compared to postnatal. This paper reports the first case of one of the first myelomeningocele prenatal surgery programs in the North and Northeast regions of Brazil and discusses some issues about the implementation of new programs. The patient was a 34 years old woman in her second pregnancy, who was diagnosed at 22 weeks. She was submitted to an open fetal surgery applying MOMS protocol at 26 weeks of pregnancy and underwent cesarean at 36 weeks and five days of pregnancy. After two-years follow up, the baby girl did not need shunt for hydrocephalus, but has motor deficit in the lower limbs. Although fetal surgery is a high-tech procedure that demands a well-trained team, many families come from low-income regions. This way, the implementation of new services has an important social impact.

A partir do que Santos (1991, p. 77) define como paisagem, “o conjunto das coisas que se dão diretamente aos nossos sentidos”, as fotografias aqui apresentadas partem de uma reflexão acerca do visto e sentido desde a janela de um apartamento localizado em Aubervilliers, periferia norte de Paris, França, em que a fumaça compõe esta paisagem urbana. Datadas de Outubro e Novembro de 2020, o objetivo destas fotografias é evocar uma reflexão sobre onde se encontram determinados fenômenos e por que?

Resumo Objetivo: Analisar desigualdades regionais e sociais na realização de mamografia e exame citopatológico. Métodos: Estudo transversal, com dados da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel), de 2019. As variáveis de desfecho foram realização de mamografia e exame citopatológico; e as variáveis de exposição, raça/cor da pele, escolaridade e macrorregião nacional de residência. Medidas de desigualdades absolutas foram apresentadas por meio do slope index of inequality (SII) e equiplots. Resultados: Foram incluídas 23.339 mulheres. A realização de mamografia foi 5,2 pontos percentuais maior naquelas com maior escolaridade, e de exame citopatológico, 5,3 pontos percentuais menor nas mulheres de raça/cor da pele preta. A realização de mamografia e exame citopatológico foram 3,9 e 11,2 pontos percentuais maiores na região Sul, respectivamente. Conclusão: Desigualdades sociais e regionais persistem no país e afetam, principalmente, mulheres de raça/cor da pele preta, de baixa escolaridade e residentes no Nordeste brasileiro.

Abstract Introduction Individuals with pre-diabetes have altered glycemic levels, are generally asymptomatic, and are at increased risk for developing type 2 diabetes mellitus. Objective Identify the prevalence of periodontal individuals with undiagnosed hyperglycemia and associated impact factors. Material and method Fifty-six patients with periodontitis and without diabetes self-report, users of dental clinic services at Federal University of Juiz de Fora were included in this research, during one year and a half of experimental evaluation. Socioeconomic and demographic data, anthropometric patterns, fasting capillary blood glucose, and complete periodontal examination (six sites per tooth) were evaluated. Result The sample consisted of 58.9% female, mean age 53 years old, 58.9% obese/overweight and 45.3% had a low level of education. A total of 28.6% (n=16) participants had undiagnosed hyperglycemia (between 100 to 160 mm / dL), of which 81.3% were obese/overweight, 25% were smokers, 56.3% reported having a history of diabetes in the family, 93.8% had a family income up to 2 brazilian´s minimum wages. BMI values were higher in the group of patients with hyperglycemia (29.8 ± 5.7, p = 0.03) compared to the group without hyperglycemia (26.6 ± 5.6). Patients with hyperglycemia had a greater number of sites with clinical attachment loss (CAL) between 4 and 6 mm (p = 0.04) when compared with the normoglycemic group. Conclusion Undiagnosed CAL attachment loss between 4 and 6 mm due to periodontitis than normoglycemic individuals.

Electrical signals are generated and transmitted through plants in response to stimuli caused by external environment factors, such as touching, luminosity, and leaf burning. By analyzing a specific plant’s electrical responses, it is possible to interpret the impact of external aspects in the plasma membrane potential and, thus, determine the cause of the electrical signal. Moreover, these signals permit the whole plant structure to be informed almost instantaneously. This work presents a brief discussion of plants electrophysiology theory and low-cost signal conditioning circuits, which are necessary for the acquisition of plants’ electrical signals. Two signal conditioning circuits, which must be chosen depending on the signal to be measured, are explained in detail and electrical simulation results, performed in OrCAD Capture Software are presented. Furthermore, Monte Carlo simulations were performed to evaluate the impact of components variations on the accuracy and efficiency of the signal conditioning circuits. Those simulations showed that, even after possible component variations, the filters’ cut-off frequencies had at most 4% variation from the mean.

Introducción: Han sido llevadas a cabo diferentes iniciativas con el fin de mejorar la calidad del cuidado y la seguridad del paciente en Brasil. Sin embargo, el cumplimiento de esas normas como una serie de requisitos parece no corresponder a la real incorporación de cambios y mejora en la seguridad. Objetivos: Evaluar la cultura de seguridad del paciente en un hospital filantrópico de Minas Gerais, observando, además, posibles diferencias por turnos de trabajo, diurno y nocturno. Métodos: Se trata de un estudio observacional del tipo transversal. La población estudiada fue constituida por profesionales de Enfermería actuantes en esa institución filantrópica. Para la evaluación de la cultura de seguridad fue utilizado el Cuestionario Hospitalario sobre Cultura de Seguridad del Paciente (HSOPSC), creado por la Agency for Healthcare Research and Quality (AHRQ), validado, traducido y adaptado transculturalmente en Brasil. En el análisis e interpretación de los datos fueron seguidas las orientaciones de la AHRQ, observándose dimensiones fortalecidas y debilitadas. Este trabajo fue aprobado por el Comité de Ética en Investigación. Resultados: Fueron incluidos 118 participantes en el estudio, siendo 17,2% de ese total enfermeros y los demás técnicos de Enfermería. Ninguna dimensión de la cultura de seguridad fue identificada como fortalecida en la institución. Fueron consideradas como áreas débiles: la “apertura a la comunicación”, el “trabajo en equipo entre las unidades hospitalarias”, la “adecuación de personal”, los “cambios de turno y transición entre las unidades”, y las “respuestas no punitivas a los errores”. En algunas dimensiones fueron observadas diferencias por turno de trabajo, diurno y nocturno. Conclusión: El análisis de la cultura de seguridad en ese hospital puede contribuir para un mejor direccionamiento de conductas con el fin de garantizar una asistencia más segura. Como citar este artículo: Magalhães, Eduarda Vieira; de Paiva, Fernanda Oliveira; Alves, Maria Eduarda Soares; de Almeida, Meire Cavalieri. Cultura de segurança do paciente entre profissionais de Enfermagem em um hospital filantrópico de Minas Gerais. Revista Cuidarte. 2021;12(3): e1990. http://dx.doi.org/10.15649/cuidarte.1990

COVID-19 is a contagious infectious disease, which quickly spreads worldwide, whose clinical presentation includes from mild flu-like symptoms to pneumonia and severe acute respiratory syndrome. The severe presentation of the disease can affect different organs and systems. Coagulopathy has been associated with a worse clinical outcome, with manifestations such as pulmonary embolism and systemic arterial thrombosis. Thromboelastometry has been used to identify hypercoagulability in early stages of disease. We report the case of a 59-year-old woman with COVID-19 infection complicated by pulmonary embolism and acute arterial thrombosis associated with critical lower limb ischemia requiring amputation. This report showed a case of thrombotic complication in patient with infection caused by novel coronavirus 2019 whose thromboelastometry allowed the early identification of hypercoagulability pattern. This is a single case report and the use of thromboelastometry should be further evaluated in large prospective cohort studies.