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1.
Ann Surg Oncol ; 31(6): 3639-3648, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38530529

RESUMO

BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) on postoperative recovery from oncology surgeries should be understood for the clinical decision-making. Therefore, this study was designed to evaluate the postoperative cumulative 28-day mortality and the morbidity of surgical oncology patients during the COVID-19 pandemic. METHODS: This retrospective cohort study included patients consecutively admitted to intensive care units (ICU) of three centres for postoperative care of oncologic surgeries between March to June 2019 (first phase) and March to June 2020 (second phase). The primary outcome was cumulative 28-day postoperative mortality. Secondary outcomes were postoperative organic dysfunction and the incidence of clinical complications. Because of the possibility of imbalance between groups, adjusted analyses were performed: Cox proportional hazards model (primary outcome) and multiple logistic regression model (secondary outcomes). RESULTS: After screening 328 patients, 291 were included. The proportional hazard of cumulative 28-day mortality was higher in the second phase than that in the first phase in the Cox model, with the adjusted hazard ratio of 4.35 (95% confidence interval [CI] 2.15-8.82). The adjusted incidences of respiratory complications (odds ratio [OR] 5.35; 95% CI 1.42-20.11) and pulmonary infections (OR 1.53; 95% CI 1.08-2.17) were higher in the second phase. However, the adjusted incidence of other infections was lower in the second phase (OR 0.78; 95% CI 0.67-0.91). CONCLUSIONS: Surgical oncology patients who underwent postoperative care in the intensive care unit during the COVID-19 pandemic had higher hazard of 28-day mortality. Furthermore, these patients had higher odds of respiratory complications and pulmonary infections. Trials registration The study is registered in the Brazilian Registry of Clinical Trials under the code RBR-8ygjpqm, UTN code U1111-1293-5414.


Assuntos
COVID-19 , Neoplasias , Complicações Pós-Operatórias , Humanos , COVID-19/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias/cirurgia , Neoplasias/mortalidade , Complicações Pós-Operatórias/epidemiologia , Idoso , SARS-CoV-2 , Taxa de Sobrevida , Unidades de Terapia Intensiva/estatística & dados numéricos , Incidência , Prognóstico , Pandemias , Seguimentos
2.
Rev Bras Ortop (Sao Paulo) ; 58(4): e571-e579, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37663192

RESUMO

Objective This study aims to analyze outcomes and clinical and epidemiological data of infected tibial pseudarthrosis using the Ilizarov method and the Orr dressing. Methods Data from n = 43 patients diagnosed with infected tibial pseudarthrosis were analyzed by descriptive and inferential statistical methods. In addition, Paley's assessment criteria evaluated bone and functional outcomes. Qualitative variables were presented as the distribution of absolute and relative frequencies. The presentation of quantitative variables followed the D'Agostino-Pearson test. Results Thirty-seven (86.04%) subjects were males, and six (13.95%) were females. The most frequent age group among patients was 50 to 59 years old (25.6%), with a p-value = 0.8610. The treatment time was longer for the trifocal treatment (23.8 months) when compared to the bifocal treatment (15.6 months), with a p-value = 0.0010* (highly significant). Excellent bone outcomes represented 72.09% of the sample; 23.25% of outcomes were good. Functional outcomes were excellent in 55.81%, good in 6.97%, and regular in 27.90% of subjects. The Orr dressing (using Vaseline gauze) proved effective, achieving wound healing with soft tissue coverage in all patients evaluated. Conclusions The Ilizarov method resulted in a substantial change in the treatment of bone infections, especially infected pseudarthrosis. The versatility of this method has turned it into an effective tool, allowing the healing of the infectious process and the correction of potential deformities and shortening.

3.
Rev. Bras. Ortop. (Online) ; 58(4): 571-579, July-Aug. 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1521807

RESUMO

Abstract Objective This study aims to analyze outcomes and clinical and epidemiological data of infected tibial pseudarthrosis using the Ilizarov method and the Orr dressing. Methods Data from n = 43 patients diagnosed with infected tibial pseudarthrosis were analyzed by descriptive and inferential statistical methods. In addition, Paley's assessment criteria evaluated bone and functional outcomes. Qualitative variables were presented as the distribution of absolute and relative frequencies. The presentation of quantitative variables followed the D'Agostino-Pearson test. Results Thirty-seven (86.04%) subjects were males, and six (13.95%) were females. The most frequent age group among patients was 50 to 59 years old (25.6%), with a p-value = 0.8610. The treatment time was longer for the trifocal treatment (23.8 months) when compared to the bifocal treatment (15.6 months), with a p-value = 0.0010* (highly significant). Excellent bone outcomes represented 72.09% of the sample; 23.25% of outcomes were good. Functional outcomes were excellent in 55.81%, good in 6.97%, and regular in 27.90% of subjects. The Orr dressing (using Vaseline gauze) proved effective, achieving wound healing with soft tissue coverage in all patients evaluated. Conclusions The Ilizarov method resulted in a substantial change in the treatment of bone infections, especially infected pseudarthrosis. The versatility of this method has turned it into an effective tool, allowing the healing of the infectious process and the correction of potential deformities and shortening.


Resumo Objetivo Analisar os resultados e os dados clínicos e epidemiológicos do tratamento das pseudoartroses infectadas da tíbia pelo método de Ilizarov associado ao curativo de Orr. Métodos Para analisar os dados de n = 43 pacientes com diagnóstico de pseudoartrose infectada da tíbia foram aplicados métodos estatísticos descritivos e inferenciais e os resultados ósseos e funcionais foram avaliados de acordo com os critérios de avaliação de Paley. As variáveis qualitativas foram apresentadas por distribuição de frequências absolutas e relativas. As variáveis quantitativas foram apresentadas pelo teste de DAgostino-Pearson. Resultados Foi encontrado que 37 (86,04%) eram do sexo masculino, 6 (13,95%) femininos. A faixa etária mais frequente entre os pacientes foi de 50 a 59 anos (25.6%), p-valor = 0.8610. O tempo de tratamento é maior no tratamento trifocal (23.8 meses) quando comparado com o Bifocal (15.6 meses), p-valor =0.0010* (altamente significante). Os resultados ósseos excelentes representaram 72,09%, 23,25% foram de resultados considerados bons. Os resultados funcionais considerados excelentes foram 55,81%, os resultados bons foram 6,97%, resultados regulares foram 27,90. O curativo com gaze vaselinada (curativo de Orr) mostrou-se eficaz, alcançando assim a cicatrização das feridas com cobertura de partes moles em todos os pacientes avaliados. Conclusões O método de Ilizarov proporcionou uma mudança substancial no tratamentos das infecções ósseas, especialmente das pseudoartroses infectadas. A versatilidade deste método se transformou em uma ferramenta eficaz, permitindo a cura do processo infeccioso, bem como correção das possíveis deformidades e do encurtamento.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pseudoartrose/terapia , Tíbia/patologia , Resultado do Tratamento , Técnica de Ilizarov/reabilitação
4.
Cad Saude Publica ; 37(suppl 1): e00195520, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35475877

RESUMO

Actions in the promotion of healthy eating are strategic for reversing nutritional problems. This article analyzes the disputes over ideas in discursive repertoires on healthy eating in Brazil's national policies and international, government, civil society, and private commercial sector documents in the last 20 years. Based on the document analysis method in dialogue with the academic literature, the following perspectives on healthy eating were identified: traditional culturalist; medicalizing biological/nutritional; multidimensional; and systemic. The disputes are established between ideas in the following areas: the existence of "unhealthy foods"; the attributions, limits, and forms of State intervention; eating as an individual or public matter; and the meanings of sustainability, commensality, culture, and food. Policy positions on pesticides, food fortification, and supplementation are key elements in these disputes. In the policy sphere, the private commercial sector adopts strategies of fragmentation, downplaying, and distortion of meanings that reinforce polarization between individual actions (lifestyles, freedom of choice) and environmental interventions, thereby disseminating a narrow approach to food and nutrition education. Civil society pressures governments to establish concepts and principles in policies that directly affect the disputes' parameters. The latter act with greater or lesser permeability to pressures from internal or external stakeholders, depending on their composition and the institutional spaces for dialogue with society.


As ações de promoção da alimentação saudável são estratégicas para reversão dos problemas nutricionais. Este artigo analisa as disputas em torno das ideias presentes em repertórios discursivos sobre alimentação saudável em políticas nacionais, documentos internacionais, societários e do setor privado comercial, nos últimos vinte anos. Com base no método de análise documental em diálogo com a literatura acadêmica, foram identificadas as seguintes perspectivas de alimentação saudável: tradicional culturalista; nutricional biologicista medicalizante; multidimensional e sistêmica. As disputas instituem-se em torno das ideias sobre: a existência de "alimentos não saudáveis"; as atribuições, limites e formas de intervenção do Estado; a alimentação como uma questão da esfera individual ou de caráter público; os sentidos da sustentabilidade, da comensalidade, da cultura e da comida. Os posicionamentos adotados nas políticas em relação aos agrotóxicos, à fortificação de alimentos e à suplementação são elementos-chave dessas disputas. No âmbito da ação política, a fragmentação, a relativização e a distorção de significados são estratégias adotadas pelo setor privado comercial que reforçam a polarização entre ações individuais (estilos de vida, liberdade de escolha) e intervenções ambientais, e disseminam uma concepção restrita de educação alimentar e nutricional. A sociedade civil incide politicamente pressionando os governos a instituírem, em suas políticas, concepções e princípios que afetam diretamente os parâmetros das disputas. Estes, por sua vez, agem de forma mais ou menos permeável às pressões dos atores (internos ou externos) a depender de sua composição e dos espaços institucionais de interlocução com a sociedade.


Las acciones de promoción de la alimentación saludable son estratégicas para la reversión de los problemas nutricionales. Este artículo analiza las disputas en torno a las ideas presentes en repertorios discursivos sobre alimentación saludable en políticas nacionales, documentos internacionales, societarios y del sector privado comercial, en los últimos 20 años. En base al método de análisis documental, en diálogo con la literatura académica, se identificaron las siguientes perspectivas de alimentación saludable: tradicional-cultural; nutricional-biologicista-medicalizante; multidimensional y sistémica. Las disputas se instituyen en torno a las ideas sobre: la existencia de "alimentos no saludables"; las atribuciones, límites y formas de intervención del Estado; la alimentación como una cuestión de la esfera individual o de carácter público; los significados de la sostenibilidad, comensalidad, cultura y comida. Las posturas adoptadas en las políticas, relacionadas con los pesticidas, fortificación de alimentos y suplementación, son elementos-clave de esas disputas. En el ámbito de la acción política, la fragmentación, relativización y distorsión de significados son estrategias adoptadas por el sector privado comercial, que refuerzan la polarización entre acciones individuales (estilos de vida, libertad de elección) e intervenciones ambientales, y diseminan una concepción restringida de educación alimentaria y nutricional. La sociedad civil incide políticamente, presionando a los gobiernos a que instituyan en sus políticas concepciones y principios que afectan directamente los parámetros de las disputas. Estos, a su vez, actúan de forma más o menos permeable a las presiones de los actores (internos o externos) dependiendo de su composición y de los espacios institucionales de interlocución con la sociedad.


Assuntos
Dieta Saudável , Dissidências e Disputas , Brasil , Governo , Educação em Saúde , Humanos
7.
Front Nutr ; 9: 921498, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36741995

RESUMO

Introduction: In 2020, Brazil approved the introduction of a new front-of-package nutrition labeling (FoPNL) in the format of a magnifying glass (MG) after years of discussion. There is currently a lack of understanding of the role of the food industry in that process. This study aimed to describe the corporate political activity (CPA) of the food industry and conflicts of interest situations, as they happened during the development and approval of a new FoPNL system in Brazil. Materials and methods: We undertook bibliographical and documentary searches using material from food companies, trade associations and front groups involved in the regulatory process. We (1) collected information about the case study context, (2) collected data from documentary sources, and (3) prepared a synthesis of the results and a timeline of key events. Results/Discussion: During the FoPNL regulatory process in Brazil, the food industry opposed the introduction of warning labels, a model supported by health authorities and implemented with success in other countries in Latin America. The food industry rather promoted a traffic-light labeling system, known to be less effective at guiding individuals to make healthier food choices. Later in the process, when it was evident that its preferred model would not be used, and a MG would rather be introduced, the food industry argued for the use of a different version of this FoPNL model. We found that the food industry, all along the process, was directly involved in and influenced the development of the FoPNL, by providing technical support, advising and lobbying policymakers. The food industry also established relationships with a consumer non-governmental organization and nutrition professional societies. The food industry also produced and disseminated information supporting its position in order to influence public opinion and high-level decision makers, and used the legal system to delay the process. Conclusion: The FoPNL in Brazil is neither aligned with the recommendations of international health organizations nor with existing independent scientific evidence. The new FoPNL, as adopted in Brazil, reflects some of the preferences of the industry; it is likely that the influence of that sector during the legislative process was pivotal, even if its initial proposal was not adopted.

10.
Cad. Saúde Pública (Online) ; 37(supl.1): e00195520, 2021. tab
Artigo em Português | LILACS | ID: biblio-1374802

RESUMO

As ações de promoção da alimentação saudável são estratégicas para reversão dos problemas nutricionais. Este artigo analisa as disputas em torno das ideias presentes em repertórios discursivos sobre alimentação saudável em políticas nacionais, documentos internacionais, societários e do setor privado comercial, nos últimos vinte anos. Com base no método de análise documental em diálogo com a literatura acadêmica, foram identificadas as seguintes perspectivas de alimentação saudável: tradicional culturalista; nutricional biologicista medicalizante; multidimensional e sistêmica. As disputas instituem-se em torno das ideias sobre: a existência de "alimentos não saudáveis"; as atribuições, limites e formas de intervenção do Estado; a alimentação como uma questão da esfera individual ou de caráter público; os sentidos da sustentabilidade, da comensalidade, da cultura e da comida. Os posicionamentos adotados nas políticas em relação aos agrotóxicos, à fortificação de alimentos e à suplementação são elementos-chave dessas disputas. No âmbito da ação política, a fragmentação, a relativização e a distorção de significados são estratégias adotadas pelo setor privado comercial que reforçam a polarização entre ações individuais (estilos de vida, liberdade de escolha) e intervenções ambientais, e disseminam uma concepção restrita de educação alimentar e nutricional. A sociedade civil incide politicamente pressionando os governos a instituírem, em suas políticas, concepções e princípios que afetam diretamente os parâmetros das disputas. Estes, por sua vez, agem de forma mais ou menos permeável às pressões dos atores (internos ou externos) a depender de sua composição e dos espaços institucionais de interlocução com a sociedade.


Las acciones de promoción de la alimentación saludable son estratégicas para la reversión de los problemas nutricionales. Este artículo analiza las disputas en torno a las ideas presentes en repertorios discursivos sobre alimentación saludable en políticas nacionales, documentos internacionales, societarios y del sector privado comercial, en los últimos 20 años. En base al método de análisis documental, en diálogo con la literatura académica, se identificaron las siguientes perspectivas de alimentación saludable: tradicional-cultural; nutricional-biologicista-medicalizante; multidimensional y sistémica. Las disputas se instituyen en torno a las ideas sobre: la existencia de "alimentos no saludables"; las atribuciones, límites y formas de intervención del Estado; la alimentación como una cuestión de la esfera individual o de carácter público; los significados de la sostenibilidad, comensalidad, cultura y comida. Las posturas adoptadas en las políticas, relacionadas con los pesticidas, fortificación de alimentos y suplementación, son elementos-clave de esas disputas. En el ámbito de la acción política, la fragmentación, relativización y distorsión de significados son estrategias adoptadas por el sector privado comercial, que refuerzan la polarización entre acciones individuales (estilos de vida, libertad de elección) e intervenciones ambientales, y diseminan una concepción restringida de educación alimentaria y nutricional. La sociedad civil incide políticamente, presionando a los gobiernos a que instituyan en sus políticas concepciones y principios que afectan directamente los parámetros de las disputas. Estos, a su vez, actúan de forma más o menos permeable a las presiones de los actores (internos o externos) dependiendo de su composición y de los espacios institucionales de interlocución con la sociedad.


Actions in the promotion of healthy eating are strategic for reversing nutritional problems. This article analyzes the disputes over ideas in discursive repertoires on healthy eating in Brazil's national policies and international, government, civil society, and private commercial sector documents in the last 20 years. Based on the document analysis method in dialogue with the academic literature, the following perspectives on healthy eating were identified: traditional culturalist; medicalizing biological/nutritional; multidimensional; and systemic. The disputes are established between ideas in the following areas: the existence of "unhealthy foods"; the attributions, limits, and forms of State intervention; eating as an individual or public matter; and the meanings of sustainability, commensality, culture, and food. Policy positions on pesticides, food fortification, and supplementation are key elements in these disputes. In the policy sphere, the private commercial sector adopts strategies of fragmentation, downplaying, and distortion of meanings that reinforce polarization between individual actions (lifestyles, freedom of choice) and environmental interventions, thereby disseminating a narrow approach to food and nutrition education. Civil society pressures governments to establish concepts and principles in policies that directly affect the disputes' parameters. The latter act with greater or lesser permeability to pressures from internal or external stakeholders, depending on their composition and the institutional spaces for dialogue with society.


Assuntos
Humanos , Dissidências e Disputas , Dieta Saudável , Brasil , Educação em Saúde , Governo
11.
Cien Saude Colet ; 22(6): 1905-1911, 2017 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28614510

RESUMO

Oral health teams can work with both information of the people related to the family context as individual epidemiological through risk ratings, considering equity and service organization. The purpose of our study was to evaluate the association between tools that classify individual and family risk. The study group consisted of students from the age group of 5-6 years and 11-12 years who were classified regarding risk of caries and whether their parents had periodontal disease, in addition to the family risk. There was an association between the risk rating for decay in children (n = 128) and family risk classification with Coef C = 0.338 and p = 0.01, indicating that the higher the family's risk, the higher the risk of caries. Similarly, the association between the risk classification for periodontal disease in parents and family risk classification with Coef C = 0.5503 and p = 0.03 indicated that the higher the family risk, the higher the risk of periodontal disease. It can be concluded that the use of family risk rating tool is indicated as a possibility of ordering actions of the dental service, organizing their demand with greater equity, in this access door.


Assuntos
Cárie Dentária/epidemiologia , Saúde da Família , Saúde Bucal , Doenças Periodontais/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pais , Risco , Medição de Risco/métodos
12.
Am J Trop Med Hyg ; 85(4): 732-8, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21976580

RESUMO

The main objective of this study was to measure the quality of life (QoL) during a dengue episode. We conducted a facility-based survey in central Brazil in 2005 and recruited 372 laboratory-confirmed dengue patients greater than 12 years of age in hospital and ambulatory settings. We administered the World Health Organization QoL instrument approximately 15 days after the onset of symptoms. We used principal component analysis with varimax rotation to identify domains related to QoL. The median age of interviewees was 36 years. Most (85%) reported their general health status as very good or good before the dengue episode. Although ambulatory patients were mainly classified as having dengue fever, 44.8% of hospitalized patients had dengue hemorrhagic fever or intermediate dengue. Principal component analysis identified five principal components related to cognition, sleep and energy, mobility, self-care, pain, and discomfort, which explained 73% of the variability of the data matrix. Hospitalized patients had significantly lower mean scores for dimensions cognition, self-care, and pain than ambulatory patients. This investigation documented the generally poor QoL during a dengue episode caused by the large number of domains affected and significant differences between health care settings.


Assuntos
Dengue/fisiopatologia , Qualidade de Vida , Adulto , Brasil/epidemiologia , Dengue/epidemiologia , Humanos , Análise de Componente Principal
13.
Ci. Rural ; 29(1)1999.
Artigo em Português | VETINDEX | ID: vti-703461

RESUMO

The study was carried with the objective to evaluate the effect of the sex upon the weight gain, dry matter intake and food conversion of feedlot lambs and slaughtered at one hundred days of age. Eighteen lambs (six whole males, six castrated males and six females) descendents of a Texel male with (Texel x Ideal) female sheeps, were used. The animals (sheeps + lambs) were confined in individuals bails 24 hours after delivery until the weaning at the 50 days. After, they remained along until the slaughter at the age of 100 days. The food used was corn silage + concentrated (corn + soybean meal + minerals), in the proportion 58:42 in dry matter. The values obtained for weight gain, dry matter intake (kg/animal/day), % live weight and g/metabolic size and food conversion, did not differ (P>0,05) among the sex of the lambs. The results obtained showed that whole males lambs, castrated males lambs and females lambs, present performance similar at the age of 100 days.


O estudo foi realizado com o objetivo de avaliar o efeito do sexo sobre o ganho de peso, consumo de matéria seca e conversão alimentar de cordeiros confinados e abatidos aos 100 dias de idade. Foram utilizados 18 cordeiros (6 machos não castrados, 6 machos castrados e 6 fêmeas), filhos de carneiro Texel com ovelhas cruzas (Texel e Ideal). Os animais (ovelhas + cordeiros) foram confinados em baias individuais 24 horas após o parto até o desmame, que ocorreu aos 50 dias. Após, os cordeiros permaneceram sozinhos até o abate aos 100 dias de idade. O alimento utilizado foi silagem de milho + concentrado (milho + farelo de soja + minerais), na proporção 58:42 na matéria seca. Os valores encontrados para ganho de peso, consumo de matéria seca (kg/animal/dia, %PV e g/UTM) e conversão alimentar não diferiram (P>0,05) entre os sexos dos cordeiros. Os resultados obtidos mostram que cordeiros machos não castrados, castrados e fêmeas apresentam desempenho semelhante até os 100 dias de idade.

14.
Artigo em Português | LILACS-Express | VETINDEX | ID: biblio-1475212

RESUMO

The study was carried with the objective to evaluate the effect of the sex upon the weight gain, dry matter intake and food conversion of feedlot lambs and slaughtered at one hundred days of age. Eighteen lambs (six whole males, six castrated males and six females) descendents of a Texel male with (Texel x Ideal) female sheeps, were used. The animals (sheeps + lambs) were confined in individuals bails 24 hours after delivery until the weaning at the 50 days. After, they remained along until the slaughter at the age of 100 days. The food used was corn silage + concentrated (corn + soybean meal + minerals), in the proportion 58:42 in dry matter. The values obtained for weight gain, dry matter intake (kg/animal/day), % live weight and g/metabolic size and food conversion, did not differ (P>0,05) among the sex of the lambs. The results obtained showed that whole males lambs, castrated males lambs and females lambs, present performance similar at the age of 100 days.


O estudo foi realizado com o objetivo de avaliar o efeito do sexo sobre o ganho de peso, consumo de matéria seca e conversão alimentar de cordeiros confinados e abatidos aos 100 dias de idade. Foram utilizados 18 cordeiros (6 machos não castrados, 6 machos castrados e 6 fêmeas), filhos de carneiro Texel com ovelhas cruzas (Texel e Ideal). Os animais (ovelhas + cordeiros) foram confinados em baias individuais 24 horas após o parto até o desmame, que ocorreu aos 50 dias. Após, os cordeiros permaneceram sozinhos até o abate aos 100 dias de idade. O alimento utilizado foi silagem de milho + concentrado (milho + farelo de soja + minerais), na proporção 58:42 na matéria seca. Os valores encontrados para ganho de peso, consumo de matéria seca (kg/animal/dia, %PV e g/UTM) e conversão alimentar não diferiram (P>0,05) entre os sexos dos cordeiros. Os resultados obtidos mostram que cordeiros machos não castrados, castrados e fêmeas apresentam desempenho semelhante até os 100 dias de idade.

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