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The quality of data in electronic healthcare databases is a critical component when used for research and health practice. The aim of the present study was to assess the data quality in the Paulista Cardiovascular Surgery Registry II (REPLICCAR II) using two different audit methods, direct and indirect. The REPLICCAR II database contains data from 9 hospitals in São Paulo State with over 700 variables for 2229 surgical patients. The data collection was performed in REDCap platform using trained data managers to abstract information. We directly audited a random sample (n = 107) of the data collected after 6 months and indirectly audited the entire sample after 1 year of data collection. The indirect audit was performed using the data management tools in REDCap platform. We computed a modified Aggregate Data Quality Score (ADQ) previously reported by Salati et al. (2015). The agreement between data elements was good for categorical data (Cohen κ = 0.7, 95%CI = 0.59–0.83). For continuous data, the intraclass coefficient (ICC) for only 2 out of 15 continuous variables had an ICC < 0.9. In the indirect audit, 77% of the selected variables (n = 23) had a good ADQ score for completeness and accuracy. Data entry in the REPLICCAR II database proved to be satisfactory and showed competence and reliable data for research in cardiovascular surgery in Brazil. [ABSTRACT FROM AUTHOR]

The article focuses on the RISPALI (risperidone-paliperidone) study on the effects of oral paliperidone extended-release (ER) in Brazilian adults with schizophrenia. Topics include the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) of adults with chronic schizophrenia, potential issues regarding the treatment and conduction of the study in accordance with the guidelines of the International Conference on Harmonization for Good Clinical Practice (ICH GCP).

Swainsonine-containing plants comprise a very important group of toxic plants in Brazil, including Ipomoea carnea subsp. fistulosa, Ipomoea riedelii, Ipomoea sericophyla, Ipomoea verbascoidea. Turbina cordata and Sida carpinifolia, which cause a glycoprotein storage disease in goats, and with less frequency in cattle, horses, sheep, and deer. A characteristic of swainsonine poisoning is that the animals that eat these plants develop the habit of eating them compulsively and, by social facilitation, induce other animals of the same species to eat them. Clinical signs of the poisoning are rough hair coat, weight loss, and nervous signs associated mainly with cerebellar and brain stem lesions. Weight losses or decreased weight gains still occurring also in animals with chronic clinical signs removed from the areas where the plants occur. Reproductive losses are also reported. Chronically affected animals, also without still ingesting the plant, are more susceptible to gastrointestinal parasites. Cerebellar atrophy has been observed grossly in chronic cases. Main histologic lesions are vacuolation of neurons, epithelial cells of the pancreas and kidney, thyroidfollicular cells, hepatocytes, and macrophages of lymphoid organs. To control the poisoning animals must be removed immediately from the areas invaded by the plant. The only preventive measure to prevent the ingestion of the plant is their elimination from invaded areas or through conditionedfood aversion. [ABSTRACT FROM AUTHOR]

Objective: To analyze the sociodemographic and occupational influences on health professionals' quality of life., Method: This descriptive-exploratory, cross-sectional, analytical, and quantitative study addressed 94 health workers, including nursing technicians, nurses, and physical therapists working in Intensive Care Units in a town in the extreme south of Brazil in 2023. The student's t-test and Spearman correlation were used., Results: A significant positive correlation was found between being a woman and the psychological domain and between income and the social and environmental domain while working hours were inversely related to general QoL. Additionally, workload negatively impacted the physical, psychological, and general QOL, furniture negatively influenced the psychological domain, and equipment was negatively associated with the physical and psychological domain., Conclusion: The characteristics of the work environment interfere with several areas of quality of life.

The degradation of water resources available for human consumption is increasing with the continuous release of chemicals into aquatic environments and their inefficient removal in wastewater treatment. Several watersheds in Brazil, such as the Iguaçu River, are affected by multiple sources of pollution and lack information about their pollution status. The Iguaçu River basin (IRB) has great socioeconomic and environmental relevance to both the supply of water resources and its considerable hydroelectric potential, as well as for the high rate of endemism of its ichthyofauna. Also, the IRB is home to large conservation units, such as the Iguaçu National Park, recognized by UNESCO as a natural World Heritage Site. Thus, this article discusses the chemical pollution in the IRB approaching: (i) the main sources of pollution; (ii) the occurrence of inorganic and organic micropollutants; (iii) the available ecotoxicological data; and (iv) the socioeconomic impacts in three regions of the upper, middle, and lower IRB. Different studies have reported relevant levels of emerging contaminants, persistent organic pollutants, toxic metals, and polycyclic aromatic hydrocarbons detected in the water and sediment samples, especially in the upper IRB region, associated with domestic and industrial effluents. Additionally, significant concentrations of pesticides and toxic metals were also detected in the lower IRB, revealing that agricultural practices are also relevant sources of chemicals for this watershed. More recently, studies indicated an association between fish pathologies and the detection of micropollutants in the water and sediments in the IRB. The identification of the main sources of pollutants, associated with the distribution of hazardous chemicals in the IRB, and their potential effects on the biota, as described in this review, represent an important strategy to support water management by public authorities for reducing risks to the local endemic biodiversity and exposed human populations. Integr Environ Assess Manag 2024;20:1280-1305. © 2023 SETAC., (© 2023 SETAC.)

Objective: To learn the strategies used regarding underreporting of pesticide use in rural areas., Methods: A qualitative study was carried out in eight primary healthcare units in rural areas and two emergency care units in a municipality in southern Brazil. Data collection took place in 2023 through interviews. Twenty professional nurses participated. The data was submitted to content analysis., Results: The strategies identified were lifelong and continuing education for the professionals who carry out the notification, active search and training of workers who deal directly with this type of substance, computerizing the notification by filling in the forms online, and carrying out research on the subject., Final Considerations: Nurses play an important role in reporting occupational accidents caused by the use of pesticides, improving occupational safety in rural areas.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in Brazil, several government policies have been taken. Herein, we aimed to assess the impact of the COVID-19 pandemic on hospital admissions and in-hospital lethality for cardiovascular diseases (CVD) in Brazil in 2020. An ecological and time-series study on hospitalizations and deaths from CVD in Brazil was conducted from January 2018 to December 2020.The hospital admission rate for CVD reduced by 17.1%, with a significant decreasing trend between January and May 2020 (Annual Percent Change: -8,7%; P-value < 0.001). The in-hospital lethality rate increased from 8.2% in 2018 to 9.3% in 2020. During this period, Brazil totaled 21.8 million days of hospital stay. Indicators of hospital admissions and lethality from CVD in Brazil were impacted by the emergence of the COVID-19 pandemic in different ways in the regions and depending on the nature of the indicator., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: The short-term results after using arterial grafts still raise questions and doubts for medical society., Objective: To compare the immediate outcomes of patients undergoing single arterial graft versus multiple arterial grafts coronary artery bypass grafting surgery., Methods: Cross-sectional cohort study in the São Paulo Registry of Cardiovascular Surgery II (REPLICCAR II). Perioperative data from 3122 patients were grouped by the number of arterial grafts used, and their outcomes were compared: reoperation, deep sternal wound infection (DSWI), stroke, acute kidney injury, prolonged intubation (>24 hours), short hospital stay (<6 days), prolonged hospital stay (>14 days), morbidity and mortality. Propensity Score Matching (PSM) matched 1062 patients, adjusted for the mortality risk., Results: After PSM, the single arterial graft group showed patients with advanced age, more former smokers, hypertension, diabetes, stable angina, and previous myocardial infarction. In the multiple arterial grafts, there was a predominance of males, recent pneumonia, and urgent surgeries. After the procedure, there was a higher incidence of pleural effusion (p=0.042), pneumonia (p=0.01), reintubation (p=0.006), DSWI (p=0.007), and sternal debridement (p=0.015) in the multiple arterial grafts group, however, less need for blood transfusion (p=0.005), extremity infections (p=0.002) and shorter hospital stays (p=0.036). Bilateral use of the internal thoracic artery was not related to increased DSWI rate, but glycosylated hemoglobin >6.40% (p=0.048)., Conclusion: Patients undergoing the multiarterial technique had a higher incidence of pulmonary complications, and DSWI, where glycosylated hemoglobin ≥6.40%, had a greater influence on the infectious outcome than the choice of grafts.

Background: The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units., Objective: Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020)., Methods: This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level., Results: There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: -1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions., Conclusions: There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset.

Objective: To assess the temporal trends of hospitalizations for pulmonary embolism (PE) in Brazil, its regions, and states between 2008 and 2019., Methods: An ecological and time series study was conducted. Data were obtained from the Hospital Information System (SIH) of the Brazilian Ministry of Health. The inflection point regression model was applied for temporal trend analyses. Trends were classified as increasing, decreasing, or stationary according to the slope of the regression line. The Annual Percent Charge (APC) and the Average Annual Percent Change (AAPC) were calculated considering a confidence interval of 95% and p-value <0.05. Furthermore, spatial distribution maps of epidemiological indicators related to PE in Brazil were elaborated., Results: There was an increasing trend in the hospitalization rate for PE in Brazil, ranging from 2.57 in 2008 to 4.44/100,000 in 2019 (AAPC=5.6%; p<0.001). Total and average hospitalizations costs also showed increasing trend in the country (AAPC=9.2% and 3.0%, respectively). Still, there was a decrease in the in-hospital mortality rate (from 21.21% to 17.11%; AAPC=-1.9%; p<0.001). Similar trends were observed in most regions. The average hospitalization time in Brazil showed a stationary trend. The hospitalization rate has also increased in 18 states (66.67%). Seven states showed a decrease in the mortality rate (25.93%), except for Roraima, which showed an increasing trend., Conclusion: Hospitalizations for PE represent a serious public health problem in Brazil and the temporal patterns observed herein demonstrate an increasing trend in all regions and states of the country.

Background: Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic., Objective: To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic., Design and Setting: This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states., Methods: Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020., Results: A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month., Conclusion: The pandemic caused a negative impact on meningitis notifications in Brazil.