Search

Women have a specific hormonal risk associated with contraception, pregnancy and menopause, in addition to more risk factors for the development of cardiovascular diseases (CVD); and rapid, non-invasive, low-cost cardiovascular risk prediction tools can streamline the identification and prevention of CVD. Objective of the study to evaluate the risk of developing CVD in adult women using cardiometabolic indices such as plasma atherogenic index (AIP) and triglyceride-glucose (TyG) index for insulin resistance. This is an observational, cross-sectional and retrospective study. Data on the metabolic, clinical and anthropometric profile of adult women were analyzed and used for risk stratification of developing CVD through the use of TyG and AIP indices. Of the participating women (n = 60, 28.55 ± 8.30 years), 50% women had an increased risk according to AIP despite having normolipidemia, normoglycemia, and normal BMI. Also, they had higher TyG index values. Further, the correlations of TyG and AIP with biometric and lipid parameters were associated with metabolic syndrome. AIP and TyG index can identify the risk of developing CVD, even in the presence of normal anthropometric and biochemical parameters.

Background:. Body contouring surgery and surgical drawings are usually performed based on the surgeon’s experience without considering the nature of the unique anatomical structures of each patient. Thus, we propose a more reliable surgical design approach that considers the anatomical structures of each patient. Ultrasonography is increasingly used in plastic surgery and helps plastic surgeons to highlight anatomical features representing results in their interventions by providing a better understanding of the patients’ unique structures. Methods:. This study presents a series of cases involving 100 recruited patients (36 men and 64 women) between 18 and 60 years of age. Five surgeons examined the patients and created a presurgical design based on palpation, which was validated later by a physician skilled in evaluating the anterior wall of the abdomen using ultrasonography. The concordance between the findings of the palpation and ultrasonography was assessed for each patient. Results:. The concordance rate for each structure in both evaluations was midline (49%) (P > 0.92), diastasis recti (15%), semilunar line (23%), upper edge of rectus abdominis muscles (12%), lower edge of pectoral muscles (16%), border of oblique muscle (13%), number of tendinous intersections (12%), shape of tendinous intersections (11%), serratus anterior muscle (15%), subcostal triangle (15%), and oblique triangle (26%) (P < 0.0001). Conclusion:. All the structures evaluated by palpation in comparison with ultrasound show discordance, except the midline where agreement is evident, with a very good level of statistical significance.

With Gaia Data Release 3 (DR3), new and improved astrometric, photometric, and spectroscopic measurements for 1.8 billion stars have become available. Alongside this wealth of new data, however, there are challenges in finding efficient and accurate computational methods for their analysis. In this paper, we explore the feasibility of using machine learning regression as a method of extracting basic stellar parameters and line-of-sight extinctions from spectro-photometric data. To this end, we built a stable gradient-boosted random-forest regressor (xgboost), trained on spectroscopic data, capable of producing output parameters with reliable uncertainties from Gaia DR3 data (most notably the low-resolution XP spectra), without ground-based spectroscopic observations. Using Shapley additive explanations, we interpret how the predictions for each star are influenced by each data feature. For the training and testing of the network, we used high-quality parameters obtained from the StarHorse code for a sample of around eight million stars observed by major spectroscopic stellar surveys, complemented by curated samples of hot stars, very metal-poor stars, white dwarfs, and hot sub-dwarfs. The training data cover the whole sky, all Galactic components, and almost the full magnitude range of the Gaia DR3 XP sample of more than 217 million objects that also have reported parallaxes. We have achieved median uncertainties of 0.20 mag in V-band extinction, 0.01 dex in logarithmic effective temperature, 0.20 dex in surface gravity, 0.18 dex in metallicity, and 12% in mass (over the full Gaia DR3 XP sample, with considerable variations in precision as a function of magnitude and stellar type). We succeeded in predicting competitive results based on Gaia DR3 XP spectra compared to classical isochrone or spectral-energy distribution fitting methods we employed in earlier works, especially for parameters AV and Teff, along with the metallicity values. Finally, we showcase some potential applications of this new catalogue, including extinction maps, metallicity trends in the Milky Way, and extended maps of young massive stars, metal-poor stars, and metal-rich stars. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patient Reported Outcomes (PROs) are a report that comes from patients on a specific subject, describing how they feel about a condition or therapy. The term includes a range of constructions and methodology and can cover concepts such as symptoms to physical assessment, well-being and social involvement. The process can be described as a measure of patient reported outcome (Patient Reported Outcome Measure - PROM). In oncology, PROMs help healthcare professionals and systems to reduce the impact of treatment on patient’s quality of life. In recent years, several studies have shown improvement in the evaluated outcomes. In our country, there is still little information on this subject, especially when it comes to cancer patients. Hence, we think that it is of utmost importance to review the particularities of this tool, in order to stimulate further discussion of the subject in our country.

What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a “new normal” are discussed in this article.

Introduction: Sepsis is a systemic inflammatory response to suspected or confirmed infection. Clinical evaluations are essential for its early detection and treatment. Blood cultures may take as long as 2 days to yield a result and are not always reliable. However, recent studies have suggested that neutrophil CD64 expression may be a sensitive and specific alternative for the diagnosis of systemic infection. Objective: The objective of the study was to analyze the difference in CD64 values between subjects with systemic inflammatory response syndrome (SIRS), suspected or confirmed sepsis, who meet diagnostic criteria for SIRS upon arriving at an emergency department. Materials and Methods: This was a prospective observational cohort study, an accuracy study of CD64 prospectively evaluated. The sample consisted of 109 patients aged 18 years with criteria for SIRS on arrival to emergency department. CD64 expression was measured within 6 h of hospital admission and once again after 48 h. Results: ROC curve analysis suggested that a cutoff of 1.45 for CD64 expression could diagnose sepsis with a sensitivity of 0.85, a specificity of 0.75, an accuracy of 82.08%, a positive predictive value of 0.96, a negative predictive value of 0.38 and a positive likelihood ratio of 3.33. The area under the curve was 0.83. Conclusion: CD64 seems to be a useful, sensitive, and specific biomarker in discriminating between SIRS and sepsis.

Introdução: A obesidade é uma doença crônica multifatorial, que promove comorbidades importantes desencadeando grande repercussão à saúde. Porém, quando instalada e diante do insucesso de formas conservadoras de tratamento, a gastroplastia é indicada, entretanto, indivíduos submetidos à técnica apresentam maior risco de desenvolver deficiências nutricionais pela limitação da ingestão alimentar e restrição na absorção intestinal, necessitando, por vezes, de suplementação adequada. Objetivo: Analisar as deficiências nutricionais em indivíduos submetidos à gastroplastia e os aspectos da suplementação. Materiais e métodos: Participaram do estudo 93 indivíduos submetidos à gastroplastia redutora tipo Y de Roux, ambos os gêneros, maiores de 18 anos, com tempo de pós-operatório superior a 12 meses. Foi aplicado um questionário semiestruturado voltado à identificação de deficiências nutricionais e realização de suplementação. Resultados e discussão: A idade média dos avaliados foi de 39,20 (± 11,21) anos, maioria mulheres (86,02%) com tempo de pós-operatório de 53,22 (± 43,89) meses. A carência de algum nutriente foi notificada em 75,26% dos indivíduos, sendo mais prevalente no gênero feminino e com tempo de pós-operatório maior. Dentre as deficiências evidenciou-se diminuição de vitamina B12 (30,83%), ferro (29,01%), vitamina D (25,92%) e cálcio (14,16%). A suplementação envolveu 88,17% dos indivíduos, sendo os benefícios notificados em 73,17% dos casos. Conclusão: Deficiências nutricionais em indivíduos submetidos à gastroplastia é uma constatação comum, sendo imprescindível a suplementação para normalização dos componentes assegurando um emagrecimento saudável e seguro. ABSTRACT Nutritional deficiencies and supplementation in subject individuals a reducing type and roux gastroplasty Introduction: Obesity is a chronic multifactorial disease, which promotes important comorbidities, triggering great repercussions on health. However, when installed and faced with the failure of conservative treatment, gastroplasty is indicated, however, individuals submitted to the technique present a higher risk of developing nutritional deficiencies due to limitation of food intake and restriction of intestinal absorption, sometimes requiring supplementation proper. Objective: To analyze nutritional deficiencies in individuals submitted to gastroplasty and aspects of supplementation. Materials and methods: Participating in the study were 93 subjects submitted to Roux in Y type reductive gastroplasty, both genders, older than 18 years, with a postoperative period of more than 12 months. A semi-structured questionnaire was used to identify nutritional deficiencies and supplementation. Results and discussion: The mean age of the patients evaluated was 39.20 (± 11.21) years, mostly women (86.02%) with a postoperative period of 53.22 (± 43.89) months. The lack of some nutrients was reported in 75,26% of the individuals, being more prevalent in the female gender and with a longer postoperative period. Among the deficiencies, vitamin B12 (30.83%), iron (29.01%), vitamin D (25.92%) and calcium (14.16%) decreased. Supplementation involved 88.17% of the individuals, and the benefits were reported in 73.17% of the cases. Conclusion: Nutritional deficiencies in individuals submitted to gastroplasty is a common finding, and supplementation is essential for normalization of the components, ensuring healthy and safe weight loss.

A atual política escolar indígena, norteada pelo modelo da educação diferenciada, garante o ensino da cultura indígena na escola, sobretudo o ensino da língua nativa. Contudo, este modelo tem reduzido algumas vezes, a alfabetização na língua indígena como sendo o equivalente ao ensino da cultura indígena. Embora não siga o modelo de educação diferenciada, já que seus membros não estão filiados à escola indígena do Território Indígena (T.I.) Vanuíre (pertencente ao município de Arco-Íris no estado de São Paulo), o Grupo de Cultura Kaingang tem respondido a esses desafios através do agir dos Veinkupri Hã ou espíritos dos mortos bons (guerreiros guardiões da cultura Kaingang). Para investigar como esse ensino tem sido retomado pelos membros do Grupo de Cultura Kaingang do T.I. Vanuíre, assim como o que ele elege manter e o que elege mudar da tradição, utilizou-se o método psicanalítico agregando-lhe procedimentos etnográficos (escuta participante). O ensino pautado pelos Veinkupri Hã contempla a totalidade do corpo e, por isso, não prioriza a esfera cognitiva ou representacional em voga na Educação. Antes, visa o preparo e fortalecimento do corpo da criança para que ela consiga agir conforme os espíritos dos mortos bons, buscando a consolidação de uma alma indígena atuante. A criança aprende a respeitar e a se comunicar com os Veinkupri Hã por meio da expressão em si mesma de um espírito guerreiro. Embora tradicionalmente os Kaingang evitassem os mortos, o Grupo de Cultura Kaingang mantém a comunicação com eles para combater as subjugações históricas e contemporâneas que os destinam a não ser quem são. Deste modo, evidencia-se a impossibilidade de desvincular o ensino cultural do ensino espiritual indígena. O Grupo de Cultura Kaingang provoca a sociedade brasileira a repensar suas políticas públicas versadas à Educação. Na busca por uma educação intercultural não há como deixar de fora o âmbito espiritual dos povos indígenas. ABSTRACT: The current indigenous school policy, guided by the model of differentiated learning, guarantees the teaching of indigenous culture in school, especially the teaching of the native language. However, this model has sometimes reduced literacy of indigenous culture in the indigenous language learning. Although it does not follow the model of differentiated learning, since its members are not affiliated to the indigenous school of the Indigenous Territory (Território Indígena, TI) Vanuíre (belonging to the city of Arco-Íris in the state of São Paulo, Brasil), the Kaingang Culture Group has responded to these challenges through the action of the Veinkupri Hã, spirits of honorable deceased Kaingang (guardian warriors of the Kaingang culture).To investigate, as this teaching has been taken up by members of the Kaingang Culture Group of TI Vanuíre, as well as what it elects to maintain and what it chooses to change from tradition, the psychoanalytic method was used by adding ethnographic procedures (participant listening). In order to investigate how this teaching has been taken up, by members of the Kaingang Culture Group of TI Vanuíre, as well what it chooses to maintain and what it chooses to change from the tradition, the psychoanalytic method with ethnographic tools has been applied (participant listening). The teaching guided by the Veinkupri Hã includes the totality of the body and, therefore, does not prioritize the cognitive or representational sphere. Its purpose is to strengthen the child’s body so that it acts according to the honorable deceased Kaingang, seeking the consolidation of an active indigenous soul. The child learns to respect and communicate with the Veinkupri Hã through the manifestation of a warrior spirit. Although the Kaingang people have traditionally avoided the dead, the Kaingang Culture Group maintains communication with them to counter the historical and contemporary subjugations that aim them to not be who they are. Thus, it is evident that it is impossible to disassociate cultural teaching from indigenous spiritual teaching. The Kaingang Culture Group encourages Brazilian society to rethink its public policies to education. In the search for an intercultural education there is no way to leave out the spiritual scope of the indigenous peoples.

ABSTRACT Introdution: Chronic myeloid leukemia (CML) is a genetic disorder of hematopoietic stem cells, resulting in a myeloproliferative expansion of blood cells. CML is associated with the presence of the Philadelphia chromosome (Ph), generating an oncogene (BCR-ABL). The current treatment of choice is imatinib mesylate (IM). Objective: To correlate serum levels of MI with hematological parameters in patients with CML. Method: A retrospective cross-sectional study in patients treated for CML. Serum level of IM was determined by a high-performance liquid chromatography with diode array detector (HPLC-DAD), and statistical analysis was performed using SPSS version 20.0 software. Results: We studied 55 CML patients - 24 men (43.6%) and 31 women (56.4 %) - with a mean age of 54 years, who used IM. Among these, 45 patients were in the chronic phase (81.6 %); seven, in the accelerated phase (13.1%); and three, in the blast crisis (5.2%). Patients received a mean IM dose of 434 mg/day. Serum levels of the patients presented an average of 1,092 ± 617 ng/ml, and, in all, 47 patients (85.4%) had hematologic response (HR). Conclusion: There was no correlation between the number of leukocytes, platelets and hemoglobin and the serum level of IM, although there is a trend with respect to hemoglobin (p = 0.062).

A geração Y é representada por adolescentes e jovens adultos nascidos entre 1980 e 2000. É uma geração de consumidores com grande poder econômico, com capacidade estimada de compra anual de 200 bilhões de dólares. Nesse cenário, o objetivo desta pesquisa é identificar a relação entre as dimensões da imagem de varejo de vestuário e a lealdade dos consumidores da geração Y. O framework proposto baseou-se na revisão bibliográfica sobre imagem de loja e lealdade. A pesquisa é do tipo survey, com 394 consumidores da geração Y. Os resultados apontam que a imagem de loja tem impacto sobre a dimensão da lealdade. Dentre as dimensões que mais explicam a imagem de loja, destacaram-se as de serviços, mix de produtos (mercadorias) e atmosfera da loja.