Nevin Manimala

Rev Bras Epidemiol. 2023 Dec 11;26:e230060. doi: 10.1590/1980-549720230060. eCollection 2023.

ABSTRACT

OBJECTIVE: To analyze the spatial distribution of mortality from cardiovascular diseases in the municipalities of the state of Ceará, Brazil, between 2009-2019.

METHODS: This is an ecological study with a spatial focus on the state of Ceará, considering the period from 2009 to 2019. Death data from the Brazilian Mortality Information System and population data from the Brazilian Institute of Geography and Statistics were used to calculate crude and standardized mortality rates from cardiovascular diseases. Temporal analysis was carried out using the Joinpoint Regression Program 4.9.0 software and spatial analysis of the municipalities’ average mortality. The values were smoothed by the local empirical Bayesian method using QGIS 3.16. For spatial clusters, the Global and Local Moran Index was used through Moran Map and LISA Map, with analyses carried out in TerraView 4.2.2.

RESULTS: A total of 132,145 deaths from cardiovascular diseases were recorded in the period, with an average increase of 3% per year. Higher mortality rates were observed in men, people aged ≥80 years, mixed-race ethnicity/skin color, married, and with lower level of education. There was the formation of clusters of municipalities with high mortality rates in the regions of Vale do Jaguaribe, Sertão Central, Centro Sul, Sertão dos Inhamuns and Serra da Ibiapaba.

CONCLUSION: This study identified municipalities with high mortality and exposed the need for strategies aligned with the reality and particularities of these locations.

PMID:38088719 | DOI:10.1590/1980-549720230060

Rev Bras Epidemiol. 2023 Dec 11;26:e230057. doi: 10.1590/1980-549720230057. eCollection 2023.

ABSTRACT

OBJECTIVE: To evaluate accuracy and agreement between creatinine clearance (CrCl) measured in 12-h urine and glomerular filtration rate (GFR) calculated by the Modification of Diet in Renal Disease (MDRD-4) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, with and without adjustment for race/color.

METHODS: Baseline data from the Longitudinal Study of Adult Health (ELSA-Brazil) in adults (35-74 years of age) of both genders were used. Serum creatinine was measured in fasting blood and urinary creatinine was measured in an overnight 12-h urine collect. The agreement between CrCl and the calculated GFR was analyzed by the Bland-Altman method. One-way analysis of variance (ANOVA) with race/color factor was used to verify differences between means of CrCl and GFR with and without correction for race/color. Statistical significance was accepted for p<0.05.

RESULTS: From 15,105 participants in the ELSA-Brazil, 12,813 had a validated urine collect. The Bland-Altman diagrams showed that formulas and CrCl agree with each other with a better accuracy for GFR <90 mL/.min x 1.73m2. The adjustment by race/color increased data dispersion. In this range, one-way ANOVA of CrCl with race/color factor showed similarity between groups (p=0.27).

CONCLUSION: MDRD-4 and CKD-EPI are useful formulas for screening cases of chronic kidney disease, and correction by race/color, only in blacks or in black and brown subjects, proved to be unnecessary and reduced the reliability of the equations.

PMID:38088716 | DOI:10.1590/1980-549720230057

Rev Bras Epidemiol. 2023 Dec 11;26:e230055. doi: 10.1590/1980-549720230055. eCollection 2023.

ABSTRACT

OBJECTIVE: To describe the space-time evolution of TB incidence rates (TI) in indigenous and non-indigenous people, according to the Federative Units (UF) of Brazil, from 2011 to 2022.

METHODS: Ecological, temporal, and spatial study on new tuberculosis cases in Brazil among indigenous and non-indigenous populations. Data from the Notifiable Diseases Information System (Sinan) were collected from 2011 to 2022 and stratified by Federal Unit, explored and statistically analyzed using R software version 4.2.3.

RESULTS: The mean TI among indigenous populations in Brazil was 71.7 new cases per 100,000 inhabitants, while for non-indigenous populations it was 28.6/100,000 inhabitants. The regions of the country that presented the highest (mean) incidence among indigenous populations were: Central-West (102.8/100,000 inhabitants), Southeast (99.6/100,000 inhabitants), and North (79.9/100,000 inhabitants). For non-indigenous populations the highest incidence was in the North region (36.5/100,000 inhabitants), followed by the Southeast (31.3/100,000), and the Northeast (27,4/100,000 inhabitants). The analysis showed that the highest incidence of TB cases among indigenous populations occurred in the states of: SP, RO, RJ, MS, MT e PA.

CONCLUSION: High incidence of the disease compared to the non-indigenous population show the need for a specific approach to address the health needs of these populations. Regional disparities in incidence indicate the need to address socioeconomic and infrastructure issues that affect the health of indigenous populations.

PMID:38088714 | DOI:10.1590/1980-549720230055

Rev Bras Enferm. 2023 Dec 8;76Suppl 4(Suppl 4):e20230108. doi: 10.1590/0034-7167-2023-0108. eCollection 2023.

ABSTRACT

OBJECTIVES: to analyze the influence of sociodemographic and clinical variables, as well as the surgical checklist adherence score, on the occurrence of surgical site infection among patients undergoing myocardial revascularization.

METHODS: an observational, longitudinal, retrospective study was conducted at a university hospital, involving 266 medical records of patients who underwent myocardial revascularization surgery. Instruments containing sociodemographic, clinical, and infection-related variables were used, along with the Perioperative Surgical Safety Checklist. Descriptive, bivariate, and logistic regression analyses were employed.

RESULTS: surgical site infection occurred in 89 (33.5%) patients. There was a statistically significant association between body temperature outside the range of 36 degrees Celsius to 36.5 degrees Celsius (p=0.01), the presence of invasive devices (p=0.05), surgical procedures with the anticipation of critical events (p<0.001), and the occurrence of infection.

CONCLUSIONS: body temperature, the presence of invasive devices, and surgical procedures with the anticipation of critical events were significant factors contributing to an increased risk of infection.

PMID:38088713 | DOI:10.1590/0034-7167-2023-0108

Rev Bras Enferm. 2023 Dec 8;76Suppl 4(Suppl 4):e20210485. doi: 10.1590/0034-7167-2021-0485. eCollection 2023.

ABSTRACT

OBJECTIVE: to assess nursing students’ and nurses’ knowledge, satisfaction and self-confidence after a theoretical workshop on emergency care for traumatized children and clinical simulation.

METHODS: a quasi-experimental study, carried out with nursing students and nurses residing at a public university in southern Brazil. A workshop on pediatric trauma care was created and a mannequin was created for simulations. A knowledge pre-test and post-test and the Student Satisfaction and Self-Confidence in Learning instrument were applied to measure satisfaction and self-confidence in learning. For analysis, descriptive statistics and the Wilcoxon test were used to compare means before and after intervention.

RESULTS: the difference between misses and hits was statistically significant (p<0.005), demonstrating an increase in participants’ knowledge after the workshop. Satisfaction and self-confidence were demonstrated in the instrument’s high scores.

CONCLUSIONS: the effectiveness of the workshop in teaching-learning emergency care for pediatric trauma was demonstrated.

PMID:38088706 | DOI:10.1590/0034-7167-2021-0485

An Acad Bras Cienc. 2023 Dec 11;95(4):e20200656. doi: 10.1590/0001-3765202320200656. eCollection 2023.

ABSTRACT

This study estimated biomass and carbon from components, future carbon values ​​and to obtain economic productive value of carbon fixation of a Seasonal Semideciduous Forest. Biomass and carbon were estimated using adjusted equations and selected using regression statistics. The prognosis of the diametric distribution was performed using the movement ratio method. In the economic evaluation, it was estimated productive value of the stand, referring to the current and future carbon fixation capacity. The coefficients of determination (adjusted R²) of the equations ranged from 0.11 to 0.90 and the standard error of the estimate (Syx) ranged from 41.53% to 141.89% for the biomass of the components, and from 0.03 to 0.87 for adjusted R² and from 46.20% to 143.64% for the error, for stored carbon in the components. The total biomass of the tree component estimated was 56.25 t ha-1 and 25.88 t ha-1 of total carbon. Using the future distributions by the method of the ratio of movements, total stored carbon (aerial + roots) estimated was 14.44 t. ha-1 over the 20-year period. The productive value for the fragment reached R$ 299.95 per ha. year-1.

PMID:38088704 | DOI:10.1590/0001-3765202320200656

An Acad Bras Cienc. 2023 Dec 11;95(4):e20191247. doi: 10.1590/0001-3765202320191247. eCollection 2023.

ABSTRACT

Understanding the spatial pattern of a particular geographic phenomenon such as deforestation is a key issue to establish monitoring programs to prevent the depletion of natural resources. Thus, the goal of this study was to assess the spatial pattern of deforested areas in the Pardo and Jequitinhonha River basins using Ripley’s K function. First, we mapped all deforested areas in these basins using Landsat multispectral imagery from 2007 to 2015. Then, we used the Ripley’s K function to test for spatial interactions between deforestation events. Our results showed that deforestations predominantly occur in a clustering spatial pattern in these basins. Spatial statistical analyses as Ripley’s K function may provide a baseline for deforestation monitoring, as well as allowing us to understand the spatial pattern of deforestation in different natural ecosystems, especially in countries like Brazil, where the territorial dimension presents a great difficulty for the effectiveness of deforestation monitoring.

PMID:38088697 | DOI:10.1590/0001-3765202320191247

Sao Paulo Med J. 2023 Dec 8;142(3):e2022488. doi: 10.1590/1516-3180.2022.0488.R1.070723. eCollection 2023.

ABSTRACT

BACKGROUND: Kidney transplantation is often regarded as the preferred therapy for end-stage renal disease. Several surgical procedures have been developed to reduce postoperative donor complications, while maintaining kidney quality.

OBJECTIVE: This study aimed to compare the preoperative and postoperative outcomes of living kidney donors who underwent either transperitoneal laparoscopic nephrectomy or open nephrectomy.

DESIGN AND SETTING: Retrospective study conducted in Istanbul, Turkey.

METHODS: Fifty-five living-related kidney donors underwent nephrectomy and were retrospectively divided into two groups: 21 donors who underwent open nephrectomy (Group 1) and 34 donors who underwent transperitoneal laparoscopic nephrectomy (Group 2).

RESULTS: In comparison to the donors who underwent open nephrectomy, those who underwent transperitoneal laparoscopic nephrectomy had significantly shorter postoperative hospital stays (2.3 ± 0.2 versus 3.8 ± 0.8 days, P = 0.003), duration of urinary catheterization (1.2 ± 0.8 days versus 2.0 ± 0.7 days, P = 0.0001), operating times (210 ± 27 minutes versus 185 ± 24 minutes, P = 0.02), and less blood loss (86 ml versus 142 ml, P = 0.048). There was no statistically significant difference between the two groups with regard to the estimated blood transfusion and warm ischemia time. The preoperative week, first postoperative week, and 1-month postoperative serum creatinine levels were comparable between the groups.

CONCLUSIONS: Laparoscopic donor nephrectomy can be safely performed at centers with expertise in laparoscopic surgery. Laparoscopic donor nephrectomy has better outcomes than open donor nephrectomy in terms of length of hospital stay, duration of urinary catheterization, operating time, and blood loss.

PMID:38088685 | DOI:10.1590/1516-3180.2022.0488.R1.070723

Rev Paul Pediatr. 2023 Dec 11;42:e2023053. doi: 10.1590/1984-0462/2024/42/2023053. eCollection 2023.

ABSTRACT

OBJECTIVE: To describe the newborn population with Patau (T13) and Edwards Syndrome (T18) with congenital heart diseases that stayed in the Intensive Care Unit (ICU) of a quaternary care hospital complex, regarding surgical and non-surgical medical procedures, palliative care, and outcomes.

METHODS: Descriptive case series conducted from January/2014 to December/2018 through analysis of records of patients with positive karyotype for T13 or T18 who stayed in the ICU of a quaternary hospital. Descriptive statistics analysis was applied.

RESULTS: 33 records of eligible patients were identified: 27 with T18 (82%), and 6 T13 (18%); 64% female and 36% male. Eight were preterm infants with gestational age between 30-36 weeks (24%), and only 4 among the 33 infants had a birth weight >2500 g (12%). Four patients underwent heart surgery and one of them died. Intrahospital mortality was 83% for T13, and 59% for T18. The majority had other malformations and underwent other surgical procedures. Palliative care was offered to 54% of the patients. The median hospitalization time for T18 and T13 was 29 days (range: 2-304) and 25 days (13-58), respectively.

CONCLUSIONS: Patients with T13 and T18 have high morbidity and mortality, and long hospital and ICU stays. Multicentric studies are needed to allow the analysis of important aspects for creating protocols that, seeking therapeutic proportionality, may bring better quality of life for patients and their families.

PMID:38088680 | DOI:10.1590/1984-0462/2024/42/2023053

Rev Paul Pediatr. 2023 Dec 11;42:e2023030. doi: 10.1590/1984-0462/2024/42/2023030. eCollection 2023.

ABSTRACT

OBJECTIVE: To compare and analyze pulmonary function and respiratory mechanics parameters between healthy children and children with cystic fibrosis.

METHODS: This cross-sectional analytical study included healthy children (HSG) and children with cystic fibrosis (CFG), aged 6-13 years, from teaching institutions and a reference center for cystic fibrosis in Florianópolis/SC, Brazil. The patients were paired by age and sex. Initially, an anthropometric evaluation was undertaken to pair the sample characteristics in both groups; the medical records of CFG were consulted for bacterial colonization, genotype, and disease severity (Schwachman-Doershuk Score – SDS) data. Spirometry and impulse oscillometry were used to assess pulmonary function.

RESULTS: In total, 110 children were included, 55 in each group. In the CFG group, 58.2% were classified as excellent by SDS, 49.1% showed the ΔF508 heterozygotic genotype, and 67.3% were colonized by some pathogens. Statistical analysis revealed significant differences between both groups (p<0.05) in most pulmonary function parameters and respiratory mechanics.

CONCLUSIONS: Children with cystic fibrosis showed obstructive ventilatory disorders and compromised peripheral airways compared with healthy children. These findings reinforce the early changes in pulmonary function and mechanics associated with this disease.

PMID:38088678 | DOI:10.1590/1984-0462/2024/42/2023030