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Evaluation of the effects of SPONDIAS MOMBIN extract as an alternative antimicrobial drug
(Universidade Federal de Goiás, 2023-04-17) Taia, Thais Aratak Marques; Peres, Marcos Felipe Vilela; Oliveira, Igor Mendes Moreira de; Teófilo, Monatha Nayara Guimarães; Stoko, Natália Correia; Alves, Suzana Ferreira; Blanch, Graziela Torres; Costa, Sérgio Henrique Nascente; Borges, Leonardo Luiz; Cardoso, Alessandra Marques; Oliveira, Milton Adriano Pelli de
The extract of Spondias mombin has constituents which may improve psychiatric disorders, in addition to having antiviral, antifungal, and antimicrobial activity. But despite having several benefits, it is necessary to assess whether the extract may interfere with cell metabolism so furthermore its microbicide potential can be explored. Fifteen Wistar rats were used, divided into four groups (control group; control with extract; hyperlipidemic diet; hyperlipidemic diet and extract). For 12 weeks, the animals were weighed and their blood glucose was assessed. Afterwards, they were euthanized, and the biological material was collected. The evaluation confirmed the efficacy of the extract of S. mombin against cell metabolism of rats, without negatively altering cell viability; the group of rats with an hyperlipidemic diet showed an increase in body weight; however, in the individual assessment of the organs, there were no significant changes. The glycemic index, liver parameters, lipids, and mineral ions did not show changes. Furthermore, the antimicrobial potential of S. mombin extract was observed against Staphylococcus aureus ATCC 29213 and Staphylococcus aureus BLACC. The results suggest that S. mombin extract did not interfere with cell viability, did not show cytotoxicity to cells that were exposed to it, nor did it interfere with the metabolism, organs, and biochemical indices of rats with a standard or hyperlipidemic diet. Considering such characteristics and the potential activities observed in this present study, additional evaluation should be conducted to further assess the role of S. mombin extract as a source of new alternative antimicrobial drug as well as its possible beneficial activity to the cardiovascular system.
Spatial distribution of leprosy in municipalities of the state of Goiás in the year 2020
(Universidade Federal de Goiás, 2023-03-29) Milhomem, Antoninho Barros; Borges, Diana de Lima; Melo, Leila Medeiros; Morais Neto, Otaliba Libânio de
Leprosy is a chronic infectious disease caused by an acid-resistant bacillus called Mycobacterium leprae and the disease is characterized by its slow multiplication, with an excessively long incubation period. The objective of the research was to evaluate the spatial distribution of leprosy cases among the municipalities of the State of Goiás in 2020. This is a descriptive study and the data collection took place from the Notifiable Diseases Information System (SINAN) in November, 2021 and it considered the diagnosis´ year and the patient’s municipality of residence. The following indicators were adopted in the analysis: a) annual prevalence rate per 10,000 inhabitants; b) annual rate of new cases detection in the general population; and c) annual rate of new cases detection in individuals under 15 years of age, these last two per 100,000 inhabitants. The analysis of the spatial occurrence pattern of leprosy in Goiás State municipalities was carried out in the free software Terraview version 4.2.2. A higher prevalence of distribution of the gross rate of the disease was observed in the Central-North and Central-West macro-regions, with a concentration of cases also in the Northeast region of the State. From the 246 Goiás municipalities, 68.7% (n = 169) had cases of leprosy, 18.3% (n = 45) were in a situation of hyperendemia and 23.2% (n = 57) had a very high detection coefficient. Considering the rate of detection in those people under 15 years of age, only 11 municipalities (4.5%) were in a situation of hyperendemia and 1.2% (n = 3) had a very high detection coefficient (5.00 to 9.99/ 10.000 inhabitants). The current investigation indicates the maintenance of leprosy hyperendemic areas in the State of Goiás, when compared to previous studies. This finding highlights the importance of readjustment of leprosy management and assistance in municipalities at greater risk of leprosy hyperendemicity in order to interrupt the M. leprae transmission chain.
Neurosyphilis in patients at a university hospital in the central west region of Brazil
(Universidade Federal de Goiás, 2023-07-06) Rosa, Pâmella Wander; Borges, Moara Alves Santa Bárbara; Coutinho, João Victor Soares Coriolano; Teles Filho, Ricardo Vieira; Guilarde, Adriana Oliveira
Syphilis remains a significant public health concern, and the central nervous system (CNS) involvement may occur at any stage of infection. Neurosyphilis must be ruled out in patients diagnosed with syphilis and exhibiting neurological or psychiatric symptoms, and cerebrospinal fluid (CSF) examination should be performed prior to treatment. A cohort of patients with neurosyphilis (aged ≥18 years old) was studied in a university hospital in the Central West Region of Brazil from 2018 to 2021. Twenty-four patients met the criteria for inclusion of confirmed neurosyphilis; 17 (70%) were male, with a median age of 37.5 (22–64). Six were asymptomatic, one had isolated otosyphilis, 11 had ocular syphilis, one had both ocular and otosyphilis, and five had other neurological symptoms. Thirteen patients (54%) were coinfected with HIV. Visual changes (50%) were the most common symptom; otosyphilis was present in 8.3%. Fourteen patients (58%) had positive VDRL in the CSF, and the median CSF-VDRL titer was 1:4. The cure rate was 87%, with three cases having persistent CSF-VDRL positivity after six months from the first treatment. In conclusion, understanding neurosyphilis, its clinical diversity, and its epidemiological and laboratory profile allows early diagnosis and treatment, consequently reducing its morbidity
Multisystem inflammatory disorder in children and kawasaki disease in the course of the SARS-COV-2 pandemic
(Universidade Federal de Goiás, 2023-10-18) Machado, Gabriela Stefany Lopes; Lima, Vitor Carvalho; Bicudo, Lucilene Arilho Ribeiro
After the onset of the new SARS-CoV-2 coronavirus pandemic, several countries reported an increase in cases of Kawasaki Disease (KD) in the pediatric centers. KD, also called mucocutaneous lymph node syndrome, presents as an acute, multisystem pediatric vasculitis of unknown etiology. In this present study, we research to determine the influence of SARS CoV-2 on the manifestation of KD, the overlap with the so-called Multisystem Inflammatory Syndrome in children (MIS-C) and to compare the main characteristics of these pathologies, since this relationship was evidenced throughout the year of 2020 with pediatric patients infected with coronavirus. To carry out the work, it was performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. Articles published or pre-published in the PubMed and Scielo databases in 2020 were considered. A total of 924 scientific articles were identified, and after excluding duplicates from the selection and data extraction, 52 remained for data comparison. None of the analyzed parameters, such as clinical manifestation, age of affected patients, laboratory variants showed a significant difference between the two groups, associated with the fact that there was no increase in the number of KD cases in the absence of concomitant SARS-CoV-2 infection, compared to pre-pandemic period. Thus, we conclude that MIS-C and KD concomitant with Coronavirus Disease 2019 (COVID-19) were named without technical criteria given the urgency in publishing information during the period of severity of the COVID-19 pandemic.
Evaluation of the snakebite severity in the brazilian midwest
(Universidade Federal de Goiás, 2023-07-03) Coutinho, João Victor Soares Coriolano; Guimarães, Taiguara Fraga; Valente, Bruno Borges; Tomich, Lísia Gomes Martins de Moura
Snakebites are of important public health concern as they can progress in severity and they may cause death, especially in populations with low socioeconomic status or in rural areas of tropical countries. In this retrospective cross-sectional study, we evaluated the clinical-epidemiological profiles of patients admitted for snakebites envenoming at a Reference Hospital in Goiás State, Brazil, from January 2018 to November 2019 with criteria and definitions for venomous accidents notified by the Epidemiological Surveillance Center. Of 326 reported cases, 268 (82.2%) involved Bothrops, 56 (17.9%) involved Crotalus, and 1 (0.3%) involved an elapid. The remaining case (0.3%) was caused by an unidentified snake, as the clinical signs were suggestive of both Bothrops and Crotalus envenomation and the patient received bivalent antivenom serum. Most snakebites occurred in men (n= 252, 77%) and in individuals from rural areas (n= 215, 65.9%). Pain occurred in 315 (96.9%) patients and edema in 274 (84.3%), being more common in the bothropic accidents. In the crotalic accidents, pain occurred in 50 (89.3%) patients and edema in 24 (44.9%). The snakebite severity was considered mild in 107 (32.8%), moderate in 129 (39.8%), and severe in 90 (27.6%) patients. Acute renal injury was the most common systemic complication, occurring in 64 patients (19.9%), while secondary infection was the most important local complication, occurring in 155 (47.5%) patients. Most cases were classified as moderate or severe, probably because our tertiary level hospital service handles with more complex cases. Additionally, a significant number of crotalic accidents had a local presentation, indicating that the venom of snakes in the region has a particular composition.
Factors for unfavorable evolution of snakebites in children
(Universidade Federal de Goiás, 2023-04-13) Coutinho, João Victor Soares Coriolano; Silva, Marcos Vinicius da; Guimarães, Taiguara Fraga; Valente, Bruno Borges; Tomich, Lísia Gomes Martins de Moura
Pediatric patients have particularities in the clinical manifestations and complications of snakebite envenomation (SBEs), and few studies have examined this population. The objective of this paper was to study snakebites in a pediatric age group treated at a reference hospital and to evaluate factors associated with unfavorable evolution. A cross-sectional study with a clinical-epidemiological description and identification of the factors related to unfavorable evolution in patients aged <19 years old seen from January, 2018 to November, 2019 was performed. Complications related to the SBE, such as compartment syndrome, secondary infection, extensive necrosis, hemorrhage, and kidney damage, were considered unfavorable evolution. From the 325 patients in the sample, 58 were aged <19 years old; 40 (69%), 0-12 years old; and 18 (31%), 13-18 years old. All patients had local manifestations (mild, moderate, and severe), and 36 (62%) had an unfavorable evolution. Fourteen (24.1%) patients had compartment syndrome, with a significant risk association between 0 and 12 years old (p = 0.019). Two factors significantly contributed to unfavorable evolution: the timing from the bite to medical care being ≥6 hours and additional antivenom therapy needed. We conclude that the younger the patient, the smaller body segment affected, leading to disproportionality between the affected area and the amount of inoculated venom, contribute to more frequent local manifestations and complications in children rather than adults. Because of the relationship between body area and vascular volume in children differs from that in adults, the same volume of venom inoculated by snakes will be disproportionate in these two groups. Therefore, in the treatment of pediatric patients, increasing the volume of antivenom therapy is possibly necessary. Furthermore, as in adults, six hours between the bite to medical care increases the risk of complications and mortality.
Acquired antiretroviral drug resistance mutations upon treatment failure in hiv-1 infected pediatric patients in central brazil
(Universidade Federal de Goiás, 2020-09-09) Albuquerque, Maly de; Marques, Solomar Martins; Teles-Filho, Ricardo Vieira; Costa, Paulo Sérgio Sucasas da
Tuberculose latente em indivíduos de uma unidade prisional do centro oeste do Brasil
(Universidade Federal de Goiás, 2016-02-25) Costa-Junior, Abadio Oliveira; Silva Júnior, José Laerte Rodrigues da; Costa, Adeliane Castro da; Kipnis, André; Rabahi, Marcelo Fouad; Junqueira-Kipnis, Ana Paula
Tuberculosis (TB) is the second main cause of death by infectious diseases worldwide and is a persistent world public health problem. The prevalence of active TB among individuals deprived of freedom (DF) is greater than in the general population average. Late diagnosis and delayed adequate treatment aggravates the TB problem within correctional facilities. In spite of being tightly closed institutions, prisoner movement within the different departments of the institution as well as outside the prison walls, such as visits to courthouses, have resulted in these facilities becoming significant TB reservoirs. The purpose of this work was to perform the tuberculin skin test (TST) among DF volunteers. 50.3% men and 38.1% women tested positive in this first test within the premises a correctional facility in Goiás. The one-year follow up revealed that 1.7% (n=9) of the volunteers developed active TB, 4 of which were in the same male prison ward. The high infection and disease incidence reinforce the urgent need for latent infection diagnosis, as well as recruitment of these individuals in general for testing
Diagnosis of chromoblastomycosis: an historical review
(Universidade Federal de Goiás, 2022-07-21) Borges, Jules Rimet; Eda, Yann Victor Medeiros; Ianhez, Mayra; Garcíazapata, Marco Tulio Antonio
Chromoblastomycosis is a skin infection caused by dematiaceous fungi, characterized by a verrucous plaque on the limbs. It mainly affects rural workers in tropical countries. The purpose of this review is to identify how the diagnostic methods used in the propaedeutic of chromoblastomycosis emerged and were developed. The MeSH terms “chromoblastomycosis” or “chromomycosis” or “verrucous dermatitis” and “diagnosis” were used to search articles indexed in MEDLINE and LILACS databases. The description of a first-time-used method in diagnosing chromoblastomycosis or modifications and innovations in an existing technique was the criteria used to deem the article eligible. The first methods described in diagnosing chromoblastomycosis were histopathological examination and culture, which characterizes and defines the disease in the early 20th century. Subsequently, they were described as direct microscopic examination, fine needle aspiration for cytology, electron microscopy, serology, molecular tests, scintigraphy, nuclear magnetic resonance and dermoscopy. Tests based on the direct identification of the fungus through biopsy, culture, or direct microscopy are the oldest and more employed methods for diagnosing chromoblastomycosis. The polymerase chain reaction was introduced in the last few decades and is a promising technique. Dermoscopy of chromoblastomycosis shows blackish red dots and white and pink areas along with scaling. Other techniques, such as serology and skin testing for delayed-type hypersensitivity, have not been incorporated into clinical practice.
Occurrence of potentially highly pathogenic free-living amoebae in ready made salads from restaurants in Jatai, Goias, Brazil
(Universidade Federal de Goiás, 2022-04-18) Moura, Vanessa Oliveira Lopes de; Dornelas, Júlia Batista; Moraes, Laís Silva Pinto de; Torrente, Leticia Ferreira; Rezende, Stéfanne Rodrigues; Oliveira, Tainá Francisca Cardoso de; Costa, Webster Leonardo Guimarães da; Braoios, Alexandre; Alves, Daniella de Sousa Mendes Moreira; Rezende, Hanstter Hallison Alves
Free-living amoebae (FLA) are part of a group of protozoa found worldwide and in the most diverse environments. They resist various temperatures and disinfection methods, and are a risk to human health. Pathogenic strains grow at high temperatures and under hyperosmolarity conditions. Some FLA genera are mainly related to primary amoebic meningoencephalitis (PAM), skin ulcerations, corneal lesions, kidney and lung infections and keratitis. Therefore, studies that assess the pathogenic potential of FLA are public health issues of great concern. We aimed to evaluate the pathogenic potential of FLA isolated in salads from restaurants in vitro, using osmotolerance and thermotolerance tests. Forty-five isolates were used from ready-made salads purchased in restaurants in Jatai, Goias. Twelve isolates subjected to the osmotolerance test (26.6%) showed growth in 0.5 M mannitol, 18 (40.0%) in 1.0 M mannitol and 16 (35.5%) in 1.5 M mannitol, 13 (28.8%) isolates did not show growth. Four isolates that underwent the thermotolerance test (8.9%) showed growth at 25°C, 8 (17.8%) showed growth at 30°C, 3 (6.7%) showed growth at 37°C and 30 (66.7%) did not show growth. With the indices obtained in the present study, we concluded that 15.6% of the isolates were osmotolerant and thermotolerant. Our findings highlight a public health problem once these FLA are associated with harboring or being harbored by microorganisms responsible for diseases such as diarrhea and meningitis. Measures are required to improve food hygiene and so avoid FLA-related health problems.
Chemical composition, larvicidal activity and residual effect of Pterodon polygalaeflorus (Benth.) benth. (Fabaceae) fruit oil extracts against Aedes aegypti (Diptera: Culicidae)
(Universidade Federal de Goiás, 2020-01-28) Menezes, Armanda Amando Teles de; Beltrão, Tayrrana Silva; Silva, Liliane Sousa; Silva, Heloisa Helena Garcia da; Silva, Ionizete Garcia da; Paula, Jose Realino de; Romano, Camila Aline; Guissoni, Ana Carla Peixoto
The purpose of this study was to investigate the larvicidal activity of Pterodon polygalaeflorus oil extract against the mosquito vector Aedes aegypti. For this, crushed P. polygalaeflorus fruit underwent solvent extraction to obtain the oil extract. The chemical characterization was performed by gas chromatography coupled to mass spectrometry. For the bioassays third instar larvae of Ae. aegypti were utilized. Tests were carried out to determine the larvicidal activity and the residual effect under laboratory conditions, as well as field screening (small scale). The major components of P. polygalaeflorus oil extract were, respectively, E-caryophyllene, germacrene D and bicyclogermacrene. Lethal concentrations of 50% and 90% were 36.5 and 64.8 μg/mL respectively. The solution presented a residual effect for seven days and the efficiency of the product was preserved under field conditions. The results encourage continuing studies with the oil extract of P. polygalaeflorus as a research target for bioinsecticides.
Detection of DNA and anti-Toxoplasma gondii antibodies in errant cats (felis catus domesticus, linnaeus, 1758) captured by the zoonoses control center of Goiânia, state of Goiás, Brazil
(Universidade Federal de Goiás, 2019-12-02) Rezende, Hanstter Hallison Alves; Igreja, Jaqueline Ataíde Silva Lima da; Gomes Junior, Antonio Roberto; Melo, Jade de Oliveira; Storchio, Heloísa Ribeiro; Gomes, Taynara Cristina; Vinaud, Marina Clare; Castro, Ana Maria de
The purpose of this study was to verify the seropositivity of IgG antiT. gondii antibodies in serum samples and to detect T. gondii DNA detection in tissue from stray cats captured by the Zoonosis Control Center (ZCC)of Goiânia, state of Goiás, during 2016. Antibodies were analyzed by means of an indirect hemagglutination assay (IHA), while DNA was detected by polymerase chain reaction (PCR), using primers that amplify the B1 gene in specimens of brain, muscle and heart from the animals. The serological analysis revealed that 87.4% (21/24) of the cats were positive and the molecular test indicated a positivity rate of 75% (18/24). These high rates of serological and molecular detection are worrisome for public health because they confirm the important role cats play in environmental contamination, and hence, in the transmission of toxoplasmosis to humans.
A educação permanente em saúde e os desafios das Comissões de Integração em Ensino Serviço
(Universidade Federal de Goiás, 2020-12-31) Lemos, Cristiane Lopes Simão; França, Mary Anne de Souza Alves; Pereira, Edsaura Maria; Pereira, Fernando Marcello Nunes; Alves, José Antonio Oliveira
In 2004 the Ministry of Health created the National Policy on Permanent Education in Health (PNEPS), which has as a pedagogical concept the Permanent Education in Health (EPS). The GM/MS Administrative Rule No. 1996, of 2007, aligned PNEPS with the intention regarding regionalization strengthening, structuring the Services and Education Integration Commissions (CIES). This research analyzes the context of the PNEPS structure in the state of Goiás, through the implementation of the CIES, from 2009 to 2018. It’s a qualitative study, performed through the analysis of documents and interviews with PNEPS managers in this universe. Although the CIES structured in this period, was observed that, the decentralization of the EPS barely advanced, evidencing difficulty points such as: the low execution of actions by the CIES, the discontinuity of the formative processes, educational actions disconnected from PNEPS and poor transparency in regards to the use of the financing of EPS’s actions.
Accuracy in clinical examinations for the diagnosis of vulvovaginitis by Candida ssp. and In vitro susceptibility to the main antifungals
(Universidade Federal de Goiás, 2020-09-29) Santos, Andressa Santana; Zara, Ana Laura de Sene Amâncio; Ataídes, Fábio Silvestre; Gomes, Elisangela Christhianne Barbosa da Silva; Freitas, Vivianny Aparecida Queiroz; Costa, Carolina Rodrigues; Silva, Thaísa Cristina; Silva, Maria do Rosário Rodrigues
Vulvovaginal candidiasis (VVC) is a common infection. This work aims to determine the positive predictive value (PPV) of the clinical diagnosis of VVC and to characterize Candida species isolated from the vaginal mucosa. This cross-sectional study was conducted from February 2016 to February 2017 at the Gynecology and Obstetrics Outpatient Clinic of the Hospital das Clínicas, in Goiânia, Goiás State, Brazil. The study included samples of vaginal secretion from 55 women who complained of vaginal discharge and itching as their main symptoms. The PPV of the clinical diagnosis of VVC was estimated in comparison to the laboratory culture method. The phenotypic methods and molecular tests were performed to identify Candida spp. In vitro susceptibility of Candida spp. isolates to fluconazole, itraconazole, clotrimazole, nystatin, and amphotericin B was determined using the broth microdilution assay. Yeast growth using the enzymes protease, phospholipase, and hemolysin was carried out in media containing respectively bovine albumin, egg yolk, and sheep erythrocytes. A PPV of 61.8% (34/55) was determined. Among the 55 vulvovaginal samples collected, we identified 36 isolates in which C. albicans was the most common species. High resistance to fluconazole and low minimal inhibitory concentration (MIC) values for clotrimazole, nystatin and amphotericin B were observed. All isolates were proteinase and hemolysin producers, while seven strains were phospholipase negative. The clinical diagnosis of VVC presented a moderate PPV, which meant that cultures had to be conducted in the laboratory to confirm infection. The high resistance to fluconazole and itraconazole indicated the importance of the in vitro susceptibility test.
Meningoencephalitis and optical neuritis caused by Cryptococcus gattii in an immunocompetent patient
(Universidade Federal de Goiás, 2020-12-21) Souza, Beatriz Antunes de; Souza, Luiz Carlos Silva; Guilarde, Adriana Oliveira; Barbosa, Alexandre Augustus Costa; Ferreira Filho, Luiz Alves; Souza, Marta Antunes de
The following case is of a 59-year-old man, undergoing no medication, with no pathological history or others risk factors, who presented dizziness, fever and asthenia twenty days before admission. The patient was admitted for investigation when the asthenia intensified, followed by seizures. On admission, blood count, biochemical tests and chest computed tomography were normal, a serological test for anti-HIV proved negative, while the magnetic resonance of the brain showed signs suggestive of meningoencephalitis. Cerebrospinal fluid (CSF) analysis suggested bacterial meningitis due to increased leukocytes with a predominance of polymorphonuclear cells, reduced glucose and increased proteins as well as positive Gram cocci in pairs by Gram and negative fungi by India ink test. Treatment with ceftriaxone was started. Since there was no significant improvement, CSF analysis was repeated on the seventh day of treatment. Intracranial pressure was measured by manometry (29 mmHg) and CSF analysis showed the presence of encapsulated yeasts similar to Cryptococcus neoformans by the India ink test. The treatment was modified to liposomal amphotericin B and flucytosine; the intracranial hypertension was controlled by repeated CSF punctures. After fourteen days of antifungal treatment, the patient presented visual turbidity and bilateral papillar edema, so corticosteroid therapy was prescribed. The evolution was favorable, with progressive resolution of symptoms, improvement of CSF parameters and visual acuity. The patient was discharged eight weeks after admission, with outpatient guidance. Corticosteroid therapy associated with antifungal therapy proved to be beneficial in this case, since following the introduction of corticosteroids there was progressive visual improvement.
Detection of salivirus in raw sewage samples in Rio de Janeiro, Brazil
(Universidade Federal de Goiás, 2020-05-27) Sales, Marcelle Figueira Marques da Silva; Caldas, Mariana Seglia; Fioretti, Julia Monassa; Rocha, Mônica Simões; Fumian, Túlio Machado; Miagostovich, Marize Pereira
Yokenella regensburgei osteoarticular infection: a case report
(Universidade Federal de Goiás, 2021-12-22) Guilarde, Adriana Oliveira; Teles Filho, Ricardo Vieira; Padilha, Daniella da Mata; Mendes, Aderrone Vieira; Matsunaga, Kely Tiemi; Kipnis, André; Godoi, Ariana Rocha Romão
Yokenella regensburgei belongs to the family Enterobacteriaceae and is an opportunistic agent rarely associated with infections in humans. We report a case of osteoarticular knee infection caused by Y. regensburgei in a patient under treatment for rheumatoid arthritis, using corticosteroids, with complication in primary total arthroplasty of the knee. Y. regensburgei was identified using the VITEK2 system. Antimicrobial susceptibility testing was performed using the disk-diffusion method, according to the guidelines from the Clinical and Laboratory Standards Institute. The patient presented favorable clinical evolution after the second debridement, with complete removal of the prosthesis and antibiotic therapy with sulfamethoxazole/trimethoprim. This is the first case of Y. regensburgei infection described in Brazil
Temporal trends of ventilatorassociated pneumonia in adult intensive care units in the municipality of Goiânia, Goiás, Brazil
(Universidade Federal de Goiás, 2021-12-22) Alves, Ana Caroliny Faria; Santos, Silvana de Lima Vieira dos; Silva, Alexsandra Gomes Resende de Souza da; Nascimento, Júlio César Coelho do; Galdino Júnior, Hélio; Mendonça, Katiane Martins; Alves, Sergiane Bisinoto; Neves, Heliny Carneiro Cunha
Given the potential for morbidity and mortality of ventilator-associated pneumonia (VAP), the profile of these infections in adult intensive care units was evaluated in the city of Goiânia. Data were collected from a secondary base in the Department of Prevention and Control of Infection in Health Services, of the Municipal Health Department of Goiânia, from 2014 to 2016, in private (82.7%), public (17.2%), and philanthropic (6.0%) health care services. The rate of use of mechanical ventilation did not change significantly over the three years (32.6%). However, there was a decrease in the mean of VAP incidence density, and in 2016 there was a reduction of 7% in the 90th percentile. These reductions highlight the benefit of the implementation and adherence to bundles by the multidisciplinary team.
Identifying student profiles and their impact on academic performance in a Brazilian undergraduate student sample
(2012) Silva, Erica Tatiane da; Nunes, Maria de Fátima; Santos, Laura Barbosa; Queiroz, Maria Goretti; Leles, Cláudio Rodrigues
The recognition of the student profile provides strategic information for planning educational policies in the university environment. The aims of this study were to identify natural segmentation of freshman undergraduate dental students based on demographic, socioeconomic and educational variables, and to subsequently investigate their impact on academic performance of Brazilian undergraduate students. Cluster analysis (two-step algorithm) was used to segment students who entered dental school in the time period from 1999 to 2001 (n = 158) into groups based on responses to a questionnaire completed by students at the time of the admission examination. Clustering analysis revealed three natural groups. Age, the parents’ level of education, and performance on the first admission test were the most important variables for cluster segmentation. Cluster 1 (n = 42; 26.6%) was characterized by female students with higher socioeconomic status and better previous educational indicators. Cluster 2 (n = 62; 39.2%) represented disadvantaged socioeconomic profiles, with a predominance of females and older students. Cluster 3 (n = 54; 34.2%) showed similar socioeconomic characteristics to cluster 1, except for male prevalence, higher age, and experiencing difficulty in the admission test. Clusters’ academic performance was satisfactory in both overall course and course groups (grade point average of at least 7.0), with average ranging from 7.89 (SD = 0.44) to 8.13 (SD = 0.31) and 7.37 (SD = 0.75) to 8.31(SD = 0.26), respectively. Our findings provide encouraging evidence for the current context of equality of access to education and reveal the importance of financial support to maximize successful educational experiences of socioeconomically disadvantaged dental students.
Cross-cultural adaptation and validation of the brazilian version of the Wisconsin Brief Pain Questionnaire
(2013-07) Toledo, Flávia Oliveira; Barros, Patrícia de Sá; Herdman, Michael; Vilagut, Gemma; Reis, Geraldo C.; Alonso, Jordi; Sobreira, Cláudia Ferreira da Rosa
Context. Chronic pain is a common complaint among patients with muscular disease. The Wisconsin Brief Pain Questionnaire (WBPQ) has been used to quantify pain severity and pain interference with daily functions. Objectives. To translate the WBPQ for use with Brazilian patients and to evaluate the psychometric properties of the adaptation. Methods. We conducted a cross-cultural adaptation of the original English version of the WBPQ for use in Brazil (WBPQ-B) and evaluated the psychometric properties of the adapted version. The original questionnaire was translated, evaluated by an expert panel, pilot tested in 40 patients, and back-translated. Subsequently, the tool was administered, in a cross-sectional study, to 100 adult patients who had muscular disease and were being attended to at our university hospital. Results. We performed a confirmatory factor analysis and assessed the reliability and validity of the questionnaire (Appendix). The two-factor structure (pain intensity and pain interference) was confirmed satisfactorily. Internal consistency for both scales was adequate (Cronbach’s alpha ¼ 0.74 and 0.79, respectively), as was the interrater stability (intraclass correlation coefficients ¼ 0.88 and 0.92, respectively). Convergent validity with the 36-Item Short Form Health Survey was supported by confirmation of a priori hypotheses of negative and satisfactory correlations between the WBPQ-B and some of the 36-Item Short Form Health Survey domains. The pain interference scale correlated higher with the mental summary component. Known-group validity analysis showed that the pain intensity items and scale of the WBPQ-B were higher in the groups where patients with exercise intolerance were concentrated.Conclusion. We found the WBPQ-B to be a reliable and valid instrument for pain assessment of Brazilians who have muscular disease. The survey presents similar psychometric properties to the original version. J Pain Symptom Manage 2013;46:121e130. 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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