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Perspectives on perioperative management of children’s surgical conditions during the COVID-19 pandemic in low-income and middle-income countries:a global survey

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World Journal of Pediatric Surgery 2020年第3期3卷 29-36页

作者： Paul Truche Alexis Bowder Amber Trujillo Lalla Robert Crum Fabio Botelho Henry Elliot Rice bellisa caldas lopes Sarah Greenberg Faye Evans John Gerard Meara Emmanuel Adoyi Ameh David Patrick Mooney Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Boston Children's HospitalBostonMassachusettsUSA University of New Mexico School of Medicine AlbuquerqueNew MexicoUSA Hospital das Clinicas da Universidade Federal de Minas Gerais Belo HorizonteMinas GeraisBrazil Division of Pediatric General Surgery Duke Children's Hospital and Health CenterDurhamNorth CarolinaUSA Department of Pediatric Surgery Instituto de Medicina Integral Prof.Fernando FigueiraRecifeBrazil Department of Surgery University of WashingtonSeattleWashingtonUSA Division of Pediatric General&Thoracic Surgery Seattle Children’s HospitalSeattleWashingtonUSA Department of Anesthesiology Critical Care and Pain MedicineBoston Children's HospitalBostonMassachusettsUSA Department of Plastic and Oral Surgery Boston Children's HospitalBostonMassachusettsUSA Division of Paediatric Surgery Department of SurgeryNational HospitalAbujaNigeria

Background Many organizations have issued recommendations to limit elective surgery during the coronavirus disease 2019(COVID-19)*** surveyed providers of children’s surgical care working in low-income and middle-income countries(LMICs)to understand their perspectives on surgical management in the wake of the COVID-19 pandemic and how they were subsequently modifying their surgical care *** A survey of children’s surgery providers in LMICs was *** reported how their perioperative practice had changed in response to *** were also presented with 26 specific procedures and asked which of these procedures they were allowed to perform and which they felt they should be allowed to *** in surgical practice reported by respondents were analyzed *** A total of 132 responses were obtained from 120 unique institutions across 30 LMICs.117/120 institutions(97.5%)had issued formal guidance on delaying or limiting elective children’s surgical *** in LICs were less likely to have issued guidance on elective surgery compared with middle-income facilities(82%in LICs vs 99%in lower middle-income countries and 100%in upper middle-income countries,p=0.036).Although 122(97%)providers believed cases should be limited during a global pandemic,there was no procedure where more than 61%of providers agreed cases should be delayed or *** There is little consensus on which procedures should be limited or delayed among LMIC *** of testing capacity and local,context-specific guidelines may be a better strategy than international consensus,given the disparities in availability of preoperative testing and the lack of consensus towards which procedures should be delayed.

关键词： income survey testing

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Delivery of essential pediatric congenital surgical care within Brazil’s universal health coverage system:a national survey of pediatric surgeons

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World Journal of Pediatric Surgery 2023年第3期6卷 136-146页

作者： Paul R Truche Abbie E Naus Fabio Botelho Julia Ferreira Alexis Bowder Luke Caddell Kathrin Zimmerman Isabella Maria de Freitas Faria bellisa caldas lopes Eduardo Corrêa Costa Fernanda Lage Lima Dantas Augusto J S A Cavalcante Carlos A L B Carvalho Simone Abib David P Mooney Nivaldo Alonso Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Department of Pediatric Surgery McGill UniversityMontrealQuébecCanada Department of Surgery Medical College of WisconsinMilwaukeeWisconsinUSA Division of Otolaryngology-Head and Neck Surgery Department of SurgeryUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA School of Medicine UFMGBelo HorizonteMinas GeraisBrazil Department of Pediatric Surgery Instituto de Medicina Integral Professor Fernando FigueiraRecifeBrazil Department of Pediatric Surgery Hospital de Clinicas de Porto AlegrePorto AlegreBrazil Department of Pediatric Surgery Federal University of AcreRio BrancoBrazil Department of Pediatric Surgery Hospital Santa Casa de Belo HorizonteBelo HorizonteBrazil Department of Pediatric Surgery Federal University of Mato GrossoCuiabaBrazil Department of Pediatric Surgery UNIFESPSao PauloBrazil Department of Pediatric Surgery Boston Children's HospitalBostonMassachusettsUSA Department of Plastic Surgery University of São Paulo Institute of Biomedical SciencesSao PauloBrazil

Objective In this study,we assess the delivery of congenital pediatric surgical care under Brazil’s system of universal health coverage and evaluate differences in delivery between public and private *** A cross-sectional national survey of pediatric surgeons in Brazil was *** were asked which of 23 interventions identified through the Disease Control Priorities 3(Surgical Interventions for Congenital Anomalies)they perform and to report barriers faced while providing surgical *** were weighted by state and stratified by sector(public vs private).Results A sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in Brazil during the survey time.73%spend the majority of their time working in the public sector(‘SistemaÚnico de Saúde’and Foundation hospitals),and most of them also work in the private ***,Brazilian pediatric surgeons have the expertise to provide thoracic,abdominal,and urologic *** working mostly in the public sector were more likely to report a lack of access to essential medications(25%vs 9%,p<0.01)and a lack of access to hospital beds for surgical patients(52%vs 32%,p<0.01).Conclusions Brazilian pediatric surgeons routinely perform thoracic,abdominal,and urologic *** working in government-financed hospitals face barriers related to infrastructure,which may impact Brazilians who rely on Brazil’s universal health coverage *** that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.

关键词： pediatric survey Brazil

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Gastroesophageal reflux disease and non-esophageal cancer

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World Journal of Gastroenterology 2015年第3期21卷 815-819页

作者： Fernando AM Herbella Sebastiao Pannocchia Neto Ilka lopes Santoro Licia caldas Figueiredo Department of Surgery Federal University of Sao PauloSao Paulo 04037-003Brazil Pneumology Division Department of MedicineFederal University of Sao PauloSao Paulo 04037-003Brazil

The association of gastroesophageal reflux disease(GERD) and esophageal cancer is well *** carcinogenic properties of the gastroduodenal contents may also lead to cancer in target organs for GERD especially considering that they do not have intrinsic protective mechanisms as found in the *** review focuses on the putative relation between GERD and non-esophageal *** of the papers reviewed are far from ideal to prove the relationship of extraesophageal cancer and GERD since a small number ofpatients is presented,most do not control cases based on tobacco usage and obesity,and the diagnosis of GERD is variable,not always from an objective measurement such as p H monitoring but relying on symptoms in most ***,head and neck and lung cancer have a growing incidence parallel to GERD and a shift towards non-smoking,female gender and adenocarcinoma(compared to squamous cell carcinoma) is arising,similar to the example of esophageal cancer with the exception of the female gender.

关键词： Gastroesophageal reflux Cancer Pharynx Larynx Trachea Lung

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Physico-chemical characterization of acid base disorders in patients with COVID-19:A cohort study

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World Journal of Nephrology 2024年第2期13卷 16-23页

作者： Sergio Pinto de Souza Juliana R caldas Marcelo Barreto lopes Marcelo Augusto Duarte Silveira Fernanda Oliveira Coelho Igor Oliveira Queiroz Pedro Domingues Cury Rogério da Hora Passos Department of Nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of Nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： COVID-19 Physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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Can the Ucides cordatus Fishing and the Crassostrea gasar Creation on the Amazon Coast Make up the Curriculum of Rural Schools

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Journal of Fisheries Science 2021年第1期3卷 37-46页

作者： Ivaney dos Santos Cardoso Elaine Vasconcelos Bezerra Alves Leandro lopes Rodrigues Ana Célia Barbosa Guedes Luãcaldas de Oliveira Manoel Luciano Aviz de Quadros Débora Tatyane Oliveira Xavier Altevir Signor Fabricio Nilo Lima da Silva Instituto Federal de Educação Ciência e Tecnologia do Pará(IFPA)Campus Avançado VigiaRodovia PA-140Km 55próximo ao trevo de São CaetanoVigiaPará68.780-000Brasil Universidade da Amazônia(UNAMA) Campus Alcindo Cacela.Avenida Alcindo Cacela287-UmarizalBelémPará66060-000Brasil Instituto Federal de Educação Ciência e Tecnologia do Pará(IFPA)Campus Breves.Rua Antônio Fulgêncio da Silvas/n-Bairro:Parque UniversitárioBrevesPará68.800-000Brasil Faculdade Católica Paulista.Avenida Cristo Rei n 305 17515-200MaríliaSão PauloBrasil Universidade Estadual do Oeste do Paraná(UNIOESTE) Campus Toledo.Rua da Faculdade645-Jardim La Salle85903-000ToledoParanáBrasil

The fishing and ostreiculture activities practiced in the coast of the Eastern Amazon in the state of Pará,Brazil,became important to be inserted in rural ***,this literature review aimed to realize a brief theoretical discussion about the important aspects of rural education in promoting the development of fishing and *** the accomplishment of the literary research it was sought to explain the definition in education;rural education and valorization of the rural environment;environmental education as a transversal theme;fishing and aquaculture as a teaching strategy;considerations of fishing and ostreiculture;challenges and perspectives of the teaching of fishing and aquaculture in education;and booklet as a pedagogical tool in *** conclusion,the use of fishing and ostreiculture as a strategy for rural schools through environmental education is important to foster fishing activity in communities,as well as the sustainable use of natural resources.

关键词： Fishing resources Ostreiculture Environmental education Brazil

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