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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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Influence of biological maturation on cardiac autonomic recovery in female volleyball players during&after repeated sprints training:An experimental trial

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Sports Medicine and Health Science 2024年第3期6卷 279-286页

作者： Paulo Francisco de Almeida-Neto fernanda Cristina Silva de Oliveira Jose Marcondes de Oliveira-Júnior Júlio Cesar Medeiros Alves Matheus de lima Rocha Iago Medeiros da Silva Roberto Felipe Camara Rocha Paulo Moreira Silva dantas Breno Guilherme de Araújo Tinoco Cabral Health Sciences Center Federal University of Rio Grande do NorteCCS-UFRNNatal59012-570RNBrazil Department of Physical Education Federal University of Rio Grande do NorteDEF-UFRNNatal59078-970RNBrazil

Previously,it was suggested that biological maturation(BM)could be linked to cardiac autonomic recovery(CAR)in the pediatric ***,this influence hasn’t been confirmed *** aim was to investigate the impact of BM on CAR in female volleyball *** study with a sample of 38 volleyball players,comprising 20 girls(age:[11.62.1]years)and 18 women(age:[24.55.5]years),we analyzed BM,comparing maturing subjects(girls)with mature subjects(women).Additionally,we assessed peak height velocity(PHV)in *** conducted a training session involving repeated sprints(3 rounds of 6 sprints interspersed by 5 min[min]of passive rest).Using short-range radio telemetry,we analyzed CAR during(at the end of the 1st and 2nd rounds)and after(following the 3rd round)the training session of repeated sprints by applying the 60-s to 300-s heart rate recovery index(HRR-Index).Girls exhibited superior CAR compared to women(round 2:60-s,120-s,240-s,and 300-s,p0.4,p0.4,p<0.05).We have concluded that biological maturation has a significant impact on cardiac autonomic recovery.

关键词： Exercise Sport Volleyball Heart rate Pediatric

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Sepsis after Administering an Intramuscular Iron Injection in the Arm of an Elder Patient with Multiple Comorbidities: A Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 158-165页

作者： Michele Paula dos Santos Taís Michele Werle Mariana Martins dantas Santos Carolina Boeira Soares Carlos Augusto Treviso Italo Trois Maestri Stella Duarte Pinto Carolina Hack Alves Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Guilherme Boeira Soares Gabriel Lorentz Trein Aline Porto Bárbara Adelmann de lima fernanda Bercht Merten Luane Pereira Gomes Rafaela Siviero Caron-Lienert Miriam Viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of Medicine and Health Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and Health Education Porto Alegre Brazil

Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.

关键词： Critical Care Education Continuing Injectables Septicemia Soft Tissue Infections Suppuration

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