Objetivos de Desenvolvimento Sustentável - ODS
URI Permanente desta comunidade
Comunidade temática que disponibiliza a produção científica do Sistema FMUSP-HC de acordo com os Objetivos do Desenvolvimento Sustentável (ODS). Os ODS são 17 metas globais, para alcance até 2030, estabelecidas pela Assembleia Geral das Nações Unidas, que tem como finalidades primordiais: acabar com a pobreza, proteger o meio ambiente e o clima e garantir que as pessoas, em todos os lugares, possam desfrutar de paz e de prosperidade.
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- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
- ODS - Objetivos de Desenvolvimento Sustentável
Submissões Recentes
Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
Combined transcatheter aortic valve replacement and left atrial appendage occlusion in patients ineligible for oral anticoagulation: A case series
(2022) FREIRE, A. F. D.; FILIPPINI, F. B.; BIGNOTO, T. C.; BRITO, P. H. F. de; NICZ, P. F. G.; MELO, P. H. M. C. D.; SILVA, R. C. e; QUEIROGA, M.; RIBEIRO, H. B.; PROCóPIO, A. G. M.; BEZERRA, C. G.; GRUBE, E.; ABIZAID, A.; FILHO, R. K.; BRITO JR., F. S. de
Patients presenting with aortic stenosis and atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR) are commonly at increased risk for stroke and bleeding complications. Concomitant left atrial appendage occlusion (LAAO) after TAVR may be an alternative to oral anticoagulation (OAC). Between 2018 and 2022, 7 consecutive patients who were ineligible for OAC underwent simultaneous TAVR and LAAO. The mean age was 84.9 ± 4.9 years. The mean CHA2DS2-VASc, HAS-BLED, and STS predicted risk of mortality scores were 5.9 ± 0.7, 3.9 ± 1.1, and 8.8 ± 3.4%, respectively. The median follow-up time was 23 (1 to 27) months. All procedures achieved technical success and no adverse events were observed during follow-up. This case series shows that concomitant TAVR and LAAO is feasible and safe among patients with severe aortic stenosis and AF who are deemed ineligible for OAC. Learning objectives: Atrial fibrillation is the most common arrhythmia in the transcatheter aortic valve replacement (TAVR) population. In those who experience major or life-threatening bleeding, mortality is doubled. We report a case series of 7 concomitant left atrial appendage occlusions (LAAO) after TAVR in patients ineligible for oral anticoagulation. All procedures achieved technical success and no adverse events were observed. The simultaneous approach with TAVR and LAAO was feasible and safe in this case series.
Delayed left main coronary obstruction following transfemoral inovare transcatheter aortic valve replacement: A challenging case
(2022) KANHOUCHE, G.; CIVIDANES, F. R.; SAMPAIO, R. O.; SILVA, J. C. A. da; MACHADO, R. D.; WERNECK, M.; ACCORSI, T. A. D.; MORALES, K. R. D. P.; ABIZAID, A. C.; BRITO, F. S. D. Jr.; TARASOUTCHI, F.; PALMA, J. H.; RIBEIRO, H. B.
Coronary obstruction is an uncommon and severe complication after a transcatheter aortic valve replacement (TAVR), that occurs during the procedure in the vast majority of patients. In the present case even in the absence of classic risk factors, an acute coronary syndrome occurred one day after TAVR. Selective angiography revealed a severe left main ostium obstruction by the bulky native leaflet calcification. This is the first case of delayed presentation of coronary obstruction with a transfemoral balloon-expandable valve using the Inovare bioprosthesis (Braile Biomedica, Brazil). In addition, after drug-eluting stent placement in the left main coronary, intravascular ultrasound revealed severe stent underexpansion, so that a second layer of a bare-metal stent and high-pressure balloon post-dilatation was necessary to improve the final result. The patient was discharged after 7 days, and at the 6-month follow-up remained asymptomatic.
Comparison of Quality of Life in Breast Cancer Survivors with and without Persistent Depressive Symptoms: A 12-Month Follow-Up Study
(2023) RIBEIRO, F. E.; TEBAR, W. R.; FERRARI, G.; PALMA, M. R.; FREGONESI, C. E.; CALDEIRA, D. T.; SILVA, G. C. R.; VANDERLEI, L. C. M.; BERETTA, V. S.; CHRISTOFARO, D. G. D.
Although breast cancer treatments reduce mortality, their adverse effects can increase depression which impacts one’s quality of life (QoL). Physical activity (PA) seems to improve the QoL of breast cancer survivors (BCS). However, an unanswered question is the influence of PA on the QoL in BCS with depressive symptoms. Thus, we analyzed the influence of PA on the QoL in BCS with persistent depressive symptoms during 12 months of follow-up. The sample included 70 female BCS. Depression and QoL domains (i.e., functional capacity, physical limitations, body pain, general health status, vitality, social and emotional aspects, and mental health) were assessed at baseline and follow-up periods by the Hospital Anxiety and Depression Scale and SF-36, respectively. Habitual PA was assessed by Baecke’s questionnaire. Our results indicate a prevalence of 17.1% of depressive symptoms. Non-depressives BCS improved their physical limitations and general health status domains over time, but there were no observed differences in depressive BCS. BCS with persistent depressive symptoms (baseline and follow-up) showed worse QoL scores than non-depressives in all domains, regardless of confounding factors. When adjusted for PA, the difference between BCS depressives and non-depressives lost its significance in the functional capacity domain. In conclusion, habitual PA practice positively influenced the functional capacity domain of the QoL in BCS.
Application of thermography to estimate respiratory rate in the emergency room: The journal Temperature toolbox
(2023) ALDRED, A.; RIBEIRO, J. A. S.; BEZERRA, P. M. S.; ANTUNES, A. C. M.; GOULART, A. C.; DESUó, I. C.; GOMES, G.
Among the vital signs collected during hospital triage, respiratory rate is an important parameter associated with physiological, pathophysiological, and emotional changes. In recent years, the importance of its verification in emergency centers due to the severe acute respiratory syndrome 2 (SARS2) pandemic has become very clear, although it is still one of the least evaluated and collected vital signs. In this context, infrared imaging has been shown to be a reliable estimator of respiratory rate, with the advantage of not requiring physical contact with patients. The objective of this study was to evaluate the potential of analyzing a sequence of thermal images as an estimator of respiratory rate in the clinical routine of an emergency room. We used an infrared thermal camera (T540, Flir Systems) to obtain the respiratory rate data of 136 patients, based on nostrils’ temperature fluctuation, during the peak of the COVID-19 pandemic in Brazil and compared it with the chest incursion count method, commonly employed in the emergency screening procedures. We found a good agreement between both methods, with Bland-Altman limits of agreement ranging from −4 to 4 min−1, no proportional bias (R2 = 0.021, p = 0.095), and a strong correlation between them (r = 0.95, p < 0.001). Our results suggest that infrared thermography has potential to be a good estimator of respiratory rate in the routine of an emergency room.
Effect of Menstrual Cycle Phase on Fuel Oxidation Post HIT in Women Reproductive Age: A Pilot Study
(2023) FRIENTES, C. S.; MARQUEZI, M. L.; APARECIDO, J. M. L.; CASCAPERA, M. S.; ROGERI, P. S.; LANCHA JUNIOR, A. H.
Women of childbearing age have variations in substrate oxidation rates that can lead to overweight, type II diabetes, and other conditions that may be associated with metabolic inflexibility and the variations in estrogen concentrations observed during the monthly ovarian cycle. Purpose: This study aimed to verify and compare the influence of eight treadmill high-intensity interval training (HIT) sessions on carbohydrate and lipid oxidation rates (CHOox and LIPox, respectively) and intensities of ventilatory anaerobic thresholds (VATs) of women in different phases of the monthly ovarian cycle. Methods: Eleven irregularly active women performed incremental treadmill exercise testing followed by submaximal work-rate running for 45 min to determine VATs, VO2peak, peak velocity (Vpeak), and substrate oxidation rates, before and after a training period, in different phases of their monthly ovarian cycle (follicular phase group, FL, n = 6; luteal phase group, LT, n = 5). The training period consisted of eight HIT sessions, composed each one of eight sets of 60 s running at 100%Vpeak interspersed by 75 s recovery every 48 h. Results: Our results showed no significant differences in VATs intensities between groups. The comparison between groups showed significant differences in relative energy derived from CHO pre- and post-training of −61.42% and −59.26%, respectively, and LIP pre- and post-training of 27.46% and 34.41%, respectively. The relative energy derived from CHO after the training period was 18.89% and 25.50% higher for FL and LT, respectively; consequently, the relative energy derived from LIPox after the training period was 8,45% and 3.46% lower for FL and LT, respectively. Over the training period, Vpeak was ~13.5 km/h, which produced the relative intensities of ~89%VO2peak e ~93%HRpeak for both groups. Conclusion: The monthly ovarian cycle phases promote significant changes in substrate oxidation rates leading to a decrease in CHOox. High-intensity interval training can minimize the differences observed and constitute an alternative intervention.
Glycemic Variability and Fluctuations in Cognitive Status in Adults With Type 1 Diabetes (GluCog): Observational Study Using Ecological Momentary Assessment of Cognition
(2023) FONSECA, L. M.; STRONG, R. W.; SINGH, S.; BULGER, J. D.; CLEVELAND, M.; GRINSPOON, E.; JANESS, K.; JUNG, L.; MILLER, K.; PASSELL, E.; RESSLER, K.; SLIWINSKI, M. J.; VERDEJO, A.; WEINSTOCK, R. S.; GERMINE, L.; CHAYTOR, N. S.
Background: Individuals with type 1 diabetes represent a population with important vulnerabilities to dynamic physiological, behavioral, and psychological interactions, as well as cognitive processes. Ecological momentary assessment (EMA), a methodological approach used to study intraindividual variation over time, has only recently been used to deliver cognitive assessments in daily life, and many methodological questions remain. The Glycemic Variability and Fluctuations in Cognitive Status in Adults with Type 1 Diabetes (GluCog) study uses EMA to deliver cognitive and self-report measures while simultaneously collecting passive interstitial glucose in adults with type 1 diabetes. Objective: We aimed to report the results of an EMA optimization pilot and how these data were used to refine the study design of the GluCog study. An optimization pilot was designed to determine whether low-frequency EMA (3 EMAs per day) over more days or high-frequency EMA (6 EMAs per day) for fewer days would result in a better EMA completion rate and capture more hypoglycemia episodes. The secondary aim was to reduce the number of cognitive EMA tasks from 6 to 3. Methods: Baseline cognitive tasks and psychological questionnaires were completed by all the participants (N=20), followed by EMA delivery of brief cognitive and self-report measures for 15 days while wearing a blinded continuous glucose monitor. These data were coded for the presence of hypoglycemia (<70 mg/dL) within 60 minutes of each EMA. The participants were randomized into group A (n=10 for group A and B; starting with 3 EMAs per day for 10 days and then switching to 6 EMAs per day for an additional 5 days) or group B (N=10; starting with 6 EMAs per day for 5 days and then switching to 3 EMAs per day for an additional 10 days). Results: A paired samples 2-tailed t test found no significant difference in the completion rate between the 2 schedules (t17=1.16; P=.26; Cohen dz=0.27), with both schedules producing >80% EMA completion. However, more hypoglycemia episodes were captured during the schedule with the 3 EMAs per day than during the schedule with 6 EMAs per day. Conclusions: The results from this EMA optimization pilot guided key design decisions regarding the EMA frequency and study duration for the main GluCog study. The present report responds to the urgent need for systematic and detailed information on EMA study designs, particularly those using cognitive assessments coupled with physiological measures. Given the complexity of EMA studies, choosing the right instruments and assessment schedules is an important aspect of study design and subsequent data interpretation. ©Luciana Mascarenhas Fonseca, Roger W Strong, Shifali Singh, Jane D Bulger, Michael Cleveland, Elizabeth Grinspoon, Kamille Janess, Lanee Jung, Kellee Miller, Eliza Passell, Kerry Ressler, Martin John Sliwinski, Alandra Verdejo, Ruth S Weinstock, Laura Germine, Naomi S Chaytor.
Response letter: Neuropsychiatric presentation of Covid-19-related encephalitis: Case report
(2022) PORTO, F. H. de Gobbi; ORSINI, M.
Covid-19-related encephalitis is a heterogeneous syndrome characterized by a combination of clinical, laboratory, and imaging features related to inflammation of the brain, where the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presumably the causative agent. We reported a case of Covid-19-related encephalitis presenting with neuropsychiatric symptoms, including intense agitation. Reverse-transcriptase polymerase-chain-reaction in cerebrospinal fluid was positive for SARS-CoV-2. Our case expands the literature about neurologic manifestations of Covid-19 and emphasizes the possibility of prominent behavioral symptoms as the initial manifestation.
Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries
(2023) MCGRATH, J. J.; AL-HAMZAWI, A.; ALONSO, J.; ALTWAIJRI, Y.; ANDRADE, L. H.; BROMET, E. J.; BRUFFAERTS, R.; ALMEIDA, J. M. C. de; CHARDOUL, S.; CHIU, W. T.; DEGENHARDT, L.; DEMLER, O. V.; FERRY, F.; GUREJE, O.; HARO, J. M.; KARAM, E. G.; KARAM, G.; KHALED, S. M.; KOVESS-MASFETY, V.; MAGNO, M.; MEDINA-MORA, M. E.; MOSKALEWICZ, J.; NAVARRO-MATEU, F.; NISHI, D.; PLANA-RIPOLL, O.; POSADA-VILLA, J.; RAPSEY, C.; SAMPSON, N. A.; STAGNARO, J. C.; STEIN, D. J.; HAVE, M. ten; TORRES, Y.; VLADESCU, C.; WOODRUFF, P. W.; ZARKOV, Z.; KESSLER, R. C.; AGUILAR-GAXIOLA, S.; ALTWAIJRI, Y. A.; ATWOLI, L.; BENJET, C.; BUNTING, B.; CALDAS-DE-ALMEIDA, J. M.; CARDOSO, G.; CíA, A. H.; GIROLAMO, G. De; HARRIS, M. G.; HINKOV, H.; HU, C.-Y.; JONGE, P. De; KARAM, A. N.; KAZDIN, A. E.; KAWAKAMI, N.; KESSLER, R. C.; KIEJNA, A.; MCGRATH, J. J.; PIAZZA, M.; SCOTT, K. M.; STEIN, D. J.; VIANA, M. C.; VIGO, D. V.; WILLIAMS, D. R.; WOODRUFF, P.; WOJTYNIAK, B.; XAVIER, M.; ZASLAVSKY, A. M.
Background: Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-onset distributions, lifetime prevalence, and morbid risk. Methods: In this cross-national analysis, we analysed data from respondents aged 18 years or older to the World Mental Health surveys, a coordinated series of cross-sectional, face-to-face community epidemiological surveys administered between 2001 and 2022. In the surveys, the WHO Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders until age 75 years across surveys by sex. We did not assess ethnicity. The surveys were geographically clustered and weighted to adjust for selection probability, and standard errors of incidence rates and cumulative incidence curves were calculated using the jackknife repeated replications simulation method, taking weighting and geographical clustering of data into account. Findings: We included 156 331 respondents from 32 surveys in 29 countries, including 12 low-income and middle-income countries and 17 high-income countries, and including 85 308 (54·5%) female respondents and 71 023 (45·4%) male respondents. The lifetime prevalence of any mental disorder was 28·6% (95% CI 27·9–29·2) for male respondents and 29·8% (29·2–30·3) for female respondents. Morbid risk of any mental disorder by age 75 years was 46·4% (44·9–47·8) for male respondents and 53·1% (51·9–54·3) for female respondents. Conditional probabilities of first onset peaked at approximately age 15 years, with a median age of onset of 19 years (IQR 14–32) for male respondents and 20 years (12–36) for female respondents. The two most prevalent disorders were alcohol use disorder and major depressive disorder for male respondents and major depressive disorder and specific phobia for female respondents. Interpretation: By age 75 years, approximately half the population can expect to develop one or more of the 13 mental disorders considered in this Article. These disorders typically first emerge in childhood, adolescence, or young adulthood. Services should have the capacity to detect and treat common mental disorders promptly and to optimise care that suits people at these crucial parts of the life course. Funding: None.
Educational interventions on preventing pressure injuries targeted at nurses: systematic review and meta-analysis
(2023) KITAMURA, J. C.; NICOLOSI, J. T.; PAGGIARO, A. O.; CARVALHO, V. F. de
Background: Although preventable, pressure injuries are commonly observed in the hospital setting and are estimated to be the third most costly condition, after cancer and cardiovascular disease. Aim: Nurses play a crucial role in the prevention and management of pressure injuries, however, published evidence on the effectiveness of educational interventions, directed specifically at nurses in the hospital environment, is scarce. Method: The authors retrieved published studies on the subject from selected databases (Pubmed/Medline, Embase, Web of Science and the Cochrane Library) in a number of languages (Portuguese, English, French and Spanish). The search yielded randomised controlled trials, as well as quasi-experimental and comparative studies. Findings: In total, 11 studies were selected. The outcomes analysed, following some type of educational intervention, included the attitudes and knowledge of the nursing professionals, as well as the incidence of pressure injuries. Conclusion: The present study demonstrated that different educational strategies can help prevent pressure injuries in the hospital environment.