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Painel de monitoramento do NMN em Sergipe: subsídios para redução da mortalidade infantil

2026-01-01T00:00:00Z

Título: Painel de monitoramento do NMN em Sergipe: subsídios para redução da mortalidade infantil Autor(es): Teixeira, Luciana Alice Santana Abstract: Introduction: Neonatal NMN (NNM) is an important indicator of severe neonatal morbidity and contributes to understanding the determinants of infant mortality. The analysis of cases that nearly resulted in death but survived makes it possible to identify weaknesses and strengths in maternal and child healthcare. In the state of Sergipe, systematic monitoring of this outcome is still limited, hindering the implementation of prevention strategies. Objective: To monitor NNM cases in Sergipe, identifying epidemiological patterns, associated risk factors, and priority areas for intervention. Methods: A descriptive study based on secondary data from the Live Birth Information System (SINASC), referring to all live births in Sergipe between 2011 and 2023. The definition of NNM followed pragmatic criteria widely used in the literature: Apgar score < 7 at the 5th minute, birth weight < 1500 g, and gestational age (GA) < 32 weeks. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated, analyzing maternal, gestational, neonatal, and obstetric variables. For the development of the interactive dashboard, functionalities provided by Streamlit version 1.51.0 and the Python programming language version 3.14 were used through a virtual environment (venv). Results: The prevalence of NNM in the state of Sergipe was 14,200 cases, with a rate of 33.7 NNM per thousand live births, and the municipality of Malhada dos Bois presented the highest NNM rate. Lack of prenatal care was the factor most strongly associated with the outcome, while having seven or more prenatal visits showed a consistent protective effect. Low educational level, single marital status, and prematurity also stood out as significant determinants. Higher risk was identified among male neonates, multiple pregnancies, non-cephalic fetal presentations, births outside the hospital setting, and the presence of congenital anomalies. Neonates classified as NNM presented worse Apgar scores, lower birth weight, and reduced gestational age. Conclusion: The findings reveal that NNM in Sergipe is a multifactorial event, strongly influenced by biological conditions, social determinants, and characteristics of healthcare services. Lack of prenatal care, multiple pregnancies, and out-of-hospital births constitute the main risk factors. The results reinforce the need to strengthen prenatal care policies, expand access to safe childbirth, and improve the quality of neonatal care.

Oncocare System: uma ferramenta para auxiliar o gerenciamento assistencial da neutropenia em pacientes oncológicos

2025-01-01T00:00:00Z

Título: Oncocare System: uma ferramenta para auxiliar o gerenciamento assistencial da neutropenia em pacientes oncológicos Autor(es): Vieira, Marina Provinciali Mendonça Abstract: Introduction: Neutropenia, especially in its febrile form (NF), represents a serious and frequent complication in cancer patients, associated with high morbidity and mortality. It affects up to 80% of patients with hematological malignancies and generates serious complications in up to 30% of cases. Fever may be the only clinical sign present, requiring immediate empirical antibiotic diagnosis and treatment. Institutional strategies based on international guidelines and the incorporation of Information and Communication Technologies (ICT) have been fundamental in promoting rapid, safe, and standardized procedures, favoring early diagnosis and reducing mortality. Objective: o develop and describe the OncoCare System, composed of a prototype clinical surveillance software and a multidisciplinary care guide, to support the care management of febrile neutropenia in cancer patients hospitalized at the University Hospital of Sergipe, based on scientific evidence on strategies, challenges, and the use of technologies in the management of this condition. Methodology: his is characterized as a technological production study, aiming to develop a software prototype using the Scrum agile methodology. The research was structured in main stages: (i) prior art search, (ii) conducting an integrative literature review, (iii) developing the Oncocare system prototype, and (iv) creating a care guide for febrile neutropenia. Results: The integrative review identified challenges and opportunities in the use of information technologies for the management of NF, highlighting the need for tools that support risk stratification and clinical decision-making. Based on this evidence, the OncoCare System was developed, a software prototype created in partnership with the Computer Science Department of UFS, aimed at monitoring, alerting, and following up on cancer patients. In addition, a Febrile Neutropenia Care Guide was developed for the multidisciplinary team. Conclusions: The study achieved its purpose of integrating scientific fundamentals and technological innovation. The OncoCare System was developed based on real demands of the University Hospital of Sergipe, with the potential to improve safety, standardize procedures, and expedite clinical decisions. It was completed and registered with the INPI (Brazilian National Institute of Industrial Property) under number BR512024001695- 3. The Care Guide complements the tool, especially in educational contexts.

Adaptação transcultural do Skin Cancer Index para o português e avaliação da qualidade de vida em pacientes com câncer de pele não melanoma cervicofacial

2023-01-01T00:00:00Z

Título: Adaptação transcultural do Skin Cancer Index para o português e avaliação da qualidade de vida em pacientes com câncer de pele não melanoma cervicofacial Autor(es): Hora, Evânia Curvelo Abstract: Non-melanoma skin cancer (NMSC) is the most frequent malignant neoplasm in Brazil. NMSCs occur mostly in the cervicofacial region, are associated with high morbidity, and often require surgical management. This causes functional, aesthetic, and emotional sequelae impacting the patient's quality of life (QoL). The Skin Cancer Index (SCI) was created to measure the QoL of NMSC patients. This study aimed to perform a cross-cultural adaptation of the SCI to the Portuguese language and the culture of northeastern Brazil, and measure its psychometric properties of reliability, validity, and responsiveness in assessing the QoL of patients with cervicofacial NMSC. This way, a specific instrument was developed to measure the QoL of this population. This study was performed in two stages. The first stage consisted of methodological research on the cross-cultural adaptation of the SCI through five steps: initial translation, synthesis of translations, back-translation, expert committee approval, and testing of the pre-final version (n=40). The second stage was a cross-sectional study on the clinical validation and assessment of the QoL of these patients (n= 182). The first stage resulted in an adapted version of the SCI. This version reached a Content Validity Index level significantly higher than 80% (p<0.05), evaluated through the Exact Binomial test. Temporal stability of the SCI during the test and retest periods was observed. Moreover, the Pearson’s correlations, as well as the Intraclass Correlation Coefficient, showed coefficients higher than 0.9, indicating excellent reliability. In the second stage, the adapted version was administered together with the Brazilian version of the Dermatology Life Quality Index (DLQI), during the pre-and post- operative periods (4 months postoperatively). Reliability in the subscales, and the total instrument, guaranteed by McDonald's ω, were considered ideal (>0.8) in all sub- dimensions. Moreover, α was considered ideal in the “emotional” and “social” sub-dimensions.Construct validity was obtained in all sub-dimensions and on the scale using the criteria (χ2) p-value > 0.05, RMSEA < 0.08, CFI ≥ 0.9, and SRMR ≤ 0.08. QoL and responsiveness were assessed by the student’s t-test in a paired sample at T0 (preoperatively) and T1 (4 monthspostoperatively). Significant results were observed with an increase in the SCI scale scores in all its dimensions and the total instrument (p < 0.001), and a decrease in the DLQI scale (p = 0.001). This showed that the adapted scale demonstrated a better postoperative QoL. The variables that presented significant results in the total scale, which indicated better QoL, were “men” (p = 0.002), “without children” (p = 0.019), “income above 4 minimun wages (p < 0.001), “from the private sector” (p < 0.001), “did not report itching” (p = 0.021), and “no scalp lesions” (p=0.012). The QoL measurement indicated a change from the baseline and postoperative improvement in all subscales and in the total instrument. The final version of the SCI adapted to the Portuguese language was called “SCI-versão brasileira” and proved to be a valid, reliable, and responsive instrument that allows health professionals to identify changes in the QoL of patients with NMSC.

Desenvolvimento de uma interface tecnológica para o rastreio do risco de broncoaspiração no ambiente hospitalar

2025-01-01T00:00:00Z

Título: Desenvolvimento de uma interface tecnológica para o rastreio do risco de broncoaspiração no ambiente hospitalar Autor(es): Silva, Patricia Sales Leal da Abstract: Introduction: Bronchoaspiration is a serious complication, frequently associated with dysphagia, and is characterized by high morbidity and mortality, especially in elderly and hospitalized patients. In addition to compromising patient safety, it is related to increased hospital costs and prolonged length of stay, which highlights the importance of early identification. Although screening instruments exist, methodological heterogeneity and lack of standardization in the detection of specific clinical predictors of bronchoaspiration are observed. In this context, the use of digital technologies and artificial intelligence emerges as a promising strategy to improve screening, allowing greater accuracy and agility in the prevention of this adverse outcome. Objective: To build an instrument with an accessible technological interface for screening the risk of bronchoaspiration in a hospital setting, a technological product in healthcare. Methods: The study followed a descriptive and exploratory methodology, based on Design Thinking, applied iteratively in the stages of problem awareness, ideation, and prototyping.The initial phase included a systematic review and the use of an empathy map to identify user needs. During the ideation phase, the interface proposal was developed, defining materials, technologies, and requirements, guided by the 4+1 architecture. Finally, prototyping was carried out to validate the solution. Results: The systematic review identified screening instruments for bronchoaspiration risk in adults, including checklists associated with functional swallowing tests, water swallowing tests, cough test, EAT-10 questionnaire, accelerometry, voice analysis, and the modified Blue Dye Test, evidencing methodological heterogeneity and lack of standardization. To address this gap, a technological interface was developed in the form of a responsive web-based software (Python/Django, PostgreSQL database), structured with a checklist of eight clinical risk criteria (respiratory support, level of consciousness, alternative feeding route, cough, saliva/secretions, voice, orofacial movements, and speech); in addition to a functional swallowing test, preventive recommendations, and suggestions for food consistency. Conclusion: The study resulted in the creation of a functional prototype to support the screening of bronchoaspiration risk in hospital settings, providing healthcare professionals with a standardized, evidence-based, and technologically accessible tool.