Development and content validation of a risk classification instrument.

Objective: Develop and validate the content of an instrument for patient risk classification in emergency services of Primary Health Care.

Method: The study included two stages: item generation and content validity. A literature review and retrospective analysis of medical records were conducted to create the instrument items.

Development of a clinical investigation protocol for occupational auditory health.

Introduction: Considering that noise is present in different work environments, occupational health regulations have been created that advocate for the care of employees' auditory system in these environments. Occupational hearing assessment should be performed by audiologists through audiological examinations, otoscopy, as well as an interview to assess possible risk factors for the development of hearing loss. However, up to the present moment, a standardized set of updated questions for this interview has not been defined.

What are the implications of problem-solving capacity at Primary Health Care in older adult health?

Objective: To evaluate Primary Health Care attributes and analyze the association between the fulfilment of these attributes and problem-solving capacity of services for elderly patients.

Methods: A cross-sectional, observational, quantitative study. The Primary Care Assessment Tool, designed to assess Primary Health Care attributes, was employed to evaluate elderly users of Primary Care Units located in the south region of the city of São Paulo (SP).

Development and validation of predictive model for long-term hospitalization, readmission, and in-hospital death of patients over 60 years old.

Objective: To develop and validate a high-risk predictive model that identifies, at least, one common adverse event in older population: early readmission (up to 30 days after discharge), long hospital stays (10 days or more) or in-hospital deaths.

Methods: This was a retrospective cohort study including patients aged 60 years or older (n=340) admitted at a 630-beds tertiary hospital, located in the city of São Paulo, Brazil. A predictive model of high-risk indication was developed by analyzing logistical regression models.

Epidemiology and treatment of sepsis at a public pediatric emergency department.

Objective: To describe the clinical characteristics and treatment of children with sepsis, severe sepsis, and septic shock at a pediatric emergency department of a public hospital.

Methods: A retrospective, observational study. The medical records of patients included in the hospital Pediatric Sepsis Protocol and patients with discharge ICD-10 A41.

Assessment of staffing needs for registered nurses and licensed practical nurses at primary care units in Brazil using Workload Indicators of Staffing Need (WISN) method.

Background: The balance between supply and demand for primary health care (PHC) services is one of the main challenges to the health system in Brazil. In this context, the application of planning methods could benefit the decision-making process for human resources organizations. Hence, the objective of this study was to assess the staffing needs for registered nurses (RNs) and licensed practical nurses (LPNs) at PHC services using the WISN method.

A Pediatric Sepsis Protocol Reduced Mortality and Dysfunctions in a Brazilian Public Hospital.

Few studies in the literature discuss the benefits of compliance with sepsis bundles in hospitals in low- and middle-income countries, where resources are limited and mortality is high. This is a retrospective cohort study conducted at a public hospital in a low-income region in Brazil. We evaluated whether completion of a sepsis bundle is associated with reduced in-hospital mortality for sepsis, severe sepsis, and septic shock, as well as prevention of septic shock and organ dysfunction.

Dental vulnerability scale in primary health care: evidence of content and structure internal validity.

Background: Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC).

A prospective evaluation of inter-rater agreement of routine medical records audits at a large general hospital in São Paulo, Brazil.

Background: The quality of patient medical records is intrinsically related to patient safety, clinical decision-making, communication between health providers, and continuity of care. Additionally, its data are widely used in observational studies. However, the reliability of the information extracted from the records is a matter of concern in audit processes to ensure inter-rater agreement (IRA).

Fasting glucose of patients from public health care in the southern region of São Paulo: correlation with glycated hemoglobin and lipid levels.

Introduction: Fasting glucose is a test used for monitoring diabetes mellitus, as well as its screening and diagnosis. The objective of this study was to evaluate fasting glucose results and their correlation with glycated hemoglobin and lipids.

Methods: Cross-sectional study, involving 77,581 patients, attended in 2014.

Effect of an educational program for the knowledge and quality of blood pressure recording.

Objective: to evaluate the effect of an educational program on blood pressure recording for nursing professionals in relation to theoretical knowledge and the quality of these records.

Method: quasi-experimental study conducted in a hospital service located in the city of São Paulo. The theoretical knowledge of 101 professionals was measured using a validated questionnaire before and after the educational intervention; the quality of blood pressure records was evaluated using a validated form which was applied to 354 records in the pre-intervention period and 288 in the post-intervention period.

Association of blood pressure documentation with adverse outcomes in an emergency department in Brazil.

Objective: To associate blood pressure (BP) documentation with adverse outcomes in an emergency department (ED).

Methods: This is a retrospective observational study, and 642 records of patients admitted to the ED of a tertiary hospital in Brazil were used. We included medical records of patients of both sexes aged over 18 years, who were allocated in general wards in the period December 2015-June 2016.

Consensus for vaginal stenosis prevention in patients submitted to pelvic radiotherapy.

Objective: To propose a consensus for prevention of vaginal stenosis in patients submitted to pelvic radiotherapy.

Method: In this methodological study, Delphi technique was applied for content validation on vaginal stenosis prevention. Data regarding content validation were collected from 32 specialists practicing in the oncology profession.

The variation of the burden of hypertension and diabetes in two large districts of the city of São Paulo, Brazil, based on primary health care routinely-collected data.

Background: Noncommunicable diseases (NCDs) were responsible for 72.3% of global deaths in 2016, with cardiovascular diseases accounting for almost half of those deaths and low- and middle-income countries carrying the biggest burden. As a result, the prevention and control of NCDs is recognized as urgent, while better surveillance at the country level could result in more effective policies.

Detecting latent safety threats in an interprofessional training that combines in situ simulation with task training in an emergency department.

Background: During in situ simulation, interprofessional care teams practice in an area where clinical care occurs. This study aimed to detect latent safety threats (LST) in a training program, which combined in situ simulation scenarios with just-in-time and just-in-place self-directed task training in an emergency department. We hypothesized this simulation-based training in actual care areas allows the detection of at least one LST per simulation scenario.

Evaluation of Influenza A H1N1 infection and antiviral utilization in a tertiary care hospital.

Background: Influenza A H1N1 infections carry a significant mortality risk. This study describes inpatients with suspected and confirmed Influenza A H1N1 infection who were prescribed oseltamivir, the risk factors associated with infection, the association between infection and mortality, and the factors associated with in-hospital mortality in infected patients.

Methods: This study was a matched case-control study of hospitalized patients who underwent real-time polymerase chain reaction testing for Influenza A H1N1 and were treated with oseltamivir from 2009 to 2015 in a tertiary care hospital.

Evaluation of Candida bloodstream infection and antifungal utilization in a tertiary care hospital.

Background: Candida bloodstream infections carry a significant mortality risk, justifying the importance of adequate antifungal therapy. This study describes trends in antifungal consumption using the Defined Daily Dose (DDD) and Days of Therapy (DOT) metrics, identifies the microbiological profile, the time to initiation of empirical therapy, the adjustment after positive blood culture results for Candida, and the impact on in-hospital mortality rate in patients with candidemia.

Methods: An analysis of antifungal consumption from 2008 to 2016, and of candidemia cases from 2012 to 2016 was carried out in a private tertiary hospital.

Identification of Asymptomatic Carriers in a Tertiary Care Hospital.

Background: The diagnosis of infection (CDI) increases concern that asymptomatic carriers of toxigenic may be diagnosed with CDI.

Methods: A matched case control study was conducted in inpatients in a tertiary care center. The first 50 patients with diarrhea and a positive polymerase chain reaction (PCR) test beginning February 1, 2015, were identified as cases.

Toxicological profile of IQG-607 after single and repeated oral administration in minipigs: An essential step towards phase I clinical trial.

IQG-607 is an anti-tuberculosis drug candidate, with a promising safety and efficacy profile in models of tuberculosis infection both in vitro and in vivo. Here, we evaluated the safety and the possible toxic effects of IQG-607 after acute and 90-day repeated administrations in minipigs. Single oral administration of IQG-607 (220 mg/kg) to female and male minipigs did not result in any morbidity or mortality.

Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol.

Background: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes.

[Case-control studies with multinomial responses: a proposal for analysis].

This study reviews articles on case-control studies in which the cases were classified in two or more types. Application of multinomial models and their adequacy for case-control studies are discussed. Among the available multinomial adjustments, we argue that the polytomous logistic model is the most suitable for obtaining epidemiological measures of risk and association in case-control studies.