Metabolic bone disease in premature infants receiving parenteral nutrition: Incidence, clinical, laboratory and nutritional profile.

Background: Metabolic bone disease (MBD) of newborns (NB) is characterized by tissue reduction and inadequate postnatal bone mineralization with clinical, laboratory, and/or radiologic repercussions between the third and twelfth weeks of postnatal life, which, in its most severe forms, can lead to a growth deficit and fractures. The aim of our study is to evaluate the incidence of MBD in premature patients receiving parenteral nutrition for >15 days in the neonatal intensive care unit (NICU) and assess their clinical and laboratory characteristics.

Methods: Single-center retrospective cohort study.

Work-related stress in Medical and Dentistry programs.

Introduction: Stress occurs more frequently in groups in which the degree of responsibility and decision-making power play notable roles in society, such as professors and health professionals.

Objectives: To measure and understand the stress of professors in the undergraduate course of Medicine and Dentistry of a private educational institution in northeastern Brazil.

Methods: Observational, descriptive and exploratory study with a quantitative approach was conducted between November 2018 and September 2019.

Outcomes of the First 54 Pediatric Patients on Long-Term Home Parenteral Nutrition from a Single Brazilian Center.

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil.

Methods: We retrospectively reviewed patients aged 0-18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020.

Adjunctive Therapy to Manage Neuropsychiatric Symptoms in Moderate and Severe Dementia: Randomized Clinical Trial Using an Outpatient Version of Tailored Activity Program.

Background: Neuropsychiatric symptoms (NPS) such as aggression, apathy, agitation, and wandering may occur in up to 90%of dementia cases. International guidelines have suggested that non-pharmacological interventions are as effective as pharmacological treatments, however without the side effects and risks of medications. An occupational therapy method, called Tailored Activity Program (TAP), was developed with the objective to treat NPS in the elderly with dementia and has been shown to be effective.

Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome.

Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline.

Homework "Dose," Type, and Helpfulness as Predictors of Clinical Outcomes in Prolonged Exposure for PTSD.

Homework is often viewed as central to prolonged exposure (PE) for posttraumatic stress disorder (PTSD), but its relationship with treatment outcome is not well understood. We evaluated homework type, dose, and patients' perceptions of helpfulness as predictors of symptom change and posttreatment outcomes in PE. Patients with chronic PTSD received PE in a randomized clinical trial.

Iris metastases from systemic cancer: a report of three cases.

Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema.

Enhanced depth imaging optical coherence tomography of choroidal osteoma with secondary neovascular membranes: report of two cases.

We report enhanced depth imaging optical coherence tomography (EDI-OCT) features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle.

Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review.

Introduction: Behavioral and psychological symptoms of dementia (BPSD) are defined as a group of symptoms of disturbed perceptive thought content, mood, or behavior that include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, and wandering. Care of patients with BPSD involves pharmacological and nonpharmacological interventions. We reviewed studies of nonpharmacological interventions published in the last 10 years.

An update on the efficacy of cognitive-behavioral therapy, cognitive therapy, and exposure therapy for posttraumatic stress disorder.

Objective: Even though cognitive-behavioral therapy (CBT) is the current treatment of choice for posttraumatic stress disorder (PTSD), it is still unclear which components of its protocol are more important for clinical improvement. This study aims to replicate a previous review, updating findings on the efficacy of CBT, cognitive therapy (CT), and exposure therapy (ET) for PTSD when compared with other well-established treatments or conditions without active treatment.

Method: The search was performed in the databases Cochrane, Embase, and Medline.

Azithromycin therapy in hospitalized infants with acute bronchiolitis is not associated with better clinical outcomes: a randomized, double-blinded, and placebo-controlled clinical trial.

Objective: To test the hypothesis that azithromycin reduces the length of hospitalization and oxygen requirement in infants with acute viral bronchiolitis (AB).

Study Design: We performed a randomized, double-blinded, placebo-controlled trial in southern Brazil, from 2009 to 2011. Infants (<12 months of age) hospitalized with AB were recruited in 2 hospitals.

Outcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury.

Objectives: Critically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury.

Methods: Prospective multicenter cohort study conducted in intensive care units from 28 hospitals in Brazil over a two-month period.

Survey on physicians' knowledge of sepsis: do they recognize it promptly?

Purpose: In Brazil, sepsis has a high mortality; and early recognition is essential in outcome. The aim of the study was to evaluate physicians' knowledge about systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock concepts.

Methods: This was a prospective, observational study performed in 21 hospitals in Brazil, which enrolled physicians working in the participant institutions.

Early determinants of death due to multiple organ failure after noncardiac surgery in high-risk patients.

Background: Prediction of perioperative cardiac complications is important in the medical management of patients undergoing noncardiac surgery. However, these patients frequently die as a consequence of primary or secondary multiple organ failure (MOF), often as a result of sepsis. We investigated the early perioperative risk factors for in-hospital death due to MOF in surgical patients.

Characteristics and outcomes of patients with cancer requiring admission to intensive care units: a prospective multicenter study.

Objective: To evaluate the characteristics and outcomes of patients with cancer admitted to several intensive care units. Knowledge on patients with cancer requiring intensive care is mostly restricted to single-center studies.

Design: : Prospective, multicenter, cohort study.

Delirium recognition and sedation practices in critically ill patients: a survey on the attitudes of 1015 Brazilian critical care physicians.

Purpose: The aim of the study was to characterize the practices of Brazilian ICU physicians toward sedation and delirium.

Materials And Methods: A cross-sectional survey was conducted among a convenience sample of critical care physicians between April and June 2008.

Results: One thousand fifteen critical care physicians responded.

Epidemiology and outcomes of non-cardiac surgical patients in Brazilian intensive care units.

Objectives: Due to the dramatic medical breakthroughs and an increasingly ageing population, the proportion of patients who are at risk of dying following surgery is increasing over time. The aim of this study was to evaluate the outcomes and the epidemiology of non-cardiac surgical patients admitted to the intensive care unit.

Methods: A multicenter, prospective, observational, cohort study was carried out in 21 intensive care units.

Development and simultaneous application of multiple care protocols in critical care: a multicenter feasibility study.

Objective: To test the feasibility of and interactions among three software-driven critical care protocols.

Design: Prospective cohort study.

Setting: Intensive care units in six European and American university hospitals.

Pharmacotherapy of dual substance abuse and dependence.

The US FDA has approved a limited number of treatments for alcohol, nicotine and opioid dependence; however, no treatments for other abused drugs such as marijuana, cocaine or methamphetamine are approved. This review focuses on research into drug pharmacotherapies, particularly single-drug therapies, for substance abuse and dependence contributing to the most important dual substance use disorders (SUDs). Given the implications of poly-substance abuse, it is essential that clinicians and researchers be aware of potential pharmacotherapies for the treatment of dual SUDs.

[Gastric rupture following cardiopulmonary resuscitation: case report].

Background And Objectives: Gastric rupture is a rare complication from cardiopulmonary resuscitation (CPR), with a reported incidence of 0.1%. Unawareness of this possible complication during these maneuvers delays its recognition and reduces the patient’s surviving chance.

[Brazilian consensus of monitoring and hemodynamic support - part III: alternative methods for cardiac output monitoring and volemia estimation].

Background And Objectives: Cardiac output and preload as absolute data do not offer helpful information about the hemodynamic of critically ill patients. However, monitoring the response of these variables to volume challenge or inotropic drugs is a very useful tool in the critical care setting, particularly for patients with signs of tissue hypoperfusion. Although PAC remains the " gold standard" to measure cardiac output and preload, new and alternative technologies were developed to evaluate these hemodynamic variables.