Trombocitopenia induzida por heparina de baixo peso molecular em pós-operatório de cirurgia não cardíaca: coorte prospectiva

A trombocitopenia induzida por heparina (HIT) é uma reação adversa protrombótica. O objetivo do estudo consiste em identificar a ocorrência de trombocitopenia induzida por heparina de baixo peso molecular em pacientes submetidos a cirurgias não cardíacas em um Hospital Terciário do Distrito Federal. Metodologia: trata-se de um estudo prospectivo de coorte de braço único, com inclusão por conveniência com delineamento STROBE Statement. O estudo foi realizado no período de agosto a dezembro de 2019. Resultados: foram selecionados 46 pacientes cirúrgicos elegíveis, que foram expostos a anticoagulação por heparina de baixo peso molecular e obtiveram monitoramento da contagem de plaquetas durante a exposição. A ocorrência de trombocitopenia com redução plaquetária <150.000mm³ foi de 19,56% no período perioperatório, relacionada a outras causas clínicas. Todos os casos obtiveram um escore 4 Ts (<4 pontos), sendo improvável HIT. Conclusão: A HIT é uma síndrome imunohematológica rara em pacientes em utilização da heparina de baixo peso molecular no pós operatório de cirurgias não-cardíacas.

Factors Associated With Informational Support in Transitional Care for Older Adults With Chronic Diseases: A Cross-Sectional Study

To evaluate the current situation and associated factors of informational support for older adults with chronic diseases in transitional care. Study was conducted in five hospitals of five different cities in Jiangsu Province, China. A random cluster sample of 800 older adults with chronic diseases responded to the informational support questionnaire of transitional care survey. Descriptive analysis, t-tests, variance analysis, and stepwise multiple linear regression were used to analyze data. The STROBE statement for observational studies was applied. Total score of ISQTC for older adults with chronic diseases was (44.05 ± 17.21). Marital status, educational level, past occupation, close friends, medical insurance, complications, and exercise habits were significantly correlated with informational support. The level of informational support in transitional care for older adults with chronic diseases was low. Clinical staff should periodically and primarily assess their informational support, help find information resources for those who have low initial informational support, and identify which information they preferred to carry out accurate transitional care.

Connection between nurse managers’ stress from workload and overall job stress, job satisfaction and practice environment in central hospitals: A cross-sectional study

Nurse managers’ workload is considered overwhelming and the resources and support insufficient. Stress from workload has adverse psychological and physical effects and impedes strategic, visible and active leadership. This study aimed to examine nurse managers’ stress from workload and its associations to overall job stress, job satisfaction and practice environment. A survey comprising the Nursing Context Index was administered to 490 nurse managers in Finnish central hospitals. The study was reported using the STROBE statement. The response rate was 42.7% ( n = 209). A statistical analysis revealed that almost every fifth nurse manager experienced high stress from workload with connection to higher job stress overall, higher intent to leave the organization, lower job satisfaction overall, personally and professionally, as well as a more negative perception of the practice environment. Nurse managers’ jobs require adequate resources, clear division of work and better empowering structures.

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. Translation to Russian

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www. strobe-statement.org/) should be helpful resources to improve reporting of observational research. This article is the reprint with Russian translation of the original that can be observed here: Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Med 2007;4(10):e297. doi:10.1371/journal.pmed.0040297

Prevalence of burnout syndrome in university students: A systematic review

Introdution. Burnout syndrome is a social and health problem in college students. Objective. To synthesize evidence from previous studies on the prevalence of burnout syndrome in university students in their three-dimensional approach. Method. The search strategies followed the PRISMA guidelines and were based on the following descriptive terms: “burnout,” “studies,” “prevalence,” “students.” Pubmed, Web of Science Core Collection, PsicINFO, and Scielo were consulted. An evaluation of the quality of the information was carried out applying the STROBE positioning guidelines. Results. We found 1,406 studies that were reduced to 46 studies for final analysis using the STROBE statement, eventually leaving 20 studies. One study (5%) was conducted in North America, five (25%) in Asia, nine (45%) in Latin America, and five (25%) in Europe. Of the 20 studies evaluated in the systematic review, those that had the best overall evaluation in the STROBE analysis were selected for discussion, corresponding to 10 (out of 75% of STROBE). Overall prevalence of each dimension of the syndrome was estimated at 55.4% for emotional exhaustion, 31.6% for cynicism, and 30.9% for academic efficacy. Discussion and conclusion. Moderate levels of burnout syndrome prevail in the different populations of university students of different careers worldwide. In only a few studies is the prevalence low and this could be due to multiple evaluative variables.

Contracting COVID-19 in the First and Second trimester of pregnancy, What We Know- a Concise Qualitative Systematic Review

published from January 1st to 27th of December 2020. Two independent reviewers evaluated studies using the STROBE statement in combination with the CERQual quality assessment of findings. Total 1387 articles were screened and a final 24 studies evaluated (220 1st/2nd trimesters COVID-19 pregnant women). 132/220 (60%) were symptomatic, most commonly with fever (86/220=39%) or cough (73/220=33%). Minority of studies reported complications, notably preeclampsia (2/15 patients-13%). 3 cases of maternal death were reported. Majority of neonates had unreported status concerning the outcome of pregnancy. Neonatal death occurred in 17 cases (including one chemical pregnancy, 5 miscarriages, 2 IUFD, 6 stillbirths and 3 abortions) Majority of reported mothers who contracted COVID-19 during 1st/2nd trimesters are yet to complete their pregnancy. Usually, mothers are discharged from the hospital without any serious complications, however, placental inflammation/fibrin deposition and neonatal death has been reported in a number of cases.

Evaluation of the reporting quality of observational studies in master of public health dissertations in China

Backgrounds Master of public health (MPH) plays an important role in Chinese medical education, and the dissertations is an important part of MPH education. In MPH dissertations, most are observational studies. Compared with randomized controlled trial (RCT), observational studies are more prone to information bias. So, the reporting of the observational studies should be transparent and standard. But, no research on evaluating the reporting quality of the MPH dissertation has been found. Methods A systematic literature search was performed in the Wanfang database from January 1, 2014 to May 31, 2019. The Strengthening the Reporting of Observation Studies in Epidemiology (STROBE) statement was adopted to evaluate the reporting quality of the selected studies. Articles that met the following criteria were selected: (1) observational studies, including cross-sectional studies, case-control studies, and cohort studies; (2) original articles; (3) studies on humans, including both adults and children. Results The Median of compliance to individual STROBE items was 74.79%. The mean (standard deviation) of STROBE score was 14.29 (1.84). Five items/sub-items were 100% reported (“reported” and “partly reported” were combined): background, objectives, study design, report numbers of individuals at each stage, and key result. Fifteen items/sub-items were reported by 75% or more. Reporting of methods and results was often omitted: missing data (6.67%), sensitivity analyses (3.63%), flow diagram (15.15%), and absolute risk (0%). Logistic regression analysis indicated that cohort studies (OR = 3.41, 95% CI = 1.27–9.16), funding support (OR = 4.37, 95% CI = 1.27–9.16) and more published papers during postgraduate period (OR = 3.46, 95% CI = 1.40–8.60) were related to high reporting quality. Conclusion In short, the reporting quality of observational studies in MPH’s dissertations in China is suboptimal. However, it’s necessary to improve the reporting of method and results sections. We recommend that authors should be stricter to adhere STROBE statement when conducting observational studies.

Perception of Inpatient Oncologic Rehabilitation in Children, Adolescents and Young Adults Diagnosed with Cancer in Switzerland

Background Inpatient rehabilitation improves physical and psychosocial performance in childhood cancer patients and their families. Two kinds of inpatient rehabilitation are available in specialized institutions in Germany: family-oriented rehabilitation or peer group-oriented rehabilitation for adolescents and young adults (AYA). Our study aimed to find out what Swiss childhood and AYA cancer patients and their families thought about the rehabilitation programs in which they had participated. Patients and methods We conducted a questionnaire-based, cross-sectional study of Swiss childhood and AYA cancer patients and their families whose inpatient rehabilitation stays were scheduled to take place in Germany between May 2012 and March 2019. We analyzed the data descriptively and present our findings in accordance with the STROBE statement. Results Of the 57 eligible families contacted, 38 (67%) responded. Most rated the rehabilitation stay as very good (68%) or good (26%). Nearly all participants emphasized that these programs should be available to all affected patients and their families. Most (80%) thought the program gave them enough valuable information to enable them to cope with daily life after the stay ended. Only one fifth (19%) of the rehabilitation stays were fully funded by the health or disability insurance. Conclusion Participants expressed an overwhelmingly positive opinion about the rehabilitation programs they attended. We are convinced that childhood and AYA cancer patients and their families in Switzerland benefit from these programs and encourage insurances to cover the costs.

Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology Statement in Observational Studies Published in Iranian Medical Journals

Background: Although much medical knowledge comes from observational research, such studies are more prone to confounding and bias than others. This study was conducted to evaluate the adherence of the observational studies published in Iranian medical journals to the STROBE (strengthening the reporting of observational studies in epidemiology) statement. Methods: In this cross-sectional study, we selected 150 articles of Iranian medical journals, using multistage sampling from Aug 2016 to Jun 2017. The reported items of the STROBE statement in the articles was determined and considered as the adherence of the articles to the statement. The adherence of the articles with different characteristics was compared. Results: The adherence of the articles to the statement varied from 24% to 68% with a mean score of 48%±9%. The lowest mean scores were found in the Result (36%) and Method (49%) sections. The adherence was significantly better in the articles published in the journals indexed in PubMed or Web of Knowledge (ISI) databases (P<0.001) and those written by cooperation of the authors from other countries (P=0.044). Conclusion: The evaluated articles in our study had not adequately reported the items recommended by the STROBE statement. This indicates deficiency in key elements for readers to assess the validity and applicability of a study.