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OBJECTIVES: to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women. METHODS: a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo's methodology and Roy's Adaptation Model. RESULTS: various types of stimuli - focal, contextual, and residual - were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women's adaptation, offering significant support and generating positive feedback for childbirth preparation. FINAL CONSIDERATIONS: the importance of pregnant women's groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.
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Adaptación Psicológica , COVID-19 , Pandemias , Parto , Investigación Cualitativa , SARS-CoV-2 , Humanos , Femenino , COVID-19/epidemiología , COVID-19/psicología , Embarazo , Adulto , Parto/psicología , Mujeres Embarazadas/psicología , BrasilRESUMEN
Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the standard of care for patients with advanced NSCLC and EGFR-sensitizing mutations. Both in osimertinib pivotal trials and in the post-marketing phase, asymptomatic creatinine phosphokinase elevation and clinically relevant muscle damage have been reported. However, the mechanisms underlying these conditions remain unclear. Herein, we report the first muscle biopsy description of osimertinib-induced myopathy and hypothesize that the mechanisms underpinning muscle toxicity could be driven by hyporegenerative mechanisms and mitochondrial dysfunction with subsequent reduced metabolic endurance, both directly linked to the inhibition of downstream molecular pathways mediated by EGFR in muscle cells.
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OBJECTIVE: To perform a cross-cultural adaptation and assess the content validity of the Neonatal Medical Index (NMI) for the Brazilian context. METHODS: The cross-cultural adaptation was completed in six steps, including translation, synthesis of translations, back translation, submission to an expert committee, testing of the prefinal version, and appraisal by the original author. The expert committee assessed the equivalence between versions based on the percentage of agreement, and content validity was evaluated using the content validity index (CVI) for each item of the scale (I-CVI) and for the overall scale (S-CVI) in terms of representativeness and clarity. Participants of the prefinal version also evaluated the CVI for clarity. RESULTS: After two evaluation rounds of the expert committee it was attained 98% agreement, attesting to the equivalence between the instrument versions, maximum values for representativeness I-CVI and S-CVI/Ave (1.00), and high values for clarity I-CVI (all items ≥0.97) and S-CVI/Ave (0.98). The expert committee members defined that the Brazilian version of the instrument would be called Índice Clínico Neonatal (NMI-Br). The NMI-Br reached high values of CVI for clarity (all I-CVI ≥0.86 and S-CVI/Ave=0.99) among the participants of the prefinal version. CONCLUSIONS: The NMI-Br is the Brazilian version of the NMI, obtained in a rigorous cross-cultural validation process, counting with adequate values of content validity.
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Comparación Transcultural , Traducciones , Humanos , Brasil , Recién Nacido , Reproducibilidad de los Resultados , Características Culturales , Encuestas y Cuestionarios , Enfermedades del Recién Nacido/diagnósticoRESUMEN
COQ7 pathogenetic variants cause primary CoQ10 deficiency and a clinical phenotype of encephalopathy, peripheral neuropathy, or multisystemic disorder. Early diagnosis is essential for promptly starting CoQ10 supplementation. Here, we report novel compound heterozygous variants in the COQ7 gene responsible for a prenatal onset (20 weeks of gestation) of hypertrophic cardiomyopathy and intestinal dysmotility in a Bangladesh consanguineous family with two affected siblings. The main clinical findings were dysmorphisms, recurrent intestinal occlusions that required ileostomy, left ventricular non-compaction cardiomyopathy, ascending aorta dilation, arterial hypertension, renal dysfunction, diffuse skin desquamation, axial hypotonia, neurodevelopmental delay, and growth retardation. Exome sequencing revealed compound heterozygous rare variants in the COQ7 gene, c.613_617delGCCGGinsCAT (p.Ala205HisfsTer48) and c.403A>G (p.Met135Val). In silico analysis and functional in vitro studies confirmed the pathogenicity of the variants responsible for abolished activities of complexes I + III and II + III in muscle homogenate, severe decrease of CoQ10 levels, and reduced basal and maximal respiration in patients' fibroblasts. The first proband deceased at 14 months of age, whereas supplementation with a high dose of CoQ10 (30 mg/kg/day) since the first days of life modified the clinical course in the second child, showing a recovery of milestones acquirement at the last follow-up (18 months of age). Our study expands the clinical spectrum of primary CoQ10 deficiency due to COQ7 gene defects and highlights the essential role of multidisciplinary and combined approaches for a timely diagnosis.
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Enfermedades Mitocondriales , Ubiquinona , Humanos , Ubiquinona/análogos & derivados , Ubiquinona/deficiencia , Ubiquinona/genética , Masculino , Enfermedades Mitocondriales/genética , Enfermedades Mitocondriales/patología , Enfermedades Mitocondriales/diagnóstico , Femenino , Linaje , Lactante , Mutación , Ataxia/genética , Ataxia/patología , Ataxia/diagnóstico , Oftalmoplejía/genética , Oftalmoplejía/patología , Oftalmoplejía/diagnóstico , Debilidad Muscular/genética , Debilidad Muscular/patología , Cardiomiopatías/genética , Cardiomiopatías/patología , Cardiomiopatías/diagnóstico , Cardiomiopatía Hipertrófica/genética , Cardiomiopatía Hipertrófica/patología , Cardiomiopatía Hipertrófica/diagnósticoRESUMEN
PURPOSE: We aim to propose a visual quantitative score for muscle edema in lower limb MRI to contribute to the diagnosis of idiopathic inflammatory myopathy (IIM). MATERIAL AND METHODS: We retrospectively evaluated 85 consecutive patients (mean age 57.4 ± 13.9 years; 56.5% female) with suspected IIM (muscle weakness and/or persistent hyper-CPK-emia with/without myalgia) who underwent MRI of lower limbs using T2-weighted fast recovery-fast spin echo images and fat-sat T2 echo planar images. Muscle inflammation was evaluated bilaterally in 11 muscles of the thigh and eight muscles of the leg. Edema in each muscle was graded according to a four-point Likert-type scale adding up to 114 points ([11 + 8)] × 3 × 2). Diagnostic accuracy of the total edema score was explored by assessing sensitivity and specificity using the area under the ROC curve. Final diagnoses were made by a multidisciplinary Expert Consensus Panel applying the Bohan and Peter diagnostic criteria whenever possible. RESULTS: Of the 85 included patients, 34 (40%) received a final diagnosis of IIM (IIM group) while 51 (60%) received an alternative diagnosis (non-IIM group). A cutoff score ≥ 18 was able to correctly classify patients having an IIM with an area under the curve of 0.85, specificity of 96%, and sensitivity of 52.9%. CONCLUSION: Our study demonstrates that a quantitative MRI score for muscle edema in the lower limbs (thighs and legs) aids in distinguishing IIM from conditions that mimic it.
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Edema , Extremidad Inferior , Imagen por Resonancia Magnética , Miositis , Humanos , Femenino , Masculino , Persona de Mediana Edad , Imagen por Resonancia Magnética/normas , Imagen por Resonancia Magnética/métodos , Miositis/diagnóstico por imagen , Miositis/diagnóstico , Estudios Retrospectivos , Extremidad Inferior/diagnóstico por imagen , Edema/diagnóstico por imagen , Anciano , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/patología , Adulto , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
Objetivo: conhecer a experiência de mulheres que compartilharam a vivência do ciclo gravídico-puerperal durante a Pandemia Covid-19 em um grupo de aplicativo de mensagem criado para complementar as atividades educativas de um grupo de gestantes. Método: estudo qualitativo, descritivo e exploratório. Os dados são provenientes das mensagens de 94 mulheres participantes de Grupos de Gestantes e Casais Grávidos realizados em 2020, vinculado a um projeto de extensão de uma Universidade do Sul do país. Resultados: apresentam sentimentos relacionados à ausência do contato físico com família e amigos, dúvidas e desafios encontrados durante a gestação e puerpério, medos e incertezas em relação ao processo de parto e nascimento. Conclusão: o grupo de gestantes mediado por aplicativo de mensagens mostrou ser um aliado na interação entre as mulheres, possibilitando a educação em saúde e a criação de uma rede de apoio respeitando o distanciamento social
Objective: to know the experience of women who shared the livingness of the pregnancy-puerperal cycle during the Covid-19 Pandemic in a message app group created to complement the educational activities of a group of pregnant women. Methods: qualitative, descriptive and exploratory study. The data comes from the messages of 94 women participating in Groups of Pregnant Women and Pregnant Couples held in 2020, linked to an extension project of a University in the south of the country. Results: feelings related to the absence of physical contact with family and friends, doubts and challenges encountered during pregnancy and puerperium, fears and uncertainties regarding the labor and birth process were highlighted. Conclusion: the group of pregnant women mediated by a messaging application proved to be an ally in the interaction between women, enabling health education and the creation of a support network respecting social distance
Objetivos: conocer la vivencia de mujeres que compartieron la vivencia del ciclo embarazo-puerperio durante la Pandemia del Covid-19 en un grupo de aplicación de mensajes creado para complementar las actividades educativas de un grupo de gestantes. Método: estudio cualitativo, descriptivo y exploratorio. Los datos provienen de los mensajes de 94 mujeres participantes de Grupos de Embarazadas y Parejas Embarazadas realizados en 2020, vinculados a un proyecto de extensión de una Universidad del Sur del país. Resultados: presentan sentimientos relacionados con la ausencia de contacto físico con familiares y amigos, dudas y desafíos encontrados durante el embarazo y el puerperio, miedos e incertidumbres en relación al proceso de trabajo de parto y nacimiento Conclusión: el grupo de gestantes mediado por una aplicación de mensajería demostró ser un aliado en la interacción entre mujeres, posibilitando la educación en salud y la creación de una red de apoyo respetando el distanciamiento social
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Humanos , Femenino , Embarazo , Adulto , Adulto Joven , Aislamiento Social , Embarazo , Pandemias , Periodo PospartoRESUMEN
ABSTRACT Objective: To perform a cross-cultural adaptation and assess the content validity of the Neonatal Medical Index (NMI) for the Brazilian context. Methods: The cross-cultural adaptation was completed in six steps, including translation, synthesis of translations, back translation, submission to an expert committee, testing of the prefinal version, and appraisal by the original author. The expert committee assessed the equivalence between versions based on the percentage of agreement, and content validity was evaluated using the content validity index (CVI) for each item of the scale (I-CVI) and for the overall scale (S-CVI) in terms of representativeness and clarity. Participants of the prefinal version also evaluated the CVI for clarity. Results: After two evaluation rounds of the expert committee it was attained 98% agreement, attesting to the equivalence between the instrument versions, maximum values for representativeness I-CVI and S-CVI/Ave (1.00), and high values for clarity I-CVI (all items ≥0.97) and S-CVI/Ave (0.98). The expert committee members defined that the Brazilian version of the instrument would be called Índice Clínico Neonatal (NMI-Br). The NMI-Br reached high values of CVI for clarity (all I-CVI ≥0.86 and S-CVI/Ave=0.99) among the participants of the prefinal version. Conclusions: The NMI-Br is the Brazilian version of the NMI, obtained in a rigorous cross-cultural validation process, counting with adequate values of content validity.
RESUMO Objetivo: Realizar a adaptação transcultural e avaliar a validade de conteúdo do Neonatal Medical Index (NMI) para o contexto brasileiro. Métodos: A adaptação transcultural foi realizada em seis etapas, incluindo tradução, síntese das traduções, retrotradução, submissão a um comitê de especialistas, teste da versão pré-final e avaliação do autor original. O comitê de especialistas avaliou a equivalência entre as versões com base na porcentagem de concordância, e a validade de conteúdo foi avaliada por meio do índice de validade de conteúdo (IVC) para cada item da escala (I-IVC) e para a escala geral (S-IVC) em termos de representatividade e clareza. Os participantes da versão pré-final também avaliaram o IVC quanto à clareza. Resultados: Após duas rodadas de avaliação do comitê de especialistas obteve-se 98% de concordância, atestando a equivalência entre as versões do instrumento, valores máximos para representatividade I-IVC e S-IVC/Ave (1,00) e altos valores para clareza I-IVC (todos os itens ≥0,97) e S-IVC/Ave (0,98). Os membros do comitê de especialistas definiram que a versão brasileira do instrumento se chamaria Índice Clínico Neonatal (NMI-Br). O NMI-Br alcançou altos valores de IVC para clareza (todos I-IVC ≥0,86 e S-IVC/Ave=0,99) entre os participantes da versão pré-final. Conclusões: O NMI-Br é a versão brasileira do NMI, obtido em rigoroso processo de validação transcultural, contando com valores adequados de validade de conteúdo.
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Abstract Objectives: to evaluate the association between the time to initiate the first skin-to-skin contact (SSC) and the daily practice time with the rates of late-onset sepsis in newborns ≤1,800g. Methods: a multicentric cohort study was carried out at the neonatal units located in three Brazilian geographic regions. The SSC time was recorded in individual files by the hospital staff and the newborn's parents. Maternal and neonatal data were obtained from medical records and through questionnaires applied to the mothers. Data analysis was carried out using a tree algorithm classification, which divided the data set into mutually exclusive subsets that best described the variable response. Results: 405 newborns participated in the study, with an average of 31.3 ± 2.7 weeks and 1,412g (QR=1,164-1,605g) as a median birth weight. The first SSC was carried out within 137 hours of life (≤5.7 days) was associated with a lower rate of late sepsis (p=0.02) for newborns who underwent daily SSC of 112.5 to 174.7 min/day (1.9 to 2.9h/day), with a reduction in the sepsis rate from 39.3% to 27.5%. Furthermore, the duration of SSC >174.7min/day (>2.9h/day) was relevant (p<0.001) for newborns who weighed >1,344g, with a reduction in this rate from 24.1% to 6%. Conclusions: SSP has been proven to be significant in reducing late-onset sepsis rates in preterm newborns, especially when carried out in a timely manner (≤5.7 days) and prolonged (>2.9h/day).
Resumo Objetivos: avaliar a associação entre o tempo para iniciar o primeiro contato pele a pele (CPP) e o tempo diário praticado com a taxa de sepse tardia em recém-nascidos ≤1.800g. Métodos: coorte multicêntrica realizada em unidades neonatais de três regiões geográficas brasileiras. O CPP foi registrado em ficha individual pela equipe e pais do recém-nascido. Dados maternos e neonatais foram obtidos por questionários aplicados às mães e em prontuários médicos. A análise dos dados foi realizada por algoritmo da árvore de classificação, que dividiu o conjunto de dados em subconjuntos mutuamente exclusivos que melhor descreveram a variável resposta. Resultados: 405 recém-nascidos participaram do estudo, com média de 31,3±2,7 semanas de idade gestacional e mediana de peso ao nascer 1.412g (IQ=1.164-1.605g). Realizar o primeiro CPP com até 137h de vida (≤5,7 dias) foi associado a menor taxa de sepse tardia (p=0,02) para recém-nascidos que fizeram CPP diário de 112,5 a 174,7 min/dia (1,9 a 2,9h/dia), com redução na taxa de sepse (39,3% para 27,5%). Além disso, a duração do CPP>174,7min/dia (>2,9h/dia) foi relevante (p<0,001) para os recém-nascidos >1.344g, com redução nesse desfecho (21,1% para 6%). Conclusões: o CPP mostrou-se importante para redução das taxas de sepse tardia em recém-nascidos pré-termo, especialmente quando realizado de forma oportuna (≤5,7 dias) e prolongada (>2,9h/dia).
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Humanos , Recién Nacido , Recién Nacido de Bajo Peso , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Método Madre-Canguro , Sepsis Neonatal/diagnóstico , Brasil , Factores de Riesgo , Estudios de CohortesRESUMEN
Introdução: O Programa Nacional de Imunizações presente na Atenção Primária à Saúde coordena o processo de imunização e o torna mais eficaz, porém esse sistema enfrenta problemas como a falta de acesso à internet e desabastecimento de imunizantes, que prejudicam a cobertura vacinal da população e dificultam o registro eletrônico dos dados indicadores, além de aumentar a taxa de abandono vacinal. Objetivo:Analisar os indicadores de Cobertura Vacinal e Taxa de Abandono nas capitais do Nordeste nos últimos cinco anos. Metodologia:Estudo epidemiológico, quantitativo e descritivo. As nove capitais do Nordeste do Brasil foram selecionadas para o estudo. A temática abordada é a Taxa de Abandono Vacinal e a Cobertura Vacinal nos últimos cinco anos nas capitais. Os dados foram coletados através doSistema de Informação do Programa Nacional de Imunização e armazenadosno Microsoft Excel. Resultados:Quanto às taxasde cobertura vacinal, Fortaleza teve o maior percentual, com 74,87%. Maceió obteve o segundo maior índice, com 66,12%. Em relação às taxas de abandono vacinal, Salvador registrou o maior número,com 27,39% nos últimos cinco anos. Não obstante, João Pessoaobteve a menor taxa, com 16,08%. Conclusões:Verificou-se que Fortaleza teve a maiorCobertura Vacinal e Salvador teve a maiorTaxa de Abandono Vacinal.Algumas capitais tiveram redução naCobertura Vacinal e aumento na Taxa de Abandono Vacinalno período pandêmico, indicando a necessidade de mais pesquisas sobre o impacto da Covid-19 e a circulação de informações equivocadas sobre vacinação. Logo, a atuação da atenção primária à saúde é crucial para reverter essa tendência, trabalhando na implementação de campanhas de imunização e na educação em saúde (AU).
Introduction: The National Immunization Program present in Primary Health Carecoordinates the immunization process and makes it more effective, but this system faces problems such as lack of internet access and shortages of immunizers, which underminethe population's vaccination coverage and hinderthe electronic recording of indicator data, besides increasing the vaccination abandonment rate.Objective: To analyze the Vaccination Coverage and AbandonmentRate indicators in theNortheasterncapitalsover the last five years.Methodology: Epidemiological, quantitative and descriptive study. The nine capitals of NortheasternBrazil were selected for the study. The themesaddressed arethe VaccinationAbandonment Rate andtheVaccinationCoverage overthe last five years in the capitals. The data was collected through the National Immunization Program Information System and stored in Microsoft Excel.Results:As for vaccination coverage rates, Fortaleza had the highest percentage, with 74.87%. Maceió obtainedthe second highest index, with 66.12%. Regardingvaccinationabandonment rates, Salvador recordedthe highest number,with 27.39% over the last five years. Nonetheless, João Pessoa obtainedthe lowest rate, with 16.08%. Conclusions:It was found that Fortaleza had the highest Vaccination Coverage and Salvador had the highest VaccinationAbandonment Rate.Some capitals had a reduction in Vaccination Coverage and an increase in the VaccinationAbandonment Rate in the pandemic period, indicating the need for more research aboutthe impact of Covid-19 and the circulation of misinformation about vaccination. Therefore, the role of primary health care is essential forreversing this trend, working on the implementation of immunization campaignsand health education (AU).
Introducción:El Programa Nacional de Inmunizaciónpresente en la Atención Primariade Saludcoordina el proceso de inmunización y lo hace más eficaz, pero este sistema se enfrenta a problemas como la falta de acceso a internet y la escasez de inmunizadores, queperjudicanla cobertura de vacunación de la población y dificultan el registro electrónico de los datos de los indicadores, además de aumentar la tasa de abandono de vacunación.Objetivo:Analizar los indicadores de Cobertura de Vacunación y Tasa de Abandono en las capitales del Nordeste en los últimos cinco años.Metodología:Estudio epidemiológico, cuantitativo y descriptivo. Fueron seleccionadas para el estudio las nueve capitales del Nordeste de Brasil. LostemasabordadossonlasTasa de Abandono deVacunacióny la Cobertura de Vacunación en los últimos cinco años en las capitales. Los datos se recogieron a través del Sistema de Información del Programa Nacional de Inmunización y se almacenaron en Microsoft Excel.Resultados:En cuanto a las tasas de cobertura de vacunación, Fortaleza tuvo el porcentaje más elevado, con un74,87%. Maceióobtuvo lasegunda tasa más alta, con un66,12%. En cuanto a las tasas de abandono de vacunación, Salvador registró la cifra más alta, con un27,39% en los últimos cinco años. Sin embargo, João Pessoa obtuvola tasa más baja, con un16,08%.Conclusiones:Se notó queFortaleza tuvo la mayor Cobertura de Vacunación y Salvadortuvola mayor Tasa de Abandono de Vacunación. Algunas capitales tuvieron una reducción de la Cobertura de Vacunacióny un aumento de la Tasa de Abandono de Vacunacióndurante el período pandémico, indicandola necesidad de más investigaciones sobre el impacto de laCovid-19 y la circulación de información errónea sobre la vacunación. Por lo tanto, el rolde la atención primaria de salud es crucial para revertiresta tendencia, trabajando en la implementación de campañas de inmunización y educación sanitaria (AU).
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Vacunación , Programas de Inmunización , Cobertura de Vacunación , Vacilación a la Vacunación , Brasil/epidemiología , Estudios Epidemiológicos , Interpretación Estadística de Datos , COVID-19/epidemiologíaRESUMEN
Introdução:A maioria das doenças respiratórias se enquadram no grupo de causas evitáveis e, dessa forma, taxas elevadas de mortalidade em crianças são reflexo das condições de desenvolvimento socioeconômico, além de mensurar o acesso e qualidade dos serviços de saúde.Objetivo:Avaliar a mortalidade por doenças respiratórias em crianças menores de 0 a 4 anos de idade no Brasil, no período de 2015 a 2020.Metodologia:Trata-se deum estudo ecológico de série temporal, retrospectivo, de abordagem quantitativa, com ênfase nas cinco doenças respiratórias mais evidentes em crianças de até 4 anos no Brasil, entre os anos de 2015 a 2020. Realizou-se coleta de dados pelo DATASUS, sendo utilizado o software Microsoft Excel©para subsidiar as etapas de processamento e análise. Resultados:A análise mostra a pneumonia como a principal causa de morte no país e, a partir da análise regional, a Região Norte possui taxas que excedem as demais regiões dentro do período observado. A mesma tendência é observada na análise das demais infecções respiratórias, porém é importante ressaltar o declínio da mortalidade em todas as variáveis e regiões observadas em 2020.Conclusões:Conclui-se que as maiorestaxas de mortalidade entre crianças no Brasil ratificam a premissa de que as afecções respiratórias são diretamente proporcionais à vulnerabilidade socioeconômica, enquanto a cobertura vacinal e a disponibilidade de leitos contribuem na redução dos indicadores. Não obstante, em 2020 evidenciou-se queda abrupta decorrente das medidas preventivas do coronavírus e, a partir da menor procura por atendimento, maior probabilidade de subnotificação dos casos (AU).
Introduction:The majority of respiratory diseases fall into the group of preventable causes and, therefore, high mortality rates in children are a reflection of socioeconomic development conditions, beyond measurethe access and the quality of health services. Objective:Evaluate the mortality by respiratory diseases in children younger than 4 years of age in Brazil, in the period from 2015 to 2020. Methodology:It is about ecologic study from time series, retrospective, of quantitative approach, with emphasis on the five respiratory diseases more evident in children of up to 4 years in Brazil, between the years from 2015 to 2020. Data was collected by DATASUS, being used byMicrosoft Excel to subsidize the processing steps and analysis. Results:The analysis shows pneumonia as the main cause of death in the country, and, from the regional analysis, the North region can have rates that exceed other regions under the period observed. The same trend is observed in the analysis from the other respiratory infections, although it is important to emphasize the decline of mortality in all variables and regions observed in 2020. Conclusions:It is concluded that the higher rates of mortality between children in Brazil ratifies the premise that respiratory affections are directly proportional to socioeconomic vulnerability, while the vaccination coverage and the availability of beds contribute to the reduction of indicators. However, in 2020, there was an evident steep drop dueto coronavirus preventive measures and, from smaller demand to attendance, higher probability of underreporting of cases (AU).
Introducción: La mayoría de las enfermedades respiratorias se enmarcan en elgrupo de las causas prevenibles y, por tanto, las altas tasas de mortalidad infantil son un reflejo de las condiciones de desarrollo socioeconómico, además de medir el acceso y la calidad de los servicios de salud.Objetivo: Evaluar la mortalidad por enfermedades respiratorias en niños de 0 a 4 años en Brasil, de 2015 a 2020. Metodología: Se trata de un estudio ecológico, retrospectivo, de serie temporal, con abordaje cuantitativo, con énfasis en las cinco enfermedades respiratorias más evidentes en niños de hasta 4 años en Brasil, entre los años 2015 a 2020. Los datos fueron recolectados mediante DATASUS, utilizando Microsoft Software Excel© para apoyar los pasos de procesamiento y análisis. Resultados: El análisis muestra a la neumonía como la principal causa de muerte en el país y, con base en el análisis regional, la Región Norte presenta tasas que superan a las demás regiones dentro del período observado. La misma tendencia se observa en el análisis de otras infecciones respiratorias, pero es importantedestacar la disminución de la mortalidad en todas las variables y regiones observadas en 2020.Conclusiones: Se concluye que las mayores tasas de mortalidad infantil en Brasil confirman la premisa de que las condiciones respiratorias son directamente proporcionales a la vulnerabilidad socioeconómica, mientras que las coberturas de vacunación y la disponibilidad de camas contribuyen para la reducción de los indicadores. Sin embargo, en 2020 hubo una caída abrupta por las medidas preventivas por el coronavirus y, a partir de la menor demanda de atención, una mayor probabilidad de subregistro de casos (AU).
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Calidad de la Atención de Salud , Mortalidad Infantil , Servicios de Salud , Estudios EcológicosRESUMEN
Objetivo:descrever como ocorre a prática do contato pele a pele em uma unidade neonatal referência para o Método Canguru. Método: estudo descritivo, transversal, realizado em unidade intensiva neonatal do sul do Brasil. Dados analisados por meio de estatística descritiva simples. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: analisados dados de29 recém-nascidos pré-termo, com peso menor de 1.800 gramas. O primeiro contato pele a pele foi realizado, em média, com 6,38 dias. A frequência de contato pele a pele foi de 1,6 vezes ao dia, sendo o tempo mínimo de 56 minutos e o ganho ponderal médio de 26,98gramaspor dia. Conclusão: a realização do contato pele a pele acontece, em sua maioria, após o quinto dia de vida, na primeira etapa do Método. A frequência de realização deste contato foi de uma vez por dia e o tempo de duração médio foi de 120 minutos. Na segunda etapa do Método,os dados pouco variaram(AU)
Objective:to describe how skin-to-skin contact is practiced in a neonatal unit that is a reference for the Kangaroo Mother Care. Method:descriptive, cross-sectional study, carried out in a neonatal intensive unit in southern Brazil. Data analyzed using simple descriptive statistics. Protocol approved by the Research Ethics Committee. Results:data from 29 preterm newborns weighing less than 1,800 grams were analyzed. The first skin-to-skin contact took place, on average, after 6.38 days. The frequency of skin-to-skin contact was 1.6 times a day, with a minimum time of 56 minutes and an averageweight gain of 26.98g per day. Conclusion:skin-to-skin contact occurs, for the most part, after the fifth day of life, in the first stage of the Method. The frequency of this contact was once a day, and the average duration was 120 minutes. In the second stage of the Method, the data varied little(AU)
Objetivo:describir cómo se practica el contacto piel con piel en una unidad neonatal que es referencia del Método Madre Canguro. Método:Estudio descriptivo, transversal, realizado en una unidad intensiva neonatal del sur de Brasil. Datos analizados mediante estadística descriptiva simple. Protocolo aprobado por el Comité de Ética en Investigación. Resultados:se analizaron los datos de 29 recién nacidos prematuros, cuyo peso era inferior a 1.800 gramos. El primer contacto piel con pielse produjo, en promedio, después de 6,38 días. La frecuencia de contacto piel con piel fue de 1,6 veces al día, durante un tiempo mínimo de 56 minutos y un aumento medio de peso de 26,98 g por día. Conclusión: el contacto piel con piel ocurre, en su mayor parte, después del quinto día de vida, en la primera etapa del Método. La frecuencia de este contacto fue una vez al día y laduración, en promedio, fue de 120 minutos. En la segunda etapa del Método los datos variaron poco(AU)
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Adulto , Adulto Joven , Tacto , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Método Madre-Canguro , Relaciones Madre-Hijo , Estudios TransversalesRESUMEN
O Método Canguru é uma política de saúde no Brasil e propõe uma assistência humanizada aos recém-nascidos pré-termo e/ou de baixo peso e à sua família. Segundo a concepção brasileira, é desenvolvido em três etapas, sendo as duas primeiras realizadas no âmbito hospitalar e a terceira realizada no domicílio, com acompanhamento compartilhado entre a equipe hospitalar e a equipe da Atenção Primária à Saúde. O estudo teve como objetivo conhecer a percepção dos profissionais da Atenção Primária à Saúde em relação à continuidade do cuidado ao recém-nascido pré-termo e/ou baixo peso egresso da unidade neonatal. Trata-se de uma pesquisa descritiva exploratória com abordagem qualitativa, realizada com 22 profissionais da Atenção Primária que atuam no cuidado direto ao recém-nascido pré-termo e/ou baixo peso no município de Florianópolis, no período de fevereiro a março de 2020, utilizando a Análise de Conteúdo. Da pesquisa emergiram quatro categorias: Vínculo com a Família, Relacionamento Interdisciplinar na Atenção Primária à Saúde, Comunicação na Referência e contrarreferência e Aspectos Necessários para a Continuidade do Cuidado ao Recém-Nascido pré-termo e/ou baixo peso. Os profissionais consideram que há dificuldade na comunicação entre a atenção especializada e a Atenção Primária e sugerem capacitações a respeito do Método Canguru. Relatam, ainda, bom relacionamento interpessoal entre médicos e enfermeiros. Conclui-se que apesar das fragilidades apresentadas quanto à comunicação entre os serviços e o cuidado por vezes fragmentado, a vinculação com a estratégia saúde da família apresenta potencialidades para a manutenção da terceira etapa do Método.
The Kangaroo Method is a health policy in Brazil and proposes a humanized care for preterm and/or low birth weight newborns and their families. Based on the Brazilian conception, it is developed in three stages, the first two being carried out in the hospital and the third at home, with shared monitoring between the hospital staff and the Primary Health Care staff. The study sought to understand the perception of Primary Health Care professionals regarding the continuity of care for preterm and/or low birth weight newborns discharged from the neonatal unit. This is an exploratory descriptive research with a qualitative approach, carried out with 22 Primary Care professionals who work in direct care for preterm and/or low birth weight newborns in the city of Florianópolis, from February to March 2020, using Content Analysis. Four categories emerged from the research: Bond with the Family, Interdisciplinary Relationship in Primary Health Care, Communication in Reference and Counter-reference, and Required Aspects for Continuity of Care for Preterm and/or Low Birth Weight Newborns. Professionals consider that there is a lack of communication between specialized care and Primary Care and suggest training on the Kangaroo Care Method. They also report a good interpersonal relationship between doctors and nurses. It is concluded that despite the fragilities presented in terms of communication between services and the sometimes fragmented care, the connection with the family as a health strategy has potential for maintaining the third stage of the Method.
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In Brazil, during the pandemic caused by COVID-19, screening for breast and cervical cancers was postponed or interrupted due to the prevailing health conditions. These neoplasms, however, are responsible for high morbidity and mortality among women in Brazil and have a major impact on the quality of life of this population and public health. Thus, this study aims to evaluate the epidemiological behavior of hospitalization for cervical and breast cancer in Brazilian women, as well as the trend of screening tests of breast and cervical cancer in the years 2010 to 2022 according to the regions of Brazil. This is ecological research of time series, based on secondary data obtained from information systems of the country, about hospital admissions for breast and cervical cancer and screening methods used for these tumors. The data were analyzed in the Joinpoint Regression Program, to obtain the linear regression and temporal analysis of the variables. As a result, between 2010 and 2022, the rates of mammography varied from 36 to 71 exams, while in the pap smear, the variations were 126 and 226 cytopathological exams per 1000 women. Hospitalizations for these cancers peaked in 2019, with 48 hospitalizations for cervical cancer per 100,000 women and 147 hospitalizations for breast cancer for the same population. For both, in the pandemic years, between 2020 and 2022, there is a decrease in Brazil and in all its regions. As for the tracking of these diseases, it was observed that the performance of mammograms and preventive tests showed a similar behavior, in which there is a higher supply of these tests until 2019 and a drop during the pandemic period. This leads to the conclusion that even though Brazil has several policies for the screening of these diseases, there is still instability in the offering of these tests and that there was instability in this area during the pandemic.
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Neoplasias de la Mama , Neoplasias del Cuello Uterino , Femenino , Humanos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Frotis Vaginal , Brasil/epidemiología , Calidad de Vida , Tamizaje Masivo/métodos , Detección Precoz del Cáncer/métodos , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Mamografía , HospitalizaciónRESUMEN
Background and Objective: the alcoholic preparation consumption indicator is a measure that can help monitor compliance with hand hygiene, however there is no guidance regarding the profile for application of consumption reference published by the World Health Organization for many health institutions. Thus, the study sought information available in scientific literature to support the definition of alcohol preparation consumption for hand hygiene in outpatient clinics and Day Hospitals. Method: an integrative review for the period between 2010 and 2021, conducted in the Scopus, Web of Science, SciELO, PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Database on Nursing and Latin American and Caribbean Literature on Health Sciences databases, through the Virtual Health Library. Five articles were selected, being divided into two categories: Milliliters of alcoholic preparation for each hand hygiene, identifying the expected average volume of 3 ml, and Consumption of alcohol-based hand rub per patient-day, observing the prevalence of studies in general hospitals. A study brought the perspective regarding consumption in a Nursing Home. Conclusion: in the review, no articles related to outpatient clinics and Day Hospitals were found. The selected studies demonstrate that alcohol preparation consumption for hand hygiene is different depending on the profile of the sector and the patient treated and that both the minimum volume for each hand hygiene and the opportunities are not considered for analysis of the indicator.(AU)
Justificativa e Objetivo: o indicador de consumo de preparação alcoólica é uma medida que pode auxiliar no monitoramento da adesão à higienização das mãos, entretanto não existe direcionamento quanto ao perfil para aplicação da referência de consumo publicada pela Organização Mundial da Saúde para muitas instituições de saúde. Assim, o estudo buscou analisar as informações disponíveis na literatura científica para subsidiar a definição do consumo de preparação alcoólica para higienização das mãos em instituições ambulatoriais e Hospitais-Dia. Método: revisão integrativa referente ao período entre 2010 e 2021, realizada nas bases de dados Scopus, Web of Science, SciELO, PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Banco de Dados em Enfermagem e Literatura Latino-Americana e do Caribe em Ciências da Saúde, através da Biblioteca Virtual em Saúde. Foram selecionados cinco artigos que abordam o tema, sendo divididos em duas categorias: Mililitros de preparação alcoólica para cada higienização das mãos, identificando-se o volume médio previsto de 3 ml, e Consumo de preparação alcoólica por paciente/dia, observando-se a prevalência de estudos em hospitais gerais. Um estudo trouxe a perspectiva referente ao consumo em uma Instituição de Longa Permanência. Conclusão: na revisão, não foram encontrados artigos relacionados a ambulatórios e Hospitais-Dia. Os estudos selecionados demonstram que o consumo de preparação alcóolica é diferente dependendo do perfil do setor e do paciente atendido e que tanto o volume mínimo para cada higienização das mãos quanto as oportunidades geralmente não são considerados para análise do indicador.
Justificación y Objetivos: el indicador de consumo de preparados alcohólicos es una medida que ayuda a monitorear la adherencia a la higiene de manos, pero no existe una orientación respecto al perfil de aplicación de la referencia publicada por la Organización Mundial de la Salud para muchas instituciones de salud. Así, el estudio buscó información disponible en la literatura científica para sustentar la definición del consumo de preparados alcohólicos en instituciones ambulatorias y Hospitales Día. Método: una revisión integrativa para el período comprendido entre 2010 y 2021, realizada en bases de datos Scopus, Web of Science, SciELO, PubMed/MEDLINE; Cumulative Index to Nursing and Allied Health Literature, Base de Datos de Enfermería y Literatura Latinoamericana y del Caribe en Ciencias de la Salud, a través de la Biblioteca Virtual en Salud. Se seleccionaron cinco artículos que abordaban el tema y se dividieron en dos categorías: Mililitros de preparación alcohólica para cada higiene de manos, identificando el volumen promedio esperado de 3 ml, y Consumo de preparación alcohólica por paciente-día, observando la prevalencia de estudios en hospitales generales. Un estudio trajo la perspectiva sobre el consumo en una Institución de Larga Estancia. Conclusión: en la revisión, no se encontraron artículos relacionados con ambulatorios y Hospitales Día. Los estudios seleccionados demuestran que el consumo de preparados alcohólicos para la higiene de manos es diferente según el perfil del sector y del paciente tratado y que tanto el volumen mínimo como las oportunidades no suelen ser considerados para el análisis del indicador.(AU)
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Humanos , Desinfección de las Manos , Desinfectantes para las Manos , Antiinfecciosos LocalesRESUMEN
OBJECTIVE: To describe the elaboration and content validity stages of a digital educational technology for nursing professionals about Japanese bathtub (ofurô) in newborns in neonatal care units. METHOD: A methodological study conducted between August 2019 and July 2021, in a public maternity hospital in Manaus, Amazonas, developed in two stages. In the first, the e-book images, text and editing were produced. In the second, material content validity was carried out, through the opinion of 15 expert judges, nurses and neonatal care experts. In data analysis, the percentage of agreement was applied with agreement score estimation. Items with 80% or more agreement were considered valid. RESULTS: The e-book "Japanese bathtub: manual for nursing professionals" was produced, organized into nine sessions, which describe the technique execution. Content was considered valid by expert judges (general score 90%). CONCLUSION: The e-book was considered suitable for use in training nursing professionals, with potential for dissemination of knowledge regarding humanization of care for premature babies.
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Baños , Educación a Distancia , Atención de Enfermería , Femenino , Humanos , Recién Nacido , Baños/métodos , Brasil , Educación en Enfermería/métodos , Tecnología Educacional/métodos , Recien Nacido Prematuro , Encuestas y CuestionariosRESUMEN
Historically, the oro-nasal mask has been the preferred interface to deliver Non-Invasive Positive Pressure Ventilation (NPPV) in critically ill patients. To overcome the problems related to air leaks and discomfort, Total Full-face masks have been designed. No study has comparatively evaluated the performance of the total Full-face masks available.The aim of this bench study was to evaluate the influence of three largely diffuse models of total Full -face masks on patient-ventilator synchrony and performance during pressure support ventilation. NPPV was applied to a mannequin, connected to an active test lung through three largely diffuse Full-face masks: Dimar Full-face mask (DFFM), Performax Full-face mask (RFFM) and Pulmodyne Full-face mask (PFFM).The performance analysis showed that the ΔPtrigger was significantly lower with PFFM (p < 0.05) at 20 breaths/min (RRsim) at both pressure support (iPS) levels applied, while, at RRsim 30, DFFM had the longest ΔPtrigger compared to the other 2 total full face masks (p < 0.05). At all ventilator settings, the PTP200 was significantly shorter with DFFM than with the other two total full-face masks (p < 0.05). In terms of PTP500 ideal index (%), we did not observe significant differences between the interfaces tested.The PFFM demonstrated the best performance and synchrony at low respiratory rates, but when the respiratory rate increased, no difference between all tested total full-face masks was reported.
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Máscaras , Ventilación no Invasiva , Humanos , Respiración con Presión Positiva , Pulmón , RespiraciónRESUMEN
This article aims to evaluate the factors associated with a skin-to-skin contact time <180 min/day in newborns weighing up to 1,800 g during neonatal hospitalization. Prospective observational cohort study conducted in neonatal units of reference for the Kangaroo Method in Brazil. Data from 405 dyads (mother/child) were analyzed from May 2018 to March 2020. Maternal and neonatal explanatory variables were collected from medical records and interviews. Skin-to-skin contact was recorded in forms posted at the bedside, filled out by parents and staff. The outcome variable was the mean time of skin-to-skin contact < 180 min/day. Hierarchical modeling was performed by Poisson regression with robust variance. The variables associated with the outcome were "without easy access to the hospital", "without previous knowledge of the kangaroo method" and "having had morbidities during pregnancy". Mothers without easy access to the hospital and who are unaware of the kangaroo method should be priority targets for health policies to develop strategies that promote greater exposure to skin-to-skin contact during the hospitalization period of their children.
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Método Madre-Canguro , Femenino , Humanos , Embarazo , Niño , Método Madre-Canguro/métodos , Estudios Prospectivos , Madres , Hospitalización , BrasilRESUMEN
OBJECTIVES: to analyze the work of nurses portrayed in the journalistic media and its impact on the construction of professional nursing identity. METHODS: this is qualitative, retrospective, descriptive and documentary research, with 51 reports from Folha de São Paulo. Time frame from March to December 2020. Thematic Content Analysis carried out from Claude Dubar's theoretical perspective. Organization and coding of data performed with the help of ATLAS.ti®. RESULTS: three categories emerged: Working conditions in the pandemic - a problem that worsened; Impacts of the pandemic on daily work; Feelings generated by the pandemic. CONCLUSIONS: despite adversities, such as the precariousness of health institutions, inadequate working conditions for nurses, lack of basic items of individual protection, negative feelings and hopelessness, these professionals used their knowledge, skills and innovations in the act of caring, which contributed to reconstructing their professional identity.
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Enfermeras y Enfermeros , Pandemias , Humanos , Estudios Retrospectivos , Brasil , Emociones , Investigación CualitativaRESUMEN
Abstract This article aims to evaluate the factors associated with a skin-to-skin contact time <180 min/day in newborns weighing up to 1,800 g during neonatal hospitalization. Prospective observational cohort study conducted in neonatal units of reference for the Kangaroo Method in Brazil. Data from 405 dyads (mother/child) were analyzed from May 2018 to March 2020. Maternal and neonatal explanatory variables were collected from medical records and interviews. Skin-to-skin contact was recorded in forms posted at the bedside, filled out by parents and staff. The outcome variable was the mean time of skin-to-skin contact < 180 min/day. Hierarchical modeling was performed by Poisson regression with robust variance. The variables associated with the outcome were "without easy access to the hospital", "without previous knowledge of the kangaroo method" and "having had morbidities during pregnancy". Mothers without easy access to the hospital and who are unaware of the kangaroo method should be priority targets for health policies to develop strategies that promote greater exposure to skin-to-skin contact during the hospitalization period of their children.
Resumo O objetivo deste artigo é avaliar os fatores associados ao tempo de contato pele a pele < 180 min/dia em recém-nascidos com peso até 1.800 g durante a internação neonatal. Estudo observacional tipo coorte prospectivo conduzido em unidades neonatais de referência no Brasil. Foram analisados dados de 405 díades (mãe/filho), no período de maio de 2018 a março de 2020. As características da mãe e do recém-nascido foram coletadas em prontuários e entrevistas, a realização do contato pele-a-pele era registrada em fichas anexadas ao leito, preenchidas pela equipe e pelos pais. A variável desfecho foi o tempo médio diário de contato pele-a-pele inferior a 180 minutos. Foi realizada modelagem hierarquizada utilizando a regressão de Poisson com variância robusta para cálculo das razões de prevalência. As variáveis que permaneceram independentemente associadas foram: "não ter fácil acesso ao hospital" (morar longe ou ter dificuldade de transporte), "não possuir conhecimento prévio sobre o método canguru" e "ter apresentado morbidades durante a gestação". Mães sem fácil acesso ao hospital e que desconhecem o método canguru devem ser alvos prioritários das políticas de saúde para desenvolver estratégias que promovam maior exposição ao contato pele a pele durante o período de internação de seus filhos.
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RESUMO: Objetivo: descrever o processo de construção e validação de infográfico educativo com orientações para gestantes e acompanhantes em atendimento obstétrico no contexto da Covid-19. Método: pesquisa metodológica baseada nas diretrizes da Instrucional System Design. Realizada de janeiro de 2021 a março de 2022, no Estado de Santa Catarina - Brasil, em três momentos: revisão de escopo; entrevistas com enfermeiros de uma Emergência Obstétrica; e elaboração da tecnologia educativa e validação com experts. A análise foi ancorada na análise de conteúdo com Índice de Validade de Conteúdo. Resultados: o infográfico aborda cuidados para prevenção da infecção Covid-19, orientações sobre início do trabalho de parto, quando procurar a maternidade e os cuidados na internação das gestantes. O infográfico obteve Índice de Validade de Conteúdo de 83,3%. Conclusão: a tecnologia educacional foi considerada adequada para disseminação de informações e auxílio dos profissionais na promoção de saúde e na prevenção de agravos à população obstétrica.
ABSTRACT Objective: to describe the process of construction and validation of an educational infographic with guidelines for pregnant women and companions in obstetric care in the context of Covid-19. Method: methodological research based on Instructional System Design guidelines and conducted from January 2021 to March 2022, in the State of Santa Catarina - Brazil, in three moments: scoping review, interviews with nurses from an Obstetric Emergency, and elaboration of educational technology and validation with experts. The analysis was anchored in content analysis with Content Validity Index. Results: the infographic addresses care for the prevention of Covid-19 infection, guidance on the onset of labor, when to seek maternity care, and care during hospitalization of pregnant women. The infographic obtained a Content Validity Index of 83.3%. Conclusion: educational technology was considered adequate for disseminating information and assisting professionals in promoting health and preventing injuries to the obstetric population.
RESUMEN Objetivo: describir el proceso de construcción y validación de una infografía educativa con directrices para embarazadas y acompañantes en la atención obstétrica en el contexto de Covid-19. Método: investigación metodológica basada en las directrices del Instrucional System Design. Realizado de enero de 2021 a marzo de 2022, en el Estado de Santa Catarina - Brasil, en tres momentos: revisión de alcance; entrevistas con enfermeros de una Emergencia Obstétrica; y elaboración de tecnología educativa y validación con expertos. El análisis se ancló en el análisis de contenido con el Índice de Validez del Contenido. Resultados: La infografía abarca los cuidados para la prevención de la infección por Covid-19, las orientaciones sobre el inicio del parto, cuándo acudir a la maternidad y los cuidados durante la hospitalización de las embarazadas. La infografía obtuvo un índice de validez del contenido del 83,3%. Conclusión: La tecnología educativa se consideró apropiada para difundir información y ayudar a los profesionales a promover la salud y prevenir lesiones en la población obstétrica.