Protocol for reducing radiation exposure during pediatric thoracic radiography.

INTRODUCTION: This work aims to assess if the anode position during chest radiography of pediatric patients with heart congenital disease (HCD) influences medical image results. The approach is to reverse the orientation of the x-ray tube, with the anode end directed towards the patient's face (anode-heel effect). METHODS: Five specialists analyzed 48 images, 24 from the control group (CG) and 24 with the anode end directed towards the patients' face (experimental group, EC). An ionization chamber was used to assess radiation dose received by sensitive organs. RESULTS: The specialists considered both CG and EC images acceptable. But, the EC group's dose evaluation revealed that the thyroid received 12% less radiation and the gonads presented a 5.9% reduction. Based on the results, a new protocol was developed. DISCUSSION/CONCLUSION: The standardization of radiographic imaging procedures will reduce acquisition errors, resulting in adequate images in pediatric patients with HCD with less radiation dose, thus increasing patient safety and extending the life of the equipment.

Autophagy-targeted therapy to modulate age-related diseases: Success, pitfalls, and new directions.

Autophagy is a critical metabolic process that supports homeostasis at a basal level and is dynamically regulated in response to various physiological and pathological processes. Autophagy has some etiologic implications that support certain pathological processes due to alterations in the lysosomal-degradative pathway. Some of the conditions related to autophagy play key roles in highly relevant human diseases, e.g., cardiovascular diseases (15.5%), malignant and other neoplasms (9.4%), and neurodegenerative conditions (3.7%). Despite advances in the discovery of new strategies to treat these age-related diseases, autophagy has emerged as a therapeutic option after preclinical and clinical studies. Here, we discuss the pitfalls and success in regulating autophagy initiation and its lysosome-dependent pathway to restore its homeostatic role and mediate therapeutic effects for cancer, neurodegenerative, and cardiac diseases. The main challenge for the development of autophagy regulators for clinical application is the lack of specificity of the repurposed drugs, due to the low pharmacological uniqueness of their target, including those that target the PI3K/AKT/mTOR and AMPK pathway. Then, future efforts must be conducted to deal with this scenery, including the disclosure of key components in the autophagy machinery that may intervene in its therapeutic regulation. Among all efforts, those focusing on the development of novel allosteric inhibitors against autophagy inducers, as well as those targeting autolysosomal function, and their integration into therapeutic regimens should remain a priority for the field.

Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review.

OBJECTIVE: to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. METHOD: this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. RESULTS: the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy. CONCLUSION: the results found suggest that anxiety can be reduced using non-pharmacological strategies.

Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review / Estratégias não farmacológicas para diminuição da ansiedade no cateterismo cardíaco: revisão integrativa / Estrategias no farmacológicas para disminuir la ansiedad en el cateterismo cardíaco: revisión integradora

ABSTRACT Objective: to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. Method: this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. Results: the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy. Conclusion: the results found suggest that anxiety can be reduced using non-pharmacological strategies.

RESUMO Objetivo: identificar na literatura estudos que abordam as estratégias não farmacológicas utilizadas para redução da ansiedade de pacientes que se submetem ao cateterismo cardíaco. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases de dados LILACS, SciELO, Medline (via BVS e PubMed) e Scopus. Os estudos foram analisados de acordo com seu objetivo, métodos, instrumentos utilizados para avaliar ansiedade dos pacientes e resultados obtidos. Resultados: a musicoterapia foi a estratégia mais abordada para a redução da ansiedade. Entretanto, não foi encontrado nenhum estudo que identificasse o momento mais adequado para esta intervenção (antes, durante e/ou após o procedimento hemodinâmico). Outras estratégias identificadas nesta revisão foram o vídeo educacional, massagem e terapia na palma das mãos. Conclusão: os resultados encontrados sugerem que a ansiedade pode ser diminuída com o emprego de estratégias não farmacológicas.

RESUMEN Objetivo: identificar y revisar los estudios de literatura que abordan las estrategias no farmacológicas utilizadas para reducir la ansiedad en los pacientes que reciben un cateterismo cardíaco. Método: revisión integradora. La investigación se llevó a cabo utilizando las bases de datos LILACS, SciELO, Medline (BVS y PubMed) y Scopus. Los estudios se analizaron de acuerdo con sus objetivos, la metodo, los instrumentos utilizados para la evaluación de la ansiedad de los pacientes, y los resultados obtenidos. Resultados: la estrategia dirigida más para reducir la ansiedad en los pacientes que recibieron cateterización cardíaca fue la musicoterapia. No se encontró estudio, sin embargo, identificando el momento más adecuado para esta intervención (antes, durante y / o después de este procedimiento). Otras estrategias identificados en esta revisión eran videos educativos, masajes y terapia de palma. Conclusión: los resultados sugieren que la ansiedad se puede reducir el uso de estrategias no farmacológicas.