Exercise effect on symptom severity, morbidity and mortality in viral infections: a systematic review and meta-analysis.

There is a knowledge gap regarding the consequences of exercise during acute infections in humans and contradictory findings in animal studies, compromising public health advice on the potential benefits of physical activity for immunity. Here, we carried out a meta-analysis of studies of the effects of moderate exercise (ME) and exercise until fatigue (EF) on symptom severity, morbidity and mortality during viral infection in animal models. The systematic review on PubMed, Scopus, Embase, Web of Science, Cochrane and EBSCOhost (CINAHL and SPORT Discus) identified 8 controlled studies, with 15 subgroups within them. The studies exposed the animals (mice [7 studies] and monkeys [1 study]) to exercise immediately before or after viral inoculation (HSV-1, H1N1 influenza and B.K. virus) with follow-up for 21 days. ME significantly reduced morbidity (OR 0.43 [0.19; 0.98], P = 0.04) with no change for symptom severity (SMD -3.37 [-9.01; 2.28], P = 0.24) or mortality (OR 0.48 [0.08;3.03], P = 0.43). In contrast, EF gave a trend towards increased symptom severity (SMD 0.96 [-0.06; 1.98], P = 0.07) and mortality (OR 1.47 [0.96;2.28], P =0.08) with no change in morbidity (OR 1.22 [0.60;2.5], P = 0.58). We conclude that in animals moderate exercise during infection is advantageous, whilst exercise until fatigue should be avoided. Further research is required to determine if moderate exercise may also be beneficial in humans during infection.

Regulation of Lin28a-miRNA let-7b-5p pathway in skeletal muscle cells by peroxisome proliferator-activated receptor delta.

Lin28a/miRNA let-7b-5p pathway has emerged as a key regulators of energy homeostasis in the skeletal muscle. However, the mechanism through which this pathway is regulated in the skeletal muscle has remained unclear. We have found that 8 wk of aerobic training (Tr) markedly decreased let-7b-5p expression in murine skeletal muscle, whereas high-fat diet (Hfd) increased its expression. Conversely, Lin28a expression, a well-known inhibitor of let-7b-5p, was induced by Tr and decreased by Hfd. Similarly, in human muscle biopsies, Tr increased LIN28 expression and decreased let-7b-5p expression. Bioinformatics analysis of LIN28a DNA sequence revealed that its enrichment in peroxisome proliferator-activated receptor delta (PPARδ) binding sites, which is a well-known metabolic regulator of exercise. Treatment of primary mouse skeletal muscle cells or C2C12 cells with PPARδ activators GW501516 and AICAR increased Lin28a expression. Lin28a and let-7b-5p expression was also regulated by PPARδ coregulators. While PPARγ coactivator-1α (PGC1α) increased Lin28a expression, corepressor NCoR1 decreased its expression. Furthermore, PGC1α markedly reduced the let-7b-5p expression. PGC1α-mediated induction of Lin28a expression was blocked by the PPARδ inhibitor GSK0660. In agreement, Lin28a expression was downregulated in PPARδ knocked-down cells leading to increased let-7b-5p expression. Finally, we show that modulation of the Lin28a-let-7b-5p pathway in muscle cells leads to changes in mitochondrial metabolism in PGC1α dependent fashion. In summary, we demonstrate that Lin28a-let-7b-5p is a direct target of PPARδ in the skeletal muscle, where it impacts mitochondrial respiration.

Compression of left renal vein and left common iliac vein on CT scans: how often are they detected?

BACKGROUND: The nutcracker and May-Thurner syndromes are rare and, although often underdiagnosed, they can cause limiting symptoms. They are frequently considered only after exclusion of other diagnoses and there is no consensus in the literature on prevalence, incidence, or diagnostic criteria. OBJECTIVES: To estimate the frequency of compression of the left common iliac vein and left renal vein in CT scans of the abdomen and pelvis. METHODS: Descriptive, quantitative, cross-sectional study. The criteria used to define compression of the left renal vein were a hilar/aortomesenteric diameter ratio > 4 and aortomesenteric angle < 39° and the criterion for compression of the left common iliac vein was a diameter < 4mm. RESULTS: CT scans of 95 patients were analyzed; 61% were women and 39% were men. Left renal vein compression was observed in 24.2% of the sample, with a mean age of 48.8 years, occurring in 27.6% of the women and 18.9% of the men (p = 0.3366). Compression of the left common iliac vein was detected in 15.7% of the sample, with a mean age of 45.9 years, occurring in 24.1% of the women and 2.7% of the men (p = 0.0024). Both veins were compressed in 7.4% of the patients. CONCLUSIONS: Left renal vein compression was detected in women and men at similar frequencies, whereas left common iliac vein compression was more frequent in women. Both venous compressions were most frequently found in patients aged 41 to 50 years.

Role of NCoR1 in mitochondrial function and energy metabolism.

Mitochondrial number and shape are constantly changing in response to increased energy demands. The ability to synchronize mitochondrial pathways to respond to energy fluctuations within the cell is a central aspect of mammalian homeostasis. This dynamic process depends on the coordinated activation of transcriptional complexes to promote the expression of genes encoding for mitochondrial proteins. Recent evidence has shown that the nuclear corepressor NCoR1 is an essential metabolic switch which acts on oxidative metabolism signaling. Here, we provide an overview of the emerging role of NCoR1 in the transcriptional control of energy metabolism. The identification and characterization of NCoR1 as a central, evolutionary conserved player in mitochondrial function have revealed a novel layer of metabolic control. Defining the precise mechanisms by which NCoR1 acts on energy homeostasis will ultimately contribute towards the development of novel therapies for the treatment of metabolic diseases such as obesity and type 2 diabetes.

Early detection of left ventricular contractility abnormalities by two-dimensional speckle tracking strain in Chagas' disease.

BACKGROUND: Chagas' disease is an important cause of heart failure, and early identification of cardiac involvement may help to identify patients at risk for disease progression. Two-dimensional (2D) speckle tracking (ST) strain seems to be a useful tool to detect incipient ventricular dysfunction. This study aims to analyze if 2D strain can detect contractility abnormalities in asymptomatic patients with Chagas' disease. METHODS: Seventy-eight asymptomatic Chagas' disease patients (46% male; age 44.7 ± 8.6 years) with normal cardiovascular exams and a control group of 38 healthy subjects (58% male; age 44.1 ± 9.2 years) were included in the study. Using 2D strain software, left ventricular (LV) end-systolic longitudinal, radial, and circumferential strain were measured. Global right ventricular (RV) longitudinal strain was also assessed. RESULTS: Echocardiographic parameters of LV systolic and diastolic function were similar between patients and controls. 2D longitudinal strain in the basal inferior, and inferoseptal walls, as well as apical segment of the inferolateral wall were lower in patients compared with controls. 2D radial strain was reduced in several segments of the LV walls as well as the global radial strain. 2D circumferential strain at the basal segment of the anterior wall showed a lower value in patients compared with controls, whereas global circumferential strain was similar between patients and controls. 2D RV strain did not differ between groups. CONCLUSION: In a subgroup of asymptomatic patients with Chagas' disease without evident cardiac involvement, 2D strain was reduced compared with healthy individuals, suggesting incipient LV dysfunction in these patients. 2D ST strain has the potential for detecting early myocardial impairment in the setting of Chagas' disease.

Occurrence of Myxobolus spp. (Myxozoa) in the blood of Metynnis lippincottianus (Osteichthyes: Serrasalmidae) from eastern Amazon, Brazil.

Myxozoans are obligatory parasites and can be found in various organs and bloodstreams of fish, thus, the objective of this work was to describe the occurrence of Myxobolus spp. in the circulating blood of Metynnis lippincottianus from River Curiaú, Macapá City, eastern Amazon, Brazil. The samples of M. lippincottianus (11) were caught using cast net and gillnets. The fish blood was collected by puncturing the caudal vessel, using needles and syringes containing 10% of EDTA solution. Blood smear were prepared and panchromatic stained with a combination of May Grunwald-Giemsa-Wright, for observation and examination of the parasitic structures in optical microscope. Tissues from the kidney was examined using specific stereoscopic binoculars to check for the presence of cysts, lesions and parasites. The prevalence of Myxobolus spp. infecting the circulating blood of the fish was 36.36% (4/11) and 15 spores of mixosporyds were visualized. Myxobolus spp. had a prevalence of 54.55% (6/11) in host's kidney tissue and the morphometric spores data converge with observed in the blood. The morphological characteristics of the spores in the blood samples revealed two morphotypes of Myxobolus spp. This is the sixth occurrence recorded of Myxobolus spp. infecting fish blood in Brazil.

The Influence of Degrees of Severity of Temporomandibular Dysfunction on Report of Vestibular Symptoms - A Cross-Sectional Study.

INTRODUCTION: Due to the anatomical proximity and functional connection, vestibular symptoms (VS) are common in temporomandibular disorders (TMD). However, it is not known whether the degree of severity of TMD affect the report of associated vestibular symptoms. OBJECTIVE: To evaluate associations of demographic, clinical and functional factors, as well as report of VS, with the severity of TMD. METHOD: Cross-sectional study carried out at a higher education institution in Salvador, Bahia, Brazil. After approval by the Ethics Committee of Hospital Santo Antônio (CAAE 81517317.2.0000.0047), the collection team applied the Dizziness Handicap Inventory (DHI), the Fonseca Anamnestic Questionnaire (QAF) and the Research Diagnostic Criteria for Temporomandibular Disorders axis II questions (RDC/TMD) in employees, teachers and students. Statistical tests of association with the Chi-square, t test for independent samples and ANOVA (alpha 5% and 80% power) were performed. RESULTS: The sample of 623 participants identified 333 (63.7%) people with TMD and 418 (79.9%) with VS. Females were associated with both temporomandibular dysfunction and vestibular symptoms. The degree of severity of the TMD showed a strong correlation with VS (p < 0.001). CONCLUSION: In the studied sample, it was observed that the greater the degree of severity of the TMD, the greater the VS, which confirms the need to evaluate both systems in symptomatic patients for each of the clinical conditions.

Efficacy of Acupuncture on Quality of Life, Functional Performance, Dyspnea, and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Clinical Trial.

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by the presence of chronic airflow obstruction. Previous studies have evaluated the effect of acupuncture treatment (AT) in patients with COPD. Nevertheless, these studies show a great deal of heterogeneity in treatment protocols, having sample sizes that are too small to estimate and clarify effect size and heterogeneity in patients' baseline. The aim of this study is to evaluate the effectiveness of acupuncture on quality of life, functional performance, dyspnea, and pulmonary function in patients with COPD. As such, patients will go through the following three phases: Phase I-pretreatment: period of subject selection and inclusion in the protocol, with an interview and performance of exams and tests as follows: Mini-Cog, dual-energy X-ray absorptiometry, spirometry, the Patient-Generated Index, Saint George's Respiratory Questionnaire, the six-minute walk test, the London Chest Activity of Daily Living, and the COPD Assessment Test. Phase II-8 weeks of treatment, with AT 3 times a week, with two parallel groups: Group I-with 50 subjects-AT according to the recommended technical standards; Group II-with 50 subjects-Control, without acupuncture. Phase III-Continuation of AT for 8 weeks, maintaining the subjects in the previously allocated groups and following the same methodology.

Endurance and resistance exercise training programs elicit specific effects on sciatic nerve regeneration after experimental traumatic lesion in rats.

OBJECTIVE: To evaluate the effects of endurance, resistance, and a combination of both types of exercise training on hindlimb motor function recovery and nerve regeneration after experimental sciatic nerve lesion in rats. METHODS: Sciatic nerve crush was performed on adult male rats, and after 2 weeks of the nerve lesion, the animals were submitted to endurance, resistance, and a combination of endurance-resistance training programs for 5 weeks. Over the training period, functional recovery was monitored weekly using the Sciatic Functional Index (SFI) and histological and morphometric nerve analyses were used to assess the nerve regeneration at the end of the trainings. RESULTS: The SFI values of the endurance-trained group reached the control values from the first posttraining week and were significantly better than both the resistance-trained group at the first, second, and third posttraining weeks and the concurrent training group at the first posttraining week. At the distal portion of the regenerating sciatic nerve, the endurance-trained group showed a greater degree of the myelinated fiber maturation than the sedentary, resistance-trained, and concurrent training groups. Furthermore, the endurance-trained group showed a smaller percentage area of endoneurial connective tissue and a greater percentage area of myelinated fibers than the sedentary group. CONCLUSION: These data provide evidence that endurance training improves sciatic nerve regeneration after an experimental traumatic injury and that resistance training or the combination of 2 strategies may delay functional recovery and do not alter sciatic nerve fiber regeneration.

As percepções na formação de egressos da residência em enfermagem obstétrica: estudo descrito-exploratório / Perceptions in the formation of graduates of residency in obstetric nursing: a described-exploratory study / Percepciones en la formación de egresados de residencia en enfermería obstétrica: un estudio exploratorio descrito

Objetivo: compreender a percepção da formação de egressos da residência em enfermagem obstétrica. Método: pesquisa descritiva e exploratória, com abordagem qualitativa, com 14 egressos da residência em enfermagem obstétrica da Universidade Federal do Pará mediante de entrevista semiestruturada pelo aplicativo google meets, durante o período de outubro a dezembro de 2020. Os dados foram transcritos e submetidos à análise de conteúdo com auxílio do software ATLAS.ti 8.0. Resultados: a residência constitui pilar para trajetória profissional, com novos saberes e práticas para construção de competências profissionais, atuando em toda linha de cuidado do ciclo gravídico-puerperal. Mas, o modelo obstétrico centrado no médico e uma atuação volata mais para a burocracia, constituem com limitação da atuação dos egressos. Conclusão: a formação da residência possibilitou para os egressos o seu exercício com segurança, com os conhecimentos adquiridos, mas ainda necessita um amplo movimento para a garantia de sua prática

Objective: to understand the perception of training graduates of the residency in obstetric nursing. Method: descriptive and exploratory research, with a qualitative approach, with 14 graduates of the residency in obstetric nursing at the Federal University of Pará through a semi-structured interview using the google meets application, during the period from October to December 2020. The data were transcribed and submitted to the content analysis using the ATLAS.ti 8.0 software. Results: the residency constitutes a pillar for a professional trajectory, with new knowledge and practices for the construction of professional competences, acting in the entire line of care of the pregnancy-puerperal cycle. However, the obstetric model centered on the doctor and a performance focused more on bureaucracy, constitute a limitation of the performance of the graduates. Conclusion: the training of the residency made it possible for the graduates to exercise it safely, with the knowledge acquired, but it still needs a broad movement to guarantee its practice

Objetivo: comprender la percepción de los graduados en formación de la residencia en enfermería obstétrica. Método: investigación descriptiva y exploratoria, con enfoque cualitativo, con 14 egresadas de la residencia en enfermería obstétrica de la Universidad Federal de Pará a través de una entrevista semiestructurada utilizando la aplicación google meet, durante el período de octubre a diciembre de 2020. Los datos fueron transcritas y sometidas al análisis de contenido utilizando el software ATLAS.ti 8.0. Resultados:la residencia constituye un pilar para una trayectoria profesional, con nuevos conocimientos y prácticas para la construcción de competencias profesionales, actuando en toda la línea de atención del ciclo gestante-puerperal. Sin embargo, el modelo obstétrico centrado en el médico y una actuación más centrada en la burocracia, constituyen una limitación de la actuación de los egresados. Conclusión: la formación de la residencia posibilitó que los egresados la ejerzan con seguridad, con los conocimientos adquiridos, pero aún necesita un amplio movimiento para garantizar su práctica

Compressões das veias renal e ilíaca comum esquerdas em tomografias computadorizadas: com que frequência são detectadas? / Compression of left renal vein and left common iliac vein on CT scans: how often are they detected?

Resumo Contexto As síndromes de nutcracker e May-Thurner são raras e, apesar de muitas vezes subdiagnosticadas, podem causar sintomas limitantes de gravidade variável. Frequentemente são consideradas diagnóstico de exclusão e não há consenso na literatura quanto a prevalência, incidência e critérios diagnósticos. Objetivos Estimar a frequência da compressão das veias ilíaca comum e renal esquerdas em tomografias computadorizadas de abdome e pelve. Métodos Estudo descritivo, quantitativo e transversal. Para veia renal esquerda, foram considerados como critérios de compressão a relação diâmetro hilar/aortomesentérico > 4 e o ângulo aortomesentérico < 39° e, para veia ilíaca comum esquerda, o diâmetro < 4 mm. Resultados Foram analisadas tomografias computadorizadas de 95 pacientes; destes, 61% eram mulheres e 39% eram homens. A compressão da veia renal esquerda foi encontrada em 24,2% da amostra, com idade média de 48,8 anos, ocorrendo em 27,6% das mulheres e 18,9% dos homens (p = 0,3366). A compressão da veia ilíaca comum esquerda foi detectada em 15,7% da amostra, com idade média de 45,9 anos, ocorrendo em 24,10% das mulheres e 2,7% dos homens (p = 0,0024). Em 7,4% dos pacientes, ambas compressões venosas foram detectadas. Conclusões A compressão da veia renal esquerda ocorreu em mulheres e homens com frequência semelhante, enquanto a compressão da veia ilíaca comum esquerda foi mais frequente em mulheres. Ambas as compressões venosas foram mais frequentemente encontradas em pacientes com idade entre 41 e 50 anos.

Abstract Background The nutcracker and May-Thurner syndromes are rare and, although often underdiagnosed, they can cause limiting symptoms. They are frequently considered only after exclusion of other diagnoses and there is no consensus in the literature on prevalence, incidence, or diagnostic criteria. Objectives To estimate the frequency of compression of the left common iliac vein and left renal vein in CT scans of the abdomen and pelvis. Methods Descriptive, quantitative, cross-sectional study. The criteria used to define compression of the left renal vein were a hilar/aortomesenteric diameter ratio > 4 and aortomesenteric angle < 39° and the criterion for compression of the left common iliac vein was a diameter < 4mm. Results CT scans of 95 patients were analyzed; 61% were women and 39% were men. Left renal vein compression was observed in 24.2% of the sample, with a mean age of 48.8 years, occurring in 27.6% of the women and 18.9% of the men (p = 0.3366). Compression of the left common iliac vein was detected in 15.7% of the sample, with a mean age of 45.9 years, occurring in 24.1% of the women and 2.7% of the men (p = 0.0024). Both veins were compressed in 7.4% of the patients. Conclusions Left renal vein compression was detected in women and men at similar frequencies, whereas left common iliac vein compression was more frequent in women. Both venous compressions were most frequently found in patients aged 41 to 50 years.

Treadmill training increases the size of A cells from the L5 dorsal root ganglia in diabetic rats.

The aim of this study was to evaluate the effects of physical training on the L5 dorsal root ganglion (DRG) cells in streptozotocin diabetic rats. Male adult rats were divided into 3 groups: (control, diabetic and trained diabetic). Treadmill training was performed for 10 weeks (5 days/week, twice a day). Blood glucose concentrations and body weight were evaluated 48h after diabetes induction and every 30 days thereafter. Then, animals were killed and the right L5 DRG removed. Histological and morphometric analysis consisted of evaluating nuclear and cellular volumes and areas in A and B cells at light and ultrastructural levels. Blood glucose concentrations were higher in both diabetic groups vs controls at all periods. Body weights were lower in all diabetics vs controls at all periods after diabetes induction, with a significant time vs group interaction. In A cells, the cellular and nuclear volumes were lower than control animals only in the diabetic group; control and trained diabetic animals did not differ; in B cells the cellular and nuclear volumes were lower in diabetic and trained diabetic rats. The cellular areas of A cells were smaller in diabetic rats than in control and trained diabetic rats, while the cellular areas of B cells were smaller in the diabetic and trained groups. In conclusion, treadmill training was able to increase the size of A cells from the DRG in diabetic rats and improved the morphological features of these cells.

Focal epithelial hyperplasia in a Brazilian family / Hiperplasia epitelial focal em uma família brasileira

Focal Epithelial Hyperplasia (FEH) or Heck’s disease is a rare and benign condition characterized by cell proliferation in the squamous epithelium, which is manifested clinically as verrucous projections. It is associated with Human Papillomavirus (HPV) subtype 13 or 32, and it is often observed in children, young adults, and middle aged individuals, as well as some ethnic groups such as Indians and Eskimos, which suggests a possible hereditary influence. Objective: knowing that FEH is a rare disease among the Brazilian population, this article reports a case of FEH in a Brazilian family. Case report: a 27 year-old woman was assisted in the Department of Dentistry of the Federal University of Rio Grande do Norte (UFRN) showing round, plane, and well-defined lesions localized in the oral cavity, with an evolution of six years. Lesions underwent incisional biopsy, and the microscopic analysis revealed epithelial changes such as epithelium hyperplasia and prominent acanthosis. These histopathologic findings were consistent with the clinical hypothesis of FEH. Final considerations: this report reinforces the need for an accurate clinical assessment, so dentists are able to recognize, diagnose, and treat FEH in their own patients.

A hiperplasia epitelial focal (HEF) ou doença de Heck é uma doença benigna, rara e caracterizada por proliferação celular no epitélio escamoso, que se manifesta clinicamente como projeções verrucosas. É associada com o papilomavírus (HPV), subtipo humano 13 ou 32, e, muitas vezes, é observada em crianças, adultos jovens e pessoas de meia-idade, bem como em alguns grupos étnicos, como os índios e esquimós, o que sugere uma possível influência hereditária. Objetivo: sabendo que a HEF é uma doença rara na população brasileira, este artigo relata um caso de HEF em uma família brasileira. Relato de caso: paciente feminina, de 27 anos de idade, foi atendida no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte (UFRN), mostrando lesões bem definidas, arredondadas, planas, localizadas em cavidade oral e com uma evolução de seis anos. As lesões foram submetidas a biópsia incisional, e a análise microscópica revelou alterações epiteliais, como hiperplasia do epitélio e acantose proeminente. Esses resultados histopatológicos foram consistentes com a hipótese clínica de HEF. Considerações finais: este relatório reforça a necessidade de uma avaliação precisa da clínica, para dentistas serem capazes de reconhecer, diagnosticar e tratar HEF em seus próprios pacientes.

Banco de termos da linguagem especial de enfermagem da unidade de terapia intensiva neonatal de um hospital de ensino - estudo descritivo / Bank of terms of the nursing special language in a neonatal intensive care unit of a teaching hospital - descriptive study

Background: The lack of standardization in the nursing special language has been identified as one of the main problems to overcome so that the profession can be recognized as a science. The emphasis on addressing these concerns led to the development of nursing terminologies that often do not reflect the local nursing practices, and this fact motivated the identification of professional nursing terms in a teaching hospital. Objective: To build, based on the ICNP® Seven Axes Model, a bank of terms of the nursing special language for the Neonatal Intensive Care Unit of a teaching hospital, by using the terms found in the nursing records of this unit. Methodology: Descriptive research developed with the goal of contributing to the systematization of nursing care at the Neonatal Intensive Care Unit of a teaching hospital. The steps followed in this research were: identification and evaluation of specialized documents; cross mapping of the identified terms with the ICNP® Version 1.0 terms; establishment of databases domain trees; development of definitions for terms not included in ICNP®, validation of the terms and definitions included in the database. Results: The results show that the 596 terms and definitions validated will enable the building of a bank of terms of the nursing special language for the Neonatal Intensive Care Unit, containing 226 terms that are included and 374 terms that are not included in ICNP® Version 1.0. Conclusion: It is expected that this database will become a source for the development of ICNP® Catalogues, including sets of diagnostic statements, nursing results and interventions, which can be used to implement the systematization of nursing care in the unit in question.

Problema: A falta de uniformização da linguagem de enfermagem tem sido apontada com um dos grandes problemas enfrentados para que a profissão passe a ser reconhecida como ciência. A ênfase para solucionar essas inquietações levou ao desenvolvimento de terminologias de enfermagem, que muitas vezes não refletem a prática de enfermagem local, fato que motivou a identificação de termos da prática de enfermagem de um hospital de ensino. Objetivo: Construir o Banco de Termos da Linguagem Especial de Enfermagem, fundamentado no Modelo de Sete Eixos da CIPE®, para a Unidade de Terapia Intensiva Neonatal de um hospital de ensino, a partir dos termos identificados nos registros de enfermagem desta unidade. Metodologia: Pesquisa descritiva desenvolvida com o propósito de contribuir para a sistematização da assistência de enfermagem da Unidade de Terapia Intensiva Neonatal de um hospital de ensino. As etapas executadas nesta pesquisa foram: identificação e avaliação de documentação especializada; mapeamento cruzado dos termos identificados com os termos da CIPE® Versão 1.0; estabelecimento de árvores de domínio das bases de dados; elaboração de definições para os termos não constantes na CIPE®; validação dos termos e definições incluídos nas bases de dados. Resultados: Os resultados evidenciam que os 596 termos e definições validadas permitiram a construção do Banco de Termos da Linguagem Especial de Enfermagem da Unidade de Terapia Intensiva Neonatal, contendo 226 termos constantes e 374 não constantes na CIPE® Versão 1.0. Conclusão: Espera-se que esse banco seja fonte para desenvolvimento de Catálogos CIPE®, ou seja, conjuntos de afirmativas de diagnósticos, resultados e intervenções de enfermagem, que poderão ser utilizados para implementação da sistematização da assistência de enfermagem na referida unidade.

Aspectos histoquímicos da membrana basal associados a variáveis clínicas em carcinoma epidermóide oral / Histochemical aspects of the basal membrane associated with clinical variables in oral squamous cell carcinoma

Objetivo: Avaliar o comportamento da membrana basal em lesões do carcinoma epidermóide oral, relacionando esse comportamento com a classificação clínica TNM, localização anatômica e sobrevida dos pacientes. Método: O estudo foi baseado em uma revisão retrospectiva incluindo a observação histológica de 20 casos de carcinoma epidermóide oral dos arquivos do Laboratório de Patologia do Hospital Estadual Dr. Luis Antônio em Natal, RN, Brasil. Com a análise dos prontuários médicos, foram obtidos os dados referentes à classificação clínica TNM e localização anatômica. A gradação histológica de malignidade foi realizada na área invasiva do tumor por dois patologistas em secções histológicas de 3 micrometros de espessura coradas pela hematoxilina e eosina (HE), para obtenção dos escores histológicos de malignidade, e pelo ácido periódico de Schiff (PAS) para o estudo da membrana basal. Resultados: O principal padrão de marcação da membrana basal foi contínuo, variando entre fraco, moderado e intenso, em lesões com baixo escore de malignidade e principalmente localizadas no lábio com a maioria dos pacientes livres da doença. Em lesões reincidentes principalmente em língua, com alto escore de malignidade, o padrão mais evidente de marcação da membrana basal foi descontínuo ou ausente. Conclusão: Lesões de língua com membrana basal descontínua ou ausente em pacientes com estadiamento clínico TNM III ou IV estão relacionadas com um prognóstico desfavorável, ao contrário, das lesões em lábio com a membrana basal contínua e estadiamento clínico TNM I ou II.

Objective: To evaluate the behavior of the basal membrane in oral squamous cell carcinoma lesions, relating this behavior to the TNM clinical classification, anatomic location and patient survival rate. Method: The study was based on a retrospective review, including the histological examination of 20 oral squamous cell carcinoma cases from the fi les of the Dr. Luis Antonio State Hospital's Pathology Laboratory in the city of Natal, RN, Brazil. Data referring to TNM clinical classification and anatomic location were obtained from the analysis of medical records. The histological grading of malignancy was made by the analysis of 3-micrometrics - thick histological sections stained with hematoxylin and eosin by two pathologists in order to obtain the histological malignancy scores, and by the periodic acid-Schiff (PAS) for the analysis of the basal membrane. Results: The main labeling pattern of the basal membrane was continuous, varying among weak, moderate and severe in lesions with low malignancy scores and were predominantly located in the lower lip in most healthy patients. For the recurrent lesions, mainly located on the tongue, with high malignancy scores, the most evident basal membrane labeling pattern was discontinuous or absent. Conclusion: Tongue lesions with discontinuous or absent basal membrane in patients in the III or IV TNM clinical stages are related to a poor prognosis, unlike lip lesions with continuous basal membrane and classified as I or II TNM clinical stages.

Diagnósticos de enfermagem relacionados à complicação periostomal segundo nanda: análise crítica das habilidades necessárias ao enfermeiro / Nursing diagnoses related to peristomal complication according to nanda: critical analysis on the necessary nurse's abilities

Ao assistir o paciente colostomizado, o enfermeiro utiliza o processo de enfermagem que possibilita, ao profissional enfermeiro, assistência planejada, tanto ambulatorial quanto hospitalar. O atendimento a pacientes com colostomia presume a percepção de condições clínicas consideradas patológicas, entre elas, as complicações periostomais. Este trabalho objetiva elencar os diagnósticos de enfermagem relacionados às complicações periostomais, discutindo habilidades clínicas necessárias ao enfermeiro para a definição destes diagnósticos. Diagnóstico de enfermagem é o estudo de algo, para determinação de sua natureza, necessário para o desenvolvimento de um plano de cuidado de enfermagem. Para se definir os diagnósticos de enfermagem relativos a complicações periostomais se faz necessário que o enfermeiro reconheça tais complicações. Os diagnósticos de enfermagem que se relacionam às complicações periostomais podem ser integridade da pele prejudicada e risco para a integridade da pele prejudicada. A avaliação clínica do enfermeiro deve ser pormenorizada para se identificar alterações de pele já existentes, ou em risco de acontecer. Após a realização do diagnóstico de enfermagem é de suma importância que o enfermeiro oriente o paciente para o autocuidado. O enfermeiro deve compreender os parâmetros de normalidade da pele, saber realizar o exame físico e identificar alterações da região do periostoma, a fim de estabelecer o diagnóstico de enfermagem para uma assistência de qualidade e individualizado. As habilidades de exame clínico dermatológico assumem principal destaque na avaliação do enfermeiro para o paciente portador de íleo/colostomia.

While assisting the colostomized patient, the nurse uses the nursing process which allows planned either ambulatory or hospital assistance. Colostomized patient implies assistance in the perception of clinical conditions considered pathological – among themselves – the peristomal complications. The objective of this article is to relate nursing diagnoses to peristomal complications by discussing the necessary clinical abilities necessary for the nurse to defi ne such diagnoses. Nursing diagnosis is the study of something in order to determine its nature. It is necessary for the development of a nursing care plan. In order to defi ne the nursing diagnoses related to peristomal complication, it is necessary that the nurse recognize such complications. Nursing diagnoses related to peristomal complication may be the damaged skin integrity as well as the risk for the damaged skin integrity. The nurse’s clinical assessment should be detailed in order to identify existing skin alterations or those at risk. After the nursing diagnosis accomplishment it is extremely important that the nurse orientates the patient with respect to self care. The nurse should understand the skin normality parameter, how to carry out the physical exam, and identify alterations in the peristomal region in order to establish a nursing diagnosis towards qualifi ed and individualized assistance. The abilities concerning clinic dermatological exam are important for the nurse’s assessment of the patient with ileo-colostomy.

Definições teóricas de termos atribuídos a fenômenos de enfermagem identificados em prontuários clínicos de um hospital escola / Theoretical definitions of terms attributed to nursing phenomena identified in a school hospital. A systematic review

Este estudo teve como objeto o vocabulário utilizado na prática pelos diferentes componentes da equipe de enfermagem. O objetivo geral foi o de contribuir para a construção de um banco de dados essenciais de enfermagem, a ser introduzido em sistemas de informação, tendo como objetivos específicos os de determinar, com base na literatura e em outras terminologias de enfermagem, o significado de termos relacionados a fenômenos de enfermagem, identificados e mapeados nas clínicas de um hospital escola e desenvolver definições teóricas para os termos classificados no eixo Foco da CIPE Versão 1. Na realização do estudo utilizaram-se as seguintes etapas: revisão da literatura para a identificação do significado dos termos; mapeamento do significado dos termos e afirmação da definição teórica. Esta última etapa foi desenvolvida por enfermeiras, mestrandas em enfermagem e alunas de graduação em enfermagem, que participam do Grupo de Estudos e Pesquisa em Fundamentação da Assistência de Enfermagem. Espera-se com esses resultados contribuir para a construção de um banco de dados essenciais de enfermagem, que integre o conhecimento científico e prático da profissão e, ao mesmo tempo, seja sensível a nossa realidade, de modo a favorecer a utilização de uma linguagem profissional comum.

This study had as object the vocabulary which the different components of the nursing team use in practice. The primary objective was to contribute to the construction of a database essential of nursing to be introduced in systems of information. The specific objectives were to identify, in the literature and in other nursing terminologies, the meaning of the terms related to nursing phenomena, identified and mapped at school hospital's clinics, and to develop theoretical definitions for the terms classified in the axis Focus of ICNP Version 1. The following methodological stages were used: review of the literature for the identification of the meaning of the terms; mapping of the meaning of the terms and, statement of the theoretical definitions. This last stage was developed by nurses, nursing undergraduate students, and nursing postgraduate students, which participate in the Group of Studies and Research in Fundamentals of Nursing Assistance. One expect that the results of the study could, not only, contribute to the construction of a nursing essential database, which integrates the scientific and practical knowledge of the profession but, at the same time, be more sensitive to our reality and that includes terms related to nursing phenomena in order to facilitate the use of a professional common language.

O Acesso as políticas públicas de saúde pelos pacientes em cuidados paliativos oncológicos e seus familiares

O trabalho é uma abordagem acerca do acesso as políticas públicas de saúde pelos pacientes em cuidados paliativos oncológicos e seus familiares da Clinica de Cuidados Paliativos Oncológicos do Hospital Ophir Loyola (HOL). Como objetivo principal buscou-se identificar o nível de acesso às politicas públicas de saúde e direitos sociais dos pacientes. E os específicos são compreender os fatores sociais que interferem no acesso a estes direitos e analisar de que forma o Assistente Social pode interferir para a viabilização dos mesmos. O desenvolvimento desse trabalho foi pautado no método qualitativo, tendo como subsídio as pesquisas bibliográficas, documental e de campo, sendo utilizada nesta última a entrevista de caráter semi-estruturado enquanto instrumental à coleta dos dados. Os resultados mostraram as dificuldades que os participantes encontraram ao longo do seu tratamento de saúde, assim como as principais consequências econômicas e sociais devido ao processo de tratamento com reflexos na vida sócio-familiar e financeira, tendo em vista os princípios e diretrizes do SUS, que esses pacientes são amparados legalmente e possuem, portanto o direito aos serviços de saúde necessários