Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola.

During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test-positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data.

[Assessment of bariatric surgery results]. / Avaliação dos resultados da cirurgia bariátrica.

The objective was to evaluate the results of bariatric surgery in patients in the late postoperative period using the Bariatric Analysis and Reporting Outcome System (BAROS). This cross-sectional study was conducted from November 2011 to June 2012 at a hospital in the state of Ceará, Brazil. Data were collected from 92 patients using the BAROS protocol, which analyzes weight loss, improved comorbidities, complications, reoperations and Quality of Life (QoL). Data were analysed using the chi-squared test, Fischer's exact test and the Mann-Whitney test. There was a reduction in the Body Mass Index (47.2±6.8 kg/m2 in the pre-operatory and 31.3±5.0 kg/m2 after surgery, p<0.001). The comorbidity with the highest resolution was arterial hypertension (p<0.001), and QV improved in 94.6% of patients. The main complications were hair loss, incisional hernia and cholelithiasis. The surgery provided satisfactory weight loss and improvements in the comorbidities associated to a better QL. Use of the BAROS protocol allows nurses to plan interventions and maintain the good results.

Assessment of the yellow fever outbreak in Angola from December 2015 through December 2016: A retrospective study.

Background and Aims: The acute tropical infectious disease known as yellow fever (YF) is caused by an arbovirus and is characterized by fever, jaundice, hemorrhage, headache, muscle pain, nausea, vomiting, and fatigue. Angola experienced a yellow fever virus (YFV) outbreak that was documented in December 2015. However, little is known about the outcome of this outbreak. We aimed to demonstrate epidemic features and lessons learned during the YF epidemic in Angola. Methods: A total of 4618 blood samples from suspected YF cases were sent to the Instituto Nacional de Investigação em Saúde (INIS), a national referral and public health laboratory, between December 5, 2015, and December 23, 2016. Sample analyses were conducted using enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) assays. Blood samples were sent from 16 out of the 18 provinces of Angola. Results: We detected 884 (19.1%) cases that were positive for ELISA, which were confirmed by RT-PCR assay. Considering the positive cases, the incidence among male patients was around three times higher (n = 223; 10.9%) than in female patients (n = 59; 2.6%) in the 20-29 age group, followed by the age group 10-19 with n = 211 (6.8%) in males versus n = 108 (3.3%) in females; and the age group 30-39 had n = 68 (4.8%) in males versus n = 28 (1.8%) in females. The other groups had an incidence below 3.0%. The case fatality ratio for YF was in young adults in the age group 20-29 with n = 39 cases, followed by the age group 10-19 with n = 16 cases, and finally the age group 0-9 with n = 13 cases. The other age groups had several deaths by YF below 10 cases. Conclusions: This study demonstrates features of the YF epidemic that occurred in Angola. Also, it demonstrates that YF causes deaths in young people but is preventable by high vaccine coverage. Thus, public health laboratory surveillance must be strengthened to reduce the possibility of emerging and re-emerging human infections.

[Nursing diagnoses, related factors and risk factors during the postoperative period following bariatric surgery]. / Diagnósticos de enfermagem, fatores relacionados e de risco no pós-operatório de cirurgia bariátrica.

The objective was to identify the main diagnoses, related factors and risk factors regarding the cardiovascular/pulmonary responses class proposed by NANDA version 2009-2011. This case series descriptive study was performed with twenty patients who underwent bariatric surgery in a public hospital in Fortaleza-CE, Brazil. Data were collected by two intensive care unit nurse specialists through interviews, physical examinations and the reviewing of medical records, and analyzed through descriptive statistics and cross-mapping. The nursing diagnoses identified with a frequency greater than 50% were: decreased cardiac output (75%), ineffective breathing patterns (65%), dysfunctional ventilatory weaning response (55%) and ineffective peripheral tissue perfusion (75%); in addition, fourteen related factors and five risk factors were identified. We verified the need for further studies to better define the diagnostic profile of these patients in order to direct nursing care towards the early detection of complications.

Effect of Systemic and Auricular Acupuncture with a 2/100 Hz Frequency and Nogier Frequency in Fibromyalgia: a Randomized Clinical Trial, Pilot Study.

Background: Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture. Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia. Methods: Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied. Results: There was no statistically significant difference for the primary outcome for NPRS (p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains (p = 0.008) and some variables such as pain (p = 0.02) and anxiety (p = 0.006). There was no significant difference for the FDC 2010 and HRV variables (p > 0.05). Conclusion: 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change.

Pulsed Laser Acupuncture in the Treatment of Pain and Heart Rate Variability in Fibromyalgia Patients: A Pilot Randomized Clinical Trial.

Introduction: Laser acupuncture (LA) is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of LA with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency on fibromyalgia. Therefore, this study aimed to evaluate whether an individualized intervention protocol applying pulsed LA would provide benefits related to pain symptoms and cardiac autonomic modulation in patients with fibromyalgia. Methods: In this pilot randomized clinical controlled trial, the sample consisted of women with fibromyalgia between the ages of 40 and 80, randomized into two groups: a control group (CG; n=10) and an experimental group (EG; n=10). EG received the intervention twice per week for 3 weeks. Statistical analysis was conducted by delta (difference between post-intervention and pre-intervention) and the Shapiro-Wilk test (normality). For comparison between the groups, the Mann-Whitney test was used. Results: The results showed a significant reduction in pain intensity as reported via the pain numerical scale (PNS; P=0.00), generalized pain index (GPI; P=0.00), and symptom severity scale (SSS; P=0.00). There was no significant difference in any HRV variable (P>0.05). Conclusion: Pulsed LA, when applied in an individualized protocol, can reduce pain intensity, as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV.

[Juvenile obesity with a focus on health promotion: integrative review]. / Obesidade juvenil com enfoque na promoção da saúde: revisão integrativa.

This integrative review summarizes nursing researches that contribute to study juvenile obesity with a focus on health promotion. 20 articles were identified in a bibliographical survey that followed the criteria: date, language, and the descriptors: nursing, adolescent, obesity and health promotion. The Pediatric Nursing Journal published seven of these papers (35%). Indexed papers were published in the last ten years in Portuguese and English. Results showed the construction of scientific knowledge in nursing that developed health promotion strategies in cases of juvenile obesity, thus contributing to the development of the profession. Showing the cumulative risk that juvenile obesity presents of turning subjects into obese adults is a precious resource to plan nursing actions for this population, and for these actions to achieve effective results.

Supplementation with Curcuma longa Reverses Neurotoxic and Behavioral Damage in Models of Alzheimer's Disease: A Systematic Review.

BACKGROUND: The formation of senile plaques and neurofibrillary tangles of the tau protein are the main pathological mechanism of Alzheimer's disease (AD). Current therapies for AD offer discrete benefits to the clinical symptoms and do not prevent the continuing degeneration of neuronal cells. Therefore, novel therapeutic strategies have long been investigated, where curcumin (Curcuma longa) has shown some properties that can prevent the deleterious processes involved in neurodegenerative diseases. OBJECTIVE: The aim of the present work is to review studies that addressed the effects of curcumin in experimental models (in vivo and in vitro) for AD. METHOD: This study is a systematic review conducted between January and June 2017, in which a consultation of scientific articles from indexed periodicals was carried out in Science Direct, United States National Library of Medicine (PubMed), Cochrane Library and Scielo databases, using the following descriptors: "Curcuma longa", "Curcumin" and "Alzheimer's disease". RESULTS: A total of 32 studies were analyzed, which indicated that curcumin supplementation reverses neurotoxic and behavioral damages in both in vivo and in vitro models of AD. CONCLUSION: The administration of curcumin in experimental models seems to be a promising approach in AD, even though it is suggested that additional studies must be conducted using distinct doses and through other routes of administration.

Pro-oxidant action of diphenyl diselenide in the yeast Saccharomyces cerevisiae exposed to ROS-generating conditions.

Organoselenium compounds have a potential thiol peroxidase-like activity. Diphenyl diselenide (DPDS) is an electrophilic reagent used in the synthesis of a variety of pharmacologically active organic selenium compounds. Using TRAP assay of chemiluminescense we have shown that diphenyl diselenide clearly possesses a pro-oxidant property. For an investigation on the mechanisms of this property, we used mutant strains of Saccharomyces cerevisiae defective in antioxidant defenses, i.e. in superoxide dismutase, in biosynthesis of glutathione, and the transcription factor yAP-1-lacking yap 1 mutant that cannot activate genes of the oxidative stress response. Exposure of growing cultures to the drug increased cell sensitivity to oxidizing agents. The pro-oxidant effect was independent of the metabolic condition or of the oxidative mutagen tested. N-acetylcysteine, a precursor of glutathione biosynthesis, could neutralize the pro-oxidant effects of diphenyl diselenide by stimulating an increase of endogenous glutathione biosynthesis or by directly binding to the drug. Vitamin E (Trolox), a known antioxidant, was also able to protect S. cerevisiae against the pro-oxidant effect of diphenyl diselenide. In vitro assays showed that diphenyl diselenide interacts non-enzymatically with the thiol group of glutathione.

Effect of salinity and inorganic nitrogen concentrations on nitrification and denitrification rates in intertidal sediments and rocky biofilms of the Douro River estuary, Portugal.

The regulatory effects of salinity and inorganic nitrogen compounds on nitrification and denitrification were studied in intertidal sandy sediments and rocky biofilms in the Douro River estuary, Portugal, over a 12-month period. Nitrification and denitrification rates were measured in slurries of field samples and enrichment experiments using the difluoromethane and the acetylene inhibition techniques, respectively. Salinity did not regulate denitrification in either environment, suggesting that halotolerant bacteria dominated the denitrifier communities. However, nitrification rates were stimulated when salinity increased from 0 to 15 practical salinity units. NO3- addition experiments revealed that NO3- availability stimulates denitrification rates in sandy sediments, but not in rocky biofilms; however, in rocky biofilms a positive and linear relationship was observed between denitrification rates and water column NO3- concentrations (r=0.92) during the monthly surveys. The N2O:N2 ratios increased rapidly when NO3- increased from 63 to 363 microM; however, results from monthly surveys showed that environmental parameters other than NO3- availability may be important in controlling the variation in N2O production via denitrification. Ammonium additions to sandy sediments stimulated nitrification rates by 35% for the 20 microM NH4+ addition, but NH4+ appeared to inhibit nitrification at high concentration addition (200 microM NH4+). In contrast, rocky biofilm nitrification was stimulated by 65% when 200 microM NH4+ was added.

Intervenção educativa e indicadores de obesidade de candidatos à gastroplastia: estudo quase-experimental / Intervención educativa e indicadores de obesidad de candidatos a gastroplastía: estudio cuasi experimental / Educational intervention and obesity indicators of gastroplasty candidates: a quasi-experimental study

Resumo Objetivo Avaliar o efeito de intervenção educativa nos indicadores de obesidade de pacientes em pré-operatório da cirurgia bariátrica. Métodos Estudo quase-experimental realizado de junho a agosto de 2017, em hospital de referência na realização de cirurgias bariátricas no Ceará, com 55 participantes (28 no Grupo Controle e 27 no Grupo Intervenção). O Grupo Controle foi submetido às orientações verbais sobre o procedimento cirúrgico, de rotina da instituição. O Grupo Intervenção, além de tal rotina, foi submetido à intervenção educativa realizada por enfermeira, semanalmente, a partir de leitura de cartilha educativa com informações e esclarecimentos acerca do perioperatório, durante três semanas. Para análise foram utilizados o teste de Wilcoxon para comparar os indicadores de obesidade entre os momentos de coleta e o teste de Mann-Whithey para comparar as variáveis entre os grupos. Resultados As variáveis redução de peso, índice de massa corporal, circunferência abdominal, relação cintura estatura e percentual do excesso de peso tiveram aumento no Grupo Controle e redução, com significância estatística, no Grupo Intervenção. Conclusão O acesso às informações no material impresso foi eficaz para aprendizagem e contribui significativamente para redução de indicadores de obesidade, os quais são clinicamente importantes para realização da cirurgia bariátrica. O uso de tecnologias educacionais deve ser estimulado no preparo pré-operatório de candidatos à gastroplastia.

Resumen Objetivo Evaluar los efectos de la intervención educativa en los indicadores de obesidad de pacientes en preoperatorio de cirugía bariátrica. Métodos Estudio cuasi experimental realizado de junio a agosto de 2017, en hospital de referencia en realización de cirugías bariátricas en el estado de Ceará, con 55 participantes (28 en el Grupo de Control y 27 en el Grupo Experimental). Al Grupo de Control se le dieron instrucciones verbales sobre el procedimiento quirúrgico, de rutina de la institución. El Grupo Experimental, además de recibir dicha rutina, recibió una intervención educativa realizada por enfermera, semanalmente, a partir de la lectura de manual educativo con información y explicaciones sobre el perioperatorio, durante tres semanas. Para el análisis se utilizó la Prueba de Wilcoxon para comparar los indicadores de obesidad entre los momentos de recolección y la prueba de Mann-Whitney para comparar las variables entre los grupos. Resultados Las variables reducción de peso, índice de masa corporal, circunferencia abdominal, relación cintura/estatura y porcentaje de exceso de peso aumentaron en el Grupo de Control y se redujeron, con significación estadística, en el Grupo Experimental. Conclusión El acceso a la información del material impreso fue eficaz para el aprendizaje y contribuyó significativamente para la reducción de indicadores de obesidad, los cuales son clínicamente importantes para la realización de la cirugía bariátrica. El uso de tecnologías educativas debe ser estimulado en la preparación preoperatoria de candidatos a gastroplastía.

Abstract Objective To assess the effect of educational intervention on obesity indicators in preoperative bariatric surgery patients. Methods A quasi-experimental study conducted from June to August 2017 at a referral hospital for bariatric surgery in Ceará, with 55 participants (28 in the Control Group and 27 in the Intervention Group). The Control Group was submitted to verbal instructions on the surgical procedure, routine of the institution. The Intervention Group, in addition to this routine, underwent an educational intervention performed by a nurse, weekly, from reading an educational booklet with information and clarifications about the perioperative period for three weeks. The Wilcoxon test was used for analysis to compare obesity indicators between collection times and the Mann-Whitney test to compare variables among groups. Results The variables weight reduction, body mass index, waist circumference, waist-to-height ratio and percentage of overweight increased in the Control Group and statistically significantly reduced in the Intervention Group. Conclusion Access to information in the printed material was effective for learning and significantly contributes to the reduction of obesity indicators, which are clinically important for bariatric surgery. The use of educational technologies should be encouraged in the preoperative preparation of gastroplasty candidates.

Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women.

BACKGROUND: Urinary tract infections (UTIs) in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in order to make early diagnosis and prevent serious clinical complications secondary to UTI. METHODS: This was a prospective population-based study, with elderly women, during their first medical office visit. Medical records were obtained by clinical history and physical examination in order to detect signs and symptoms of UTI and the presence of co-morbidities. Clean-catch midstream urine specimens for urinary dipstick test, sediment, and culture were collected; cervical samples for conventional Pap smears were also collected. RESULTS: UTI was found in 16.55% of elderly women. The most frequent urinary symptom was foul smelling urine, in 60.6%. E. coli was responsible for 98 (76.56%) cases of significant bacteriuria; 34 (34.69%) were resistant to trimethoprim-sulfamethoxazole, and 21 (21.42%) to fluoroquinolones. Asymptomatic bacteriuria (AB) was not treated. The presence of predisposing factors demonstrated that the history of previous UTI (p < 0.001), vaginitis (p < 0.001), and diabetes (p = 0.042) increased the risk for UTI. CONCLUSION: This study confirmed the high prevalence of UTI among elderly women and its unusual clinical presentation. Diabetes, history of previous UTI, and vaginitis were shown to be predisposing factors for UTI; it is not necessary to treat AB in elderly women, even among diabetics.

Qualidade de vida entre obesos mórbidos e pacientes submetidos à cirurgia bariátrica / Quality of life among morbid obese and patients submitted to bariatric surgery

Objetivou-se avaliar a Qualidade de Vida (QV) entre os obesos que aguardam a realização da cirurgia bariátrica e pacientes que estão no pós-cirúrgico. Estudo transversal com abordagem quantitativa realizado em um hospital referência em cirurgia bariátrica em Fortaleza-CE. A amostra foi de 64 pacientes do pré-operatório e 92 do pós-operatório. Dados coletados por meio do questionário de QV de Moorehead-Ardelt II do protocolo Bariatric Analisys and Reporting Outcome System (BAROS). A maioria dos indivíduos do período do pré-operatório classificou sua QV como mínima - 57,8% (37), enquanto que, no grupo do pós-operatório, observou-se uma mudança significativa em que 75% (69) dos participantes consideraram que sua QV estava muito boa após a cirurgia (p<0,001). Em ambos os grupos, os aspectos da QV que apresentaram pior avaliação foram: atividade física, interesse sexual e comportamento alimentar. A cirurgia bariátrica representa uma melhora na qualidade de vida dos indivíduos.

The objective was to assess Quality of Life (QoL) among obese waiting for bariatric surgery and post-surgery patients. A cross-sectional quantitative study conducted in a hospital reference in bariatric surgery in Fortaleza-CE. The sample was composed by 64 pre- and 92 post-surgery patients. Data was collected through the QoL questionnaire Moorehead-Ardelt II from the Bariatric Analysis and Reporting Outcome System (BAROS) protocol. Most individuals at pre-surgery stage classified their QoL as minimal ­ 57,8% (37), while the post-surgery group observed a significant change where 75% (69) of participants considered their QoL very good after the procedure (p< 0,001). In both groups, the QoL aspects that presented worse evaluation were: physical activity, sexual interest and eating behavior. Bariatric surgery represents improvement in quality of life of individuals.

Assessment of bariatric surgery results / Evaluación de los resultados de la cirugía bariatrica / Avaliação dos resultados da cirurgia bariátrica

The objective was to evaluate the results of bariatric surgery in patients in the late postoperative period using the Bariatric Analysis and Reporting Outcome System (BAROS). This cross-sectional study was conducted from November 2011 to June 2012 at a hospital in the state of Ceará, Brazil. Data were collected from 92 patients using the BAROS protocol, which analyzes weight loss, improved comorbidities, complications, reoperations and Quality of Life (QoL). Data were analysed using the chi-squared test, Fischer's exact test and the Mann-Whitney test. There was a reduction in the Body Mass Index (47.2 ± 6.8 kg/m2 in the pre-operatory and 31.3 ± 5.0 kg/m2 after surgery, p< 0.001). The comorbidity with the highest resolution was arterial hypertension (p<0.001), and QV improved in 94.6% of patients. The main complications were hair loss, incisional hernia and cholelithiasis. The surgery provided satisfactory weight loss and improvements in the comorbidities associated to a better QL. Use of the BAROS protocol allows nurses to plan interventions and maintain the good results.

El objetivo fue evaluar los resultados de cirugías bariátricas en pacientes postoperatorio tardío a partir del protocolo Bariatric Analysis and Reporting Outcome System (BAROS). Estudio transversal realizado entre noviembre de 2011 y junio de 2012 en un hospital del estado de Ceará-Brasil. La recolección de datos ocurrió en 92 pacientes con el Protocolo BAROS, que analiza: la pérdida de peso, mejora de las comorbilidades, complicaciones, reintervenciones y calidad de vida. Para el análisis de los datos, se utilizó las pruebas estadísticas chi-cuadrado, prueba exacta de Fisher y de Mann-Whithey. Hubo una reducción en el índice de masa corporal (47,2 ± 6,8 kg/m2 en el preoperatorio y 31,3 ± 5,0 kg/m2 después de la cirugía, p <0,001). La comorbilidad que tuvo una resolución más alta fue la hipertensión (p <0,001) y la calidad de vida mejoró en un 94,6% de los pacientes. Las principales complicaciones fueron la caída del cabello, la hernia incisional y colelitiasis. La cirugía proporcionó pérdida de peso satisfactorio y la mejora de las comorbilidades asociadas al aumento de la calidad de vida. El uso del protocolo BAROS por el enfermero, permiten planificar las intervenciones que posibiliten el mantenimiento de buenos resultados.

Objetivou-se avaliar os resultados da cirurgia bariátrica em pacientes no pós-operatório tardio com o protocolo Bariatric Analysis and Reporting Outcome System (BAROS). Estudo transversal realizado no período de novembro de 2011 e junho de 2012 em um hospital do Estado do Ceará-Brasil. A coleta dos dados ocorreu com 92 pacientes por meio do Protocolo BAROS, o qual analisa: perda de peso, melhora das comorbidades, ocorrência de complicações, necessidade de reoperações e Qualidade de Vida (QV). Para análise dos dados, utilizaram-se os testes estatísticos Qui-Quadrado, Exato de Fischer e Mann-Whithey. Houve redução no Índice de Massa Corporal (47,2 ± 6,8 kg/m2 no pré-operatório e 31,3 ± 5,0 kg/m2 após a cirurgia, p < 0,001). A comorbidade que teve maior resolução foi a hipertensão arterial (p<0,001), e a QV melhorou em 94,6% pacientes. As principais complicações foram queda de cabelo, hérnia incisional e colelitíase. A cirurgia proporcionou perda de peso satisfatória e melhora das comorbidades associada ao aumento da QV. O uso do protocolo BAROS pelo enfermeiro permite o planejamento de intervenções que possibilitem a manutenção dos bons resultados.

Identificação dos diagnósticos de enfermagem da classe de respostas cardiovasculares/pulmonares em pacientes submetidos à cirurgia bariátrica / Identificación de los diagnósticos de enfermería de la clase de respuestas cardiovasculares/pulmonares en pacientes sometidos a la cirugía bariátrica / Identification of the Nursing Diagnoses f the Cardiovascular/Pulmonary Responses Class in Patients Subject to Bariatric Surgery

O objetivo deste estudo foi identificar as respostas humanas apresentadas por pacientes no pós-operatório de cirurgia bariátrica que se configurem como diagnósticos de enfermagem da classe respostas cardiovasculares/pulmonares. Estudo observacional de caráter transversal realizado no período de julho de 2010 a maio de 2011, em um hospital referência em cirurgia bariátrica em Fortaleza-CE. Os diagnósticos de enfermagem identificados foram: risco de perfusão gastrintestinal ineficaz (87,9%), risco de intolerância à atividade (70,7%), perfusão tissular periférica ineficaz (67,2%), risco de choque (63,8%), débito cardíaco diminuído (60,3%), risco de perfusão tissular cardíaca diminuída (58,6%), intolerância à atividade (51,7%), risco de perfusão tissular cerebral ineficaz (48,3%), ventilação espontânea prejudicada (46,5%), risco de perfusão renal ineficaz (43,1%), padrão respiratório ineficaz (37,9%) e resposta disfuncional ao desmame ventilatório (36,2%). Assim, com base nesses resultados será possível direcionar a assistência de enfermagem prestada aos pacientes submetidos à cirurgia bariátrica e, consequentemente, reduzir complicaçóes pós-operatórias.

El objetivo de este estudio fue identificar las respuestas humanas presentadas por pacientes en el postoperatorio de cirugía bariátrica que se configuren como diagnósticos de enfermería de la clase de respuestas cardiovasculares/pulmonares. Estudio observacional de carácter transversal realizado en el periodo de julio de 2010 a mayo de 2011, en un hospital referencia en cirugía bariátrica en Fortaleza (Ceará, Brasil). Los diagnósticos de enfermería identificados fueron: riesgo de perfusión gastrointestinal ineficaz (87,9%), riesgo de intolerancia a la actividad (70,7%), perfusión tisular periférica ineficaz (67,2%), riesgo de choque (63,8%), débito cardíaco disminuido (60,3%), riesgo de perfusión tisular cardíaca disminuida (58,6%), intolerancia a la actividad (51,7%), riesgo de perfusión tisular cerebral ineficaz (48,3%), ventilación espontánea perjudicada (46,5%), riesgo de perfusión renal ineficaz (43,1%), patrón respiratorio ineficaz (37,9%) y respuesta disfuncional al desmame ventilatorio (36,2%).

This observational and cross-sectional study aimed to identify human responses presented by patients during the postoperative period for bariatric surgery classified into the cardiovascular/pulmonary responses class of the nursing diagnoses. The study was carried out between July 2010 and May 2011, in a reference hospital for bariatric surgery in Fortaleza, state of Ceará. The following nursing diagnoses were identified: risk for ineffective gastrointestinal perfusion (87.9%), risk for activity intolerance (70.7%), ineffective peripheral tissue perfusion (67.2%), risk for shock (63.8%), decreased cardiac output (60.3%), risk for decreased cardiac tissue perfusion (58.6%), activity intolerance (51.7%), risk for ineffective cerebral tissue perfusion (48.3%), impaired spontaneous ventilation (46.5%), risk for ineffective renal perfusion (43.1%), ineffective breathing pattern (37.9%) and dysfunctional ventilatory weaning response (36.2%). Thus, based on these results, it will be possible to direct nursing care to patients subject to bariatric surgery and consequently reduce postoperative complications.

Aspectos clínicos e epidemiológicos da leishmaniose visceral em crianças / Aspectos clínicos y epidemiológicos de la leischmaniasis visceral en niños / Clinical and epidemiological aspects of visceral leishmaniasis in children

Objective: describing the epidemiological and clinical profile of Visceral Leishmaniasis (VL) in hospitalized children. Method: this was a documentary and retrospective research performed from January 2001 to December 2009, at a hospital in Fortaleza-Ceará. There were evaluated the variables such as: cases per year, age, weight and symptoms. For analysis of the correlation between the variables the Spearman’s coefficient was calculated. The study was approved by the Ethics Committee (CEP 42/2005). Results: the largest number of cases occurred in 2007, with 23, 5% (46) cases. The predominant age range was between 0 and 2 years old. A part of the children 47,96% (94) were malnourished and 47,4% and 49% had diarrhea and weight loss, respectively. Clinical manifestations were: fever, swollen spleen and liver. Conclusion: although the incidence of cases of VL is decreasing along the years, the number of children affected by VL remains a source of concern, due to the susceptibility of this age range.

Objetivo: descrever o perfil clínico e epidemiológico da Leishmaniose Visceral (LV) em crianças internadas. Método: pesquisa documental e retrospectiva realizada no período de janeiro de 2002 a dezembro 2009 em um hospital de Fortaleza-CE. Foram avaliadas variáveis como: casos por ano, idade, peso e sintomas. Foi calculado o coeficiente de Spearman para investigar a correlação entre variáveis. O estudo foi aprovado pelo Comitê de Ética, sob o protocolo (CEP 42/2005). Resultados: o maior número de casos ocorreu em 2007, com 23,5% (46) casos, a faixa etária predominante foi entre 0-2 anos. Parte das crianças, 47,96% (94), era desnutrida e 47,4% e 49% apresentaram diarreia e emagrecimento, respectivamente. Manifestações clínicas: febre, esplenomegalia e hepatomegalia. Conclusão: embora a incidência de casos de LV seja decrescente com o decorrer dos anos, observa-se, ainda que a quantidade de crianças acometidas pela LV ainda é preocupante devido à suscetibilidade dessa faixa etária.

Objetivo: este estudio tiene como objetivo describir el perfil clínico y epidemiológico de la Leishmaniasis Visceral (LV) en niños internados. Método: investigación documental y retrospectiva hecha entre enero de 2002 y diciembre de 2009 en un hospital de Fortaleza-Ceará. Las variables fueron evaluadas: casos por año, edad, peso y síntomas. Para investigar la correlación de las variables fue calculado el coeficiente de Spearman. El estudio fue aprobado por el Comité de Ética (CEP 42/2005). Resultados: el mayor número de casos ocurrió en 2007, con 23,5% (46) casos. El grupo de edad predominante fue entre 0-2 años. Una grande parte de los niños, 47,96% (94) era desnutrida y 47,4% y 49% tuvieron diarrea y pérdida de peso, respectivamente. Manifestaciones clínicas: fiebre, esplenomegalia y hepatomegalia. Conclusión: aunque la incidencia de casos de LV está descendiendo en los años, el número de niños afectados por el LV es todavía preocupante debido a la susceptibilidad de este grupo de edad.

Diagnósticos de enfermagem, fatores relacionados e de risco no pós-operatório de cirurgia bariátrica / Nursing diagnoses, related factors and risk factors during the postoperative period following bariatric surgery / Diagnósticos de enfermería, factores relacionados y de riesgo en el postoperatorio de cirugía bariátrica

Objetivou-se com esta pesquisa identificar os principais diagnósticos, fatores relacionados e de risco da classe resposta cardiovascular/pulmonar, propostos pela NANDA, versão 2009-2011. Trata-se de estudo de série de caso, descritivo, realizado com vinte pacientes submetidos à cirurgia bariátrica em hospital público de Fortaleza-CE, Brasil. Duas enfermeiras especialistas em unidade de terapia intensiva coletaram os dados por meio de entrevista, exame físico e leitura do prontuário, que foram analisados a partir de estatística descritiva e mapeamento cruzado. Os diagnósticos de enfermagem identificados com frequência maior que 50% foram: débito cardíaco diminuído (75%), padrão respiratório ineficaz (65%), resposta disfuncional ao desmame ventilatório (55%) e perfusão tissular periférica ineficaz (75%), dos quais 14 eram fatores relacionados e cinco, de risco. Reconhece-se a necessidade de outros estudos para melhor definir o perfil diagnóstico dessa clientela e, assim, direcionar a assistência de enfermagem para a detecção precoce de complicações.

The objective was to identify the main diagnoses, related factors and risk factors regarding the cardiovascular/pulmonary responses class proposed by NANDA version 2009-2011. This case series descriptive study was performed with twenty patients who underwent bariatric surgery in a public hospital in Fortaleza-CE, Brazil. Data were collected by two intensive care unit nurse specialists through interviews, physical examinations and the reviewing of medical records, and analyzed through descriptive statistics and cross-mapping. The nursing diagnoses identified with a frequency greater than 50% were: decreased cardiac output (75%), ineffective breathing patterns (65%), dysfunctional ventilatory weaning response (55%) and ineffective peripheral tissue perfusion (75%); in addition, fourteen related factors and five risk factors were identified. We verified the need for further studies to better define the diagnostic profile of these patients in order to direct nursing care towards the early detection of complications.

Se objetivó identificar los principales diagnósticos, factores relacionados y de riesgo del tipo respuesta cardiovascular/pulmonar, propuestos por la NANDA, versión 2009-2011.Estudio de serie de casos, descriptivo, realizado con veinte pacientes sometidos a cirugía bariátrica en hospital público de Fortaleza-CE, Brasil. Dos enfermeras especialistas en unidad de terapia intensiva recolectaron los datos mediante entrevista, examen físico y lectura de historia clínica, dichos datos fueron analizados mediante estadística descriptiva y mapeo cruzado. Los diagnósticos de enfermería identificados con frecuencia mayor al 50% fueron: gasto cardíaco disminuido (75%), patrón respiratorio ineficaz (65%), respuesta disfuncional al destete del respirador (55%) y perfusión tisular periférica inefectiva (75%), de los cuales 14 constituían factores relacionados, y 5 de riesgo. Se reconoce la necesidad de otros estudios para definir mejor el perfil diagnóstico de estos pacientes, y así enfocar la atención de enfermería en la detección precoz de complicaciones.

Diagnósticos, intervenções e resultados de enfermagem no pós-operatório de cirurgia bariátrica / Nursing diagnoses, interventions and outcomes in the bariatric surgery postoperative care

Objetivou-se identificar os diagnósticos de enfermagem da classe respostas cardiovasculares/pulmonares pertencentes ao domínio atividade/repouso, segundo a taxonomia II da NANDA-I em pacientes no pós-operatório imediato de cirurgia bariátrica e propor as intervenções e os resultados de enfermagem de acordo com a Nursing Interventions Classification e a Nursing Outcomes Classification. Estudo exploratório e transversal, realizado de julho de 2010 a junho de 2011 com 59 pacientes no pós-operatório imediato de cirurgia bariátrica. Os principais diagnósticos de enfermagem foram: Perfusão Tissular Periférica Ineficaz, Débito Cardíaco Diminuído, Intolerância à Atividade, Perfusão Tissular Cardíaca Diminuída e Risco de Perfusão Renal Ineficaz. Um plano assistencial de enfermagem foi elaborado com 10 resultados e 16 intervenções. A escolha das intervenções adequadas diminui o tempo de internação e consequentemente as complicações cardiopulmonares no pós-operatório. Outro ponto importante é a padronização da linguagem na construção dos diagnósticos e resultados, o que favorece a documentação de enfermagem.

Autocuidado universal praticado por idosos em uma instituição de longa permanência / Universal self-care practiced by the elderly in a long-term institution

OBJETIVO: Descrever as ações do autocuidado universal em idosos institucionalizados com enfoque na promoção da saúde. MÉTODOS: Estudo quantitativo, exploratório e descritivo, realizado em uma instituição de longa permanência situada em Fortaleza-CE, com 170 idosos. Os dados foram coletados no período de fevereiro a junho de 2010, por meio de entrevista com a utilização de um roteiro estruturado com base nos requisitos universais do autocuidado de Orem. RESULTADOS: 65,8% (112) dos idosos tinham idade de 60 a 79 anos, 54,1% (92) pertenciam ao sexo feminino, 28,9% (49) eram viúvos, 64,8% (110) tinham escolaridade até o ensino fundamental e 44,2% (75) tinham renda familiar mensal menor que um salário mínimo. Alguns idosos descuidaram em alguns aspectos relacionados ao autocuidado no que se refere a oxigenação, hidratação, atividade e promoção da saúde. Esse déficit de autocuidado pode estar associado às limitações físicas inerentes ao ciclo vital, ao déficit de conhecimento e ao baixo poder aquisitivo. CONCLUSÕES: Faz-se necessário desenvolver atividades voltadas para o lazer e exercícios físicos nessa população, uma vez que essas ações são consideradas importantes para a promoção da saúde e a interação social.

OBJECTIVE: To describe the actions of the universal self-care in institutionalized elderly focusing on health promotion. METHODS: Quantitative, exploratory and descriptive study carried out in a long-term institution in Fortaleza-CE, with 170 elderly. Data were collected from February to June 2010, through interviews using a structured questionnaire from the requirements of the universal self-care of Orem. RESULTS: 65.8% (112) of the elderly were aged 60-79 years, 54.1% (92) were female, 28.9% (49) were widowed, 64.8% (110) had education up to primary school and 44.2% (75) had monthly income less than minimum wage. Some older neglected in some aspects of self-care with regard to oxygen, moisture, and health promotion activities. This lack of self-care may be associated with physical limitations inherent in the life cycle, the knowledge deficit and the low purchasing power. CONCLUSIONS: It is necessary to develop activities for leisure and exercise in this population, since these actions are considered important for health promotion and social interaction.