Cuidado transcultural em maternidades a puérperas e neonatos expostos a substâncias psicoativas no pré-natal / Cross-Cultural Care In Maternities To Puerpera And Newborns Exposed To Psychoactive Substances In Prenatal

O abuso de substâncias psicoativas pela mulher no período pré-natal tem chamado a atenção para a necessidade de práticas de cuidado materno-neonatal que sejam culturalmente competentes. Desta forma, este estudo teve como objetivo relatar limitações e potencialidades de cuidado transcultural ao binômio mãe usuária de álcool ou outras drogas e seu neonato, observadas no dia a dia da maternidade. Trata-se de uma pesquisa qualitativa de natureza exploratória, descritiva, com perspectiva etnográfica sobre o cuidado prestado ao binômio mãe usuária de álcool ou outras drogas e seu neonato, realizada entre 2018 e 2020 em maternidades. Os dados foram obtidos por meio de observação participante e entrevistas às puérperas e profissionais de saúde, discutindo-os à luz da Teoria de Madeleine Leininger. As limitações e potencialidades do cuidado focaram no acolhimento, na comunicação entre os profissionais e as pacientes, na identificação de sinais de dependência e abstinência na puérpera, nas orientações em saúde e na rotina de avaliação neonatal. A compreensão cultural e o vínculo etnográfico permitiram uma relação de confiança, de busca de conhecimento e de construção coletiva para o efetivo cuidado culturalmente congruente frente às limitações encontradas.

The abuse of psychoactive substances by women during the prenatal period has called attention to the need for culturally competent maternal-neonatal care practices. Thus, this study aimedto report limitations and potentialities of cross-cultural care to the binomial mother who uses alcohol or other drugs and her newborn, observed in the daily life of the maternity ward. It is qualitative research of exploratory, descriptive nature, with ethnographic perspective on the care provided to the binomial mother who uses alcohol or other drugs and her newborn, conducted between 2019 to 2020 in maternity hospitals. The data were obtained through participant observation and interviews to puerperae and health professionals, discussing them in the light of Madeleine Leininger's Theory. The limitations and potentialities of care focused on the reception, communication between professionals and patients, identification of signs of dependence and abstinence in puerperae, health guidelines, and routine neonatal evaluation. The cultural understanding and the ethnographic bond allowed a relationship of trust, search for knowledge, and collective construction for the effective culturally congruent care in face of the limitations found.

Diagnósticos e intervenções de enfermagem a crianças com sinais respiratórios de gravidade da covid-19 / Diagnósticos e intervenciones de enfermería para niños con signos respiratorios de gravedad covid-19 / Nursing diagnoses and interventions for children with respiratory signs of covid-19 severity

Objetivo descrever diagnósticos e intervenções de enfermagem a crianças com sinais respiratórios de gravidade da COVID-19. Método estudo exploratório, descritivo, do tipo revisão narrativa, realizado em junho de 2020, embasado pelas evidências científicas publicadas na base PUBCOVID-19, para posterior elaboração de diagnósticos utilizando a Taxonomia North American Nursing Diagnoses Association - International, e intervenções ancoradas na Nursing Interventions Classification. Resultados a dispneia e o desconforto respiratório foram os sinais de gravidade mais evidenciados na criança com COVID-19. Foram elaboradas três principais afirmativas diagnósticas: Troca de Gases Prejudicada, Padrão Respiratório Ineficaz e Ventilação Espontânea Prejudicada, com 24 Intervenções de Enfermagem correspondentes em quatro domínios: o fisiológico, comportamental, de segurança, e o de família. Conclusão a descrição dos diagnósticos e intervenções de enfermagem, ancorados pelas taxonomias NANDA e NIC, respectivamente, apresenta inovação na literatura científica brasileira.

Objetivo describir diagnósticos e intervenciones de enfermería a niños con signos respiratorios de gravedad COVID-19. Método estudio exploratorio, descriptivo, de revisión narrativa, realizado en junio de 2020, basado en evidencia científica publicada en la base de datos PUBCOVID-19, para la preparación ulterior de diagnósticos utilizando la Taxonomía North American Nursing Diagnosis Association - International, e intervenciones ancladas en la Clasificación de Intervenciones de Enfermería. Resultados la disnea y la dificultad respiratoria fueron los signos más evidentes de gravedad en niños con COVID-19. Se elaboraron tres declaraciones diagnósticas principales: Deterioro de Intercambio de Gases, Patrón Respiratorio Ineficaz y Deterioro de Ventilación Espontánea, con 24 Intervenciones de Enfermería correspondientes en cuatro ámbitos: fisiológica, conductual, seguridad y familia. Conclusión la descripción de los diagnósticos e intervenciones de enfermería, anclados por taxonomías NANDA y NIC, respectivamente, presenta innovación en la literatura científica brasileña.

Objective to describe nursing diagnoses and interventions to children with respiratory signs of COVID-19 severity. Method exploratory, descriptive, narrative review study, conducted in June 2020, based on scientific evidence published in the PUBCOVID-19 database, for further preparation of diagnoses using the North American Nursing Diagnoses Association - International Taxonomy, and interventions anchored in the Nursing Interventions Classification. Results dyspnea and respiratory distress were the most evident signs of severity in children with COVID-19. Three main diagnostic statements were elaborated: Impaired Gas Exchange, Ineffective Respiratory Pattern and Impaired Spontaneous Ventilation, with 24 Nursing Interventions corresponding in four domains: physiological, behavioral, safety, and family. Conclusion the description of nursing diagnoses and interventions, anchored by NANDA and NIC taxonomies, respectively, presents innovation in the Brazilian scientific literature.

Beta-Blockers and Cancer: Where Are We?

Cancer is one of the leading causes of death worldwide. After diagnosis, cancer treatment may involve radiotherapy, chemotherapy, and surgery. Several of the approaches used to treat cancer also attack normal cells and, thus, there is the need for more effective treatments that decrease the toxicity to normal cells and increase the success rates of treatment. The use of beta-blockers in cancer has been studied for their antagonist action on the adrenergic system through inhibition of beta-adrenergic receptors. Besides regulating processes such as blood pressure, heart rate, and airway strength or reactivity, beta-blockers block mechanisms that trigger tumorigenesis, angiogenesis, and tumor metastasis. This study presents a literature review of the available studies addressing cancer treatments and beta-blockers. Overall, data suggest that propranolol may be used as a complement for the treatment of several types of cancer due to its ability to improve cancer outcomes by decreasing cancer cell proliferation rates. Nonetheless, additional in vitro studies should be performed to fully understand the protective role of BBs in cancer patients.

Local pharmacological induction of angiogenesis: Drugs for cells and cells as drugs.

The past decades have seen significant advances in pro-angiogenic strategies based on delivery of molecules and cells for conditions such as coronary artery disease, critical limb ischemia and stroke. Currently, three major strategies are evolving. Firstly, various pharmacological agents (growth factors, interleukins, small molecules, DNA/RNA) are locally applied at the ischemic region. Secondly, preparations of living cells with considerable bandwidth of tissue origin, differentiation state and preconditioning are delivered locally, rarely systemically. Thirdly, based on the notion, that cellular effects can be attributed mostly to factors secreted in situ, the cellular secretome (conditioned media, exosomes) has come into the spotlight. We review these three strategies to achieve (neo)angiogenesis in ischemic tissue with focus on the angiogenic mechanisms they tackle, such as transcription cascades, specific signalling steps and cellular gases. We also include cancer-therapy relevant lymphangiogenesis, and shall seek to explain why there are often conflicting data between in vitro and in vivo. The lion's share of data encompassing all three approaches comes from experimental animal work and we shall highlight common technical obstacles in the delivery of therapeutic molecules, cells, and secretome. This plethora of preclinical data contrasts with a dearth of clinical studies. A lack of adequate delivery vehicles and standardised assessment of clinical outcomes might play a role here, as well as regulatory, IP, and manufacturing constraints of candidate compounds; in addition, completed clinical trials have yet to reveal a successful and efficacious strategy. As the biology of angiogenesis is understood well enough for clinical purposes, it will be a matter of time to achieve success for well-stratified patients, and most probably with a combination of compounds.

Primary thyroid lymphoma: A case report and review of the literature.

INTRODUCTION: A rapidly enlarging mass of the anterior compartment of the neck with compressive symptoms may represent, among other diagnosis, a neoplasm of the thyroid gland. PRESENTATION OF CASE: We describe the case of a 59-year-old woman referred to the endocrine surgical unit because of compressive cervical symptoms for 3 months. The cervical ultrasound revealed a sub-sternal goiter with heterogeneous echo structure and the fine-needle aspirating cytology was inconclusive. Given the large impact of symptoms on life quality, she was submitted to a total thyroidectomy. Histological examination of the surgical specimen revealed the presence of a Diffuse Large B Cell Lymphoma of the thyroid. DISCUSSION: Primary thyroid lymphomas are rare and there are few randomized studies for diagnostic and therapeutic guidance. New immunohistochemical and molecular techniques have improved the diagnostic accuracy with corebiopsy limiting the role of surgery. The treatment should first include the control of local disease with radiotherapy and/or surgery combined with chemotherapy to control obscure or disseminated disease. Palliative surgery may be needed to relieve airway compression symptoms. Under these circumstances, surgery should be performed by a specialized surgeon to decrease the associated morbidity. The prognosis of patients depends on the histological classification of the tumor and the stage of the disease. CONCLUSION: Due to the rarity of the disease, each case must be evaluated and treated individually, since there is not a consensual therapeutic approach.