Características sociodemográficas e clínicas na internação de adolescentes submetidos a pulsoterapia com glicocorticoides / Sociodemographic and clinical characteristics in the hospitalization of dolescents submitted to pulsotherapy with glycocorticoids / Características sociodemográficas y clínicas en la hospitalización de dolescentes sometidos a pulsoterapia con glicocorticoides

Introdução: Adolescentes com Lúpus Eritematoso Sistêmico desenvolvem doença autoimune inflamatória sistêmica, demandando assistência de enfermagem especializada. Objetivo: Levantar as características sociodemográficas e clínicas de adolescentes com Lúpus Eritematoso Sistêmico submetidos a pulsoterapia com glicocorticoides em um serviço especializado em saúde do adolescente. Material e Método: Estudo descritivo, retrospectivo quantitativo, realizado em uma enfermaria de um hospital universitário no Estado do Rio de Janeiro, Brasil, cuja amostra incluiu 12 prontuários de adolescentes internados no período de janeiro a julho de 2021, submetidos ao protocolo de pulsoterapia com glicocorticoide, totalizando 23 internações. Os dados foram coletados no período de maio a julho. Resultados: Das 23 internações para realização de pulsoterapia, 95,7% (n=22) foram em decorrência das complicações oriundas do Lúpus. As queixas predominantes durante a internação foram as dores articulares, edema e febre. Sobre o conhecimento dos adolescentes em relação a doença, foi possível identificar que 50% (n=6) possuíam conhecimento. A maioria dos adolescentes era do sexo feminino (75%), raça branca (50%) e faixa etária de 14 a 16 anos (75%), com ensino fundamental incompleto (58,3%) e renda familiar de 1 a 2 salários-mínimos (83,3%). Conclusão: É importante levantar as características sociodemográficas e clínicas dos adolescentes com Lúpus, pois favorece a realização de um plano assistencial de enfermagem individualizado e integral, dadas as necessidades dessa população.(AU)

Introduction: Adolescents with Systemic Lupus Erythematosus develop systemic inflammatory autoimmune disease, requiring specialized nursing care. Objective: To survey the sociodemographic and clinical characteristics of adolescents with Systemic Lupus Erythematosus undergoing pulse therapy with glucocorticoids in a specialized service in adolescent health. Material and Method: Descriptive, quantitative retrospective study, carried out in a ward of a university hospital in the State of Rio de Janeiro, Brazil, whose sample included 12 medical records of adolescents hospitalized from January to July 2021, submitted to the pulse therapy protocol with glucocorticoid, totaling 23 hospitalizations. Data were collected from May to July. Results: Of the 23 hospitalizations for pulse therapy, 95.7% (n=22) were due to complications from Lupus. The predominant complaints during hospitalization were joint pain, swelling and fever. About the knowledge of adolescents and the disease, it was possible to identify that 50% (n=6) had knowledge. Most adolescents were female (75%), white (50%) and aged between 14 and 16 years (75%), with incomplete primary education (58.3%) and family income of 1 to 2 salaries-minimum (83.3%). Conclusion: It is important to survey the sociodemographic and clinical characteristics of adolescents with Lupus, as it favors the implementation of an individualized and comprehensive nursing care plan, given the needs of this population.(AU)

Introducción: Los adolescentes con Lupus Eritematoso Sistémico desarrollan enfermedad autoinmune inflamatoria sistémica, requiriendo atención de enfermería especializada. Objetivo: Relevar las características sociodemográficas y clínicas de adolescentes con Lupus Eritematoso Sistémico en tratamiento de pulso con glucocorticoides en un servicio especializado en salud del adolescente. Material y Método: Estudio descriptivo, cuantitativo, retrospectivo, realizado en una sala de un hospital universitario del Estado de Río de Janeiro, Brasil, cuya muestra incluyó 12 prontuarios de adolescentes hospitalizados de enero a julio de 2021, sometidos al protocolo de pulsoterapia. con glucocorticoide, totalizando 23 hospitalizaciones. Los datos fueron recolectados de mayo a julio. Resultados: De las 23 hospitalizaciones por pulsoterapia, el 95,7% (n=22) fueron por complicaciones del Lupus. Las quejas predominantes durante la hospitalización fueron dolor articular, hinchazón y fiebre. Sobre el conocimiento de los adolescentes y la enfermedad, fue posible identificar que el 50% (n=6) tenía conocimiento. La mayoría de los adolescentes eran del sexo femenino (75%), blancos (50%) y con edades entre 14 y 16 años (75%), con instrucción primaria incompleta (58,3%) y renta familiar de 1 a 2 salarios mínimos (83,3%). Conclusión: Es importante relevar las características sociodemográficas y clínicas de los adolescentes con Lupus, ya que favorece la implementación de un plan de atención de enfermería individualizado e integral, dadas las necesidades de esta población.(AU)

PANDAS: What nurses need to know.

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) describes a disorder that develops in children who abruptly develop neurologic abnormalities following a streptococcal infection. The authors discuss what is known about this poorly understood disorder and how nurses can educate and support patients and their families.

Immunosuppressive/Autoimmune Disorders.

Autoimmune disorders are a category of diseases in which the immune system attacks healthy cells as a result of a dysfunction of the acquired immune system. Clinical presentation and diagnosis are disease specific and often correspond with the degree of inflammation, as well as the systems involved. Treatment varies based on the specific disease, its stage of presentation, and patient symptoms. The primary goal of treatment is to decrease inflammation, minimize symptoms, and lessen the potential for relapse. Graves disease, Hashimoto thyroiditis, rheumatoid arthritis, Crohn disease, ulcerative colitis, systemic lupus erythematosus, and multiple sclerosis are discussed in this article.

Is It PANS, CANS, or PANDAS? Neuropsychiatric Pediatric Disorders That Are Not Black and White--Implications for the School Nurse.

The terms pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), pediatric acute-onset neuropsychiatric syndrome (PANS), and childhood acute neuropsychiatric symptoms (CANS) have all been used to describe certain acute onset neuropsychiatric pediatric disorders. Additionally, controversy is ongoing concerning the diagnosis and etiology of the disorders. The school nurse, as a member of a multidisciplinary team, benefits from an awareness of these disorders, the resulting impact on school performance, and the recommended treatment. The school nurse assists the team through the development of an Individualized Healthcare Plan to help the student to achieve success in school.

Chemotherapy and biotherapeutic agents for autoimmune diseases.

New trends have emerged in treating patients with autoimmune diseases with medications traditionally used in oncology. This article will summarize a comprehensive literature review performed to identify effective chemotherapy and biotherapeutic agents for treating each of the main autoimmune subtypes (nervous, gastrointestinal, blood and blood vessel, skin, endocrine, and musculoskeletal systems). In addition to agents currently used, some of the newer therapeutic options show great promise to radically improve treatment choices when considering individualized plans. Improved outcomes and symptom management using newer nontraditional therapies provide a great impetus for oncology and nononcology healthcare professionals to remain abreast of the advancements made to current treatment options. All nurses (oncology and nononcology) need to be aware of these new trends and strengthen their understanding of certain oncology medications and their side effects, as well as establish the safe-handling practices necessary to administer these agents. The Oncology Nursing Society's Treatment Basics Course is one option that can provide nononcology nurses with the knowledge needed to fulfill new practice gaps. In addition, oncology nurses need to be aware of the many autoimmune diseases that may be treated with chemotherapy or biotherapy.

Young-onset dementia: a review of the literature and what it means for clinicians.

It is estimated that more than a half million people in the United States are living with young-onset dementia and another half million with mild cognitive impairment, a precursor of dementia. Relatively little has been written about the psychosocial needs of these people, but information can be extrapolated from the literature on dementia in older adults and the developmental tasks and roles of middle age. This article synthesizes this literature and provides information to help psychiatric nurses and other health care professionals better understand individuals living with young-onset dementia.

Latent autoimmune diabetes of adulthood (LADA): an often misdiagnosed type of diabetes mellitus.

PURPOSE: The purpose of this article is to raise awareness about a frequently misdiagnosed form of diabetes, latent autoimmune diabetes of adulthood (LADA), to describe its clinical and epidemiological characteristics, and to compare them to those of the more common and widely known types of diabetes, type 1 diabetes mellitus (DM) and type 2 DM. DATA SOURCES: A review of the pertinent literature describing the features of LADA from 2000-2007 is summarized. CONCLUSIONS: LADA is a rather common and often underrecognized form of diabetes whose clinical presentation falls somewhere between that of type 1 DM and type 2 DM. From a pathophysiological perspective, it is more closely related to type 1 DM, and some have even used the term type 1.5 diabetes to refer to it; however, it is most often misdiagnosed and treated as type 2 DM. IMPLICATIONS FOR PRACTICE: Nurse practitioners (NPs) should always consider alternate diagnoses when patients with newly or previously identified adult-onset diabetes mellitus do not fit the traditional stereotype of type 2 DM (i.e., overweight with signs of insulin resistance and a significant family history of diabetes). Statistically, strong consideration must be given to the diagnosis of LADA, especially in those who are of normal weight, show little evidence of insulin resistance, and have hardly any family history of diabetes. Knowing the patient's exact diabetes type can give the NP a much greater understanding of the natural history of the patient's disease, the changes that may occur as the patient ages, and how to optimally manage their diabetes to minimize complications. Likewise, when a patient is correctly diagnosed, they can be empowered to manage their diabetes with the appropriate therapies.

Nononcologic use of chemotherapy.

Autoimmune disorders currently number more than 80 and have the potential for rising higher. Intravenous chemotherapy drugs, including antineoplastic and biologic agents, have long been associated with the treatment of malignant diseases. Because intravenous "chemotherapy" drugs are also included as treatment options for these disorders, more nononcology nurses are expected to possess the knowledge and skill to administer and manage these therapies. Issues such as drug knowledge, safe handling, disposal, side effect management, and patient education must be a part of the administering nurse's education and competency.

Perioperative care of the immunocompromised patient.

Immunity refers to the body's capacity to resist invading organisms and toxins, thereby preventing tissue and organ damage. A patient whose immune system is impaired may be at higher risk for untoward perioperative events. Some populations most at risk for immunocompromise include infants, geriatric patients, people who have undergone organ transplantation, and people with cancer. Patients who are immunocompromised have an increased risk for hypothermia, which can affect postoperative wound healing processes and can increase the risk of wound infection. This article provides a basic overview of the immune system, a discussion of common disorders and diseases of the immune system, and a guide for perioperative nurses to use when they care for a patient who is immunocompromised.

Celiac disease: a multisystem autoimmune disorder.

Just a few years ago, celiac disease was thought to be relatively rare in the United States, but recent data suggest celiac disease may affect 3 million Americans of all ages, many of whom have no diagnosis of the disease. With increased awareness of this disease among adult and pediatric primary care providers, there undoubtedly will be an increase in the number of persons being evaluated for celiac disease in outpatient diagnostic centers and gastroenterology practices. Gastroenterology nurses, therefore, need to have a thorough understanding of celiac disease to fully participate as members of the multidisciplinary team required to manage this challenging disease. This article discusses the pathogenesis, prevalence, diagnosis, clinical manifestations, management, and complications of celiac disease.

Understanding cytokines. Part II: Implications for nursing research and practice.

Cytokines are small signaling proteins released from a variety of cells that influence virtually every aspect of growth and development and every host response to infection, injury, and inflammation. Because of their widespread and potent effects across the life span, cytokines without a doubt influence nursing research and practice. From physiological and adaptive effects of cytokines to cytokine-induced diseases, nurses and nursing care are involved. Part II of this review highlights a few of the many examples of cytokines functioning in response to infection and inflammation, during the processes of reproduction, and in a variety of pathophysiological states. Implications for nursing research and practice are emphasized.