In Utero Treatment of Obstructive Ureterocele.

Lower urinary tract obstruction consists of a heterogeneous group of conditions in which the normal urethral egress of urine from the fetal bladder is impaired. The most frequent diagnoses are posterior urethral valves, urethral atresia, and less common obstructive ureterocele. We report a case of a fetus with prenatal diagnosis of obstructive ureterocele who presented progressive bilateral hydronephrosis. A fetal cystoscopy with laser ablation was performed.

Fetal hemivertebra: a rare form of 18q deletion prenatal presentation.

The 18q deletion is a rare condition with several described features. A common phenotype includes short stature, microcephaly, facial defects, small feet, intellectual disability and hypotonia.We present a rare case of a fetus with del18q22.1q23 whose diagnosis was obtained by amniocentesis after a routine ultrasound at 20 weeks, where a hemivertebra was detected.Congenital hemivertebra is infrequent and is rarely associated with chromosomal anomalies. Expectant management can be advocated in isolated hemivertebra. This report shows that a hemivertebra can be an isolated prenatal finding in del18 so it is important to screen for, and exclude, chromosomal anomalies.

Torcular pseudomass is frequently detected on fetal magnetic resonance imaging and reduces with gestational age.

BACKGROUND: The torcular pseudomass is an incidental extra-axial midline mass located between the venous sinuses and the occipital squama in the pediatric population. Although this structure is presumed to be a developmental feature, it has not been characterized on fetal MRI. OBJECTIVE: To determine the frequency, imaging features and longitudinal in utero evolution of torcular pseudomass using fetal MRI. MATERIALS AND METHODS: We present a single-center retrospective study of fetal MRI performed at a tertiary hospital. Two independent reviewers first ordinally scored torcular pseudomass as absent, focal, crescentic or bulky based on morphology. We reviewed available follow-up fetal and postnatal MRI and further classified torcular pseudomass as stable, involuted or progressive. We also collected clinical and demographic data from electronic charts and compared them among categories, corrected for multiple comparisons. RESULTS: This study included a total of 219 fetuses with median gestational age of 28 weeks (interquartile range [IQR]: 23-32 weeks). Torcular pseudomass was absent in 8% (n=17) and present as a focal mass in 15% (n=33), crescentic in 45% (n=98) and bulky in 32% (n=71) of the cases. Median gestational age was statistically different among torcular pseudomass categories and inversely associated with size. Follow-up fetal MRI was available in 9.6% (n=21) of cases (median interval 4 weeks; IQR: 2-9 weeks) and torcular pseudomass in these cases was classified as stable in 67% (n=14), involuted in 29% (n=6) and progressive in 5% (n=1). Postnatal MRI was available in 5% (n=12) of fetuses (median interval 11.5 months, IQR: 3-17 months), and among these cases torcular pseudomass was classified as stable in 33% (n=4) and involuted in 67% (n=8). CONCLUSION: Torcular pseudomass is highly prevalent in the fetal population and shows a natural tendency to involute, even in utero, although it sometimes persists during early infanthood.

Placental spectrum features between mesenchymal dysplasia and partial hydatidiform mole coexisting with a live fetus.

We report a case of a singleton hydrops pregnancy with placental gross and microscopic features between partial hydatidiform mole (PHM) and placental mesenchymal dysplasia (PMD) in a diploid live fetus. Pregnancy was complicated by early onset of growth restriction and pre-eclampsia. A female newborn was born at 29 weeks with no congenital malformations. Histology of the placenta revealed mixed phenotype of PMD and PHM, and genetic test results were normal.

Production of knowledge based on the Theory of Culture Care Diversity and Universality: documental research.

OBJECTIVES: To analyze the abstracts that relate nursing to the Theory of Culture Care Diversity and Universality, published in the annals of the main national scientific events in the category, over a 12-year period. METHODS: documental research carried out in the annals of the Brazilian Nursing Congress and the National Nursing Research Seminar. Data collection took place from July/2018 to June/2019 using a form. Data was analyzed using descriptive statistics and content analysis. RESULTS: 99 studies were analyzed, and three categories emerged: Cultural diversity, emic perspective, and cultural context: possibilities for applying the theory; Incongruencies and peculiarities of the care sectors: limitations of the application of the theory; Knowledge production to improve care: implications for professional nursing practice. FINAL CONSIDERATIONS: the investigated scientific production enabled the construction of knowledge of cultural aspects related to nursing care and showed similarities and variations in care practices.

Fragilidade física e mobilidade funcional em idosos da atenção primária à saúde / Physical frailty and functional mobility in elderly people in primary health care

Resumo: Trata-se de estudo quantitativo de corte transversal, cujo objetivo foi analisar a associação da condição e dos marcadores de fragilidade física à mobilidade funcional de idosos. Participaram-se 389 idosos (?60 anos) assistidos em uma Unidade Básica de Saúde em Curitiba, Paraná. Para a coleta de dados, aplicaram-se questionários sociodemográfico e clínico, testes do fenótipo de fragilidade física e o timed up and go para avaliar a mobilidade funcional. Analisaram-se os dados mediante estatística descritiva, associação (Teste de Qui-quadrado com nível de significância estatístico considerado de p<=0,05 (a=0,05) e de correlação (Teste de Pearson). As chances de associação entre os marcadores de fragilidade e a mobilidade funcional diminuída foram analisados pela Odss Ratio, com intervalo de confiança de 95%. O modelo de regressão final foi elaborado pelo critério da acurácia, sensibilidade, especificidade, coeficientes de correlação linear e ajustado. O estudo foi aprovado pelo Comitê de Ética do Setor de Ciências da Saúde da Universidade Federal do Paraná, sob o parecer n°2918847. Dos 389 idosos, 34 (8,7%) eram frágeis, 186 (47,8%) pré-frágeis, 169 (43,5%) não frágeis, e 330 (84,8%) apresentaram mobilidade funcional diminuída. Os marcadores de fragilidade mais expressivos foram o baixo nível de atividade física (n=82; 21,0%), redução da força de preensão manual (n=82; 21,0%), redução da velocidade da marcha (n=81; 20,8%). Houve associação significativa entre a mobilidade funcional preservada e a condição de não frágeis (p=0,001). Correlacionaram-se à mobilidade funcional diminuída, a fragilidade (r=2,08; p=0,037), pré-fragilidade (r=2,04; p=0,041) e os marcadores redução da força de preensão manual (p=0,026), baixo nível de atividade física (p=0,026) e redução da velocidade da marcha (p<0,001). A razão de chance de idosos frágeis apresentarem mobilidade funcional diminuída é significativamente elevada (RC 9,25) quando comparada aos não frágeis. No modelo preditivo final permaneceram os marcadores redução da força de preensão manual, baixo nível de atividade física e redução da velocidade da marcha. O idoso com redução da força de preensão manual tem 1,96 vezes mais chance de desenvolver MF diminuída, quando comparado aquele FPM preservada (OR 1,968, IC95%, 0,798-4,854, p=0,141), e o idoso com baixo nível de atividade física tem 2,10 vezes mais chances de desenvolver declínio da mobilidade funcional, em relação ao fisicamente ativo (OR 2,101, IC95%, 0,855-5,163, p=0,105). O idosos com redução da velocidade da marcha possui 7,21 vezes mais chances de apresentar diminuição na MF, ao comparar com a condição de não frágil para esse componente (OR 7,213, IC95%, 1,703-30,537, p=0,007). Conclui-se que, os idosos frágeis e com o marcador redução da velocidade da marcha possuem chances elevadas de desenvolverem mobilidade funcional diminuída. Apesar da correlação entre mobilidade funcional e redução da força de preensão manual e baixo nível de atividade física, esses marcadores não se mostraram preditivos para mobilidade funcional diminuída. O presente estudo destaca resultados expressivos para a prática clínica de enfermagem gerontológica, os quais são essenciais para subsidiar estratégias preventivas para a mobilidade funcional do idoso e proporcionar uma visão mais ampla e clara na gestão dos cuidados, sobretudo para a fragilidade marcada pelo componente velocidade da marcha.

Abstract: This is a quantitative cross-sectional study, with the aim of analyzing the association between the condition and the markers of physical frailty and functional mobility in the elderly. Three-hundred and eighty-nine elderly people aged (?60 years) assisted at a Basic Health Unit in Curitiba, Paraná, participated. For data collection, sociodemographic and clinical questionnaires, physical frailty phenotype and timed up and Go tests were used to evaluate functional mobility. Data were analyzed using descriptive statistics, association (Chi-square test) with a level of statistical significance considered of p<=0.05 (a=0.05) and correlation (Pearson test). The chances of an association between frailty markers and decreased functional mobility were analyzed by the Odss Ratio, with a 95% confidence interval. The final regression model was elaborated by the criterion of accuracy, sensitivity, specificity, linear and adjusted correlation coefficients. The study was approved by the Ethics Committee of the Health Sciences Sector of the Universidade Federal do Paraná, under Opinion Report No. 2918847. Of the 389 elderly, 34 (8.7%) were frail, 186 (47.8%) pre-frail, 169 (43.5%) non-frail, and 330 (84.8%) had reduced functional mobility. The most expressive markers of frailty were low level of physical activity (n=82; 21.0%), reduced handgrip strength (n=82; 21.0%), reduced gait speed (n=81; 20.8). Frailty (r=2.08; p=0.037), pre-frailty (r=2.04; p=0.041) and, markers of handgrip strength (p=0.026), level of physical activity (p=0.026) and gait speed (p<0.001) associated to the decreased functional mobility. There was a significant association between preserved functional mobility and the condition of not being frail (p=0.001). The odds ratio for frail elderly people with reduced functional mobility is significantly high (OR 9.25) when compared to non-frail people. In the final predictive model, the markers remained: reduced handgrip strength, low level of physical activity and reduced gait speed. The elderly with reduced handgrip strength is 1.96 times more likely to develop decreased MF when compared to that preserved HGS (OR 1.968, 95%CI, 0.798-4.854, p=0.141), and the elderly with low activity level physical activity is 2.10 times more likely to develop a decline in functional mobility, compared to physically active (OR 2.101, 95%CI, 0.855- 5.163, p=0.105). The elderly with reduced gait speed are 7.21 times more likely to have a decrease in MF, when compared to the condition of non-frail for this component (OR 7.213, 95%CI, 1.703-30.537, p=0.007). It is concluded that the frail elderly and with the marker reduced gait speed have a high chance of developing reduced functional mobility. Despite the correlation between functional mobility and reduced handgrip strength and low level of physical activity, these markers were not predictive for decreased functional mobility. The present study highlights expressive results for the clinical practice of gerontological nursing, which are essential to support preventive strategies for the functional mobility of the elderly and provide a broader and clearer view in the management of care, especially for the frailty marked by the gait speed component.

Production of knowledge based on the Theory of Culture Care Diversity and Universality: documental research / Producción de conocimientos fundamentados en la Teoría de la Diversidad y Universalidad de los Cuidados Culturales: investigación documental / Produção de conhecimentos fundamentados na Teoria da Diversidade e Universalidade do Cuidado Cultural: pesquisa documental

ABSTRACT Objectives: To analyze the abstracts that relate nursing to the Theory of Culture Care Diversity and Universality, published in the annals of the main national scientific events in the category, over a 12-year period. Methods: documental research carried out in the annals of the Brazilian Nursing Congress and the National Nursing Research Seminar. Data collection took place from July/2018 to June/2019 using a form. Data was analyzed using descriptive statistics and content analysis. Results: 99 studies were analyzed, and three categories emerged: Cultural diversity, emic perspective, and cultural context: possibilities for applying the theory; Incongruencies and peculiarities of the care sectors: limitations of the application of the theory; Knowledge production to improve care: implications for professional nursing practice. Final Considerations: the investigated scientific production enabled the construction of knowledge of cultural aspects related to nursing care and showed similarities and variations in care practices.

RESUMEN Objetivos: analizar resúmenes que relacionan la enfermería a la Teoría de la Diversidad y Universalidad de los Cuidados Culturales, publicados en anuales de los principales eventos científicos nacionales de la categoría, en el período de 12 años. Métodos: investigación documental realizada en anuales del Congreso Brasileño de Enfermería y Seminario Nacional de Investigación en Enfermería. Recogida de datos ocurrió de julio/2018 a junio/2019 mediante formulario. Datos analizados por estadística descriptiva y análisis de contenido. Resultados: analizaron 99 estudios, y emergieron tres categorías: Diversidad cultural, perspectiva emic y contexto cultural: posibilidades de aplicación de la teoría; Incongruencias y peculiaridades de sectores de cuidado: limitaciones de aplicación de la teoría; Producción de conocimientos para perfeccionamiento de cuidados: implicaciones para la práctica profesional de enfermería. Consideraciones Finales: producción científica investigada posibilitó construcción de conocimientos de aspectos culturales relacionados a los cuidados de enfermería y mostró semejanzas y variaciones en las prácticas de cuidados.

RESUMO Objetivos: analisar os resumos que relacionam a enfermagem com a Teoria da Diversidade e Universalidade do Cuidado Cultural, publicados nos anais dos principais eventos científicos nacionais da categoria, no período de 12 anos. Métodos: pesquisa documental realizada nos anais do Congresso Brasileiro de Enfermagem e Seminário Nacional de Pesquisa em Enfermagem. A coleta dos dados ocorreu de julho/2018 a junho/2019 mediante formulário. Os dados foram analisados por estatística descritiva e análise de conteúdo. Resultados: analisaram-se 99 estudos, e emergiram três categorias: Diversidade cultural, perspectiva êmica e contexto cultural: possibilidades de aplicação da teoria; Incongruências e peculiaridades dos setores de cuidado: limitações da aplicação da teoria; Produção de conhecimentos para aperfeiçoamento dos cuidados: implicações para a prática profissional de enfermagem. Considerações Finais: a produção científica investigada possibilitou a construção de conhecimentos dos aspectos culturais relacionados com os cuidados de enfermagem e mostrou semelhanças e variações nas práticas de cuidados.

Production of knowledge based on the Theory of Culture Care Diversity and Universality: documental research / Producción de conocimientos fundamentados en la Teoría de la Diversidad y Universalidad de los Cuidados Culturales: investigación documental / Produção de conhecimentos fundamentados na Teoria da Diversidade e Universalidade do Cuidado Cultural: pesquisa documental

ABSTRACT Objectives: To analyze the abstracts that relate nursing to the Theory of Culture Care Diversity and Universality, published in the annals of the main national scientific events in the category, over a 12-year period. Methods: documental research carried out in the annals of the Brazilian Nursing Congress and the National Nursing Research Seminar. Data collection took place from July/2018 to June/2019 using a form. Data was analyzed using descriptive statistics and content analysis. Results: 99 studies were analyzed, and three categories emerged: Cultural diversity, emic perspective, and cultural context: possibilities for applying the theory; Incongruencies and peculiarities of the care sectors: limitations of the application of the theory; Knowledge production to improve care: implications for professional nursing practice. Final Considerations: the investigated scientific production enabled the construction of knowledge of cultural aspects related to nursing care and showed similarities and variations in care practices.

RESUMEN Objetivos: analizar resúmenes que relacionan la enfermería a la Teoría de la Diversidad y Universalidad de los Cuidados Culturales, publicados en anuales de los principales eventos científicos nacionales de la categoría, en el período de 12 años. Métodos: investigación documental realizada en anuales del Congreso Brasileño de Enfermería y Seminario Nacional de Investigación en Enfermería. Recogida de datos ocurrió de julio/2018 a junio/2019 mediante formulario. Datos analizados por estadística descriptiva y análisis de contenido. Resultados: analizaron 99 estudios, y emergieron tres categorías: Diversidad cultural, perspectiva emic y contexto cultural: posibilidades de aplicación de la teoría; Incongruencias y peculiaridades de sectores de cuidado: limitaciones de aplicación de la teoría; Producción de conocimientos para perfeccionamiento de cuidados: implicaciones para la práctica profesional de enfermería. Consideraciones Finales: producción científica investigada posibilitó construcción de conocimientos de aspectos culturales relacionados a los cuidados de enfermería y mostró semejanzas y variaciones en las prácticas de cuidados.

RESUMO Objetivos: analisar os resumos que relacionam a enfermagem com a Teoria da Diversidade e Universalidade do Cuidado Cultural, publicados nos anais dos principais eventos científicos nacionais da categoria, no período de 12 anos. Métodos: pesquisa documental realizada nos anais do Congresso Brasileiro de Enfermagem e Seminário Nacional de Pesquisa em Enfermagem. A coleta dos dados ocorreu de julho/2018 a junho/2019 mediante formulário. Os dados foram analisados por estatística descritiva e análise de conteúdo. Resultados: analisaram-se 99 estudos, e emergiram três categorias: Diversidade cultural, perspectiva êmica e contexto cultural: possibilidades de aplicação da teoria; Incongruências e peculiaridades dos setores de cuidado: limitações da aplicação da teoria; Produção de conhecimentos para aperfeiçoamento dos cuidados: implicações para a prática profissional de enfermagem. Considerações Finais: a produção científica investigada possibilitou a construção de conhecimentos dos aspectos culturais relacionados com os cuidados de enfermagem e mostrou semelhanças e variações nas práticas de cuidados.

Chorionic bump in a pregnant patient with a history of infertility.

Chorionic bump is a rare condition in the first trimester of pregnancy. It appears as a bulge from the choriodecidual surface into the gestational sac. So far, there have been no ultrasound or clinical markers that can predict a difference in outcomeWe report a case of a pregnant woman with history of infertility, diagnosed in the first trimester with a chorionic bump. It disappeared spontaneously at 23 weeks of gestation. The pregnancy went well and she delivered a healthy baby.The aetiology and clinical significance of the chorionic bump remains unclear.

Anophtalmia y microftalmia: caso clínico con el diagnóstico prenatal / Anophthalmia and microphthalmia: A clinical case with a prenatal diagnosis

Introduction: Anophthalmia and microphthalmia are serious eye malformations that describe, respectively, the absence of an eye and the presence of a small eye within the orbit. These conditions are the most frequent congenital eye malformations in the newborn, and the precise aetiology remains unknown, but they may occur in isolation or as part of a syndrome, with chromosomal, monogenic and environmental causes already identified. The pre- and post-natal diagnosis can be made using imaging techniques and genetic analysis. The authors present a clinical case diagnosed prenatally. Case report: A 35 year-old primiparous woman, with normal first trimester examinations and karyotype 46,XX, in whom the ultrasound at 18/23 weeks revealed an asymmetry of ocular globes, with a small diameter of the left orbit. This study was complemented with foetal magnetic resonance that confirmed a severe microphthalmia in the left eye, with difficulty in observing the integrity of the optic nerve. The interruption of the pregnancy was discussed, but the parents did not want this. The remaining routine examinations were normal. The pregnancy was terminated at 37 weeks, palpebral closure with absence of ocular globe of the left eye and opacification of cornea and microphthalmia in the right eye was confirmed. Conclusion: This case shows that a difficult diagnosis of a rare pathology can be made in utero by ultrasound. However, some are impossible to diagnosis, and this must be explained to parents (AU)

Introducción: Anophtalmia y microftalmia son malformaciones graves en los ojos que describen, respectivamente, la ausencia de un ojo y de la presencia de un ojo pequeño dentro de la órbita. Estas condiciones son la malformación ocular congénita más frecuente en el recién nacido, y la etiología exacta se desconoce, pero pueden ocurrir en forma aislada o como parte de un síndrome, con chromossomal, monogénica y las causas ambientales ya identificados. Los autores presentan un caso clínico diagnosticado prenatalmente. Reporte de un caso: Primípara, de 35 años, con exámenes trimestrales primero normales y cariotipo 46, XX. En 18/23 semanas, la ecografía reveló una asimetría de los globos oculares, con un pequeño diámetro en órbita izquierda. Este estudio se complementa con resonancias magnética foetal, que confirmó una microftalmia severa de la izquierda con dificultad en la observación de la integridad del nervio óptico. Nesse momento se discutió la interrupción del embarazo, pero los padres no aceptó. Los restantes exámenes de rutina fueron normales. El embarazo se dio por terminada a las 37 semanas, y se confirmó el cierre palpebral con la ausencia de globo ocular a la izquierda y la opacificación de la córnea y microftalmia en el ojo derecho. Conclusión: Este caso demuestra que un diagnóstico difícil de una patología poco frecuente, se puede hacer en el útero por ecografía. Sin embargo, algunos son imposibles de diagnóstico y esto debe ser explicado a los padres (AU)