Limitação da utilização do acesso intraósseo: aspectos da enfermagem e da instituição de saúde / Limitation of the use of intraosseous access: aspects of nursing and health institution

Objetivo: Verificar a realização do acesso intraósseo por enfermeiros. Método: Estudo analítico transversal, realizado por meio da aplicação de um questionário. Resultados: Demonstrou-se que 97,0% dos profissionais nunca realizaram o acesso (p<0,001), e 48,5% tiveram um treinamento adequado. Apenas 9,1% relatou se sentir seguro para executar a técnica (p<0,001) e 69,7% responderam que não possuem apoio técnico, e não possuem material apropriado. Conclusão: Demonstrou-se que existe uma limitação do uso do acesso intraósseo. A falta de autonomia para realizar a técnica pode se explicar pela falta de habilidade prática e conhecimento teórico dos enfermeiros, e pela falta de protocolos e acesso à informações institucionais, treinamentos e insumos.

Objective: To verify the achievement of intraosseous access by nurses. Method: Cross-sectional analytical study, carried out through the application of a questionnaire. Results: It was demonstrated that 97,0% of the professionals never performed access (p <0.001), and 48,5% had adequate training. Only 9,1% reported feeling safe to perform the technique (p <0.001) and 69,7% answered that they do not have technical support, and do not have appropriate material. Conclusion: It has been demonstrated that there is a limitation of the use of intraosseous access. The lack of autonomy to perform the technique can be explained by the lack of practical skills and theoretical knowledge of nurses, and the lack of protocols and access to institutional information, training and inputs.

Objetivo: Verificar la realización del acceso intraóseo para las enfermeras. Método: Estudio transversal analítico realizado mediante la aplicación de un cuestionario. Resultados: Se demostró que 97,0% de los encuestados nunca hizo de acceso (p <0,001), y 48,5% tenía una formación adecuada. Sólo 9.1% reportó sentirse seguro para llevar a cabo la técnica (p <0,001) y 69,7% dijeron que no tienen soporte, y no tienen ningún material adecuado. Conclusión: Se ha demostrado que existe una limitación del uso de la vía intraósea. La falta de autonomía para llevar a cabo la técnica puede explicarse por la falta de habilidades prácticas y conocimientos teóricos de las enfermeras, y la falta de protocolos y el acceso a la información institucional, la capacitación y los insumos.

[Health, pain and daily activities among elderly people practicing Lian Gong and sedentary elderly people]. / Saúde, dor e atividades de vida diária entre idosos praticantes de Lian Gong e sedentários.

It is a well-known fact that the practice of physical activity on a regular basis among elderly people contributes to the prevention and reduction of pain, as well as promote active ageing. Based on this premise, the scope of this study was to evaluate the presence of chronic pain among elderly people attended in a primary health care unit in a city in the interior of Sao Paulo State, Brazil, by comparing those who practice Chinese gymnastics (Lian Gong) and the sedentary. Sixty elderly people were divided between 30 sedentary and 30 who participate in a group practicing Lian Gong. The presence of pain was assessed through the Nordic Questionnaire on Musculoskeletal Symptoms, already adapted and validated for Brazilian culture. When questioned about pain in the last seven days, the Lian Gong group showed a higher presence (62,3%) of pain when compared to the sedentary group, although they had fewer difficulties in performing daily activities (55,5%). Among the active elderly the presence of lower back pain was statistically inferior (p < 0.05) when comparing the groups. The practice of Lian Gong was associated to a more positive perception of one's health, less use of medicines, as well as the adopting of self-care practices and the feeling of fewer impairments in performing daily activities.

Saúde, dor e atividades de vida diária entre idosos praticantes de Lian Gong e sedentários / Health, pain and daily activities among elderly people practicing Lian Gong and sedentary elderly people

Resumo A prática regular de atividade física entre idosos contribui tanto para a prevenção e a redução da dor, quanto atua na promoção do envelhecimento ativo. Diante disso, este estudo teve como objetivo avaliar a presença de dor crônica em idosos atendidos em uma unidade de atenção primária do interior do estado de São Paulo, comparando os praticantes da ginástica chinesa (Lian Gong) e os idosos sedentários. Participaram deste estudo 60 idosos, sendo 30 integrantes de um grupo de Lian Gong e 30 sedentários. A presença da dor foi avaliada pelo Questionário Nórdico de Sintomas Osteomusculares, adaptado e validado para a cultura brasileira. A presença da dor nos últimos sete dias foi maior (62,3%) no grupo de praticantes de Lian Gong, porém com menor impedimento para realização de atividades (55,5%) quando comparados com o grupo de sedentários. Nos indivíduos ativos a presença da dor na parte inferior das costas foi estatisticamente menor (p < 0,05) quando comparados ambos os grupos. A prática do Lian Gong esteve relacionada com a percepção positiva da própria saúde, o menor uso de medicamentos, a adoção de práticas de autonomia no próprio cuidado e a sensação de menor impedimento para realizar atividades de vida diária.

Abstract It is a well-known fact that the practice of physical activity on a regular basis among elderly people contributes to the prevention and reduction of pain, as well as promote active ageing. Based on this premise, the scope of this study was to evaluate the presence of chronic pain among elderly people attended in a primary health care unit in a city in the interior of Sao Paulo State, Brazil, by comparing those who practice Chinese gymnastics (Lian Gong) and the sedentary. Sixty elderly people were divided between 30 sedentary and 30 who participate in a group practicing Lian Gong. The presence of pain was assessed through the Nordic Questionnaire on Musculoskeletal Symptoms, already adapted and validated for Brazilian culture. When questioned about pain in the last seven days, the Lian Gong group showed a higher presence (62,3%) of pain when compared to the sedentary group, although they had fewer difficulties in performing daily activities (55,5%). Among the active elderly the presence of lower back pain was statistically inferior (p < 0.05) when comparing the groups. The practice of Lian Gong was associated to a more positive perception of one's health, less use of medicines, as well as the adopting of self-care practices and the feeling of fewer impairments in performing daily activities.

Effects of topical topiramate in wound healing in mice.

Recent studies have indicated that systemic topiramate can induce an improvement on the aesthetic appearance of skin scars. Here, we evaluated topical topiramate as an agent to improve wound healing in C57/BL6 mice. Mice were inflicted with a 6.0 mm punch to create two wounds in the skin of the dorsal region. Thereafter, mice were randomly assigned to either vehicle or topical topiramate (20 µl of 2% cream) once a day for 14 days, beginning on the same day as wound generation. We analyzed the wound samples over real-time PCR, Western blotting, and microscopy. There was no effect of the topiramate treatment on the time for complete reepithelization of the wound. However, on microscopic analysis, topiramate treatment resulted in increased granulation tissue, thicker epidermal repair, and improved deposition of type I collagen fibers. During wound healing, there were increased expressions of anti-inflammatory markers, such as IL-10, TGF-ß1, and reduced expression of the active form of JNK. In addition, topiramate treatment increased the expression of active forms of two intermediaries in the insulin-signaling pathway, IRS-1 and Akt. Finally, at the end of the wound-healing process, topiramate treatment resulted in increased expression of SOX-2, a transcription factor that is essential to maintain cell self-renewal of undifferentiated embryonic stem cells. We conclude that topical topiramate can improve the overall quality of wound healing in the healthy skin of mice. This improvement is accompanied by reduced expression of markers involved in inflammation and increased expression of proteins of the insulin-signaling pathway.