DNA barcoding and morphology revealed the existence of seven new species of squat lobsters in the family Munididae (Decapoda, Galatheoidea) in the southwestern Pacific.

Specimens of squat lobsters belonging to the family MunididaeAhyong et al., 2010, representing the genera Garymunida Macpherson & Baba, 2022, Trapezionida Macpherson & Baba, 2022 and Typhlonida Macpherson & Baba, 2022, were collected during several cruises around New Caledonia and Papua New Guinea, Southwest Pacific. The integrative study of these specimens revealed the presence of one new species in Garymunida, five in Trapezionida and one in Typhlonida. We describe and illustrate these new species, providing some new data on the taxonomy of several rare or scarcely studied species of Trapezionida. Molecular data from different markers (mitochondrial and nuclear) was also included, based on data availability, to support the taxonomic status of different species. Finally, a key to species for each genus is also provided.

Infecção de sítio cirúrgico e o telemonitoramento pelo enfermeiro no pós-operatório: uma revisão de escopo / Surgical site infection and nurse telemonitoring in the postoperative period: a scoping review

OBJETIVO: mapear evidências científicas sobre a prevenção e o manejo precoce de infecção de sítio cirúrgico por telemonitoramento em pacientes cirúrgicos após alta hospitalar. MÉTODO: revisão de escopo desenvolvida conforme proposto pelo Instituto Joanna Briggs (JBI). Foi realizada a pesquisa nas bases de dados PubMed, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration, Scopus, CINAHL, MEDLINE, Web of Science e Embase. Os estudos foram adicionados ao gerenciador Endnote Basic e Rayyan por três pesquisadores independentes. RESULTADOS: foram identificados 1.386 estudos e incluídos 31, os quais apresentaram relevância em relação a sinais de alerta precoce e tardio da infecção de sítio cirúrgico, complicações, fatores de risco, prevenção e utilização do telemonitoramento. CONCLUSÃO: observou-se que, embora os estudos abordem a infecção de sítio cirúrgico e o telemonitoramento, faz-se necessário a formulação dos instrumentos utilizados nas consultas telefônicas, contemplando com maior especificidade os critérios indispensáveis a serem abordados.

OBJECTIVE: This study aims to map scientific evidence regarding the prevention and early management of surgical site infection through telemonitoring in surgical patients after discharge from the hospital. METHOD: A scoping review was conducted following the guidelines proposed by the Joanna Briggs Institute (JBI). The search was performed across PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Collaboration, Scopus, CINAHL, MEDLINE, Web of Science, and Embase databases. Three independent researchers collect the identified studies using Endnote Basic and Rayyan. RESULTS: A total of 1,386 studies were identified, of which 31 were included in the analysis. These selected studies demonstrated significance regarding early and late warning signs of surgical site infection, complications, risk factors, prevention strategies, and the utilization of telemonitoring. CONCLUSION: While the studies address surgical site infection and telemonitoring, it is imperative to formulate the instruments employed in telephonic consultations, incorporating a more specific consideration of essential criteria to be addressed.

Cuidado domiciliar da criança em uso de traqueostomia: perspectiva dos cuidadores no contexto amazônico / Home care for children using a tracheostomy: caregivers' perspective in the amazon context / Atención domiciliaria a niños con traqueostomía: la perspectiva de los cuidadores en el contexto amazónico

RESUMO Objetivo: descrever a percepção dos cuidadores de crianças traqueostomizadas sobre os desafios no processo de alta para o domicílio no contexto amazônico. Método: estudo descritivo, qualitativo, realizado com 16 cuidadores de crianças traqueostomizadas que vivenciaram a desospitalização, em um Hospital Infantil de Rio Branco - Acre - Brasil. Amostragem definida por saturação, dados coletados com roteiro semiestruturado de agosto a dezembro de 2021, submetidos à Análise de Conteúdo de Bardin. Resultados: a análise resultou em quatro categorias: (1) sentimentos vivenciados com o uso do dispositivo traqueal; (2) cuidados rotineiros com a traqueostomia que os cuidadores julgam importantes; (3) dúvidas e relatos sobre a aspiração traqueal; e (4) condutas diante de intercorrências nas crianças em uso de traqueostomia. Considerações finais: o temor em aprender a técnica de aspiração traqueal e da alta hospitalar reforça a necessidade de educação precoce e contínua dos cuidadores, com foco no atendimento de rotina e de emergência para as crianças traqueostomizadas.

ABSTRACT Objective: To describe caregivers' perception of tracheostomized children about the challenges in discharge to their homes in the Amazonian context. Method: A descriptive, qualitative study was conducted with 16 caregivers of tracheostomized children who experienced dehospitalization in a children's hospital in Rio Branco - Acre - Brazil. Saturation-defined sampling, data collected with a semi-structured script from August to December 2021, submitted to Bardin Content Analysis. Results: the analysis resulted in four categories: (1) feelings experienced with the use of the tracheal device; (2) routine tracheostomy care that caregivers consider important; (3) questions and reports about tracheal aspiration; and (4) conduct in the face of complications in children using tracheostomy. Final remarks: the fear of learning the tracheal aspiration technique and of being discharged from the hospital reinforces the need for early and continuous education for caregivers, focusing on routine and emergency care for tracheostomized children.

RESUMEN Objetivo: describir la percepción de los cuidadores de niños traqueostomizados sobre los desafíos del alta domiciliaria en el contexto amazónico. Material y método: estudio descriptivo, cualitativo, realizado con 16 cuidadores de niños traqueostomizados que pasaron por la experiencia de des-hospitalización en un Hospital Infantil de Rio Branco - Acre - Brasil. Muestreo definido por saturación, datos recogidos mediante guion semiestructurado de agosto a diciembre de 2021, sometidos al Análisis de Contenido de Bardin. Resultados: el análisis dio lugar a cuatro categorías: (1) sentimientos experimentados con el uso del dispositivo traqueal; (2) cuidados rutinarios con la traqueostomía que los cuidadores consideran importantes; (3) dudas e informes sobre la aspiración traqueal; y (4) comportamiento en caso de complicaciones en niños que utilizan una traqueostomía. Consideraciones finales: el miedo a aprender la técnica de aspiración traqueal y a recibir el alta hospitalaria refuerza la necesidad de una formación precoz y continuada de los cuidadores, centrada en los cuidados rutinarios y de urgencia de los niños traqueostomizados.

Hidden species diversity and mito-nuclear discordance within the Mediterranean cone snail, Lautoconus ventricosus.

The Mediterranean cone snail, Lautoconus ventricosus, is currently considered a single species inhabiting the whole Mediterranean basin and the adjacent Atlantic coasts. Yet, no population genetic study has assessed its taxonomic status. Here, we collected 245 individuals from 75 localities throughout the Mediterranean Sea and used cox1 barcodes, complete mitochondrial genomes, and genome skims to test whether L. ventricosus represents a complex of cryptic species. The maximum likelihood phylogeny based on complete mitochondrial genomes recovered six main clades (hereby named blue, brown, green, orange, red, and violet) with sufficient sequence divergence to be considered putative species. On the other hand, phylogenomic analyses based on 437 nuclear genes only recovered four out of the six clades: blue and orange clades were thoroughly mixed and the brown one was not recovered. This mito-nuclear discordance revealed instances of incomplete lineage sorting and introgression, and may have caused important differences in the dating of main cladogenetic events. Species delimitation tests proposed the existence of at least three species: green, violet, and red + blue + orange (i.e., cyan). Green plus cyan (with sympatric distributions) and violet, had West and East Mediterranean distributions, respectively, mostly separated by the Siculo-Tunisian biogeographical barrier. Morphometric analyses of the shell using species hypotheses as factor and shell length as covariate showed that the discrimination power of the studied parameters was only 70.2%, reinforcing the cryptic nature of the uncovered species, and the importance of integrative taxonomic approaches considering morphology, ecology, biogeography, and mitochondrial and nuclear population genetic variation.

Nomenclatural changes in a taxonomically complex group (Amphipoda: Gammaridae).

The family Gammaridae is a large monophyletic group with a complicated taxonomy. A nomenclatural review of the taxonomic status of Pectenogammarus Reid, 1940 was conducted based on Hou & Sket (2016) and Sket & Hou (2018) phylogenetic proposals. These authors used the name Homoeogammarus Schellenberg, 1937 for a set of morphologically diverse taxa previously included mainly within Echinogammarus Stebbing, 1899. Unfortunately, the use of the name Homoeogammarus Schellenberg, 1937 is problematic. As a result of a detailed bibliographic review, we propose the name Pectenogammarus Reid, 1940 (stat. nov.) for the "Homoeogammarus" clade (Sket & Hou 2018), which results in 20 new combinations. In addition, two genera are here formally synonymised as follows: Pectenogammarus Reid, 1940 = Homoeogammarus Barnard et Barnard, 1983, syn. nov. = Laurogammarus G.S. Karaman, 1984, syn. nov. A synonymic catalogue is provided.

Multicenter retrospective study on benign testicular tumors in children: save as much as you can please.

BACKGROUND: Testicular tumors (TT) are infrequent in pediatric patients, representing 1% of pediatric solid tumors; benign testicular tumors (BTT) are the most common. We present a multicenter study aiming to describe the incidence, histology and surgical technique of BTT, with special emphasis on which approach could present better outcomes. METHODS: The records of pediatric patients diagnosed with BTT between 2005 and 2020 from 8 centers in 5 different countries in Latin-America, were reviewed. RESULTS: Sixty two BTTs were identified. 73% tumors presented as a testicular mass, and 97% underwent testicular ultrasound as the initial imaging study, all of them had findings suggestive of a benign tumor. 87% had preoperative tumor markers (AFP and BHCG). In 66%, an intraoperative biopsy was done and 98% of the intraoperative biopsies were concordant with the final pathology report. Tumorectomy was performed in 81% of patients and total orchiectomy in the remaining 19%. Six percentage of patients underwent a subsequent orchiectomy. Mean follow-up was 39 months (1-278 months) where no cases of atrophy were observed clinically or on ultrasound. Fertility was not evaluated in this series. CONCLUSIONS: Proper management of BTTs is essential to avoid unnecessary orchiectomies. Preoperative ultrasound associated with intraoperative biopsy seems accurate in identifying benign pathology, thus enabling conservative testicular surgery with safety margins. Based on this multicenter series, we suggest performing an intraoperative biopsy with subsequent tumorectomy preserving healthy testicular tissue in BTT.

Transgenic NADH dehydrogenase restores oxygen regulation of breathing in mitochondrial complex I-deficient mice.

The hypoxic ventilatory response (HVR) is a life-saving reflex, triggered by the activation of chemoreceptor glomus cells in the carotid body (CB) connected with the brainstem respiratory center. The molecular mechanisms underlying glomus cell acute oxygen (O2) sensing are unclear. Genetic disruption of mitochondrial complex I (MCI) selectively abolishes the HVR and glomus cell responsiveness to hypoxia. However, it is unknown what functions of MCI (metabolic, proton transport, or signaling) are essential for O2 sensing. Here we show that transgenic mitochondrial expression of NDI1, a single-molecule yeast NADH/quinone oxidoreductase that does not directly contribute to proton pumping, fully recovers the HVR and glomus cell sensitivity to hypoxia in MCI-deficient mice. Therefore, maintenance of mitochondrial NADH dehydrogenase activity and the electron transport chain are absolutely necessary for O2-dependent regulation of breathing. NDI1 expression also rescues other systemic defects caused by MCI deficiency. These data explain the role of MCI in acute O2 sensing by arterial chemoreceptors and demonstrate the optimal recovery of complex organismal functions by gene therapy.

New records and species of deep-sea squat lobsters (Galatheoidea, Munidopsidae) from the Hawaiian Archipelago: an integrative approach using micro-CT and barcodes.

The Hawaiian Archipelago remains extensively under-sampled for many marine invertebrate taxa, including squat lobsters. During the last few years, several deep-sea expeditions carried out in the Pacific Ocean have conducted opportunistic collections of specimens and image data from the vicinity of Hawai'i. Here we describe a new species: Munidopsis hawaii sp. nov. and provide new records for Munidopsidae in the Archipelago and its associations. We illustrate and describe the new species using an integrative approach including micro-CT 3D imaging. Phylogenetic analyses of the species collected from seamounts from Hawai'i indicate that the new species represents a divergent lineage compared to morphologically similar species such as M. dispar and M. papanui. We also study the genetic distances for the species recorded in Hawai'i and other populations of the same species in the adjacent West Pacific. Three species are now known in the Hawaiian region. We also compiled identifications from images captured with ROVs in the area. These observations suggest that munidopsid species are common in the deep sea of Hawaiian waters below 1,000 m.

Orientação ao paciente em pós-operatório de traqueostomia no processo de alta para o domicílio: revisão integrativa / Patient guidance during discharge after a tracheostomy: an integrative review

RESUMO Objetivo mapear as orientações fornecidas pelo enfermeiro para o autocuidado de pacientes no pós-operatório de traqueostomia durante o período de transição hospital-casa. Métodos trata-se de uma revisão integrativa. Utilizou-se o acrônimo PCC, considerando População - pacientes adultos em uso de traqueostomia; Conceito - autocuidado (educação/orientação pelo enfermeiro); e Contexto - períodos operatórios e cuidado domiciliar, com base na questão: Quais orientações para o autocuidado devem ser dadas pelo enfermeiro ao paciente em pós-operatório de traqueostomia no processo de alta hospitalar para o domicílio? Realizou-se busca ampla e seus resultados foram tratados por dois revisores e organizados com foco no fenômeno de interesse. Resultados encontrou-se 1.940 artigos e 28 foram selecionados. 16 fenômenos de interesse foram organizados em três categorias: manejo da traqueostomia, cuidados com as vias aéreas, e atividades de vida diária. Conclusão verificou-se que as orientações para o autocuidado estão relacionadas ao cuidado direto com o estoma, a atuação em emergências no domicílio e questões psicossociais. Contribuições para a prática a identificação, sumarização e organização das evidências sobre práticas clínicas do enfermeiro possibilitam o consumo de material de qualidade, para rápida implementação na prática clínica, sobretudo no que concerne ao preparo para alta dos pacientes com uso de traqueostomia.

ABSTRACT Objective to map the orientations provided by nurses for the self-care of patients during the postoperative period of tracheostomy and their transition from hospital to home. Methods this is an integrative review. We used the PCC acronym, where the Population was adult patients with tracheostomy; the Concept, self-care (education/orientation by the nurse); and the Context, operation periods and home care. The study was based on the question: What guidelines for self-care should the nurse given to patients in the postoperative period of a tracheostomy and in the process of discharge? We carried out a wide search, whose results were reviewed by two researchers and organized around the phenomenon of interest. Results 1,940 articles were found and 28 were selected. 16 phenomena of interest were organized into three categories: tracheostomy management, airway care, and activities of daily living. Conclusion Self-care guidance is related to direct care of the stoma, how to act in home emergencies, and psychosocial aspects. Contributions to practice identifying, summarizing, and organizing evidence about nursing clinical practice creates quality materials that can be implemented fast into clinical practice, especially in regard to preparing patients with tracheostomy for their discharge.

Cross-mapping of nursing diagnoses and interventions in decompensated heart failure.

OBJECTIVE: To map the terms recorded in medical records of patients with decompensated heart failure for nursing diagnoses and interventions from the NANDA International and Nursing Interventions Classification. METHOD: This is an exploratory and descriptive research, carried out by a cross-mapping study. Data were collected from 107 medical records of a Hospital Institute in the city of Rio de Janeiro/Brazil, in a period between October 2017 to February 2019. The diagnoses and interventions mapped were assessed by four clinical experts. Data analysis was performed using the content validation index and the Fleiss Kappa. RESULTS: The most frequent nursing diagnoses were: risk for infection (74.8%), decreased cardiac output (55.1%) and excessive fluid volume (49.5%). The interventions were: vital signs monitoring (79.4%), fluid monitoring (72.9%) and positioning (52.3%). CONCLUSION: The research mapped 32 titles of nursing diagnoses from NANDA-I and 21 nursing interventions from NIC. The diagnoses and interventions mapped will contribute to the quality of the nurses' records and patient safety.

T2 Biomarkers as Predictors of Exacerbations of Chronic Obstructive Pulmonary Disease

Introduction: Type 2 (T2) biomarkers such as blood eosinophil count (BEC) and FeNO have been related to a higher risk of exacerbations in COPD. It is unknown whether combining these biomarkers could be useful in forecasting COPD exacerbations. Methods: COPD patients were enrolled in this prospective, multicenter, observational study and followed up for 1 year, during which BEC were analysed at baseline (V0) while FeNO analyses were performed at baseline (V0), 6 months (V1) and 12 months (V2). The risk of moderate or severe exacerbation during follow up was assessed by Cox regression analysis, and the predictive capacity of both measurements was assessed by ROC curves and the DeLong test. Statistical significance was assumed at P<.05. Results: Of the 322 COPD patients initially recruited, 287 were followed up. At baseline, 28.0% were active smokers, and experienced moderate airflow limitation (mean FEV1 56.4%±17.0% predicted). Patients with at least one elevated T2 biomarker (n=125, 42.5%) were at increased risk of COPD exacerbation (HR 1.75, 95% CI 1.25–2.45, P=.001) and of shorter time to first COPD exacerbation. There was no difference between BEC and FeNO regarding the predictive capacity for moderate to severe exacerbation (AUC 0.584 vs 0.576, P=.183) but FeNO predicted severe episodes more accurately than BEC (AUC 0.607 vs 0.539, P<.05). Combining the two biomarkers enhanced the detection of moderate and severe COPD exacerbations. Conclusions: Both eosinophil count and FeNO have limited utility for predicting COPD exacerbations. Combining these T2 biomarkers could enhance the detection of future COPD exacerbations. (AU)

Performance of a C-containing Cu-based photocatalyst for the degradation of tartrazine: Comparison of performance in a slurry and CPC photoreactor under artificial and natural solar light.

A carbon-containing Cu-based material (Cu@C) was used as photocatalyst for the degradation of a commonly food-industry azo-dye (tartrazine, also called Y5), under solar light at laboratory and pilot scale photoreactors. Important performance parameters such as dark adsorption capacity, catalyst́s loading and initial concentration of the dye were first optimized in a slurry photoreactor at laboratory scale under artificial solar light following the kinetics of degradation of the dye. Afterwards, the photocatalytic activity was investigated at pilot scale in a compound parabolic collector (CPC) photoreactor operating for 10 h of irradiation. The degradation of tartrazine is among the highest values reported for alternative metal oxide semiconductors, in both photoreactor configurations. Catalytic data revealed a 3 times faster degradation kinetics of tartrazine in the CPC photoreactor under natural solar light than in the slurry reactor under artificial solar light. This behavior indicates that a moderate photon flux in the CPC is more adequate to operate with the prepared photocatalyst, as it minimizes the recombination of charge carriers in the catalyst. This is important, since most of the photocatalytic tests designed to evaluate the activity of novel materials are frequently carried out under simulated solar light and disregard the impact of photon flux in outdoor conditions.

Dependencia emocional en estudiantes de Medicina / Emotional dependence of students of medicine

RESUMEN Objetivos: Identificar la dependencia emocional en los estudiantes de medicina de universidad pública. Material y métodos : Estudio cuantitativo, no experimental, exploratorio, descriptivo, transversal. Se aplicó la escala de dependencia emocional de Ancima, Caballero, Cirilo y Aguirre (2013) integrada por 42 ítems. Las respuestas se establecen dicotómicamente Si o no. La población se conformó por 332 estudiantes de medicina de quinto año de una universidad pública. La escala fue aplicada a 303 estudiantes una muestra no probabilística, por conveniencia. Resultados: De 303 estudiantes, 183 (60,39%) eran del género femenino y 120 (39,60%) masculino, con promedio de edad de 24 años, con una desviación estándar de 1,46. Solo el 2,98% fueron "estables" y el 90,39% con "tendencia a la dependencia". Conclusiones: Los estudiantes de medicina presentan una marcada tendencia a la dependencia emocional. Siendo las mujeres las más dependientes.

SUMMARY Objective: To determine the emotional dependence of students of medicine in a public university. Methods: A cross-sectional study was carried-out applying the 42-item scale of emotional dependence of Ancima, Caballero, Cirilo y Aguirre (2013) with dichotomous responses (yes/no); 332 five-year medical students were selected; a nonprobabilistic sample of 303 students was finally recruited. Results: 183 (60.39%) were females: mean age was 24 years; only 2.98% were stables and 90.39% had a tendency for dependence. Conclusions: Five-year medical students had a marked tendency for dependence, especially female students.

T2 Biomarkers as Predictors of Exacerbations of Chronic Obstructive Pulmonary Disease.

INTRODUCTION: Type 2 (T2) biomarkers such as blood eosinophil count (BEC) and FeNO have been related to a higher risk of exacerbations in COPD. It is unknown whether combining these biomarkers could be useful in forecasting COPD exacerbations. METHODS: COPD patients were enrolled in this prospective, multicenter, observational study and followed up for 1 year, during which BEC were analysed at baseline (V0) while FeNO analyses were performed at baseline (V0), 6 months (V1) and 12 months (V2). The risk of moderate or severe exacerbation during follow up was assessed by Cox regression analysis, and the predictive capacity of both measurements was assessed by ROC curves and the DeLong test. Statistical significance was assumed at P<.05. RESULTS: Of the 322 COPD patients initially recruited, 287 were followed up. At baseline, 28.0% were active smokers, and experienced moderate airflow limitation (mean FEV1 56.4%±17.0% predicted). Patients with at least one elevated T2 biomarker (n=125, 42.5%) were at increased risk of COPD exacerbation (HR 1.75, 95% CI 1.25-2.45, P=.001) and of shorter time to first COPD exacerbation. There was no difference between BEC and FeNO regarding the predictive capacity for moderate to severe exacerbation (AUC 0.584 vs 0.576, P=.183) but FeNO predicted severe episodes more accurately than BEC (AUC 0.607 vs 0.539, P<.05). Combining the two biomarkers enhanced the detection of moderate and severe COPD exacerbations. CONCLUSIONS: Both eosinophil count and FeNO have limited utility for predicting COPD exacerbations. Combining these T2 biomarkers could enhance the detection of future COPD exacerbations.

On the single and multiple associations of COVID-19 post-acute sequelae: 6-month prospective cohort study.

Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. However, most manuscripts published to date only analyze the effects of post-COVID-19 in patients discharged from hospital, which may induce significant bias. Here, we propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. The cohort study was conducted from May to October 2020 at the University Hospital Virgen de la Nieves, the leading hospital assigned for patients with COVID-19 in Granada, Spain. A total of 372 and 217 patients-with 217 and 207 included in the first and second follow-up visits-were referred 2 and 6 months after diagnosing COVID-19, respectively. We find out that post-COVID-19 clinical and mental health impairment symptoms are correlated with patient gender. Logistic adjustments showed strong statistically robust single and multiple associations of demographic, clinical, mental health, X-ray, laboratory indices, and pulmonary function variables. The functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients. Bilateral lung involvement, subpleural reticulum, ground-glass opacity, peripheral lung lesions, and bronchiectasis were the most common findings of the high-resolution computed tomography images. Non-hospitalized patients suffer more severe thromboembolic events and fatigue than those hospitalized.

Generalized tympanism in a horse and its possible association with Sarcina-like microorganism: A case report.

Background: Sarcina spp. is a Gram-positive, coccoid microorganism that forms tetrads or octets, and is observed with a characteristic "bundle" arrangement. The most recognized species are Sarcina ventriculi and Sarcina maxima. It has been described as part of the normal microbiota in horses and cats, but it has also been linked to abomasal bloat in goats, lambs, and calves, although its causality has not been proven yet. Case Description: This work presents the case of a 3-months-old female horse that died of generalized tympanism. Macroscopic findings showed mild cyanosis and abundant gas in the lumen of the stomach, and small and large bowel. Microscopically, high numbers of Gram-positive microorganisms compatible with Sarcina spp. in the gastric lumen and on the surface of the small and large bowel were observed, along with mild inflammation. Conclusion: The severe tympanism was the only relevant lesion observed and could explain the death of the animal. Although it is not possible to determine a relationship between these lesions and Sarcina spp., it is interesting to highlight that the high amount of these bacteria could be associated with gas production and tympanism. It is important to continue investigating the role of Sarcina spp. in horses, and its possible link with tympanism.

Sinais e sintomas de pacientes com insuficiência cardíaca em cuidados paliativos: revisão de escopo / Señales y síntomas de pacientes con insuficiencia cardíaca en cuidados paliativos: revisión de alcance / Signs and symptoms of patients with heart failure in palliative care: scoping review

RESUMO Objetivo Mapear a produção de conhecimento acerca dos sinais e sintomas de pacientes com insuficiência cardíaca em cuidados paliativos. Método Revisão de escopo conduzida de acordo com a metodologia JBI e com a redação guiada pelo Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. A busca foi realizada em setembro de 2021 por dois revisores independentes nas bases de dados referenciais e em portais de informação e de literatura cinzenta, utilizando majoritariamente os descritores "heart failure", "signs and symptoms" e "palliative care", com o operador booleano "and", sem recorte temporal. Resultados Foram incluídos 34 artigos publicados entre 2001 e 2021, provenientes de revistas nacionais e internacionais, sendo 21 publicados nos Estados Unidos da América. Por meio desses artigos, foi possível mapear 93 sinais e sintomas, sendo que os mais frequentes foram dor, dispneia, fadiga, náusea e depressão. Conclusão Implicações para a prática esta revisão de escopo produziu um mapa da produção científica sobre os sinais e sintomas de insuficiência cardíaca em cuidados paliativos. O conhecimento dos sinais e sintomas auxilia os profissionais da saúde no desenvolvimento de técnicas e tecnologias para avaliar a severidade da insuficiência cardíaca, planejar intervenções paliativas e avaliar os seus resultados.

RESUMEN Objetivo Mapear la producción de conocimiento sobre las señales y síntomas de pacientes con insuficiencia cardíaca en cuidados paliativos. Método Revisión de Alcance realizada de acuerdo con la metodología JBI y con la escritura guiada por el Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. La búsqueda fue realizada por dos revisores independientes, en bases de datos de referencia, portales de información y literatura gris, utilizando mayoritariamente las palabras clave "heart failure", "signs and symptoms" y "palliative care", con el operador booleano "and", en septiembre 2021, sin marco de tiempo. Resultados se incluyeron 34 artículos, publicados entre 2001 y 2021, de revistas nacionales e internacionales, 21 de los cuales fueron realizados en los Estados Unidos de América. A través de estos artículos, fue posible mapear 93 señales y síntomas, siendo los más frecuentes el dolor, la disnea, la fatiga, las náuseas y la depresión. Conclusión e Implicaciones para la práctica Esta revisión de alcance produjo un mapa de la producción científica sobre las señales y síntomas de insuficiencia cardíaca en cuidados paliativos. El conocimiento de las señales y síntomas ayuda a los profesionales de la salud en el desarrollo de técnicas y tecnologías para evaluar la gravedad de la insuficiencia cardíaca, planificar intervenciones paliativas y evaluar sus resultados.

Abstract Objective To map the knowledge production on signs and symptoms of patients with heart failure in palliative care. Method This is a scoping review conducted according to the JBI method. Its writing was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. The search was carried out by two independent reviewers in reference databases, information, and gray literature portals mostly using the descriptors "heart failure," "signs and symptoms," and "palliative care," with the Boolean operator "and," in September 2021 without a time frame. Results Thirty-four articles were included and published between 2001 and 2021 from national and international journals, 21 of which were carried out in the United States of America. These articles made it possible to map 93 signs and symptoms, including pain, dyspnea, fatigue, nausea, and depression — the most frequent ones. Conclusion and Implications for the practice This scoping review produced a scientific production map about the signs and symptoms of heart failure in palliative care. The knowledge of signs and symptoms helps health care professionals develop techniques and technologies to assess the severity of heart failure, plan palliative interventions, and assess their results.

Cross-mapping of nursing diagnoses and interventions in decompensated heart failure / Mapeo cruzado de diagnósticos e intervenciones de enfermería en insuficiencia cardíaca descompensada / Mapeamento cruzado dos diagnósticos e intervenções de enfermagem na insuficiência cardíaca descompensada

ABSTRACT Objective To map the terms recorded in medical records of patients with decompensated heart failure for nursing diagnoses and interventions from the NANDA International and Nursing Interventions Classification. Method This is an exploratory and descriptive research, carried out by a cross-mapping study. Data were collected from 107 medical records of a Hospital Institute in the city of Rio de Janeiro/Brazil, in a period between October 2017 to February 2019. The diagnoses and interventions mapped were assessed by four clinical experts. Data analysis was performed using the content validation index and the Fleiss Kappa. Results The most frequent nursing diagnoses were: risk for infection (74.8%), decreased cardiac output (55.1%) and excessive fluid volume (49.5%). The interventions were: vital signs monitoring (79.4%), fluid monitoring (72.9%) and positioning (52.3%). Conclusion The research mapped 32 titles of nursing diagnoses from NANDA-I and 21 nursing interventions from NIC. The diagnoses and interventions mapped will contribute to the quality of the nurses' records and patient safety.

RESUMEN Objetivo Mapear los términos registrados en los registros médicos de pacientes con insuficiencia cardíaca descompensada para los diagnósticos e intervenciones de enfermería de NANDA International y la clasificación de las intervenciones de enfermería. Método Investigación exploratoria, descriptiva, realizada mediante mapeo cruzado. La recolección de datos se realizó en 107 historias clínicas de un hospital de la ciudad de Río de Janeiro / RJ, en el período comprendido entre octubre de 2017 y febrero de 2019. Los diagnósticos e intervenciones mapeados fueron evaluados por cuatro expertos. El análisis de los datos se realizó utilizando el índice de validación de contenido y el Kappa de Fleiss. Resultados: Los diagnósticos de enfermería más frecuentes fueron: riesgo de infección (74,8%), disminución del gasto cardíaco (55,1%) y volumen excesivo de líquidos (49,5%). Las intervenciones mapeadas fueron: monitoreo de signos vitales (79.4%) y posicionamiento (52.3%). Conclusión La investigación mapeó 32 títulos de diagnóstico de enfermería NANDA-I y 21 intervenciones de enfermería NIC. Los diagnósticos y las intervenciones mapeadas contribuirán a la calidad del registro de enfermeras y la seguridad del paciente.

RESUMO Objetivo Mapear os termos registrados em prontuários de pacientes com insuficiência cardíaca descompensada para diagnósticos e intervenções de enfermagem da NANDA Internacional e Classificação de Intervenções de Enfermagem. Método Pesquisa exploratória, descritiva, realizada através do mapeamento cruzado. Os dados foram coletados em 107 prontuários de um hospital do município do Rio de Janeiro/RJ, no período entre outubro de 2017 e fevereiro de 2019. Os diagnósticos e intervenções mapeados foram avaliados por quatro peritos. A análise dos dados foi realizada pelo índice de validação de conteúdo e o Kappa de Fleiss. Resultados Os diagnósticos de enfermagem mais frequentes foram: risco de infecção (74,8%), débito cardíaco diminuído (55,1%) e volume de líquidos excessivo (49,5%). As intervenções foram: monitoração de sinais vitais (79,4%), monitoração hídrica (72,9%) e posicionamento (52,3%). Conclusão A pesquisa mapeou 32 títulos de diagnósticos de enfermagem da NANDA-I e 21 intervenções de enfermagem da NIC. Os diagnósticos e intervenções mapeados irão contribuir para a qualidade do registro de enfermeiros e segurança do paciente.

Revision of the squat lobsters of the genus Phylladiorhynchus Baba, 1969 (Crustacea, Decapoda, Galatheidae) with the description of 41 new species.

The genus Phylladiorhynchus Baba, 1969 currently contains 11 species, all occurring in the shallow waters and on the continental shelf of the Indian and Pacific oceans. Recent expeditions in these oceans have resulted in the collection of numerous new specimens in need of analysis. We have studied this material using an integrative approach analysing both morphological and molecular (COI and 16S) characters. We describe 41 new species and resurrect three old names: P. integrus (Benedict, 1902) and P. lenzi (Rathbun, 1907), previously synonymized with P. pusillus (Henderson, 1885), and P. serrirostris (Melin, 1939), previously synonymized with P. integrirostris (Dana, 1852). Most species of the genus are described and illustrated. Some species are barely discernible on the basis of morphological characters but are highly divergent genetically. Species of Phylladiorhynchus are mainly distinguishable by the number of epigastric spines and lateral spines of the carapace, the shape and the armature of the rostrum, the number and pattern of the ridges on the carapace and pleon, the shape of thoracic sternite 3 and the armature of the P24 dactyli. A dichotomous identification key to all species is provided.

Effectiveness of health education in the self-care and adherence of patients with heart failure: a meta-analysis.

OBJECTIVE: to evaluate in the literature the effectiveness of the health education interventions in self-care and adherence to treatment of patients with Chronic Heart Failure. METHOD: a systematic review with meta-analysis. Studies were selected that compared health education interventions with the usual care to assess the outcomes of adherence and self-care. The quality of the methodological evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation system. RESULTS: the educational interventions were more effective in relation to the usual care in the outcome of adherence (fixed effect=0-3841; p-value <0.001). There was no statistical difference in the outcome of self-care (fixed effect=0.0063; p-value=0.898). CONCLUSION: the educational interventions improved the outcome of adherence, though not self-care in the patient with Heart Failure.