Effects of Hyaluronic Acid With Intra-articular Corticosteroid Injections in the Management of Subtalar Post-traumatic Osteoarthritis - Randomized Comparative Trial.

We investigated the potential of exogenous hyaluronic acid (HA) associated with corticosteroid injections to improve pain and function for the treatment of post-traumatic subtalar osteoarthritis, in comparison with isolated intra-articular corticosteroid. Twenty-five symptomatic participants (50 ± 8 years) with a minimum follow-up of 1 year after surgery for calcaneus fractures were enrolled. Participants were randomly assigned into a therapeutic group that underwent isolated corticosteroid intra-articular subtalar injection (Corticosteroid Group, n = 12) or a combination of HA plus corticosteroid (HA+C Group, n = 13). All participants underwent three repeated injections with intervals of 1 week. We assessed the visual analog scale of pain (VAS) and the AOFAS scores at 4 moments: before treatment (pre), 4-, 12-, and 24-weeks following the last injection. HA+C Group showed lower VAS at the 12th (p = .003) and 24th weeks (p = .003) and greater AOFAS at the 4th (p = 0.040), 12th (p = .014), and 24th weeks (p = .021), in comparison to Corticosteroid Group. We observed a reduction in VAS in the Corticosteroid Group only at the 4th week (p = .007), compared with pretreatment values. In the HA+C Group, VAS presented lower levels at the 4- (p < .001), 12- (p < .001), and 24 weeks (p < .001). In the Corticosteroid Group, participants presented higher AOFAS score only at the 4th week (p < .001), while in the HA+C Group, the AOFAS scores were greater at the 4th, 12th, and 24th weeks compared to baseline (p < .001). The combination of exogenous HA and corticosteroid showed greater and longer analgesic effects and function improvement in comparison with isolated intra-articular corticosteroids.

Safe and effective protocol for discharge 3 days after cardiac surgery.

The Enhanced Recovery After Surgery (ERAS) protocol affected traditional cardiac surgery processes and COVID-19 is expected to accelerate its scalability. The aim of this study was to assess the impact of an ERAS-based protocol on the length of hospital stay after cardiac surgery. From January 2019 to June 2020, 664 patients underwent consecutive cardiac surgery at a Latin American center. Here, 46 patients were prepared for a rapid recovery through a multidisciplinary institutional protocol based on the ERAS concept, the "TotalCor protocol". After the propensity score matching, 46 patients from the entire population were adjusted for 12 variables. Patients operated on the TotalCor protocol had reduced intensive care unit time (P < 0.025), postoperative stay (P ≤ 0.001) and length of hospital stay (P ≤ 0.001). In addition, there were no significant differences in the occurrence of complications and death between the two groups. Of the 10-central metrics of TotalCor protocol, 6 had > 70% adherences. In conclusion, the TotalCor protocol was safe and effective for a 3-day discharge after cardiac surgery. Postoperative atrial fibrillation and renal failure were predictors of postoperative stay > 5 days.

Sobrecarga gerada pelo convívio com o portador de esquizofrenia: enfermagem construindo o cuidado à família / Recargo generado por el convivio con el portador de esquizofrenia: la enfermería construyendo el cuidado a la familia / Overload generated by the interaction with schizophrenia patients: nursing building family care

A esquizofrenia é doença mental crônico-degenerativa, em que o portador apresenta dificuldades para o autocuidado. Em razão da desinstitucionalização, a vivência cotidiana acarreta sobrecarga aos familiares. O objetivo, aqui, foi analisar o grau de sobrecarga do principal cuidador que convive com o portador de esquizofrenia, em um hospital de emergência psiquiátrica do Estado do Rio de Janeiro. Trata-se de pesquisa descritiva, com abordagem quantitativa. Participaram dez familiares, em um período de quinze dias para coleta de dados. Utilizou-se a escala de sobrecarga dos familiares de pacientes psiquiátricos, analisados pela escala Likert. Foram encontradas sobrecargas elevadas na rotina diária do familiar e intenso abalo da sua saúde mental, sendo fundamental que a enfermagem inclua as famílias no tratamento, diminuindo as sobrecargas.(AU)

Schizophrenia is a chronic degenerative mental disease, in which the patient has difficulty in self care. Due to deinstitutionalization, the daily life brings burden to family. The goal here was to analyze the degree of overload of the primary caregiver living with the holder of schizophrenia in a psychiatric emergency hospital in the State of Rio de Janeiro. This is a descriptive research with quantitative approach. The participants were ten families in a period of fifteen days for data collection. We used the scale of burden of psychiatric patients' relatives, analyzed by the Likert scale. Overloads were found high in the familiar daily routine and intense shock of their mental health, being fundamental that nursing include families in treatment, reducing the overload.(AU)

La esquizofrenia es enfermedad mental crónico-degenerativa, en que el portador presenta dificultades para el autocuidado. En razón de la desinstitucionalización, la vivencia cotidiana acarrea recargo a los familiares. El objetivo, aquí, fue analizar el grado de recargo del principal cuidador que convive con el portador de esquizofrenia, en un hospital de emergencia psiquiátrica de la Provincia de Rio de Janeiro. Se trata de pesquisa descriptiva, con abordaje cuantitativo. Participaron diez familiares, en un período de quince días para recogida de datos. Se utilizó la escala de recargo de los familiares de pacientes psiquiátricos, analizados por la escala Likert. Fueron encontrados recargos elevados en la rutina diaria del familiar e intenso estremezco de su salud mental, siendo fundamental que la enfermería incluya las familias en el tratamiento, apocando los recargos.(AU)

Sobrecarga gerada pelo convívio com o portador de esquizofrenia: enfermagem construindo o cuidado à família / Overload generated by the interaction with schizophrenia patients: nursing building family care / Recargo generado por el convivio con el portador de esquizofrenia: la enfermería construyendo el cuidado a la familia

A esquizofrenia é doença mental crônico-degenerativa, em que o portador apresenta dificuldades para o autocuidado. Em razão da desinstitucionalização, a vivência cotidiana acarreta sobrecarga aos familiares. O objetivo, aqui, foi analisar o grau de sobrecarga do principal cuidador que convive com o portador de esquizofrenia, em um hospital de emergência psiquiátrica do Estado do Rio de Janeiro. Trata-se de pesquisa descritiva, com abordagem quantitativa. Participaram dez familiares, em um período de quinze dias para coleta de dados. Utilizou-se a escala de sobrecarga dos familiares de pacientes psiquiátricos, analisados pela escala Likert. Foram encontradas sobrecargas elevadas na rotina diária do familiar e intenso abalo da sua saúde mental, sendo fundamental que a enfermagem inclua as famílias no tratamento, diminuindo as sobrecargas.(AU)

Schizophrenia is a chronic degenerative mental disease, in which the patient has difficulty in self care. Due to deinstitutionalization, the daily life brings burden to family. The goal here was to analyze the degree of overload of the primary caregiver living with the holder of schizophrenia in a psychiatric emergency hospital in the State of Rio de Janeiro. This is a descriptive research with quantitative approach. The participants were ten families in a period of fifteen days for data collection. We used the scale of burden of psychiatric patients' relatives, analyzed by the Likert scale. Overloads were found high in the familiar daily routine and intense shock of their mental health, being fundamental that nursing include families in treatment, reducing the overload.(AU)

La esquizofrenia es enfermedad mental crónico-degenerativa, en que el portador presenta dificultades para el autocuidado. En razón de la desinstitucionalización, la vivencia cotidiana acarrea recargo a los familiares. El objetivo, aquí, fue analizar el grado de recargo del principal cuidador que convive con el portador de esquizofrenia, en un hospital de emergencia psiquiátrica de la Provincia de Rio de Janeiro. Se trata de pesquisa descriptiva, con abordaje cuantitativo. Participaron diez familiares, en un período de quince días para recogida de datos. Se utilizó la escala de recargo de los familiares de pacientes psiquiátricos, analizados por la escala Likert. Fueron encontrados recargos elevados en la rutina diaria del familiar e intenso estremezco de su salud mental, siendo fundamental que la enfermería incluya las familias en el tratamiento, apocando los recargos.(AU)

Sobrecarga gerada pelo convívio com o portador de esquizofrenia: enfermagem construindo o cuidado à família / Overload generated by the interaction with schizophrenia patients: nursing building family care / Recargo generado por el convivio con el portador de esquizofrenia: la enfermería construyendo el cuidado a la familia

A esquizofrenia é doença mental crônico-degenerativa, em que o portador apresenta dificuldades para o autocuidado. Em razão da desinstitucionalização, a vivência cotidiana acarreta sobrecarga aos familiares. O objetivo, aqui, foi analisar o grau de sobrecarga do principal cuidador que convive com o portador de esquizofrenia, em um hospital de emergência psiquiátrica do Estado do Rio de Janeiro. Trata-se de pesquisa descritiva, com abordagem quantitativa. Participaram dez familiares, em um período de quinze dias para coleta de dados. Utilizou-se a escala de sobrecarga dos familiares de pacientes psiquiátricos, analisados pela escala Likert. Foram encontradas sobrecargas elevadas na rotina diária do familiar e intenso abalo da sua saúde mental, sendo fundamental que a enfermagem inclua as famílias no tratamento, diminuindo as sobrecargas.

Schizophrenia is a chronic degenerative mental disease, in which the patient has difficulty in self care. Due to deinstitutionalization, the daily life brings burden to family. The goal here was to analyze the degree of overload of the primary caregiver living with the holder of schizophrenia in a psychiatric emergency hospital in the State of Rio de Janeiro. This is a descriptive research with quantitative approach. The participants were ten families in a period of fifteen days for data collection. We used the scale of burden of psychiatric patients' relatives, analyzed by the Likert scale. Overloads were found high in the familiar daily routine and intense shock of their mental health, being fundamental that nursing include families in treatment, reducing the overload.

La esquizofrenia es enfermedad mental crónico-degenerativa, en que el portador presenta dificultades para el autocuidado. En razón de la desinstitucionalización, la vivencia cotidiana acarrea recargo a los familiares. El objetivo, aquí, fue analizar el grado de recargo del principal cuidador que convive con el portador de esquizofrenia, en un hospital de emergencia psiquiátrica de la Provincia de Rio de Janeiro. Se trata de pesquisa descriptiva, con abordaje cuantitativo. Participaron diez familiares, en un período de quince días para recogida de datos. Se utilizó la escala de recargo de los familiares de pacientes psiquiátricos, analizados por la escala Likert. Fueron encontrados recargos elevados en la rutina diaria del familiar e intenso estremezco de su salud mental, siendo fundamental que la enfermería incluya las familias en el tratamiento, apocando los recargos.