Assistência de enfermagem ao paciente com delirium na unidade de terapia intensiva: uma revisão integrativa / Nursing care for delirium patient in the intensive care unit: an integrative review / Atención de enfermería para pacientes de delirium en la unidad de atención intensiva: una revisión integrativa

OBJETIVO: Avaliar o nível de conhecimento do enfermeiro na identificação do Delirium na UTI. METODOLOGIA: Trata-se de uma revisão integrativa, na base de dados SciELO, LILACS e BDENF em março/abril de 2018. Foi dividido em categorias acerca do Delirium, tais como: Reconhecimento do Delirium, Papel da Enfermagem na Utilização da Escala CAM-ICU e Aplicação nas UTIs e Medidas preventivas pelo enfermeiro. RESULTADOS: Para coleta de dados, utilizou-se um instrumento sobre à identificação do artigo, autor (es), periódico publicado, ano da publicação, metodologia do artigo e país de publicação na totalidade de 10 produções. CONCLUSÃO: A dificuldade na identificação da patologia existe, uma vez, que a mesma é subvalorizada e de difícil reconhecimento. Percebemos como uma prática complexa e minuciosa com alguns pontos de fragilidade no que se refere a percepção do Delirium pela equipe multidisciplinar com a finalidade de evitar agravos ao quadro clínico do paciente.(AU)

OBJECTIVE: Assess the level of knowledge of nurses in the identification of Delirium in the ICU. METHODOLOGY: this is an integrative review in SciELO, LILACS and BDENF in March/April 2018. Was divided into categories about the of the Delirium, such as: Recognition of Delirium, and the Role of Nursing in the use of the Scale CAM-ICU and the ICUs and preventive Measures by the nurse. RESULTS: For data collection we used an instrument on the identification of the article, the author (s) journal published, year of publication, methodology of the article and country of publication in all 10 productions. CONCLUSION: The difficulty in identifying the pathology once exists is that it is undervalued and difficult to recognize. We perceive as a complex and meticulous practice with some fragility points regarding the perception of Delirium by the multidisciplinary team with the purpose of avoiding damages to the clinical picture of the patient.(AU)

OBJETIVO: Evaluar el nivel de conocimiento del enfermero en la identificación del Delirium en la UTI. METODOLOGÍA: Se trata de una revisión integrativa, en la base de datos SciELO, LILACS y BDENF en marzo/abril de 2018. Se dividieron en categorías acerca del Delirium, tales como: Reconocimiento del Delirium, Papel de la Enfermería en la Utilización de la Escala CAM-ICU y Aplicación en las UTIs y Medidas preventivas por El enfermero. RESULTADOS: Para la recolección de datos se utilizó un instrumento sobre la identificación del artículo, autor (es), periódico publicado, año de la publicación, metodología del artículo y país de publicación en la totalidad de 10 producciones. CONCLUSIÓN: La dificultad en la identificación de la patología existe, una vez, que la misma es subvalorizada y de difícil reconocimiento. Percibimos como una práctica compleja y minuciosa con algunos puntos de fragilidad en lo que se refiere a la percepción del Delirium por el equipo multidisciplinario con la finalidad de evitar agravios al cuadro clínico del paciente.(AU)

The TNF-α -308 polymorphism may affect the severity of Crohn's disease.

OBJECTIVE: The goal of this project was to analyze the association between Crohn's disease, its clinical features, and the tumor necrosis factor alpha (TNF-α) -308 polymorphism. METHODS: This is a case-control and cross-sectional study that enrolled 91 patients with Crohn's disease and 91 controls. Patients with Crohn's disease were characterized according to the Montreal Classification, along with their clinical and surgical treatment history. Analysis of the TNF-α -308 polymorphism was performed using a commercial kit. A stratified analysis was applied using an OR (odds ratio) with a 95% confidence interval. The chi-square and Fisher's exact tests were utilized for analysis of the association between the polymorphism and the clinical features of Crohn's disease. RESULTS: The low producer predicted phenotype was present in 76.9% of Crohn's disease cases and 75.8% of controls (OR 0.94 [0.45-1.97]). The TNF2 allele and the high producer predicted phenotype were more frequent among patients with Crohn's disease penetrating behavior (p = 0.004). The TNF2 allele and the high producer predicted phenotype were also associated with a history of colectomy (p = 0.02), and the TNF2 allele was associated with small bowel resection (p = 0.03). CONCLUSIONS: The TNF-α -308 polymorphism appears to affect the severity of the disease. However, TNF-α -308 polymorphism does not appear to be important for the susceptibility in the development of Crohn's disease.

The TNF-α -308 polymorphism may affect the severity of Crohn's disease

OBJECTIVE: The goal of this project was to analyze the association between Crohn's disease, its clinical features, and the tumor necrosis factor alpha (TNF-α) -308 polymorphism. METHODS: This is a case-control and cross-sectional study that enrolled 91 patients with Crohn's disease and 91 controls. Patients with Crohn's disease were characterized according to the Montreal Classification, along with their clinical and surgical treatment history. Analysis of the TNF-α -308 polymorphism was performed using a commercial kit. A stratified analysis was applied using an OR (odds ratio) with a 95 percent confidence interval. The chi-square and Fisher's exact tests were utilized for analysis of the association between the polymorphism and the clinical features of Crohn's disease. RESULTS: The low producer predicted phenotype was present in 76.9 percent of Crohn's disease cases and 75.8 percent of controls (OR 0.94 [0.45-1.97]). The TNF2 allele and the high producer predicted phenotype were more frequent among patients with Crohn's disease penetrating behavior (p = 0.004). The TNF2 allele and the high producer predicted phenotype were also associated with a history of colectomy (p = 0.02), and the TNF2 allele was associated with small bowel resection (p = 0.03). CONCLUSIONS: The TNF-α -308 polymorphism appears to affect the severity of the disease. However, TNF-α -308 polymorphism does not appear to be important for the susceptibility in the development of Crohn's disease.

Potencial hidrogeniônico de soluções de cloridrato de dobutamina expostas a condições ambientais de unidades de cuidados intensivos neonatais / Hydrogen-ion potential of dobutamine hydrochloride solutions exposed to environmental conditions of neonatal intensive care units

OBJETIVO: Verificar o potencial hidrogeniônico (pH) de soluções de cloridrato de dobutamina sob condições ambientais que mimetizam unidades de cuidados intensivos neonatais. MÉTODOS: Analisou-se pH do fármaco em solução glicosada 5 por cento ou NaCl 0,9 por cento segundo temperatura (22 e 37 °C), luz (escuro, lâmpadas fluorescentes ambiente e equipamento de fototerapia) e equipos (incolor e âmbar) em intervalos de tempo (0, 1, 24, 48, 72 e 96 horas). RESULTADOS: Evidenciaram-se valores próximos de pH do fármaco na apresentação comercial e diluído. Obteve-se média de pH de 3,45±0,19 a 22 °C e de 3,55±0,20 a 37 °C. A média de pH das soluções mantidas no escuro foi de 3,62±0,09, na luz ambiente, de 3,63±0,07, e sob fototerapia, de 3,31±0,16. Soluções em equipos incolores tiveram média menor (3,41±0,24) do que em âmbares (3,52±0,15). Obtiveram-se menores valores de pH nas soluções sob fototerapia em equipos incolores (3,17±0,03) do que em âmbares (3,55±0,03). CONCLUSÃO: Sob a luz da fototerapia houve maior variação do pH das soluções, e o emprego de equipos âmbares minimizou tal efeito.

OBJECTIVE: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units. METHODS: We analyzed the pH of the drug diluted in 5 percent dextrose in water or 0.9 percent NaCl under different conditions of temperature (22 and 37 °C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours. RESULTS: The pH values of the marketed form of the drug and the diluted drug were similar. The pH means were 3.45±0.19 at 22 °C and 3.55±0.20 at 37 °C. The average of the pH according to light conditions were as follows: in the dark = 3.62±0.09, under room light = 3.63±0.07, and exposed to phototherapy = 3.31±0.16. Solutions stored in colorless intravenous sets had a lower mean (3.41±0.24) than those kept in amber intravenous sets (3.52±0.15). We found lower pH values in the solutions exposed to phototherapy using colorless intravenous sets (3.17±0.03) than in those using amber intravenous sets (3.55±0.03). CONCLUSION: There was higher variation in the pH of the solutions exposed to phototherapy, and the use of amber intravenous sets reduced such effect.

Hydrogen-ion potential of dobutamine hydrochloride solutions exposed to environmental conditions of neonatal intensive care units.

OBJECTIVE: To verify the hydrogen-ion potential (pH) of dobutamine hydrochloride solutions under environmental conditions similar to those of neonatal intensive care units. METHODS: We analyzed the pH of the drug diluted in 5% dextrose in water or 0.9% NaCl under different conditions of temperature (22 and 37 degrees C) and light (dark, fluorescent light bulbs, and phototherapy equipment), using colorless and amber intravenous sets at time intervals of 0, 1, 24, 48, 72, and 96 hours. RESULTS: The pH values of the marketed form of the drug and the diluted drug were similar. The pH means were 3.45+/-0.19 at 22 degrees C and 3.55+/-0.20 at 37 degrees C. The average of the pH according to light conditions were as follows: in the dark = 3.62+/-0.09, under room light = 3.63+/-0.07, and exposed to phototherapy = 3.31+/-0.16. Solutions stored in colorless intravenous sets had a lower mean (3.41+/-0.24) than those kept in amber intravenous sets (3.52+/-0.15). We found lower pH values in the solutions exposed to phototherapy using colorless intravenous sets (3.17+/-0.03) than in those using amber intravenous sets (3.55+/-0.03). CONCLUSION: There was higher variation in the pH of the solutions exposed to phototherapy, and the use of amber intravenous sets reduced such effect.

Crohn's disease in one mixed-race population in Brazil.

AIM: To evaluate the classification and severity of Crohn's disease in different racial groups. METHODS: Patients with Crohn's disease from the outpatient clinic of the University Hospital Prof. Edgard Santos were enrolled in the study. This hospital is a reference centre for inflammatory bowel disease. Race was determined using self-identification. The Vienna's classification was applied for all subjects. The severity of Crohn's disease was determined according to the number of surgical procedures, hospital admissions in the last year and treatment with steroids and immunosuppressors. Statistical analysis was calculated using t test for means, chi2 or F for proportions. A P value < 0.05 was considered to be significant. RESULTS: Sixty-five patients were enrolled. Non-white patients were more frequently diagnosed with Crohn's disease in the age less than 40 years than white patients. The behaviour of disease was similar in both groups with a high frequency of the penetrating form. There was a tendency for non-white patients to have a greater frequency of hospital admissions in the last year compared to white subjects. Non-whites also had a higher rate of colonic and upper gastrointestinal involvement, and were also more frequently on treatment with immunossupressors than white patients although this difference was not statistically significant. CONCLUSION: Non-white patients with Crohn's disease had an earlier diagnosis and appeared to have had a more severe disease presentation than white patients.

O Trabalho noturno e a prática de enfermagem: uma percepção dos estudantes de enfermagem / The Night-work and the nursing practical: a perception of the nursing students

Trata-se de uma pesquisa cadastrada no Núcleo de Pesquisa em Enfermagem e Saúde do Trabalhador (NUPENST) EEAN/UFRJ. O serviço vem trazendo consequências muitas vezes prejudiciais para a saúde do trabalhador. Este estudo objetivou identificar a percepção do acadêmico de enfermagem sobre o trabalho noturno e analisá-la em relação à influência desse plantão na saúde do trabalhador de enfermagem. Foi utilizado o referencial teórico Regis, Pitta, Fisher et al. Estudo quantitativo, onde participaram 67 acadêmicos de enfermagem de uma Universidade Pública...

Violência do cotidiano e no trabalho de enfermagem: apreensões e expectativas de alunos de um curso de graduação em enfermagem do Rio de Janeiro / Violence of the everyday and in the nursing work: apprehensions and expectations of the students from a course of graduation in nursing of Rio de Janeiro

Pesquisa de abordagem quantitativa, teve por objetivos: identificar as expectativas dos alunos de enfermagem sobre a violência do cotidiano; descrever as apreensões dos alunos de enfermagem sobre a violência no trabalho de enfermagem. A partir da aprovação pelo Comitê de Ética em Pesquisa da Escola de Enfemagem Anna Nery da Universidade Federal do Rio de Janeiro (EEAN/UFRJ), a pesquisa foi realizada com a participação de 52 alunos do 3. período letivo do Curso de Graduação em Enfermagem e Obstetrícia da EEAN/UFRJ. Para a coleta de dados utilizou-se um questionário com 14 perguntas abertas sobre as expectativas profissionais em relação ao significado da violência; à violência no cotidiano do aluno de enfermagem; e à violência no trabalho de enfermagem...

Percepçäao das mäes que participaram do grupo terapêutico de massagem em bebês acerca das experiências, benefícios e mudanças no comportamento do bebê / The perception of mothers who participated of the massage therapeutic group in infants on their experiencer, benefits and their infants behavioral changes

O presente estudo pretende descrever e explicar os fenômenos do objeto estudado: Percepcao das mäes que participaram do grupo terapêutico de massagem em bebês, acerca das experiências, benefícios e mudanças no comportamento do bebê. Foi desenvolvido no período de setembro de 1997 a junho de 1999. Tem por objetivos conhecer alguns aspectos das experiências de mäes que frequentaram o grupo terapêutico de massagem; o que as mäes identificaram como contribuiçäo para a saúde de seus filhos; a aprendizagem do conteúdo ensinado; contribuir para com o projeto. Os sujeitos deste estudo säo mäes que participaram da atividade denominada Grupo Terapêutico de Massagem do Projeto Massagem e Estimulaçäo de Bebês do Departamento de Enfermagem na Universidade Federal de Säo Paulo/Escola Paulista de Medicina. Como metodologia para este estudo, utilizamos a pesquisa descritiva. Como instrumento de coleta de dados optamos pela entrevista, com questöes näo estruturadas e para tratamento e análise dos dados usamos da análise de conteúdo (análise categorial)