A aplicabilidade das pics na assistencia de enfermagem em pacientes com doença crônica: revisão integrativa / The applicability of pics in nursing care for patients with chronic disease: integrative review / La aplicabilidad de la pics en los cuidados de enfermería a pacientes con enfermedades crónicas: revisión integradora

A implementação das PICs no Brasil é uma realidade, dessa forma, compreende-se que o enfermeiro é o profissional que em tese deve possuir habilidades para aplicar as técnicas em pacientes. Com base nisso, o objetivo do trabalho foi descrever a atuação da enfermagem através de Planos de ações por intermédio das PICs em individuos com diminuição da qualidade de vida em razão do desenvolvimento de doenças crônicas degenerativas. Dessa forma, o presente artigo trata-se de uma revisão integrativa de literatura. Os resultados obtidos mostram que a aplicabilidade das PICs, está consolidada, sendo uma prática bastante utilizada na intervenção terapêutica de indivíduos portadores de doenças crônicas degenerativas, na qual as mais utilizadas são: plantas medicinais, reiki, homeopatia, acupuntura e auricuoterapia, entretanto, em relação a assistência de enfermagem, foi observado impasses em relação a capacitação profissional. Logo, concluímos que com base nas produções cientificas existentes a respeito das PICs, a prática infere em diversos benefícios ao indivíduo, estas que se convergem a promoção de maior qualidade de vida ao paciente com doenças crônicas, porém, a falta de capacitação profissional revela um impasse ainda persistente.

The implementation of PICs in Brazil is a reality, therefore, it is understood that the nurse is the professional who, in theory, must have the skills to apply the techniques to patients. Based on this, the objective of the study was to describe the role of nursing through Action Plans through PICs in individuals with reduced quality of life due to the development of chronic degenerative diseases. Thus, this article is an integrative literature review. The results obtained show that the applicability of PICs is consolidated, being a practice widely used in the therapeutic intervention of individuals with chronic degenerative diseases, in which the most used are: medicinal plants, reiki, homeopathy, acupuncture and auricutherapy, however, in regarding nursing care, impasses regarding professional training were observed. Therefore, we conclude that based on the existing scientific productions regarding PICs, the practice infers in several benefits to the individual, these that converge to the promotion of a better quality of life for the patient with chronic diseases, however, the lack of professional training reveals a stalemate still persistent.

La implementación de los PICs en Brasil es una realidad, por lo tanto, se entiende que la enfermera es el profesional que, en teoría, debe tener las habilidades para aplicar las técnicas a los pacientes. Con base en esto, el objetivo del estudio fue describir el papel de la enfermería a través de Planes de Acción por medio de PICs en individuos con calidad de vida reducida debido al desarrollo de enfermedades crónico degenerativas. Así, este artículo es una revisión bibliográfica integradora. Los resultados obtenidos muestran que la aplicabilidad de los PICs está consolidada, siendo una práctica ampliamente utilizada en la intervención terapéutica de individuos con enfermedades crónicas degenerativas, en la que las más utilizadas son: plantas medicinales, reiki, homeopatía, acupuntura y auricuterapia, sin embargo, en lo que respecta a los cuidados de enfermería, se observaron impasses en cuanto a la formación profesional. Por lo tanto, concluimos que con base en las producciones científicas existentes en relación a las PICs, la práctica infiere en varios beneficios al individuo, estos que convergen a la promoción de una mejor calidad de vida para el paciente con enfermedades crónicas, sin embargo, la falta de formación profesional revela un impasse aún persistente.

Planejamento e desenvolvimento de novos compostos com atividade frente a Leishmania spp: Síntese, avaliação da atividade e toxicidade de derivados 5-nitro-2-furfurilidênicos e estudos de relações estrutura-atividade / Design of new compounds against Leishmania spp: synthesis, biological evaluation and toxicity of 5-nitro-2-furfurylidene derivates and structure-activity relationship studies

A leishmaniose é uma zoonose de ampla distribuição mundial, causada pelos parasitas tripanossomatídeos do gênero Leishmania. Infelizmente, o arsenal terapêutico disponível é precário, mas vê-se crescente o interesse científico pela busca do potencial de derivados nitroheterocíclicos como alternativas terapêuticas. Nesse contexto, este trabalho analisou o potencial de derivados 5-nitro-2-furfurilidênicos contra diferentes cepas de Leishmania, assim como investigou um possível modo de ação para esta classe de nitrocompostos. Para tal, a quimioteca foi sintetizada de acordo com publicações prévias do grupo. O potencial de inibição de crescimento das culturas de promastigotas de L. (L.) infantum (Linf) e L. (L.) major (Lmaj) foi determinado, utilizando miltefosina (MILT) (Linf - IC50: 8,28±0,33 µM), anfotericina B (AMB) (Linf - IC50: 0,02±0,002 µM) e nifurtimox (NFX) (Lmaj - IC50: 3,5±0,09 µM) como referência. A maioria dos compostos apresentaram maior potencial que as referênias, destacando o composto 40 (Linf - IC50: 0,2±0,019 µM/ Lmaj - IC50: 0,087 ± 0,001 µM) como mais eficaz. Contra as formas amastigotas intracelulares, para Linf os compostos 40, 13 e 15 foram mais eficazes em reduzir a carga parasitária dos macrófagos infectados que fármacos de referência. Para Lmajor, o composto 40 (IC50: 0,006 ± 0,0003 µM) foi mais ativo que o NFX (IC50: 2,15 ± 0,01 µM). Também foi determinada a atividade da quimioteca frente a enzima nitrorredutase (NTR1), utilizando cepas de T. brucei superexpressantes de NTR1, e os compostos analisados foram até 18 vezes mais eficazes que à cepa wild-type. Ademais, a partir da análise exploratória de dados por análise de componentes principais (PCA) e de grupamentos hierárquicos (HCA), foi reconhecida a influência das propriedades relacionadas com o equilíbrio hidrófilo-lipófilo e da natureza estérica/geométrica das moléculas para atividade anti-Leishmania

Leishmaniasis is a worldwide zoonosis caused by trypanosomatid parasites of the genus Leishmania. Unfortunately, the available therapeutic arsenal is precarious, but there is growing scientific interest in searching the potential of nitroheterocyclic derivatives as therapeutic alternatives. In this context, this work analyzed the potential of 5-nitro-2-furfurylidene derivatives against different Leishmania strains, as well as investigated the potential mode of action for this nitro compounds class. To this end, the chemolibrary was synthesized according to our group's previous publications. The growth inhibitory potential potential for promastigote cultures of L. (L.) infantum (Linf) and L. (L.) major (Lmaj) was determined using miltefosine (MILT) (Linf - IC50: 8.28±0.33 µM), amphotericin B (AMB) (Linf - IC50: 0.02±0.002 µM) and nifurtimox (NFX) (Lmaj - IC50: 3.5±0.09 µM) as reference. Most of the compounds were more potent than the references, highlighting compound 40 (Linf - IC50: 0.2±0.019 µM/ Lmaj - IC50: 0.087 ± 0.001 µM) as the most effective. Against intracellular amastigote, for Linf, compounds 40, 13 and 15 were more effective in reducing the parasite load of infected macrophages than reference drugs. For Lmajor, compound 40 (IC50: 0.006 ± 0.0003 µM) was more active than NFX (IC50: 2.15 ± 0.01 µM). The activity against nitroreductase (NTR1) enzyme was determined using overexpressing NTR1 mutant T. brucei strains, and the analyzed compounds were up to 18 times more effective than wild-type. Furthermore, exploratory data analysis using principal component analysis (PCA) and hierarchical clustering (HCA) methods were used. The influence of properties related to the hydrophiliclipophilic balance and the steric/geometric nature of the molecules was associated with the anti-Leishmanial activity

Entre quimioterapias, herbolaria y espiritualidades: estudio antropológico sobre el pluralismo terapéutico en adultos con cáncer en México / Between chemotherapies, herbalism and spiritualities: anthropological study of therapeutic pluralism in adults with cancer in Mexico

RESUMEN Objetivos Analizar las características del pluralismo terapéutico en torno al cáncer de adultos, atendidos en un hospital de cancerología, a partir de sus trayectorias de salud/enfermedad/atención-desatención. Métodos Estudio analítico-explicativo, etnográfico, transversal-aplicado y de carácter cualitativo. Se realizaron registros etnográficos, observación participante y entrevistas semiestructuradas. Para el artículo se tomaron los datos proporcionados por diez personas participantes con cáncer, atendidas en el Centro Estatal de Cancerología de Veracruz. La identificación de participantes se hará mediante seudónimos, para preservar la privacidad de datos personales. Los instrumentos de trabajo estuvieron conformados por guías de observación, guías de entrevistas semiestructuradas y expedientes clínicos del hospital mencionado. Resultados Se muestran dos resultados principales: 1) caracterización de la diversidad de terapias de acuerdo con las referencias de los participantes, y lo que utilizaron durante toda su trayectoria biográfica en torno a procesos salud/enfermedad/ atención-desatención; 2) identificación de los aspectos socioculturales que intervienen en estos procesos complejos de pluralidad terapéutica, estrechamente relacionados con la aparición del cáncer. Conclusión Los aspectos socioculturales están entretejidos con la pluralidad terapéutica emergente en los procesos complejos de la enfermedad del cáncer. La implicación de dichos factores en los procesos salud/enfermedad/atención-desatención al cáncer se manifiestan incluso antes de los primeros síntomas, es decir, en las acciones cotidianas del autocuidado y acciones de atención preventiva. El mestizaje terapéutico registrado da cuenta de los efectos de la globalización, característica de las sociedades capitalistas, en la que el pluralismo de terapias deviene en un fenómeno óptimo de comercialización y consumo.(AU)

ABSTRACT Objectives To analyze the characteristics of therapeutic pluralism in adult patients at a hospital Cancer Center, based on their health/illness/care-neglect trajectories. Methods Analytical-explanatory, ethnographic, transversal-applied qualitative study. Data was provided by ten participants with cancer treated at the Veracruz State Cancer Center. Ethnographic records, participant observation and semi-structured interviews were carried out using observational guides, semi-structured interview guides and hospital clinical records. Participants were identified with pseudonyms for privacy and confidentiality. Results Two main results were: 1) characterization of the diversity of therapies utilized by participants throughout their biographical trajectory related to their health/disease/care-neglect processes; 2) identification of the cultural characteristics involved in these complex processes of therapeutic plurality, closely related to the appearance of cancer. Conclusion Sociocultural aspects are interwoven with emerging therapeutic pluralities in the complex disease processes in cancer. The implications of these factors in the health/disease/care-neglect processes in cancer are manifest even before the first symptoms, in daily actions of self-care and preventive care. The mixing of therapies is an effect of the globalization characteristic of capitalist societies, in which therapeutic pluralism becomes an optimal phenomenon for commercialization and consumption.(AU)

Taller de radio: una experiencia a viva voz

El presente trabajo tiene como objetivo realizar un análisis y dar cuenta de las distintas actividades e intervenciones desplegadas en el taller de radio perteneciente al dispositivo de hospital de día. Para tal fin se utilizan fragmentos de la obra de Freud y Lacan, así como aportes de autores contemporáneos para llevar adelante una articulación teórico-clínica. La elección del taller como eje del trabajo se debe a la idea de repensar la práctica cotidiana y la posición de los profesionales dentro del dispositivo. (AU)

Fútbol y psicoanálisis: una experiencia entre varios

En el Centro de Salud Mental Nº 1 de la Ciudad de Buenos Aires, el equipo de Niños Tarde comenzó en 2018 a integrar a los niños en tratamiento a un taller de fútbol, pensado como un espacio en el cual pudieran jugar con otros, y posibilitar múltiples transferencias e intervenciones. Se describe cómo fueron desarrollándose las actividades de este dispositivo.

Benefícios das práticas integrativas e complementares no cuidado de enfermagem / Benefits of integrative and complementary practices in nursing care / Beneficios de las prácticas integrativas y complementarias en el cuidado de enfermería

Objetivo: caracterizar os benefícios das práticas integrativas e complementares no cuidado de enfermagem. Método: revisão integrativa realizada nas bases de dados Scielo, Lilacs, PudMed e BVS. Os descritores de busca foram terapias complementares, cuidados em enfermagem, enfermagem holística, toque terapêutico, acupuntura, fitoterapia, aromaterapia, homeopatia. Encontrou-se 4421 artigos disponíveis nos idiomas Português, Espanhol e Inglês; publicados entre os anos 2006 e 2018. Destes foram selecionados 21 artigos. Resultados: entre os benefícios das práticas integrativas foi evidenciado o relaxamento e bem estar, alívio da dor e da ansiedade, diminuição de sinais e sintomas de doenças, estimula o contato profissional-paciente, redução do uso de medicamentos, fortalecimento do sistema imunológico, melhoria da qualidade de vida e diminuição de reações adversas. Considerações finais: É preciso protagonismo empoderamento e preparo da enfermagem para a implementação das PICs em sua prática diária qualificando as práticas assistenciais e reduzindo os custos hospitalares. (AU)

Objective: to characterize the benefits of integrative and complementary practices in nursing care. Method: integrative review in the SciELO, Lilacs, PudMed and Virtual Health Library databases. The search descriptors were Complementary Therapies, Nursing Care, Holistic Nursing, Therapeutic Touch, Acupuncture, Phytotherapy, Aromatherapy and Homeopathy. There were 4421 articles available in Portuguese, Spanish and English published between the years 2006 and 2018. Of these, 21 articles were selected. Results: the benefits of integrative practices showed relaxation and well-being, relief of pain and anxiety, reduction of signs and symptoms of diseases, stimulation of professional-patient contact, reduction of medication use, strengthening of the immune system, quality of life and reduction of adverse reactions. Final considerations: it is necessary to lead, empower and prepare nursing for the implementation of ICPs in their daily practice, qualifying care practices and reducing hospital costs.(AU)

Objetivo: caracterizar los beneficios de las prácticas integrativas y complementarias en el cuidado de enfermería. Método: revisão integrativa realizada nas bases de dados SciELO, Lilacs, PudMed y BVS. Los descriptores de búsqueda fueron Terapias Complementarias, Cuidados en Enfermería, Enfermería Holística, Toque Terapéutico, Acupuntura, Fitoterapia, Aromaterapia, Homeopatía. Se encontró 4421 artículos disponibles en portugués, español e Inglés; publicados entre los años 2006 y 2018. De ellos se seleccionaron 21 artículos. Resultados: los beneficios de las prácticas integrativas fueron evidenciados por la relajación y el bienestar, alivio del dolor y la ansiedad, disminución de signos y síntomas de enfermedades, estimula el contacto profesional-paciente, reducción del uso de medicamentos, fortalecimiento del sistema inmunológico, calidad de vida y disminución de las reacciones adversas. Consideraciones finales: Es necesario protagonismo, empoderamiento y preparación de la enfermería para la implementación de las PICs en su práctica diaria calificando las prácticas asistenciales y reduciendo los costos hospitalarios.(AU)

Social Robots as a Complementary Therapy in Chronic, Progressive Diseases.

Globally, the world population is ageing, which increases the prevalence of non-communicable diseases that affect patients both physically and psychologically, such as is the case of dementia. Consequently, there is a greater demand for the healthcare system as it needs to develop solutions to answer to these needs.The literature review shows that complementary therapies may be applied in dementia in order to aid the symptom management as well as to slow down the progression of the disease. The Socially Assistive Robots (SAR) are tools that may be used as a complementary therapy in dementia and have shown to promote a potentially beneficial relationship. The zoomorphic models of SAR have shown to have similar results to complementary therapies with animals, as they generate positive emotions and promote multisensorial interaction through the sight, hearing and touch.The use of SAR is a new tool that has shown to have benefits in terms of slowing down the progression of the disease, aiding to improving the quality of life in the elderly.

Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: a systematic review of qualitative studies.

BACKGROUND: The prevalence of complementary medicine use in pregnancy and lactation has been increasingly noted internationally. This systematic review aimed to determine the complementary medicine products (CMPs) used in pregnancy and/or lactation for the benefit of the mother, the pregnancy, child and/or the breastfeeding process. Additionally, it aimed to explore the resources women used, and to examine the role of maternal health literacy in this process. METHODS: Seven databases were comprehensively searched to identify studies published in peer-reviewed journals (1995-2017). Relevant data were extracted and thematic analysis undertaken to identify key themes related to the review objectives. RESULTS: A total of 4574 articles were identified; 28 qualitative studies met the inclusion criteria. Quantitative studies were removed for a separate, concurrent review. Herbal medicines were the main CMPs identified (n = 21 papers) in the qualitative studies, with a smaller number examining vitamin and mineral supplements together with herbal medicines (n = 3), and micronutrient supplements (n = 3). Shared cultural knowledge and traditions, followed by women elders and health care professionals were the information sources most accessed by women when choosing to use CMPs. Women used CMPs for perceived physical, mental-emotional, spiritual and cultural benefits for their pregnancies, their own health, the health of their unborn or breastfeeding babies, and/or the breastfeeding process. Two over-arching motives were identified: 1) to protect themselves or their babies from adverse events; 2) to facilitate the normal physiological processes of pregnancy, birth and lactation. Decisions to use CMPs were made within the context of their own cultures, reflected in the locus of control regarding decision-making in pregnancy and lactation, and in the health literacy environment. Medical pluralism was very common and women navigated through and between different health care services and systems throughout their pregnancies and breastfeeding journeys. CONCLUSIONS: Pregnant and breastfeeding women use herbal medicines and micronutrient supplements for a variety of perceived benefits to their babies' and their own holistic health. Women access a range of CMP-related information sources with shared cultural knowledge and women elders the most frequently accessed sources, followed by HCPs. Culture influences maternal health literacy and thus women's health care choices including CMP use.

Doll therapy for dementia sufferers: A systematic review.

Dementia affects more than 47.5 million people worldwide, and the number is expected to continue to increase as the population ages. Doll therapy is an emerging nonpharmacologic management strategy for patients with advanced dementia, especially in patients with challenging behaviours. A total of 12 published studies (mainly cohort and observational studies) were identified and discussed in this systematic review. In most instances, cognitive, behavioural and emotional symptoms were alleviated and overall wellbeing was improved with doll therapy, and dementia sufferers were found to be able to better relate with their external environment. Despite the relative paucity of empirical data and ethical concerns, we are of the opinion that doll therapy is effective for dementia care, is well-aligned with the ethos of person-centred care and should be applied in the management of dementia patients. Future research should include more robust randomized controlled trials.

Naturologia e Agroecologia: Um Diálogo Complexo / Naturplogy and Agroecology: a complex dialogue

Introdução: As relações conceituais entre a Naturologia e a Agroe¬cologia apresentam interfaces comuns e complementares demons¬trando novos paradigmas epistemológicos e potencialidades quando dialogadas e em busca de objetivos comuns tais como segurança e consciência alimentar, autonomia, visão ecológica e resgate de saberes tradicionais. Objetivos: Compreender a importância de ações integra¬das de forma participativa e dialógica de diferentes áreas e verificar se ações transdisciplinares potencializam o entendimento da educação em saúde de forma sistêmica e integral. Metodologia: De abordagem qualitativa utilizando-se da pesquisa-ação e mapa-falante e realizada na ONG Casa do Zezinho com crianças e jovens de 06 a 21 anos. Re¬sultados: Foram obtidos por meio de ações participativas na constru¬ção de hortas-urbanas agroecológicas a fim de valorizar dimensões sociais, culturais, políticas e ambientais. Tais ações mostraram ser possível, por meio da transdisciplinaridade promover a educação em saúde. Discussão: Permitiu reconhecer a complexidade do processo de interagência na integralidade da saúde convergida com ações das áreas estudadas. Considerações: O estudo indica e fortalece a pers¬pectiva acerca da construção de um paradigma onde conhecimentos herdados da natureza não deverão ser apropriados por sistemas he¬gemônicos, mas partilhados solidariamente. Ressalta-se a necessida¬de de mais estudos nos contextos analisados para melhor validar os resultados, principalmente pensando o construto da complexidade da saúde que busca um olhar sistêmico e integral da realidade.(AU)

Introduction: The conceptual links between Naturology and Agroecology presents commom and complementary interfaces that when dialogues between themselves demonstrate new paradigms and potencialities seeking commom objectives on food conciousness and security, autonomy, ecologic vision and revival of tradicional knowledge. Objective: Comprehend the importance of integrated actions in different participative and dialogic areas, also as verify if transdisciplinary actions empower the understanding th health education in tintegraated and sistemic perspedtive. Metodology: Qualitative approaching that uses action-research and talking-map kealized by the NGO "Casa do Zezinho" with kids between 6 and 21 years old. Results: Were obtained by means of participative actions that builde urban vegetable agroecologic gardens in order to compregend social, cultural, political and ambiental dimensions. Action that through transdisciplinarity demonstrates to be possible to promote health education. Discussion: Allowed recognition of the complexity of the integrance integrativity health process converged with actions in studied areas. Considerations: This study indicates and empowers the perspective regarding the construction of inherited nature knowledge paradigms that should be shared instead of hijacked by the hegemonic system. Emphasis in the need of studies at the context here analized to better evaluate the results, speccialy to build the health complexity which seeks a sistemic and integrative perspective of reality.(AU)

Have complementary therapies demonstrated effectiveness in rheumatoid arthritis? / ¿Han demostrado eficacia las terapias complementarias en la artritis reumatoide?

In recent decades the treatment of rheumatoid arthritis (RA) has improved thanks to the use of highly effective drugs. However, patients usually require long term therapy, which is not free of side effects. Therefore RA patients often demand complementary medicine, they seek additional sources of relief and/or less side effects. In fact 30-60% of rheumatic patients use some form of complementary medicine. Therefore, from conventional medicine, if we want to optimally treat our patients facilitating communication with them we must know the most commonly used complementary medicines. The aim of this review is to assess, based on published scientific research, what complementary therapies commonly used by patients with RA are effective and safe (AU)

En las últimas décadas el tratamiento de la Artritis Reumatoide (AR) ha mejorado mucho gracias a la utilización de fármacos altamente eficaces. Sin embargo, los enfermos suelen requerir tratamiento farmacológico de por vida, no exento de efectos adversos. Por esta razón los pacientes con AR a menudo acuden a la medicina complementaria, buscan fuentes adicionales de alivio y/o menores efectos secundarios. Un 30-60% de los pacientes reumáticos utilizan algún tipo de medicina complementaria. Por lo tanto, desde la medicina convencional, si queremos optimizar el tratamiento de nuestros pacientes y facilitar la comunicación con ellos debemos conocer las medicinas complementarias más utilizadas. El objetivo de esta revisión es valorar, en base a la investigación científica publicada, qué tratamientos complementarios habitualmente utilizados por los pacientes con AR son efectivos y seguros (AU)

Masoterapia en las alteraciones conductuales de ancianos con demencia / Therapeutic massage on behavioral disturbances of elderly patients with dementia

OBJETIVO: Conocer la eficacia del masaje terapéutico sobre las alteraciones conductuales de ancianos con demencia. DISEÑO: Revisión de la literatura científica. Fuente de datos: La búsqueda de las publicaciones se llevó a cabo en 6 bases de datos científicas: PubMed, Cochrane Library Plus, PEDro, Dialnet, Scopus y CSIC, entre 1983 y 2013. Los términos de búsqueda incluyeron la combinación de las palabras clave (R)massage», (R)dementia», (R)therapy», (R)behavior disorders» y (R)Alzheimer». Selección de los estudios: Se seleccionaron 11 registros de los 496 localizados tras aplicar los CRITERIOS DE INCLUSIÓN: Los criterios de inclusión han sido ensayos clínicos, publicados en inglés o en español, en los que se ha analizado los efectos de la terapia del masaje sobre los comportamientos alterados en personas con demencia. Extracción de datos: Las principales variables recogidas son los beneficios del masaje, el tipo de masaje y el lubricante utilizado. RESULTADOS: Los estudios que han analizado las alteraciones conductuales de los pacientes con demencia han sido escasos. Sus autores utilizan diferentes técnicas de masaje (effleurage, pétrissage, presiones, fricciones y amasamientos), obteniendo beneficios en la mejora de los trastornos de conducta (agresividad, ansiedad, agitación y resistencia a los cuidados) de estos ancianos. CONCLUSIONES: El masaje terapéutico puede ser un tratamiento complementario en el programa de rehabilitación tradicional para mejorar las alteraciones conductuales de la demencia

OBJECTIVE: To know the efficacy of therapeutic massage on behavioral disturbances of elderly patients with dementia. Design: Literature review. Data source: The literature search was done in six scientific databases: PubMed, Cochrane Library Plus, PEDro, Dialnet, Scopus and CSIC, between 1983 and 2013. The search terms were 'massage', 'dementia', 'therapy', 'behavior disorders' and 'Alzheimer'. Selecion of studies: Of the 496 articles analyzed, 11 scientific articles have met the selection criteria. Inclusion criteria were: clinical trials, published in English or Spanish, which had analyzed the effects of massage therapy on altered behaviors in people with dementia. Data extraction: The variables were massage benefits, type of massage and massage lubricant. Results: Their authors use different massage techniques (effleurage, pétrissage, pressures, frictions and kneading), obtain better conduct disorders (aggression, anxiety, agitation, and resistance to care) of elderly. Conclusions: The therapeutic massage can be a complementary treatment in the rehabilitation program for better behavior disorders

¿Qué aporta la denominada «medicina integrativa» a la asistencia clínica científica cotidiana? / What does «integrative medicine» provide to daily scientific clinical care?

La medicina integrativa es un intento ambicioso y, a la vez, generoso de suplir las deficiencias del sistema de salud operativo en nuestras sociedades occidentales, lastradas por la limitación de tiempo disponible, sobre todo en consultas externas. Por otro lado, supone no finiquitar las posibilidades de cierta utilidad terapéutica contrastada a través de los siglos (China, India, etc.), amén de algunos recursos que no alcanzan el nivel de fiabilidad científica deseable, pero que suponen un cierto apoyo terapéutico en determinados casos (homeopatía, acupuntura, etc.), y que siguen requiriendo un abordaje científico. Finalmente, el recurso de productos botánicos (fitoterapia) constituye un amplio mundo de posibilidades en el que se debe avanzar por parte de las universidades —y se está haciendo— al ir adquiriendo dichas sustancias un marchamo farmacológico asentado en el método científico y en los criterios de la medicina basada en la evidencia. Con ello se evitaría la sinrazón que supone el enfrentamiento cotidiano entre la medicina convencional científica, a la que nos sometemos la inmensa mayoría de los pacientes, y las otras «orientaciones» diagnóstico-terapéuticas (medicina naturista, medicina alternativa, medicina complementaria, medicina centrada en el paciente y otras) (AU)

Integrative medicine is an ambitious and noble-minded attempt to address the shortcomings of the current public health systems in our Western societies, which is restricted by the limited time available, especially in outpatient clinics. Integrative medicine also does not limit the possibilities of useful therapies that have been tested over the centuries (from China, India, etc.) or of certain resources that do not achieve the level of desired scientific credibility but that present certain therapeutic support in specific cases (homeopathy, acupuncture, etc.) but still require a scientific approach. Finally, the resource of botanical products (phytotherapy) constitutes a wide range of possibilities that universities can (and do) make progress on by providing drug brands for these products through the use of the scientific method and evidence-based medical criteria. This approach will help avoid the irrationality of the daily struggle between conventional scientific medicine (which we apply to the immense majority of patients) and the other diagnostic-therapeutic «guidelines» (natural medicine, alternative medicine, complementary medicine, patient-focused medicine and others) (AU)

Utilización de terapias complementarias y alternativas en niños con cáncer / Use of complementary and alternative therapies in children with cancer

Objetivo Determinar frecuencia, características y factores asociados al uso de terapias complementarias y alternativas en pacientes pediátricos en Colombia. Métodos Estudio transversal aplicando una encuesta a 398 cuidadores de pacientes pediátricos con cáncer en el Instituto Nacional de Cancerología en Bogotá, Colombia. Se registró información sociodemográfica y clínica, se evaluó el tipo de terapia, mecanismos de acción propuestos y patrones de uso. Con regresión logística se evaluaron factores asociados con el uso de estas terapias. Resultados Todos los casos correspondieron a terapias complementarias para curar o controlar síntomas de la enfermedad o del tratamiento. Un 81,9 % de los pacientes (IC95 %: 77,8% a 85,6 %) había recibido algún tipo de 81 diferentes modalidades utilizadas. Lo más utilizado fueron las terapias basadas biológicamente (especialmente jugos de frutos rojos). Quienes más frecuentemente usaron estas terapias fueron mujeres con mayor nivel educativo. El tiempo desde el diagnóstico y haber recibido tratamiento quirúrgico también se asoció con el uso de estas terapias. El mecanismo de acción más frecuentemente atribuido fue el refuerzo inmunológico. Conclusión Se encontró alta prevalencia de uso de terapias complementarias. Los pediatras deberían explorar en los pacientes el uso de estas terapias dado el potencial de interacciones con tratamientos farmacológicos o efectos adversos.(AU)

Objective To determine the frequency, characteristics and related factors for the use of complementary and alternative therapies in pediatric patients with cancer in a Colombian pediatric oncology department. Methods: Cross-sectional study consisting of a survey of 398 caregivers of pediatrics patients with cancer evaluated in the Instituto Nacional de Cancerología in Bogotá, Colombia. The survey collected sociodemographic and clinical information and evaluated the type of complementary and alternative therapies, mechanisms of action, and patterns of use of these treatments. Logistic regression was conducted to identify predictors of complementary and alternative therapies use. Results In this study complementary therapies were used not as a substitute but in addition to conventional treatments to cure or to control the disease or to treat symptoms. A total of 326 patients (81.9 %, CI95 %: 77.8 % to 85.6 %) had received some type of complementary therapy and 81 different types of therapies were used. The most common type of complementary therapy corresponded to the group of biologically based therapies (mainly berry juices). Female family caregivers with higher educational status were more likely to use complementary therapies. Time from diagnosis and having received surgical treatment were also associated with the use of therapies. Reinforcement of the immune system appears to be the most likely mechanism of action. Conclusion A high prevalence of use of complementary therapies was found in this sample. Pediatricians need to ask their patients about complementary and alternative therapy practices considering the potential for interactions with pharmacological treatments or adverse effects.(AU)

The Use of ShotBlocker for Reducing the Pain and Anxiety Associated With Intramuscular Injection: A Randomized, Placebo Controlled Study.

There are few studies evaluating the effect of ShotBlocker on pain acquired from intramuscular injection, and these are mostly in children. We hypothesized that the use of ShotBlocker, while administering an intramuscular injection, would reduce the pain and anxiety due to intramuscular injection in adults. A randomized, placebo controlled trial was carried out for more than 20 months in 2010-2011 on 180 adults aged 18 to 80 years who received intramuscular injections of diclofenac sodium (75 mg/3 mL) at the outpatient clinic of a hospital. The patients were grouped into 3 groups: control, placebo control, and experimental. The experimental group was given an intramuscular injection of diclofenac sodium with ShotBlocker. Pain intensity was measured through a visual analog scale after the injection and anxiety was measured using Spielberger's State-Trait Anxiety Inventory. Pulse rate was counted and state and trait anxiety was measured before and after the injection. The Mann-Whitney U test and Wilcoxon and Kruskall-Wallis tests were used to evaluate the data. Patients in the ShotBlocker group had significantly lower pain intensity than those in the placebo and control groups. State anxiety level increased after the injection in the experimental group but did not change in the other 2 groups. ShotBlocker did not affect the pulse rate. Our results suggest that using ShotBlocker during intramuscular injection reduced patients' pain intensity because of injection but did not reduce anxiety levels. Thus, ShotBlocker is recommended as a pain-relieving tool during intramuscular injection in adults.

Differential negative reinforcement of other behavior to increase wearing of a medical bracelet.

We used a changing criterion design to evaluate the extent to which differential negative reinforcement of other behavior increased compliance with wearing a medical alert bracelet for a young boy with autism. Results showed the duration for which the participant wore the bracelet systematically increased across trials from 5 s to 7 hr over several weeks.

Cutaneous Application of Silicone Wafers Containing Carbon Microcoils: Efficacy in Relieving Chronic Muscle Tension and Pain.

BACKGROUND: Chronic musculoskeletal pain is highly prevalent worldwide. PRIMARY STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of Helical(®) microcoils, a new, noninvasive treatment for chronic musculoskeletal pain. DESIGN: This was a prospective, observational study. SETTING: The study was conducted at the main author's private clinic, in São Paulo, Brazil. PARTICIPANTS: We evaluated 20 physicians, from 2 different hospitals, who suffered from chronic musculoskeletal pain and volunteered to participate in the study. INTERVENTION: The Helical(®) microcoils were applied to the skin over the affected areas. Before and after the intervention, the physician-patients completed questionnaires and a visual analog scale. PRIMARY OUTCOME MEASURES: We quantified postintervention improvement or worsening of pain and muscle tension. RESULTS: Significant improvements in pain and muscle tension were observed in 95% of the physician-patients evaluated. The only side effect reported was mild pruritus at the application site, which occurred in 5 of the 20 cases. CONCLUSION: The use of Helical microcoils was found to be safe and efficacious in relieving muscle tension and pain.