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1.
Soins ; 65(845): 10-13, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32862956

RESUMO

There is a close link between care and communication. The purpose of the study is to evaluate therapeutic communication when bed washing patients, which dependent patients may experience as an aggressive treatment. Improved comfort, improved serenity, less intense pain, lower pulse and blood pressure have been observed in patients looked after by caregivers practising therapeutic communication.


Assuntos
Banhos , Cuidadores/psicologia , Comunicação , Relações Profissional-Paciente , Humanos , Resultado do Tratamento
2.
Epidemiol Health ; 42: e2020056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32777883

RESUMO

OBJECTIVES: In Korea, there have been 10,480 confirmed cases of coronavirus disease 2019 (COVID-19) as of April 11, 2020. We investigated the transmission of COVID-19 in a cluster of cases. METHODS: We analyzed the epidemiological characteristics of 10 confirmed COVID-19 patients in an outbreak that started at Spa facility A in a local community in Korea on March 28, 2020 and traced them through April 8, 2020. Epidemiological surveys and diagnostic tests were conducted for each contact, and the secondary attack rate was estimated. RESULTS: There were 3 male confirmed patients (30.0%) and 7 female confirmed patients (70.0%), and their mean age was 53.5 years (range, 2.0 to 73.0). Two patients (20.0%) were asymptomatic. The incubation period was between 3 days and 12 days. Three confirmed patients were infected at female's Spa facility A and 7 confirmed patients were second, third, and fourth generations of transmission. Seven confirmed patients contracted COVID-19 through presymptomatic contact. In total, 192 contacts were identified, with a secondary attack rate of 3.6%. Eighty-three contacts (43.2%) were aged 40-59 years, and the secondary attack rate was the highest (12.1%) in those aged ≥60 years. Most exposures (n=156, 81.3%) involved casual contact. The number of visitors using the female's spa facility was 58, including 3 confirmed patients, resulting in a secondary outbreak rate of 5.9%. CONCLUSIONS: This study presents a cluster of cases occurring in a setting with high temperature and humidity. The second, third, and fourth generations were transmitted through presymptomatic contact.


Assuntos
Banhos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Estâncias para Tratamento de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Busca de Comunicante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , República da Coreia/epidemiologia , Adulto Jovem
3.
Rev Lat Am Enfermagem ; 28: e3329, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32813782

RESUMO

OBJECTIVE: develop and validate a video on bed bathing directed to nursing professionals and students. METHOD: the video was based on the literature and presents the definition of bed bath, indications for its performance, steps to perform it, and potential complications. Nursing professors and nurses validated it. They assessed the pertinence of content, clarity, and language of the video scenes. The Delphi Technique was used in this phase. After recording, three nursing professors, along with undergraduate nursing students from a public university, assessed the educational video. The professors first watched the video and suggested changes, and then the students watched the video after the changes were implemented. RESULTS: six rounds were needed for experts to validate the video script using the Delphi Technique. After the video recording, undergraduate students considered the video of easy understanding. CONCLUSION: the video script was composed of four topics and was validated by experts after six rounds. The video was assessed by the professors and nursing undergraduate students, who considered the topics and the video as a whole as apprehensible. This study is expected to contribute to professional training and improvement of the knowledge and skills of nursing students.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Banhos , Humanos , Gravação em Vídeo
4.
Enferm. foco (Brasília) ; 11(2): 127-132, jul. 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1104392

RESUMO

Objetivo: identificar os critérios clínicos e insumos utilizados para a administração do primeiro banho em recém-nascido prematuro de muito baixo peso internado em unidades de terapia intensiva neonatal.Métodos: estudo descritivo, com abordagem quantitativa. Com base no Método Canguru/Ministério da saúde, realizado em cinco unidades de terapia intensiva neonatal; população composta por 82 profissionais da equipe de enfermagem. Resultados: os critérios clínicos não apontados na avaliação foram 19,5% para a saturação de oxigênio, 23,2% frequência cardíaca e 29,3% frequência respiratória. Os insumos utilizados na realização do primeiro banho: água de torneira aquecida 56,1%, com controle bacteriológico 52,4%, sabão líquido 89,0%, com pH neutro em 76,8%. Conclusão: a não observância dos sinais clínicos e os insumos inadequados para a realização do banho do recém-nascido prematuro de muito baixo peso pode colocar em risco a segurança do paciente; emergindo adequações para fortalecimento da prática clínica da enfermagem. (AU)


Objective: To identify the clinical criteria and inputs used for the administration of the first bath in a very low birth weight premature newborns in neonatal intensive care units. Methods: descriptive study, with a quantitative approach based on the Kangaroo/Ministry of Health Method, carried out in five neonatal intensive care units; population composed of 82 professionals from the nursing team. Results: The clinical criteria not mentioned in the evaluation were 19.5% for oxygen saturation, 23.2% heart rate and 29.3% respiratory rate. The inputs used in the first bath: heated tap water (56.1%), with bacteriological control (52.4%), liquid soap (89.0%), with neutral pH (76.8%). Conclusion: Failure to observe clinical signs and inadequate supplies for bathing the very low birth weight premature newborn can put patient safety at risk; emerging adaptations to strengthen clinical nursing practice. (AU)


Objetivo: Identificar los criterios clínicos y los insumos utilizados para la administración del primer baño en recién nacidos prematuros de muy bajo peso al nacer en unidades de cuidados intensivos neonatales. Métodos: Estudio descriptivo, con enfoque cuantitativo, basado en el Método Canguro/Ministerio de Salud, realizado en cinco unidades de cuidados intensivos neonatales; población compuesta por 82 profesionales del equipo de enfermería. Resultados: Los criterios clínicos no mencionados en la evaluación fueron 19.5% para la saturación de oxígeno, 23.2% de frecuencia cardíaca y 29.3% de frecuencia respiratoria. Los insumos utilizados en el primer baño: agua caliente del grifo (56.1%), con control bacteriológico (52.4%), jabón líquido (89.0%), con pH neutro (76.8%). Conclusión: El incumplimiento de los signos clínicos y los suministros inadecuados para bañar al recién nacido prematuro de muy bajo peso pueden poner en riesgo la seguridad del paciente; adaptaciones emergentes para fortalecer la práctica clínica de enfermería. (AU)


Assuntos
Recém-Nascido de muito Baixo Peso , Banhos , Unidades de Terapia Intensiva Neonatal , Enfermagem Neonatal
5.
Medicine (Baltimore) ; 99(29): e21166, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702872

RESUMO

INTRODUCTION: Insomnia is a major public health problem. Due to the side effects of pharmacological therapy, people are seeking to choose complementary and alternative therapies for insomnia disorder. Traditional Chinese herbal bath therapy is an important complementary therapy which combines advantages of Chinese herbs and bathing therapy. This protocol describes the methodology of a systematic review assessing the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia. METHODS AND ANALYSIS: Reporting of this review will be adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We will electronically search the following seven databases from inception to January 23, 2020: PubMed, Cochrane database (CENTRAL), EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Database, and Wanfang Database. Parallel randomized controlled trials evaluating the effectiveness and safety of traditional Chinese herbal bath therapy for insomnia will be included. Study selection, data extraction and assessment of risk of bias will be performed independently by two researchers. The sleep quality will be assessed as the primary outcome. Global symptom improvement, anxiety and depression, and adverse events will be evaluated as secondary outcomes. The Cochrane's risk of bias tool will be utilized for assessing the methodological quality of included studies. Revman software (v.5.3) will be used for data synthesis and statistical analysis. Data will be synthesized by either fixed-effects or random-effects model according to a heterogeneity test. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. GRADE system will be used to assess the quality of evidence. PROSPERO REGISTRATION NUMBER: CRD42020168507.


Assuntos
Banhos/normas , Protocolos Clínicos , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Banhos/métodos , Medicina Herbária/métodos , Medicina Herbária/normas , Humanos , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/normas , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Revisões Sistemáticas como Assunto
7.
J Environ Public Health ; 2020: 3694627, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32695190

RESUMO

Natural therapy modalities such as thermal therapy and balneotherapy are commonly being practiced for the management of chronic aches and pain all over the world. Nepal has many such natural hot water springs among which few are famous for therapeutic purposes. Thousands of people with some musculoskeletal problem visit those places in the hope of getting rid of their problems. This study aimed to understand their belief in such therapies, expectations, and satisfaction after treatment along with their knowledge of the safety of hot spring water bath. Among 126 participants interviewed, 31% had inflammatory arthritis, followed by degenerative disorders in 29.4% and soft-tissue rheumatism in 12.7%. Around three-quarters believed that hot spring water has natural healing power and thus can improve their pain. Many even believed that water in natural springs is devoid of any chemicals. So, it is a safe treatment option. Regarding the expectation of cure, they had mixed opinions. Naïve participants hoped they might find a permanent cure in thermal baths. However, repeated visitors said that the effect usually lasted for a few months and they have to visit there regularly. Almost two-thirds of people thought that such natural treatment does not have any side effects. Few stated that they had faced certain problems after the treatment. The water tested from the study site showed that it contained a higher amount of chlorine and sulfate in comparison to other hot water springs in Nepal. The minerals present in water might be a cause of temporary relief of pain. Also, outbreaks of infection from common spring baths have to be considered as such cases have been reported in the past. In conclusion, the medicinal benefits of such natural hot water springs have to be studied further and awareness regarding safety should be given to the people seeking treatment.


Assuntos
Banhos/psicologia , Fontes Termais , Doenças Musculoesqueléticas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Banhos/estatística & dados numéricos , Feminino , Fontes Termais/química , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/patologia , Doenças Musculoesqueléticas/psicologia , Nepal , Adulto Jovem
8.
Medicine (Baltimore) ; 99(21): e20488, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481354

RESUMO

BACKGROUND: Psoriasis is a common, chronic, and recurrent skin inflammatory disease, with psoriasis vulgaris considered as the most prevalent type of psoriasis. Chinese herbal bath, a type of traditional Chinese medicine, is an external therapy widely used to treat psoriasis vulgaris in China, and it has achieved satisfactory clinical effects. However, there are few studies evaluating the safety and efficacy of Chinese herbal bath compared with other external therapies administered under similar conditions. The purpose of this study is to comprehensively evaluate the clinical safety and efficacy of Chinese herbal bath in the treatment of psoriasis vulgaris through a systematic evaluation of the literature, so as to provide a reference basis for future clinical applications. METHODS: PubMed, Embase, CENTRAL, the Web of Science, the China Biology Medicine Database (CBM), the China National Knowledge Database (CNKI), the Wan Fang Database, and the Chong Qing VIP Database will be searched to collect randomized controlled trials of Chinese herbal bath used to treat psoriasis vulgaris. The search time limits will be from the establishment of the database to December 2019. Two researchers will independently screen the studies, extract data, and evaluate the risk of bias of the studies. Meta-analysis will be carried out with the RevMan5.3 software. The mean difference will be used as the effect index for the measurement data, and the odds ratio will be used as the effect index for the enumeration data. The 95% confidence interval will be provided for each effect. Heterogeneity among the results of each study will be evaluated by the Chi-square test. RESULTS: This study will comprehensively evaluate the clinical safety and efficacy of Chinese herbal bath in the treatment of psoriasis vulgaris, so as to provide a reference basis for future clinical applications. CONCLUSION: This study will provide a theoretical basis for the standardized administration of Chinese herbal bath. OSF REGISTRATION NUMBER:: doi: 10.17605/OSF.IO/4HRPJ.


Assuntos
Banhos/normas , Medicina Herbária/normas , Psoríase/terapia , Banhos/métodos , China , Protocolos Clínicos , Medicina Herbária/métodos , Humanos , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/normas , Metanálise como Assunto , Psoríase/fisiopatologia , Revisões Sistemáticas como Assunto
9.
Artigo em Alemão | MEDLINE | ID: mdl-32590860

RESUMO

In German intensive care units, 10 000 to 15 000 patients die annually due to nosocomial infections. Estimated 20 to 30% of these infections are preventable. Disinfecting is one of the most effective measures to avoid these infections. Hand disinfection in particular is one of the most important components to prevent infections. Another tool is whole body bathing, but it is rarely used in intensive care units. Antiseptics-impregnated dressings represent a further possibility for reducing device-associated infections. However, recently there has been an increase in reports of resistance not only to antibiotics but also to antiseptics. Proper hygienic work and the rational use of antiseptics is a requirement for avoiding nosocomial infections and can reduce the development of resistance.


Assuntos
Anti-Infecciosos Locais , Bandagens , Infecção Hospitalar , Banhos , Desinfecção , Humanos , Unidades de Terapia Intensiva
10.
Rev Lat Am Enfermagem ; 28: e3264, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491124

RESUMO

OBJECTIVE: to compare the time for performance of dry and traditional bed bathing and its effects on transcutaneous arterial oxygen saturation and respiratory rates in critical adult patients. METHOD: pilot study of a randomized, open, crossover clinical trial, performed with 15 adult critically ill patients. Each patient received a dry and a traditional bed bath. Analysis of variance with repeated measures was used, adopting p-value ≤ 0.05. RESULTS: most patients were male (73.3%), white (66.7%), with a mean age of 69.7 years. The dry bath was faster (20.0 minutes) than the traditional bath (30.0 minutes) (p<0.001). There was no significant difference between the patients' saturation means between baths (p=0.381), with 94.7% for the dry bath and 95.2% for the traditional bath. During the traditional bath, the patients' respiratory rate mean was higher (24.2 incursions per minute) and statistically different (p<0.001) from the value obtained for the dry bath (20.5 incursions per minute). CONCLUSION: the dry bath had a shorter duration than did the traditional bath, resulting in less patient exposure. The traditional bed bath had a negative effect on patients' respiratory rate, increasing it. Brazilian Registry of Clinical Trials (ReBEC): RBR-5qwkqd.


Assuntos
Banhos/métodos , Estado Terminal/enfermagem , Taxa Respiratória/fisiologia , Idoso , Idoso de 80 Anos ou mais , Banhos/enfermagem , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
11.
PLoS One ; 15(6): e0232935, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497117

RESUMO

BACKGROUND: The lack of established measurement tools in the study of menstrual health and hygiene has been a significant limitation of quantitative studies to date. However, there has been limited exploration of existing measurement to identify avenues for improvement. METHODS: We undertook two linked systematic reviews of (1) trials of menstrual health interventions and their nested studies in low- and middle-income countries, (2) studies developing or validating measures of menstrual experiences from any location. Systematic searching was undertaken in 12 databases, together with handsearching. We iteratively grouped and audited concepts measured across included studies and extracted and compared measures of each concept. RESULTS: A total of 23 trials, 9 nested studies and 22 measure development studies were included. Trials measured a range of outcomes including menstrual knowledge, attitudes, and practices, school absenteeism, and health. Most measure validation studies focused on assessing attitudes towards menstruation, while a group of five studies assessed the accuracy of women's recall of their menstrual characteristics such as timing and cycle length. Measures of menstrual knowledge, attitudes, beliefs and restrictions were inconsistent and frequently overlapped. No two studies measured the same menstrual or hygiene practices, with 44 different practices assessed. This audit provides a summary of current measures and extant efforts to pilot or test their performance. CONCLUSIONS: Inconsistencies in both the definition and operationalisation of concepts measured in menstrual health and hygiene research should be addressed. To improve measurement, authors should clearly define the constructs they aim to measure and outline how these were operationalised for measurement. Results of this audit indicate the need for the development and validation of new measures, and the evaluation of the performance of existing measures across contexts. In particular, the definition and measurement of menstrual practices, knowledge, attitudes, norms and restrictions should be addressed. REVIEW PROTOCOL REGISTRATION: CRD42018089884.


Assuntos
Higiene , Ciclo Menstrual , Adolescente , Adulto , Atitude Frente a Saúde , Banhos , Ensaios Clínicos como Assunto , Cultura , Dismenorreia/epidemiologia , Dismenorreia/psicologia , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Ciclo Menstrual/psicologia , Produtos de Higiene Menstrual , Pessoa de Meia-Idade , Comportamento Social , Adulto Jovem
12.
PLoS One ; 15(5): e0232512, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365130

RESUMO

In this work, we want to investigate the impact of different substrates and different environmental condition on the biofilm communities growing on plaster, marble, and mortar substrates inside the Herculaneum Suburban Baths. To do so, we measured environmental conditions and sampled biofilm communities along the walls of the baths and used culture-dependent and -independent molecular techniques (DGGE) to identify the species at each sampling sites. We used the species pool to infer structure and richness of communities within each site in each substrate, and confocal light scanning microscopy to assess the three-dimensional structure of the sampled biofilms. To gather further insights, we built a meta-community network and used its local realizations to analyze co-occurrence patterns of species. We found that light is a limiting factor in the baths environment, that moving along sites equals moving along an irradiation gradient, and that such gradient shapes the community structure, de facto separating a dark community, rich in Bacteria, Fungi and cyanobacteria, from two dim communities, rich in Chlorophyta. Almost all sites are dominated by photoautotrophs, with Fungi and Bacteria relegated to the role of rare species., and structural properties of biofilms are not consistent within the same substrate. We conclude that the Herculaneum suburban baths are an environment-shaped community, where one dark community (plaster) and one dim community (mortar) provides species to a "midway" community (marble).


Assuntos
Banhos/história , Biofilmes/crescimento & desenvolvimento , Microbiota , Materiais de Construção/história , Materiais de Construção/microbiologia , Microbiologia Ambiental , História Antiga , Humanos , Itália , Microbiota/genética , Microscopia Confocal
13.
Cutis ; 105(3): 118-120, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32352435

RESUMO

Compared to head and pubic lice, body lice (Pediculus humanus corporis) carry increased morbidity in the form of greater body surface area involvement, possible infectious disease transmission, and the potential for secondary iron-deficiency anemia. They thrive in high-density urban populations in which hygiene is poor, such as among the homeless. Treatment includes washing of affected individuals, their possessions, and treatment with topical insecticides. Growing patterns of treatment resistance seen in body lice necessitate development of new strategies, with oral medications serving as a promising option.


Assuntos
Infestações por Piolhos/diagnóstico , Infestações por Piolhos/terapia , Pediculus , Animais , Banhos , Vestuário , Humanos , Higiene , Infestações por Piolhos/complicações , Higiene da Pele
14.
Cochrane Database Syst Rev ; 5: CD011941, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32368795

RESUMO

BACKGROUND: Chronic plaque psoriasis is an immune-mediated, chronic, inflammatory skin disease, which can impair quality of life and social interaction. Disease severity can be classified by the psoriasis area and severity index (PASI) score ranging from 0 to 72 points. Indoor artificial salt bath with or without artificial ultraviolet B (UVB) light is used to treat psoriasis, simulating sea bathing and sunlight exposure; however, the evidence base needs clear evaluation. OBJECTIVES: To assess the effects of indoor (artificial) salt water baths followed by exposure to artificial UVB for treating chronic plaque psoriasis in adults. SEARCH METHODS: We searched the following databases up to June 2019: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trial registers, and checked the reference lists of included studies, recent reviews, and relevant papers for further references to relevant trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) of salt bath indoors followed by exposure to artificial UVB in adults who have been diagnosed with chronic plaque type psoriasis. We included studies reporting between-participant data and within-participant data. We evaluated two different comparisons: 1) salt bath + UVB versus other treatment without UVB; eligible comparators were exposure to psoralen bath, psoralen bath + artificial ultraviolet A UVA) light, topical treatment, systemic treatment, or placebo, and 2) salt bath + UVB versus other treatment + UVB or UVB only; eligible comparators were exposure to bath containing other compositions or concentrations + UVB or UVB only. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We used GRADE to assess the certainty of the evidence. The primary efficacy outcome was PASI-75, to detect people with a 75% or more reduction in PASI score from baseline. The primary adverse outcome was treatment-related adverse events requiring withdrawal. For the dichotomous variables PASI-75 and treatment-related adverse events requiring withdrawal, we estimated the proportion of events among the assessed participants. The secondary outcomes were health-related quality of life using the Dermatology Life Quality Index, (DLQI) pruritus severity measured using a visual analogue scale, time to relapse, and secondary malignancies. MAIN RESULTS: We included eight RCTs: six reported between-participant data (2035 participants; 1908 analysed), and two reported within-participant data (70 participants, 68 analysed; 140 limbs; 136 analysed). One study reported data for the comparison salt bath with UVB versus other treatment without UVB; and eight studies reported data for salt bath with UVB versus other treatment with UVB or UVB only. Of these eight studies, only five reported any of our pre-specified outcomes and assessed the comparison of salt bath with UVB versus UVB only. The one included trial that assessed salt bath plus UVB versus other treatment without UVB (psoralen bath + UVA) did not report any of our primary outcomes. The mean age of the participants ranged from 41 to 50 years of age in 75% of the studies. None of the included studies reported on the predefined secondary outcomes of this review. We judged seven of the eight studies as at high risk of bias in at least one domain, most commonly performance bias. Total trial duration ranged between at least two months and up to 13 months. In five studies, the median participant PASI score at baseline ranged from 15 to 18 and was balanced between treatment arms. Three studies did not report PASI score. Most studies were conducted in Germany; all were set in Europe. Half of the studies were multi-centred (set in spa centres or outpatient clinics); half were set in a single centre in either an unspecified settings, a psoriasis daycare centre, or a spa centre. Commercial spa or salt companies sponsored three of eight studies, health insurance companies funded another, the association of dermatologists funded another, and three did not report on funding. When comparing salt bath plus UVB versus UVB only, two between-participant studies found that salt bath plus UVB may improve psoriasis when measured using PASI 75 (achieving a 75% or more reduction in PASI score from baseline) (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.24 to 2.35; 278 participants; low-certainty evidence). Assessment was conducted at the end of treatment, which was equivalent to six to eight weeks after start of treatment. The two trials which contributed data for the primary efficacy outcome were conducted by the same group, and did not blind outcome assessors. The German Spas Association funded one of the trials and the funding source was not stated for the other trial. Two other between-participant studies found salt bath plus UVB may make little to no difference to outcome treatment-related adverse events requiring withdrawal compared with UVB only (RR 0.96, 95% CI 0.35 to 2.64; 404 participants; low-certainty evidence). One of the studies reported adverse events, but did not specify the type of events; the other study reported skin irritation. One within-participant study found similar results, with one participant reporting severe itch immediately after Dead Sea salt soak in the salt bath and UVB group and two instances of inadequate response to phototherapy and conversion to psoralen bath + UVA reported in the UVB only group (low-certainty evidence). AUTHORS' CONCLUSIONS: Salt bath with artificial ultraviolet B (UVB) light may improve psoriasis in people with chronic plaque psoriasis compared with UVB light treatment alone, and there may be no difference in the occurrence of treatment-related adverse events requiring withdrawal. Both results are based on data from a limited number of studies, which provided low-certainty evidence, so we cannot draw any clear conclusions. The reporting of our pre-specified outcomes was either non-existent or limited, with a maximum of two studies reporting a given outcome. The same group conducted the two trials which contributed data for the primary efficacy outcome, and the German Spas Association funded one of these trials. We recommend further RCTs that assess PASI-75, with detailed reporting of the outcome and time point, as well as treatment-related adverse events. Risk of bias was an issue; future studies should ensure blinding of outcome assessors and full reporting.


Assuntos
Banhos/métodos , Águas Minerais/uso terapêutico , Psoríase/terapia , Terapia Ultravioleta/métodos , Adulto , Banhos/efeitos adversos , Doença Crônica , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Feminino , Ficusina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Águas Minerais/efeitos adversos , Terapia PUVA/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Cloreto de Sódio/uso terapêutico , Terapia Ultravioleta/efeitos adversos
17.
Arch. argent. pediatr ; 118(2): e183-e187, abr. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1100433

RESUMO

La epilepsia refleja por agua caliente es un tipo de convulsión poco frecuente cuya fisiopatología se desconoce. Estas crisis reflejas suelen iniciarse pocos segundos tras el contacto con el agua y, comúnmente, a temperaturas de 37-48 ºC. Los automatismos y las crisis parciales complejas, con o sin generalización secundaria, son el modo de manifestación principal.La exploración neurológica y el electroencefalograma intercrítico no suelen presentar alteraciones, lo que puede condicionar un retraso en el diagnóstico, por lo que es fundamental la sospecha clínica.El tratamiento antiepiléptico se inicia cuando se asocia a otro tipo de epilepsia o cuando ciertas medidas sencillas, como el descenso de la temperatura del agua en el baño, no controlan las crisis. Es posible la desaparición espontánea. Cuando es necesaria la terapéutica farmacológica, existe, normalmente, buena respuesta.Se presenta el caso de un lactante con diagnóstico de epilepsia refleja por agua caliente.


Hot-water epilepsy is a rare type of seizure whose pathophysiology is unknown. These reflex seizures usually begin a few seconds after contact with water, commonly at temperatures between 37-48 ºC. Automations and complex partial crises, with or without secondary generalization, are the main manifestation mode of this type of reflex epilepsies.Neurological examination and intercritical electroencephalography are usually normal, which may condition a delay in diagnosis, and the clinical suspicion is fundamental.Antiepileptic treatment is initiated when associated with another type of epilepsy or when certain simple measures, such as lowering the water temperature in the bath, do not control crises. Spontaneous disappearance is possible; when pharmacological therapy is necessary, there is usually a good response.We present the case of an infant diagnosed with hot-water epilepsy.


Assuntos
Humanos , Masculino , Lactente , Epilepsia Reflexa/diagnóstico , Convulsões , Banhos , Epilepsia Reflexa/tratamento farmacológico , Temperatura Alta
18.
PLoS One ; 15(4): e0232062, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330165

RESUMO

INTRODUCTION: Daily bathing with chlorhexidine gluconate (CHG) in hospitalized patients reduces healthcare-associated bloodstream infections and colonization by multidrug-resistant organisms. Achieving compliance with bathing protocols is challenging. This non-intensive care unit multicenter project evaluated the impact of organizational context on implementation of CHG and assessed compliance with and healthcare workers' perceptions of the intervention. MATERIALS AND METHODS: This was a multiple case study based on the SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety. The four sites included an adult cardiovascular unit in a community hospital, a medical-surgical unit in an academic teaching pediatric hospital, an adult medical-surgical acute care unit and an adult neuroscience acute care unit in another academic teaching hospital. Complementary data collection methods included focus groups and interviews with healthcare workers (HCWs) and leaders, and direct observations of the CHG treatment process and skin swabs. RESULTS: We collected 389 bathing observations and 110 skin swabs, conducted four focus groups with frontline workers and interviewed leaders. We found variation across cases in CHG compliance, skin swab data and implementation practices. Mean compliance with the bathing process ranged from 64% to 83%. Low detectable CHG on the skin was related to immediate rinsing of CHG from the skin. Variation in the implementation of CHG treatments was related to differences in organizational education and training practices, feedback and monitoring practices, patient education or information about CHG treatments, patient preferences and general unit patient population differences. CONCLUSION: Organizations planning to implement CHG treatments in non-ICU settings should ensure organizational readiness and buy-in and consider delivering systematic and ongoing training. Clear and systematic implementation policies across patients and units may help reduce potential confusion about treatment practices and variation across HCWs. Patient populations and unit factors need to be carefully considered and procedures developed to manage unique challenges.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/análogos & derivados , Infecção Hospitalar/prevenção & controle , Adulto , Banhos/métodos , Clorexidina/administração & dosagem , Clorexidina/uso terapêutico , Cuidados Críticos/métodos , Infecção Hospitalar/epidemiologia , Feminino , Hospitais Comunitários , Humanos , Unidades de Terapia Intensiva , Masculino
19.
Medicine (Baltimore) ; 99(17): e19841, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332634

RESUMO

BACKGROUND: Diabetic foot (DF) is among the most serious complications of type 2 diabetes. DF infection (DFI) is a key factor in the deterioration and development of DF, so controlling infection plays an important role in the treatment of the disease. Traditional Chinese medicine foot bath has been widely used in China as a complementary and alternative therapy to improve circulation and infection control of DF. However, the existing evidence shows that its efficacy and safety are still insufficient. We report a study protocol about a multicenter, double-blind, randomized, placebo controlled trial which aims to make well-designed clinical trials to evaluate the efficacy and safety of herbal medicine foot bath decoction (FBD) and explore the mechanism of external washing of Chinese herbs in DFI. METHODS: This study is a multicenter, double-blind, randomized, placebo controlled clinical trial in which 60 eligible participants were randomly divided into an experimental group and control group at a 1:2 ratio. Both groups received the same basic treatment for DF disease, the experimental group used FBD and ordinary dressing changes, while half of the patients in the control group received placebo and ordinary dressings, and the other half received placebo and silver ion dressings. Patients in both groups will be evaluated weekly for efficacy during the intervention. The primary efficacy indicators include the types of wound pathogens, interleukin 6 and tumor necrosis factor α. Secondary efficacy indicators included blood glucose, blood lipids, wound area, lower extremity blood vessel diameter, blood flow speed, walking speed, walking distance, and traditional Chinese medicine syndrome scores. We will also conduct a safety evaluation of the drug at the end of the trial. DISCUSSION: This multicenter, double-blind, randomized, placebo clinical trial not only provides data on the efficacy and safety of FBD, but also provides a novel treatment strategy for clinicians and DF patients.


Assuntos
Banhos , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Adolescente , Adulto , Idoso , Pé Diabético/fisiopatologia , Método Duplo-Cego , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Cicatrização , Adulto Jovem
20.
Int J Infect Dis ; 96: 54-60, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32304821

RESUMO

INTRODUCTION: Sepsis is the leading cause of infectious morbidity and mortality among hospitalized neonates. In high-resource pediatric and adult intensive care units, use of aqueous chlorhexidine (CHG) solution has been associated with reduced risk of bloodstream infections (BSI). OBJECTIVES: To assess the impact of bathing of neonates with 2% CHG on BSI, suspected sepsis, and mortality in a low-income country neonatal care unit. METHODS: We conducted a secondary analysis of data from the Sepsis Prevention in Neonates in Zambia (SPINZ) study, a prospective observational cohort study performed at a large public referral hospital in Lusaka, Zambia. The SPINZ study assessed the impact of an infection control bundle (consisting of alcohol hand rub, SMS hygiene reminders, enhanced environmental cleaning, and CHG baths for babies ≥1.5 kg) on sepsis, BSI, and all-cause mortality. Episodic shortages in study staffing resulted in some enrolled babies not receiving a CHG bath. Using Longitudinal Targeted Maximum Likelihood Estimation and Cox proportional hazards regression to adjust for observed confounding, we estimated the causal effect of receiving a CHG bath within the first 3 days of life on suspected sepsis, BSI, and death among inborn babies enrolled during the study implementation and intervention phases. RESULTS: The majority of inborn, enrolled babies ≥1.5 kg received a CHG bath within 3 days of NICU admission (864 of 1233, 70%). We found that CHG bathing reduced the hazard rate of BSI among inborn babies ≥1.5 kg by a factor of 0.58 (p = 0.10, 95% CI: 0.31, 1.11), corresponding to an absolute risk reduction of 9.6 percentage points within a week of admission (p = 0.002, 95% CI: 3.4-15.7 percentage points). We did not find a statistically significant effect of CHG bathing on culture-negative sepsis (p = 0.54) or death (p = 0.85). CONCLUSION: In our single center study, CHG bathing at admission was associated with a reduced risk of BSI due to a pathogenic organism after adjusting for potential confounding. Our results suggest that CHG may be an effective intervention for preventing neonatal sepsis in high-risk, low-income country settings.


Assuntos
Clorexidina , Controle de Infecções , Sepse/prevenção & controle , Banhos , Estudos de Coortes , Feminino , Mortalidade Hospitalar , Humanos , Higiene , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Estudos Prospectivos , Zâmbia
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