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1.
Texto & contexto enferm ; 29: e20180345, Jan.-Dec. 2020. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059130

RESUMO

ABSTRACT Objective: to analyze the content of the defining characteristics of the Disturbed Sleep Pattern Nursing Diagnosis (00198) in patients with Acute Coronary Syndrome. Method: content analysis performed by specialists who achieved a score equal to or greater than five, according to established criteria: clinical experience, teaching and/or research; participation in research groups; doctorate degree; master's degree; specialization and/or residency in cardiology and/or sleep and/or nursing classifications. Eight defining characteristics were evaluated for their relationship to population, relevance, clarity and accuracy. Descriptive statistics were performed to characterize the sample, binomial statistical test to establish if there is agreement between the experts and chi-square and Fisher's exact to establish associations between the evaluated items and the experts' variables. Results: 54 experts participated in the study. The defining characteristics validated by the experts were the following: dissatisfaction with sleep, feeling unrested, sleep deprivation, alteration in sleep pattern, unintentional awakening, difficulty initiating sleep and daytime sleepiness. There was a statistically significant association between evaluated items and the variables time of training, time of operation and punctuation. Conclusion: seven of the eight defining characteristics were considered valid after the application of binomial test. This study will contribute to the refinement of the Disturbed Sleep Pattern Nursing Diagnosis (000198) and may enable the improvement of the quality of care of patients hospitalized with Acute Coronary Syndrome regarding changes in sleep pattern. The content analysis stage will support the next stage of the validation process of the present diagnosis, the clinical validation.


RESUMEN Objetivo: analizar el contenido de las características definidoras del Diagnóstico de Enfermería de Patrón de Sueño Perjudicado (00198) en pacientes con Síndrome Coronario Agudo. Método: análisis de contenido realizado por especialistas que obtuvieron una puntaje mayor o igual a cinco, de acuerdo con los criterios establecidos: experiencia clínica, en docencia y/o en investigación; participación en grupos de investigación; doctorado; maestría; especialización y/o residencia en cardiología y/o en clasificaciones de enfermería. Se evaluaron ocho características definidoras en cuanto a su relación con la población, relevancia, claridad y precisión. Se realizó un análisis estadístico descriptivo para caracterizar la muestra, una prueba estadística de binomios para establecer si había concordancia entre los especialistas y las pruebas de chi-cuadrado y exacto de Fisher para establecer asociaciones entre los puntos evaluados y las variables de los especialistas. Resultados: del estudio participaron 54 especialistas. Las características definidoras que evaluaron los especialistas fueron las siguientes: insatisfacción con el sueño, no sentirse descansado, privación del sueño, alteración en el patrón de sueño, despertar no intencional, dificultad para iniciar el sueño y somnolencia diurna. Se registró una asociación estadística significativa entre los puntos evaluados y las siguientes variables: tiempo de formación, tiempo de ejercicio en la profesión y puntuación. Conclusión: siete de las ocho Características definidoras se consideraron válidas después de aplicar la prueba de binomios. El presente estudio contribuirá a perfeccionar el Diagnóstico de Enfermería de Patrón de Sueño Perjudicado (000198) y podrá hacer posible que se mejore la calidad de la atención de pacientes internados con Síndrome Coronario Agudo en lo referente a alteraciones en el patrón de sueño. La etapa del análisis de contenido servirá de ayuda para la próxima etapa del proceso de validación del presente diagnóstico: la validación clínica.


RESUMO Objetivo: analisar o conteúdo das características definidoras do Diagnóstico de Enfermagem Padrão de Sono Prejudicado (00198) em pacientes com Síndrome Coronariana Aguda. Método: análise de conteúdo realizada por especialistas que atingiram pontuação igual ou maior a cinco, de acordo com critérios estabelecidos: experiência clínica, no ensino e/ou pesquisa; participação em grupos de pesquisa; doutorado; mestrado; especialização e/ou residência em cardiologia e/ou sono e/ou classificações de enfermagem. Oito características definidoras foram avaliadas quanto a sua relação com a população, relevância, clareza e precisão. Realizou-se estatística descritiva para caracterização da amostra, teste estatístico binomial para estabelecer se há concordância entre os especialistas e qui-quadrado e exato de Fisher para estabelecer associações entre os itens avaliados e variáveis dos especialistas. Resultados: 54 especialistas participaram do estudo. As características definidoras validadas pelos especialistas foram: insatisfação com o sono, não se sentir descansado, privação do sono, alteração do padrão de sono, despertar não intencional, dificuldade para iniciar o sono e sonolência diurna. Houve associação estatística significativa entre itens avaliados e as variáveis tempo de formação, tempo de atuação e pontuação. Conclusão: sete das oito características definidoras foram consideradas válidas após aplicação de teste binomial. O presente estudo contribuirá para o refinamento do Diagnóstico de Enfermagem Padrão de Sono Prejudicado (000198) e poderá possibilitar a melhoria da qualidade do atendimento de pacientes internados com Síndrome Coronariana Aguda no que tange a alterações do padrão de sono. A etapa de análise de conteúdo subsidiará a próxima etapa do processo de validação do presente diagnóstico, a validação clínica.


Assuntos
Cardiologia , Estudo de Validação , Processo de Enfermagem , Pesquisa , Sono , Privação do Sono , Diagnóstico de Enfermagem , Unidades de Cuidados Coronarianos , Diagnóstico , Síndrome Coronariana Aguda
2.
J Biol Regul Homeost Agents ; 34(4 Suppl. 2): 1-1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000592

RESUMO

This special issue provides a rich blend of news, reviews and clinical studies on many aspects of the understanding, management and prevention of cardiovascular disease in childhood. Primary care in pediatric cardiology, principally, must concern with prevention of heart disease and early detection of existing illness. In addition, pediatricians must be able to maintain the vigilance of "healthy" children in order to prevent cardiovascular risk in adulthood. With these goals, the themes presented in this "mosaic" of topics include - Cardiovascular involvement in genetic syndromes, SIDS and infectious, endocrine, kidney, storage or autoimmune diseases. - Pulmonary hypertension and patent ductus arteriosus in premature infants. - Cardiovascular risk in obese or hypertensive children. - Bicupid aortic valve and aortic dysfunction - Covid 19 and heart disease in childhood I thank the Researchers and Professors of Catanzaro, Palermo, Pavia, Brescia, Taormina and Messina University for their interesting and up-to-date scientific contributions, and I hope the information gathered in this issue will be useful to the reader.


Assuntos
Cardiologia , Pediatria , Betacoronavirus , Criança , Infecções por Coronavirus , Humanos , Lactente , Pandemias , Pneumonia Viral
3.
Arq Bras Cardiol ; 115(3): 547-557, 2020 09.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33027380

RESUMO

The challenges that the COVID-19 pandemic cretead to the healthcare system have made it necessary to adapt routines and services, with the objectives of controlling the spread of the virus and preserving health. Safe and correct management of patients in risks groups, such as elderly patients, patients with cardiovascular diseases, and patients with cancer, has become even more important. Thus, cardio-oncology has gained a new dimension, with the aim of adapting to patients' needs during the pandemic by restructuring the system of care in a manner that offers quality and safety in healthcare.


Assuntos
Doenças Cardiovasculares/terapia , Infecções por Coronavirus/epidemiologia , Neoplasias/terapia , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus , Cardiologia , Assistência à Saúde , Humanos , Oncologia , Pandemias
6.
Curr Atheroscler Rep ; 22(12): 72, 2020 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-33009957

RESUMO

PURPOSE OF REVIEW: The review highlights selected studies related to cardiovascular disease (CVD) prevention that were presented at the 2020 European Society of Cardiology (ESC) Congress-The Digital Experience. RECENT FINDINGS: The studies reviewed include clinical trials on novel RNA interference-based lipid-lowering therapies AKCEA-APOCIII-LRx and vupanorsen (AKCEA-ANGPTL3-LRx); the EVAPORATE trial assessing the effects of icosapent ethyl on coronary plaque volume progression; the LoDoCo2 trial evaluating the efficacy of low-dose colchicine in cardiovascular disease risk reduction among patients with chronic coronary artery disease; as well as the EMPEROR-Reduced trial evaluating cardiovascular and renal outcomes with empagliflozin in patients with heart failure and reduced ejection fraction. In addition, we review the BPLTTC analysis on blood pressure treatment across blood pressure levels and CVD status and discuss findings from the BRACE CORONA study that examined continuing versus suspending angiotensin-converting enzyme inhibitor or angiotensin receptor blockers in patients on these antihypertensive medications who were hospitalized with COVID-19 infection. The studies presented at the 2020 digital ESC Congress highlight the continuing advancements in the field of CVD prevention.


Assuntos
Betacoronavirus/fisiologia , Cardiologia , Fármacos Cardiovasculares/farmacologia , Doenças Cardiovasculares , Infecções por Coronavirus , Reguladores do Metabolismo de Lipídeos/farmacologia , Pandemias , Pneumonia Viral , Compostos Benzidrílicos/farmacologia , Cardiologia/métodos , Cardiologia/tendências , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Ensaios Clínicos como Assunto , Congressos como Assunto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Ácido Eicosapentaenoico/análogos & derivados , Ácido Eicosapentaenoico/farmacologia , Europa (Continente) , Glucosídeos/farmacologia , Humanos , Oligonucleotídeos/farmacologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Sociedades Médicas , Telecomunicações
7.
Assist Inferm Ric ; 39(3): 118-121, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-33077980

RESUMO

. Care path for non-deferred elective hospitalizations in cardiology in the Covid-19 period. INTRODUCTION: The novel coronavirus-19 (Covid-19) has rapidly resulted in a global pandemic. Our hospital had to postpone all elective admissions to increase capacity for COVID-19 patients. Therefore, a rearrangement of the elective admissions was necessary to guarantee a restart of ordinary procedures. AIM: To describe the organizational model adopted for elective procedures during the Covid-19 pandemic, to guarantee maximum safety for patients and healthcare workers. METHODS: Patients on waiting list for cardiac procedures were rearranged based on risks prioritization. Procedure of coronary angiography and cardiac devices (PM and ICD) implants or replacement took priority upon other cardiac procedures. Each patient underwent a telephone nurse triage to assess for any covid-19 symptoms. The hospital admissions were organized in accordance with health and safety measures declared by the National Institute of Health, with different paths according to the swab results. RESULTS: A total of 66 patients were contacted and 40 accepted the hospital admission (26 refused it, for fear of infection or covid-19 related family problems). No patient resulted positive to the nasal swab. CONCLUSIONS: In view of the impact on the health care system of this new pandemic, the choice of an appropriate pathway which can preserve patients' safety is essential, while guaranteeing the treatment of problems, such as cardiovascular diseases, with a high mortality rate.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Planejamento de Assistência ao Paciente , Pneumonia Viral/epidemiologia , Cardiologia/estatística & dados numéricos , Hospitais , Humanos , Modelos Organizacionais , Pandemias , Listas de Espera
10.
Rev Med Suisse ; 16(705): 1626-1633, 2020 Sep 09.
Artigo em Francês | MEDLINE | ID: mdl-32914594

RESUMO

Intermediate-risk pulmonary embolism (PE) is usually defined as PE associated with right ventricular dysfunction (echocardiographic, radiological and/or biological) without hemodynamic instability. It is associated with significant mortality, and its management is challenging for the clinician due to its variable clinical presentation. In its recent recommendations, the European Society of Cardiology proposes to differentiate high intermediate risk from low intermediate risk, based on clinical, biological and radiological criteria. The management strategy differs for these two categories, particularly about the need for monitored surveillance. Beyond therapeutic anticoagulation, which remains the first-line treatment in intermediate-risk PE, other therapeutic modalities can be considered, and will be discussed.


Assuntos
Embolia Pulmonar/terapia , Cardiologia , Ecocardiografia , Humanos , Embolia Pulmonar/complicações , Medição de Risco , Disfunção Ventricular Direita/complicações , Disfunção Ventricular Direita/terapia
15.
Circ Heart Fail ; 13(9): e007516, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32894988

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic imposed severe restrictions on traditional methods of patient care. During the pandemic, the heart failure program at New York-Presbyterian Hospital in New York, NY rapidly and comprehensively transitioned its care delivery model and administrative organization to conform to a new healthcare environment while still providing high-quality care to a large cohort of patients with heart failure, heart transplantation, and left ventricular assist device. In addition to the widespread adoption of telehealth, our program restructured outpatient care, initiating a shared clinic model and introducing a comprehensive remote monitoring program to manage patients with heart failure and heart transplant. All conferences, including administrative meetings, support groups, and educational seminars were converted to teleconferencing platforms. Following the peak of COVID-19, many of the new changes have been maintained, and the program structure will be permanently altered as a lasting effect of this pandemic. In this article, we review the details of our program's transition in the face of COVID-19 and highlight the programmatic changes that will endure.


Assuntos
Cardiologia/organização & administração , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Insuficiência Cardíaca/terapia , Pneumonia Viral/epidemiologia , Telemedicina/organização & administração , Planejamento Antecipado de Cuidados , Assistência Ambulatorial/organização & administração , Betacoronavirus , Transplante de Coração , Coração Auxiliar , Humanos , Cidade de Nova Iorque/epidemiologia , Profissionais de Enfermagem , Pandemias , Médicos , Papel Profissional , Grupos de Autoajuda , Telecomunicações , Centros de Atenção Terciária/organização & administração , Comunicação por Videoconferência
17.
Pediatr Clin North Am ; 67(5): 923-944, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32888690

RESUMO

Although progress had been made in reducing cardiovascular disease (CVD) mortality, the positive trend has reversed in recent years, and CVD remains the most common cause of mortality in US women and men. Youth represent the future of CVD prevention; emerging evidence suggests exposure to risk factors in children contributes to atherosclerosis and results in vascular changes and increased CVD events. The contributors to CVD include those commonly seen in adults. This article reviews hypercholesterolemia, hypertension, obesity, diabetes, and smoking. It discusses the prevalence of each disease, diagnosis, treatment, and cardiovascular complications.


Assuntos
Cardiologia/métodos , Doenças Cardiovasculares/prevenção & controle , Gerenciamento Clínico , Medicina Preventiva/métodos , Criança , Humanos
18.
Pediatr Clin North Am ; 67(5): 973-993, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32888693

RESUMO

This article aims to summarize some of the key advances in congenital interventional cardiology over the past few years, from novel imaging technologies, such as virtual reality, fusion imaging, and 3-dimensional printed models, to newly available devices and techniques to facilitate complex procedures including percutaneous pulmonary valve replacement and hybrid procedures. It is an exciting time for the field, with rapid development of techniques, devices, and imaging tools that allow a minimally invasive approach for many congenital cardiac defects with progressively less radiation and contrast doses.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Cardiologia/tendências , Diagnóstico por Imagem/métodos , Cardiopatias Congênitas/cirurgia , Cirurgia Assistida por Computador/tendências , Humanos
19.
Pediatr Clin North Am ; 67(5): 995-1009, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32888694

RESUMO

Artificial intelligence (AI) in the last decade centered primarily around digitizing and incorporating the large volumes of patient data from electronic health records. AI is now poised to make the next step in health care integration, with precision medicine, imaging support, and development of individual health trends with the popularization of wearable devices. Future clinical pediatric cardiologists will use AI as an adjunct in delivering optimum patient care, with the help of accurate predictive risk calculators, continual health monitoring from wearables, and precision medicine. Physicians must also protect their patients' health information from monetization or exploitation.


Assuntos
Algoritmos , Inteligência Artificial , Cardiologia/métodos , Medicina de Precisão/métodos , Criança , Registros Eletrônicos de Saúde , Humanos
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