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1.
Einstein (Sao Paulo) ; 22: eAO0811, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39258690

RESUMEN

OBJECTIVE: To estimate the point prevalence of and risk factors associated with the development of pressure ulcers at a university hospital in Brazil. METHODS: This study was conducted on 196 participants using a structured questionnaire, physical examination of the skin, and the Braden scale. The Mann-Whitney U, χ2, or Fisher's exact tests were used to compare the participants and the associations of variables with pressure ulcers. A modified multivariate Poisson regression model was built considering the presence of pressure injuries and the independent variables. RESULTS: The point prevalence of pressure ulcers was 10.71% and was significantly associated with less than 12 years of schooling (p=0.0213), use of antihypertensive drugs during hospital stay (p=0.0259), diagnosis of systemic hypertension (p=0.0035), and diabetes mellitus. Lower scores on the Braden scale (p=0.0001) were positively associated with the presence of pressure ulcers. Furthermore, cardiovascular disease (p=0.0267) and diaper use (p=0.0001) were associated with the presence of pressure ulcers. Moreover, they were also associated with prolonged hospital stay, advanced age, less than 12 years of schooling, use of antihypertensive drugs, hypertension, diabetes, and lower Braden scale scores. CONCLUSION: Health professionals should be aware of the risk factors associated with pressure ulcers, evaluate patient skin daily, and offer prevention. Our findings support the need to allocate resources for the prevention and treatment of pressure injuries.


Asunto(s)
Úlcera por Presión , Humanos , Úlcera por Presión/epidemiología , Úlcera por Presión/etiología , Masculino , Femenino , Estudios Transversales , Factores de Riesgo , Brasil/epidemiología , Persona de Mediana Edad , Prevalencia , Adulto , Anciano , Hospitalización/estadística & datos numéricos , Factores Socioeconómicos , Hipertensión/epidemiología , Hipertensión/complicaciones , Adulto Joven , Encuestas y Cuestionarios , Anciano de 80 o más Años
2.
Wound Manag Prev ; 70(2)2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38959345

RESUMEN

BACKGROUND: Burns are classified according to their mechanism of injury, depth, affected body area, affected region or part of the body, and extent of the lesions. Topical insulin modulates the healing process. However, studies evaluating the effects of topical insulin treatment on burns in human patients are lacking. PURPOSE: The purpose of this study was to investigate the effects of topical insulin on healing time of second-degree burns. METHODS: In this nonrandomized clinical trial, patients with second-degree burns were allocated to a control group (CG) or an intervention group (IG) in which wounds were treated with 1% silver sulfadiazine and topical insulin, respectively. RESULTS: Healing time was significantly shorter in the IG relative to the CG (9.1 ± 1.9 days and 12.7 ± 3.3 days, respectively; P < .05). The estimated burn area was similar in both groups (CG 1.44 ± 1.0%; IG 1.42 ± 0.53%). CONCLUSION: In this study, topical insulin reduced healing time in second-degree burns. Further investigation is warranted to support wider use in clinical practice.


Asunto(s)
Administración Tópica , Quemaduras , Insulina , Cicatrización de Heridas , Humanos , Quemaduras/tratamiento farmacológico , Quemaduras/fisiopatología , Cicatrización de Heridas/efectos de los fármacos , Insulina/uso terapéutico , Insulina/administración & dosificación , Insulina/farmacología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Sulfadiazina de Plata/uso terapéutico , Sulfadiazina de Plata/farmacología , Sulfadiazina de Plata/administración & dosificación , Factores de Tiempo
3.
Regen Ther ; 26: 425-431, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39045578

RESUMEN

The development of diabetic foot ulcers is a common and severe complication of diabetes that can significantly affect quality of life. The physiological healing cascade does not progress tissue repair in diabetic foot ulcerations in a timely manner. Serum markers from foot ulcers have been used to characterize the healing process of the diabetic foot using various collection techniques. This study aimed to compare the use of cervical brushes and the Levine technique to collect wound fluid from foot ulcers of people with diabetes in order to determine the presence of cytokines. The collected material was used for gene expression analysis of macrophage/monocyte-associated cytokines IL1-ß, IL-6, TNF-α, regulatory cytokine IL-10 and growth factor TGFß, via quantitative polymerase chain reaction (qPCR). Both collection methods produced sufficient amounts of RNA, but significantly more RNA was collected using a cervical brush (brush 224.82 ng/µL vs. Levine 80.90 ng/µL p = 0.0001). Significantly higher levels of expression of the following cytokine genes were detected in samples collected using a cervical brush: IL1-ß (p = 0.0001), IL-6 (p = 0.0106), IL-10 (p = 0.0277) and TGFß (p = 0.0002). Understanding why some wounds are difficult to heal is important for developing more effective treatments, and biomarkers may be useful for predicting the healing trajectory. These results demonstrate that it is possible to collect material from the wound bed for RT-qPCR analysis, and the cervical brush proved to be a simple and rapid method for monitoring cytokine gene expression.

5.
Physiother Res Int ; 29(2): e2079, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38477078

RESUMEN

OBJECTIVE: To investigate the effects of unilateral upper limbs' (ULM) neuromuscular electrical stimulation (NMES) superimposed on a voluntary contraction added to a protocol of intradialytic leg cycle ergometer exercise on muscle strength, functional capacity and quality of life of adult patients with chronic kidney disease (CKD). METHODS: This randomized controlled clinical trial will be carried out at a Brazilian University Hospital. The patients will be evaluated and randomly allocated to an intervention group (i.e., unilateral NMES on the upper limb without hemodialysis fistula for 20 min and leg cycle ergometer for 30 min) or a control group (i.e., unilateral NMES-Sham on the upper limb without hemodialysis fistula for 20 min and leg cycle ergometer for 30 min). The patients will be treated for 8 weeks, with three weekly treatment sessions totaling 24 sessions. MEASUREMENTS: ULM muscle strength, functional capacity, quality of life and also the feasibility, safety and patient adherence to the exercise protocol. All physical measurements will be collected by trained researchers before treatment (week 0) and at the end of treatment (week 9), always in the second hemodialysis session of the week. It will be used in an intention-to-treat analysis. RESULTS/CONCLUSIONS: The outcomes of this clinical trial protocol may help to know the possible benefits of unilateral ULM' NMES superimposed on a voluntary contraction added to a protocol of leg cycle ergometer for patients with CKD and to aid clinical decisions about future implementation or not of this technique (NMES) in intradialytic physical training programs.


Asunto(s)
Terapia por Estimulación Eléctrica , Fístula , Insuficiencia Renal Crónica , Adulto , Humanos , Calidad de Vida , Pierna , Fuerza Muscular/fisiología , Terapia por Estimulación Eléctrica/métodos , Estimulación Eléctrica , Extremidad Superior , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
Bioengineering (Basel) ; 11(2)2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38391653

RESUMEN

Treatment of chronic wounds is challenging, and the development of different formulations based on insulin has shown efficacy due to their ability to regulate oxidative stress and inflammatory reactions. The formulation of insulin with polysaccharides in biohybrid hydrogel systems has the advantage of synergistically combining the bioactivity of the protein with the biocompatibility and hydrogel properties of polysaccharides. In this study, a hydrogel formulation containing insulin, chitosan, and hydroxypropyl methyl cellulose (Chi/HPMC/Ins) was prepared and characterized by FTIR, thermogravimetric, and gel point analyses. The in vitro cell viability and cell migration potential of the Chi/HPMC/Ins hydrogel were evaluated in human keratinocyte cells (HaCat) by MTT and wound scratch assay. The hydrogel was applied to excisional full-thickness wounds in diabetic mice for twenty days for in vivo studies. Cell viability studies indicated no cytotoxicity of the Chi/HPMC/Ins hydrogel. Moreover, the Chi/HPMC/Ins hydrogel promoted faster gap closure in the scratch assay. In vivo, the wounds treated with the Chi/HPMC/Ins hydrogel resulted in faster wound closure, formation of a more organized granulation tissue, and hair follicle regeneration. These results suggest that Chi/HPMC/Ins hydrogels might promote wound healing in vitro and in vivo and could be a new potential dressing for wound healing.

7.
Acta Diabetol ; 61(4): 461-471, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38095701

RESUMEN

PURPOSE: Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann-Whitney and Kruskal-Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient. RESULTS: Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress. CONCLUSION: Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management.


Asunto(s)
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/psicología , Calidad de Vida/psicología , Brasil/epidemiología , Estudios Transversales , Atención Primaria de Salud , Encuestas y Cuestionarios
8.
Rev Bras Enferm ; 76(6): e20230019, 2023.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38055485

RESUMEN

OBJECTIVE: to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses. METHODS: methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74. CONCLUSION: two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.


Asunto(s)
Competencia Clínica , Simulación de Paciente , Humanos
9.
Rev Lat Am Enfermagem ; 31: e4073, 2023.
Artículo en Español, Inglés, Portugués | MEDLINE | ID: mdl-38055591

RESUMEN

OBJECTIVE: evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. METHOD: integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. RESULTS: self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. CONCLUSION: the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.


Asunto(s)
Diabetes Mellitus , Trastornos Mentales , Enfermería Psiquiátrica , Humanos , Diabetes Mellitus/terapia , Trastornos Mentales/terapia , Apoyo Social
10.
Rev. latinoam. enferm. (Online) ; 31: e4073, Jan.-Dec. 2023. tab, graf
Artículo en Español | LILACS, BDENF - Enfermería | ID: biblio-1530187

RESUMEN

Objetivo: evaluar las evidencias disponibles en la literatura sobre la atención de enfermería en salud mental a personas con diabetes mellitus en los diferentes niveles de atención de salud. Método: revisión integrativa de la literatura. Búsqueda en cinco bases de datos. Muestra de 14 estudios, exportados al gerenciador EndNote®. Los datos se organizaron en planilla de Microsoft Excel®. La calidad metodológica de los estudios fue evaluada mediante herramientas propuestas por el Joanna Briggs Institute. Las etapas de muestreo, categorización, evaluación, interpretación de resultados y síntesis de los estudios incluidos fueron realizadas por dos revisores de manera independiente y ciega. El análisis descriptivo de resultados está presentado en tres categorías. Resultados: recomendaciones para autocuidado reforzado por la red de apoyo social, incluyendo herramientas y estrategias de los ámbitos físico y psíquico; estrategias de comunicación terapéutica y psicoterapia, haciendo foco en la psicoterapia y la comunicación terapéutica; e intervenciones de autogestión/autogerenciamiento, abordando el autocuidado en base a teorías conductuales. Conclusión: la síntesis de conocimientos reveló que las pautas de autocuidado reforzadas por la red de apoyo social, las estrategias de comunicación terapéutica y psicoterapia y las intervenciones de autogestión/autogerenciamiento son intervenciones positivas que ayudan a las personas con diabetes mellitus y trastornos mentales a prevenir complicaciones.


Objective: evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. Method: integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. Results: self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. Conclusion: the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.


Objetivo: avaliar as evidências disponíveis sobre os cuidados de enfermagem em saúde mental para pessoas com diabetes mellitus nos diferentes níveis de atenção à saúde. Método: revisão integrativa da literatura. Busca realizada em cinco bases de dados. Amostra composta por 14 estudos. Os estudos foram exportados para o gerenciador EndNote, e seus dados, para uma planilha desenvolvida pelo Microsoft Excel. A qualidade metodológica dos estudos foi avaliada por meio de ferramentas propostas pelo Joanna Briggs Institute. Etapas de amostragem, categorização, avaliação, interpretação dos resultados e síntese dos estudos incluídos foram realizadas por dois revisores de forma independente e mascarada. A análise descritiva dos resultados é apresentada em três categorias. Resultados: orientações para o autocuidado potencializadas pela rede de suporte social, englobando ferramentas e estratégias no âmbito físico e psíquico; estratégias de comunicação terapêutica e psicoterapia, focalizando a psicoterapia e a comunicação terapêutica; e intervenções de autogestão/ autogerenciamento, abordando o autocuidado com base em teorias comportamentais. Conclusão: a síntese do conhecimento revelou que as orientações para o autocuidado potencializadas pela rede de suporte social, estratégias de comunicação terapêutica e psicoterapia e intervenções de autogestão/autogerenciamento são intervenções positivas que auxiliam as pessoas com transtornos mentais e diabetes mellitus na prevenção de agravos.


Asunto(s)
Humanos , Enfermería Psiquiátrica , Apoyo Social , Diabetes Mellitus/terapia , Trastornos Mentales/terapia
11.
Life (Basel) ; 13(2)2023 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-36836932

RESUMEN

BACKGROUND: Photobiomodulation consists of inducing healing by irradiating light. This scoping review investigates the effect of blue light on the healing process. METHODS: The MEDLINE, Web of Science, Scopus, and CINAHL databases were searched. Two reviewers independently examined the search results and extracted data from the included studies. A descriptive analysis was performed. RESULTS: Twenty-two articles were included. Studies were categorized as in vitro/mixed, preclinical, and clinical. The power density used was 10-680 mW/cm2 in most of the in vitro/preclinical studies, the irradiation time ranged from 5 s to 10 min, and different wavelengths and energy densities were used. In clinical studies, the wavelength ranged from 405 to 470 nm, and the energy density varied from 1.5 to 30 J/cm2. CONCLUSIONS: A low energy density (<20 J/cm2) was able to stimulate the different cell types and proteins involved in healing, while a high energy density, 20.6-50 J/cm2, significantly reduced cell proliferation, migration, and metabolism. There is a great variety of device parameters among studies, and this makes it difficult to conclude what the best technical specifications are. Thus, further studies should be performed in order to define the appropriate parameters of light to be used.

12.
Online braz. j. nurs. (Online) ; Online braz. j. nurs. (Online);22(supl.1): e20236605, 03 fev 2023. ilus
Artículo en Inglés | BDENF - Enfermería, LILACS | ID: biblio-1414695

RESUMEN

OBJECTIVE: to assess the effectiveness and safety of the peripherally inserted central catheter for hematopoietic stem cell transplantation. METHOD: this review will follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and the search steps will be presented through the flow diagram. The search strategy aims to locate both published and unpublished studies. No time or language restrictions will be applied. The review will consider experimental and observational studies that include adult and pediatric patients undergoing hematopoietic stem cell transplantation. Patients using peripherally inserted central catheters will be compared with those using other central catheters.


Asunto(s)
Cateterismo Periférico , Trasplante de Células Madre Hematopoyéticas , Acondicionamiento Pretrasplante
13.
Texto & contexto enferm ; 32: e20230097, 2023. tab
Artículo en Inglés | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1515607

RESUMEN

ABSTRACT Objective: To build and validate a clinical simulation scenario for teaching students about nursing consultations for people with type 2 Diabetes Mellitus in initial insulin use. Method: A methodological study, carried out in a higher education institution in Minas Gerais, Brazil, between December 2021 and November 2022. The steps taken involved scenario construction, validity by 16 judges and scenario testing by 30 students. The conceptual model proposed by Jeffries and International Nursing Association for Clinical Simulation in Learning guidelines were followed to elaborate the scenario. Results: The scenario was called "Nursing consultation for teaching initial insulin use to people with type 2 Diabetes Mellitus". The scenario and the checklist for its validity were constructed, then, face and content validity was performed. The final validated version consisted of seven conceptual components (context, background, design, simulated experience, facilitator actions and educational strategy, participants and expected results). The overall value of the Content Validity Index was 0.98. High comprehensibility was noted by the target audience when testing the scenario. Conclusion: The scenario obtained adequate validity and comprehensibility. Using this teaching tool can contribute to the training of future nurses regarding the consultation for patients using insulin.


RESUMEN Objetivo: Construir y validar un escenario de simulación clínica para enseñar a los estudiantes sobre consultas de enfermería para personas con diabetes mellitus tipo 2 que usan insulina por primera vez. Método: Estudio metodológico, realizado en una institución de educación superior de Minas Gerais, Brasil, entre los meses de diciembre de 2021 y noviembre de 2022. Los pasos seguidos fueron la construcción del escenario, la validación por 16 jueces y la prueba del escenario por 30 estudiantes. Para la elaboración del escenario se siguió el modelo conceptual propuesto por Jeffries y las guías de la International Nursing Association for Clinical Simulation in Learning. Resultados: El escenario se denominó "Consulta de Enfermería para la enseñanza del uso inicial de insulina a personas con Diabetes Mellitus Tipo 2". Se construyó el escenario y la lista de chequeo para su validación. Luego se realizó la validación facial y de contenido. La versión final validada constó de siete componentes conceptuales (contexto, background, design, experiencia simulada, acciones del facilitador y estrategia educativa, participantes y resultados esperados). El valor global del índice de validez de contenido fue de 0,98. El público objetivo notó una alta comprensibilidad al probar el escenario. Conclusión: El escenario obtuvo adecuada validez y comprensibilidad. El uso de esta herramienta didáctica puede contribuir a la formación de los futuros enfermeros en cuanto a la consulta de pacientes usuarios de insulina.


RESUMO Objetivo: construir e validar um cenário de simulação clínica para o ensino de estudantes sobre consulta de enfermagem à pessoa com diabetes mellitus tipo 2 em uso inicial de insulina. Método: Estudo metodológico, realizado em instituição de ensino superior de Minas Gerais, Brasil, entre os meses de dezembro de 2021 e novembro de 2022. As etapas percorridas envolveram construção do cenário, validação por 16 juízes e testagem do cenário por 30 estudantes. O modelo conceitual proposto por Jeffries e os guias da International Nursing Association for Clinical Simulation in Learning foram seguidos para elaboração do cenário. Resultados: O cenário denominou-se "Consulta de enfermagem para o ensino do uso inicial de insulina à pessoa com Diabetes Mellitus tipo 2". Construiu-se o cenário e a lista de verificação para a sua validação; em seguida, realizou-se validação de face e conteúdo. A versão final validada foi constituída por sete componentes conceituais (contexto, background, design, experiência simulada, ações do facilitador e estratégia educacional, participantes e resultados esperados). O valor geral do índice de validade de conteúdo foi 0,98; notou-se alta compreensibilidade pelo público-alvo na testagem do cenário. Conclusão: O cenário obteve adequada validade e compreensibilidade. A utilização desta ferramenta de ensino pode contribuir para a formação de futuros enfermeiros com relação à consulta para o paciente em uso de insulina.

14.
Rev. bras. enferm ; Rev. bras. enferm;76(6): e20230019, 2023. tab
Artículo en Inglés | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1529774

RESUMEN

ABSTRACT Objective: to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses. Methods: methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74. Conclusion: two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.


RESUMEN Objetivo: construir, evaluar y probar dos escenarios de simulación clínica para planificar y gestionar terapias de infusión por enfermeros. Métodos: es un estudio metodológico, con escenarios basados en la Teoría de la Simulación de Jeffries NLN y en el modelo teórico Vessel Health Preservation; evaluación del diseño de los escenarios por jueces mediante cálculo del Coeficiente de Kappa Modificado (CKM); prueba de los escenarios con el público-objeto. Resultados: escenarios construidos para: 1. evaluación de pacientes y selección de dispositivos vasculares; y 2. identificación y manejo de trombosis venosa profunda. En la evaluación por jueces, en la prueba de los escenarios validados respecto a las prácticas educativas y en el diseño de la simulación, los ítems sopesados alcanzaron el CKM ≥ 0,74. Conclusión: se construyeron dos escenarios sobre evidencias relacionadas con la terapia de infusión, con valores de concordancia altos entre los jueces, referente a su diseño. En las pruebas con enfermeros, se obtuvieron buenos resultados en cuanto al diseño y a la estructuración de la práctica educativa.


RESUMO Objetivo: construir, avaliar e testar dois cenários de simulação clínica para o planejamento e gerenciamento da terapia infusional pelo enfermeiro. Método: estudo metodológico, com construção de cenários baseado na NLN Jeffries Simulation Theory e no modelo teórico Vessel Health Preservation; avaliação do desenho dos cenários por juízes, com cálculo do Coeficiente de Kappa Modificado (CKM); testagem dos cenários com o público-alvo. Resultados: cenários construídos para: 1. Avaliação do paciente e seleção do dispositivo vascular; e 2. Identificação e gerenciamento de trombose venosa profunda. Na avaliação por juízes, na testagem dos cenários validados em relação às práticas educativas e ao design da simulação, os itens apreciados apresentaram valores do CKM ≥ 0,74. Conclusão: foram construídos dois cenários baseados em evidências relacionadas à terapia infusional, com elevados valores de concordância dos juízes, quanto ao seu desenho. Na testagem com enfermeiros, obteve-se bons resultados quanto ao desenho e estruturação da prática educativa.

15.
Polymers (Basel) ; 14(21)2022 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-36365748

RESUMEN

The purpose of this study was to investigate tissue repair of excisional wounds in hyperglycemic animals treated with chitosan-alginate membranes (CAM) produced in the presence of glycerol. 8-week C57B1 male mice were divided into normoglycemic animals with a 0.9% saline solution topical treatment (CTSF); hyperglycemic animals with 0.9% saline solution topical treatment (DMSF) and hyperglycemic animals with glycerol-plasticized chitosan-alginate membrane topical treatment (DMCAM). On post-wound day three, the DMCAM group presented a lower number of leukocytes, mature mastocytes, a higher number of vessels (p < 0.05), and active mastocytes (p < 0.05) when compared to the CTSF and DMSF groups. There were no differences regarding the distribution, deposition, organization, and thickness of collagen fibers. On day 7 there were no differences in the analysis of fibroblasts, mastocytes, and TGF−ß1 and VEGF expressions among the groups. Regarding collagen fibers, the DMCAM group presented slight red-orange birefringence when compared to the CTSF and DMSF groups. On day 14 there was a slight concentration of thinner elastic fibers for the DMCAM group, with a greater reorganization of papillary skin and improved red-orange birefringence collagen fibers, as well as net-shaped orientation, similar to intact skin. In addition, improved elastic fiber organization distributed in the entire neo-dermis and a larger presence of elaunin fibers were observed, in a similar pattern found in the intact skin. The use of CAM in cutaneous lesions boosted tissue repair since there was a smaller number of inflammatory cells and mastocytes, and an improvement in collagen deposition and collagen fibers. These results demonstrate the high potential of plasticized chitosan-alginate membrane for skin wound dressing of hyperglycemic patients.

16.
Av. enferm ; 40(1 supl. Especial Nuevo Coronavirus): 37-51, 12 de marzo de 2022.
Artículo en Portugués | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1391624

RESUMEN

Objetivo: explorar, na literatura científica, práticas atuais de cuidado de enfermagem ou intervenções para pacientes com síndrome respiratório agudo grave (SRAG) submetidos à posição prona. Síntese do conteúdo: revisão integrativa, na qual foram realizadas buscas nas bases de dados PubMed, CINAHL, Scopus, Web of Science e LILACS em setembro de 2020 e janeiro de 2022, sem recorte temporal, por meio da questão deste estudo: "Quais são os cuidados de enfermagem para pacientes com SRAG submetidos à posição prona?". Foram selecionados 15 artigos, a partir da busca nas bases de dados. Após a leitura, os cuidados encontrados foram categorizados em alinhamento do corpo para a prevenção de lesões neuromusculares, cuidados com equipamentos diversos, cuidados tegumentares e recomendações neurológicas. Conclusões: o enfermeiro deve ter conhecimento sobre as implicações e as complicações de se manter um paciente na posição prona. Tal conhecimento permitirá tomadas de decisões na construção ou no seguimento de protocolos institucionais que contribuam com a prevenção de riscos e resultem em melhores desfechos para o paciente.


Objetivo: explorar dentro de la literatura científica las prácticas o intervenciones actuales del cuidado de enfermería para los pacientes con síndrome respiratorio agudo grave (SRAG) sometidos a la posición de decúbito prono. Síntesis de contenido: revisión integradora mediante búsquedas en las bases de datos Pubmed, CINAHL, Scopus, Web of Science y LILACS, entre septiembre de 2020 y enero de 2022, sin recorte temporal, a través de la pregunta: ¿cuáles son los cuidados de enfermería para los pacientes con SRAS sometidos a la posición de decúbito prono? En total, se seleccionaron 15 artículos tras la búsqueda en bases. Tras la lectura de estos documentos, se observó que los cuidados identificados se podían categorizar en lineación corporal para prevenir lesiones neuromusculares, cuidados con equipos diversos, cuidados cutáneos y recomendaciones neurológicas. Conclusiones: el profesional de enfermería debe conocer las implicaciones y complicaciones de mantener a los pacientes en decúbito prono. Este conocimiento permitirá tomar decisiones para la construcción o el seguimiento de protocolos institucionales que contribuyan a la prevención de riesgos y generen mejores resultados para el paciente.


Objective: To explore within scientific literature the current nursing care practices or interventions for patients with severe acute respiratory syndrome (SARS) submitted to prone positioning. Content synthesis: Integrative review carried out in Pubmed, CINAHL, Scopus, Web of Science and LILACS databases from September 2020 to January 2022, with no time cutting, addressing the question: What are the nursing care practices for patients with SARS and placed under prone positioning? A total of 15 articles were selected from the database search. After analysis, it was observed that the care provided by nursing professionals could be categorized in body alignment to prevent neuromuscular injuries, care with various equipment, cutaneous care, and neurological recommendations. Conclusions: Nurses must acknowledge the implications and complications of keeping a patient in the prone position. Such awareness will allow decision making in the development or follow-up of institutional protocols that contribute to risk prevention and that will result in better outcomes for patients.


Asunto(s)
Humanos , Posición Prona , Síndrome Respiratorio Agudo Grave , Atención de Enfermería
17.
Online braz. j. nurs. (Online) ; Online braz. j. nurs. (Online);21(supl.2): e20226569, 21 janeiro 2022. tab
Artículo en Inglés, Español, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1400273

RESUMEN

OBJETIVO: avaliar a incidência de lesão por pressão na posição prona e seus fatores de risco em pacientes admitidos em unidades de terapia intensiva diagnosticados com COVID-19. MÉTODO: trata-se de um estudo de coorte prospectiva (n=30) com duração de seis meses. Informações relacionadas a estado da prona, tempo de duração, presença ou ausência de lesão por pressão e características sociodemográficas e clínicas foram coletadas. Estatística descritiva e inferencial foi realizada para comparar os pacientes que desenvolveram e os que não desenvolveram lesão por pressão. Para análise dos dados, foi utilizada Regressão de Poisson com variância robusta. RESULTADOS: o tempo médio na posição prona foi de 20,1 horas (DP=3,9). A incidência de lesão por pressão foi de 70%, sendo as localizações mais comuns: tórax esquerdo, abdômen, bochechas e testa. Ao comparar os grupos com e sem lesão por pressão, não houve diferença entre eles (p>0,05). CONCLUSÃO: a incidência não foi associada a nenhuma variável sociodemográfica ou clínica dos pacientes.


OBJECTIVE: this study aimed to assess the incidence of prone-positioning pressure sores and its risk factors in patients admitted to intensive care units diagnosed with COVID-19. METHOD: a six-month follow-up prospective cohort study (n=30) was conducted. Information regarding proning status, duration of prone position (PP), presence or absence of PPPS, and sociodemographic and clinical variables were collected. Descriptive and inferential statistics were performed to compare the patients who developed or did not develop pressure sores. Poisson regression with robust variance was used for data analysis. RESULTS: the mean PP time was 20.1 hours (SD=3.9). The incidence of PPPS was 70%, with the most common locations being the left chest, abdomen, cheek, and forehead. When comparing the groups with and without prone-positioning pressure sores, there was no difference between them (p>0.05). CONCLUSION: the incidence of prone-positioning pressure sores was not associated with any sociodemographic or clinical variable of the patients.


OBJETIVO: evaluar la incidencia de lesión por presión en decúbito prono y sus factores de riesgo en pacientes ingresados ​​en unidades de cuidados intensivos con diagnóstico de COVID-19. MÉTODO: se trata de un estudio de cohorte prospectivo (n=30) con una duración de seis meses. Se recolectó información relacionada con el decúbito prono, tiempo de duración, presencia o ausencia de lesión por presión y características sociodemográficas y clínicas. Se realizó estadística descriptiva e inferencial para comparar pacientes que desarrollaron y no desarrollaron lesiones por presión. Para el análisis de datos se empleó la regresión de Poisson con varianza robusta. RESULTADOS: el tiempo medio en decúbito prono fue 20,1 horas (DE=3,9). La incidencia de lesiones fue 70%, siendo las localizaciones más frecuentes: tórax izquierdo, abdomen, mejillas y frente. Al comparar los grupos, no hubo diferencia (p>0,05). CONCLUSIÓN: la incidencia no se asoció con ninguna variable sociodemográfica o clínica de los pacientes.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Posición Prona , Úlcera por Presión , COVID-19 , Factores de Riesgo , Pacientes Internos , Unidades de Cuidados Intensivos
18.
Online braz. j. nurs. (Online) ; 21: e20226592, 01 jan 2022. tab
Artículo en Inglés, Español, Portugués | BDENF - Enfermería, LILACS | ID: biblio-1412151

RESUMEN

OBJETIVO: este estudo teve como objetivo analisar as atitudes, conhecimentos e interesse dos estudantes de saúde em relação à geriatria e gerontologia e avaliar suas associações. MÉTODO: participaram do estudo 225 estudantes do último ano dos cursos de Enfermagem, Medicina, Fonoaudiologia, Farmácia e Educação Física. Os questionários incluíram um formulário de características demográficas, a Escala de Diferencial Semântico de Envelhecimento e Questionário Palmore - Fatos sobre o envelhecimento. Foram utilizados modelos de regressão múltipla. RESULTADOS: a atitude em relação aos idosos foi negativa (50,67%) e associada ao menor interesse. O nível de conhecimento foi melhor entre os estudantes de Enfermagem, Medicina e estudantes mais velhos. O aumento do conhecimento se relacionou com a atitude e, no total, 71,43% apresentavam interesse em geriatria. O interesse esteve fortemente associado ao gênero feminino. CONCLUSÃO: os estudantes apresentaram um alto nível de conhecimento, interesse em geriatria e uma atitude negativa em relação aos cuidados geriátricos. Ações focadas na capacitação em geriatria devem ser implementadas.


OBJECTIVE: this study aimed to examine health students' attitudes, knowledge, and interest towards geriatrics and gerontology and evaluate associations. METHOD: a total of 225 students in the final year of Nursing, Medicine, Speech therapy, Pharmacy, and Physical education participated. The questionnaires included a characterization form, the Aging Semantic Differential Scale, and the Palmore Fact on Aging Quiz. Multiple regression models were used. RESULTS: the attitude towards older people was negative (50.67%) and associated with less interest. The level of knowledge was better among Nursing, Medicine, and older students. Increased knowledge was related to attitude and, in total, 71.43% were interested in geriatrics. Interest was strongly associated with female gender. CONCLUSION: students showed a high level of knowledge, interest in geriatrics, and a negative attitude towards geriatric care. Actions focused on geriatric training should be implemented.


OBJETIVO: este estudio tuvo como objetivo examinar las actitudes, los conocimientos y el interés de los estudiantes de salud hacia la geriatría y la gerontología y evaluar las asociaciones. MÉTODO: participaron un total de 225 estudiantes de los últimos años de cursos de Enfermería, Medicina, Fonoaudiología, Farmacia y Educación Física. Los cuestionarios incluían un formulario de caracterización, la Escala de Diferencial Semántico de Envejecimiento y el Cuestionario de Hechos sobre el Envejecimiento de Palmore. Se utilizaron modelos de regresión múltiple. RESULTADOS: la actitud hacia las personas mayores fue negativa (50,67%) y asociada a un menor interés. El nivel de conocimiento fue mejor entre los estudiantes de Enfermería, Medicina y de edad mayor. El aumento de conocimientos estuvo relacionado con la actitud, en total, el 71,43% estaba interesado en la geriatría. El interés estuvo fuertemente asociado con el género femenino. CONCLUSIÓN: los estudiantes mostraron un alto nivel de conocimiento, interés por la geriatría y una actitud negativa hacia la atención geriátrica. Deben implementarse acciones enfocadas a la formación geriátrica.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Estudiantes del Área de la Salud , Anciano , Selección de Profesión , Actitud , Geriatría , Envejecimiento
19.
Artículo en Portugués | LILACS | ID: biblio-1352966

RESUMEN

Patient safety.Estudo transversal. Objetivo: avaliar a sensibilidade e especificidade de sistemas de rastreamento de acesso aberto para interações medicamentosas potenciais (IMp) em comparação com o DRUG-REAX® system e analisar o impacto clínico potencial das IMp de gravidades "Contraindicada" e "Maior" não detectadas. Métodos: amostra composta por 140 pacientes em acompanhamento em um ambulatório especializado no atendimento a pessoas com doenças crônicas não transmissíveis (DCNT) de um hospital universitário. As IMp foram identificadas e classificadas no DRUG-REAX® System e em oito sistemas de rastreamento de acesso aberto. As IMp de gravidade "Contraindicada" e "Maior" foram analisadas segundo o impacto clínico. Utilizou-se estatística descritiva e calculou-se sensibilidade e especificidade dos sistemas de rastreamento na identificação das IMp. Resultados: Os sistemas de acesso aberto pertencentes as bases Drugs.com, UCLA School of Health e CVC Caremark apresentaram sensibilidade e especificidade > 70%. A totalidade dos sistemas de acesso aberto não detectou os pares ciprofibrato + estatinas e metformina + sitagliptina, cujos impactos clínicos incluíram risco de miopatia e rabdomiólise e hipoglicemia, respectivamente. Cerca de um terço (37,5%) dos sistemas de acesso aberto não detectou a IMp ácido acetilsalicílico + hidroclorotiazida, capaz de ocasionar nefrotoxicidade. Conclusão: A maioria dos pares de IMp integra o rol terapêutico de pacientes com DCNT e cujos impactos clínicos são tempo-dependentes. A combinação de julgamento clínico, revisão periódica do plano terapêutico e os atributos de precisão (sensibilidade e especificidade) são fundamentais para garantir a segurança do paciente, sobretudo no contexto ambulatorial. (AU)


This study aims to evaluate the sensitivity and specificity of open-access screening systems in detecting potential drug-drug interactions (PDDIs) compared to the DRUG-REAX® system and analyze the potential clinical impact of PDDIs of "Contraindicated" and "Major" severities not detected. A cross-sectional study was conducted in an outpatient clinic specialized in caring for patients with noncommunicable diseases (NCDs) of a university hospital. PDDIs were identified and classified in the DRUG-REAX® System and eight open-access screening systems. The "Contraindicated" and "Major" severity PDDIs were analyzed according to clinical impact. Descriptive statistics were used and the sensitivity and specificity of the screening systems were calculated to identify the PDDIs. Results: The open-access systems Drugs.com, UCLA School of Health and CVC Caremark showed sensitivity and specificity > 70%. All open access systems did not detect the pairs ciprofibrate + statins and metformin + sitagliptin, whose clinical impacts included the risk of myopathy/ rhabdomyolysis and hypoglycemia, respectively. About a third (37.5%) of open-access systems did not detect PDDI acetylsalicylic acid + hydrochlorothiazide, which is capable of causing nephrotoxicity. Conclusion: Most pairs of PDDIs are part of the therapeutic role of patients with NCDs and whose clinical impacts are time-dependent. The combination of clinical judgment, periodic review of the therapeutic plan and the attributes of precision (sensitivity and specificity) are essential to ensure patient safety, especially in the outpatient setting. (AU)


Asunto(s)
Tamizaje Masivo , Acceso a la Información , Interacciones Farmacológicas , Seguridad del Paciente , Enfermedades no Transmisibles , Hospitales Universitarios
20.
PLoS One ; 16(10): e0259134, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34699564

RESUMEN

Epidermal growth factor (EGF) promotes cell growth, proliferation, and survival in numerous tissues. Piperonylic acid, a metabolite present in peppers (Piper nigrum L. and Piper longum L.), can bind to the epidermal growth factor receptor (EGFR) and induce an intracellular signaling cascade leading to the transcription of genes responsible for these actions, especially in keratinocytes. These cells are fundamental in maintaining cutaneous homeostasis and are the first to be damaged in the case of a wound. Thus, we hypothesized that piperonylic acid improves wound healing. C57BL6/J male mice were submitted to dorsal skin wounds caused by a 6 mm punch and treated topically with piperonylic acid or vehicle. The wounds were evaluated macro- and microscopically, and tissue samples were collected for immunofluorescence and real-time PCR analyses on days 6, 9 and 19 post-injury. Topical piperonylic acid improved wound healing from day 6 post-injury until closure. This phenomenon apparently occurred through EGFR activation. In addition, piperonylic acid modulated the gene expression of interleukin (Il)-6, il-1ß, tumor necrosis factor (Tnf)-α, il-10, monocyte chemoattractant protein (Mcp)-1 and insulin-like growth factor (Igf)-1, which are important for the healing process. By day 19 post-injury, the new tissue showed greater deposition of type I collagen and a morphology closer to intact skin, with more dermal papillae and hair follicles. We conclude that piperonylic acid may be a viable option for the treatment of skin wounds.


Asunto(s)
Benzoatos/administración & dosificación , Colágeno/metabolismo , Inflamación/metabolismo , Piel/efectos de los fármacos , Cicatrización de Heridas/efectos de los fármacos , Animales , Citocinas/metabolismo , Queratinocitos/efectos de los fármacos , Queratinocitos/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Piel/metabolismo
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