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OBJECTIVE: to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services. METHOD: a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents. RESULTS: 229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate. FINAL CONSIDERATIONS: nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
Assuntos
Saúde do Adolescente , Saúde da Criança , Saúde Mental , Adolescente , Criança , Humanos , Emoções , Papel do Profissional de Enfermagem , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Enfermagem , Transtornos Mentais/enfermagemRESUMO
Objetivo: evaluar la capacidad de los Centros de Atención Psicosocial de Alcohol y Otras Drogas 24 horas para manejar situaciones de crisis de las personas que consumen AOD en la atención integral. Método: estudio cuantitativo, evaluativo y longitudinal, realizado de febrero a noviembre de 2019. La muestra inicial estuvo compuesta por 121 personas que consumen AOD, que recibieron atención integral en situaciones de crisis en dos Centros de Atención Psicosocial para Alcohol y Otras Drogas 24 horas en el centro de São Paulo. Los mismos fueron reevaluados después de 14 días de atención. La capacidad para manejar la crisis se evaluó mediante un indicador validado. Los datos se analizaron utilizando estadísticas descriptivas y modelos de regresión de efectos mixtos. Resultados: sesenta y siete personas que consumen AOD completaron el follow-up (54,9%). Durante la atención de las situaciones de crisis, nueve personas que consumen AOD (13,4%; p=0,470) fueron derivadas a otros servicios de la red de salud: siete por complicaciones clínicas, una por intento de suicidio y una por hospitalización psiquiátrica. La capacidad de los servicios para manejar situaciones de crisis fue del 86,6%, fue considerada positiva. Conclusión: los dos servicios evaluados fueron capaces de manejar situaciones de crisis en su área de influencia, evitando internaciones y contando con el apoyo de la red cuando fue necesario, logrando así los objetivos de desinstitucionalización.
Objective: to assess the ability of 24-hour Psychosocial Care Centers specialized in Alcohol and Other Drugs to handle the users' crises in comprehensive care. Method: a quantitative, evaluative, and longitudinal study was conducted from February to November 2019. The initial sample consisted of 121 users, who were part of the comprehensibly care in crises by two 24-hour Psychosocial Care Centers specialized in Alcohol and other Drugs in downtown São Paulo. These users were re-evaluated 14 days after admission. The ability to handle the crisis was assessed using a validated indicator. The data were analyzed using descriptive statistics and regression of mixed-effects models. Results: 67 users (54.9%) finished the follow-up period. During crises, nine users (13.4%; p=0.470) were referred to other services from the health network: seven due to clinical complications, one due to a suicide attempt, and another for psychiatric hospitalization. The ability to handle the crisis in the services was 86.6%, which was evaluated as positive. Conclusion: both of the services analyzed were able to handle crises in their territory, avoiding hospitalizations and enjoying network support when necessary, thus achieving the de-institutionalization objectives.
Objetivo: avaliar a capacidade dos Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas em manejar situações de crise dos usuários no acolhimento integral. Método: estudo quantitativo, avaliativo e longitudinal, realizado de fevereiro a novembro de 2019. A amostra inicial foi composta por 121 usuários, acolhidos integralmente em situações de crise por dois Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas do centro de São Paulo. Estes foram reavaliados após 14 dias de acolhimento. A capacidade de manejar a crise foi avaliada por um indicador validado. Os dados foram analisados por estatística descritiva e por regressão de modelos de efeitos mistos. Resultados: sessenta e sete usuários concluíram o follow-up (54,9%). Durante o acolhimento às situações de crise, nove usuários (13,4%; p=0,470) foram encaminhados para outros serviços da rede de saúde: sete por complicações clínicas, um por tentativa de suicídio e um para internação psiquiátrica. A capacidade de manejo das situações de crise pelos serviços foi de 86,6%, avaliada como positiva. Conclusão: os dois serviços avaliados foram capazes de manejar situações de crise no próprio território, evitando internações e tendo apoio da rede quando necessário, atingindo assim, os objetivos da desinstitucionalização.
Assuntos
Humanos , Brasil , Estudos Longitudinais , Transtornos Relacionados ao Uso de Substâncias/terapia , Intervenção em Crise , Reabilitação Psiquiátrica , Hospitais PsiquiátricosRESUMO
OBJECTIVE: (1) To our knowledge, this is the first study to evaluate CAPS AD's ability to handle crises. (2) The ability to handle crises of the CAPS AD from downtown São Paulo was 86.6%. (3) Of the nine users referred to other services, only one evolved to hospitalization. to assess the ability of 24-hour Psychosocial Care Centers specialized in Alcohol and Other Drugs to handle the users' crises in comprehensive care. METHOD: a quantitative, evaluative, and longitudinal study was conducted from February to November 2019. The initial sample consisted of 121 users, who were part of the comprehensibly care in crises by two 24-hour Psychosocial Care Centers specialized in Alcohol and other Drugs in downtown São Paulo. These users were re-evaluated 14 days after admission. The ability to handle the crisis was assessed using a validated indicator. The data were analyzed using descriptive statistics and regression of mixed-effects models. RESULTS: 67 users (54.9%) finished the follow-up period. During crises, nine users (13.4%; p=0.470) were referred to other services from the health network: seven due to clinical complications, one due to a suicide attempt, and another for psychiatric hospitalization. The ability to handle the crisis in the services was 86.6%, which was evaluated as positive. CONCLUSION: both of the services analyzed were able to handle crises in their territory, avoiding hospitalizations and enjoying network support when necessary, thus achieving the de-institutionalization objectives.
Assuntos
Reabilitação Psiquiátrica , Humanos , Estudos Longitudinais , Brasil , HospitalizaçãoRESUMO
ABSTRACT Objective: to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services. Method: a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents. Results: 229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate. Final considerations: nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
RESUMEN Objetivo: sintetizar evidencia de estudios cualitativos sobre experiencias de enfermería en la atención a la salud mental de niños y adolescentes en servicios especializados. Método: revisión sistemática, con metasíntesis de estudios cualitativos, según directrices del JBI. Se utilizaron las bases de datos CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus y Web of Science. Los hallazgos se clasificaron según el nivel de confiabilidad y credibilidad, y se categorizaron según la similitud entre los contenidos. Resultados: se identificaron 229 artículos, cinco de los cuales fueron incluidos en la muestra final y organizados en categorías: Impacto emocional; y Comprender el papel de la enfermería. El nivel de evidencia encontrado fue moderado. Consideraciones finales: las experiencias de enfermería están permeadas por agotamiento emocional, sentimientos de frustración y dificultad para comprender su lugar profesional. Se destaca la necesidad de espacios de formación que cualifiquen esta atención.
RESUMO Objetivo: sintetizar as evidências de estudos qualitativos sobre as experiências da enfermagem frente ao cuidado em saúde mental infantojuvenil em serviços especializados. Método: revisão sistemática, com metassíntese de estudos qualitativos, segundo as diretrizes do JBI. Utilizaram-se as bases de dados CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus e Web of Science. Os achados foram classificados segundo o nível de confiabilidade e credibilidade, e categorizados pela similaridade entre os conteúdos. Resultados: 229 artigos foram identificados, e cinco foram incluídos na amostra final e organizados nas categorias: Impacto emocional; e Compreensão do papel da enfermagem. O nível de evidência encontrado foi moderado. Considerações finais: as experiências da enfermagem são permeadas por desgaste emocional, sentimento de frustração e dificuldade de compreender o seu lugar profissional. Destaca-se a necessidade de espaços formativos que qualifiquem este cuidado.
RESUMO
CONTEXT: (-)-6,6'-Dinitrohinokinin (DNHK) display remarkable antiparasitic activity and was, therefore, incorporated into a nanoparticle formulation. OBJECTIVE: Incorporation of DNHK in poly lactic-co-glycolic acid (PLGA) nanoparticles aiming to improve its biological activities. MATERIALS AND METHODS: Synthesis, characterization and incorporation of DNHK into glycolic acid (PLGA) nanoparticles by nanoprecipitation method. The nanoparticles were characterized by ultraviolet-visible spectroscopy, X-ray diffraction, field emission electron microscopic scanning mansoni (FESEM), and dynamic light scattering (DLS). For the in vitro test with Schistosoma mansoni, the DNHK-loaded PLGA was diluted into the medium, and added at concentrations 10-200 µM to the culture medium containing one adult worm pair. The parasites were kept for 120 h and monitored every 24 h to evaluate their general condition, including: pairing, alterations in motor activity and mortality. RESULTS: The loaded PLGA nanoparticles gave an encapsulation efficiency of 42.2% and showed spherical characteristics in monodisperse polymeric matrix. The adult worm pairs were separated after 120 h of incubation for concentrations higher than 50 µM of DNHK-loaded PLGA. The groups incubated with 150 and 200 µM of DNHK-loaded PLGA for 24 and 120 h killed 100% of adult worms, afforded LC50 values of 137.0 ± 2.12 µM and 79.01 ± 1.90 µM, respectively, which was similar to the effect displayed by 10 µM of praziquantel. DISCUSSION AND CONCLUSIONS: The incorporation of DNHK-loaded showed schistosomicidal activity and allowed its sustained release. The loaded PLGA system can be administered intravenously, as well as it may be internalized by endocytosis by the target organisms.
Assuntos
4-Butirolactona/análogos & derivados , Benzodioxóis/administração & dosagem , Ácido Láctico/administração & dosagem , Lignanas/administração & dosagem , Nanopartículas/administração & dosagem , Ácido Poliglicólico/administração & dosagem , Schistosoma mansoni/efeitos dos fármacos , Esquistossomicidas/administração & dosagem , 4-Butirolactona/administração & dosagem , 4-Butirolactona/química , Animais , Benzodioxóis/química , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/química , Feminino , Ácido Láctico/química , Lignanas/química , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Nanopartículas/química , Tamanho da Partícula , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Schistosoma mansoni/fisiologia , Esquistossomicidas/química , Caramujos , Difração de Raios XRESUMO
UNLABELLED: Epidemiological data from oral squamous cell carcinoma (OSCC) is mostly derived from North American, European and East Asian populations. OBJECTIVE: The aim of this study was to report the demographic and clinicopathological features from OSCC diagnosed in an Oral Pathology service in southeastern Brazil in an 8-year period. MATERIAL AND METHODS: All OSCC diagnosed from 2005 to 2012 were reviewed, including histological analysis of all hematoxylin and eosin stained slides and review of all demographic and clinical information from the laboratory records. RESULTS: A total of 346 OSCC was retrieved and males represented 67% of the sample. Mean age of the patients was 62.3 years-old and females were affected a decade older than males (p<0.001). Mean time of complaint with the tumors was 10 months and site distribution showed that the border of the tongue (37%), alveolar mucosa/gingiva (20%) and floor of mouth/ventral tongue (19%) were the most common affected sites. Mean size of the tumors was 3.4 cm, with no differences for males and females (p=0.091) and males reported both tobacco and alcohol consumption more frequently than females. Histological grade of the tumors revealed that 27%, 40% and 21% of the tumors were, respectively, classified as well-, moderately- and poorly-differentiated OSCC, 26 cases (7.5%) were microinvasive OSCC and 17 cases were OSCC variants. OSCC in males mostly affected the border of tongue, floor of mouth/ventral tongue and alveolar mucosa/gingival, while they were more frequent on the border of tongue, alveolar mucosa/gingival and buccal mucosa/buccal sulcus in females (p=0.004). CONCLUSIONS: The present data reflect the epidemiological characteristics of OSCC diagnosed in a public Oral Pathology laboratory in southeastern Brazil and have highlighted several differences in clinicopathological features when comparing male and female OSCC-affected patients.
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Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Gradação de Tumores , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Carga TumoralRESUMO
Epidemiological data from oral squamous cell carcinoma (OSCC) is mostly derived from North American, European and East Asian populations. OBJECTIVE: The aim of this study was to report the demographic and clinicopathological features from OSCC diagnosed in an Oral Pathology service in southeastern Brazil in an 8-year period. MATERIAL AND METHODS: All OSCC diagnosed from 2005 to 2012 were reviewed, including histological analysis of all hematoxylin and eosin stained slides and review of all demographic and clinical information from the laboratory records. RESULTS: A total of 346 OSCC was retrieved and males represented 67% of the sample. Mean age of the patients was 62.3 years-old and females were affected a decade older than males (p<0.001). Mean time of complaint with the tumors was 10 months and site distribution showed that the border of the tongue (37%), alveolar mucosa/gingiva (20%) and floor of mouth/ventral tongue (19%) were the most common affected sites. Mean size of the tumors was 3.4 cm, with no differences for males and females (p=0.091) and males reported both tobacco and alcohol consumption more frequently than females. Histological grade of the tumors revealed that 27%, 40% and 21% of the tumors were, respectively, classified as well-, moderately- and poorly-differentiated OSCC, 26 cases (7.5%) were microinvasive OSCC and 17 cases were OSCC variants. OSCC in males mostly affected the border of tongue, floor of mouth/ventral tongue and alveolar mucosa/gingival, while they were more frequent on the border of tongue, alveolar mucosa/gingival and buccal mucosa/buccal sulcus in females (p=0.004). CONCLUSIONS: The present data reflect the epidemiological characteristics of OSCC diagnosed in a public Oral Pathology laboratory in southeastern Brazil and have highlighted several differences in clinicopathological features when comparing male and female OSCC-affected patients. .
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Distribuição por Idade , Brasil/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Distribuição de Qui-Quadrado , Neoplasias Bucais/epidemiologia , Gradação de Tumores , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Carga TumoralRESUMO
YVO(4):Eu(3+) phosphors have been prepared by the hydrolytic sol-gel methodology, with and without alkaline catalyst. The solid powder was obtained by reaction between yttrium III chloride and vanadium alkoxides; the europium III chloride was used as structural probe. The powder was treated at 100, 400, 600, or 800 °C for 4 h. The samples were characterized by X-ray diffraction, thermal analysis, and photoluminescence. The XRD patterns revealed YVO(4) crystalline phase formation for the sample prepared without the catalyst and heat-treated at 600 °C and for the sample prepared in the presence of ammonium as catalyst and heat-treated at 100 °C. The average nanosized crystallites were estimated by the Scherrer equation. The sample which was produced via alkaline catalysis underwent weight loss in two stages, at 100 and 400 °C, whereas the sample obtained without catalyst presented four stages of weight loss, at 150, 250, 400, and 650 °C. The excitation spectra of the samples treated at different temperatures displayed the charge transfer band (CTB) at 320 nm. PL data of all the samples revealed the characteristic transition bands arising from the (5)D(0) â (5)F(J) (J = 0, 1, 2, 3, and 4) manifolds under maximum excitation at 320, 394, and 466 nm in all cases. The (5)D(0) â (7)F(2) transition often dominates the emission spectra, indicating that the Eu(3+) ion occupies a site without inversion center. The long lifetime suggests that the matrix can be applied as phosphors. In conclusion, the sol-gel methodology is a very efficient approach for the production of phosphors at low temperature.
RESUMO
The incorporation of the curcumin into poly(lactic-co-glycolic)acid (PLGA) nanospheres by the nanoprecipitation technique, the characterization of the nanoparticles and the schistosomicidal activity of the curcumin-loaded into PLGA nanospheres were reported. The incorporation process occurred with high efficiency and the images of field-emission scanning electron microscopy (FESEM) revealed the production of spherically shaped particles. According to the dynamic light scattering measurements, the particles are nanometric and monodisperse. The curcumin-loaded PLGA nanoparticles (50 and 100 µM) caused the death of all worms and a separation between 50% and 100% of Schistosoma mansoni couples at concentrations from 30 µM. Moreover, the curcumin-loaded PLGA nanoparticles also decreased the motor activity and caused partial alterations in the tegument of adult worms. This study marks the first time that schistosomicidal activity has been reported for curcumin-loaded PLGA nanoparticles.
Assuntos
Anti-Helmínticos/farmacologia , Curcumina/farmacocinética , Portadores de Fármacos/metabolismo , Ácido Láctico/metabolismo , Nanopartículas , Ácido Poliglicólico/metabolismo , Schistosoma mansoni/efeitos dos fármacos , Animais , Anti-Helmínticos/farmacocinética , Curcumina/farmacologia , Feminino , Humanos , Locomoção/efeitos dos fármacos , Masculino , Microscopia Eletrônica , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Schistosoma mansoni/fisiologia , Schistosoma mansoni/ultraestrutura , Análise de SobrevidaRESUMO
Porphyrins are currently used in photodynamic therapy as photosensitizers. In this paper we studied the interaction of two charged porphyrins, 5, 10, 15, 20-mesotetrakis(N-metyl-4-pyridyl) porphyrin, (TMPyP/chloride salt) cationic, and 5, 10, 15, 20-meso-tetrakis(sulfonatophenyl) porphyrin, (TPPS4/sodium salt) anionic, nanoassembled in phospholipid Langmuir monolayers and Langmuir-Blodgett films. Furthermore, we used chitosan to mediate the interaction between the porphyrins and the model membrane, aiming to understand the role of the polysaccharide in a molecular level. The effect of the interaction of the photosensitizers on the fluidity of the lipid monolayer was investigated by using dilatational surface elasticity. We also used photoluminescence (PL) spectroscopy to identify the porphyrins adsorbed in the phospholipid films. We observed an expansion of the monolayer promoted by the adsorption of the porphyrins into the lipid-air interface which was more pronounced in the case of TMPyP, as a consequence of a strong electrostatic interaction with the anionic monolayer. The chitosan promoted a higher adsorption of the porphyrins on the phospholipid monolayers and enabled the porphyrin to stay in its monomeric form (as confirmed by PL spectroscopy), thus demonstrating that chitosan can be pointed out as a potential photosensitizer delivery system in photodynamic therapy.
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Adesivos/química , Quitosana/química , Adsorção , Sistemas de Liberação de Medicamentos , Membranas Artificiais , Nanotecnologia , Fosfatidilgliceróis/química , Fosfolipídeos/química , Fotoquimioterapia , Fármacos Fotossensibilizantes/administração & dosagem , Fármacos Fotossensibilizantes/química , Porfirinas/química , Eletricidade EstáticaRESUMO
BACKGROUND AND OBJECTIVES: Job's syndrome (JS), one of the presentations of the Hyper IgE Syndrome, is a rare immunodeficiency. It includes cutaneous abscesses, recurring pneumonias, pneumatoceles, eosinophilia, hyperimmunoglobulinemia E (> 2,000 IU.mL(-1)), and craniofacial and bone growth changes. This report describes the disease and its anesthetic management. CASE REPORT: The patient is a 13 year old black male, 40 kg, ASA II, with Job's Syndrome diagnosed 6 months prior to this admission. The patient was admitted for elongation of the right femur. He denied use of drugs and prior surgeries; he presented good cervical mobility, interincisive distance greater than 3 cm, Mallampati II, without signs of infection. Preoperative exams were within normal limits. He was monitored with electrocardioscope, SpO(2), non-invasive blood pressure, and P(ET)CO(2). After pre-oxygenation, general anesthesia was induced and he was maintained with sevoflurane. At the end of the procedure, the patient was extubated after reversal of the neuromuscular blockade, and the patient was transferred to the PACU with Aldrete 9, He was discharged from the hospital 72 hours later, without complications. CONCLUSIONS: The choice of anesthetic technique is guided by rigorous observation among risks and benefits for each patient, according to respiratory sequelae, risk of infection, and surgical site. In the patient described here, we considered that neuroaxis anesthesia could be associated with an increased risk of severe infections due to the patient immunologic background. The procedure was safely performed with general anesthesia.
Assuntos
Anestesia , Síndrome de Job , Adolescente , Alongamento Ósseo , Humanos , MasculinoRESUMO
No fully effective treatment has been developed since the discovery of Chagas' disease. Since drug-resistant Trypanosoma cruzi strains are occurring and the current therapy is effective in the acute phase but with various adverse side effects, more studies are needed to characterize the susceptibility of T. cruzi to new drugs. Pre-mRNA maturation in trypanosomatids occurs through a process called trans-splicing, which is unusual RNA processing reaction, and it implies the processing of polycistronic transcription units into individual mRNAs; a short transcript spliced leader (SL RNA) is trans-spliced to the acceptor pre-mRNA, giving origin to the mature mRNA. Cubebin derivatives seem to provide treatments with less collateral effects than benznidazole and showed similar or better trypanocidal activities than benznidazole. Therefore, the cubebin derivatives ((-)-6,6'-dinitrohinokinin (DNH) and (-)-hinokinin (HQ)) interference in the mRNA processing was evaluated using T. cruzi permeable cells (Y and BOL (Bolivia) strains) following by RNase protection reaction. These substances seem to intervene in any step of the RNA transcription, promoting alterations in the RNA synthesis, even though the RNA processing mechanism still occurs. Furthermore, HQ presented better activity against the parasites than DNH, meaning that BOL strain seems to be more resistant than Y.
Assuntos
Antiprotozoários/farmacologia , Lignanas/farmacologia , RNA Mensageiro/metabolismo , Trans-Splicing/efeitos dos fármacos , Trypanosoma cruzi/efeitos dos fármacos , Antiprotozoários/síntese química , Lignanas/síntese químicaRESUMO
JUSTIFICATIVA E OBJETIVOS: A síndrome de Jó (SJ) é imunodeficiência rara, uma das formas de apresentação da Síndrome hiper IgE. O quadro clínico compreende abscessos cutâneos, pneumonias de repetição, pneumatoceles, eosinofilia, hiperimunoglobulinemia E (> 2.000 UI.mL-1), alterações craniofaciais e de crescimento ósseo. O relato descreve a doença e seu manuseio anestésico. RELATO DO CASO: Paciente masculino, negro, 13 anos, 40 kg, ASA II, com Síndrome de Jó diagnosticada aos 6 meses. Foi admitido para realização de alongamento de fêmur direito. Negava uso de medicamentos e não tinha antecedentes cirúrgicos, boa mobilidade cervical, distância interincisivos superior a 3 cm, Mallampati II e sem sinais de infecção. Os exames pré-operatórios eram normais. Foi monitorado com eletrocardioscópio, SpO2, PANI e P ET CO2. Após pré-oxigenação, realizou-se indução de anestesia geral venosa e manutenção com sevoflurano. Ao término do procedimento, o paciente foi extubado após reversão do bloqueio neuromuscular e encaminhado para a sala de RPA com Aldrete 9. Teve alta hospitalar após 72 horas, sem complicações. CONCLUSÕES: A opção da técnica anestésica é orientada pela observação criteriosa entre os riscos e benefícios específicos para cada paciente, de acordo com as sequelas respiratórias e o risco de infecção e sítio cirúrgico. No paciente em questão, havia a consideração de que a anestesia em neuroeixo poderia representar, pela predisposição de base imunológica, risco aumentado de infecções graves. O presente caso foi realizado de forma segura com anestesia geral.
BACKGROUND AND OBJECTIVES: Job's syndrome (JS), one of the presentations of the Hyper IgE Syndrome, is a rare immunodeficiency. It includes cutaneous abscesses, recurring pneumonias, pneumatoceles, eosinophilia, hyperimmunoglobulinemia E (> 2,000 IU.mL-1), and craniofacial and bone growth changes. This report describes the disease and its anesthetic management. CASE REPORT: The patient is a 13 year old black male, 40 kg, ASA II, with Job's Syndrome diagnosed 6 months prior to this admission. The patient was admitted for elongation of the right femur. He denied use of drugs and prior surgeries; he presented good cervical mobility, interincisive distance greater than 3 cm, Mallampati II, without signs of infection. Preoperative exams were within normal limits. He was monitored with electrocardioscope, SpO2, non-invasive blood pressure, and P ET CO2. After pre-oxygenation, general anesthesia was induced and he was maintained with sevoflurane. At the end of the procedure, the patient was extubated after reversal of the neuromuscular blockade, and the patient was transferred to the PACU with Aldrete 9, He was discharged from the hospital 72 hours later, without complications. CONCLUSIONS: The choice of anesthetic technique is guided by rigorous observation among risks and benefits for each patient, according to respiratory sequelae, risk of infection, and surgical site. In the patient described here, we considered that neuroaxis anesthesia could be associated with an increased risk of severe infections due to the patient immunologic background. The procedure was safely performed with general anesthesia.
JUSTIFICATIVA Y OBJETIVOS: El síndrome de Job (SJ) es una inmunodeficiencia rara, una de las formas de presentación del Síndrome hiper IgE. El cuadro clínico comprende abscesos cutáneos, neumonías de repetición, neumatoceles, eosinofilia, hiperinmunoglobulinemia E (> 2.000 UI.mL-1), alteraciones craneofaciales y de crecimiento óseo. El relato describe la enfermedad y su manejo anestésico. RELATO DEL CASO: Paciente masculino, negro, de 13 años, 40 kg, ASA II, con el Síndrome de Job diagnosticado a los 6 meses. Se le admitió para la realización de estiramiento del fémur derecho. Negaba el uso de medicamentos y no tenía antecedentes quirúrgicos, una buena movilidad cervical, una distancia interincisivos superior a los 3 cm, Mallampati II y tampoco tenía señales de infección. Los exámenes preoperatorios fueron normales. Fue monitorizado con electrocardioscopio, SpO2, PANI y PETCO2. Después de la preoxigenación se procedió a la inducción de anestesia general venosa y al mantenimiento con sevoflurano. Al finalizar el procedimiento, el paciente fue extubado después de la reversión del bloqueo neuromuscular y fue derivado a la sala de RPA con Aldrete 9. Tuvo su alta a las 72 horas, sin complicaciones. CONCLUSIONES: La opción de la técnica anestésica está orientada por la observación de un riguroso criterio entre los riesgos y beneficios específicos para cada paciente, de acuerdo con las secuelas respiratorias y con el riesgo de infección y el sitio quirúrgico. En el paciente en cuestión, se consideraba que la anestesia en el neuro eje podría representar, por la predisposición de base inmunológica, un riesgo aumentado de infecciones graves. El presente caso fue realizado de forma segura con anestesia general.
Assuntos
Adolescente , Humanos , Masculino , Anestesia , Síndrome de Job , Alongamento ÓsseoRESUMO
This is an article in which we discuss the concept of the care according to the perspective of the philosophy, linking with the practice of the nurses, who appropriates themselves of this concept to substantiate their professional practice. We defend that a way to look after with ethics can be carried out when the professional call upon the partners of the HIV/AIDS infected patients. We believe that this moment is very delicate and deserves to be argued and to be institutionalized by the professional team that carries out the specialized attendance in HIV/AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida , Busca de Comunicante , Parceiros Sexuais , Síndrome da Imunodeficiência Adquirida/enfermagem , Brasil , Infecções por HIV/enfermagem , História da Enfermagem , História do Século XX , Humanos , Filosofia MédicaRESUMO
This article analyzes the performance of the professionals who accompany HIV/aids carrier in the direction to identify which its behavior is face the communication or not of the seropositivity of the patient to its sexual partner in a public service of reference in HIV/aids of the city of Fortaleza, Ceará State. The study is of exploratory character with qualitative boarding. The participants of the study were the health professionals of the institution that was accompanying HIV/aids carrier. The collection of the data was made through a half-structuralized interview. The discussions of the data had been made through the Analysis of Content, being possible to identify that the professionals live deeply personal and institutional difficulties, and that they do not feel supported by the institution in relation to the convocation of partners. In this direction, the creation of a protocol for the convocation of the sexual partners becomes necessary.
Assuntos
Atitude do Pessoal de Saúde , Busca de Comunicante , Soropositividade para HIV , Parceiros Sexuais , Sorodiagnóstico da AIDS , Síndrome da Imunodeficiência Adquirida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Trata-se de um artigo no qual discutimos o conceito do cuidado na perspectiva da filosofia, articulando-o com a prática do enfermeiro, que se apropria desse conceito para fundamentar sua prática profissional. Defendemos que uma maneira de cuidar com ética pode ser realizada na convocação dos parceiros de portadores do HIV/aids. Acreditamos que esse momento é de grande delicadeza e merece ser discutido e institucionalizado pela equipe interdisciplinar que realiza atendimento especializado em HIV/aids.
This is an article in which we discuss the concept of the care according to the perspective of the philosophy, linking with the practice of the nurses, who appropriates themselves of this concept to substantiate their professional practice. We defend that a way to look after with ethics can be carried out when the professional call upon the partners of the HIV/AIDS infected patients. We believe that this moment is very delicate and deserves to be argued and to be institutionalized by the professional team that carries out the specialized attendance in HIV/AIDS.
Assuntos
História do Século XX , Humanos , Síndrome da Imunodeficiência Adquirida , Busca de Comunicante , Parceiros Sexuais , Síndrome da Imunodeficiência Adquirida/enfermagem , Brasil , Infecções por HIV/enfermagem , História da Enfermagem , Filosofia MédicaRESUMO
Este artigo analisa a atuação dos profissionais que realizam o acompanhamento ao portador do HIV/aids no sentido de identificar qual é a sua conduta frente à comunicação ou não da soropositividade do paciente ao seu parceiro sexual no Hospital São José de Doenças Infecciosas, localizado no município de Fortaleza (CE). O estudo é de caráter exploratório com abordagem qualitativa. Participaram do estudo os profissionais de saúde da própria instituição que realizavam acompanhamento ambulatorial ao portador do HIV/aids. A coleta dos dados foi feita através de uma entrevista semiestruturada. As discussões dos dados foram feitas através da análise de conteúdo, sendo possível identificar que os profissionais vivenciam dificuldades pessoais e institucionais e que não se sentem amparados pela instituição em relação à convocação de parceiros. Nesse sentido, faz-se necessária a criação de um protocolo para a convocação dos parceiros sexuais.
This article analyzes the performance of the professionals who accompany HIV/aids carrier in the direction to identify which its behavior is face the communication or not of the seropositivity of the patient to its sexual partner in a public service of reference in HIV/aids of the city of Fortaleza, Ceará State. The study is of exploratory character with qualitative boarding. The participants of the study were the health professionals of the institution that was accompanying HIV/aids carrier. The collection of the data was made through a half-structuralized interview. The discussions of the data had been made through the Analysis of Content, being possible to identify that the professionals live deeply personal and institutional difficulties, and that they do not feel supported by the institution in relation to the convocation of partners. In this direction, the creation of a protocol for the convocation of the sexual partners becomes necessary.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Busca de Comunicante , Soropositividade para HIV , Parceiros Sexuais , Sorodiagnóstico da AIDS , Síndrome da Imunodeficiência AdquiridaRESUMO
Photophysical properties of porphyrins in aqueous solutions are strongly affected by aggregation. One possible solution to this problem is to encapsulate the porphyrin into polymeric spheres, to provide an environment where the photosensitizer can be administered in its monomeric form in such treatments as photodynamic therapy. Here we report the microencapsulation of the meso-tetrakis(4-sulphonatophenyl) porphyrin (TPPS(4)) photosensitizer by the ultrasonic spray-drying technique. The encapsulated TPPS(4) was morphologically characterized by scanning electron microscopy, and its photophysical properties were studied and compared with those of a physical blend of dextrin and TPPS(4). We successfully encapsulated TPPS(4) into dextrin microspheres, and the encapsulated photosensitizer displays higher luminescence intensity than that of the prepared physical blends.
Assuntos
Dextrinas/química , Fotoquimioterapia/métodos , Porfirinas/química , Físico-Química/métodos , Dessecação , Composição de Medicamentos , Luz , Luminescência , Proteínas Luminescentes/química , Microscopia Eletrônica de Varredura , Microesferas , Modelos Moleculares , Fotoquímica/métodos , Fármacos Fotossensibilizantes/químicaRESUMO
O estudo analisa a produção científica da atuação de enfermagem na atenção sistemática às famílias de pessoas com transtorno mental mediante análise de periódicos científicos indexados e publicados em bibliotecas universitárias, no sistema de banco de dados MEDLINE, LILACS e SCIELO no período de 2000 a 2005. A pesquisa é de natureza bibliográfica baseada nos pressupostos da análise de Pimentel, a qual considera o levantamento do material, análise de conteúdo com elaboração detemáticas buscando realizar contrapontos entre os diversos autores. Os resultados demonstraram o aumento do número de pesquisas que abordam a participação da família no cuidado terapêutico da pessoa com transtorno mental severo, enfatizam condutas e percepções das famílias e dos profissionais acerca do tratamento e alertam para a promoção da inserção social da família, compreensão das necessidades e promoção da participação da família nos problemas de saúde.
Assuntos
Cuidados de Enfermagem , Enfermagem Psiquiátrica , Saúde Mental , FamíliaRESUMO
The spray drying method was used to prepare luminescent microspheres. These microspheres were prepared by spraying an aqueous solution of dextrin and an europium(III) complex with subsequent drying in a hot medium. The spray dried powder was characterized by scanning electron microscopy (SEM) and photoluminescence spectroscopy (PL). Particle size distribution was estimated from SEM images. The ultrasonic spray drying technique was successfully applied to yield a microparticulated and red luminescent powder composed by the [Eu(dpa)(3)](3-) (dpa = dipicolinic acid) complex incorporated in dextrin microspheres.