A ansiedade e os sistemas de informação em enfermagem: elaboração de um catálogo CIPE®

Contexto/Objetivos: Considerando a crescente importância dos sistemas de informação de Enfermagem em Portugal, bem como a necessidade de uma prática de Enfermagem cada vez mais baseada na evidência científica, o presente trabalho tem como principal objetivo a criação de um catálogo CIPE® para um foco de Enfermagem altamente prevalente na prática clínica: a ansiedade. Metodologia: Revisão sistemática da literatura através da análise de artigos científicos presentes nas bases de dados disponibilizadas pela EBSCO Host® (1995 a 2011), SciELO® e Web of Science® (sem datas pré-definidas) relativa aos dados relevantes e intervenções de Enfermagem para o diagnóstico “Ansiedade”. Resultados: A avaliação/vigilância da angústia, inquietação, movimento corporal, sono, nervosismo e preocupação é essencial para o diagnóstico/avaliação da ansiedade. As intervenções mais efetivas são, sobretudo, as intervenções psicoterapêuticas. A utilização de um instrumento psicométrico permite avaliar, de forma mais objetiva, os progressos realizados pela pessoa com ansiedade. Conclusões: A elaboração de catálogos CIPE® permite o desenvolvimento dos sistemas de informação de Enfermagem (SIE), constituindo ainda o caminho para uma prática de Enfermagem cada vez mais baseada na evidência científica. Ainda assim, seria fundamental, em termos de progresso, que os SIE acompanhassem a evolução que se tem vindo a verificar ao nível da linguagem classificada

Risk Factors for Active Asthma at School Age: an 8-Year Prospective Study

A sibilância recorrente na infância é uma entidade clínica prevalente e heterogénea do pontode vista da história natural e do prognóstico. Efectuou-se um estudo prospectivo com 8 anos de duração, com o objectivo de relacionar a evolução clínica da sibilância recorrente nos primeiros anos de vida, com factores de prognóstico associados com a persistência da sintomatologia. Uma coorte de 308 crianças com sibilância recorrente, com idade ≤6 anos, foi incluída no estudo em 1993. Foi aplicado um questionário clínico, realizados testes cutâneos por prick e efectuado doseamento sérico de IgE total. Em 1996 procedeu-se a uma primeira reavaliação sistemática destas crianças. Em 2001 foi efectuada nova reavaliação sistemática, possível em 81% destas crianças (n=249), com repetição dos testes cutâneos e realização de avaliação funcional respiratória,em período intercrise, com espirometria com prova de broncodilatação (BD). As crianças reavaliadas apresentavam média etária de 11 anos (8-14 anos) e relação sexo M/F de 1.7/1. Permaneciam sintomáticas em 61% dos casos. A prevalência de atopia foi de 48% em 1993, 65% em 1996 e 75% em 2001. Pela realização de um modelo de regressão logística múltiplo foram identificados como factores de risco para asma activa em idade escolar: história pessoal de rinite alérgica (OR=15.8, IC95%=6.1-40.8; p<0.001), asma paterna (OR=7.2, IC95%=1.7-29.7; p=0.007), história pessoal de eczema atópico (OR=5.9, IC95%=2.2-15.7; p<0.001), asma materna (OR=5.4, IC95%=1.7-17.1; p=0.004), evidência de sensibilização alergénica (OR=3.4, IC95%=1.2-10.4;p=0.03) e início dos sintomas ≥2 anos de idade (OR=2.1, IC95%=1.1-4.8; p=0.04); a frequência de infantário antes dos 12 meses de idade foi identificada como factor protector (OR=0.4, IC95%=0.2- 0.9; p=0.04). Desenvolveram sensibilização alergénica de novo (ácaros do pó >80%) 66 das 128 crianças não atópicas em 1993 (52%). Apresentavam obstrução brônquica 36% das crianças: 47% das sintomáticas e 18% das assintomáticas (p<0.001). A prova de BD foi positiva em 35%: 47% nos sintomáticos e 13% nos assintomáticos (p<0.001). Concluindo, foram identificados como factores de mau prognóstico, antecedentes pessoais de doença alérgica, história parental de asma, presença de sensibilização alergénica e início dos sintomas na segunda infância. Os sintomas clínicos podem preceder em anos a sensibilização alergénica, realçando a importância da instituição precoce de medidas de controlo ambiental. Alterações nas provas funcionais respiratórias, mais frequentes nas asmas activas, estavam também presentes em crianças actualmente sem clínica, reforçando a necessidade de valorizar marcadores objectivos nesta cada vez mais prevalente doença respiratória crónica

Expertise differences in anticipatory judgements during a temporally and spatially occluded dynamic task

There is contradictory evidence surrounding the role of critical cues in the successful anticipation of penalty kick outcome. In the current study, skilled and less-skilled soccer goalkeepers were required to anticipate spatially (full body; hip region) and temporally (–160 ms, –80 ms before, foot–ball contact) occluded penalty kicks. The skilled group outperformed the less-skilled group in all conditions. Both groups performed better in the full body, compared to hip region condition. Later temporal occlusion conditions were associated with increased performance in the correct response and correct side analysis, but not for correct height. These data suggest that there is enough postural information from the hip region for skilled goalkeepers to make highly accurate predictions of penalty kick direction, however, other regions are needed in order to make predictions of height. These data demonstrate the evolution of cues over time and have implications for anticipation training

A prospective study of nutrition education and oral nutritional supplementation in patients with Alzheimer's disease

<p>Abstract</p> <p>Background</p> <p>Weight loss in patients with Alzheimer's disease (AD) is a common clinical manifestation that may have clinical significance.</p> <p>Objectives</p> <p>To evaluate if there is a difference between nutrition education and oral nutritional supplementation on nutritional status in patients with AD.</p> <p>Methods</p> <p>A randomized, prospective 6-month study which enrolled 90 subjects with probable AD aged 65 years or older divided into 3 groups: Control Group (CG) [n = 27], Education Group (EG) [n = 25], which participated in an education program and Supplementation Group (SG) [n = 26], which received two daily servings of oral nutritional supplementation. Subjects were assessed for anthropometric data (weight, height, BMI, TSF, AC and AMC), biochemical data (total protein, albumin, and total lymphocyte count), CDR (Clinical Dementia Rating), MMSE (Mini-mental state examination), as well as dependence during meals.</p> <p>Results</p> <p>The SG showed a significant improvement in the following anthropometric measurements: weight (H calc = 22.12, p =< 0.001), BMI (H calc = 22.12, p =< 0.001), AC (H calc = 12.99, p =< 0.002), and AMC (H calc = 8.67, p =< 0.013) compared to the CG and EG. BMI of the EG was significantly greater compared to the CG. There were significant changes in total protein (H calc = 6.17, p =< 0.046), and total lymphocyte count in the SG compared to the other groups (H cal = 7.94, p = 0.019).</p> <p>Conclusion</p> <p>Oral nutritional supplementation is more effective compared to nutrition education in improving nutritional status.</p

Bio-coloration of bacterial cellulose assisted by immobilized laccase

In this work a process for the bio-coloration of bacterial cellulose (BC) membranes was developed. Laccase from Myceliophthora thermophila was immobilized onto BC membranes and retained up to 88% of residual activity after immobilization. Four compounds belonging to the flavonoids family were chosen to test the in situ polymerase activity of immobilized laccase. All the flavonoids were successfully polymerized by laccase giving rise to yellow, orange and dark brown oligomers which conferred color to the BC support. The optimal bio-coloration conditions were studied for two of the tested flavonoids, catechol and catechin, by varying the concentration and time of incubation. High color depth and resistance to washing were obtained for both compounds. The highly porous bacterial cellulose material demonstrated great performance as a bio-coloration support, in contrast to other materials cited in literature, like cotton or wool. The process developed is presented as an environmentally friendly alternative for bacterial cellulose bio-coloration and will contribute deeply for the development of new fashionable products within this material.The authors would like to acknowledge Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit and COMPETE 2020 (POCI‑01‑0145‑FEDER‑006684) and BioTecNorte operation (NORTE‑01‑0145‑FEDER‑000004) funded by Euro‑ pean Regional Development Fund under the scope of Norte2020‑Programa Operacional Regional do Norte. The authors would like also to acknowl‑ edge the Basic Science Research Program through the National Research Foundation of Korea (NRF), which was funded by the Ministry of Education (2017R1D1A1B03031959).info:eu-repo/semantics/publishedVersio

Stone clearance in lower pole nephrolithiasis after extra corporeal shock wave lithotripsy – the controversy continues

BACKGROUND: To determine factors influencing the clearance of fragments after extra-corporeal shock wave lithotripsy (ESWL) for lower pole calyceal (LPC) stones. METHODS: In the period between July 1998 and Oct 2001, 100 patients with isolated lower polar calyceal calculi ≤ 20 mm, in patients aged ≥ 14 years, were included in the study. Intravenous urograms (IVU) were reviewed to define the LPC anatomy (width of the infundibulum and pelvicalyceal angle). Study end points i.e. stone free status; number of shock waves used and number of sessions were correlated with variables like LPC anatomy, body mass index and stone size. RESULTS: At three months follow up the clearance for stone size ≤ 10 mm, 11–15 mm and 16–20 mm were 95, 96 and 90% respectively. Patients with acute LPC (<90°) and obtuse angle (>90°) had stone clearance of 94 and 100% respectively. For the infundibular width of < 4 mm, the stone clearance was 93% were as for > 4 mm, it was 100%. For body mass index (BMI) less than and > 30 kg/m(2), the stone clearance was 92 and 95% respectively. CONCLUSIONS: There is a trend towards more ESWL sessions and shock wave requirement in patients with acute pelvi-calyceal angle and narrow infundibulum but it is not statistically significant. Size (≤ 20 mm) and BMI has no relation with stone clearance. With modern lithotripter, stones up to 20 mm could primarily be treated by ESWL, irrespective of an un-favorable lower polar calyceal anatomy and body habitus

Species Accumulation Curves and Incidence-Based Species Richness Estimators to Appraise the Diversity of Cultivable Yeasts from Beech Forest Soils

Background: Yeast-like fungi inhabit soils throughout all climatic zones in a great abundance. While recent estimations predicted a plethora of prokaryotic taxa in one gram of soil, similar data are lacking for fungi, especially yeasts. Methodology/Principal Findings: We assessed the diversity of soil yeasts in different forests of central Germany using cultivation-based techniques with subsequent identification based on rDNA sequence data. Based on experiments using various pre-cultivation sample treatment and different cultivation media we obtained the highest number of yeasts by analysing mixed soil samples with a single nutrient-rich medium. Additionally, several species richness estimators were applied to incidence-based data of 165 samples. All of them predicted a similar range of yeast diversity, namely 14 to 16 species. Randomized species richness curves reached saturation in all applied estimators, thus indicating that the majority of species is detected after approximately 30 to 50 samples analysed. Conclusions/Significance: In this study we demonstrate that robust species identification as well as mathematical approaches are essential to reliably estimate the sampling effort needed to describe soil yeast communities. This approach has great potential for optimisation of cultivation techniques and allows high throughput analysis in the future

Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis

We report a 14-year-old girl with juvenile dermatomyositis (JDM) complicated by severe inflammatory calcinosis successfully treated with thalidomide. She was diagnosed as JDM when she was 4 years old after a few months of increasing lethargy, muscle pain, muscle weakness, and rash. During three months, clinical manifestations and abnormal laboratory findings were effectively treated with oral prednisolone. However, calcinosis was recognized 18 months after disease onset. Generalized calcinosis rapidly progressed with high fever, multiple skin/subcutaneous inflammatory lesions, and increased level of CRP. Fifty mg/day (1.3 mg/kg day) of oral thalidomide was given for the first four weeks, and then the dose was increased to 75 mg/day. Clinical manifestations subsided, and inflammatory markers had clearly improved. Frequent high fever and local severe pain with calcinosis were suppressed. The levels of FDP-E, IgG, and tryglyceride, which were all elevated before the thalidomide treatment, were gradually returned to the normal range. Over the 18 months of observation up to the present, she has had no inflammatory calcinosis, or needed any hospitalization, although established calcium deposits still remain. Her condition became painless, less extensive and less inflammatory with the CRP level below 3.08 mg/dL. Recent examination by whole-body 18F-FDG-PET-CT over the 15 months of thalidomide treatment demonstrated fewer hot spots around the subcutaneous calcified lesions