Novas diretrizes da ressuscitação cardiopulmonar

Cardiopulmonary arrest (CPA) poses a severe threat to life; cardiopulmonary resuscitation (CPR) represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on the 2005 Guidelines by the American Heart Association (AHA). These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR). High-quality basic and advanced CPR maneuvers can save lives.A parada cardiorrespiratória (PCR) é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP) representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA). Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR). As manobras básicas e avançadas de RCP com qualidade podem salvar vidas.La parada cardiorrespiratoria (PCR) es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP) representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionales sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA). Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR). Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas

Aspiração endotraqueal em pacientes adultos com via aérea artificial: revisão sistemática

OBJETIVO: identificar e analisar evidências oriundas de ensaios clínicos controlados e randomizados sobre os cuidados relacionados à aspiração de secreções endotraqueais em pacientes adultos, em estado crítico, intubados e sob ventilação mecânica. MÉTODO: a busca foi realizada nas bases de dados Pubmed, Embase, Central, Cinahl e Lilacs. Das 631 referências encontradas, 17 estudos foram selecionados. RESULTADOS: identificaram-se evidências quanto a seis categorias de intervenções relacionadas à aspiração endotraqueal, as quais foram analisadas segundo desfechos referentes a alterações hemodinâmicas e dos gases sanguíneos, colonização microbiana, infecção nosocomial, dentre outros. RESULTADOS: as evidências obtidas são relevantes para a prática da aspiração endotraqueal, entretanto, os riscos de viés dos estudos selecionados comprometem a sua confiabilidade.OBJETIVO: identificar y analizar evidencias oriundas de ensayos clínicos controlados y hechos aleatorios sobre las atenciones relacionados a la aspiración de secreciones endotraqueales en pacientes adultos, en estado crítico, intubados y bajo ventilación mecánica. MÉTODO: la busca fue realizada en las bases de datos PUBMED, EMBASE, CENTRAL, CINAHL y LILACS. De las 631 referencias encontradas, 17 estudios fueron seleccionados. RESULTADOS: se identificaron evidencias en cuanto a seis categorías de intervenciones relacionadas a la aspiración endotraqueal, las cuales fueron analizadas según los resultados referentes a alteraciones hemodinámicas y de los gases sanguíneos, colonización microbiana, infección nosocomial, entre otros. RESULTADOS: las evidencias logradas son relevantes para la práctica de la aspiración endotraqueal, mientras, los riesgos de bies de los estudios seleccionados comprometen su confiabilidad.AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability

Diagnósticos de enfermagem em vítimas de trauma atendidas em um serviço pré- hospitalar avançado móvel

O serviço de atendimento pré-hospitalar móvel de urgência presta atendimento a toda e qualquer solicitação de ajuda fora do âmbito hospitalar visando a manutenção da vida e minimização de sequelas, exigindo do enfermeiro conhecimentos e habilidades específicas. Este estudo teve como objetivo identificar os diagnósticos de enfermagem em vítimas de trauma atendidas em um Serviço Avançado Móvel de Urgência (SAMU) do interior do estado de São Paulo. Foi elaborado e validado um instrumento de coleta de dados, segundo o modelo conceitual de Horta; os dados coletados foram validados por peritos na temática. O projeto foi aprovado por Comitê de Ética e Pesquisa. Foram avaliadas 23 vítimas de trauma, sendo 17 (73,9%) homens, 16 (69,5%) com idade entre 18 e 30 anos e 14 (60,1%) vítimas de acidentes de transito. Os diagnósticos de enfermagem mais frequentes foram: Risco para infecção (91%), Risco para trauma (82%), Dor aguda (74%), Integridade tissular prejudicada (65%), Volume de líquidos deficiente (43%) e Risco para volume de líquido deficiente (43%). Este estudo permitiu identificar os principais diagnósticos de enfermagem nesta clientela específica, os quais poderão fornecer importantes subsídios para futuras investigações, sobretudo abordando intervenções de enfermagem

Indicators species of saflufenacil residue in soils

Um dos métodos, eficientes e de baixo custo, para estimar a presença de herbicidas no solo é o biológico. Entretanto, antes de se utilizar este método é necessário identificar espécies que apresentam alta sensibilidade ao herbicida em estudo. Esta pesquisa teve como objetivo selecionar espécies que apresentem alta sensibilidade ao saflufenacil para posteriores estudos da dinâmica desse herbicida no solo. Foram avaliadas a sensibilidade de sete espécies de plantas ao saflufenacil (Curcubita pepo, Beta vulgaris, Daucus carota, Citrullus lanatus, Cucumis sativus, Sorghum bicolor e Solanum lycopersicum). Para isso, estas espécies foram cultivadas em substrato inerte (areia lavada) tratado com doses crescentes do saflufenacil (0,0; 0,625; 1,25; 2,50; 5,0; 10,0 e 20,0 g ha-1). As espécies B. vulgaris, S. lycopersicum e S. bicolor foram as mais sensíveis ao saflufenacil. Dentre estas espécies, B. vulgaris é de fácil cultivo, crescimento rápido e permite rápida visualização dos sintomas de intoxicação. Concluiu-se que B. vulgaris pode ser considerada como indicadora da presença do saflufenacil na solução do solo para estudos da dinâmica desse herbicida em solos.One of the methods, efficient and low cost, to estimate the presence of herbicides in the soil is the biological. However, before using this method it is necessary to identify species that have high sensitivity to the herbicide under controlled conditions. This research aimed to select species that show high sensitivity to saflufenacil for later studies of the dynamics of this herbicide in soil. The sensitivity of seven plants species to saflufenacil (Curcubita pepo, Beta vulgaris, Daucus carota, Citrullus lanatus, Cucumis sativus, Sorghum bicolor and Solanum lycopersicum) were evaluated. For this, these species were cultivated on an inert substrate (washed sand) treated with increasing doses of saflufenacil (0.0, 0.625, 1.25, 2.50, 5.0, 10.0 and 20.0 g ha-1). The species B. vulgaris, S. lycopersicum and S. bicolor were the most sensitive to saflufenacil. Among these species, B. vulgaris is easy to grow, fast growing and allows rapid visualization of the symptoms of intoxication. It was concluded that B. vulgaris can be considered as an indicator of the presence of saflufenacil in the soil solution to study the dynamics of this herbicide in soils

Aspiración endotraqueal en pacientes adultos con veía aérea artificial: revisión sistemática

AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability

Photobiomodulation reduces the cytokine storm syndrome associated with Covid-19 in the zebrafish model

Although the exact mechanism of the pathogenesis of COVID-19 is not fully understood, oxidative stress and the release of pro-inflammatory cytokines have been highlighted as playing a vital role in the pathogenesis of the disease. In this sense, alternative treatments are needed to reduce the inflammation caused by COVID-19. Therefore, this study aimed to investigate the potential effect of red PBM as an attractive therapy to downregulate the cytokine storm caused by COVID-19 from a zebrafish model. RT-PCR analyses and protein-protein interaction prediction among SARS-CoV-2 and Danio rerio proteins showed that rSpike was responsible for generating systemic inflammatory processes with significantly increased pro-inflammatory (il1b, il6, tnfa, and nfkbiab), oxidative stress (romo1) and energy metabolism (slc2a1a, coa1) mRNA markers, with a pattern like those observed in COVID-19 cases in humans. On the other hand, PBM treatment decreased the mRNA levels of these pro-inflammatory and oxidative stress markers compared with rSpike in various tissues, promoting an anti-inflammatory response. Conversely, PBM promotes cellular and tissue repair of injured tissues and significantly increases the survival rate of rSpike-inoculated individuals. Additionally, metabolomics analysis showed that the most impacted metabolic pathways between PBM and the rSpike-treated groups were related to steroid metabolism, immune system, and lipids metabolism. Together, our findings suggest that the inflammatory process is an incisive feature of COVID-19, and red PBM can be used as a novel therapeutic agent for COVID-19 by regulating the inflammatory response. Nevertheless, the need for more clinical trials remains, and there is a significant gap to overcome before clinical trials.publishedVersio

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality