Assistência de Enfermagem em Crianças com Leishmaniose Visceral: Revisão Integrativa.

Visceral Leishmaniasis is characterized as a disease of serious public health problem in Brazil and worldwide, popularly known as calazar, identified by long-lasting fever, asthenia, anemia, weight loss, among other clinical manifestations. When not properly treated, the individual dies. Therefore, the objective of this study is to describe the nursing attributions in the cases of children affected by visceral leishmaniasis. The integrative literature review was developed through articles found in the following databases: Lilacs; Scielo, PubMed; BVS-BIREME, and BDENF, considering the time frame of the last 10 years. After applying the eligibility criteria, ten studies were found for analysis. As a result, it was observed that the nursing process is characterized by the interrelationship and dynamism of each step. The implementation of this assistance is an indispensable procedure both for early detection of children with visceral leishmaniasis and for rehabilitation. Thus, patient care involves dialogue, humanized care, multidisciplinary service provision, focusing not only on curative assistance, but also to develop educational actions.A Leishmaniose Visceral caracteriza-se por ser uma doença de grave problema para saúde pública no Brasil e no mundo, popularmente conhecida como calazar, identificada por febre de longa duração, astenia, anemia, perda de peso, dentre outras manifestações clínicas. Quando não tratada adequadamente leva o indivíduo ao óbito. Para tanto, o objetivo deste trabalho, consiste em descrever as atribuições da enfermagem frente aos casos de crianças acometidas por leishmaniose visceral. A revisão integrativa da literatura foi desenvolvida através de artigos alcançados nas bases de dados: Lilacs; Scielo, PubMed; BVS-BIREME, e BDENF, considerando o recorte temporal dos últimos 10 anos. Diante da aplicação dos critérios de elegibilidades, encontraram-se dez estudos para análise. Como resultado, observou-se que o processo de enfermagem é caracterizado pelo inter-relacionamento e dinamismo de cada etapa. A implementação dessa assistência faz-se um procedimento imprescindível tanto para detecção precoce de crianças com leishmaniose visceral quanto para a reabilitação. Assim, o cuidado com o paciente envolve diálogo, atendimento humanizado, prestação de serviço multidisciplinar, com foco não apenas na assistência curativa, mas também, o desenvolvimento de ações educativas

O papel do enfermeiro no tratamento dos transtornos alimentares: Revisão integrativa.

Eating disorders are worrying pathologies that are related to eating behavior and the main eating disorders are: anorexia and bulimia. The treatment of these eating disorders contains a great challenge for nurses, because it is important that they have knowledge and dedication to treatments, where the prognosis is given due to an early diagnosis. The study proposed to develop a review about eating disorders, emphasizing the role of nursing. Having as objective the importance of nursing in the treatment of patients with eating disorders. This is a study carried out through a bibliographical survey, with the purpose of performing an integrative review in the following databases: LILACS, BVS-BIREME, MEDLINE and BDENF. In this context, the present study found that it is fundamental that nurses first need to recognize the severity of the problem before establishing strategies so that those affected by eating disorders do not need to resort to hospital services when the condition is already critical and that nurses are able to guide and conduct high quality and efficient clinical follow-up to patients and their families, focusing on establishing bonds of trust, emotional support and guidance on the pathology and its physical consequences.Os transtornos alimentares são patologias preocupantes, que estão relacionados ao comportamento alimentar e os principais transtornos alimentares são: anorexia e a bulimia. O tratamento desses transtornos alimentares contém um grande desafio para o enfermeiro, pois é importante que o mesmo possua conhecimentos e se dedique diante dos tratamentos, onde o prognóstico se dá em razão um diagnóstico precoce. O estudo se propôs a desenvolver uma revisão sobre transtornos alimentares, dando ênfase ao papel da enfermagem. Tendo como objetivo a importância da enfermagem frente ao tratamento de pacientes com transtornos alimentares. Tratando de um estudo realizado por meio de levantamento bibliográfico, com o propósito de realizar uma revisão integrativa nas bases de dados: LILACS, BVS-BIREME, MEDLINE E BDENF como critérios de inclusão foram utilizados artigos disponíveis na íntegra, em idioma português, inglês e espanhol e como critérios de exclusão artigos que não abordaram a temática estudada. Neste contexto o presente estudo constatou que é fundamental que os enfermeiros precisaram em primeiro lugar reconhecer a gravidade do problema antes de estabelecer estratégias para que aqueles acometidos pelos transtornos alimentares não precisassem recorrer aos serviços hospitalares quando o quadro já se encontra crítico e que o enfermeiro esteja apto para orientar e conduzir o acompanhamento clínico de alta qualidade e eficiência ao paciente e seus familiares, com foco no estabelecimento de vínculos de confiança, suporte emocional e orientação sobre patologia e suas consequências físicas

A violência sexual contra crianças e adolescentes: atuação do enfermeiro em sua prática profissional.

The sexual barbarity faced in childhood is identified as an obstacle in public health and a factor that causes numerous complications in the personal, family and social life of the victim; covering psychological, legal, social aspects causing traumas for the entire experience. Nursing is of utmost importance in preventive and educational actions, as well as in the suspicion of what has happened. Therefore, the article aims to identify sexual violence against children and adolescents, recognizing the role of nurses in their professional practice. This is an integrative bibliographic analysis with a qualitative approach, through bibliographic searches in the bases of BVS-BIREME, LILACS, SciELO and BDENF, and analysis of studies published in full, from 2017 to 2022, free in Portuguese, English and Spanish, which have in their title the health descriptors related to the theme. The research used for the preparation of this article demonstrate the assistance and care of nurses aimed at victims, describing their attributions and interventions in professional practice as well as possible complications and related diagnoses. It is concluded that nursing has an incisive role in the detection of such occurrences. However, to implement an effective performance and offer an adequate and efficient service, nurses must be trained for this purpose.A barbaridade sexual enfrentada na infância é identificada como um obstáculo na saúde pública e um fator que ocasiona inúmeras complicações na vida pessoal, familiar e social da vítima; abrangendo aspectos psicológicos legais, sociais ocasionando traumas para toda vivência. A enfermagem é de suma importância nas ações preventivas, educativas e da suspeita do ocorrido. Portanto, o artigo objetiva identificar a violência sexual contra crianças e adolescentes, reconhecendo a atuação do enfermeiro na sua prática profissional. Discorre de uma análise bibliográfica integrativa com abordagem qualitativa, por intermédio de buscas bibliográficas referentes nas bases da BVS-BIREME, LILACS, SciELO e BDENF, e análise dos estudos publicados na íntegra, de 2017 a 2022, gratuitos na língua portuguesa, inglesa e espanhola, que tem em seu título os descritores em saúde relacionados à temática. As pesquisas utilizadas para a elaboração deste artigo demonstram a assistência e os cuidados do enfermeiro voltado às vítimas, descrevendo as suas atribuições e intervenções no exercício profissional bem como possíveis complicações e diagnósticos relacionados. Conclui-se que a enfermagem tem um papel incisivo na detecção de tais ocorrências. Contudo, para implementação de uma atuação eficaz e ofertar um serviço adequado e eficiente, o enfermeiro deve capacitar-se para essa finalidade

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030