Desenvolvimento de material que facilite a convivência e a comunicação em enfermaria pediátrica / Development of materials that facilitate living and communication in pediatric nursing

O objetivo dessa pesquisa foi criar condições para melhorar a comunicação e a convivência entre todos os atores envolvidos no processo de adoecimento relativos à internação pediátrica e de desenvolver material ilustrativo que favoreça a comunicação e as relações interpessoais além de avaliar o material produzido. A metodologia foi qualitativa, na modalidade exploratória. Para identificação dos artigos para a revisão bibliográfica da pesquisa, foram designadas as seguintes plataformas de busca: Scielo Brasil, Pepsic, Google Acadêmico e Medline, no período de 2017 a 2018. O trabalho de campo foi desenvolvido no hospital universitário Santa Lucinda em Sorocaba/ SP. O trabalho teve duas fases de coleta de dados através de entrevistas semi-dirigidas. Na primeira fase foram entrevistados profissionais de enfermagem, médicos, pacientes e seus acompanhantes, com foco na internação, na comunicação e a convivência no hospital. Na segunda fase foram entrevistados profissionais e paciente/acompanhantes avaliando a cartilha, que depois foi refeita. Observou-se na primeira fase, que as principais dificuldades de comunicação e convivência se davam entre os responsáveis das crianças e a equipe do hospital (médicos, enfermeiros e técnicos de enfermagem). Já na segunda aplicação obteve-se uma avaliação positiva do material, com poucos ajustes. A cartilha foi feita em formato de banner e colocada na enfermaria. Os pesquisados afirmam que o material ilustrativo foi útil e é necessário. Ao final do projeto observou-se que uma linguagem lúdica pode favorecer as relações na enfermaria, diminuindo o estresse na convivência, entretanto é necessário um trabalho constante para uma melhora significativa

Pediatric tuberculosis in Italian children: Epidemiological and clinical data from the Italian register of pediatric tuberculosis

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

Severe COVID-19 Complicated by Cerebral Venous Thrombosis in a Newborn Successfully Treated with Remdesivir, Glucocorticoids, and Hyperimmune Plasma

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic, affecting all age groups with a wide spectrum of clinical presentation ranging from asymptomatic to severe interstitial pneumonia, hyperinflammation, and death. Children and infants generally show a mild course of the disease, although infants have been observed to have a higher risk of hospitalization and severe outcomes. Here, we report the case of a preterm infant with a severe form of SARS-CoV-2 infection complicated by cerebral venous thrombosis successfully treated with steroids, hyperimmune plasma, and remdesivir

Importance of EEG in validating the chronic effects of drugs: suggestions from animal models of epilepsy treated with rapamycin

Purpose: The development of new drugs for the treatment of epilepsy is a major challenge for modern neurology and its first steps demand basic research. Preclinical studies on animal models of epilepsy are mainly based on the analysis of brain electrical activity to detect seizures, when they are not just limited to behavioral tests like the Racine scale.Methods: In the present review, we discuss the importance of using time-locked video and EEG recordings (Video-EEG) coupled with behavioral tests as tools to monitor and analyze the effects of anti-epileptic drugs in pre-clinical research. Particularly, we focus on the utility of a multimodal approach based on EEG/behavioral analysis to study the beneficial effects of chronic rapamycin treatment as a potential anti-epileptogenic therapy for a broad spectrum of epilepsy, including both genetic (as in tuberous sclerosis complex) and acquired diseases.Results: Changes and synchronization of neuronal activity of different areas have been correlated with specific behavior in both physiological and pathological conditions. In the epileptic brain, during a seizure there is an abnormal activation of many cells all at once, altering different networks.Conclusion: A multimodal approach based on video, EEG analysis and behavioral tests would be the best option in preclinical studies of epilepsy. (C) 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved

Abdominal Tuberculosis in Children: A Case Series of Five Patients

: Tuberculosis remains (TB) to be one of the most common causes of child morbidity and mortality. Abdominal TB is not frequently diagnosed and, although its incidence is not definitively established, there are data that seem to indicate that it accounts for approximately 1-3% of all pediatric TB cases and for no more than 10% of those with extrapulmonary manifestations. It seems, however, that abdominal TB is significantly more common than usually thought as signs and symptoms are non-specific and may mimic other diseases. The delayed or wrong diagnosis of pediatric abdominal TB can have dramatic consequences as they can lead to untreated TB with miliary dissemination, unnecessary surgery, or dangerous drug therapies. This report describes five cases of abdominal TB diagnosed among 216 pediatric patients admitted for TB in Italy from 2011 to 2021. Our cases evidence that abdominal TB is a complex and potentially very severe disease that, when not appropriately diagnosed, may be associated with severe complications and prolonged anti-TB therapy. Discussion among specialists is crucial to achieve an early diagnosis and to promptly start the anti-TB treatment. Further studies are needed to clarify the appropriate duration of therapy as well as management of MDR abdominal TB cases