Atuação do enfermeiro nos cuidados à criança autista: revisão integrativa da literatura

Objetivou-se em descrever a atuação e o preparo dos enfermeiros nos cuidados à criança autista. Trata-se de um estudo descritivo, do tipo revisão integrativa da literatura (RIL), sobre a atuação do enfermeiro frente aos cuidados com a criança autista, a coleta de dados ocorreu em novembro de 2022. Foram utilizadas as bases eletrônicas de dados da Biblioteca Virtual em Saúde (BVS), nas bases de dados do Centro Latino-Americano e do Caribe de Informações em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), IBECS e MEDLINE. Foram identificados 297 artigos e, depois de aplicados os critérios de seleção, foram selecionados (7) artigos para composição do estudo. Concluiu-se que a atuação do enfermeiro está baseada em evidências científicas, sendo demonstrada em literaturas de abrangência nacional e internacional. O enfermeiro é um profissional de linha de frente, possuindo habilidades e competência para promover a assistência em saúde em diversos campos de prática à criança autista. Entretanto, através dos estudos observou-se que muitos profissionais de enfermagem possuem pouco conhecimento, medo e despreparo em relação aos cuidados com a criança com TEA. Para isso, torna-se imprescindível a formação desde a graduação e a capacitação frequentemente desses profissionais através de treinamentos e educação continuada sobre os cuidados à criança autista, seja na atenção básica, hospitalar, em escolas ou na comunidade em geral. O mesmo precisa reconhecer e acolher de forma holística a essa criança e de seus cuidadores, para que além de favorecer o vínculo possibilita também uma assistência em saúde funcional e plausível

BCL3-rearrangements in B-cell lymphoid neoplasms occur in two breakpoint clusters associated with different diseases

The t(14;19)(q32;q13) often juxtaposes BCL3 with IGH resulting in overexpression of the gene. In contrast to other oncogenic translocations, BCL3-rearrangement (BCL3-R) has been associated with a broad spectrum of lymphoid neoplasms. Here we report an integrative whole-genome sequence, transcriptomic, and DNA methylation analysis of 13 lymphoid neoplasms with BCL3-R. The resolution of the breakpoints at single base-pair revealed that they occur in two clusters at 5' (n=9) and 3' (n=4) regions of BCL3 associated with two different biological and clinical entities. Both breakpoints were mediated by aberrant class switch recombination of the IGH locus. However, the 5' breakpoints (upstream) juxtaposed BCL3 next to an IGH enhancer leading to overexpression of the gene whereas the 3' breakpoints (downstream) positioned BCL3 outside the influence of the IGH and were not associated with its expression. Upstream BCL3-R tumors had unmutated IGHV, trisomy 12, and mutated genes frequently seen in CLL but had an atypical CLL morphology, immunophenotype, DNA methylome, and expression profile that differ from conventional CLL. In contrast, downstream BCL3-R neoplasms were atypical splenic or nodal marginal zone lymphomas (MZL) with mutated IGHV, complex karyotypes and mutated genes typical of MZL. Two of the latter 4 tumors transformed to a large B-cell lymphoma. We designed a novel FISH assay that recognizes the two different breakpoints and validated these findings in 17 independent tumors. Overall, upstream or downstream breakpoints of BCL3-R are mainly associated with two subtypes of lymphoid neoplasms with different (epi)genomic, expression, and clinicopathological features resembling atypical CLL and MZL, respectively

BCL3-rearrangements in B-cell lymphoid neoplasms occur in two breakpoint clusters associated with different diseases

The t(14;19)(q32;q13) often juxtaposes BCL3 with immunoglobulin heavy chain (IGH) resulting in overexpression of the gene. In contrast to other oncogenic translocations, BCL3 rearrangement (BCL3-R) has been associated with a broad spectrum of lymphoid neoplasms. Here we report an integrative whole-genome sequence, transcriptomic, and DNA methylation analysis of 13 lymphoid neoplasms with BCL3-R. The resolution of the breakpoints at single base-pair revealed that they occur in two clusters at 5' (n=9) and 3' (n=4) regions of BCL3 associated with two different biological and clinical entities. Both breakpoints were mediated by aberrant class switch recombination of the IGH locus. However, the 5' breakpoints (upstream) juxtaposed BCL3 next to an IGH enhancer leading to overexpression of the gene whereas the 3' breakpoints (downstream) positioned BCL3 outside the influence of the IGH and were not associated with its expression. Upstream BCL3-R tumors had unmutated IGHV, trisomy 12, and mutated genes frequently seen in chronic lymphocytic leukemia (CLL) but had an atypical CLL morphology, immunophenotype, DNA methylome, and expression profile that differ from conventional CLL. In contrast, downstream BCL3-R neoplasms were atypical splenic or nodal marginal zone lymphomas (MZL) with mutated IGHV, complex karyotypes and mutated genes typical of MZL. Two of the latter four tumors transformed to a large B-cell lymphoma. We designed a novel fluorescence in situ hybridization assay that recognizes the two different breakpoints and validated these findings in 17 independent tumors. Overall, upstream or downstream breakpoints of BCL3-R are mainly associated with two subtypes of lymphoid neoplasms with different (epi)genomic, expression, and clinicopathological features resembling atypical CLL and MZL, respectively

Avaliação de aspectos clínicos e nutricionais em obesos em pré e pós-operatório de cirurgia bariátrica em um hospital universitário de João Pessoa-PB

Evaluation of clinical and nutritional aspects in obeses before and after bariatric surgery at the University from João Pessoa-PBThis study aimed to evaluate the clinical and nutritional aspects in morbidly obese before and after bariatric surgery at the University Hospital Lauro Wanderley (HULW). Therefore, it was evaluated the family history, weight, nutritional status, BMI, waist circumference, index waist-hip ratio, and body fat percentage, biochemical data, comorbidities, physical activity, number of consultations and multidisciplinary care. Furthermore, we evaluated only postoperatively, aspects such as weight loss, percent of weight loss and it’s over. 31 individuals participated in this study, with 18 participants were assessed using repeated measures pre-and postoperative. All participants were morbidly obese patients preoperatively, and postoperatively the majority were obese grade II (44.4%). Bariatric surgery has promoted changes in anthropometric measurements occurring a percentage of excessive weight loss of 66.04% through a weight loss of 26.71%. Biochemical data showed normality in most elements investigated, which favors a better metabolic control and consequently fewer complications in the short and long term. Bariatric surgery has promoted improvements in several physiological parameters of these individuals through monitoring by a multidisciplinary team active.Este estudo se propôs a avaliar os aspectos clínico-nutricionais em obesos mórbidos em pré e pós-operatório de cirurgia bariátrica do Hospital Universitário Lauro Wanderley (HULW). Para tanto, avaliaram-se o histórico familiar, peso, estado nutricional, IMC, circunferência da cintura, de índices de razão cintura-quadril, e de porcentagem de gordura corporal, dados bioquímicos, comorbidades, realização de atividade física, número de consultas e o acompanhamento multiprofissional. Além disso, avaliaram-se, apenas no pós-operatório, aspectos como a perda ponderal, percentual de perda de peso e de seu excesso. Participaram desse estudo 31 indivíduos, sendo que 18 participantes foram avaliados por meio de medidas repetidas pré e pós-operatórias. Todos os participantes eram obesos mórbidos no pré-operatório, sendo que no pós-operatório a maioria era composta por obesos de grau II (44,4%). A cirurgia bariátrica promoveu alterações das medidas antropométricas ocorrendo um percentual de perda excessiva de peso de 66,04% por meio de uma perda ponderal de 26,71%. Os dados bioquímicos demonstraram normalidade na maioria dos elementos investigados, o que favorece um melhor controle metabólico e consequentemente menos complicações a curto e em longo prazo. A cirurgia bariátrica promoveu melhoras em diversos parâmetros fisiológicos destes indivíduos através do acompanhamento por uma equipe multiprofissional atuante.

Avaliação de aspectos clínicos e nutricionais em obesos em pré e pós-operatório de cirurgia bariátrica em um hospital universitário de João Pessoa-PB

Este estudo se propôs a avaliar os aspectos clínico-nutricionais em obesos mórbidos em pré e pós-operatório de cirurgia bariátrica do Hospital Universitário Lauro Wanderley (HULW). Para tanto, avaliaram-se o histórico familiar, peso, estado nutricional, IMC, circunferência da cintura, de índices de razão cintura-quadril, e de porcentagem de gordura corporal, dados bioquímicos, comorbidades, realização de atividade física, número de consultas e o acompanhamento multiprofissional. Além disso, avaliaram-se, apenas no pós-operatório, aspectos como a perda ponderal, percentual de perda de peso e de seu excesso. Participaram desse estudo 31 indivíduos, sendo que 18 participantes foram avaliados por meio de medidas repetidas pré e pós-operatórias. Todos os participantes eram obesos mórbidos no pré-operatório, sendo que no pós-operatório a maioria era composta por obesos de grau II (44,4%). A cirurgia bariátrica promoveu alterações das medidas antropométricas ocorrendo um percentual de perda excessiva de peso de 66,04% por meio de uma perda ponderal de 26,71%. Os dados bioquímicos demonstraram normalidade na maioria dos elementos investigados, o que favorece um melhor controle metabólico e consequentemente menos complicações a curto e em longo prazo. A cirurgia bariátrica promoveu melhoras em diversos parâmetros fisiológicos destes indivíduos através do acompanhamento por uma equipe multiprofissional atuante. ABSTRACT Evaluation of clinical and nutritional aspects in obeses before and after bariatric surgery at the University from João Pessoa-PBThis study aimed to evaluate the clinical and nutritional aspects in morbidly obese before and after bariatric surgery at the University Hospital Lauro Wanderley (HULW). Therefore, it was evaluated the family history, weight, nutritional status, BMI, waist circumference, index waist-hip ratio, and body fat percentage, biochemical data, comorbidities, physical activity, number of consultations and multidisciplinary care. Furthermore, we evaluated only postoperatively, aspects such as weight loss, percent of weight loss and it’s over. 31 individuals participated in this study, with 18 participants were assessed using repeated measures pre-and postoperative. All participants were morbidly obese patients preoperatively, and postoperatively the majority were obese grade II (44.4%). Bariatric surgery has promoted changes in anthropometric measurements occurring a percentage of excessive weight loss of 66.04% through a weight loss of 26.71%. Biochemical data showed normality in most elements investigated, which favors a better metabolic control and consequently fewer complications in the short and long term. Bariatric surgery has promoted improvements in several physiological parameters of these individuals through monitoring by a multidisciplinary team active

Lipoma espinhal associado a seio dérmico congênito: relato de caso

Os lipomas espinhais são raros, respondendo por 1% de todos os tumores espinhais, estando associados ao disrafismo espinhal oculto em mais de 99% dos casos. Estão divididos em três tipos principais: lipomielomeningocele, lipoma intradural e fibrolipoma do filo terminal. Este relato descreve um caso de lipoma lombossacral congênito associado a estigma cutâneo do tipo seio dérmico lombar congênito

BCL3 rearrangements in B-cell lymphoid neoplasms occur in two breakpoint clusters associated with different diseases

The t(14;19)(q32;q13) often juxtaposes BCL3 with immunoglobulin heavy chain (IGH) resulting in overexpression of the gene. In contrast to other oncogenic translocations, BCL3 rearrangement (BCL3-R) has been associated with a broad spectrum of lymphoid neoplasms. Here we report an integrative whole-genome sequence, transcriptomic, and DNA methylation analysis of 13 lymphoid neoplasms with BCL3-R. The resolution of the breakpoints at single base-pair revealed that they occur in two clusters at 5' (n=9) and 3' (n=4) regions of BCL3 associated with two different biological and clinical entities. Both breakpoints were mediated by aberrant class switch recombination of the IGH locus. However, the 5' breakpoints (upstream) juxtaposed BCL3 next to an IGH enhancer leading to overexpression of the gene whereas the 3' breakpoints (downstream) positioned BCL3 outside the influence of the IGH and were not associated with its expression. Upstream BCL3-R tumors had unmutated IGHV, trisomy 12, and mutated genes frequently seen in chronic lymphocytic leukemia (CLL) but had an atypical CLL morphology, immunophenotype, DNA methylome, and expression profile that differ from conventional CLL. In contrast, downstream BCL3-R neoplasms were atypical splenic or nodal marginal zone lymphomas (MZL) with mutated IGHV, complex karyotypes and mutated genes typical of MZL. Two of the latter four tumors transformed to a large B-cell lymphoma. We designed a novel fluorescence in situ hybridization assay that recognizes the two different breakpoints and validated these findings in 17 independent tumors. Overall, upstream or downstream breakpoints of BCL3-R are mainly associated with two subtypes of lymphoid neoplasms with different (epi)genomic, expression, and clinicopathological features resembling atypical CLL and MZL, respectively