Abordagem dos cuidados com o coto umbilical na atenção básica para prevenção da onfalite: relato de experiência/ Umbilical stump care approach in basic care for prevention of onphalitis: experience report

INTRODUÇÃO: Após o nascimento da criança, o cordão umbilical é clampeado e seccionado, passando a ser chamado de coto umbilical, ele necessita de vigilância e cuidados por favorecer a ocorrência de infecções; onfalite, caracterizado por sinais de inflamação local, como edema, aumento da sensibilidade e calor local. OBJETIVO: Orientar gestantes sobre cuidados preventivos de infeção e melhor tratamento a instituir para os cuidados ao coto umbilical.  METODOLOGIA: O estudo é do tipo relato de experiência, que surgiu a partir de uma oficina para 12 gestantes realizado por acadêmicos de enfermagem onde foram abordados os primeiros cuidados ao recém-nascido com ênfase no coto umbilical. RESULTADOS: O conhecimento prévio das participantes sobre a temática possibilitou o desenvolvimento teórico do curso de maneira clara e objetiva, além de proporcionar a socialização das gestantes com os cuidados apropriados com o coto umbilical onde as mesmas realizaram a técnica correta em bonecas. CONCLUSÕES: Ao não realizar a técnica correta da limpeza do coto umbilical mães e/ou cuidadores, podem contribuir com inúmeros fatores favoráveis para a proliferação de microrganismos. Algumas intervenções são consideradas seguras para a limpeza do coto umbilical entre elas lavagem das mãos, não utilização de substâncias caseiras e a limpeza diária com antisséptico álcool a 70%

Análise comparativa dos cuidados NIDCAP e convencional nas unidades de cuidados intensivos, analisando a maturação do sono de prematuro

Tese (doutorado)—Universidade de Brasilia, Faculdade de Ciências da Saúde, 2010.A privação do sono tem sido descrita como um fator de estresse nas Unidades de Cuidados Intensivos Neonatais (UCIN), e pode estar associada ao retardo na maturação e no aumento da mortalidade e outras morbidades. Em 1986, o programa NIDCAP, Programa de Avaliação e Cuidados Individualizados para o Desenvolvimento do Neonato, foi proposto com o objetivo de melhorar o cuidado hospitalar do prematuro hospitalizado em UCIN. Poucos estudos analisaram o efeito do NIDCAP no sono do prematuro, tendo ainda análises inconclusivas. O principal objetivo deste estudo é comparar o método de cuidados NIDCAP x Cuidado Convencional das UCIN, utilizando como parâmetro o desenvolvimento do sono de prematuros durante o primeiro ano de vida. Quarenta e três prematuros nascidos entre 1999 a 2003 foram selecionados para participar do estudo. Vinte e três foram submetidos aos cuidados de UCIN do Hospital da Criança de Bruxelas, formando o Grupo Convencional e vinte prematuros, que foram beneficiados com o NIDCAP no Hospital Saint Pierre, Bruxelas (Grupo de Estudo). Os dois grupos foram comparados com relação a peso de nascimento, idade gestacional e sexo. O sono dos prematuros foi avaliado no período de 35 a 86 semanas de Idade Pós Concepcional, pela análise de 103 polissonografias. Dentre os resultados, não foi verificada diferença significativa entre os dois grupos, relativo às variáveis gênero (p=0,887), idade gestacional (p=0,588), peso de nascimento (p=0,930). Na análise das variáveis do sono, não foi verificada diferença significativa com relação: Tempo Total de Sono (p=0,1374), Eficiência do Sono (p=0,3348), Densidade de Vigília (p=0,2211), Índice de Microdespertares no Sono Calmo (p=0,7699), Índice de Microdespertares no Sono Ativo (p=0,0761), Índice de Apnéias Obstrutivas (p=0,5142), Índice de Apnéias Mistas (p=0,5453), Média da Freqüência Cardíaca no Sono Ativo (p=0,2262), Média da Freqüência Cardíaca no Sono Calmo (p=0,4248), quando comparado os grupos. No entanto, houve diferença significativa para as variáveis Porcentagem do Sono Ativo (p=0,0013), Porcentagem do Sono Calmo (p=0,0012), Densidade do Sono Ativo (p=0,0105), Densidade do Sono Calmo (p=0,0023) e Índice de Microdespertares Total (p=0,0148). Estes resultados indicaram um impacto positivo do NIDCAP sobre o sono de prematuros, quando comparado ao grupo de atendimento convencional da UCIN, verificados pelo decréscimo do percentual e densidade do SA, aumento do percentual e densidade do SC, diminuição do Índice de Microdespertares Total e o ponto de cruzamento mais precoce nos valores da razão entre SA e SC. Conclui-se que o NIDCAP tem influência positiva na maturação do sono de crianças prematuras hospitalizadas em UCIN. _______________________________________________________________________________ ABSTRACTSleep deprivation has been described as a stress factor in the Neonatal Intensive Care Unit (NICU) and may be associated with the delayed maturation and increased mortality and other morbidities. In 1986, the program NIDCAP, Neonatal Individualized Development Care and Assessments Program was proposed with the aim to improve the hospital care of premature infants hospitalized in an intensive care unit. Few studies have analyzed the effect of NIDCAP on the sleep of preterm infants, but the results are still inconclusive. The main objective of this study is to compare the method of care NIDCAP x Conventional Care of NICU using as parameter the development of sleep in premature infants during the first year of life. A total of 43 children born between 1999 and 2003 participated in the study, 23 submitted to the care of NICU at Children’s Hospital of Brussels (Conventional Group) and 20 children, who were benefited from the NIDCAP Hospital Saint Pierre, Brussels (NIDCAP Group). Both groups were compared to gender, birth weight and gestational age. One hundred and three polysomnographies of these patients were analyzed from 35 to 86 weeks of Pos Conceptional Age. There was no statistical difference for the variables gender (p=0,887), birth weight (p=0,9302), Gestational Age (p=0,5880). For the sleep variables there was no statistical difference for: Total Sleep Time (p=0,1374), Sleep Efficiency (p=0,3348) Wake Density (p=0,2211), Arousal Index in Active Sleep (p=0,0761), Arousal Index in Quiet Sleep (p=0,7699), Obstructive Apnea Index (p=0,5142), Mixed Apnea Index (p=0,5453), Mean of Heart Frequency in Active Sleep (p=0,2262), Mean of Heart Frequency in Quiet Sleep (p=0,4248). However, there was significant differences for variables: Percentage of Active Sleep (p=0,0013), Percentage of Quiet Sleep (p=0,0012), Active Sleep Density (p=0,0105), Quiet Sleep Density (p=0,0023) and Total Arousal Index (p=0,0148). The results indicate a positive impact on the sleep of premature benefited from the NIDCAP care, when compared to conventional care, verified by the decrease in the percentage and density of Active Sleep, increase in the percentage and density of Quiet Sleep, decrease Arousal Index and earlier crossover point of the reason Quiet Sleep/Active Sleep. The treatment of premature infants hospitalized in an intensive care unit by NIDCAP favors an optimal maturation of sleep

Sleep deprivation, pain and prematurity: a review study

The aim was to describe current reports in the scientific literature on sleep in the intensive care environment and sleep deprivation associated with painful experiences in premature infant. A systematic search was conducted for studies on sleep, pain, premature birth and care of the newborn. Web of Knowledge, MEDLINE, LILACS, Cochrane Library, PubMed, EMBASE, Scopus, VHL and SciELO databases were consulted. The association between sleep deprivation and pain generates effects that are observed in the brain and the behavioral and physiological activity of preterm infants. Polysomnography in intensive care units and pain management in neonates allow comparison with the first year of life and term infants. We have found few references and evidence that neonatal care programs can influence sleep development and reduce the negative impact of the environment. This evidence is discussed from the perspective of how hospital intervention can improve the development of premature infants

Ag Nanoparticles/AgX (X=Cl, Br and I) Composites with Enhanced Photocatalytic Activity and Low Toxicological Effects

This is the pre-peer reviewed version of the following article: M. Assis, F. C. Groppo Filho, D. S. Pimentel, T. Robeldo, A. F. Gouveia, T. F. D. Castro, H. C. S. Fukushima, C. C. de Foggi, J. P. C. da Costa, R. C. Borra, J. Andrés, E. Longo. Ag Nanoparticles/AgX (X=Cl, Br and I) Composites with Enhanced Photocatalytic Activity and Low Toxicological Effects, which has been published in final form at https://doi.org/10.1002/slct.202000502. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Periodic structures induced by electron irradiation are a unique phenomenon when electron beams irradiate on the surface of some materials. These periodic structures have potential for technological applications. However, the fuzzy nature of the electron‐induced structuring hinders its further exploration in such applications. In this paper, novel Ag nanoparticle/AgX (X=Cl, Br and I) composites, with enhanced photocatalytic activity and low toxicological effects, were prepared, for the first time, using electron beam irradiation. The remarkable advantage of this approach is that the Ag nanoparticles/AgX composites can be easily prepared in one‐step without the need for high‐pressure conditions, surfactants, ionic liquids, or reducing agents. Furthermore, our method does not involve any toxic substances, which makes the as‐synthesized samples highly applicable for technological applications. The structure, morphology and physicochemical properties of the Ag nanoparticles/AgX composites were studied using various characterization techniques. Using first‐principles calculations based on density functional theory and the quantum theory of atoms in molecules, we reveal how the concentration of excess electrons in the AgX materials induces the formation of the Ag nanoparticles under electron beam irradiation. These results extend the fundamental understanding of the atomic process underlying the mechanism of Ag−X bond rupture observed during the transformation induced via electron irradiation of the AgX crystals by increasing the total number of electrons in the bulk structure. Thus, our findings provide viable guidance for the realization of new materials for the degradation of contaminated wastewater with low toxicity

Combined impact of hepatitis C virus genotype 1 and interleukin-6 and tumor necrosis factor-α polymorphisms on serum levels of pro-inflammatory cytokines in Brazilian HCV-infected patients

We investigated the association between hepatitis C virus (HCV) genotypes and host cytokine gene polymorphisms and serum cytokine levels in patients with chronic hepatitis C. Serum IL-6, TNF-α, IL-2, IFN-γ, IL-4, IL-10, and IL-17A levels were measured in 67 HCV patients (68.2% genotype 1 [G1]) and 47 healthy controls. The HCV patients had higher IL-6, IL-2, IFN-γ, IL-10, and IL-17A levels than the controls. HCV G1 patients had higher IL-2 and IFN-γ levels than G2 patients. The -174IL6G>. C, -308TNFαG>. A, and -1082IL10A>. G variants were similarly distributed in both groups. However, HCV patients with the -174IL6GC variant had higher IL-2 and IFN-γ levels than patients with the GG and CC variants. Additionally, HCV patients with the -308TNFαGG genotype had higher IL-17A levels than patients with the AG genotype, whereas patients with the -1082IL10GG variant had higher IL-6 levels than patients with the AA and AG variants. A significant proportion of HCV patients had high levels of both IL-2 and IFN-γ. The subgroup of HCV patients with the G1/IL6CG/TNFαGG association displayed the highest proportions of high producers of IL-2 and IFN-γ whereas the subgroup with the G1/TNFαGG profile showed high proportions of high producers of IL-6 and IL-17A. HCV patients with other HCV/cytokine genotype associations showed no particular cytokine profile. Our results suggest that HCV genotype G1 and IL-6 and TNF-α polymorphisms have a clinically relevant influence on serum pro-inflammatory cytokine profile (IL-2 and IFN-γ) in HCV patients. © 2014 American Society for Histocompatibility and Immunogenetics

The Robust and Modulated Biomarker Network Elicited by the Plasmodium vivax Infection Is Mainly Mediated by the IL-6/IL-10 Axis and Is Associated with the Parasite Load

Submitted by Nuzia Santos ([email protected]) on 2015-02-09T16:36:53Z No. of bitstreams: 1 2014_056.pdf: 2001433 bytes, checksum: f5ee8a7b58b1f7532b4e1e0b3ea10bec (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2015-02-09T16:38:53Z (GMT) No. of bitstreams: 1 2014_056.pdf: 2001433 bytes, checksum: f5ee8a7b58b1f7532b4e1e0b3ea10bec (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2015-02-09T16:50:34Z (GMT) No. of bitstreams: 1 2014_056.pdf: 2001433 bytes, checksum: f5ee8a7b58b1f7532b4e1e0b3ea10bec (MD5)Made available in DSpace on 2015-02-09T16:50:34Z (GMT). No. of bitstreams: 1 2014_056.pdf: 2001433 bytes, checksum: f5ee8a7b58b1f7532b4e1e0b3ea10bec (MD5) Previous issue date: 2014Universidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brazil/ Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Imunopatologia. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Imunopatologia. Belo Horizonte, MG, BrazilUniversidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brazil/ Fundação Oswaldo Cruz. Centro de Pesquisas Leônidas e Maria Deane. Manaus, AM, BrazilFundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, BrazilUniversidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brazil/ Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, BrazilFundação de Medicina Tropical Doutor Heitor Vieira Dourado. Instituto de Medicina Tropical de Coari. Coari, AM, BrazilFundação Oswaldo Cruz. Centro de Pesquisas Leônidas e Maria Deane. Manaus, AM, BrazilUniversidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, BrazilUniversidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Biomarcadores de Diagnóstico e Monitoração. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Biomarcadores de Diagnóstico e Monitoração. Belo Horizonte, MG, BrazilUniversidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brazil/ Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, BrazilBackground. Recent studies have shown that the inflammatory process, including the biomarker production, and the intense activation of innate immune responses are greater in the malaria caused by Plasmodium vivax than other species. Here, we examined the levels of serum biomarkers and their interaction during acute malaria. Material and Methods. Blood samples were collected from P. vivax-infected patients at admission and from healthy donors. Levels of serum biomarkers were measured by Cytometric Bead Assay or ELISA. Results.P. vivax infection triggered the production of both inflammatory and regulatory biomarkers. Levels of IL-6, CXCL-8, IFN-γ, IL-5, and IL-10 were higher in P. vivax-infected patients than in healthy donors. On the other hand, malaria patients produced lower levels of TNF-α, IL-12p70, and IL-2 than healthy individuals. While the levels of IL-10 and IL-6 were found independent on the number of malaria episodes, higher levels of these cytokines were seen in patients with higher parasite load. Conclusion. A mixed pattern of proinflammatory and regulatory biomarkers is produced in P. vivax malaria. Analysis of biomarker network suggests that IL-10 and IL-6 are a robust axis in malaria patients and that this interaction seems to be associated with the parasite load

Liver and blood cytokine microenvironment in HCV patients is associated to liver fibrosis score: a proinflammatory cytokine ensemble orchestrated by TNF and tuned by IL-10

Submitted by Nuzia Santos ([email protected]) on 2016-07-14T14:21:24Z No. of bitstreams: 1 ve_Cruz_Soriane_Liver_CPqRR_2016.pdf: 2084473 bytes, checksum: 910c70a6f8fd89b1c9a65a31601f6660 (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2016-07-14T14:28:13Z (GMT) No. of bitstreams: 1 ve_Cruz_Soriane_Liver_CPqRR_2016.pdf: 2084473 bytes, checksum: 910c70a6f8fd89b1c9a65a31601f6660 (MD5)Made available in DSpace on 2016-07-14T14:28:13Z (GMT). No. of bitstreams: 1 ve_Cruz_Soriane_Liver_CPqRR_2016.pdf: 2084473 bytes, checksum: 910c70a6f8fd89b1c9a65a31601f6660 (MD5) Previous issue date: 2016Universidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brasil/Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil/Fundação de Medicina Tropical Doutor Heitor Vieira Dourado.Manaus, AM, Brasil.Universidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brasil/Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil/Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil/Fundação de Medicina Tropical Doutor Heitor Vieira Dourado. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil/Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Laboratorio de Biomarcadores para Diagnostico e Monitoramento. Belo Horizonte, MG, Brasil.Universidade Federal de Uberlandia. Laboratorio de Bioinformatica e Analise Molecular. Patos de Minas, MG, Brasil.Universidade Federal de Uberlandia. Laboratorio de Bioinformatica e Analise Molecular. Patos de Minas, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil/Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Laboratorio de Biomarcadores para Diagnostico e Monitoramento. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil/Fundação Oswaldo Cruz. Centro de Pesquisa Rene Rachou. Laboratorio de Biomarcadores para Diagnostico e Monitoramento. Belo Horizonte, MG, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil/Fundação de Medicina Tropical Doutor Heitor Vieira Dourado. Manaus, AM, Brasil.Universidade Federal do Amazonas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brasil/Fundação de Hematologia e Hemoterapia do Amazonas. Departamento de Ensino e Pesquisa. Manaus, AM, Brasil.Background: In this study, we have evaluated the immunological status of hepatitis C virus (HCV)-infected patients aiming at identifying putative biomarkers associated with distinct degrees of liver fibrosis. Peripheral blood and tissue T-cells as well as cytokine levels were quantified by flow cytometry. Results: Data analysis demonstrated higher frequency of circulating CD8+ T-cells and Tregs along with a mixed proinflammatory/IL-10-modulated cytokine pattern in HCV patients. Patients with severe liver fibrosis presented lower frequency of circulating CD8+ T-cells, higher levels of proinflammatory cytokines, but lower levels of IL-10, in addition to the higher viral load. Despite the lower frequency of intrahepatic T-cells and scarce frequency of Tregs, patients with severe liver fibrosis showed higher levels of proinflammatory cytokines (TNF and IFN-γ). The tissue proinflammatory cytokine pattern supported further studies of serum cytokines as relevant biomarkers associated with different liver fibrosis scores. Serum cytokine signature showed that mild liver fibrosis is associated with higher IL-10 serum levels as compared to severe liver disease. There was a clear positive connection of IL-10 with the TNF node in patients with mild liver fibrosis, whereas there is an evident inverse correlation between IL-10 with all other cytokine nodes. Conclusions: These results suggest the absence of modulatory events in patients with severe liver damage as opposed to mild fibrosis. Machine-learning data mining pointed out TNF and IL-10 as major attributes to differentiate HCV patients from non-infected individuals with highest performance. In conclusion, our findings demonstrated that HCV infection triggers a local and systemic cytokine ensemble orchestrated by TNF and tuned by IL-10 in such a manner that mirrors the liver fibrosis score, which highly suggests the relevance of these set of biomarkers for clinical investigations

Clinical Profile and Risk Factors for Severe COVID-19 in Hospitalized Patients from Rio de Janeiro, Brazil: Comparison between the First and Second Pandemic Waves

Since COVID-19 was declared a pandemic, Brazil has become one of the countries most affected by this disease. A year into the pandemic, a second wave of COVID-19 emerged, with a rapid spread of a new SARS-CoV-2 lineage of concern. Several vaccines have been granted emergency-use authorization, leading to a decrease in mortality and severe cases in many countries. However, the emergence of SARS-CoV-2 variants raises the alert for potential new waves of transmission and an increase in pathogenicity. We compared the demographic and clinical data of critically ill patients infected with COVID-19 hospitalized in Rio de Janeiro during the first and second waves between July 2020 and October 2021. In total, 106 participants were included in this study; among them, 88% had at least one comorbidity, and 37% developed severe disease. Disease severity was associated with older age, pre-existing neurological comorbidities, higher viral load, and dyspnea. Laboratory biomarkers related to white blood cells, coagulation, cellular injury, inflammation, renal, and liver injuries were significantly associated with severe COVID-19. During the second wave of the pandemic, the necessity of invasive respiratory support was higher, and more individuals with COVID-19 developed acute hepatitis, suggesting that the progression of the second wave resulted in an increase in severe cases. These results can contribute to understanding the behavior of the COVID-19 pandemic in Brazil and may be helpful in predicting disease severity, which is a pivotal for guiding clinical care, improving patient outcomes, and defining public policies