Altered Hypercoagulability Factors in Patients with Chronic Chagas Disease: Potential Biomarkers of Therapeutic. Response

Thromboembolic events were described in patients with Chagas disease without cardiomyopathy. We aim to confirm if there is a hypercoagulable state in these patients and to determine if there is an early normalization of hemostasis factors after antiparasitic treatment. Ninety-nine individuals from Chagas disease-endemic areas were classified in two groups: G1, with T.cruzi infection (n = 56); G2, healthy individuals (n = 43). Twenty-four hemostasis factors were measured at baseline. G1 patients treated with benznidazole were followed for 36 months, recording clinical parameters and performance of conventional serology, chemiluminescent enzyme-linked immunosorbent assay (trypomastigote-derived glycosylphosphatidylinositol-anchored mucins), quantitative polymerase chain reaction, and hemostasis tests every 6-month visits. Prothrombin fragment 1+2 (F1+2) and endogenous thrombin potential (ETP) were abnormally expressed in 77% and 50% of infected patients at baseline but returned to and remained at normal levels shortly after treatment in 76% and 96% of cases, respectively. Plasmin-antiplasmin complexes (PAP) were altered before treatment in 32% of G1 patients but normalized in 94% of cases several months after treatment. None of the patients with normal F1+2 values during follow-up had a positive qRT-PCR result, but 3/24 patients (13%) with normal ETP values did. In a percentage of chronic T. cruzi infected patients treated with benznidazole, altered coagulation markers returned into normal levels. F1+2, ETP and PAP could be useful markers for assessing sustained response to benznidazole

Peripherally inserted central catheter care in neonates: an integrative literature review

O cateter central de inserção periférica é tecnologia comum empregada na terapia intravenosa de neonatos. Trata-se de revisão integrativa, cujo objetivo foi investigar e analisar as evidências disponíveis na literatura acerca da temática. As bases de dados pesquisadas foram Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Biblioteca Nacional de Medicina dos Estados Unidos (PubMed). Resultados apontam lacunas no que tange à população neonatal; conhecimento insuficiente dos profissionais quanto indicações (n=1); e variados temas sobre uso de anticoagulantes (n=6), comparação com outros cateteres (n=4), diagnóstico por imagem (n=2), dor (n=2), infecção relacionada a cateter e sua prevenção (n=7), entre outros fatores. Conclui-se que há necessidade de atualização profissional, evidências científicas de fácil acesso e publicações nacionais.El catéter central de inserción periférica es una tecnología común empleada en terapia endovenosa de neonatos. Se trata de una revisión integrativa, cuyo objetivo fue investigar y analizar las evidencias disponibles en la literatura acerca de la temática. Se investigaron las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y la Biblioteca Nacional de Medicina de los Estados Unidos (PubMed). Los resultados expresan omisiones en lo referente a la población neonatal; conocimiento insuficiente de los profesionales al respecto de las indicaciones (n=1), diagnóstico por imagen (n=2), dolor (n=2), infección relacionada al catéter y su prevención (n=7), entre otras. Se necesita de actualización profesional; evidencias científicas de fácil acceso y publicaciones nacionales.The peripherally inserted central catheter is a common technology employed in the intravenous therapy of neonates. This integrative review was performed with the objective to investigate and analyze the evidence available in the literature regarding this technology. The databases searched included the Latin American and Caribbean Health Sciences Literature (LILACS) and the United States National Library of Medicine (PubMed). Results point at gaps in relation to their use in the neonatal population (n=1); various themes regarding the use of anticoagulants (n=6), comparison with other catheters (n=4), diagnostic imaging (n=2), pain (n=2), and catheter-relation infection and its prevention (n=7), among others. There is a need for staff education regarding their use; scientific evidence with easy access; and national publications regarding their use

ELABORAÇÃO DE DIRETRIZ CLÍNICA: INTEGRAÇÃO ENTRE UNIVERSIDADE E UNIDADE HOSPITALAR

The setbacks confronted in daily nursing routines are themes in undergraduate and postgraduate research, while the healthcare professional at the bedside needs to update her skills and seek the best evidence so as to offer quality care. The authors reflect on how academia can integrate itself to practice and thus contribute to improving care by elaborating and implanting clinical practice guidelines. The busy healthcare professionals sometimes do not have the opportunity to consider their literature search tools and select the best evidence to implant in their unit. For academia, however, this type of research is habitual, with the elaboration of clinical practice guidelines and their implantation in the units researched being perfectly viable. An objective was to reflect on the integration of university and hospital units, with a focus on the joint elaboration of clinical practice guidelines.Os revezes enfrentados na prática cotidiana do trabalho da enfermagem são temas para as pesquisas de graduação e pós-graduação, enquanto o profissional à beira do leito necessita atualizar-se e buscar as melhores evidências para oferecer qualidade no cuidado. Refletimos a respeito de como a academia pode integrar-se à prática e, assim, contribuir para melhoria do cuidado ao elaborar e implantar diretrizes clínicas. Os atarefados profissionais, por vezes, não têm a oportunidade de debruçar-se sobre as ferramentas de busca da literatura e selecionar as melhores evidências a serem implantadas em sua unidade. Para academia, entretanto, esse tipo de pesquisa é habitual, sendo plenamente viável a elaboração de diretrizes clínicas e sua implantação nas unidades pesquisadas. Objetivou-se refletir sobre a integração universidade e unidade hospitalar, tendo como foco a elaboração conjunta de diretriz clínica. Las dificultades afrontadas en la práctica cotidiana del trabajo de enfermería son temas para las investigaciones de graduación y posgrado, mientras el profesional que atiende el lecho necesita atualizarse y buscar las mejores evidencias para ofrecer cualidade en el cuidado. Hemos reflexionado acerca de cómo la academia puede integrarse a la práctica y, de ese modo, contribuir para el desarrollo del cuidado al elaborar e implantar diretrizes clínicas. Los atareados profesionales, por veces, no tienen oportunidad de dedicarse a las herramientas de búsqueda de la literatura y eligir las mejores evidencias a implantar en su unidad. Para academia, sin embargo, ese tipo de investigación es habitual, siendo plenamente viable la elaboración de diretrizes clínicas y su implantación en las unidades investigadas. El objetivo de este trabajo fue reflexionar sobre la integración universidad y unidad hospitalar, a la luz de la elaboración conjunta de diretriz clínica

Transcranial direct current stimulation combined with upper limb functional training in children with spastic, hemiparetic cerebral palsy: study protocol for a randomized controlled trial

The aim of the proposed study is to perform a comparative analysis of functional training effects for the paretic upper limb with and without transcranial direct current stimulation over the primary motor cortex in children with spastic hemiparetic cerebral palsy

Protocol study for a randomised, controlled, double-blind, clinical trial involving virtual reality and anodal transcranial direct current stimulation for the improvement of upper limb motor function in children with Down syndrome

Introduction Down syndrome results in neuromotor impairment that affects selective motor control, compromising the acquisition of motor skills and functional independence. The aim of the proposed study is to evaluate and compare the effects of multiple-monopolar anodal transcranial direct current stimulation and sham stimulation over the primary motor cortex during upper limb motor training involving virtual reality on motor control, muscle activity, cerebral activity and functional independence. Methods and analysis A randomised, controlled, double-blind, clinical trial is proposed. The calculation of the sample size will be defined based on the results of a pilot study involving the same methods. The participants will be randomly allocated to two groups. Evaluations will be conducted before and after the intervention as well as 1 month after the end of the intervention process. At each evaluation, three-dimensional analysis of upper limb movement muscle activity will be measured using electromyography, cerebral activity will be measured using an electroencephalogram system and intellectual capacity will be assessed using the Wechsler Intelligence Scale for Children. Virtual reality training will be performed three times a week (one 20 min session per day) for a total of 10 sessions. During the protocol, transcranial stimulation will be administered concomitantly to upper limb motor training. The results will be analysed statistically, with a p valueâ\u89¤0.05 considered indicative of statistical significance. Ethical aspects and publicity The present study received approval from the Institutional Review Board of Universidade Nove de Julho (Sao Paulo,Brazil) under process number 1.540.113 and is registered with the Brazilian Registry of Clinical Trials (N° RBR3PHPXB). The participating institutions have presented a declaration of participation. The volunteers will be permitted to drop out of the study at any time with no negative repercussions. The results will be published and will contribute evidence regarding the use of this type of intervention on children

Study of charmonium and charmonium-like contributions in B+ → J/ψηK+ decays

A study of B+→ J/ψηK+ decays, followed by J/ψ → μ+μ− and η → γγ, is performed using a dataset collected with the LHCb detector in proton-proton collisions at centre-of-mass energies of 7, 8 and 13 TeV, corresponding to an integrated luminosity of 9 fb−1. The J/ψη mass spectrum is investigated for contributions from charmonia and charmonium-like states. Evidence is found for the B+→ (ψ2(3823) → J/ψη)K+ and B+→ (ψ(4040) → J/ψη)K+ decays with significance of 3.4 and 4.7 standard deviations, respectively. This constitutes the first evidence for the ψ2(3823) → J/ψη decay

Observation of the doubly charmed baryon decay Ξcc++→Ξc′+π+

The Ξcc++→Ξc′+π+ decay is observed using proton-proton collisions collected by the LHCb experiment at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 5.4 fb−1. The Ξcc++→Ξc′+π+ decay is reconstructed partially, where the photon from the Ξc′+→Ξc+γ decay is not reconstructed and the pK−π+ final state of the Ξc+ baryon is employed. The Ξcc++→Ξc′+π+branching fraction relative to that of the Ξcc++→Ξc+π+ decay is measured to be 1.41 ± 0.17 ± 0.10, where the first uncertainty is statistical and the second systematic. [Figure not available: see fulltext.