Diagnósticos de enfermagem de pacientes em período pré-operatório de cirurgia esofágica

This study aimed to identify and analyze the nursing diagnoses of patients in the preoperative period of esophageal surgeries. Data were collected by means of an instrument, based on Horta's Conceptual Model. The study group consisted of 20 patients hospitalized at the Ribeirão Preto Medical School Hospital das Clínicas, who would undergo esophageal surgery. The patients were submitted to an interview and a physical examination. The nursing diagnoses identified at frequencies of more than 50% were: impaired swallowing (100%); risk for infection (100%); knowledge deficit about disease and perioperative period (95%), and chronic pain (75%). These diagnoses were analyzed in view of the related factors, defining characteristics or risk factors, according to the type of diagnosis and the responses to the esophageal disease.Este estudio tuvo como objetivos identificar y analizar los diagnósticos de enfermería de pacientes en el período pre operatorio de cirugías de esófago. Los datos fueron recolectados por medio de un instrumento fundamentado en el Modelo Conceptual de Horta. El grupo estudiado fue constituido por 20 pacientes internados en el Hospital de las Clínicas de la Facultad de Medicina de Ribeirao Preto, en Brasil, para ser sometidos a cirugía esofágica. Los pacientes fueron sometidos a una entrevista y a un examen físico. Los diagnósticos de enfermería identificados con una frecuencia mayor que 50% fueron: acción de deglutir perjudicada (100%), riesgo de infección (100%), conocimiento deficiente sobre la enfermedad y período peri operatorio (95%) y dolor crónico (75%). Esos diagnósticos fueron analizados considerando los factores relacionados, las características de definición o los factores de riesgo, de acuerdo con el tipo de diagnóstico, y las respuestas a la patología esofágica.Este estudo teve como objetivos identificar e analisar os diagnósticos de enfermagem de pacientes no período pré-operatório de cirurgias esofágicas. Os dados foram coletados por meio de instrumento fundamentado no Modelo Conceitual de Horta. O grupo estudado foi constituído por 20 pacientes internados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Brasil para serem submetidos a cirurgia esofágica. Os pacientes foram submetidos à entrevista e exame físico. Os diagnósticos de enfermagem identificados com freqüência maior que 50% foram: deglutição prejudicada (100%), risco para infecção (100%), conhecimento deficiente sobre a doença e período perioperatório (95%) e dor crônica (75%). Esses diagnósticos foram analisados considerando-se os fatores relacionados, as características definidoras ou fatores de risco, de acordo com o tipo de diagnóstico, e as respostas à patologia esofágica

Nursing diagnoses of patients in the preoperative period of esophageal surgery

Este estudo teve como objetivos identificar e analisar os diagnósticos de enfermagem de pacientes no período pré-operatório de cirurgias esofágicas. Os dados foram coletados por meio de instrumento fundamentado no Modelo Conceitual de Horta. O grupo estudado foi constituído por 20 pacientes internados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Brasil para serem submetidos a cirurgia esofágica. Os pacientes foram submetidos à entrevista e exame físico. Os diagnósticos de enfermagem identificados com freqüência maior que 50% foram: deglutição prejudicada (100%), risco para infecção (100%), conhecimento deficiente sobre a doença e período perioperatório (95%) e dor crônica (75%). Esses diagnósticos foram analisados considerando-se os fatores relacionados, as características definidoras ou fatores de risco, de acordo com o tipo de diagnóstico, e as respostas à patologia esofágica.This study aimed to identify and analyze the nursing diagnoses of patients in the preoperative period of esophageal surgeries. Data were collected by means of an instrument, based on Horta's Conceptual Model. The study group consisted of 20 patients hospitalized at the Ribeirão Preto Medical School Hospital das Clínicas, who would undergo esophageal surgery. The patients were submitted to an interview and a physical examination. The nursing diagnoses identified at frequencies of more than 50% were: impaired swallowing (100%); risk for infection (100%); knowledge deficit about disease and perioperative period (95%), and chronic pain (75%). These diagnoses were analyzed in view of the related factors, defining characteristics or risk factors, according to the type of diagnosis and the responses to the esophageal disease.Este estudio tuvo como objetivos identificar y analizar los diagnósticos de enfermería de pacientes en el período pre operatorio de cirugías de esófago. Los datos fueron recolectados por medio de un instrumento fundamentado en el Modelo Conceptual de Horta. El grupo estudiado fue constituido por 20 pacientes internados en el Hospital de las Clínicas de la Facultad de Medicina de Ribeirao Preto, en Brasil, para ser sometidos a cirugía esofágica. Los pacientes fueron sometidos a una entrevista y a un examen físico. Los diagnósticos de enfermería identificados con una frecuencia mayor que 50% fueron: acción de deglutir perjudicada (100%), riesgo de infección (100%), conocimiento deficiente sobre la enfermedad y período peri operatorio (95%) y dolor crónico (75%). Esos diagnósticos fueron analizados considerando los factores relacionados, las características de definición o los factores de riesgo, de acuerdo con el tipo de diagnóstico, y las respuestas a la patología esofágica

Colonização nasal por Staphylococcus aureus em indivíduos com HIV/Aids atendidos em um hospital-escola brasileiro

OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil). METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.OBJETIVO: evaluar la prevalencia de la colonización nasal por Staphylococcus aureus en individuos con VIH/sida internados en un hospital escuela del Estado de São Paulo (Brasil). MÉTODO: estudio trasversal, desarrollado en dos unidades especializadas en la atención a personas que viven con VIH/ sida, en el período de agosto del 2011 a julio del 2012. Fueron recolectados datos sociodemográficos y clínicos, mediante entrevista individual y archivo; las muestras de secreción nasal fueron recolectadas mediante Swab Stuart en el primer día de internación. Los aspectos éticos fueron contemplados. RESULTADOS: de los 229 individuos con VIH/sida internados en el período, 169 participaron del estudio, siendo identificado Staphylococcus aureus en las pruebas de cultura de 46 (27,2%) de los individuos, evidenciándose resistencia a la oxacilina en 10 (21,8%) participantes. CONCLUSIÓN: los resultados de la investigación indican que la prevalencia de la colonización por Staphylococcus aureus en individuos con VIH/sida internados en las unidades especializadas fue considerada relevante y puede contribuir a otras investigaciones y, además, para implementar medidas de prevención y de control de ese patógeno en esa población.OBJETIVO: avaliar a prevalência da colonização nasal por Staphylococcus aureus em indivíduos com HIV/Aids internados em um hospital-escola do Estado de São Paulo (Brasil). MÉTODO: estudo de corte transversal, realizado em duas unidades especializadas no atendimento a pessoas que vivem com HIV/ Aids, no período de agosto 2011 a julho 2012. Foram coletados dados sociodemográficos e clínicos, por entrevista individual e prontuário; as amostras de secreção nasal foram coletadas por meio de swab Stuart no primeiro dia de internação. Os aspectos éticos foram contemplados. RESULTADOS: dos 229 indivíduos com HIV/Aids internados no período, 169 participaram do estudo, sendo identificado Staphylococcus aureus nos exames de cultura de 46 (27,2%) dos indivíduos, evidenciando-se resistência à oxacilina em 10 (21,8%) participantes. CONCLUSÃO: os resultados da pesquisa apontam que a prevalência da colonização por Staphylococcus aureus em indivíduos com HIV/Aids internados nas unidades especializadas foi considerada relevante, podendo contribuir para novas investigações e, ainda, para implementar medidas de prevenção e de controle desse patógeno nessa população

Avaliação da adesão à higiene de mãos em unidade coronariana

Objective: To analyze the adherence of health professionals to the hand hygiene technique in a coronary care unit. Method: Cross-sectional study. All health professionals who work in the unit participated in the research. The observation was guided by an instrument of the World Health Organization which is in the public domain and which was adapted to allow the verification of which moments the professional performed hand hygiene. All opportunities for hand hygiene were computed and a ratio of the percentage of adherence was prepared. Results: 30 health professionals were evaluated, being six nurses, 18 nursing technicians, two physiotherapists and four physicians. 498 opportunities for hand hygiene were observed, with 190 actions carried out, resulting in 38.2% of compliance. Conclusion: The low compliance rates found evidence the need to invest in awareness programs about the importance of hand hygiene.Objetivo: Analisar a adesão dos profissionais da saúde à técnica de higienização de mãos em uma Unidade Coronariana. Método: Estudo transversal. Participaram da pesquisa todos os profissionais de saúde que atuam na unidade. A observação foi guiada por instrumento da Organização Mundial da Saúde que é de domínio público e que foi adaptado de forma a permitir a verificação de quais momentos o profissional realizou a higienização das mãos. Todas as oportunidades para higiene de mãos foram computadas e uma relação do percentual de adesão foi elaborada. Resultados: Foram avaliados 30 profissionais de saúde, sendo seis enfermeiros, 18 técnicos de enfermagem, dois fisioterapeutas e quatro médicos. Foram observadas 498 oportunidades de higiene de mãos, com 190 ações realizadas, resultando em 38,2% de adesão. Conclusão: As baixas taxas de adesão encontradas evidenciam a necessidade de investir em programas de conscientização sobre a importância da higienização das mãos

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Measurement of the Splitting Function in &ITpp &ITand Pb-Pb Collisions at root&ITsNN&IT=5.02 TeV

Data from heavy ion collisions suggest that the evolution of a parton shower is modified by interactions with the color charges in the dense partonic medium created in these collisions, but it is not known where in the shower evolution the modifications occur. The momentum ratio of the two leading partons, resolved as subjets, provides information about the parton shower evolution. This substructure observable, known as the splitting function, reflects the process of a parton splitting into two other partons and has been measured for jets with transverse momentum between 140 and 500 GeV, in pp and PbPb collisions at a center-of-mass energy of 5.02 TeV per nucleon pair. In central PbPb collisions, the splitting function indicates a more unbalanced momentum ratio, compared to peripheral PbPb and pp collisions.. The measurements are compared to various predictions from event generators and analytical calculations.Peer reviewe

Measurement of nuclear modification factors of gamma(1S)), gamma(2S), and gamma(3S) mesons in PbPb collisions at root s(NN)=5.02 TeV

The cross sections for ϒ(1S), ϒ(2S), and ϒ(3S) production in lead-lead (PbPb) and proton-proton (pp) collisions at √sNN = 5.02 TeV have been measured using the CMS detector at the LHC. The nuclear modification factors, RAA, derived from the PbPb-to-pp ratio of yields for each state, are studied as functions of meson rapidity and transverse momentum, as well as PbPb collision centrality. The yields of all three states are found to be significantly suppressed, and compatible with a sequential ordering of the suppression, RAA(ϒ(1S)) > RAA(ϒ(2S)) > RAA(ϒ(3S)). The suppression of ϒ(1S) is larger than that seen at √sNN = 2.76 TeV, although the two are compatible within uncertainties. The upper limit on the RAA of ϒ(3S) integrated over pT, rapidity and centrality is 0.096 at 95% confidence level, which is the strongest suppression observed for a quarkonium state in heavy ion collisions to date. © 2019 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP3.Peer reviewe

Electroweak production of two jets in association with a Z boson in proton-proton collisions root s =13 TeV

A measurement of the electroweak (EW) production of two jets in association with a Z boson in proton-proton collisions at root s = 13 TeV is presented, based on data recorded in 2016 by the CMS experiment at the LHC corresponding to an integrated luminosity of 35.9 fb(-1). The measurement is performed in the lljj final state with l including electrons and muons, and the jets j corresponding to the quarks produced in the hard interaction. The measured cross section in a kinematic region defined by invariant masses m(ll) > 50 GeV, m(jj) > 120 GeV, and transverse momenta P-Tj > 25 GeV is sigma(EW) (lljj) = 534 +/- 20 (stat) fb (syst) fb, in agreement with leading-order standard model predictions. The final state is also used to perform a search for anomalous trilinear gauge couplings. No evidence is found and limits on anomalous trilinear gauge couplings associated with dimension-six operators are given in the framework of an effective field theory. The corresponding 95% confidence level intervals are -2.6 <cwww/Lambda(2) <2.6 TeV-2 and -8.4 <cw/Lambda(2) <10.1 TeV-2. The additional jet activity of events in a signal-enriched region is also studied, and the measurements are in agreement with predictions.Peer reviewe

Inclusive Search for a Highly Boosted Higgs Boson Decaying to a Bottom Quark-Antiquark Pair

© 2018 CERN. An inclusive search for the standard model Higgs boson (H) produced with large transverse momentum (pT) and decaying to a bottom quark-antiquark pair (bb) is performed using a data set of pp collisions at s=13 TeV collected with the CMS experiment at the LHC. The data sample corresponds to an integrated luminosity of 35.9 fb-1. A highly Lorentz-boosted Higgs boson decaying to bb is reconstructed as a single, large radius jet, and it is identified using jet substructure and dedicated b tagging techniques. The method is validated with Z→bb decays. The Z→bb process is observed for the first time in the single-jet topology with a local significance of 5.1 standard deviations (5.8 expected). For a Higgs boson mass of 125 GeV, an excess of events above the expected background is observed (expected) with a local significance of 1.5 (0.7) standard deviations. The measured cross section times branching fraction for production via gluon fusion of H→bb with reconstructed pT > 450 GeV and in the pseudorapidity range -2.5 < η < 2.5 is 74±48(stat)-10+17(syst) fb, which is consistent within uncertainties with the standard model prediction

Search for new phenomena in final states with two opposite-charge, same-flavor leptons, jets, and missing transverse momentum in pp collisions at √s=13 TeV

Search results are presented for physics beyond the standard model in final states with two opposite-charge, same-flavor leptons, jets, and missing transverse momentum. The data sample corresponds to an integrated luminosity of 35.9 fb−1 of proton-proton collisions at s√=13 TeV collected with the CMS detector at the LHC in 2016. The analysis uses the invariant mass of the lepton pair, searching for a kinematic edge or a resonant-like excess compatible with the Z boson mass. The search for a kinematic edge targets production of particles sensitive to the strong force, while the resonance search targets both strongly and electroweakly produced new physics. The observed yields are consistent with the expectations from the standard model, and the results are interpreted in the context of simplified models of supersymmetry. In a gauge mediated supersymmetry breaking (GMSB) model of gluino pair production with decay chains including Z bosons, gluino masses up to 1500–1770 GeV are excluded at the 95% confidence level depending on the lightest neutralino mass. In a model of electroweak chargino-neutralino production, chargino masses as high as 610 GeV are excluded when the lightest neutralino is massless. In GMSB models of electroweak neutralino-neutralino production, neutralino masses up to 500-650 GeV are excluded depending on the decay mode assumed. Finally, in a model with bottom squark pair production and decay chains resulting in a kinematic edge in the dilepton invariant mass distribution, bottom squark masses up to 980–1200 GeV are excluded depending on the mass of the next-to-lightest neutralino