Evidence about playing in the hospital from the perspective of the child's family: integrative review / Evidências acerca do brincar no hospital na perspectiva do familiar da criança: revisão integrativa

Objective: to identify studies in the national and international literature about playing in the hospital from the perspective of the child's family. Method: Integrative review carried out from March to May 2022, in the information sources: Scielo; LILACS and BDENF via VHL; MEDLINE via PUBMED; Scopus and Google Scholar as an additional strategy. Original articles in English, Portuguese and Spanish were included; no temporal clipping; and that had family members and/or companions of hospitalized children as participants. Results: Families recognize playing as a promoter in reducing children's anxiety in the face of invasive procedures, as well as helping to cope with hospitalization and improving their mood and behavior. They also highlighted the hospital toy library as an important space that promotes distraction and continuity of development. Conclusion: from the perspective of family members about playing, the nursing team should encourage them to be a co-participant in this activity during the child's hospitalization.Objetivo: identificar estudios en la literatura nacional e internacional sobre el juego en el hospital desde la perspectiva de la familia del niño. Método: Revisión integradora realizada de marzo a mayo de 2022, en las fuentes de información: Scielo; LILACS y BDENF vía BVS; MEDLINE vía PUBMED; Scopus y Google Scholar como estrategia adicional. Se incluyeron artículos originales en inglés, portugués y español; sin recorte temporal; y que tuvo como participantes a familiares y/o acompañantes de niños hospitalizados. Resultados: Las familias reconocen jugar como un promotor en la reducción de la ansiedad de los niños frente a los procedimientos invasivos, además de ayudar a sobrellevar la hospitalización y mejorar su estado de ánimo y comportamiento. También destacaron la ludoteca del hospital como un espacio importante que promueve la distracción y la continuidad del desarrollo. Conclusión: desde la perspectiva de los familiares sobre el juego, el equipo de enfermería debe incentivarlos a ser copartícipes de esa actividad durante la hospitalización del niño.Objetivo: identificar estudos na literatura nacional e internacional acerca do brincar no hospital na perspectiva do familiar da criança. Método: revisão Integrativa realizada no período de março a maio de 2022, nas fontes de informações: Scielo; LILACS e BDENF via BVS; MEDLINE via PUBMED; Scopus e o Google Scholar como estratégia adicional. Foram incluídos artigos originais, nos idiomas inglês, português e espanhol; sem recorte temporal; e que tivessem como participantes familiares e/ou acompanhantes de crianças hospitalizadas. Resultados: as famílias reconhecem o brincar como promotor na redução da ansiedade das crianças frente aos procedimentos invasivos, além de auxiliar no enfrentamento da hospitalização e na melhora do humor e comportamento delas. Também destacaram a brinquedoteca hospitalar como um importante espaço que promove distração e continuidade do desenvolvimento. Conclusão: a partir da perspectiva dos familiares acerca do brincar, a equipe de enfermagem deve incentiva-las serem coparticipante dessa atividade durante a hospitalização da criança.

Evidence about playing in the hospital from the perspective of the child's family: integrative review / Evidências acerca do brincar no hospital na perspectiva do familiar da criança: revisão integrativa

Objetivo: identificar estudos na literatura nacional e internacional acerca do brincar no hospital na perspectiva do familiar da criança. Método: revisão Integrativa realizada no período de março a maio de 2022, nas fontes de informações: Scielo; LILACS e BDENF via BVS; MEDLINE via PUBMED; Scopus e o Google Scholar como estratégia adicional. Foram incluídos artigos originais, nos idiomas inglês, português e espanhol; sem recorte temporal; e que tivessem como participantes familiares e/ou acompanhantes de crianças hospitalizadas. Resultados: as famílias reconhecem o brincar como promotor na redução da ansiedade das crianças frente aos procedimentos invasivos, além de auxiliar no enfrentamento da hospitalização e na melhora do humor e comportamento delas. Também destacaram a brinquedoteca hospitalar como um importante espaço que promove distração e continuidade do desenvolvimento. Conclusão: a partir da perspectiva dos familiares acerca do brincar, a equipe de enfermagem deve incentiva-las serem coparticipante dessa atividade durante a hospitalização da criança.

EXPERIÊNCIAS EXTENSIONISTAS DO BRINCAR JUNTO À ACADÊMICAS DE ENFERMAGEM, FAMÍLIA E CRIANÇA NO HOSPITAL

Objetivo: relatar a experiência de acadêmicas de enfermagem de um projeto de extensão acerca do brincar junto à família e a criança no hospital. Método: relato de experiência de três acadêmicas de enfermagem de uma universidade privada, que fazem parte de um projeto do projeto de Extensão - “O significado do brincar para a família da criança hospitalizada: contribuições para enfermagem”. As atividades lúdicas extensionistas, foram realizadas em três enfermarias pediátricas ou na brinquedoteca de um hospital público localizado na cidade do Rio de Janeiro, no período de julho a dezembro de 2022, com 13 familiares e 13 crianças hospitalizadas. Resultados: as experiências das acadêmicas de enfermagem foram organizadas em três eixos temáticos: a brincadeira como forma de distração para criança e família no hospital; o brincar como um cuidado de enfermagem; a importância da brinquedoteca na ótica do familiar. Considerações Finais: o projeto de extensão acerca do brincar junto a família e sua criança no hospital, permitiu as acadêmicas de enfermagem compreenderem os benefícios da brincadeira para criança e família, bem como, passam a enxergar essa atividade como um cuidado de enfermagem. Além disso, na interação com os familiares, passam a entender a importância da brinquedoteca dentro do cenário hospitalar

Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis

BACKGROUND: The Amazon region corresponds to approximately 40% of the cases of leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures improves diagnosis in areas with high prevalence of Leishmania guyanensis. OBJECTIVES: to evaluate diagnostic methods in areas with high prevalence of Leishmania guyanensis. METHODS: All subjects were amastigote-positive by direct microscopic examination of lesion scarifications. We conducted skin biopsy and histopathology, polymerase chain reaction and parasite cultivation. RESULTS: Polymerase chain reaction detected almost ninety percent of infections when two amplification protocols were used (mini-exon and HSP-70). HSP-70 specific polymerase chain reaction matched the sensitivity of parasite cultivation plus histopathology. CONCLUSION: The best combination was polymerase chain reaction plus histopathology, which increased diagnostic sensitivity to 94%. Species discrimination by polymerase chain reaction disclosed prevalence of human infections with Leishmania guyanensis of 94% and with Leishmania braziliensis of 6% for this regio

α-Tocopherol influences glycaemic control and miR-9-3 DNA methylation in overweight and obese women under an energy-restricted diet: a randomized, double-blind, exploratory, controlled clinical trial

Abstract Background Excess weight is a strong risk factor for the development of dysglycaemia. It has been suggested that changes in the metabolism microRNAs, small non-coding RNAs that regulate gene expression, could precede late glycaemic changes. Vitamin E in turn may exert important functions in methylation and gene expression processes. This study aimed to determine the effect of α-tocopherol on glycaemic variables and miR-9-1 and miR-9-3 promoter DNA methylation in overweight women. Methods A randomized, double-blind, exploratory, placebo-controlled study was conducted in overweight and obese adult women (n = 44) who ingested synthetic vitamin E (all-rac-α-tocopherol), natural source vitamin E (RRR-rac-α-tocopherol) or placebo capsules and were followed up for a period of 8 weeks. Supplemented groups also received dietary guidance for an energy-restricted diet. An additional group that received no supplementation and did not follow an energy-restricted diet was also followed up. The intervention effect was evaluated by DNA methylation levels (quantitative real-time PCR assay) and anthropometric and biochemical variables (fasting plasma glucose, haemoglobin A1C, insulin, and vitamin E). Results Increased methylation levels of the miR-9-3 promoter region (P < 0.001) and reduced haemoglobin A1C (P < 0.05) were observed in the natural source vitamin E group after intervention. Increased fasting plasma glucose was observed in the synthetic vitamin E group, despite the significant reduction of anthropometric variables compared to the other groups. Conclusions α-Tocopherol from natural sources increased methylation levels of the miR-9-3 promoter region and reduced haemoglobin A1C in overweight women following an energy-restricted diet. These results provide novel information about the influence of vitamin E on DNA methylation. Trial registration ClinicalTrials.gov, NCT02922491. Registered 4 October, 2016

Additional file 1: of α-Tocopherol influences glycaemic control and miR-9-3 DNA methylation in overweight and obese women under an energy-restricted diet: a randomized, double-blind, exploratory, controlled clinical trial

Tests with the withdrawal of outliers values. (DOCX 22 kb

Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from BrazilResearch in context

Summary: Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz)