Perfil epidemiológico e assistência de enfermagem a pacientes com aneurisma cerebral: uma pesquisa bibliográfica / Epidemiological profile and nursing care for patients with cerebral aneurysm: a bibliographic research

Objetivo: Identificar, por meio de uma pesquisa bibliográfica, o perfil epidemiológico e a assistência de enfermagem prestada aos pacientes com diagnóstico de aneurisma cerebral. Método: Pesquisa bibliográfica e descritiva, com dados coletados na Biblioteca Virtual em Saúde, utilizando as bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde e Base de Dados da Enfermagem. Foram selecionados os descritores específicos: Aneurisma Cerebral; Aneurisma Intracraniano e Aneurisma Encefálico, que foram cruzados com os descritores gerais: Enfermagem e Epidemiologia. Definido como critérios de inclusão: artigos científicos, disponíveis para acesso na íntegra, publicados entre os anos de 2007 e 2017 e escritos no idioma português ou espanhol. Excluídos artigos de revisão bibliográfica, que não atendiam ao objetivo da pesquisa e artigos iguais publicados em bases de dados diferentes.Resultados: Foram selecionados quatro artigos científicos que identificaram o perfil do paciente com aneurisma cerebral. Um artigo foi publicado no ano de 2009, outro no ano de 2015, os dois em periódicos especializados no assunto e dois artigos foram publicados no ano de 2014 em periódicos não especializados no assunto. Foram realizados dois estudos retrospectivos, sendo que um foi realizado na Região Nordeste e outro na Região Centro-Oeste do Brasil; um estudo prospectivo foi desenvolvido em Cuba e outro transversal foi desenvolvido na Colômbia. Ao identificar o perfil do paciente com aneurisma cerebral, predominaram pacientes do sexo feminino, com maior ocorrência na quarta e quinta décadas de vida, com exceção de um estudo que predominou média de idade de 33 anos. Hipertensão arterial sistêmica, tabagismo e etilismo foram comorbidades e hábitos de vida encontrados nesses pacientes. As complicações relacionadas à ruptura do aneurisma foram o ressangramento, vasoespasmo, hidrocefalia. A maioria dos pacientes apresentou aneurismas rotos, localizados no território anterior e recebeu alta hospitalar. Um artigo identificou os diagnósticos de enfermagem: risco de infecção, sangramento, constipação e perfusão tissular cerebral ineficaz, comunicação verbal prejudicada, deambulação prejudicada, mobilidade física e no leito prejudicada, recuperação cirúrgica retardada e integridade da pele prejudicada. Conclusões: O aneurisma cerebral é mais frequente no sexo feminino, na faixa etária de 41 a 51 anos, acomete a circulação anterior, apresenta-se de forma rota, pode evoluir com hidrocefalia, vasoespasmo e ressangramento e a hipertensão arterial sistêmica é uma comorbidade presente nesses pacientes. A assistência de enfermagem está relacionada a reduzir complicações e promover a recuperação do paciente. Medidas como prevenir infecção, promover a segurança do paciente, a comunicação e a mobilização no leito foram citadas em um artigo.

Diagnósticos de enfermagem predominantes na assistência a pacientes com acidente vascular cerebral / Predominant nursing diagnoses in assistance to patients with stroke

Objetivo: Identificar e analisar, por meio de artigos científicos publicados nos últimos 10 anos, quais são os diagnósticos de Enfermagem predominantes em pacientes com acidente vascular cerebral. Metodologia: Revisão integrativa da literatura, com busca nas bases de dados BDENF, LILACS, MEDLINE e SciELO, utilizando os descritores: Acidente Vascular Cerebral e Diagnóstico de Enfermagem, buscando artigos disponíveis na íntegra, publicados nos anos de 2008 a 2018, nos idiomas português ou espanhol e que abordem a temática do estudo. Excluídos artigos de revisão e teses. Resultados: Encontrados 427 artigos e, após aplicação dos critérios de inclusão e exclusão, permanecemos com nove artigos, sendo que dois foram publicados no ano de 2015, outros dois em 2013, outros dois em 2012 e três artigos foram publicados no ano de 2010. Citados dez diagnósticos de enfermagem: incontinência urinária, comunicação verbal prejudicada, deambulação prejudicada, risco de intolerância à atividade, risco de aspiração, mobilidade física prejudicada, estilo de vida sedentário, risco de síndrome do desuso, capacidade de transferência prejudicada e risco de quedas, sendo que cinco pertenciam ao domínio 4 – atividade e repouso e a maioria pertencia à classe II – atividade e exercício. Conclusão: As vítimas do AVC são afetadas por incapacidades que limitam suas atividades, ocasionando dificuldade de mobilidade e predispondo ao risco de quedas, que foi o diagnóstico de enfermagem mais citado nos artigos. Dessa forma, a assistência de enfermagem deve ser direcionada com o enfoque em reduzir eventos que possam causar maiores danos ao paciente, proporcionando assim uma qualidade de vida mais satisfatória.

The complete ISO spectrum of NGC 6302

We present the combined Infrared Space Observatory Short-Wavelength Spectrometer and Long-Wavelength Spectrometer 2.4-197 μm spectrum of the Planetary Nebula NGC 6302 which contains in addition to strong atomic lines, a series of emission features due to solid state components. The broad wavelength coverage enables us to more accurately identify and determine the properties of both oxygen- and carbon-rich circumstellar dust. A simple model fit was made to determine the abundance and typical temperature of the amorphous silicates, enstatite and forsterite. Forsterite and enstatite do have roughly the same abundance and temperature. The origin and location of the dust in a toroidal disk around the central star are discussed

The Massive Stellar Population in the Young Association LH 95 in the LMC

We present a spectroscopic study of the most massive stars in the young (4 Myr old) stellar cluster LH 95 in the Large Magellanic Cloud. This analysis allows us to complete the census of the stellar population of the system, previously investigated by us down to 0.4 solar masses with deep HST Advanced Camera for Surveys photometry. We perform spectral classification of the five stars in our sample, based on high resolution optical spectroscopy obtained with 2.2m MPG/ESO FEROS. We use complementary ground-based photometry, previously performed by us, to place these stars in the Hertzsprung-Russel diagram. We derive their masses and ages by interpolation from evolutionary models. The average ages and age spread of the most massive stars are found to be in general comparable with those previously derived for the cluster from its low mass PMS stars. We use the masses of the 5 sample stars to extend to the high-mass end the stellar initial mass function of LH 95 previously established by us. We find that the initial mass function follows a Salpeter relation down to the intermediate-mass regime at 2 Msun. The second most massive star in LH 95 shows broad Balmer line emission and infrared excess, which are compatible with a classical Be star. The existence of such a star in the system adds a constrain to the age of the cluster, which is well covered by our age and age spread determinations. The most massive star, a 60-70 Msun O2 giant is found to be younger (<1 Myr) than the rest of the population. Its mass in relation to the total mass of the system does not follow the empirical relation of the maximum stellar mass versus the hosting cluster mass, making LH 95 an exception to the average trend.Comment: 15 pages, 9 figures, MNRAS accepte

Use of tamoxifen and raloxifene for breast cancer chemoprevention in 2010

PURPOSE: Two selective estrogen receptor modulators (SERMs), tamoxifen and raloxifene, have been shown in randomized clinical trials to reduce the risk of developing primary invasive breast cancer (IBC) in high-risk women. In 1998, the U.S. Food and Drug Administration (FDA) used these studies as a basis for approving tamoxifen for primary breast chemoprevention in both premenopausal and postmenopausal women at high risk. In 2007, the FDA approved raloxifene for primary breast cancer chemoprevention for postmenopausal women. METHODS: Data from the year 2010 National Health Interview Survey (NHIS) were analyzed to estimate the prevalence of tamoxifen and raloxifene use for chemoprevention of primary breast cancers among U.S. women. RESULTS: Prevalence of use of chemopreventive agents for primary tumors was 20,598 (95% CI, 518–114,864) for U.S. women aged 35 to 79 for tamoxifen. Prevalence was 96,890 (95% CI, 41,277–192,391) for U.S. women aged 50 to79 for raloxifene. CONCLUSION: Use of tamoxifen and raloxifene for prevention of primary breast cancers continues to be low. In 2010, women reporting medication use for breast cancer chemoprevention were primarily using the more recently FDA-approved drug raloxifene. Multiple possible explanations for the low use exist, including lack of awareness and/or concern about side effects among primary care physicians and patients

STAT3 regulates the onset of oxidant-induced senescence in lung fibroblasts

Copyright © 2019 by the American Thoracic Society. Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease of unknown cause with a median survival of only 3 years. Other investigators and we have shown that fibroblasts derived from IPF lungs display characteristics of senescent cells, and that dysregulated activation of the transcription factor signal transducer and activator of transcription 3 (STAT3) correlates with IPF progression. The question of whether STAT3 activation is involved in fibroblast senescence remains unanswered. We hypothesized that inhibiting STAT3 activation after oxidantinduced senescence would attenuate characteristics of the senescent phenotype. We aimed to characterize a model of oxidant-induced senescence in human lung fibroblasts and to determine the effect of inhibiting STAT3 activity on the development of senescence. Exposing human lung fibroblasts to 150 μM hydrogen peroxide (H2O2) resulted in increased senescence-associated β-galactosidase content and expression of p21 and IL-6, all of which are features of senescence. The shift into senescence was accompanied by an increase of STAT3 translocation to the nucleus and mitochondria. Additionally, Seahorse analysis provided evidence of increased mitochondrial respiration characterized by increased basal respiration, proton leak, and an associated increase in superoxide (O2-) production in senescent fibroblasts. Targeting STAT3 activity using the small-molecule inhibitor STA-21 attenuated IL-6 production, reduced p21 levels, decreased senescence-associated b-galactosidase accumulation, and restored normalmitochondrial function. The results of this study illustrate that stress-induced senescence in lung fibroblasts involves the activation of STAT3, which can be pharmacologically modulated

Interpretation of ambiguous situations: evidence for a dissociation between social and physical threat in Williams syndrome

There is increasing evidence that Williams syndrome (WS) is associated with elevated anxiety that is non-social in nature, including generalised anxiety and fears. To date very little research has examined the cognitive processes associated with this anxiety. In the present research, attentional bias for non-social threatening images in WS was examined using a dot-probe paradigm. Participants were 16 individuals with WS aged between 13 and 34 years and two groups of typically developing controls matched to the WS group on chronological age and attentional control ability respectively. The WS group exhibited a significant attention bias towards threatening images. In contrast, no bias was found for group matched on attentional control and a slight bias away from threat was found in the chronological age matched group. The results are contrasted with recent findings suggesting that individuals with WS do not show an attention bias for threatening faces and discussed in relation to neuroimaging research showing elevated amygdala activation in response to threatening non-social scenes in WS

Sequential Star Formation in RCW 34: A Spectroscopic Census of the Stellar Content of High-mass Star-forming Regions

We present VLT/SINFONI integral field spectroscopy of RCW 34 along with Spitzer/IRAC photometry of the surroundings. RCW 34 consists of three different regions. A large bubble has been detected on the IRAC images in which a cluster of intermediate- and low-mass class II objects is found. At the northern edge of this bubble, an HII region is located, ionized by 3 OB stars. Intermediate mass stars (2 - 3 Msun) are detected of G- and K- spectral type. These stars are still in the pre-main sequence (PMS) phase. North of the HII region, a photon-dominated region is present, marking the edge of a dense molecular cloud traced by H2 emission. Several class 0/I objects are associated with this cloud, indicating that star formation is still taking place. The distance to RCW 34 is revised to 2.5 +- 0.2 kpc and an age estimate of 2 - 1 Myrs is derived from the properties of the PMS stars inside the HII region. The most likely scenario for the formation of the three regions is that star formation propagates from South to North. First the bubble is formed, produced by intermediate- and low-mass stars only, after that, the HII region is formed from a dense core at the edge of the molecular cloud, resulting in the expansion as a champagne flow. More recently, star formation occurred in the rest of the molecular cloud. Two different formation scenarios are possible: (a) The bubble with the cluster of low- and intermediate mass stars triggered the formation of the O star at the edge of the molecular cloud which in turn induces the current star-formation in the molecular cloud. (b) An external triggering is responsible for the star-formation propagating from South to North. [abridged]Comment: 19 pages, 11 figures, accepted by Ap

Enterococcus faecalis Endocarditis Severity in Rabbits Is Reduced by IgG Fabs Interfering with Aggregation Substance

Background: Enterococcus faecalis is a significant cause of infective endocarditis, an infection of the heart endothelium leading to vegetation formation (microbes, fibrin, platelets, and host cells attached to underlying endothelial tissue). Our previous research determined that enterococcal aggregation substance (AS) is an important virulence factor in causation of endocarditis, although endocarditis may occur in the absence of AS production. Production of AS by E. faecalis causes the organism to form aggregates through AS binding to enterococcal binding substance. In this study, we assessed the ability of IgGs and IgG Fabs against AS to provide protection against AS + E. faecalis endocarditis. Methodology/Principal Findings: When challenged with AS + E. faecalis, 10 rabbits actively immunized against AS + E. faecalis developed more significant vegetations than 9 animals immunized against AS 2 E. faecalis, and 9/10 succumbed compared to 2/9 (p,0.005), suggesting enhanced aggregation by IgG contributes significantly to disease. IgG antibodies against AS also enhanced enterococcal aggregation as tested in vitro. In contrast, Fab fragments of IgG from rabbits immunized against purified AS, when passively administered to rabbits (6/group) immediately before challenge with AS + E. faecalis, reduced total vegetation (endocarditis lesion) microbial counts (7.9610 6 versus 2.0610 5, p = 0.02) and size (40 mg versus 10, p = 0.05). In vitro, the Fabs prevented enterococcal aggregation. Conclusions/Significance: The data confirm the role of AS in infective endocarditis formation and suggest that use of Fab