Percepción de padres y enfermeros sobre la atención de enfermería en neonatología – una revisión integradora

Background: The admission of a Newborn (NB) to a Neonatal Intensive Care Unit (NICU) requires specialised skills from nurses in order to not only assess the NB’s biological features, but also focus care on the NB/parents binomial. Objectives: To analyse the scientific evidence on the Nursing care experienced at NICUs from the perspective of nurses and parents of NBs during their hospital stay at those units. Methodology: An integrative literature review was conducted. The following databases were searched in the EBSCOhost platform: CINAHL; MEDLINE and Cochrane. Scientific studies published in databases of reference from 2004 to 2013 were selected based on previously defined inclusion and exclusion criteria. Results: Nine studies which emphasised the diversity of perceptions of care were included. The analysis of these studies allowed organising the results into three themes: therapeutic relationship, humanisation of care and suffering. Conclusion: The evidence obtained in this study suggest that parents of NBs admitted to NICUs experience a great emotional overload and need to receive information and support from nurses.Contexto: A admissão de um Recém-Nascido (RN) numa Unidade de Cuidados Intensivos Neonatais (UCIN) requer dos enfermeiros competências especializadas, de modo a considerar não somente os aspetos biológicos do RN, mas centrando o cuidar no binómio RN/pais. Objetivos: Conhecer a evidência científica sobre os cuidados de Enfermagem experienciados em UCIN, na perceção dos enfermeiros e dos pais dos RN durante o período de internação nessas unidades. Metodologia: Realizou-se uma revisão integrativa da literatura. Elegeuse a plataforma EBSCOhost e selecionaram-se as bases bibliográficas eletrónicas: CINAHL, MEDLINE e Cochrane. Os estudos científicos publicados em bases de dados de referência, entre 2004-2013, foram selecionados com critérios de inclusão e exclusão previamente definidos. Resultados: Incluídos nove estudos que ressaltaram diversidade de perceções sobre os cuidados de Enfermagem. A análise destes estudos permitiu organizar os resultados em três temas: relação terapêutica; humanização dos cuidados e sofrimento. Conclusão: As evidências, neste estudo, mostram que os pais que têm um RN internado em UCIN experienciam uma grande sobrecarga emocional, necessitam de receber informações e apoio dos enfermeiros.Contexto: La admisión de un Recién Nacido (RN) en una Unidad de Cuidados Intensivos Neonatales (UCIN) requiere que los enfermeros tengan competencias especializadas con el fin de tener en cuenta no solo los aspectos biológicos del RN, sino centrando la atención en el binomio RN/padres. Objetivos: Conocer la evidencia científica sobre la atención de enfermería experimentada en las UCIN, en la percepción de los enfermeros y de los padres de los RN durante el período de internamiento hospitalario en estas unidades. Metodología: Se realizó una revisión integradora de la literatura. Para ello, se consultó la plataforma EBSCOhost y se seleccionaron las bases bibliográficas electrónicas: CINAHL; MEDLINE y Cochrane. Los estudios científicos publicados en las bases de datos de referencia, entre 2004 y 2013, fueron seleccionados con criterios de inclusión y exclusión previamente definidos. Resultados: Se incluyeron nueve estudios que resaltaron una diversidad de percepciones sobre la atención de enfermería. El análisis de estos estudios permitió organizar los resultados en tres temas: relación terapéutica, humanización de la atención y sufrimiento. Conclusión: En este estudio, las evidencias indican que los padres que tienen un RN ingresado en una UCIN experimentan una gran sobrecarga emocional y necesitan recibir información y apoyo de los enfermeros.info:eu-repo/semantics/publishedVersio

Comunidade zooplanctônica de seis reservatórios no nordeste do Brasil

The aim of the present study was to investigate the zooplankton community at six reservoirs in the state of Pernambuco (Brazil). Zooplankton assemblages were identified using current literature and quantitatively analysed under a microscope and stereomicroscope. Concurrently to the sampling of zooplanktonic and phytoplanktonic communities, in situ measurements of abiotic variables, such as water temperature, dissolved oxygen and pH, were determined using field probes and transparency was determined with a Secchi disk. Total phosphorus concentrations were used for the determination of the Trophic State Index. The reservoirs were classified between eutrophic and hypertrophic, oxygenated, with pH varying from slightly acid to alkaline, high temperatures and low water transparency. A total of 27 zooplankton taxa were identified. Phytoplankton was represented by Cyanophyta, Chlorophyta, Baccilariophyta and phytoflagellates. The highest richness of species was observed for Rotifera (17), followed by Crustacea (8), Protozoa (1) and Insecta (1). Rotifers shared quantitative importance with Crustacea, which were mainly represented by juvenile forms. Jazigo Reservoir presented the highest diversity and equitability. Lowest diversity and equitability were recorded at the Poço da Cruz and Mundaú reservoirs, respectively. Dissimilarity was detected between the environments studied regarding zooplankton composition and structure.O objetivo deste trabalho foi estudar a estrutura e dinâmica do zooplâncton em seis reservatórios do Estado de Pernambuco. A comunidade zooplanctônica foi identificada com literatura atualizada e a densidade analisada sob microscópio e estereomicroscópio. Concomitantemente às coletas das comunidades zooplanctônicas e fitoplanctônicas, foram medidas in situ algumas variáveis abióticas como temperaturas da água e do ar, oxigênio dissolvido, condutividade elétrica, pH, turbidez, usando sondas de campo, transparência com disco de Secchi. As concentrações de fósforo total foram usadas para a determinação do Índice de Estado Trófico. Os reservatórios foram classificados entre eutróficos e hipertróficos, oxigenados, pH levemente ácido a alcalino, temperaturas altas e baixos valores de transparência da água. O zooplâncton esteve composto por 27 táxons. O fitoplâncton foi representado pelas Cyanophyta, Chlorophyta, Baccilariophyta e Fitoflagelados. A maior riqueza de espécies foi observada para Rotifera, (17), seguida por Crustacea (8), Protozoa (1) e Insecta (1). Rotifera compartilhou a importância quantitativa com os Crustacea, estes representados principalmente pelas formas jovens. No reservatório de Jazigo, foram obtidos os maiores valores para diversidade e equitabilidade. Os valores mais baixos foram registrados em Poço da Cruz e Mundaú, respectivamente. Foi detectada dissimilaridade entre os ambientes estudados quanto à composição e estrutura do zooplâncton

Cough in paediatrics

A tosse é provavelmente o sintoma mais frequente na criança e, consequentemente, um dos principais motivos de consulta em pediatria. Os mecanismos e as causas da tosse na criança diferem das do adulto e, por esse motivo, é necessária uma diferente abordagem diagnóstica e terapêutica. Este artigo de revisão abrange a fisiopatologia da tosse na criança, as causas mais frequentes, a avaliação diagnóstica inicial e a orientação terapêutica

Anomalia de Ebstein: um caso com uma evolução inesperada

A anomalia de Ebstein da válvula tricúspide é uma cardiopatia congénita complexa rara. A etiologia é desconhecida e, na maioria dos casos parece ser multifactorial. A mortalidade no período neonatal é alta. Os autores apresentam um caso clínico de anomalia de Ebstein grave com diagnóstico pré-natal. No período perinatal efectuou-se um shunt de Blalock-Taussig modificado à esquerda e aos cinco meses de vida foi submetida a valvuloplastia pulmonar percutânea com sucesso. A evolução clínica tem sido favorável tendo-se optado por não efectuar operação de Glenn. Actualmente com 18 meses de vida encontra-se assintomática. Ebstein’s anomaly of the tricuspid valve is a rare and complex congenital heart defect. Its etiology is unknown and in the majority of cases it is multifactorial. Mortality in the neonatal period is high. The authors present a case of severe Ebstein’s anomaly diagnosed antenatally. In the perinatal period a Blalock-Taussig shunt was performed and at the age of five months the infant underwent successful percutaneous pulmonary valvuloplasty. The clinical outcome has been favorable and we decided to postpone a Glenn procedure. At 18 months the child is asymptomatic

Caloric intake and weight gain in a neonatal intensive care unit

The aim of this paper was to study the weight gain in very-low-birthweight (VLBW) infants by adopting earlier and higher intake of proteins and earlier intake of lipids. We studied 28 VLBW infants admitted to Neonatal Intensive Care Unit during the year 2004 (group 1) and 18 during the first semester of 2006 (group 2). Dietary intakes for group 1 were: 1 g kg−1 day−1 of proteins started at postnatal day 2 (P2) and 0.5–1 g kg−1 day−1 of lipids at P3; for group 2, 1–1.5 g kg−1 day−1 of proteins and 0.5–1 g kg−1 day−1 of lipids, both started at P1. Caloric intake was significantly higher in group 2 (p<0.05), whereas cumulative nutritional deficit was higher in group 1 (p ≤ 0.01). Weight z scores were significantly lower at discharge comparing with z scores at birth for each group (p ≤ 0.01), with no differences between the two groups. Despite a higher protein intake which resulted in a lower nutritional deficit, the weight z score did not improve significantly at discharge

Spectrum and Frequency of GJB2 Mutations in a Cohort of 264 Portuguese Nonsyndromic Sensorineural Hearing Loss Patients

OBJECTIVE: To assess the spectrum and prevalence of mutations in the GJB2 gene in Portuguese nonsyndromic sensorineural hearing loss (NSSHL) patients. DESIGN: Sequencing of the coding region, basal promoter, exon 1, and donor splice site of the GJB2 gene; screening for the presence of the two common GJB6 deletions. STUDY SAMPLE: A cohort of 264 Portuguese NSSHL patients. RESULTS: At least one out of 21 different GJB2 variants was identified in 80 (30.2%) of the 264 patients analysed. Two mutant alleles were found in 53 (20%) of these probands, of which 83% (44/53) harboured at least one c.35delG allele. Twenty-seven (10.2%) of the probands harboured only one mutant allele. Subsequent analysis revealed that the GJB6 deletion del(GJB6-D13S1854) was present in at least 7.4% (2/27) of the patients carrying only one mutant GJB2 allele. Overall, one in five (55/264) of the patients were diagnosed as having DFNB1-related NSSHL, of which the vast majority (53/55) harboured only GJB2 mutations. CONCLUSIONS: This study provides clear demonstration that mutations in the GJB2 gene are an important cause of NSSHL in Portugal, thus representing a valuable indicator as regards therapeutical and rehabilitation options, as well as genetic counseling of these patients and their families

Characteristics of Dysphagia in Infants with Microcephaly Caused by Congenital Zika Virus Infection, Brazil, 2015.

We summarize the characteristics of dysphagia in 9 infants in Brazil with microcephaly caused by congenital Zika virus infection. The Schedule for Oral Motor Assessment, fiberoptic endoscopic evaluation of swallowing, and the videofluoroscopic swallowing study were used as noninstrumental and instrumental assessments. All infants had a degree of neurologic damage and showed abnormalities in the oral phase. Of the 9 infants, 8 lacked oral and upper respiratory tract sensitivity, leading to delays in initiation of the pharyngeal phase of swallowing. Those delays, combined with marked oral dysfunction, increased the risk for aspiration of food, particularly liquid foods. Dysphagia resulting from congenital Zika virus syndrome microcephaly can develop in infants >3 months of age and is severe