Safe practices for bed bathing in the intensive care unit: validation of a checklist / Prácticas seguras para baño en el lecho en la unidad de cuidados intensivos: validación de un checklist / Práticas seguras para banho no leito na unidade de terapia intensiva: validação de um checklist

ABSTRACT Objective: To validate a checklist for safe bathing in critically ill patients. Methods: This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used. Results: In the apparent and content validation, adjustments were made according to the judges' suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962). Conclusion: The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.

RESUMEN Objetivo: Validar lista de verificación para el baño seguro en pacientes críticos. Métodos: Estudio metodológico y cuantitativo. Se elaboró una lista de verificación para baño seguro en paciente crítico compuesta por 41 ítems, que fue sometida al proceso de validación aparente y de contenido, evaluada por 11 jueces, y confiabilidad interobservadores. Para el análisis de confiabilidad, el instrumento fue aplicado en 54 procedimientos de baño en el lecho en UTI; utilizados las pruebas de Kappa e ICC. Resultados: En la validación aparente y de contenido, fueron realizados ayustes conforme sugestiones de los jueces. Los valores de Kappa variaron de moderado a casi perfecto (0,462 a 0,962); y, en algunos ítems, hubo 100% de concordancia; la confiabilidad del instrumento fue excelente (ICC = 0,962). Conclusión: El instrumento se demostró confiable y de fácil aplicación. Su utilización contribuirá para el baño en el lecho seguro y subsidiará intervenciones que objetiven aumentar la calidad asistencial.

RESUMO Objetivo: Validar uma lista de verificação para o banho seguro em pacientes críticos. Métodos: Estudo metodológico e quantitativo. Elaborou-se uma lista de verificação para banho seguro no paciente crítico composta por 41 itens, que foi submetida ao processo de validação aparente e de conteúdo, avaliada por 11 juízes, e confiabilidade interobservadores. Para a análise de confiabilidade, o instrumento foi aplicado em 54 procedimentos de banho no leito em UTI; utilizaram-se os testes de Kappa e ICC. Resultados: Na validação aparente e de conteúdo, foram realizados ajustes conforme sugestões dos juízes. Os valores de Kappa variaram de moderado a quase perfeito (0,462 a 0,962); e, em alguns itens, houve 100% de concordância; a confiabilidade do instrumento foi excelente (ICC = 0,962). Conclusão: O instrumento demonstrou-se confiável e de fácil aplicação. Sua utilização contribuirá para o banho no leito seguro e subsidiará intervenções que visem aumentar a qualidade assistencial.

Correlation between Bath Ankylosing Spondylitis Disease Activity Index Score and body mass index in the patients suffering with ankylosing spondylitis

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of this disease. It is an autoimmune disease which also leads to the involvement of skeletal, cardiac, nervous tissues, and other systemic organs. Aim and Objectives: This study was conducted to assess the correlation between the Bath AS Disease Activity Index (BASDAI) score/visual analog scale (VAS) and various age groups in the patients suffering with AS using standard questionnaire. Materials and Methods: Forty-eight AS patients having BASDAI scores of ?4 were included in this study. The height and weight were taken and responses to the standard questionnaire were recorded. BASDAI Score, body mass index (BMI), and VAS were computed. The patients with history of chronic diseases such as hyper/hypothyroidism, diabetes mellitus, and hypertension or the use of any medication such as ?/? blockers, calcium channel blockers, and antiepileptics were excluded from the study. Results: The patients were divided into six different age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years. The mean ± SEM values of the BASDAI score in various age groups were 6.8 ± 0.34, 6.3 ± 0.33, 6.2 ± 0.26, 7.1 ± 0.41, 6.5 ± 0.30, and 5.8 ± 0.48, respectively. The mean ± SEM values of VAS are shown in relation to the various age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years and the values were 6.88 ± 0.312, 6.58 ± 0.22, 6.55 ± 0.66, 6.00 ± 0.23, 6.72 ± 0.25, and 6.0 ± 0.50, respectively. Conclusion: This study indicates that in the young age group, patients BASDAI score is higher and BMI is lower, and in the older age group, patients BASDAI score is lower and BMI is higher than each other indicating higher disease activity in the younger patients than older patients. An inverse correlation between VAS and age further substantiates our previous finding.

PERINEOTOMY CARE AFTER CHILDBIRTH

Every woman who became pregnant has to undergo the process of delivery. In normal process of delivery the baby is delivered per vagina, an episiotomy is performed by health care provider or midwife. Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour to enlarge the vaginal introits so as to facilitate easy and safe delivery of the fetus. Episiotomy may be advice in the situations such as inelastic perineum, fetal distress, and complicated birth, prolonged second stage of labor, instrumental vaginal delivery and previous perineal surgeries .There are four types of episiotomy: midline, mediolateral, lateral and J shaped. Care of episiotomy involves perineal care, sitz bath, infrared heat, perineal exercises, antiseptic ointments, cold and hot packs The REEDA scale is used for assessing the perineal healing. Complications of episiotomy include perineal discomfort, perineal pain, difficulty with breast feeding and walking, perineal bleeding, infection, wound dehiscence and dyspareunia

Digital educational technology content production and validity about Japanese bathtub (ofurô) in neonatal unit / Producción y validación de contenido de tecnología educativa digital sobre baño de hidromasaje en unidad neonatal / Produção e validação de conteúdo de tecnologia educacional digital sobre banho de ofurô em unidade neonatal

ABSTRACT Objective: To describe the elaboration and content validity stages of a digital educational technology for nursing professionals about Japanese bathtub (ofurô) in newborns in neonatal care units. Method: A methodological study conducted between August 2019 and July 2021, in a public maternity hospital in Manaus, Amazonas, developed in two stages. In the first, the e-book images, text and editing were produced. In the second, material content validity was carried out, through the opinion of 15 expert judges, nurses and neonatal care experts. In data analysis, the percentage of agreement was applied with agreement score estimation. Items with 80% or more agreement were considered valid. Results: The e-book "Japanese bathtub: manual for nursing professionals" was produced, organized into nine sessions, which describe the technique execution. Content was considered valid by expert judges (general score 90%). Conclusion: The e-book was considered suitable for use in training nursing professionals, with potential for dissemination of knowledge regarding humanization of care for premature babies.

RESUMEN Objetivo: Describir las etapas de elaboración y validación de contenido de una tecnología educativa digital para profesionales de enfermería sobre el baño ofurô en recién nacidos en Unidades de Cuidados Neonatales. Método: Estudio metodológico realizado entre agosto de 2019 y julio de 2021, en una maternidad pública de Manaus, Amazonas, desarrollado en dos etapas. En la primera se produjeron las imágenes, el texto y la edición del e-book. En el segundo, se realizó la validación de contenido del material, a través de la expresión de 15 jueces expertos, enfermeros y experimentados en cuidados neonatales. En el análisis de datos se aplicó el porcentaje de concordancia con estimación del puntaje de concordancia. Se consideraron válidos los ítems con un 80% o más de acuerdo. Resultados: Se elaboró el libro electrónico "Banho de ofurô: manual para profissionais de enfermagem" (Baño de Ofurô: manual para profesionales de enfermería), organizado en nueve sesiones, que describen la ejecución de la técnica. El contenido fue considerado válido por los jueces expertos (puntuación general 90%). Conclusión: El e-book se consideró apto para ser utilizado en la formación de profesionales de enfermería, con potencial para la difusión de conocimientos sobre la humanización del cuidado del recién nacido prematuro.

RESUMO Objetivo: Descrever as etapas de elaboração e validação de conteúdo de uma tecnologia educacional digital para profissionais de enfermagem sobre o banho de ofurô em recém-nascidos em Unidades de Cuidado Neonatal. Método: Estudo metodológico conduzido entre agosto de 2019 e julho de 2021, em uma maternidade pública de Manaus, Amazonas, desenvolvido em duas etapas. Na primeira, foram produzidas as imagens, texto e editoração do e-book. Na segunda, foi conduzida a validação de conteúdo do material, pela manifestação de 15 juízes especialistas, enfermeiros e experientes no cuidado neonatal. Na análise dos dados, aplicou-se a porcentagem de concordância com estimação de escore de concordância. Foram considerados válidos os itens com 80% ou mais de concordância. Resultados: Foi produzido o e-book "Banho de ofurô: manual para profissionais de enfermagem", organizado em nove sessões, que descrevem a execução da técnica. O conteúdo foi considerado válido pelos juízes especialistas (escore geral 90%). Conclusão: O e-book foi considerado adequado para ser utilizado em treinamento de profissionais de enfermagem, com potencial para a difusão do conhecimento quanto à humanização da assistência ao recém-nascido prematuro.

Effect of different immersion bath methods on the healing of skin lesions in patients with pemphigus / 中华皮肤科杂志

Objective:To analyze effects of ozone bath, 1∶8 000 potassium permanganate bath and 1∶5 000 potassium permanganate bath on the recovery of skin lesions in patients with pemphigus.Methods:Patients with pemphigus, who received immersion bath treatment during their hospitalization, were retrospectively collected from Department of Dermatology, Peking University First Hospital from January 2016 to June 2021. The efficacy and safety of different immersion bath methods including ozone bath, 1∶8 000 potassium permanganate bath and 1∶5 000 potassium permanganate bath were compared. Categorical variables were compared using chi-square test or Fisher′s exact test, and univariate and multivariate logistic regression models were used to analyze relationships between candidate variables and patients′ condition at discharge.Results:A total of 74 patients with pemphigus were included, including 45 (60.81%) males and 29 (39.19%) females, their age ( M[ Q1, Q3]) was 52 (41, 60) years, and the median percentage of primary skin lesion area in body surface area was 40%. There were no significant differences in hospital stays, disease duration (time from onset to admission) , gender ratio or skin lesion areas among patients receiving ozone bath (32 cases) , patients receiving 1∶8 000 potassium permanganate bath (25 cases) and those receiving 1∶5 000 potassium permanganate bath (17 cases, all P > 0.05) . These patients still received other treatments, including glucocorticoids, gamma globulin, plasma transfusion, rituximab, immunosuppressants, topical antibiotics, etc., and there was no significant difference in the proportions of patients using the above therapies among the three groups (all P > 0.05) , while the ozone bath group showed a lower proportion of patients using systemic antibiotics compared with the two potassium permanganate bath groups (both P < 0.01) . At discharge, in the ozone bath group, 1 case was improved, 21 were nearly cured, and 10 were cured; in the 1∶8 000 potassium permanganate bath group, 4 cases were improved, 13 were nearly cured, and 8 were cured; in the 1∶5 000 potassium permanganate bath group, 5 were improved, 8 were nearly cured, and 4 were cured. The proportion of well-recovered patients was significantly higher in the ozone bath group (31/32 cases) than in the potassium permanganate bath group (33/42 cases, P = 0.036) . Univariate and multivariate analyses showed that ozone bath significantly affected the patients′ condition at discharge ( P < 0.05) , and was an independent predictor of "good recovery" at discharge ( HR = 8.455, 95% CI: 1.011 - 70.672, P = 0.049) . Conclusion:Ozone bath therapy can facilitate recovery of skin lesions in patients with pemphigus.

A study to assess the effectiveness of warm foot bath therapy on the reduction of blood pressure among hypertensive patients attending a tertiary care setting

Background: The goal of hypertension management is to keep blood pressure within normal bounds while also enhancing elderly patients’ quality of life and health. Warm foot baths are a straightforward, affordable, and effective therapy method that can be used in naturopathy to alleviate hypertension. Materials and Methods: This study used a quasi-experimental design that included two groups, the hypertensive intervention group and hypertensive control group, which was studied over 3 months between March 2020 and May 2020. The necessary ethical committee permissions with reference number VMRF/2020/037 and informed consent from all the patients included have been obtained properly before proceeding with the study. Results: Among the 100 individuals involved in the study, 53% were males and 47% were females. The mean age among the intervention group was 53.62 ± 7.26, and 52.84 ± 6.47 among the control group. The majority of the males included in the study were nonsmokers (69.8%). The mean ± standard deviation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the intervention group during the pretest phase was 157.3 ± 13.4 and 88.1 ± 9.4, whereas, after the intervention of foot bath therapy, the measurements of SBP and DBP were reduced significantly to 133.8 ± 9.7 and 76.9 ± 7.2, which was statistically significant with a P value < 0.001. Conclusion: Warm foot bath soak therapy is anticipated to be used as a nonpharmacological treatment for hypertension in older patients.

Randomized trial with soaps - what happens to a newborn baby's skin?

Abstract Objective: Evaluate the effectiveness of a children's soap with physiological pH in maintaining cutaneous pH and moisture of the newborn (NB)'s skin after the first bath. Methods: Randomized, controlled and double-blind clinical trial in a rooming-in of a tertiary maternity hospital in southern Brazil with 204 newborns > 34 gestational weeks. Gestational and obstetric history was evaluated, and newborns were randomized into two groups according to the product applied in the bath: the control group (CG), which used common liquid soap with pH 7.0 and experimental group (EG), which used children's liquid soap with pH 5.8. Evaluation was made immediately before and after bath with skin pH measurement, corneometry and clinical parameters (erythema, scaling and moisture), on the forehead, abdomen and thigh. Results: There was no difference between groups regarding gestational, obstetric and family history (p > 0.05). In CG, skin pH increased in the abdomen and thigh (p < 0.05). In EG there was an improvement in clinical parameters after bathing with: increased moisture, less erythema and less scaling (p < 0.05). On the forehead, there was a significant increase in pH after bathing (p < 0.001) similar in both groups, although no use of soap. There was no difference in corneometry between groups after bathing. Conclusions: Children's liquid soap with physiological pH maintained the acidic skin pH and moisture of the newborn's skin after the first bath, which reinforces the importance of using products with physiological pH in the hygiene of newborns. Registration number RBR-9ky84vd.

Canales de iones potasio en la dinámica contráctil del músculo liso arterial inducida por Camphenol Plus

RESUMEN Introducción: El Camphenol Plus es un derivado clorofenólico empleado como medicación intraconducto durante los tratamientos pulporradiculares en Estomatología. Son escasos los reportes científicos sobre el papel de los canales de iones potasio en la dinámica contráctil del músculo liso arterial inducida por dicho medicamento. Objetivo: Determinar el papel de los canales de iones potasio en la dinámica contráctil del músculo liso arterial inducida por Camphenol Plus. Método: Se realizó una investigación experimental preclínica en el Instituto de Fisiología "Oscar Langerdorff", Facultad de Medicina, Universidad de Rostock, Alemania, entre octubre y diciembre de 2018, con el empleo de 30 anillos de aorta obtenidos de 10 ratas Wistar (n=10). Las preparaciones biológicas se colocaron en baño de órganos y se preactivaron con solución Krebs concentrada en iones potasio, registrándose luego la tensión desarrollada por el músculo liso vascular tras la adición de soluciones de Camphenol Plus durante diferentes intervalos de tiempo. Se utilizaron las pruebas de Wilcoxon y U de Mann-Whitney. Resultados: El 31,4 % de la musculatura lisa vascular se relajó por acción del Camphenol Plus tras la preactivación con solución Krebs concentrada en iones potasio. El mayor descenso del tono vascular se produjo con el uso de soluciones del medicamento al 7 % entre el primer y tercer minutos. Conclusiones : El efecto vasorrelajante in vitro producido por Camphenol Plus sobre el músculo liso arterial está mediado por canales de iones potasio sensibles a voltaje, a calcio y a trifosfato de adenosina del endotelio vascular y el sarcolema.

ABSTRACT Introduction: Camphenol Plus is a chlorophenolic derivative commonly used as an intra - duct medication for pulporadicular treatments in Dentistry. Scientific reports about the use of this medication on the role of potassium ion channels in the contractile dynamics of induced arterial smooth muscle are low. Objective: To determine the role of potassium ion channels in the contractile dynamics of Camphenol Plus - induced arterial smooth muscle. Method: A preclinical experimental investigation was performed at the "Oscar Langerdorff" Institute of Physiology, Rostock University Medical Center, Rostock, Germany, between October and December 2018. A total of 30 aortic rings obtained from 10 Wistar rats (n=10) were used. The biological preparations were placed in an organ bath and preactivated with Krebs solution concentrated in potassium ions, afterwards it was recorded the tension developed by the vascular smooth muscle after applying the Camphenol Plus solutions in different time intervals. The Mann-Whitney U test and Wilcoxon test were applied. Results: The 31.4% of vascular smooth muscle was relaxed by the effect of Camphenol Plus after preactivation with Krebs solution concentrated in potassium ions. The greatest decrease in vascular tone occurred between the first and third minutes after the use of the drug solutions prepared at 7 %. Conclusions: The in vitro vasorelaxant effect produced by the Camphenol Plus medication on arterial smooth muscle is mediated by the potassium ion channels sensitive to voltage, calcium and the adenosine triphosphate of the vascular endothelium and sarcolemma.

RESUMO Introdução: Camphenol Plus é um derivado clorofenólico utilizado como medicação intracanal durante tratamentos pulporradiculares em Estomatologia. Existem poucos relatos científicos sobre o papel dos canais iônicos de potássio na dinâmica contrátil do músculo liso arterial induzida pela referida droga. Objetivo: Determinar o papel dos canais iônicos de potássio na dinâmica contrátil do músculo liso arterial induzida por Camphenol Plus. Método: Uma investigação experimental pré-clínica foi realizada no Instituto de Fisiologia "Oscar Langerdorff" da Faculdade de Medicina da Universidade de Rostock, Alemanha, entre outubro e dezembro de 2018, utilizando 30 anéis aórticos obtidos de 10 ratos Wistar (n=10). As preparações biológicas foram colocadas em banho de órgãos e pré-ativadas com solução de Krebs concentrada em íons potássio, registrando-se então a tensão desenvolvida pelo músculo liso vascular após a adição de soluções de Camphenol Plus em diferentes intervalos de tempo. Foram utilizados os testes U de Wilcoxon e Mann-Whitney. Resultados: 31,4% da musculatura lisa vascular relaxada pela ação do Camphenol Plus após pré-ativação com solução de Krebs concentrada em íons potássio. A maior diminuição do tônus vascular ocorreu com o uso de soluções medicamentosas a 7% entre o primeiro e o terceiro minutos. Conclusões: O efeito vasorrelaxante in vitro produzido pelo Camphenol Plus no músculo liso arterial é mediado por canais de íons de potássio sensíveis à voltagem, trifosfato de cálcio e adenosina do endotélio vascular e do sarcolema.

Positividade de culturas por modalidades de banho no leito hospitalar: estudo ecológico / Positividad de culturas por modalidades de baño en cama hospitalaria: estudio ecológico / Culture positivity by hospital bath bed modalities: an ecological study

Resumo Objetivo Verificar positividade de culturas microbiológicas de pacientes hospitalizados, com prescrição de enfermagem para banho no leito, em três períodos disjuntos e sequenciais das modalidades de banho no leito: convencional (BLC), descartável (BLD) e descartável acrescido de clorexidina degermante à 2% (BLD-CX). Métodos Estudo ecológico, tipo séries temporais de 48 meses, em três períodos (P1=BLC; P2=BLD; P3=BLD-CX), com dados secundários de prontuário eletrônico, de pacientes que estiveram internados em hospital do estado de São Paulo, Brasil. Resultados Nos períodos de banhos descartáveis, o percentual de positividade foi, em média, 14,6% menor quando comparado aos meses cujo banho de leito foi convencional. No período de BLD-CX o percentual de positividade foi, em média, 19,3% menor quando comparado aos meses do período de BLC. Contudo, não há evidências de diferença no percentual de positividade entre o BLD (b = -14,6%; IC95% = (-18,9% a -10,3%) e o BLD-CX (b = - 19,3%; IC95% = (-24,4% a -14,22%). A cada ano a mais na idade média do paciente, o percentual de positividade aumenta, em média 0,3% (p=0,060). Não houve associação sazonal para positividades das culturas microbiológicas nas modalidades de banho. Conclusão A positividade de culturas microbiológicas, em pacientes com prescrição de enfermagem para banho no leito, é menor quando se utiliza as modalidades descartáveis. Recomenda-se adotar rotineiramente o BLD, deixando a prescrição de BLD-CX, somente para degermação da pele para procedimentos invasivos, operatórios e higienização das mãos de profissionais de saúde.

Resumen Objetivo Verificar los resultados positivos de culturas microbiológicas de pacientes hospitalizados, con prescripción de enfermería de baño en cama, en tres períodos disjuntos y secuenciales de las modalidades de baño en cama: convencional (BCC), descartable (BCD) y descartable con clorhexidina al 2 % (BCD-CX). Métodos Estudio ecológico, tipo series temporales de 48 meses, en tres períodos (P1=BCC; P2=BCD; P3=BCD-CX), con datos secundarios de historia clínica electrónica, de pacientes que estuvieron internados en hospital del estado de São Paulo, Brasil. Resultados En los períodos de baños descartables, el porcentaje de resultados positivos presentó un promedio 14,6 % inferior en comparación con los meses en que el baño en cama fue convencional. Durante el período de BCD-CX el porcentaje de resultados positivos fue, en promedio, 19,3 % inferior en comparación con los meses del período de BCC. Sin embargo, no hay evidencias de diferencias en el porcentaje de resultados positivos entre el BCD (b = -14,6 %; IC95 % = (-18,9 % a -10,3 %) y el BLD-CX (b = - 19,3 %; IC95 % = (-24,4 % a -14,22 %). Por cada año que se suma a la edad promedio del paciente, el porcentaje de resultados positivos aumenta en promedio 0,3 % (p=0,060). No se verificó una asociación estacional en las respuestas positivas de las culturas microbiológicas en las modalidades de baños. Conclusión Los resultados positivos de culturas microbiológicas de pacientes con prescripción de enfermería de baño en cama son menores cuando se utilizan las modalidades descartables. Se recomienda adoptar de forma rutinaria el BCD y dejar la prescripción de BCD-CX solo para la eliminación de los gérmenes de la piel en procedimientos invasivos, quirúrgicos e higienización de manos de los profesionales de salud.

Abstract Objective To verify microbiological culture positivity of hospitalized patients, with a nursing prescription for bed bath, in three disjoint and sequential periods of bed bath modalities: conventional (CBB), disposable (DBB) and disposable plus 2% chlorhexidine degerming (DBB-CX). Methods This is an ecological, time series study of 48 months, in three periods (P1=CBB; P2=DBB; P3=DBB-CX), with secondary data from electronic medical records of patients who were admitted to a hospital in the state of São Paulo, Brazil. Results In the periods of disposable baths, the percentage of culture positivity was, on average, 14.6% lower when compared to the months in which bed bath was conventional. In the DBB-CX period, the percentage of culture positivity was, on average, 19.3% lower when compared to the CBB period months. However, there is no evidence of difference in the percentage of culture positivity between DBB (b = -14.6%; 95%CI = (-18.9% to -10.3%) and DBB-CX (b = - 19.3%;95%CI = (-24.4% to -14.22%) For each year more in patients' mean age, the percentage of culture positivity increases by an average of 0.3% (p=0.060). There was no seasonal association for microbiological culture positivity in bath modalities. Conclusion Microbiological culture positivity in patients with a nursing prescription for bed bath is lower when disposable modalities are used. It is recommended to routinely adopt DBB, leaving the prescription of DBB-CX only for skin degermation for invasive and operative procedures and hand hygiene of health professionals.

Validação de vídeo instrucional sobre banho de ofurô em recém-nascido pré-termo para enfermeiros / Validación de video instructivo sobre baño de ofuro en recién nacido prematuro para enfermeros / Validation of an instructional video for nurses about hot tub bath for preterm newborns

Resumo Objetivo Produzir um vídeo instrucional para enfermeiros sobre o banho de ofurô em recém-nascidos pré-termo e validar seu conteúdo. Método Estudo metodológico de desenvolvimento tecnológico com ênfase na validação de conteúdo, conduzido em três etapas: revisão exploratória da literatura, produção da tecnologia educacional do tipo vídeo instrucional e validação por especialistas. Os dados foram sistematizados e organizados em planilhas e as análises foram conduzidas no pacote estatístico R. Para validar o conteúdo, aplicaram-se o Índice Kappa, para medir a concordância entre as respostas, e o Índice de Validade de Conteúdo, para estimar a representatividade do item. Resultados As publicações sobre a técnica (n=3) identificadas na revisão de literatura foram utilizadas para a produção do vídeo. O vídeo simula o cuidado em unidade neonatal e tem duração de 13 minutos. No processo de validação, o vídeo foi considerado, no geral, com representatividade de conteúdo adequada e obteve índice de concordância entre as respostas quase perfeito. Dois itens foram avaliados como "adequados com alterações" e modificados. Conclusão e implicações para a prática O material produzido foi considerado adequado para ser utilizado na capacitação de enfermeiros sobre a técnica e compartilhamento de informações, contribuindo para o cuidado de enfermagem humanizado e seguro em unidades neonatais.

Resumen Objetivo Producir un video instructivo para enfermeros sobre el baño de ofuro en recién nacidos prematuros y validar su contenido. Método Estudio metodológico de desarrollo de tecnología con énfasis en la validación de contenido, realizado en tres etapas: revisión exploratoria de la literatura, producción de tecnología educativa de tipo video instructivo y validación por expertos. Los datos fueron sistematizados y organizados en hojas de cálculo y los análisis se realizaron en el paquete estadístico R. Para validar el contenido se aplicó el Índice Kappa para medir la concordancia entre las respuestas y el Índice de Validez del Contenido para estimar la representatividad del ítem. Resultados Para la producción del video se utilizaron publicaciones sobre la técnica (n = 3) identificadas en la revisión de la literatura. El video simula la atención en una unidad neonatal y tiene una duración de 13 minutos. En el proceso de validación, el video se consideró, en general, con adecuada representación de contenido y con un índice de concordancia casi perfecto entre las respuestas. Dos ítems se evaluaron como "adecuados con cambios" y se modificaron. Conclusión e implicaciones para la práctica El material producido fue considerado por los especialistas como adecuado para uso en la formación de enfermeros sobre la técnica y el intercambio de información, contribuyendo para la atención de enfermería humanizada y segura en las unidades neonatales.

Abstract Objective To produce an instructional video for nurses about hot tub bath for preterm newborns and to validate its content. Method Methodological study of technological development with emphasis on content validation, conducted in three stages: exploratory literature review, production of an instructional video educational technology and expert validation. The data were systematized and organized in spreadsheets and the analyses were carried out in the statistical package R. For content validation, the Kappa Index was calculated to measure response agreement and the Content Validity Index was employed to estimate item representativeness. Results Publications about the technique (n=3) identified in the literature review were used for video production. The video simulates care in a neonatal unit and lasts 13 minutes. In the validation process, the video was considered, in general, to have an adequate content representation and had an almost perfect response agreement index. Two items were assessed as "adequate after revision" and modified. Conclusion and implication for the practice The produced material was considered by the experts as suitable for use in training nurses on the technique and sharing information, contributing to a humanized and safe nursing care in neonatal units.

Dinámica contráctil inducida por p-clorofenol alcanforado en anillos aórticos de ratas Wistar / Dinâmica contrátil induzida por cânfora-clorofenol em anéis aórticos de ratos Wistar / Camphorated p-chlorophenol-induced contractile dynamics in aortic rings of Wistar rats

Introducción: El p-clorofenol alcanforado es un derivado clorofenólico de uso común como medicación intraconducto en Endodoncia. Son escasos los reportes científicos sobre sus efectos en la musculatura lisa vascular arterial y la regulación del flujo sanguíneo local. Objetivo: Determinar el efecto del p-clorofenol alcanforado sobre la dinámica contráctil del músculo liso vascular arterial en el tiempo. Método: Se realizó una investigación experimental preclínica utilizando 14 anillos de aorta obtenidos de ratas Wistar. Los anillos se colocaron en baño de órganos y se preactivaron con noradrenalina, registrándose luego la tensión desarrollada por el músculo liso vascular tras la adición de p-clorofenol alcanforado durante diferentes intervalos de tiempo. Resultados: El 51,4 porciento de la musculatura lisa vascular se relajó por la acción del p-clorofenol alcanforado. El mayor descenso del tono vascular se produjo entre el tercer y quinto minuto de añadido el medicamento. Las pruebas de Wilcoxon de los rangos con signos evidenciaron diferencias significativas entre la tensión base inicial y la registrada en los diferentes intervalos de tiempo estudiados. Conclusiones: el p-clorofenol alcanforado, induce in vitro, relajación del músculo liso arterial a través de un acoplamiento excitación-contracción de tipo farmacomecánico, la cual se incrementa en función del tiempo(AU).

Introduction: Camphorated p-chlorophenol is a chlorophenolic derivative commonly used as an intra-oral medication in endodontics. Scientific reports on its effects in arterial vascular smooth muscle and local blood flow regulation are scarce. Objective: To determine the effect of camphorated p-chlorophenol on the contractile dynamics of arterial vascular smooth muscle. Method: An experimental and preclinical research was conducted with the use of 14 aortic rings of Wistar rats. The rings were placed in an organ bath and preactivated with noradrenaline, and the tension developed by the vascular smooth muscle at different time intervals was recorded after induction of camphorated p-chlorophenol. Results: Most of the vascular smooth muscle (51.4 percent) relaxed with the use of camphorated p-chlorophenol. The greatest decrease in vascular tone occurred between the third and fifth minute after use the drug. Wilcoxon rank tests showed significant differences between tension observed at baseline and those recorded at the different time intervals studied. Conclusions: Camphorated p-chlorophenol, induces in vitro, relax the arterial smooth muscle through a pharmacomechanical excitation-contraction link, which increases according to the time(AU).

Introdução: O cânfora-clorofenol é um derivado clorofenólico comumente utilizado como medicamento intracanal em Endodontia. Relatórios científicos sobre seus efeitos no músculo liso vascular arterial e na regulação do fluxo sanguíneo local são escassos. Objetivo: Determinar o efeito da cânfora-clorofenol na dinâmica contrátil do músculo liso vascular arterial ao longo do tempo. Método: Foi realizada investigação experimental pré-clínica com 14 anéis aórticos obtidos de ratos Wistar. Os anéis foram colocados em banho de órgãos e pré-ativados com norepinefrina, em seguida, a tensão desenvolvida pela musculatura lisa vascular foi registrada após a adição de cânfora-clorofenol em diferentes intervalos de tempo. Resultados: 51,4 porcento dos músculos lisos vasculares estavam relaxados pela ação do cânfora-clorofenol. A maior diminuição do tônus vascular ocorreu entre o terceiro e o quinto minuto após a adição do medicamento. Os testes de Wilcoxon das faixas com sinais mostraram diferenças significativas entre a tensão base inicial e a registrada nos diferentes intervalos de tempo estudados. Conclusões: O cânfora-clorofenol induz, in vitro, relaxamento da musculatura lisa arterial por meio de um acoplamento excitação-contração do tipo farmacomecânico, que aumenta em função do tempo(AU).

Epidemiological analysis of jellyfish stings in coastal bathing beaches in Qinhuangdao City from 2017 to 2019 / 中华危重病急救医学

Objective:To analyze the distribution and composition characteristics of jellyfish stings in various coastal baths in Qinhuangdao City from 2017 to 2019, and to provide scientific basis for the prevention, control and early warning of jellyfish stings.Methods:Statistics and analysis of the age, gender, time of stings, location of injury, first symptoms, and playing time in the sea at the time of the sting, etc. of people with jellyfish stings in various bathing beaches along the coast of Qinhuangdao from 2017 to 2019 (July to August) were conducted.Results:The number of jellyfish stings in the coastal bathing beaches of Qinhuangdao City in 2017, 2018, and 2019 was decreasing year by year, with 1 890, 492, and 171 cases respectively. Among them, Qianshuiwan Bathing Beach and Dongshan Bathing Beach had more stings (60.90% and 35.08% respectively in 2017, 24.39% and 64.23% respectively in 2018, 16.96% and 16.42% respectively in 2019). There was no significant change in the gender and age distribution of jellyfish stings each year [57.99% males in 2017, with a median age of 13 (8, 31) years old; 63.21% males in 2018, with a median age of 25 (8, 29) years old; and 59.65% males in 2019, with a median age of 12 (7, 31) years old]. Stings were mainly located at the lower limbs (the proportion of lower limb injuries: 46.54% in 2018, 45.61% in 2019), followed by upper limbs (upper arm, elbow, forearm), trunk, etc. The first symptom was mainly pain (89.43% in 2018, 38.29% in 2019), followed by rash (64.43% in 2018, 59.43% in 2019), numbness, blisters, etc. Sting incidents mainly occurred from 13:00 to 17:59 (the proportion of sting incidents in this time period in 2018 and 2019 were 68.09% and 52.63%, respectively).Conclusions:Jellyfish stings in coastal baths in Qinhuangdao City are mainly distributed in Qianshuiwan Baths and Dongshan Baths. The management of these sea areas should be strengthened, and scientific publicity and medical rescue should be strengthened to prevent jellyfish stings in peak hours and related baths.

Mechanism of Wuwei Ganlu in treatment of knee osteoarthritis:a study based on network pharmacology and molecular docking / 中国中药杂志

Wuwei Ganlu, a formula for medicated bath, consists of medicinal materials of Ephedra sinica, Platycladus orientalis, Myricaria squamosa, Artemisia carvifolia, and Rhododendron anthopogonoides, which is effective in inducing perspiration, resisting inflammation, relieving pain, regulating yellow water disease, and activating blood circulation. On this basis, a variety of formulas for Tibetan medicated bath have been derived for the treatment of diseases in internal organs, joints, nerves, etc. Modern studies have confirmed that Wuwei Ganlu has a good therapeutic efficacy on knee osteoarthritis(KOA). The present study explored the mechanism of Wuwei Ganlu in treating KOA based on network pharmacology and molecular docking. Firstly, the chemical components of Wuwei Ganlu were obtained through literature mining and database retrieval, and corresponding potential targets were predicted according to the BATMAN-TCM database. The protein-protein interaction(PPI) network was obtained after the potential targets were input into the STRING database. The network function modules were analyzed by the Molecular Complex Detection(MCODE) algorithm, and the functions of the modules were annotated to analyze the action mode of Wuwei Ganlu. Secondly, the related targets of KOA were collected through the DisGeNET database, and the overlapping targets were confirmed to analyze the mechanism of Wuwei Ganlu in treating KOA. Finally, the key targets were selected for molecular docking with the main components of Wuwei Ganlu to verify the component-target interaction. A total of 550 chemical components and 1 365 potential targets of Wuwei Ganlu were obtained. PPI analysis indicated that this formula could exert the effects of oxidation-reduction, inflammation resistance, bone absorption, bone mineralization, etc. Nineteen common targets were obtained from the intersection of potential targets of Wuwei Ganlu and KOA disease targets. It was found that the Wuwei Ganlu mainly acts on nuclear factor-κB(NF-κB), interleukin-1 beta(IL1β), tumor necrosis factor(TNF), IL6, IL1 receptor antagonist(IL1 RN), and prostaglandin-endoperoxide synthase-2(PTGS2) to treat KOA. Among the 550 chemical components of Wuwei Ganlu, 252 potential active components were docked with TNF and 163 with PTGS2, indicating good binding of the components with potential key targets. The study preliminarily explored the mechanism of Wuwei Ganlu in treating KOA to provide a reference for the further development and utilization of Tibetan medicated bath that has been included in the UN Intangible Cultural Heritage.

Retrospective observational study to evaluate the concept of the warm versus regular room temperature seitz bath in perineal wound healing

Background: Seitz bath in post-perineal surgery minimizes pain by reducing anal sphincter tone and also maintains hygiene. The aim and objective of this retrospective study is to compare the effect of warm versus regular room temperature seitz bath. The article clears the concept of seitz bath. The seitz bath gives psychological satisfaction of dressing to patient and helps in boosting the concept of hygiene in their mind.Method: Study design for this study was comparative study of warm and room temperature seitz bath on 60 patients by convenience sampling operated for perineal diseases from 01 November 2019 to 30 March 2020 with written informed consent of patient and fulfilling ethical requirements at Rajiv Gandhi Medical College, Thane, Mumbai. Patients with immunocompromised status and comorbidities like diabetes, tuberculosis, HIV were excluded from study this was the criteria for the study.Results: Out of 60 postoperative cases having perineal wounds, 35 (58.33%) patients opted for warm water seitz bath, while the rest 25 (41.66%) preferred regular room temperature seitz bath. In spite of a greater number of patients opting for warm seitz bath, wound recovery in terms of healing and wound discharge was almost similar in both the study groups. All the patients involved in the study were comfortable to resume their daily activities with significant reduction in pain by the end of first week irrespective of the choice of seitz bath they opted for.Conclusion: The study concludes that symptomatic relief and wound recovery in the operated cases of perineal surgeries completely independent of the choice of seitz bath practiced.

Faulty traditional practices in infant care / Prácticas tradicionales defectuosas en el cuidado infantil

Proper advice regarding home-based care of normal infants is no less important than managing critical diseases. Otherwise parents tend to follow traditional practices running in the family which are often deleterious. Clinicians must also be aware of the faulty traditional practices so that they can actively enquire them in the child's history.The author enlisted various such faulty traditional practices as experienced by him during his OPD practice in various public and corporate hospitals over a period of five years. Topics relating mainly to the infant age group have been chosen for this article. Relevant search was done on these topics in standard paediatric textbooks, journals, and websites (like WHO, NICE, AAP) to find the validity of these practices as well as the standard recommendations on these topics.It was found that the standard recommendations often differ from the traditional practices. Detailed text was included from various authentic sources regarding few dubious topics related to home-based infant care.Clinicians should be aware of the correct recommended methods regarding the day to day home-based infant care. They should counsel the parents accordingly so as to avoid any harm caused by faulty traditional practices and social beliefs.

El asesoramiento adecuado sobre la atención domiciliaria de los bebés normales no es menos importante que el manejo de enfermedades críticas. De lo contrario, los padres tienden a seguir las prácticas tradicionales de la familia que a menudo son perjudiciales. Los médicos también deben ser conscientes de las prácticas tradicionales defectuosas para poder investigarlas activamente en la historia del niño.El autor reclutó varias prácticas tradicionales defectuosas que experimentó durante su práctica en OPD en varios hospitales públicos y corporativos durante un período de cinco años. Para este artículo se han elegido temas relacionados principalmente con el grupo de edad infantil. Se realizaron búsquedas relevantes sobre estos temas en libros de texto, revistas y sitios web estándar de pediatría (como OMS, NICE, AAP) para encontrar la validez de estas prácticas, así como las recomendaciones estándar sobre estos temas.Se encontró que las recomendaciones estándar a menudo difieren de las prácticas tradicionales. Se incluyó texto detallado de varias fuentes auténticas con respecto a algunos temas dudosos relacionados con el cuidado infantil en el hogar.Los médicos deben conocer los métodos correctos recomendados con respecto al cuidado infantil diario en el hogar. Deben asesorar a los padres en consecuencia para evitar cualquier daño causado por prácticas tradicionales y creencias sociales defectuosas.

Ozone bath in the treatment of diabetic foot ulcer infection / 中国组织工程研究

BACKGROUND: Medical ozone is a strong oxidant, can kill bacteria, resist inflammation, improve circulation, relieve pain and promote regeneration. It has been reported that medical ozone has a positive effect on ulcer wounds such as caries. OBJECTIVE: To explore the clinical effect of ozone bath on the control of diabetic foot ulcer’s infection and the promotion of wound healing. METHODS: According to the treatment methods, 100 patients with type 2 diabetic foot ulcer who met the inclusion criteria were divided into two groups randomly. In the experimental group, ozone bath was applied to the wound for 30 minutes after cleaning the wound with local normal saline; in the control group, air bath was applied to the wound for 30 minutes after cleaning the wound with local normal saline, once a day. Three weeks later, the bacterial control (quantitative analysis of bacteria, distribution of pathogenic bacteria), the degree of decline of inflammation index, the reduction of ulcer wound, the rate of wound healing and the visual analogue scale score of wound pain were counted in both groups. The expression levels of vascular endothelial growth factor, transforming growth factor-β and platelet-derived growth factor in wound tissues were measured before and after treatment. The protocols were approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated to Capital Medical University. Patients and their family member signed the informed consent. RESULTS AND CONCLUSION: After 3 weeks of treatment, bacteria were still detected in 46 patients in the control group and 5 patients in the experimental group. The number of pathogenic bacteria was 73 before treatment and 66 after treatment in the control group, 74 before treatment and 7 after treatment in the experimental group. Bacterial quantitative analysis was significantly higher in the control group than in the experimental group after treatment. The indexes of ulcer healing, including the reduction of ulcer wound, the visual analogue scale score of wound pain, and the degree of decline of inflammation index, were better in the experimental group than those in the control group (P < 0.05). (4) The expression levels of vascular endothelial growth factor, transforming growth factor-β and platelet-derived growth factor in local wound tissues were significantly higher in the experimental group than in the control group (P < 0.05). The percentage of wound healing in the experimental group was significantly higher than that in the control group (P < 0.05). To conclude, ozone bath can significantly control the local infection of diabetic foot, reduce the distribution of pathogenic bacteria on the wound surface, relieve the inflammatory pain of the wound, stimulate the secretion of growth factor in wound, and improve the wound healing rate.

Study on structural transformation pathway of indaconitine in stir-frying with sand process and toxicity of its processing products / 中草药

Objective: To study the structural transformation pathway of indaconitine in stir-frying with sand process and compare the toxicity of indaconitine with its processing products. Methods: Using high performance liquid chromatography to screen out the temperature and time parameters of the structural transformation of indaconitine. The processing products were separated by column chromatography and identified by NMR and MS. The cardiotoxicity test was chosen to compare the toxicity of indaconitine with its processing products. Results: Indaconitine was converted into mithaconitine when it was heated at 160-180 ℃ for 10-30 min. With a dose of 0.06 mg/kg, indaconitine could induce ventricular arrhythmia in rats, such as ventricular premature beat, ventricular tachycardia. However, mithaconitine had no arrhythmogenic effect at the same dosage. Conclusion: The structural transformation pathway of indaconitine has been defined: deacetylating at C-8 position, generating 14-benzoylpseudaconine, and converting benzoylpseudaconine into mithaconitine by dehydration reaction at C-8 and C-15 position. Compared with indaconitine, the toxicity of mithaconitine was reduced.

A Study on the Safety of Hot Spring Bathing for Pregnant Women / 日本温泉気候物理医学会雑誌

  Pregnancy has been removed from the list of contraindications for hot spring bathing. Therefore, The Japanese Society of Balneology, Climatology and Physical Medicine has considered that it is necessary to conduct a joint research on the safety of hot spring bathing for pregnant women, publish the results extensively, and enlighten the public about this matter. Considering that only a small number of reports have been published in Japan about the safety of hot spring bathing for pregnant women, the Society has decided to study this subject.   Expectant and nursing mothers living in hot spring towns, such as Beppu and Ibusuki City, have responded to questions about the period between the early stages of pregnancy and delivery via a self-administered questionnaire; The questions included: 1) age when the pregnancy ended, 2) number of previous deliveries, 3) details of hot spring bathing　habits (whether they bathed in hot springs on a daily basis, how often they bathed during the different [early, middle, and late] stages of pregnancy, and whether they used hot spring baths attached to their homes or hot spring facilities away from their homes), and 4) whether they had pregnancy complications such as miscarriages (excluding those occurring in the early stages of pregnancy), premature delivery, threatened premature delivery, or toxemia of pregnancy/pregnancy-induced hypertension (edema, hypertension).  Total 1,721 responses were collected (86% reply rate). The mean participant age was 30.8 years. Importantly, there were 643 (37.6%) primigravid and 1,078 (62.4%) parous women. Age and gravidity were not associated with pregnancy complications. In the early and middle stages of pregnancy, there were no significant differences in the incidence of pregnancy complications between individuals who bathed ≥ once per week [hot spring bath (+)] group and those who bathed < once per week [hot spring bath (−)] group. In the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (20.3%) than that in the hot spring bath (−) group (25.9%) (p = 0.028). In addition, there were no significant differences in the pregnancy complications between hot spring bathing (+) and hot spring bath (−) groups in the early and middle stages of pregnancy even if we focused on the homecoming pregnant women. Whereas, in the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (13.0%) compared with the hot spring bath (−) group (24.5%) (p = 0.028) in the homecoming pregnant women.  This study has confirmed that daily hot spring bathing during pregnancy does not increase the incidence of pregnancy complications. Furthermore, it can be stated that the removal of “pregnancy” from the contraindications of hot spring bathing was appropriate.

Rhabdomyolysis Associated with Electric Bath: A Case Report and Review of the Literature / 日本温泉気候物理医学会雑誌

  A 53-year-old Japanese man living in Thailand who was diagnosed with prostate cancer was scheduled for a prostate biopsy due to increased serum PSA. Two days prior to his admission, he returned to Japan. The next day he was taken for pre-operative screening and blood tests, which revealed extremely high serum creatine kinase (CK) levels (13,631 IU/L). The following day, his serum CK increased to 29,836 IU/L with 100% type MM isozyme. In addition, his serum myoglobin was 3,289.0 ng/mL and his urinary myoglobin was 26,000 ng/mL. Based on these test results, the patient was diagnosed with rhabdomyolysis.  The patient revealed that he had gone to a public bath and bathed in an “electric bath” for a total of 90 min over the previous 2 days. During hospitalization, he remained asymptomatic and had no renal dysfunction. The prostate biopsy was performed as scheduled and he was given post-procedure care, including intravenous administration of saline. The patient’s serum CK peaked at 42,355 IU/L on the second day of hospitalization, and on the fifth day it decreased to 5,979 IU/L and he was discharged without any complications.   After a retrospective review of literature, only three reports were found mentioning an “electric bath”. Two of these reports were related to asymptomatic hyper-CK-emia caused by the electric bath, and one was a case related to the malfunction of an implantable cardioverter defibrillator due to an electric bath. The former two reports concluded that increased time in the electric bath was related to the observed increase in CK level. Since extended bathing in electric baths may cause rhabdomyolysis, further investigation is required to determine what duration of use is safe.

The Circulatory Dynamics Reactions of Elderly Community Residents during Bathing: Differences Resulting from Immersion Methods and Temperatures / 日本温泉気候物理医学会雑誌

  【Purpose】The number of deaths in the bathtub in the home is increasing year by year, of which about 90% are people over 65 years old. The purpose of this study was to verify the hypothesis that the effect on the circulatory dynamics would be less if one took a half-body bath first and then a whole- body bath after a certain period of time, rather than suddenly taking a whole- body bath.  【Methods】The subjects were ten healthy community elderly men (70.3 ± 4.0 years old). The subjects were bathed at 39°C and 41°C, respectively, with two immersion methods of a 6-min whole body bath and a 3 min whole-body bath after a 3 min half-bath (6 min total). Measured items were systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse (PR), oxygen saturation (SpO2), and forehead skin temperature. The subjective thermal sensation and comfort were also confirmed verbally. Measurements were carried out in the sitting posture before bathing, within 1 min after bathing, after 2 min, 3 min, and 5 min, just after the bath, and 5 min after sitting rest.   【Results】In both SBP (p = .010) and DBP (p = .019), the interaction between bathing conditions and measurement time was significant. SBP was greatly affected by temperature regardless of whether or not stepped immersion was used, and blood pressure decreased immediately after bathing at 41°C. DBP showed a significant decrease during bathing at 41°C compared with the whole-body bath after half-body bathing.  【Discussion】The SBP was markedly decreased immediately after taking a bath at a temperature of 41°C regardless of whether or not the subject was gradually immersed. It is thought that the condition is similar to that of orthostatic hypotension. Furthermore, DBP also showed a decrease of 10 mmHg or more, corresponding to changes during orthostatic hypotension, when bathing only with a whole-body bath at a temperature of 41°C. On the other hand, in the whole-body bath after half-body bathing, the decrease in DBP was less than 10 mmHg even at 41°C.