Efetividade da terapia Reiki para ansiedade pré-operatória na cirurgia cardíaca: ensaio clínico randomizado / Efectividad de la terapia de reiki para ansiedad preoperatoria en cirugía cardíaca: ensayo clínico aleatorizado / Effectiveness of Reiki therapy for preoperative anxiety in cardiac surgery: a randomized clinical trial

Resumo Objetivo Avaliar a efetividade de um protocolo de Reiki nos níveis de ansiedade no período pré-operatório de cirurgia cardíaca. Métodos Ensaio clínico controlado e randomizado realizado em um hospital universitário de referência em cardiologia entre junho e dezembro de 2021. Foi realizada randomização em bloco e alocação por sorteio com envelopes selados opacos em dois grupos: Controle (n=44; não submetido a intervenção) e Intervenção (n=44; submetido a duas sessões de Reiki três dias antes e na véspera da cirurgia). Os desfechos principais (ansiedade, bem-estar e tensão muscular) foram avaliados ao longo das sessões usando um modelo de efeitos mistos. Para avaliar o tamanho do efeito foram calculados os valores parciais de eta quadrado (η2p). Resultados Foram determinadas as diferenças nos escores de ansiedade (+2,7 pontos a mais para o controle), bem-estar (-0,78) e tensão muscular (1,27), sendo consideradas estatisticamente significativas (p<0,001). Na análise do tamanho do efeito, o experimento distinguiu melhor a variação na variável ansiedade (η2p=0,74) que nas outras duas variáveis (η2p=0,14; η2p=0,23). Conclusão O estudo oferece evidência favorável para efetividade do Reiki no controle da ansiedade pré-operatória de cirurgia cardíaca.

Resumen Objetivo Evaluar la efectividad de un protocolo de reiki en los niveles de ansiedad en el período preoperatorio de cirugías cardíacas. Métodos Ensayo clínico controlado y aleatorizado, realizado en un hospital universitario de referencia en cardiología entre junio y diciembre de 2021. La aleatorización se realizó por bloques y la asignación por sorteo con sobres cerrados opacos en dos grupos: Control (n=44, sin intervención) y Experimental (n=44, sometidos a dos sesiones de reiki, una tres días antes y otra en la víspera de la cirugía). Los criterios de valoración principales (ansiedad, bienestar y tensión muscular) fueron evaluados a lo largo de las sesiones, mediante un modelo de efectos mixtos. Para evaluar el tamaño del efecto se calcularon los valores parciales de eta cuadrado (η2p). Resultados Se observaron diferencias en la puntuación de ansiedad (+2,7 puntos más en el grupo de control), bienestar (-0,78) y tensión muscular (1,27), consideradas estadísticamente significativas (p<0,001). En el análisis del tamaño del efecto, el estudio percibió mejor la variación en la variable ansiedad (η2p=0,74) que en las otras dos variables (η2p=0,14; η2p=0,23). Cirugía El estudio ofrece evidencias favorables para la efectividad del reiki en el control de la ansiedad preoperatoria de cirugías cardíacas. Registro Brasileiro de Ensaios Clínicos: RBR-2nhgvn6

Abstract Objective To assess the effectiveness of a Reiki protocol on anxiety levels in the preoperative period of cardiac surgery. Methods This is a controlled and randomized clinical trial carried out in a university reference hospital in cardiology between June and December 2021. Chunk randomization and allocation by draw with opaque sealed envelopes were carried out in two groups: Control (n=44; not subjected to intervention); and Intervention (n=44; submitted to two Reiki sessions three days before and the day before surgery). The main outcomes (anxiety, well-being and muscle tension) were assessed across sessions using a mixed effects model. To assess the effect size, partial eta squared (η2p) values were calculated. Results Differences in anxiety scores (+2.7 points more than the control), well-being (-0.78) and muscle tension (1.27) were determined, being considered statistically significant (p<0.001). In analyzing the effect size, the experiment better distinguished the variation in the anxiety variable (η2p=0.74) than in the other two variables (η2p=0.14; η2p=0.23). Conclusion The study offers favorable evidence for the effectiveness of Reiki in controlling preoperative anxiety after cardiac surgery. Brazilian Clinical Trials Registry: RBR-2nhgvn6

Effectiveness of VATP on Knowledge Regarding Good and Bad Touch among Mothers of Preschool Children attending Anganawadies

Background: Touch is a fundamental need of human life. The incidence of child sexual abuse is rising day by day. Good and bad touch is a sensitive topic and theme to reduce sexual harassment among children. So, the teaching programme is an effective way to improve knowledge of good and bad touches. Methods: 100 other preschool children are included as the sample. A convenient sampling method was used. A structured knowledge questionnaire was used to gather information. Chi-square analysis uncovered the relationship between knowledge about thyroid disorders and sociodemographic factors. Results: The post-test score (17.09�71) contributes to 56.96% of the total score, and their pre-test knowledge score (9.86�08) represents 32.8%. The efficiency of VATP on good and bad touch was 7.23, with SD�63, accounting for 24.1% of the total score. Conclusion: Finally, the study concluded that VATP was extensively helpful in civilizing the consciousness level of mothers of preschool children regarding Good and bad touches.

Nuevos Recursos Digitales y 3D en la Enseñanza de Anatomía. Experiencia Internacional Reportada en el "Sectra Users Meeting 2019", Karolinska Institutet, Suecia, antes de la Pandemia de COVID-19 / New Digital and 3D Resources in the Teaching of Anatomy. International Experience Reported in the "Sectra Users Meeting 2019", Karolinska Institutet, Sweden, Before the Pandemic COVID-19

El uso de nuevos recursos tecnológicos en la enseñanza de anatomía ha impulsado la necesidad de adaptar el modelo educativo haciéndolo más centrado en el estudiante, dinámico y participativo mediante herramientas digitales y 3D; orientando los conocimientos hacia su aplicación clínica, pero bajo un ajuste curricular que tiende a cursar menos horas presenciales en aula o laboratorio. Este trabajo describe la experiencia local de una nueva Escuela de Medicina en Chile, reportada el año 2018, además y otros trabajos de centros formadores presentados en el "SECTRA Users Meeting 2019 Estocolmo", Karolinska Institutet, Suecia. Este trabajo describe los reportes orales sobre la aplicación de nuevos recursos digitales como; la mesa de disección digital táctil SECTRA® y modelos anatómicos cadavéricos impresos en 3D Erler-Zimmer®, bases de datos sobre anatomía digital, además, su impacto en el desempeño académico, reportado por usuarios de diferentes países, tales como: Australia, Canadá, Chile, China, Colombia, Estados Unidos de Norteamérica (EUA) y Suecia. Los datos fueron recopilados y analizados a partir de la información reportada en las presentaciones orales y resúmenes entregados por los expositores. La gran mayoría de los países expositores declararon el uso combinado de recursos digitales y 3D sumados a los tradicionales para la enseñanza de anatomía. Sólo el representante de EUA declaró usar exclusivamente recursos digitales (en laboratorio y en línea), experiencia correspondiente a una joven e innovadora escuela de medicina. La mayoría de los centros docentes declaró utilizar la mesa de disección digital en una amplia proporción de sus contenidos curriculares, en asociación a plataformas tipo RIS/PACS como IDS7 portal de SECTRA o las utilizadas por el centro formador. El uso de nuevas tecnologías digitales y 3D ha ganado un importante espacio en el currículum de la enseñanza de anatomía, complementando el uso de los recursos tradicionales.

SUMMARY: The use of new technological resources in the teaching of anatomy has promoted the need to adapt the educational model, making it more student-centered, dynamic, and participatory through digital and 3D tools, directing the knowledge towards its clinical application, but under a curricular adjustment that tends to take fewer contact hours in the classroom or laboratory. This work describes the local experience of a new School of Medicine in Chile, reported in 2018, and other work from training centers presented at the "SECTRA Users Meeting 2019 Stockholm", Karolinska Institutet, Sweden. This work describes the oral reports on the application of new digital resources such as; the SECTRA® digital tactile dissection table and Erler- Zimmer® 3D printed cadaveric anatomical models, databases on digital anatomy, in addition, its impact on academic performance, reported by users from different countries, such as Australia, Canada, Chile, China, Colombia, United States of America (USA) and Sweden. The data was collected and analyzed from the information reported in the oral presentations and summaries delivered by the speakers.The vast majority of the exhibiting countries declared the combined use of digital and 3D resources added to the traditional ones for teaching anatomy. Only the representative from the USA stated that they exclusively used digital resources (in the laboratory and online), an experience corresponding to a young and innovative medical school. Most of the educational centers stated that they used the digital dissection table in a large proportion of their curricular contents, in association with RIS/PACS-type platforms such as the IDS7 SECTRA portal or those used by the training center. The use of new digital and 3D technologies has gained an important space in the anatomy teaching curriculum, complementing the use of traditional resources.

Exame físico em ginecologia / Physical examination in gynecology

O exame físico na prática ginecológica diuturna é o sustentáculo de uma perspectiva diagnóstica com vistas a uma abordagem individualizada, oportuna e humanizada da paciente. Lança mão de técnica semiótica clássica, inicialmente, após avaliação de sinais vitais, minuciosa inspeção ectoscópica, seguida de exame físico especial. E deverá ser realizado em ambiente adequadíssimo, sem nenhuma improvisação e ou adaptações não compatíveis, com a importância e a segurança garantidas por um exame físico de boa qualidade. O exame físico de mamas tem como objetivo primordial a identificação de nódulos mamários e, eventualmente, de tumores localmente avançados; e relativa tranquilidade é assegurada às pacientes quando ele é considerado normal. O exame físico vulvar permite a identificação de prolapso de órgãos pélvicos, neoplasia intraepitelial e/ou invasiva vulvar e distúrbios de desenvolvimento sexual, além de oferecer subsídios para a propedêutica da vulvodínea, sendo, principalmente, uma oportunidade para o diagnóstico em dermatologia vulvar, mesmo a vulva correspondendo a apenas 1% da pele feminina. O exame especular, um clássico da ginecologia, é indispensável para a triagem do câncer de colo uterino. Por fim, o toque genital, a despeito de sua subjetividade, permite a avaliação dos órgãos genitais internos.

Physical examination in daytime gynecological practice is the mainstay of a diagnostic perspective with a view to an individualized, timely and humanized approach to the patient; resorting to the classical semiotic technique, initially, after assessing vital signs, a thorough ectoscopic inspection, followed by a special physical examination; which should be carried out in a very suitable environment, without any improvisation or adaptations that are not compatible with the importance and safety guaranteed by a good quality physical examination. The primary objective of the physical examination of the breasts is to identify breast nodules and possibly locally advanced tumors; in addition to relative tranquility, assured to patients, when the respective exam is considered normal. Vulvar physical examination allows the identification of pelvic organ prolapse; vulvar intraepithelial and/or invasive neoplasia; sexual development disorders; in addition to offering subsidies for the propaedeutics of vulvodynia; and, above all, it is an opportunity for diagnosis in vulvar dermatology, even though the vulva accounts for only 1% of female skin. Specular examination, a classic in gynecology, is essential for screening for cervical cancer. Finally, the genital touch which, despite its subjectivity, allows the evaluation of the internal genital organs.

Application of ultrasound shear wave elastography in the prediction of clinically relevant post-operative pancreatic fistula after pancreatectomy: a prospective study / 中华超声影像学杂志

Objective:To quantitatively evaluate the stiffness of pancreatic parenchyma and lesions by virtual touch tissue imaging and quantification (VTIQ) technique, and to investigate the potential usefulness of ultrasound shear wave elastography (SWE) in the prediction of clinically relevant post-operative pancreatic fistula (CR-POPF) after pancreatectomy.Methods:Patients who scheduled to receive pancreatectomy were prospectively enrolled in Zhongshan Hospital, Fudan University from March 2021 to December 2021. VTIQ assessment was applied to patients within one week before the scheduled surgery to make quantitative SWE evaluation of target tissue. The SWV values of body part pancreatic parenchyma and lesions were measured and recorded. The palpation stiffness of pancreas was qualitatively evaluated during the operation by the surgeon.CR-POPF was diagnosed according to 2016 International Study Group of Pancreatic Fistula (ISGPF) standard.Grade B/C pancreatic fistula was defined as CR-POPF positive. Recognized peri-operative risk factors of CR-POPF were analyzed. ROC curve analysis was used to evaluate the diagnostic efficacy of SWV value in predicting CR-POPF.Results:A total of 72 patients were finally enrolled in this study, including 47 (65.3%, 47/72) patients who received pancreaticoduodenectomy (PD) and 25 (34.7%, 25/72) patients who underwent distal pancreatectomy. CR-POPF occurred in 22 (30.6%, 22/72) patients after pancreatectomy. The SWV value of body part pancreatic parenchyma was significant lower in CR-POPF positive group than in CR-POPF negative group ( P<0.001). There was no significant difference in lesion SWV value between CR-POPF positive and negative groups ( P=0.664). Besides, the palpation stiffness was no difference between the two groups ( P=0.689). Taking SWV value of pancreatic parenchyma >1.16 m/s as a cut-off value for predicting CR-POPF, the area under the ROC curve (AUROC) was 0.816 with 0.760 of sensitivity, 0.634 of specificity, 67.5% of positive predictive value and 72.5% of negative predictive value, respectively. Conclusions:The VTIQ method may improve the objectivity and accuracy of CR-POPF prediction via pre-operative, non-invasive and quantitative evaluation of pancreatic stiffness, which has potential value in clinical applications.

Sound touch elastography linear combined with ultrasound score for staging liver fibrosis in patients with chronic hepatitis B / 中华超声影像学杂志

Objective:To study the value of sound touch elastography (STE) linear combined with ultrasound score (US) in the diagnosis of chronic hepatitis B (CHB) liver fibrosis, and to investigate whether their combination can improve the diagnostic efficiency of subdividing the degree of CHB liver fibrosis. Furthermore, a comparison with STE linear combined with the serological model was performed to seek the optimal linear combination model.Methods:A total of 313 subjects were enrolled from September 2018 to December 2021 in Shenzhen Third People′s Hospital Affiliated to Guangdong Medical University, including 259 patients with CHB who had completed liver biopsy and 54 healthy volunteers. CHB patients were divided into liver fibrosis group (F1-F4 group) according to METAVIR classification standard, and healthy volunteers were used as the control group. All subjects underwent liver ultrasound examination, STE and blood biochemical indexes of liver function. The US was performed according to the liver ultrasound examination, and the liver stiffness measurement (LSM) was measured by STE, aspartate aminotransferase and platelet ratio index (APRI) was calculated by blood biochemical index. Fisher discriminant analysis was used to establish the linear combination (LC) diagnostic marker of US and LSM, and the linear combination (LC2) diagnostic marker of LSM and APRI, successively. Spearman rank correlation coefficient was used to analyze the correlations between US, LSM, APRI, LC2, LC and pathological results. The ROC curves of US, LSM, APRI, LC2 and LC for diagnosing CHB liver fibrosis were plotted, and the diagnostic efficiency of above diagnostic markers was evaluated according to the accuracy, sensitivity, specificity and area under the ROC curve (AUC).Results:The formula for the linear combination of US and LSM was LC=0.986 0×US+ 0.166 7×LSM, and LC was highly positively correlated with pathological findings ( rs=0.851, P<0.001), higher than US, LSM, LC2 and APRI ( rs=0.825, 0.775, 0.802, 0.586, all P<0.001). LC showed the best diagnostic efficiency. The AUCs for diagnosing ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis were 0.945, 0.911, 0.954, 0.955, respectively, which superior to the AUCs of US (0.913, 0.879, 0.934 and 0.916, respectively), the AUCs of LSM (0.860, 0.871, 0.934 and 0.952, respectively) and the AUCs of LC2(0.899, 0.883, 0.941, 0.946, respectively). Compared with US, the AUC of LC diagnosis of ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis increased by 3.2%, 3.2%, 2.0% and 3.9%, respectively, with all significant differences ( P<0.05). Compared with LSM, the AUC of LC increased by 8.5%, 4.0%, 2.0% and 0.3%, respectively, with significant difference ( P<0.05) except for stage =F4 cirrhosis.Compared with LC2, the AUC of LC increased by 4.6%, 2.8%, 1.3% and 0.9%, respectively, and there were significant differences in the diagnosis of ≥F1 and ≥F2 liver fibrosis ( P<0.05). Moreover, the overall efficiency of LC2 was not significantly improved than LSM, the difference was not significant ( P>0.05). Conclusions:US, LSM, LC2 and LC can be used to diagnose the degree of CHB liver fibrosis, but LC is better than US or LSM and LC2 alone, especially in the subdivision of mild liver fibrosis, which is a promising new diagnostic marker to subdivide the degree of CHB liver fibrosis.

Comparison of clinical effect and postopertaive incisions between No-touch technique and traditional retractor in treating calcaneal fracture / 中国骨伤

OBJECTIVE@#To compare clinical efficacy of No-touch technique and traditional retractor in treating calcaneal fracture.@*METHODS@#Clinical data of 74 calcaneal fracture patients with closed Sanders typeⅡ to Ⅳ were retrospectively analyzed from July 2019 to June 2021. According to different treatment methods, the patients were divided into No-touch group and conventional group, 37 patinets in each group. In No-touch group, there were 25 males and 12 females, aged from 19 to 70 years old with an average of (42.64±14.16) years old;17 patients were typeⅡ, 14 patinets with type Ⅲ, 6 patients with type Ⅳ according to Sanders fracture classification;three 2.0 mm Kirschner wires were implanted into the talus body, talus neck, and cuboid bone, and the flap was turned upward to expose the operation area. In conventional group, there were 30 males and 7 females, aged from 19 to 67 years old with an average of (41.56±11.38) years old;17 patients with typeⅡ, 12 patients with type Ⅲ, 8 patients with type Ⅳ according to Sanders fracture classification;the operation was completed by exposing the operation area with traditional retractor. Operation time, postoperative incision complications, postoperaive American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score at 6 months between two groups were compared.@*RESULTS@#Seventy-four patients were followed up, and follow-up time in No-touch group ranged from 6 to 17 months with an average of(9.57±2.72) months, while in conventional group ranged from 6 to 16 months with an averge of(9.14±2.71) months, and no difference in follow-up between two groups (P>0.05). Operation time in No-touch group (55.67±7.94) min was shorter than that in conventional group (70.16±9.41) min (P<0.05);four patients in No-touch group occurred incision complications, while 8 patients in normal group, and had statistically difference(P<0.05). Daily activities and support, maximum walking distance (block), ground walking, limited degree of flexion, extension and valgus, foot alignment and total score of AOFAS scores in No-touch group was significantly higher than that of conventional group (P<0.05). There were no significant difference in pain degree, abnormal gait and ankle hind foot stability between two groups(P>0.05). According to AOFAS score, 19 patients got excellent result, 16 good and 2 poor in No-touch group;while 9 excellent, 24 good, and 4 poor in conventional group, and no difference between two groups (P>0.05).@*CONCLUSION@#Compared with traditional retractor in treating calcaneal fracture, No-touch technology could significantly shorten operation time, reduce incidence of postopertive complications, while two methods could improve excellent and good rate of ankle joint function recovery after operation.

Knowledge, Attitude, And Practices Regarding Child Sex Abuse Among School Students

Context/Background: Child Sexual Abuse is a broad term used to describe sexual offences against chil-dren. Both genders are at risk of sexual abuse. Very few studies have conducted to assess the knowledge among school students. The study was conducted for documenting knowledge and attitude of child sexu-al abuse and socio-demographic profile among school children. Methodology: We enrolled 128 school students after getting permission from school principal. First, we had filled pre-designed semi structure questionnaire about their knowledge and attitude about types of touch and what to do if it happens. Participation in the research was strictly voluntary and all the data were kept strictly confidential. Results: All the participants were girls (100%). Majority of our participants were of 10 years (95.1%) of age. Current study revealed that very few participants were knowing about good touch and bed touch. Most of the participants didn’t knew about the private parts of the body and similarly most of the partic-ipants didn’t knew what to do if anything happens to them. Conclusions: Present study recommends generating awareness about child sexual abuse among chil-dren, parents, and general population, via training through well-structured program.

Efectos del tacto terapéutico en el recién nacido prematuro con CPAP nasal: una prueba piloto / Effects of therapeutic touch in preterm infants receiving nasal CPAP: A pilot trial / Efeitos do toque terapêutico em prematuros com CPAP nasal: um estudo piloto

Introducción: El recién nacido prematuro presenta una inmadurez del sistema cardiorespiratorio, lo que dificulta su adaptación al medio extrauterino y conlleva a múltiples complicaciones las cuales se requieren intervenciones que mejoren la ventilación y el intercambio gaseoso tales como la oxigenación a través de dispositivos de apoyo terapéutico como la presión positiva continua de la vía aérea o CPAP. Objetivo: determinar el efecto del tacto terapéutico en la adaptación del recién nacido pretérmino con CPAP. Materiales y métodos: Estudio cuasi-experimental, con una muestra de 13 RNPT a quienes se les aplicó el tacto terapéutico durante 15 minutos, con 2 sesiones diarias (6 am y 8pm), con evaluación antes y después del CRE: "Adaptación del prematuro". A lo cual se le realizó el análisis descriptivo correspondiente. Resultados: El total de los participantes, fue asignado al grupo control y grupo intervenido de forma similar, evidenciando cambios antes y después de la intervención, pero en especial en el indicador postura de las manos, con una diferencia entre ambos grupos de p 0,74 con valor de 0.006. Conclusiones: La aplicación del tacto terapéutico al RNPT con CPAP nasal permite mejorar el confort del RNPT a través de indicadores fisiológicos y neurocomportamentales.

Introduction: Premature newborns have an immature cardiorespiratory system that hinders adaptation to the extrauterine environment. This leads to multiple complications which require interventions to improve ventilation and gas exchange, like oxygenating using therapeutic support devices such as continuous positive airway pressure or CPAP. Objective: To determine the effect of therapeutic touch on preterm newborns' adaptation to CPAP. Materials and methods: This is a quasi-experimental study, with a sample of 13 PTNB who underwent therapeutic touch for 15 minutes in 2 daily sessions (6 am and 8 pm), with pre- and post-assessment of NOC "Preterm Infant Organization." Descriptive analysis was performed. Results: The participants were allocated to the control group and the intervention group in a similar way. Pre- and post-intervention changes were observed, but especially in the hand posture indicator, with a difference between both groups of 0.74 with a p-value of 0.006. Conclusions: The practice of therapeutic touch with RNPT receiving nasal CPAP allows for improving the comfort of the RNPT through physiological and neurobehavioral indicators.

Introdução: O recém-nascido prematuro apresenta uma imaturidade do sistema cardiorrespiratório, o que dificulta a adaptação ao ambiente extrauterino e leva a múltiplas complicações que requerem intervenções que melhorem a ventilação e as trocas gasosas como a oxigenação por meio de dispositivos de suporte terapêutico, como via aérea positiva contínua pressão ou CPAP. Objetivo: determinar o efeito do toque terapêutico na adaptação do recém-nascido pré-termo com CPAP. Materiais e métodos: Estudo quase experimental, com uma amostra de 13 PTNIs a quem foi aplicado o toque terapêutico durante 15 minutos, com 2 sessões diárias (6h e 20h), com avaliação antes e após CRE: "Adaptação do prematuro". Ao qual foi realizada a análise descritiva correspondente. Resultados: Todos os participantes foram alocados no grupo controle e no grupo intervenção de forma semelhante, apresentando alterações antes e após a intervenção, mas principalmente no indicador de postura das mãos, com diferença entre os dois grupos foi de 0,74 com um valor de p 0,006. Conclusões: A aplicação do toque terapêutico ao RNPT com CPAP nasal permite melhorar o conforto do RNPT através de indicadores fisiológicos e neurocomportamentais.

Understanding the impact of newborn touch upon mothers of hospitalized preterm neonates

Introduction: Many interventions have been designed to support the development of the preterm baby and minimise the complications of prematurity. However, there is limited evidence of the possible psychological benefits of touch to the mother when she is the one performing the support programme during the hospitalisation of her newborn. Objective: This study explored whether the type of touch provided to preterm neonates had an impact on maternal self-efficacy, self-esteem and maternal-to-infant attachment, as-well-as newborn weight gain. Methods: Using a randomised cluster trial, forty babies and their mothers were allocated to one of two groups receiving either a touch-based intervention (TAC-TIC; Touching And Caressing; Tender In Caring) or spontaneous touch. Results: Mothers who provided the touch-based intervention demonstrated greater increases in self-efficacy, self-esteem and attachment, and babies gained more weight than those using spontaneous touch. Conclusion: The results indicate that systematic touch interventions may be used to facilitate the mother-baby relationship as well as to promote newborn weight gain.

Introdução: muitas intervenções têm sido desenhadas para apoiar o desenvolvimento do bebê prematuro e minimizar as complicações da prematuridade. No entanto, são limitadas as evidências dos possíveis benefícios psicológicos do toque para a mãe quando é ela quem realiza o programa de apoio durante a hospitalização de seu recém-nascido.Objetivo: este estudo explorou se o tipo de toque fornecido aos recém-nascidos prematuros teve impacto na autoeficácia materna, autoestima e apego materno-infantil, bem como no ganho de peso do recém-nascido.Método: usando um estudo randomizado de cluster, quarenta bebês e suas mães foram alocados em um dos dois grupos que receberam uma intervenção baseada em toque (TAC-TIC; Tocando e acariciando; Tender In Caring) ou toque espontâneo.Resultados: as mães que forneceram a intervenção baseada no toque demonstraram maiores aumentos na autoeficácia, autoestima e apego, e os bebês ganharam mais peso do que aqueles que usaram o toque espontâneo.Conclusão: os resultados indicam que intervenções sistemáticas de toque podem ser utilizadas para facilitar a relação mãe-bebê, bem como para promover o ganho de peso do recém-nascido.

Decreased self-reported receiving of social touch and social support predict loneliness in healthy adults

ABSTRACT Loneliness has emerged as a public health concern. Previous research has reported its deleterious effects on physical and mental health; however, some specific psychophysiological mechanisms in healthy adults remain to be elucidated. The aim of the current study is to investigate whether self-reported social support and social touch (giving and receiving social touch), as well as resting heart rate variability (HRV), are significant negative predictors of loneliness in healthy adults. The study sample consists of 120 healthy students (50% female) with a mean age of 21.85 years old (DP= 2.21). The students were asked to complete a psychiatric screening questionnaire utilizing loneliness, social support, and social touch scales. HRV was derived from an electrocardiographic signal recorded for 15 min, with the participant relaxed in a supine position. Linear regression analyses were conducted to evaluate loneliness as a function of social support, social touch (giving or receiving touch), and resting HRV. The results show that social support (p< 0.001) and social touch, specifically receiving touch (p< 0.002), accounted for a significant proportion of the variance in loneliness. However, neither giving touch nor resting HRV was a significant predictor of loneliness. The current study highlights specific psychosocial factors in healthy adults that should be considered as promising pathways in order to reduce or work toward preventing loneliness, thus promoting better health and well-being.

Morphological Changes in Endothelial Cell Organelles in a No-Touch Saphenous Vein Graft

ABSTRACT Introduction: Improved long-term patency of the no-touch (NT) saphenous vein graft has been reported to result from the preservation of a healthy vascular microstructure, especially endothelial cells. However, the precise morphology of endothelial cells and their organelles in NT saphenous vein graft has not been fully investigated. In this study, we assessed the ultrastructure of preserved endothelial cells in saphenous vein graft using transmission electron microscopy. Methods: Intact control (IC) vein, NT saphenous vein graft, and conventional (CT) saphenous vein graft were harvested from a patient. After observation by light microscopy, the nuclei and mitochondria in the preserved endothelial cells were compared among IC, NT, and CT using transmission electron microscopy, and the endothelial organelles were assessed quantitatively. Results: Light microscopy showed that the preservation of endothelial cells was comparable in IC, NT, and CT. Subsequent transmission electron microscopy observation showed that the nuclei in preserved endothelial cells appeared more swollen in CT than that in NT. Quantitative analysis revealed that nuclear size and circularity of preserved endothelial cells in NT and IC were similar, but those in CT were larger and higher, respectively, than those in IC and NT. In addition, the mitochondrial size in preserved endothelial cells in CT was larger than that in IC and NT. Conclusion: Necrotic changes in endothelial organelles characterized by swelling of nuclei and mitochondria were prominent in CT saphenous vein graft. The normally maintained ultrastructure of preserved endothelial cells in NT saphenous vein graft could contribute to long-term patency.

Toque e sua relação com bem-estar e satisfação com a vida / Touch and the relation with well-being and satisfaction with life

Este artigo apresentou definições do que é o toque e sua implicância no bem-estar/satisfação com a vida dentre outras variáveis, como frequência de toque interpessoal, estresse percebido (PSS-14), familismo, nível de proximidade (IOS), sentimentos de rejeição/vazio (JGSL) e nível de satisfação com o relacionamento (PRQC). A amostra foi composta por 291 pessoas de ambos os sexos e o questionário utilizado foi aplicado em uma amostra brasileira, via eletrônica e em lápis e papel. Os dados obtidos sugerem uma relação fraca entre toque e bem-estar/satisfação com a vida possivelmente devido a um efeito de teto, diferenciando da mesma pesquisa "skin to skin" aplicada em outros países, evidenciando que o fator cultural é de grande relevância. Além disso, houve uma correlação significativa indicando que quanto maior for o sentimento de rejeição/vazio, menor será o bem-estar/satisfação com a vida e que há uma correlação entre a frequência em que os participantes praticam o toque e o nível de satisfação com o relacionamento, influenciando no bem-estar.

This article presents definitions of what touch is and its implications for human well-being / satisfaction with life. Measurable variables were considered, such as the frequency of interpersonal touch, perceived stress (PSS-14), familism, level of proximity (IOS), feelings of rejection / void (JGSL) and level of satisfaction with the relationship (PRQC). The sample here consists of 291 people, both genders. The used questionnaires were applied to a Brazilian sample, electronically and in paper. The data obtained suggests a weak relationship between touch and well-being / satisfaction with life, possibly due to a ceiling effect. This contrasts with the same "skin to skin" study carried out in other countries; demonstrating that the cultural factor is of great relevance. In addition, there was a significant correlation indicating that the greater the feeling of rejection / emptiness the subject feels, the lower the well-being/ satisfaction with life. Moreover, there is a correlation between the act of touch practiced by participants and their respective levels of satisfaction with the relationship, influencing their well-being.

Estrategia de enfermería para disminuir ansiedad del paciente en procedimientos endoscópicos: ensayo clínico aleatorizado

Objetivo: Determinar la efectividad de una intervención de enfermería de acompañamiento significativo estructurado para disminuir la ansiedad en pacientes que van a ser sometidos a una endoscopia digestiva alta en un hospital público, Región del Biobío, Chile. Material y Método: Ensayo clínico aleatorizado, simple ciego, con evaluación por terceros, realizado entre enero y junio de 2021, con una muestra de 126 pacientes. Los instrumentos y parámetros hemodinámicos que midieron variables sociodemográficas, psicológicas, fisiológicas y bioquímicas fueron: Cuestionario sociodemográfico, Cuestionario de ansiedad Estado-Rasgo, Escala Visual Análoga, Frecuencia cardiaca, Presión arterial (PA) sistólica, media y diastólica, Oximetría de pulso, Glicemia y Potasio sanguíneo. La intervención consistió en la presencia visual y táctil de un acompañante significativo, antes, durante y después del procedimiento endoscópico. El análisis de datos con SPSS v.18 consideró estadística descriptiva e inferencial (valor p= 5%) con T-Student y U de Mann-Whitney. Resultados: Edad promedio 52 años, educación media completa, casados y con hijos; hubo diferencias significativas en variables psicológicas (p< 0,05) en las tres etapas, variables fisiológicas (PA media (p= 0,0025) y diastólica (p= 0,0002) intraprocedimiento; PA media (p= 0,0021) y diastólica (p= 0,0021) postprocedimiento, pulso medio o mediano (p< 0,05) en pre (p= 0,0035) y postprocedimiento endoscópico (p= 0,0003)). En la oximetría de pulso y las variables bioquímicas no se advirtieron diferencias significativas. Conclusión: A través del acompañamiento significativo, intervención simple, fácil, bajo costo y no farmacológica, disminuye la ansiedad y riesgo del paciente, se mejora la satisfacción usuaria y la relación equipo de salud/comunidad.

Objective: To determine the effectiveness of a significant structured follow-up nursing intervention to reduce anxiety in patients undergoing upper digestive endoscopy in a public hospital in the Biobío Region, Chile. Material and Method: Randomized, single-blind clinical trial, with evaluation by third parties, carried out between January and June 2021, with a sample consisting of 126 patients. The instruments and hemodynamic parameters that measured sociodemographic, psychological, physiological, and biochemical variables were: Sociodemographic Questionnaire, State-Trait Anxiety Questionnaire, Visual Analog Scale, heart rate, systolic, mean, and diastolic blood pressure (BP), pulse oximetry, glycemia and blood potassium. The intervention consisted of the visual and tactile presence of a significant companion, before, during, and after the endoscopic procedure. Data analysis with SPSS v.18 considered descriptive and inferential statistics (p value= 5%) with T-Student and Mann-Whitney U test. Results: Average age 52 years, completed secondary education, married with children; there were significant differences in psychological variables (p< 0.05) in the three stages, physiological variables (mean (p= 0.0025) and diastolic (p= 0.0002) intra-procedure BP, mean (p= 0.0021) and diastolic (p= 0.0021) post-procedure BP, average or median pulse (p< 0.05) in the pre (p= 0.0035) and post-endoscopic procedures (p= 0.0003). No significant differences were observed in pulse oximetry and biochemical variables. Conclusion: Through significant follow-up, simple, easy, low-cost and non-pharmacological intervention, patient anxiety and risk were reduced, user satisfaction and the health team/community relationship were improved.

Objetivo: Determinar a eficácia de uma intervenção de enfermagem estruturada de acompanhamento significativo para reduzir a ansiedade em pacientes que vão se submeter a uma endoscopia digestiva alta em um hospital público na Região de Biobío, Chile. Material e Método: Ensaio clínico randomizado, simples-cego, com avaliação por terceiros, realizado entre janeiro e junho de 2021, com uma amostra de 126 pacientes. Os instrumentos e parâmetros hemodinâmicos que mediram as variáveis sociodemográficas, psicológicas, fisiológicas e bioquímicas foram: Questionário Sociodemográfico, Questionário de Ansiedade Traço-Estado, Escala Visual Analógica, frequência cardíaca, pressão arterial (PA) sistólica, média e diastólica, oximetria de pulso, glicemia e potássio sanguíneo. A intervenção consistiu na presença visual e tátil de um acompanhante significativo, antes, durante e após o procedimento endoscópico. Análise dos dados com SPSS v.18, considerada estatística descritiva e inferencial (valor de p= 5%) com T-Student e teste U de Mann-Whitney. Resultados: Média de idade 52 anos, ensino médio completo, casado e com filhos; houve diferenças significativas nas variáveis psicológicas (p< 0,05) nas três etapas, variáveis fisiológicas (PA média (p= 0,0025) e diastólica (p= 0,0002) intra-procedimento, PA média (p= 0,0021) e diastólica (p= 0,0021) pós-procedimento, pulso médio ou mediano (p< 0,05) no pré (p= 0,0035) e pós-procedimento endoscópico (p= 0,0003). Não foram observadas diferenças significativas na oximetria de pulso e nas variáveis bioquímicas. Conclusão: Através de acompanhamento significativo, intervenção simple, fácil, de baixo custo e não farmacológica foi possível conseguir a redução da ansiedade e do risco do paciente, a melhora da satisfação do usuário e da relação equipe de saúde/comunidade.

Reiki for promotion of health and sleep quality in hospital nursing professionals / Reiki para la promoción de la salud y la calidad de sueño en profesionales de enfermería hospitalaria / Reiki para promoção da saúde e qualidade do sono em profissionais de enfermagem de hospital

ABSTRACT Objectives: to know the repercussions of a Reiki therapy intervention on the sleep quality of nursing professionals working in a general hospital. Methods: a qualitative-quantitative study conducted with 16 professionals from the nursing team of a hospital in northwest Paraná, who participated in an intervention consisting of six weekly Reiki sessions. Data collected from September, 2019 to March, 2020 through semi-structured interviews and application of the Pittsburgh Sleep Quality Index before and after the intervention. Results: better sleep quality, characterized by a reduction in the time to fall asleep and in nightmares, and an increase in sleeping hours. Conclusions: reiki intervention had a positive impact on the sleep quality of participants.

RESUMEN Objetivos: conocer las repercusiones de una intervención con sesiones de Reiki en la calidad del sueño de los profesionales de enfermería que actúan en un hospital general. Métodos: estudio cualitativo-cuantitativo realizado con 16 profesionales del equipo de enfermería de un hospital del noroeste de Paraná que participaron de una intervención de seis sesiones semanales de Reiki. Datos recolectados de septiembre, 2019 a marzo, 2020 a través de entrevistas semiestructuradas y aplicación del Índice de Calidad de Sueño de Pittsburgh antes y después de la intervención. Resultados: mejor calidad de sueño, caracterizada por una reducción del tiempo para conciliar el sueño y de las pesadillas y un aumento de las horas de sueño. Conclusiones: la intervención de Reiki tuvo un impacto positivo en la calidad de sueño de los participantes.

RESUMO Objetivos: conhecer as repercussões de intervenção com sessões de reiki na qualidade do sono de profissionais de enfermagem atuantes em um hospital geral. Métodos: estudo de abordagem quali-quantitativa realizado com 16 profissionais da equipe de enfermagem de um hospital no noroeste do Paraná que participaram de uma intervenção constituída por seis sessões semanais de reiki. Dados coletados de setembro/2019 a março/2020, mediante entrevista semiestruturada e aplicação do Índice de Qualidade do Sono de Pittsburgh antes e após o término da intervenção. Resultados: melhora na qualidade do sono, caracterizada por redução do tempo para adormecer e dos pesadelos e aumento nas horas dormidas. Conclusões: a intervenção com reiki repercutiu de forma positiva sobre a qualidade do sono das participantes.

Toque terapêutico no cuidado da enfermagem: uma análise conceitual / Tacto terapéutico en el cuidado de enfermería: un análisis conceptual / Therapeutic touch in nursing care: a conceptual analysis

Resumo Objetivo Analisar o conceito de toque terapêutico no cuidado de enfermagem, especificando seus atributos, antecedentes e consequentes. Métodos Trata-se de uma análise conceitual na visão evolutiva de Rodgers (2000), sobre o conceito de toque terapêutico na assistência de enfermagem, juntamente com a revisão integrativa da bibliografia baseada na questão da pesquisa: Qual é o conceito de toque terapêutico no cuidado de enfermagem? Quais são os atributos, antecedentes e consequentes do toque terapêutico no cuidado com a enfermagem? A pesquisa foi realizada nas bases de dados eletrônicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, na Biblioteca do Conhecimento Online b-on, através da conjugação dos descritores DeCS/MESH "therapeutic touch", "nursing" e "nursing care" e do operador booleano AND no período temporal de 2000 a 2020. Resultados A amostra foi formada por oito estudos que identificaram três pilares temáticos: (i) atributos: método complementar e eficaz, técnica, ferramenta, intervenção de enfermagem, uso de mãos, intenção de ajudar ou curar, tratamento complementar, toque intencional e transferência de energia; (ii) antecedentes: dor, ansiedade, fadiga, demência, doença de Alzheimer, cefaleia de tensão, síndrome de fibromialgia e problemas cardiovasculares; (iii) consequentes: promove um efeito calmante; aumenta a empatia, satisfação, interação, respeito, senso de valor e vida; promove bem-estar, conforto, tranquilidade e paz, esperança, segurança, motivação, humor e qualidade do sono; reduz o estresse e comportamentos perturbadores; promove melhor estado funcional e qualidade de vida. Conclusão O toque terapêutico está implícito na prática profissional dos enfermeiros, exigindo um ajuste concreto e singular às circunstâncias e necessidades reais da pessoa, em favor de uma prática que promova o conforto.

Resumen Objetivo Analizar el concepto de tacto terapéutico en el cuidado de enfermería y especificar sus atributos, antecedentes y consecuentes. Métodos Se trata de un análisis conceptual en la visión evolutiva de Rodgers (2000), sobre el concepto de tacto terapéutico en la atención de enfermería, junto con la revisión integradora de la bibliografía basada en la pregunta de investigación: ¿Cuál es el concepto de tacto terapéutico en el cuidado de enfermería? ¿Cuáles son los atributos, antecedentes y consecuentes del tacto terapéutico en el cuidado de enfermería? El estudio fue realizado en las bases de datos electrónicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, en la Biblioteca do Conhecimento Online b-on, a través de la unión de los descriptores DeCS/MESH "therapeutic touch", "nursing" y "nursing care" y del operador booleano AND en el período temporal de 2000 a 2020. Resultados La muestra fue formada por ocho estudios que identificaron tres pilares temáticos: (i) atributos: método complementario y eficaz, técnica, herramienta, intervención de enfermería, uso de manos, intención de ayudar o curar, tratamiento complementario, tacto intencional y transferencia de energía; (ii) antecedentes: dolor, ansiedad, fatiga, demencia, enfermedad de Alzheimer, cefalea tensional, síndrome de fibromialgia y problemas cardiovasculares; (iii) consecuentes: promueve un efecto calmante; aumenta la empatía, satisfacción, interacción, respeto, sentido de valor y vida; promueve bienestar, consuelo, tranquilidad y paz, esperanza, seguridad, motivación, humor y calidad de sueño; reduce el estrés y comportamientos perturbadores; promueve mejor estado funcional y calidad de vida. Conclusión El tacto terapéutico está implícito en la práctica profesional de los enfermeros y exige una adaptación concreta y singular a las circunstancias y necesidades reales de la persona, a favor de una práctica que promueva el bienestar.

Abstract Objective To analyze the concept of therapeutic touch in nursing care, specifying its attributes, antecedents, and consequents. Methods This is a conceptual analysis of the evolutive view of Rodgers (2000), about the concept of therapeutic touch in nursing care, together with an integrative literature review based on the research question: What is the concept of therapeutic touch in nursing care? What are the attributes, antecedents, and consequents of therapeutic touch in nursing care? The search was conducted in the electronic databases CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, in the b-on Online Knowledge Library, by combining the descriptors DeCS/MESH "therapeutic touch", "nursing" e "nursing care" and the Boolean operator AND over the period from 2000 to 2020. Results The sample was composed of eight studies that identified three thematic pillars: (i) attributes: complementary and effective method, technique, tool, nursing intervention, use of hands, intention to help or heal, complementary treatment, intentional touch, and energy transfer; (ii) antecedents: pain, anxiety, fatigue, dementia, Alzheimer's disease, tension headache, fibromyalgia syndrome, and cardiovascular problems; (iii) consequents: promotes a calming effect; increases empathy, satisfaction, interaction, respect, sense of worth and life; promotes well-being, comfort, tranquility and peace, hope, security, motivation, mood and sleep quality; reduces stress and disruptive behaviors; promotes better functional status and quality of life. Conclusion Therapeutic touch is implicit in the professional practice of nurses, requiring concrete and unique adjustment to the real circumstances and needs of the person, towards a practice that promotes comfort.

Impacto de la cercanía, toque afectivo y satisfacción con el apoyo de la pareja en los comportamientos saludables / Impact of closeness, affective touch and satisfaction with the couple´s support on healthy behaviors

RESUMEN Introducción: La pareja tiene efectos físicos y psicológicos sumamente positivos, especialmente cuando hay cercanía, debido al bienestar experimentado, toque afectivo, que enriquece la expresión de comprensión y satisfacción con el apoyo de la pareja, pues habrá mayor motivación para realizar comportamientos saludables. Objetivo: Identificar la magnitud, examinar las diferencias y conocer el grado de asociación de la cercanía, toque afectivo y satisfacción con el apoyo recibido por parte de la pareja en el empleo de comportamientos saludables. Método: Se trabajó con una muestra no probabilística de 194 hombres y 194 mujeres mexicanos integrantes de una relación de pareja heterosexual (edad M = 37), con escolaridad mínima de secundaria. Se aplicó una batería compuesta por instrumentos de medición psicológica validados para población mexicana y se realizó una serie de análisis de varianza con pruebas a posteriori de Scheffé y correlaciones producto momento de Pearson. Resultados: De los resultados se destaca que los grupos de mayor toque afectivo y satisfacción con el apoyo recibido emplean mayores comportamientos saludables de actividad y relajación. Por otra parte, para las mujeres, la cercanía se relaciona con mayores conductas de Actividad-relajación (0,168* según Pearson). Para los hombres, mayor satisfacción con el apoyo de su pareja propiciará que realicen mayores conductas de cuidado (0,157* según Pearson). Conclusión: Formar parte de una relación de pareja cercana, afectiva y donde el apoyo es satisfactorio crea un espacio para tener mejor calidad de vida y salud, por su influencia sobre actitudes, significados y conocimientos que determinan la adopción de conductas saludables.

ABSTRACT Introduction: The couple has extremely positive physical and psychological effects, especially when there is closeness, due to the experienced well-being, affective touch, which enriches the expression of compression and satisfaction with the support of the couple, since there will be greater motivation to perform healthy behaviors. Objective: Identify the magnitude, examine the differences and know the degree of association of closeness, affective touch and satisfaction with the support received from the couple in the use of healthy behaviors. Method: We worked with a non-probability sample of 194 Mexican men and 194 Mexican women who were members of a heterosexual couple relationship (age M = 37), with minimum middle school studies. A battery composed of validated psychological measurement instruments for the Mexican population was applied and a series of analysis of variance was performed with Scheffe´s posterior tests and Pearson´s product-moment correlations. Results: From the results, it is highlighted that the groups with the greatest affective touch and satis faction with the support received employ greater healthy behaviors of activity and relaxation. On the other hand, for women, closeness is related to greater Activity-relaxation behaviors (0,168* according to Pearson). For men, greater satisfaction with the support of their partner will lead to more caring behaviors (0,157* according to Pearson). Conclusion: Being part of a close, affective and supportive couple relationship creates a space to have better quality of life and health, due to its influence on attitudes, meanings and knowledge that determine the adoption of healthy behaviors.

The no-touch great saphenous vein harvesting technique for OPCABG: a single-center experience and short-term clinical outcomes / 中华胸心血管外科杂志

Objective:To study the safety and short-term clinical effect of no-touch technique for harvesting great saphenous vein in off-pump coronary artery bypass grafting(OPCABG).Methods:The clinical data of 117 patients in the single medical group who underwent OPCABG from December 2018 to April 2020 were analyzed retrospectively, including 55 patients in the no touch group (NTSV group) and 62 patients in the traditional open access group (traditional SV group). To evaluate the feasibility, safety and short-term clinical effect of using no-touch technique to harvest great saphenous vein for OPCABG. The no-touch technique was mainly based on the invention of Dr. Souza’s team in Sweden. For the treatment of isolated great saphenous veins, some improvements were made according to the clinical experience of the application of sequential bridging and radial artery in our center.Results:There were no significant differences between the two groups in hypertension, diabetes, hyperlipidemia, history of myocardial infarction, ventricular aneurysm formation, left ventricular systolic function reduction, history of cerebral infarction, chronic obstructive pulmonary disease and other complications ( P>0.05). The NTSV group had higher male proportion (96.4% vs. 61.3%) and lower mean age (53.49 years old vs. 63.76 years old), and the difference were statistically significant ( P<0.01). The patients in the two groups successfully completed the operation without cardiopulmonary bypass, and the proximal anastomosis was the first. There were no statistical significances in the average number of bypass, time to acquire great saphenous vein, operation time, 24 h postoperative thoracic drainage, blood bank transfusion, secondary thoracotomy and hemostasis, perioperative myocardial infarction, hospital death, ICU stay time, postoperative hospital stay time, and poor healing of lower limb incision of the two groups. One year after the operation, 36 patients were followed up, including 15 patients in NTSV group, and 21 patients in traditional SV group. There was no recurrence of angina pectoris, no out of hospital death and other major adverse cardiovascular events. Among them, 26 patients completed CTA reexamination of coronary artery, including 12 patients in NTSV group and 14 patients in traditional SV group, the patency rate of vein bridge was 96.4% vs. 87.2%. There was no reduction of left ventricular ejection fraction and no revascularization. Conclusion:The method of using no-touch technique to harvest great saphenous vein is safe and feasible. It does not increase the operation time and the incidence of poor healing of lower limb incision. The short-term effect of applying no-touch technique for harvesting great saphenous vein to OPCABG is better than the traditional open way.

Application value of ultrasound elastography in evaluating liver elasticity of stable recipients at different stages after liver transplantation / 器官移植

Objective To explore the value of ultrasound elastography in the non-invasive monitoring of liver elasticity of stable recipients at different stages after liver transplantation. Methods Clinical data of 73 stable recipients after liver transplantation were collected. According to the time after liver transplantation, all patients were divided into the early group (n=25) and medium-to-long group (n=48). In addition, 38 healthy subjects were assigned into the control group. The ultrasound indexes and liver function indexes were statistically compared among each group. The ultrasound elastography indexes of liver and spleen were analyzed, and their correlation with liver function indexes was analyzed. Results Compared with the control group, the ultrasound indexes, alanine aminotransferase (ALT), γ-glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels were significantly increased in the early group (all P < 0.05), and the ultrasound indexes in the medium-to-long group were significantly increased, whereas the GGT level was significantly decreased (all P < 0.05). Compared with the early group, the right oblique diameter of liver, ALT, GGT and ALP levels were significantly decreased in the medium-to-long group (all P < 0.05). Compared with the control group, the sound touch elastography (STE) and sound touch quantify (STQ) values of liver and STE value of spleen in the early group and medium-to-long group were significantly increased (all P < 0.05). Compared with the early group, the ultrasound elastography indexes of liver and spleen in the medium-to-long group were remarkably decreased (all P < 0.05). The ultrasound elastography indexes of liver were weakly correlated with the ALT, aspartate aminotransferase (AST) and GGT levels, significantly correlated with ALP level. The STE value of spleen was weakly correlated with the ALP level. The STE value of liver was significantly correlated with the STQ value of liver. The STE and STQ values of liver were weakly correlated with the STE value of spleen. Conclusions The characteristics of liver elasticity in stable recipients after liver transplantation are various among different stages. Persistent monitoring of liver elasticity may provide a novelnon-invasive monitoring method during follow-up after liver transplantation.

Effect of kangaroo mother care plus touch therapy versus kangaroo mother care alone on the low-birth-weight infant’s growth and physiologic responses: Randomized controlled trial

Background@#Kangaroo Mother Care (KMC) has facilitated infant growth and decreased morbidities and hospital stay. Adding touch therapy (TT) may potentiate the KMC benefits. @*Objective@#To compare the effectiveness of KMC+TT versus KMC alone in improving anthropometric and physiologic parameters and decreasing morbidities and hospital stay in low birth weight (LBW) infants. @*Methods@#Stable LBW infants (<2000 g) admitted in the KMC ward were randomized to either intervention (KMC+TT) or control (KMC only) group. The KMC+TT group underwent thrice daily touch therapy sessions until discharge. @*Results@#A total of 50 infants were included in the study. Baseline characteristics between the two groups were comparable. There was a significant increase in weight gain (grams/kg/day) in the KMC+TT group compared to KMC only. Physiologic parameters like heart rate, respiratory rate, and temperature were significantly better in the KMC+TT group. More infants in the KMC only group were transferred to NICU care, while more KMC+TT infants went home against advice. Hospital stay was similar between the two groups. @*Conclusion@#Touch therapy added to KMC is more effective than KMC alone in improving weight gain and physiologic parameters. It is associated with lower morbidities, although it did not affect the hospital stay.