Home-based nursing interventions improve knowledge of disease and management in patients with heart failure / Intervenções de enfermagem no domicílio melhoram conhecimento sobre a doença e tratamento em pacientes com insuficiência cardíaca / Intervenciones de enfermería en domicilio mejoran conocimiento sobre la enfermedad y tratamiento en pacientes con insuficiencia cardíaca

OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire. METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered. RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4. CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. .

OBJETIVO: verificar o conhecimento dos pacientes sobre insuficiência cardíaca, por meio de dois Resultados de Enfermagem em ambiente domiciliar, durante um seguimento de seis meses e, correlacionar a média dos seus indicadores com um Questionário de Conhecimento sobre insuficiência cardíaca. MÉTODOS: neste estudo tipo antes-depois, pacientes com insuficiência cardíaca receberam quatro visitas domiciliares, durante seis meses, após a alta hospitalar. Em cada visita foram implementadas Intervenções de Enfermagem, mensurados os Resultados e aplicado o Questionário do Conhecimento. RESULTADOS: vinte e três pacientes receberam visitas em domicílio. Na visita um, o Resultado Conhecimento: Medicação obteve média de 2,27±0,14 e na visita quatro, 3,55±0.16 (P<0,001), e o Resultado Conhecimento: Regime Terapêutico 2,33±0,13 na visita um e 3,59±0,14 na visita quatro (P<0,001). A correlação entre o Questionário do Conhecimento e os escores da Classificação dos Resultados de Enfermagem foi de forte magnitude na visita domiciliar um (r=0.7, P<0,01), mas fraca e não significativa na visita quatro. CONCLUSÃO: os resultados indicaram progresso do conhecimento sobre insuficiência cardíaca e correlação forte entre a Classificação dos Resultados de Enfermagem e os escores do Questionário do Conhecimento. A Classificação dos Resultados de Enfermagem mostrou-se efetiva na avaliação do conhecimento quando comparada ao instrumento validado. .

OBJETIVO: verificar el conocimiento de los pacientes sobre insuficiencia cardíaca mediante dos Resultados de Enfermería en ambiente domiciliario durante un seguimiento de seis meses y correlacionar el promedio de sus indicadores con un Cuestionario de Conocimiento sobre insuficiencia cardíaca. MÉTODOS: en este estudio tipo antes-después, pacientes con insuficiencia cardíaca recibieron cuatro visitas en domicilio durante un período de seis meses tras el alta hospitalario. En cada visita fueron implementadas Intervenciones de Enfermería, mensurados los Resultados y aplicado el Cuestionario del Conocimiento. RESULTADOS: veinte y tres pacientes recibieron visitas en domicilio. En la visita 1, el Resultado Conocimiento: Medicación alcanzó promedio de 2,27±0,14 y, en la visita 4 3,55±0.16 (P<0,001), y el Resultado Conocimiento: Régimen Terapéutico 2,33±0,13 en la visita 1 y 3,59±0,14 en la visita 4 (P<0,001). La correlación entre el Cuestionario del Conocimiento y los scores de la Clasificación de los Resultados de Enfermería fue de magnitud fuerte en la visita en domicilio 1 (r=0.7, P<0,01), pero débil y no significativa en la visita 4. CONCLUSIÓN: los resultados indicaron mejora del conocimiento sobre insuficiencia cardíaca y correlación fuerte entre la Clasificación de los Resultados de Enfermería y los scores del Cuestionario del Conocimiento. La Clasificación de los Resultados de Enfermería se mostró efectiva en la evaluación del conocimiento cuando comparados al instrumento validado. .

Tuberculosis in renal transplant patients: The experience of a single center in Medellín-Colombia, 2005-2013 / Tuberculose em pacientes transplantados renais: experiência de um único centro em Medellín-Colômbia, 2005-2013

Introduction: Tuberculosis is a common opportunistic infection in renal transplant patients. Objective: To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital. Methods: Retrospective and descriptive study. Results: In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%. Conclusion: Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant. .

Introdução: A tuberculose é uma infecção oportunista comum em pacientes transplantados renais. Objetivo: Oferecer uma descrição clínica e laboratorial de pacientes transplantados com diagnóstico de tuberculose e sua resposta ao tratamento durante o período entre 2005 e 2013 no Hospital Pablo Tobón Uribe. Métodos: Estudo retrospectivo descritivo. Resultados: Em 641 transplantes renais, a tuberculose foi confirmada em 12 pacientes. Destes, 25% tinham histórico de rejeição aguda e 50% apresentaram níveis de creatinina superiores a 1,5 mg/dl antes da infecção. A patologia geralmente se apresentava como pulmonar (50%) e disseminada (33,3%). A primeira fase do tratamento consistiu de três meses de HZRE (isoniazida, pirazinamida, rifampicina e etambutol) em 75% dos casos e HZME (isoniazida, pirazinamida, moxifloxacina e etambutol) em 25% dos pacientes. Durante a segunda fase do tratamento, 75% dos pacientes receberam isoniazida e rifampicina e 25% isoniazida e etambutol. A duração do tratamento variou entre seis e 18 meses. Em 41,7% dos pacientes, hepatotoxicidade foi associada ao início do tratamento da tuberculose. Durante o seguimento de um ano a função renal manteve-se estável e a taxa de mortalidade foi de 16,7%. Conclusão: A tuberculose foi responsável por diversos sintomas inespecíficos na população de transplantados renais estudada. Tuberculose pulmonar e disseminada foram as formas mais frequentes de acometimento e necessitaram de tratamento prolongado. Medicamentos contra a tuberculose apresentaram alta toxicidade e mortalidade. Esta infecção deve ser considerada quando o paciente apresenta síndrome febril de origem desconhecida, especialmente durante o primeiro ano após o transplante renal. .

GABA-induced inactivation of Cebus apella V2 neurons: effects on orientation tuning and direction selectivity

We investigated the GABA-induced inactivation of V2 neurons and terminals on the receptive field properties of this area in an anesthetized and paralyzed Cebus apella monkey. Extracellular single-unit activity was recorded using tungsten microelectrodes in a monkey before and after pressure-injection of a 0.25 or 0.5 M GABA solution. The visual stimulus consisted of a bar moving in 8 possible directions. In total, 24 V2 neurons were studied before and after blocker injections in 4 experimental sessions following GABA injection into area V2. A group of 10 neurons were studied over a short period. An additional 6 neurons were investigated over a long period after the GABA injection. A third group of 8 neurons were studied over a very long period. Overall, these 24 neurons displayed an early (1-20 min) significant general decrease in excitability with concomitant changes in orientation or direction selectivity. GABA inactivation in area V2 produced robust inhibition in 80% and a significant change in directional selectivity in 60% of the neurons examined. These GABA projections are capable of modulating not only levels of spontaneous and driven activity of V2 neurons but also receptive field properties such as direction selectivity.

Reduced hippocampal GABAergic function in Wistar audiogenic rats

Epilepsy is a neurological disorder associated with excitatory and inhibitory imbalance within the underlying neural network. This study evaluated inhibitory γ-amino-butyric acid (GABA)ergic modulation in the CA1 region of the hippocampus of male Wistar rats and Wistar audiogenic rats (aged 90 ± 3 days), a strain of inbred animals susceptible to audiogenic seizures. Field excitatory postsynaptic potentials and population spike complexes in response to Schaffer collateral fiber stimulation were recorded in hippocampal slices before and during application of picrotoxin (50 µM, 60 min), a GABA A antagonist, and the size of the population spike was quantified by measuring its amplitude and slope. In control audiogenic-resistant Wistar rats (N = 9), picrotoxin significantly increased both the amplitude of the population spike by 51 ± 19 percent and its maximum slope by 73 ± 21 percent. In contrast, in slices from Wistar audiogenic rats (N = 6), picrotoxin caused no statistically significant change in population spike amplitude (33 ± 46 percent) or slope (11 ± 29 percent). Data are reported as means ± SEM. This result indicates a functional reduction of GABAergic neurotransmission in hippocampal slices from Wistar audiogenic rats.

Gating of the dorsal penile nerve inputs by norepinephrine at the medial preoptic area in rats.

The medial preoptic area neurons related to male sexual behaviour in rats were identified by their responses to dorsal penile nerve stimulation. These neurons were further tested with norepinephrine applied iontophoretically. From the 21 medial preoptic area neurons recorded in urethane anaesthetized rats, 17 neurons responded to dorsal penile nerve stimulation. Excitatory and inhibitory responses were found in almost equal number of neurons. 14 neurons responded to norepinephrine application, out of which six neurons were excited and eight were inhibited. The direction of changes produced by dorsal penile nerve stimulation and norepinephrine application were similar in 10 neurons. The results suggest that the sensory inputs from the genitalia are possibly gated by norepinephrine at the level of the medial preoptic area. Afferent information from the genitalia carried by dorsal penile nerve and the availability of norepinephrine at the level of the medial preoptic area probably help in maintaining adequate level of sexual arousal.

Comparison of latent inhibition mechanisms before and after drug therapy in patients with schizophrenia

This study was aimed to compare the latent inhibition mechanisms [LI] in patients at the acute phase of schizophrenia with the patients whose symptoms were controlled by antipsychotic medications. LI was evaluated using visual and auditory stimuli in three groups: The first group [n=30] included the patients at the acute psychotic phase that did not take any medication. The second group [n=35] were the patients whose symptoms were controlled by antipsychotic drugs. The third group [n=31] were normal controls with no history of schizophrenia. The error score in learning in the testing phase was regarded as a dependent variable. The error scores in schizophrenia patients [acute phase and stable patients] were significantly higher as compared to the control group. The expected effect of LI was not observed in stable schizophrenia patients. Our results did not show an association between LI and the phases of schizophrenia. It seems that patient's