Conhecimento e percepção de enfermeiros frente à sedação paliativa na oncologia / Knowledge and perception of nurses dealing with palliative sedation in oncology / Conocimiento y percepción de los enfermeros frente a la sedación paliativa en oncología

Objetivo: compreender o conhecimento e a percepção de enfermeiros quanto à sedação paliativa em oncologia. Método: estudo qualitativo, exploratório e descritivo, com delineamento transversal. Participaram do estudo 16 enfermeiros atuantes na oncologia de um hospital de referência localizado ao norte do Rio Grande do Sul. A coleta de dados ocorreu por meio de entrevista gravada com duração de aproximadamente 10 minutos, sendo aplicado um roteiro de perguntas fechadas com a finalidade de caracterizar os enfermeiros participantes da pesquisa, e perguntas abertas e específicas para contemplar o objetivo do estudo. O método utilizado para o diagnóstico e verificação dos dados da pesquisa foi a análise de conteúdo de Bardin. Os dados foram analisados e codificados por meio do software NVivo 10, que gerou categorias de similaridade e correlações. Resultados: surgiram cinco categorias intituladas "Conhecimento sobre sedação paliativa; Percepção sobre sedação paliativa na oncologia; Sentimentos em relação à sedação paliativa aos pacientes oncológicos; Vivência em relação à sedação paliativa em pacientes oncológicos e Participação do enfermeiro no procedimento de sedação paliativa". Conclusão: o enfermeiro atua de forma efetiva e fundamental na prestação do cuidado e na avaliação do paciente em sedação paliativa, mas ainda encontram-se diversos obstáculos relacionados à participação na tomada de decisões. Evidencia-se a importância de novas pesquisas sobre a temática, como também a implementação de protocolos que subsidiem na indicação da sedação paliativa.(AU)

Objective: to understand the knowledge and perception of nurses dealing with palliative sedation in oncology. Method: this is a qualitative, exploratory, and descriptive study, with a cross-sectional design. The study included 16 nurses working in oncology at a reference hospital located in the north of Rio Grande do Sul. Data were collected through recorded interviews lasting approximately 10 minutes, with a script of closed questions being applied to characterize the nurses participating in the research, and open and specific questions, to contemplate the objective of the study. The method used for the diagnosis and verification of research data was Bardin's content analysis. Data were analyzed and coded using the NVivo 10 software, which generated categories of similarity and correlations. Results: five categories emerged: (i) Knowledge about palliative sedation; (ii) Perception of palliative sedation in oncology; (iii) Feelings regarding palliative sedation in cancer patients; (iv) Experience with palliative sedation in cancer patients; and (v) Participation of the nurse in the palliative sedation procedure. Conclusion: nurses act effectively and fundamentally in providing care and evaluating patients undergoing palliative sedation, but there are still several obstacles related to their participation in decision-making. The importance of new research on the subject is evident, as well as the implementation of protocols that support the indication of palliative sedation.(AU)

Objetivo: comprender el conocimiento y la percepción de los enfermeros sobre la sedación paliativa en oncología. Método: estudio cualitativo, exploratorio y descriptivo, con diseño transversal. El estudio abarcó 16 enfermeros que trabajaban en oncología en un hospital de referencia localizado en el norte de Rio Grande do Sul. La colecta de datos ocurrió por medio de entrevista grabada con duración aproximada de 10 minutos, siendo aplicado un guión de preguntas cerradas con la finalidad de caracterizar los enfermeros participantes de la investigación, y preguntas abiertas y específicas para contemplar el objetivo del estudio. El método utilizado para el diagnóstico y verificación de los datos de la investigación fue el análisis de contenido de Bardin. Los datos fueron analizados y codificados utilizando el software NVivo 10, que generó categorías de similitud y correlaciones. Resultados: surgieron cinco categorías tituladas "Conocimientos sobre sedación paliativa; Percepción de la sedación paliativa en oncología; Sentimientos con respecto a la sedación paliativa para pacientes con cáncer; Experiencia con sedación paliativa en pacientes oncológicos y participación de Enfermeros en el procedimiento de sedación paliativa". Conclusión: el enfermero actúa de forma eficaz y fundamental en la prestación del cuidado y en la evaluación del paciente en sedación paliativa, pero aún existen varios obstáculos relacionados con la participación en la toma de decisiones. Es evidente la importancia de seguir investigando sobre el tema, así como la implementación de protocolos que sustenten la indicación de la sedación paliativa.(AU)

Evaluation of obstetric outcomes in Brazilian pregnant women with Takayasu arteritis

Abstract Objective Takayasu arteritis (TAK) is a rare chronic granulomatous vasculitis that affects large vessels and usually begins in women of childbearing age, so it is not uncommon for pregnancies to occur in these patients. However, there is limited information about these pregnancies, with reports of adverse maternal and obstetric outcomes. The objective of this study is to evaluate adverse maternal, fetal and neonatal events in pregnant patients with TA. Methods This is a cross-sectional study with retrospective data collection. We reviewed 22 pregnancies in 18 patients with TAK, according to the American College of Rheumatology criteria, that were followed up in a high-risk prenatal clinic specialized in systemic autoimmune diseases and thrombophilia (PrAT) at Hospital Universitário Pedro Ernesto, from 1998 to 2021. Results In twenty-two pregnancies, the mean age of patients was 28.09 years and the mean duration disease was 10.9 years. Of the 18 patients with TAK studied, only one had the diagnosis during pregnancy and had active disease. All other patients had a previous diagnosis of TAK and only 3 had disease activity during pregnancy. Twelve patients (66.6%) had previous systemic arterial hypertension and eleven (61.1%) had renal involvement. Among maternal complications, eight patients (36.3%) developed preeclampsia and six (27.2%) had uncontrolled blood pressure without proteinuria, while 10 (45%) had puerperal complications. Four (18.1%) births were premature, all due to severe preeclampsia and eight newborns (34.7%) were small for gestational age. When all maternal and fetal/neonatal outcomes included in this study were considered, only 6 (27.2%) pregnancies were uneventful. Conclusion Although there were no maternal deaths or pregnancy losses in this study, the number of adverse events was considerably high. Hypertensive disorders and small for gestational age newborns were more common than general population, while the number of patients with active disease was low. These findings suggest that pregnancies in patients with TAK still have several complications and a high-risk prenatal care and delivery are necessary for these patients.

Anestesia para el paciente con traumatismo encéfalocraneano / Anesthesia for the Traumatic Brain Injury Patient

Traumatic brain injury (TBI) is the leading cause of death and disability for children and young adults. The Glasgow Coma Scale allows to classify TBI as mild, moderate and severe. Imaging studies show the heterogeneity of the diagnosis. Primary injury is caused by mechanical impact. Secondary injury contributes significantly to prognosis by exacerbating hypoperfusion and intracranial hypertension. Even in the absence of extracranial lesions, many patients with severe TBI present significant organ dysfunction, which transforms TBI into a multisystemic pathology. Most relevant systems compromised include cardiovascular, autonomic, respiratory and coagulation. The main aims of anesthetic management are: early decompression together with prevention, early detection, and management of determinants of secondary injury. To date, there are no techniques or drugs showing a significant impact on the outcome of TBI patients. On the other hand, maintaining good hemodynamic stability, adequate oxygenation and normocarbia all contribute to a better outcome.

El trauma encéfalocraneano (TEC) es la causa más importante de muerte y discapacidad de niños y adultos jóvenes. La escala de Glasgow permite clasificarlo en leve, moderado y severo. La imagenología da cuenta de la heterogeneidad del diagnóstico. La injuria primaria es la causada por el impacto mecánico. La injuria secundaria contribuye significativamente al pronóstico al exacerbar la hipoperfusión y la hipertensión endocraneana. Aun en ausencia de lesiones extracraneales, gran parte de los pacientes con TEC severo presenta disfunción orgánica significativa, lo que lo transforma en una patología multisistémica. Destacan el compromiso cardiovascular, autonómico, respiratorio y trastornos de la coagulación, entre otros. Los objetivos del manejo anestésico son: la descompresión precoz junto con la prevención, detección temprana y manejo de factores determinantes de injuria secundaria. No existe evidencia respecto de técnicas ni fármacos que hayan demostrado un impacto significativo en el manejo del TEC, más bien, impacta positivamente el mantener la estabilidad hemodinámica, una adecuada oxigenación y normocarbia.

Sororidad en los procesos de envejecimiento femenino / Sorority in female aging processes

Resumen La sororidad engloba las prácticas de colaboración y soporte en las relaciones entre mujeres y es el espacio propicio para la construcción de nuevas formas de significar la vejez femenina. El objetivo de este estudio cualitativo fue describir y categorizar los tipos de configuraciones vinculares que se mantienen y los que se han transformado en pro a la sororidad en los procesos de envejecimiento femenino, por medio del análisis narrativo de una entrevista profunda grupal. Los resultados muestran la necesidad de implementar políticas y acciones en aras de disminuir el ageism con relación al envejecimiento de mujeres. La construcción de la sororidad ayuda en el empoderamiento colectivo en pro de su género. La sexualidad de la mujer mayor sigue siendo un tema pendiente en la agenda de la investigación y la discusión en los estudios feministas, lo que nos lleva a concluir que, a pesar de la existencia de diferencias individuales en los propios procesos de envejecimiento, las mujeres se experimentan y comparten en una misma condición histórica, por ello es en colectivo que la acción de la sororidad se pronuncia como vía en la generación de nuevas narrativas preferidas por las mujeres. Finalmente, se expone una propuesta para trabajar la percepción del cuerpo femenino en el proceso de envejecer, y la construcción de la sororidad, desde las prácticas narrativas de White y Epston.

Abstract Sorority encompasses the practices of collaboration and support in relations between women and is the propitious space for the construction of new ways to signify female old age. We present results of a qualitative study using focus groups, which aimed to describe and categorize the types of relational configurations that remain unchanged or change towards sorority in the female aging process. Findings describe the need to implement actions to reduce ageism, not only in terms of the experiences women go through, but also towards aging in general. One of the measures we can take is undoubtedly the construction of women circle sorority, which leads to collective empowerment of gender. The female body is a focus of attention in terms of what it lives and experiences, and the right to have love and sexuality throughout life is also highlighted. We then created an intervention proposal to work on the perception of the female body and its experience in the aging process. The proposed intervention is a workshop, based on the narrative model of Michael White and David Epston.

Current knowledge on biotechnological interesting seaweeds from the Magellan Region, Chile

This paper is a compilation of data from investigations made with marine benthic algae from the Magellan Region that have biotechnological utilization in human consumption or medicine or as a source of phycolloids or food supplements or animal feed. The most important Rhodophyta species are: Ahnfeltia plicata (Hudson) E.M. Fries for agarose production, Gigartina skottsbergii Setchell & N.L.Gardner for carrageenan production, and Callophyllis variegata (Bory de Saint-Vincent) Kützing for human consumption. The most important Heterokontophyta species are: Macrocystis pyrifera (L.) C. Agardh, and Durvillaea antarctica (Chamisso) Hariot for human consumption, alginate production, and as biofertilizer for agricultural crops. M. pyrifera is also used as a food supplement for salmon, chickens, quails, sheep and bovines and for biofuel production.

Using Macrocystis pyrifera (L.) C. Agardh from southern Chile as a source of applied biological compounds

The exploitation of seaweeds in Chile has been carried out for more than 60 years. More recently, seaweeds have been used for the production of alginate, agar and carrageenan, agricultural fertilizers and industrial aquaculture (feed for abalone and sea urchins), increasing the added value of this natural resource. In the Magellan Region (56ºS), the giant kelp Macrocystis pyrifera (L.) C. Agardh presents the most extensive kelp forest, reaching a biomass of approximately 12 kg.m-2. Recent studies have shown potential benefits from adding M. pyrifera- derived flour to salmonid feed. Research is currently underway to evaluate the useof brown algae-derived products for marine aquaculture feed of Oncorhynchus mykiss in tanks. There was no apparent adverse effect on the evaluated parameters that can be attributed to the incorporation of M. pyrifera meal in the diets fed to salmonids. Even when the control diet had numerically the best performance in zootechnical terms, the analysis of variance of all parameters evaluated showed no significant differences with regard to diets containing M. pyrifera meal. These results demonstrated that seaweed meal has important benefits for animal health and nutrition that could be applied or tested in other marine organisms of commercial importance.