A assistência de enfermagem no centro cirúrgico: Cuidado humanizado e científico / Asistencia de enfermería en el centro quirúrgico: Atención humanizada y científica / Nursing assistance in the surgical center: Humanized and scientific care

Objetivo: Relatar a assistência de enfermagem no centro cirúrgico na perspectiva do cuidado humanizado. Método: É um estudo de revisão sistemática da literatura, onde foram utilizados elementos da estratégia PICO, mediante perguntas norteadoras. Foram selecionados artigos nos bancos de dados online LILACS, MEDLINE e SciELO, realizada no mês de março de 2022 e destes, 10 artigos foram escolhidos para nossa pesquisa. Resultados: A literatura aponta a importância do acolhimento no centro cirúrgico de maneira humanizada, como modo de acolher os usuários de forma holística, proporcionando assim, uma relação de confiança. Observou-se também algumas ações que tornam a prática de humanização falha pelos profissionais: a sobrecarga de trabalho, exigências burocráticas, alta rotatividade dos usuários. Conclusão: Conclui-se que a prática da humanização no centro cirúrgico ofertada pela equipe multidisciplinar oferece ao paciente mais segurança, acolhimento e um olhar holístico, favorecendo a confiança e a proximidade com esses profissionais.(AU)

Objective: To report the nursing care in the surgical center from the perspective of humanized care. Method: This is a systematic literature review study, where elements of the PICO strategy were used, through guiding questions. Articles were selected in the online databases LILACS, MEDLINE and SciELO, held in March 2022 and of these, 10 articles were chosen for our research. Results: The literature points to the importance of welcoming in the surgical center in a humanized way, as a way of welcoming users in a holistic way, thus providing a relationship of trust. It was also observed some actions that make the practice of humanization fail by professionals: work overload, bureaucratic requirements, high user turnover. Conclusion: It is concluded that the practice of humanization in the surgical center offered by the multidisciplinary team offers the patient more security, reception and a holistic view, favoring trust and proximity to these professionals.(AU)

Objetivo: Relatar el cuidado de enfermería en el centro quirúrgico bajo la perspectiva del cuidado humanizado. Método: Se trata de un estudio de revisión sistemática de la literatura, donde se utilizaron elementos de la estrategia PICO, a través de preguntas orientadoras. Se seleccionaron artículos en las bases de datos en línea LILACS, MEDLINE y SciELO, realizadas en marzo de 2022 y de estos, 10 artículos fueron elegidos para nuestra investigación. Resultados: La literatura señala la importancia de la acogida en el centro quirúrgico de forma humanizada, como forma de acoger a los usuarios de forma holística, propiciando así una relación de confianza. También se observaron algunas acciones que hacen fracasar la práctica de la humanización por parte de los profesionales: sobrecarga de trabajo, requisitos burocráticos, alta rotación de usuarios. Conclusión: Se concluye que la práctica de humanización en el centro quirúrgico ofrecida por el equipo multidisciplinario ofrece al paciente más seguridad, acogida y una visión holística, favoreciendo la confianza y cercanía con estos profesionales.(AU)

Prevalence and force of Plasmodium vivax blood-stage infection and associated clinical malaria burden in the Brazilian Amazon

BACKGROUND Understanding the epidemiology of malaria through the molecular force of the blood-stage infection of Plasmodium vivax (molFOB) may provide a detailed assessment of malaria transmission. OBJECTIVES In this study, we investigated risk factors and spatial-temporal patterns of incidence of Plasmodium infection and clinical malaria episodes in three peri-urban communities of Manaus, Western Brazilian Amazon. METHODS Monthly samples were collected in a cohort of 1,274 individuals between April 2013 and March 2014. DNA samples were subject to Plasmodium species. molFOB was calculated by counting the number of genotypes observed on each visit, which had not been present in the preceding two visits and adjusting these counts by the respective times-at-risk. FINDINGS Respectively, 77.8% and 97.2% of the population remained free of P. vivax and P. falciparum infection. Expected heterozygosity for P. vivax was 0.69 for MSP1_F3 and 0.86 for MS2. Multiplicity of infection in P. vivax was close to the value of 1. The season was associated with P. vivax positivity [adjusted hazard ratio (aHR) 2.6 (1.9-5.7)] and clinical disease [aHR 10.6 (2.4-47.2)]. P. falciparum infection was associated with previous malarial episodes [HR 9.7 (4.5-20.9)]. Subjects who reported possession of a bed net [incidence rate ratio (IRR) 1.6 (1.2-2.2)] or previous malaria episodes [IRR 3.0 (2.0-4.5)] were found to have significantly higher P. vivax molFOB. MAIN CONCLUSIONS Overall, P. vivax infection prevailed in the area and infections were mostly observed as monoclonal. Previous malaria episodes were associated with significantly higher P. vivax molFOB.

Avaliação do consumo de peixes comercializados na cidade de Esperança-Paraíba e seus critérios físico-sensoriais na escolha deste alimento / Evaluation of the consumers of fish marketed in the city of Esperança-Paraíba and its physical-sensory criteria in the selection of this food

O presente trabalho visou avaliar o consumo de peixes no município de Esperança-PB, bem como, os fatores que os influenciam no momento da compra. Foram entrevistadas 38 pessoas, através de um questionário com 15 questões objetivas sobre hábitos de consumo e prováveis fatores que afetam a decisão de compra dos peixes e consequente consumo. Foi observado que, a maioria dos participantes desta pesquisa compram peixes principalmente em feiras livres, com a mesma frequência de consumo, sendo uma vez na semana e o principal motivo para escolha desses lugares é por causa da cultura deixada por gerações e devido ao preço ser mais baixo. Segundo os entrevistados, a coloração é a principal forma de avaliação para a escolha do peixe ideal ao consumo e as guelras a parte mais observada no momento da compra. Ainda sobre a comercialização os entrevistados relataram em sua grande maioria, não terem acesso a temperatura de conservação e ao selo de inspeção, bem como, metade afirmou desconhecer a importância do Médico Veterinário para saúde pública.

Performance of an immuno-rapid malaria Pf/Pv rapid diagnostic test for malaria diagnosis in the Western Brazilian Amazon

Abstract INTRODUCTION: Rapid diagnostic tests (RDTs) for detecting Plasmodium antigens have become increasingly common worldwide. We aimed to evaluate the accuracy of the Immuno-Rapid Malaria Pf/Pv RDT in detecting Plasmodium vivax infection compared to standard thick blood smear (TBS) under microscopy. METHODS: Hundred and eighty-one febrile patients from the hospital's regular admissions were assessed using TBS and RDT in a blinded experiment. RESULTS: RDT showed a sensitivity of 98.9%, specificity of 100%, and accuracy of 99.5% for P. vivax infection when compared to TBS. CONCLUSIONS: The RDT is highly accurate, making it a valuable diagnostic tool for P. vivax infection.

Aspectos clínicos y epidemiológicos de las leucemias / Clinical and epidemiological aspects of leukemias

Leukemia is a group of clonal diseases derived from a single cell with a genetic alteration in bone marrow or peripheral lymphoid tissue, and each type is determined by the specificity of the source cell. The objective of this research was to synthesize studies that characterize the clinical and epidemiological profile of patients with leukemia, the types of treatments used, duration and outcomes for the cases. This study is an integrative review of literature through databases Medical Literature Analysis and Retrieval System Online (MEDLINE), SCOPUS, Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Science Direct. There were 4,274 articles rescued in the initial search, 188 were selected to compose the review sample after applying all the criteria for inclusion and exclusion adopted. Full articles were grouped into four categories, according to the variables of research: (a) more frequent subtypes of leukemia; (b) most widely used treatment; (c) duration of treatment; and (d) endpoint of the cases. It is concluded a prevalence of leukemia in pediatric patients, with a predominance of the subtype Acute Lymphoblastic Leukemia (ALL). In general, the male population is more affected by hematological malignancies. As the therapy is used, each leukemia subtype had its peculiarities regarding the treatment, especially the introduction of imatinib for chronic myeloid leukemia (CML) and prophylactic cranial irradiation for cases of ALL. Chronic leukemia showed higher treatment duration. There was a significant improvement in survival of Acute Myeloid Leukemia, Chronic Lymphoid leukemia, CML and ALL, the latter approximately with 90% cure rate in children.

La leucemia es un grupo de enfermedades clonales derivadas de una única célula con una alteración genética en la médula ósea o tejido linfoide periférico, y cada tipo se determina por la especificidad de la célula de origen. El objetivo de esta investigación fue sintetizar los estudios que caracterizan el perfil clínico y epidemiológico de los pacientes con leucemia, los tipos de tratamientos usados, la duración y los resultados para los casos. Este estudio es una revisión integradora de la literatura a través de bases de datos de análisis médicos, literatura y recuperación de sistema en línea (MEDLINE), SCOPUS, Cumulative Index de Enfermería y Salud Aliada Literatura (CINAHL) y Science Direct. Había 4 274 artículos rescatados en la búsqueda inicial, se seleccionaron 188 para componer la muestra de revisión después de aplicar todos los criterios de inclusión y exclusión adoptada. Los artículos completos se agruparon en cuatro categorías, según las variables de investigación: (a) los subtipos más frecuentes de leucemia; (b) el tratamiento más utilizado; (c) la duración del tratamiento; y (d) el punto final de los casos. Se concluye una prevalencia de leucemia en pacientes pediátricos, con predominio del subtipo de leucemia linfoblástica aguda (LLA). En general, la población masculina se ve más afectada por neoplasias hematológicas. Como se utiliza la terapia, cada subtipo de leucemia tenía sus peculiaridades con respecto al tratamiento, especialmente la introducción de imatinib para la leucemia mieloide crónica (CML) y la irradiación craneal profiláctica para los casos de ALL. La leucemia crónica mostró una mayor duración del tratamiento. Hubo una mejora significativa en la supervivencia de la leucemia mieloide aguda, leucemia linfoide crónica, LMC y LLA, aproximadamente, este último con la tasa de curación del 90% en los niños.

Validation of the rapid test carestart(tm) G6PD among malaria vivax-infected subjects in the Brazilian Amazon

Abstract: INTRODUCTION: In the Brazilian Amazon, malaria infections are primarily caused by Plasmodium vivax. The only drug that kills the hypnozoite form of P. vivax is primaquine, thereby preventing relapse. However, treating glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals with primaquine can lead to severe hemolysis. G6PD deficiency (G6PDd) affects approximately 400 million people worldwide, most of whom live in malaria-endemic areas. Therefore, clinicians need tools that can easily and reliably identify individuals with G6PDd. This study estimated the accuracy of the Carestart(tm) G6PD rapid test (Access Bio) in the diagnosis of G6PDd in male participants with and without P. vivax acute malaria. METHODS: Male participants were recruited in Manaus. Malaria diagnosis was determined by thick blood smear. G6PD quantitative analysis was performed spectro photometrically at a wave length of 340nm. The Carestart(tm) G6PD test was performed using venous blood. Genotyping was performed for individuals whose samples had an enzyme activity less than 70% of the normal value. RESULTS: Six hundred and seventy-four male participants were included in this study, of whom 320 had a diagnosis of P. vivax malaria. In individuals with enzyme activity lower than 30% (n=13), the sensitivity, specificity, positive predictive value, and negative predictive value of the Carestart(tm) G6PD test were as follows: 61.5% (95%CI: 35.5%-82.3%), 98.3% (95%CI: 97.0%-99.1%), 42.1% (95%CI: 23.1%-63.7%), and 99.2% (95%CI: 98.2%-82.3%), 98.3% (95%CI: 97.0%-99.1%), 42.1% (95%CI: 23.1%-63.7%), and 99.2% (95%CI: 98.2%-99.7%), respectively. Increases in sensitivity were observed when increasing the cut-off value. CONCLUSIONS: Despite low sensitivity, Carestart(tm) G6PD remains a good alternative for rapid diagnosis of G6PDd in malaria-endemic regions.

G6PD deficiency in Latin America: systematic review on prevalence and variants

Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available.

Líquen plano reticular: características clínicas patognomônicas: relato de caso clínico / Lichen planus reticular: pathognomonic clinical characteristics: case report

O Líquen Plano é uma doença inflamatória crônica mucocutânea relativamente comum e de origem imunológica. As lesões bucais podem se apresentar de diversas formas, sendo a forma reticular a mais frequente. Geralmente, esta é assintomática e apresenta-se como linhas brancas finas de aspecto rendilhado, denominadas de estrias de Wickham. Estas por si só determinam o diagnóstico de Líquen Plano reticular, já que se constituem um sinal patognomônico desta doença. O objetivo deste trabalho é relatar um caso clínico de Líquen Plano reticular, cujas manisfestações bucais apresentam-se com características clínicas que não deixam margem de dúvida quanto ao diagnóstico, dispensando a biópsia