Subgingival microbiota and immune response modulation of osseointegrable implants / Modulação da microbiota subgengival e resposta imune dos implantes osseointegráveis

ABSTRACT Osseointegrable dental implants are biomaterials made of titanium or other alloys mixed with titanium, which have high biocompatibility and allow osseointegration. However, this process can be modulated by changes in the complex mechanisms between microbiota, immune response and host. The present study aims to present how the immune system-microbiota-host interaction influences the osseointegration process of titanium dental implants and its alloys. A literature review was performed through electronic and manual searches in several databases, including PubMed, LILACS, Google Scholar, SciELO and Web of Science for articles published in the last 20 years in English and Portuguese. The formation of a temporary fibrin matrix on the implants surface after implantation implies the recruitment, adhesion and activity of immune cells at this site, with the release of pro-inflammatory molecules and recruitment of neutrophils. In the second moment, monocytes and macrophages (M1) are recruited, producing, in this step, reactive oxygen species. In the later stage of inflammation, macrophages (M2) help in tissue regeneration with expression of anti-inflammatory cytokines. In addition, the implants surface provides a site for microbial colonization mediated by salivary pellicle and topographical features. Thus, in symbiosis the modulation of the immune response will be favorable to osseointegration. However, the dysbiotic process exacerbates the inflammatory progression modulating the immune response influencing abnormal tissue healing or scar and fibrosis formation, compromising osseointegration. Different conditions of the subgingival microbiota will influence different immunological cascades, generating different cellular responses and positive or negative modulation of the osseointegration process.

RESUMO Os implantes dentários osseointegráveis são biomateriais constituídos de titânio ou outras ligas misturadas com titânio, as quais possuem alta biocompatibilidade e permitem a osseointegração. Esse processo pode ser modulado por alterações nos mecanismos complexos entre microbiota, resposta-imune e hospedeiro. O presente estudo busca apresentar como a interação sistema imune-microbiota-hospedeiro influenciam no processo de osseointegração proveniente de implantes dentários de titânio. Foi realizada uma revisão de literatura através de busca eletrônica e manual em diversas bases de dados, incluindo PubMed, LILACS, Google Acadêmico, SciELO e Web of Science para artigos publicados nos últimos 20 anos em inglês e português. A formação de uma matriz provisória de fibrina na superfície dos implantes após a implantação implica no recrutamento, adesão e atividade das células imunes, com a liberação de moléculas pró-inflamatórias e recrutamento de neutrófilos. No segundo momento, monócitos e macrófagos (M1) são recrutados, produzindo espécies reativas a oxigênio. Já no estágio posterior da inflamação, macrófagos (M2) ajudam na regeneração do tecido com expressão de citocinas anti-inflamatórias. Além disso, a superfície dos implantes oferece um local para colonização microbiana mediada pela película salivar e características topográficas. Assim, em simbiose a modulação da resposta imune vai ser favorável à osseointegração. Contudo, em estado de doença periodontal, o processo disbiótico exacerba a progressão inflamatória modulando a resposta imune influindo em um processo cicatricial comprometendo a osseointegração. Diferentes condições da microbiota subgengival vão influenciar em cascatas imunológicas diferentes gerando respostas celulares diferentes e modulação positiva ou negativa do processo de osseointegração.

Scurvy and food selectivity in childhood: a case report

ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

Efecto del Tai Chi sobre la flexibilidad, fuerza y balance en adultos mayores autovalentes de la comunidad con riesgo de caídas. Estudio piloto / Effects of Tai Chi on flexibility, strength, and balance of community-dwelling older adults with high fall risk. A pilot study

Objetivo. Determinar el efecto de un programa de 7 semanas de Tai Chi sobre la flexibilidad, fuerza y balance en adultos mayores chilenos autovalentes de la comunidad con riesgo de caídas. Métodos. En este estudio piloto participaron 4 adultos mayores de la comunidad con riesgo de caída (prueba Timed Up and Go > 10 segundos), los cuales fueron entrenados con Tai Chi durante 7 semanas, con una frecuencia de 3 sesiones semanales. Cada sesión tuvo una duración de 60 minutos. Al inicio y al final del entrenamiento, se evaluó flexibilidad (alcance de dorso y alcanzar sentado en silla), fuerza muscular (fuerza prensil, pararse y sentarse en 30 segundos) y balance (prueba Timed Up and Go). Resultados. Las cuatro participantes finalizaron el entrenamiento sin eventos adversos. En todas ellas se observaron aumentos en el rendimiento de fuerza muscular de miembros superiores e inferiores, al igual que en flexibilidad. En términos de balance dinámico, todas las participantes mostraron mejoras disminuyendo los tiempos de ejecución de la prueba Timed Up & Go. Conclusiones. En este grupo de adultas mayores, un programa de Tai Chi de 7 semanas produjo mejoras en la fuerza y flexibilidad de extremidades superiores e inferiores, además de mejorar el balance dinámico.

Objective: To determine the effects of a 7-weeks Tai Chi program on flexibility, strength, and balance in self-valent community-dwelling older adults with fall risk. Methods: In this pilot study, 4 community-dwelling older adults with fall risk (Up & Go > 10 seconds), which were trained with a 7-weeks Tai Chi-based training program, with a frequency of three sessions per week. Each session lasted for 60 minutes. At the beginning and end of the study, flexibility (back scratch and chair sit & reach), muscle strength (grip strength and 30-seconds sit-to-stand), and balance (Timed Up & Go). Results: The four participants finalised the training programs without adverse events. In all of them, increases in upper and lower limb muscle strength and flexibility were seen. In terms of balance, all participants showed improvements by decreasing the execution times of the Up & Go. Conclusion: In this group of older adults, a 7-weeks Tai Chi-based training program induced improvements in upper and lower limb muscle strength and flexibility, along with improvements of dynamic balance.

The work process of the Physical Education professional in primary care in rural areas / Processo de trabalho do profissional de Educação Física na atenção básica em territórios rurais

The aim of this study was to describe the work process of Physical Education professionals in pri-mary health care in rural areas. This study is a systematized experience report from the experiences of resident professionals of Physical Education, inserted in primary health care in the rural areas of the municipalities of Garanhuns and Caruaru, cities of the agreste of the state of Pernambuco, with quilombola populations and settlers from agrarian reform territories, from January to August 2021. The work process of Physical Education professionals in rural areas is marked by agents, objects, means, products and results that characterize work in primary care, composed of nucleus and other comprehensive actions, in addition to the specificities of the area. It permeates individual and collec-tive activities based on the reality and specific needs of the population of the countryside, contribut-ing to health care, facilitating the coordination and continuity of care of this population

O objetivo do estudo foi descrever o processo de trabalho do profissional de Educação Física na Atenção Primária à Saúde em territórios do campo. Estudo do tipo relato de experiência sistematizado a partir das vivências dos profissionais residentes de Educação Física, inseridos na Atenção Primária à Saúde nos territórios do campo dos municípios de Garanhuns e Caruaru, cidades do Agreste Pernambucano, com populações quilombolas e assentados de territórios de reforma agrária, no período de janeiro a agosto de 2021. O processo de trabalho dos profissionais de Educação Física no campo é marcado por agentes, objetos, meios, produtos e resultados que caracterizam o trabalho na Atenção Primária, composto por ações de núcleo e outras abrangentes, além das especificidades da área. Perpassa por atividades individuais, coletivas, a partir da realidade e necessidades específicas da população do campo, contribuindo com a atenção à saúde, facilitando a coordenação e continuidade do cuidado dessa população

Laser therapy in the treatment of chronic multi-site pain: a systematic review / O uso da terapia laser no tratamento da dor crônica difusa: uma revisão sistemática

Laser therapies are noninvasive techniques with painless, safe, and low-cost therapeutic procedures for chronic pain. No systematic review has evaluated the effects of laser in the treatment of multi-site chronic pain. Objective: To evaluate the effects of laser in the treatment of generalized multi-site chronic pain. Methods: This pioneering study presents a PRISMA systematic review protocol designed to up-to-date the current literature on Laser Therapy in patients with chronic multi-site pain from all founded etiologies. This protocol was registered on the PROSPERO website before data extraction (registration no. CRD42019152345). Results: About 1391 articles met the inclusion criteria and 15 studies were selected for the data extraction. We found 12 studies in patients with fibromyalgia, 01 study about myofascial pain syndrome, 01 study about rheumatoid arthritis and 01 study about diabetic sensorimotor polyneuropathy. Homogeneity was not found in the Laser protocols, clinical conditions studied, the evaluation methods, or in the controlled groups but together studies suggested that Laser could have benefits in the treatment of pain severity, quality of life, fatigue, stiffness, depression, and anxiety compared to placebo and other therapies for fibromyalgia and for pain at Rheumatoid Arthritis and Diabetic Polyneuropathy. Conclusion: Laser therapy plus the standardized exercise or amitriptilyne provided no extra advantage in the relief of symptoms at fibromyalgia. For TMD myofascial pain no benefits were founded. Studies showed numerous different points and locations of light application but none of the selected studies used spinal stimulation as the Laser application site.

As terapias a laser são técnicas não invasivas, indolores, seguras e de baixo custo e de utilidade no tratamento da dor crônica. Nenhuma revisão sistemática avaliou os efeitos do laser no tratamento da dor crônica em múltiplos locais simultâneos. Objetivo: Avaliar os efeitos do laser no tratamento da dor crônica multifocal generalizada. Métodos: Revisão sistemática PRISMA sobre o uso do laser em pacientes com dor crônica multifocal de diversas etiologias. Este protocolo foi registrado no site PROSPERO antes da extração dos dados (registro nº. CRD42019152345). Resultados: 1.391 artigos atenderam aos critérios de inclusão e 15 estudos foram selecionados para a extração de dados, sendo 12 estudos em pacientes com fibromialgia, 01 estudo sobre síndrome dolorosa miofascial, 01 estudo sobre artrite reumatoide e 01 estudo sobre polineuropatia sensório-motora diabética. Não foi encontrada homogeneidade nos protocolos do laser, nos métodos de avaliação ou nos grupos controlados, mas em conjunto os estudos sugeriram que o laser poderia ter benefícios no tratamento da intensidade da dor, qualidade de vida, fadiga, rigidez, depressão e ansiedade em comparação com placebo e outras terapias para fibromialgia e para dor na artrite reumatóide e polineuropatia diabética. A terapia a laser mais o exercício padronizado ou amitriptilina não proporcionou nenhuma vantagem extra no alívio dos sintomas da fibromialgia. Para dor miofascial DTM, nenhum benefício foi encontrado. Conclusão: Os estudos mostraram vários pontos e locais diferentes de aplicação de luz, mas nenhum dos estudos selecionados usou a estimulação espinhal como local de aplicação do laser.

Factores favorecedores de disfonía en niños en edad preescolar: diferencias entre niños con y sin disfonía / Aggravating factors of dysphonia in preschool children: differences between children with and without dysphonia

RESUMEN Objetivo Determinar si existen diferencias en factores favorecedores de disfonía, en un grupo de niños preescolares con voz saludable y otro con disfonía. Método En esta investigación se evalúo a un total de 96 niños entre los 2 y 5 años, de los cuales 17 presentaban disfonía y 79, voz saludable. Se comparó la presencia de factores favorecedores de disfonía entre ambos grupos, mediante un cuestionario dirigido a sus padres o cuidadores creado y validado especialmente para esta investigación. El análisis estadístico se realizó mediante análisis de muestras independientes para extraer el valor de p. Resultados Los resultados muestran una diferencia significativa en los valores del cuestionario (p=0,000) entre ambos grupos. El 91,6% de las preguntas se comportaron diferentes entre los grupos con y sin disfonía. Conclusión En esta investigación se encontraron diferencias entre la presencia de factores favorecedores de disfonía en niños preescolares con y sin disfonía. Los factores que tienen más diferencias tienen relación con causas físicas, ambientales y psicológicas.

ABSTRACT Objective To determine if there are differences in factors favoring dysphonia in a group of preschool children with healthy voice and another with dysphonia. Method In this research a total of 96 children between 2 and 5 years old were evaluated, of which 17 had dysphonia and 79 had a healthy voice. The presence of factors favoring dysphonia was compared between both groups, by means of a questionnaire addressed to their parents or caregivers created and validated especially for this research. Statistical analysis was performed by independent samples analysis to extract the p value. Results The results show a significant difference in the values of the questionnaire (p=0.000) between the two groups. The 91.6% of the questions behaved differently between the groups with and without dysphonia. Conclusion In this research, differences were found between the presence of factors favoring dysphonia in preschool children with and without dysphonia. The factors that have more differences are related to physical, environmental and psychological causes.

Recordatorio a través de múltiples cartas para vacunación contra influenza / Multiple mail reminders to increase adherence to influenza vaccination

INTRODUCCIÓN: Distintas intervenciones han sido propuestas para reforzar el uso de la vacuna contra la influenza. El uso de recordatorios, ya sea a través de cartas, llamadas telefónicas, panfletos o aplicaciones tecnológicas, entre otras, ha destacado dentro de aquellas orientadas a incrementar la adherencia al tratamiento. Sin embargo, su efectividad no está clara. En este resumen, que forma parte de una serie de evaluaciones de recordatorios, se abordará el envío de múltiples recordatorios enviados por correo. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta-análisis y prepara-mos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos ocho revisiones sistemáticas que en conjunto incluyeron 35 estudios primarios, de los cuales cuatro corresponden a ensayos aleatorizados que analizan el uso de múltiples recordatorios enviados por correo. Concluimos que más de un recordatorio enviado por correo probablemente aumenta la adherencia a vacunación contra influenza en pacientes mayores de 60 años, mien-tras que podría resultar en poca o nula diferencia en menores de 6 años, pero la certeza de la evidencia es baja.

INTRODUCTION: Different interventions have been proposed to reinforce the use of the influenza vaccine. The use of reminders, whether through letters, phone calls, pamphlets or technological applications, among others, has stood out among those aimed at increasing ad-herence to treatment. However, its effectiveness is not clear. In this summary, which is part of a series of reminder evaluations, we assess the use of multiple mail reminders. METHODS: We conducted a search in Epistemonikos, the largest database of systematic health reviews, which is maintained by screening multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, analyzed the data from the primary studies, performed a meta-analysis and prepared a summary table of the results using the GRADE method. RESULTS AND CONCLUSIONS: We identified eight systematic reviews including 35 primary studies, of which four analyze the use of more than one letter as a reminder. We conclude that the use of multiple mail reminders probably increase adherence to influenza vaccination in patients over 60; while it may make little or no difference in children under 6 years, but the certainty of the evidence is low.

Recordatorio enviado por correo postal para aumentar adherencia a vacunación contra influenza / Reminder sent by mail to increase adherence to influenza vaccination

INTRODUCCIÓN Distintas intervenciones han sido propuestas para reforzar el uso de la vacuna contra la influenza. El uso de recordatorios, ya sea a través de cartas, llamadas telefónicas, panfletos o aplicaciones tecnológicas, entre otras, ha destacado dentro de aquellas orientadas a incrementar la adherencia al tratamiento. Sin embargo, su efectividad no está clara. En este resumen, el primero de una serie de evaluación de recordatorios, se abordará el uso de un recordatorio enviado por correo. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta-análisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos ocho revisiones sistemáticas que en conjunto incluyeron 35 estudios primarios, de los cuales, 32 corresponden a ensayos aleatorizados. Concluimos que un recordatorio enviado por correo probablemente aumenta la adherencia a vacunación contra influenza en todos los grupos etarios (población adulta, mayores de 60 años y menores de 18 años).

INTRODUCTION Different interventions have been proposed to improve influenza vaccine coverage. The use of reminders, through letters, phone calls, pamphlets or technological applications, among others, has stood out among the different alternatives to increase adherence to vaccination. However, its effectiveness is not clear. In this summary, the first of a series of evaluation of reminders will address the use of a reminder sent by mail. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, analyzed the data from the primary studies, performed a meta-analysis and prepared a summary table of the results using the GRADE method. RESULTS AND CONCLUSIONS We identified eight systematic reviews that included 35 primary studies, of which 32 correspond to randomized trials. We concluded that a reminder sent by mail, probably increase adherence to influenza vaccination in all age groups (adult population, over 60 an under 18)

Efectos del entrenamiento sensoriomotor en balance, deambulación y calidad de vida en personas con enfermedad de Parkinson / Effects of sensorimotor training on balance, ambulation and quality of life in people with Parkinson's disease

La enfermedad de Parkinson (EP) es el segundo trastorno neurodegenerativo más frecuente del envejecimiento y el trastorno del movimiento más común. En Chile, de un total de 17.514.003 habitantes un 11,4% de la población es adulto mayor, y aproximadamente un 1-2% de la población de 65 años vive con EP, cifra que se eleva a un 3-5% en aquellos mayores de 85 años. Dentro de las alteraciones del movimiento que genera, se describen trastornos de la marcha y caídas, afectando la calidad de vida de los pacientes, por lo tanto, es fundamental generar estrategias que combatan estas alteraciones. La investigación tuvo como objetivo evaluar la efectividad de un plan de entrenamiento sensoriomotor para mejorar el balance, deambulación y calidad de vida en personas con Parkinson de la ciudad de Valdivia. Estudio cuasiexperimental con medida pre-post test tras 18 sesiones de entrenamiento sensoriomotor de 45 minutos, 3 veces por semana en días no consecutivos, durante 6 semanas. Se evaluó 8 participantes utilizando los test Timed Up and Go (TUG), Gait Speed (GS), Sharpened Romberg (SR) y la escala Unified Parkinson's Disease Rating Scale (UPDRS). Los resultados revelaron que se obtuvo una mejora significativa en las pruebas TUG y GS, con un porcentaje de cambio de 32,1% y 84,61% respectivamente, disminución de compensaciones en test SR y disminución de 2 puntos en la UPDRS. Se concluye que el entrenamiento sensoriomotor a corto plazo logra mejoras significativas en las variables de balance deambulación y calidad de vida(Au)

Introduction. Parkinson's disease (PD) is the second most common neurodegenerative disorder of aging and the most common movement disorder. In Chile, there is a total of 17,574,003 inhabitants, where 11.4% of the total population is older adult, and approximately 1-2% of the population of 65 years lives with PD, a figure that rises to 3-5% in those over 85 years old. Within the alterations of the movement that it generates, disorders of the gait and falls are described, affecting the quality of life of the patients, therefore, it is fundamental to generate strategies that combat these alterations. Objective: Evaluate the effectiveness of a sensorimotor training plan to improve balance, walking and quality of life in people with Parkinson's disease in the city of Valdivia. Methods: Quasi-experimental study with pre-post measurement after 18 sessions of sensorimotor training of 45 minutes, 3 times a week on nonconsecutive days, for 6 weeks. Eight 2 participants were evaluated using the Timed Up and Go (TUG), Gait Speed (GS), Sharpened Romberg (SR) and the escalation of the Unified Parkinson's Disease Classification Scale (UPDRS). Results: A significant improvement was obtained in the TUG and GS tests, with a percentage of change of 32.1% and 84.61% respectively, decrease of compensations in SR test and decrease of 2 points in the UPDRS. Conclusion: Short-term sensorimotor training in the short term achieved significant improvement in variables of balance, ambulation and quality of life(AU)

Ejercicio físico en pacientes con diabetes e hipertensión: prevalencia de respondedores y no respondedores para mejorar factores de riesgo cardiometabólicos / Effects of a six weeks exercise training program for type 2 diabetes mellitus and hypertensive patients

Background: There is a wide interindividual variability in the response to a period of exercise training. The science have reported that a minimum of participants could be non-responders for improving different health-related outcomes after training. Aim: To compare the effects of a 6-weeks exercise program on body composition, cardiovascular and metabolic outcomes patients with type 2 diabetes and hypertension. Material and Methods: Data from 23 trained subjects were used in a secondary analysis of the response to exercise. Of these, 14 were considered adherent to training and nine as non-adherent. Body mass, height, waist circumference, four skinfolds and their sum, blood pressure and plasma triglyceride levels were assessed before and after the training period. Results: Among adherent participants, significant reductions were observed in the sum of four skinfolds (30 ± 7 to 27 ± 6 mm, p ≤ 0.05), systolic blood pressure (133 ± 18 to 127 ± 20 mmHg; p ≤ 0.05) and plasma triglycerides (125 ± 58 to 102 ± 34 mg/dL; p ≤ 0.05). No changes were observed in weight or diastolic blood pressure. Among non-adherent participants, no changes of measured parameters were observed. Among adherent participants, 57% were considered as non-responders for waist circumference, 7% for the sum of skinfold thickness, 50% for systolic blood pressure, 64% for diastolic blood pressure and 57% for plasma triglycerides. Conclusions: Participants with a good adherence to a 6-weeks exercise training program experienced overall improvement in body composition, blood pressure and plasma triglycerides. The prevalence of non-responders varied considerably among measured outcomes.

Manejo do histórico de enfermagem no contexto da Terapia Intensiva Pediátrica / Nursing history management in the Intensive Pediatric Therapy context / Administración del histórico de enfermería en el contexto del Cuidado Intensivo Pediátrico

Objetivo: caracterizar o manejo do Histórico de Enfermagem segundo o preenchimento pelos enfermeiros da Unidade de Terapia Intensiva pediátrica. Método: pesquisa documental retrospectiva utilizando 135 Históricos de Enfermagem de crianças internadas de janeiro de 2015 a janeiro de 2016. Utilizou-se instrumento construído a partir dos itens de cada Bloco do Histórico de Enfermagem do serviço contexto da pesquisa. Os escores variaram de 1 a 189 pontos e permitiram classificar o preenchimento como Péssimo (1 - 66 pontos); Ruim (67 - 100 pontos); Regular (101 - 145 pontos); Bom/Ótimo (145 ou mais pontos). Resultados: dos Históricos de Enfermagem analisados, 47,2% foram classificados como preenchimento regular, 23,7% ruim, 22,2% ótimo e 6,9% péssimo. Conclusões: o manejo do Histórico de Enfermagem foi caracterizado como incipiente, ambivalente, ambíguo, incompleto e desqualificado no tocante à formalidade do seu preenchimento nas práticas de cuidado do enfermeiro intensivista.

Aim: to characterize the management of Nursing History according to the data filling made by the Pediatric Intensive Care Unit nurses. Methods: retrospective documentary research using 135 Nursing Histories of hospitalized children from January 2015 to January 2016. An instrument built from the items from each Nursing History Block of the research context service was used. The scores ranged from 1 to 189 points and allowed the filling to be classified as Poor (1 - 66 points); Bad (67 - 100 points); Regular (101 - 145 points); Good / Great (145 or more points). Results: from the analyzed Nursing Histories, 47.2% were classified as regular, 23.7% bad, 22.2% great and 6.9% as poor. Conclusions: the management of Nursing History was characterized as incipient, ambivalent, ambiguous, incomplete and disqualified regarding the formality of its filling in the care practices of the intensive care unit nurse.

Objetivo: caracterizar la administración del Histórico de Enfermería según el relleno hecho por los enfermeros de la Unidad de Cuidado Intensivo pediátrico. Método: investigación documental retrospectiva basada en 135 históricos de Enfermería de niños internados entre enero de 2015 y enero del 2016. Para tanto, se utilizó un instrumento construido a partir de los ítems de cada Unidad del Histórico de Enfermería del servicio contexto de la investigación. Las calificaciones variaron de 1 a 189 puntos y permitieron clasificar el relleno como Pésimo (1 - 66 puntos); Malo (67 - 100 puntos); Regular (101 - 145 puntos); Bueno/Óptimo (145 o más puntos). Resultados: de los Históricos de Enfermería analizados 47,2% fueron clasificados como relleno regular, 23,7% malo, 22,2% óptimo y 6,9% pésimo. Conclusiones: la administración del Histórico de Enfermería fue caracterizado como incipiente, ambivalente, ambiguo, incompleto y descalificado con relación a la formalidad de su relleno en las prácticas de cuidado del enfermero intensivista

Seguridad de los pacientes con tratamiento medicamentoso para el trastorno de humor / Patient safety in drug therapy for mood disorders

Introducción: las reacciones adversas a los medicamentos son indicadores de seguridad del paciente, que pueden causar impactos clínicos y económicos. Objetivo: describir las reacciones adversas a los medicamentos en pacientes con trastorno de humor. Métodos: estudio observacional, descriptivo, transversal y prospectivo con un método de búsqueda activa en farmacovigilancia, en pacientes con trastornos de humor atendidos por el Centro de Atención Psicosocial y Ambulatorio de salud en Alfenas, Brasil, durante el periodo de enero a julio de 2011. Los pacientes fueron invitados a participar y respondieron preguntas realizadas en su domicilio a fin de detectar las reacciones adversas a los medicamentos, las que fueron analizadas en cuanto a la causalidad y a la gravedad. Resultados: del total de 31 pacientes, 23 presentaron 60 reacciones adversas a los medicamentos, de ellas el 41,6 por ciento clasifican como probables y 48,3 por ciento como posibles. Todas fueron consideradas no graves, que varían de una a cinco reacciones adversas por paciente. De los 16 medicamentos diferentes utilizados, solo clorhidrato de bupropión no presentó reacciones adversas. Fueron detectadas al menos dos reacciones adversas medicamentos para el resto de los medicamentos. Conclusión: la búsqueda activa identificó que de cada diez pacientes tratados con medicamentos para el control de los trastornos de humor, siete sufrieron una reacción no grave(AU)

Introduction: adverse drug reactions are indicators of patient safety, which can cause clinical and economic impacts. Objective: to describe the adverse drug reactions in patients with mood disorders. Methods: observational, descriptive, cross-sectional and prospective study, with active search method in pharmacovigilance in patients with mood disorders attended by the Center for Psychosocial Ambulatory Health Care in Brazil from January to July 2011. Patients were invited to participate and answer questions posed in their residences in order to detect the adverse drug reactions and to analyze them in terms of causality and severity. Results: of 31 patients, 23 presented with 60 adverse drug reactions, being 41.6% probable and 48.3 percent possible. All the adverse drug reactions were not considered serious, ranging one to five adverse reaction per patient. Of the 16 different medicines used, only bupropion hydrochloride did not present ADR. At least two adverse drug reactions were detected for each medicine. Conclusion: The active search identified that seven patients out of 10 treated with medicines to control mood disorders, had no serious adverse reaction(AU)

Terapia antirretroviral em crianças e adolescentes infectados pelo HIV: o que sabemos após 30 anos de epidemia / Antiretroviral therapy in HIV-infected children and adolescents: lessons learned in 30 years of the epidemic / Terapia antirretroviral en niños y adolescentes infectados por el VIH: lo que sabemos después de 30 años de epidemia

Este estudo tem como objetivo avaliar o uso da terapia antirretroviral combinada em crianças e adolescentes com AIDS. Foram captados 247 resumos nos portais PubMed e LILACS, publicados entre 1983 e 2013, sendo utilizados 69 artigos para as referências bibliográficas. A atenção atribuída às pesquisas na faixa etária pediátrica durante os trinta anos de epidemia de AIDS se justifica por características imunológicas próprias, sendo a progressão da AIDS mais rápida em crianças que em adultos. Pesquisas recentes abordam estratégias de intervenção medicamentosa de alta potência antes do aparecimento dos sintomas iniciais. A introdução precoce da terapia antirretroviral combinada foi implantada com eficácia e segurança em populações com poucos recursos fixos, com melhora significativa da sobrevida desses pacientes. O desafio atual é lidar com uma doença crônica com intercorrências agudas. Novas pesquisas serão necessárias, atentando para as especificidades populacionais e particularizando as necessidades individuais dos pacientes pediátricos.

This study aims to evaluate antiretroviral therapy in children and adolescents with AIDS. We selected 247 abstracts published from 1983 to 2013, collected from the PubMed and LILACS databases. Sixty-nine articles were selected. Attention to research in the pediatric age bracket in 30 years of the epidemic is explained by the age group’s immunological characteristics, since AIDS progresses faster in children than in adults. Recent studies focus on the initiation of highly active antiretroviral therapy before the onset of symptoms. Early introduction of combination antiretroviral therapy has been implemented effectively and safely in populations with limited resources, leading to significantly improved survival. The current challenge is to manage a chronic disease with acute complications. New studies should focus on population specificities and identify the individual needs of pediatric patients.

El presente trabajo tiene como objetivo evaluar la terapia antirretroviral combinada, en los niños y adolescentes con SIDA. Se seleccionaron 247 resúmenes en PubMed y en el portal LILACS, publicados entre 1980 y 2013, al final se incluyeron 69 artículos para el presente estudio. La atención dada por la investigación a los grupos de edad pediátrica, durante los 30 años de la epidemia del SIDA, se justifica por las inherentes características inmunológicas: la progresión al SIDA es más rápida en los niños que en los adultos. Recientemente, se llevaran a cabo investigaciones para iniciar intervenciones farmacológicas de alta potencia antes de la aparición de los primeros síntomas. La introducción temprana de la terapia antirretroviral combinada se llevó a cabo con eficiencia y seguridad en poblaciones de escasos recursos, obteniéndose una mejora significativa en estos pacientes. El desafío actual es hacer frente a una enfermedad crónica que presenta complicaciones agudas. Son necesarias nuevas investigaciones, donde se tome en cuenta la población en donde se presenten los casos, así como las necesidades individuales de los pacientes pediátricos.