ABSTRACT
O objetivo desse relato de caso foi demonstrar as particularidades no diagnóstico e possíveis diagnósticos diferenciais em pacientes imunossuprimidos com síndrome febril aguda. Paciente feminina, 37 A, auxiliar administrativo, portadora de artrite reumatoide, imunossuprimida em uso de Simponi associado a Metotrexato 10 mg/semana, com diagnóstico anterior de tumor desmóide em 2016. Após a 2ª dose de Simponi, cursa com quadro agudo de cefaleia de característica persistente, refratária a uso de sintomáticos, acompanhado de náuseas, com queda relativa do estado geral, sudorese de característica noturna, mialgia difusa e episódios recorrentes de febre. Durante esse período foi imunizada com a 2ª dose da vacina para o covid-19. Após a vacinação surgiu nova sintomatologia, disúria isolada. Diante disso, conduzimos com a internação hospitalar para rastreio infeccioso e vigilância clínica. Foi interrogado descompensação infecciosa viral, ITU, reação medicamentosa de suspeição pouco provável e doença hematológica. Foi solicitado laboratório completo, incluindo sorologias virais para citomegalovírus, EBV, parvo vírus, toxoplasmose, leptospirose, hemocultura de 2 amostras de sítios diferentes, EAS e urocultura, ferritina e triglicerídeos devido a febre com alterações de transaminase, aventando um possível quadro viral desencadeado por síndrome hematofágica. Complementando com exames de imagem, como USG de abdome total para avaliar a possibilidade de hepatoesplenomegalia e USG de cervical para avaliar linfonodos. Paciente evolui com piora clínica em vigência de dor abdominal. Solicitada tomografia de abdome, apresentando imagem com vesícula parcialmente distendida, associado à presença de líquido perivesicular, A clínica cirúrgica opta por abordagem invasiva, sendo realizado colecistectomia videolaparoscopia. No pós-operatório, ficando aos cuidados intensivos pela UTI e escalonado para tazocin (D10). Após resultado da sorologia para leptospirose com IgM reagente interrompeu uma longa série de exames negativos e febre prolongada, sem diagnóstico. Apresentou evolução clínica satisfatória, resultando em alta hospitalar. A artrite reumatoide é acompanhada de sintomas constitucionais inespecíficos, principalmente a febre baixa em pacientes imunossuprimidos. O diagnóstico de leptospirose foi concluído mais tardiamente, quando os exames da admissão foram disponibilizados. Um caso de uma enfermidade de alto impacto, contudo negligenciada como problema de saúde pública.
ABSTRACT
Although Information and Communication Technology-ICT solutions have been used for a long time in various sectors of the economy, recent developments in Communications, IoT, Data Science and Artificial Intelligence have brought very attractive possibilities for their wider adoption, especially with regard to cities and its citizens.In this article, some aspects of the international and the Brazilian technical regulations are addressed, with special attention to issues of interest to cities. The General Data Protection Law of Brazil is highlighted.Some specific projects and initiatives related to smart cities are also presented and commented on, such as the National IoT Plan and its consequences, besides other initiatives to address smart cities.Additionally, some aspects of present days combat actions in the Covid-19 pandemic and its relationships with public policies applied to cities are highlighted.Finally, considerations about the need for effective and efficient public policies to reinforce the resilience of cities, including tackling biological hazards, are addressed. © 2020 IEEE.
ABSTRACT
Objective: to identify scientific evidence on best practices in newborn care, from the delivery room to the home, in COVID-19 times. Method: an integrative review conducted in April 2020 at National Library of Medicine National Institutes of Health (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus, through combinations between the controlled terms “newborn”, “coronavirus infections”, and “COVID-19”. Results: nineteen studies made up the final sample, from which five analytical categories emerged on best practices in newborn care: Pregnant women and puerperal women suspected of having COVID-19;Pregnant and puerperal women with confirmation for COVID-19;Newborns suspected of having COVID-19;Newborns with confirmation for COVID-19;and Horizontal transmission prevention of COVID-19 to newborns. Conclusion: several recommendations were divergent, due to the contemporary pandemic of COVID-19. Therefore, the role of nurses is essential for adherence to best practices, which are proven and recommended nationally and internationally, taking into account the local reality and the constant updating of the theme. Therefore, further research is needed, especially with a strong level of evidence, for formulation of assistance guidelines for this population group that contribute to reducing neonatal morbidity and mortality and healthy and harmonious child development during and post-pandemic. © 2020, Universidade Federal de Santa Catarina. All rights reserved.
ABSTRACT
Objective: to describe adversities experienced by nursing professionals in intensive care units in times of COVID-19. Method: descriptive and exploratory research, with a qualitative approach, involving 28 nursing professionals from intensive care units in the state of Rio de Janeiro in April 2020. Data processed in the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires. Results: by the Descending Hierarchical Classification, three classes were obtained: fear of the unknown and lack of personal protective equipment and support to nursing professionals;lack of flows, protocols, information, materials and training of teams to promote safe assistance;and stress in caring for patients with positive COVID-19, risk of contamination and death and constant need for guidance on preventive measures. Final considerations: such adversities influenced the care practice and psychoemotional health of nursing professionals, and public policies and management and care strategies were needed to minimize them. © 2022 Universidade Federal da Bahia. All rights reserved.