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1.
Revista Cuidarte ; 13(3):1-16, 2022.
Article in Spanish | ProQuest Central | ID: covidwho-2025818

ABSTRACT

Introduçâo: baseada em uma visäo holística do ser humano, os cuidados paliativos, tem como filosofía valorizar a vida e enxergar a morte como um processo natural. Objetivo: compreender as percepçoes de Enfermeiros na assistencia ao paciente em cuidados paliativos. Materiais e Método: estudo transversal, exploratorio descritivo, com abordagem qualitativa que objetivou compreender o fenómeno do cuidado paliativo na percepçâo dos profissionais envolvidos. Resultados: Após análise dos discursos dos participantes, com base no objetivo e na semelhança das respostas, emergiram seis categorias temáticas: Cuidado Humanizado, Liderança, Sentimentos, Família, Cuidado Paliativo e Conforto. Conclusäo: Os profissionais apontaram como fundamental, a participaçâo dos familiares e as habilidades adquiridas na experiencia vivida, a ressignificaçâo diária, bem como suas limitaçoes, contribuíram para compreensäo do processo de cuidar e viver humano, minimizando o sofrimento resultante de doenças terminais.Alternate :Introduction: based on a holistic view of the human being, the philosophy of palliative care is to value life and see death as a natural process. Objective: to understand the perceptions of nurses in the assistance to patients in palliative care. Materials and Method: cross-sectional, exploratory descriptive study, with a qualitative approach that aimed to understand the phenomenon of palliative care in the perception of the professionals involved. Results: After analysis of the participants' speeches, based on the objective and the similarity of the responses, six thematic categories emerged: Humanized Care, Leadership, Feelings, Family, Palliative Care and Comfort. Conclusion: The professionals pointed out as fundamental, the participation of family members and the skills acquired in the lived experience, the daily resignification, as well as their limitations, contributed to the understanding of the process of caring and human living, minimizing the suffering resulting from terminal illness.Alternate :Introducción: basada en una visión holística del ser humano, la La filosofía de los cuidados paliativos es valorar la vida y ver la muerte como un proceso natural. Objetivo: comprender la percepciones de las enfermeras en la asistencia al paciente en paliativos cuidados paliativos. Materiales y métodos: estudio transversal, estudio exploratorio descriptivo, con un enfoque cualitativo que pretendía comprender el fenómeno de los cuidados paliativos en la percepción de de los profesionales implicados. Resultados: Tras el análisis de la discursos de los participantes, con base en el objetivo y en la similitud de las respuestas, surgieron seis categorías temáticas: Atención humanizada, Liderazgo, sentimientos, familia, cuidados paliativos y confort. Conclusión: Los profesionales señalaron como fundamental, la la participación de los familiares y las habilidades adquiridas en la experiencia vivida, la resignificación diaria diariamente, así como sus limitaciones, contribuyeron a la comprensión del proceso de Cuidar y vivir de forma humana, minimizando el sufrimiento resultante de las enfermedades terminales.

2.
Am J Case Rep ; 23: e934220, 2022 Feb 23.
Article in English | MEDLINE | ID: covidwho-1707187

ABSTRACT

BACKGROUND Rhabdomyolysis is a syndrome characterized by muscle necrosis and the subsequent release of intracellular muscle constituents into the bloodstream. Although the specific cause is frequently evident from the history or from the immediate events, such as a trauma, extraordinary physical exertion, or a recent infection, sometimes there are hidden risk factors that have to be identified. For instance, individuals with sickle cell trait (SCT) have been reported to be at increased risk for rare conditions, including rhabdomyolysis. Moreover, there have been a few case reports of SARS-CoV-2 infection-related rhabdomyolysis. CASE REPORT We present a case of a patient affected by unknown SCT and admitted with SARS-CoV-2 pneumonia, who suffered non-traumatic non-exertional rhabdomyolysis leading to acute kidney injury (AKI), requiring acute hemodialysis (HD). The patients underwent 13 dialysis session, of which 12 were carried out using an HFR-Supra H dialyzer. He underwent kidney biopsy, where rhabdomyolysis injury was ascertained. No viral traces were found on kidney biopsy samples. The muscle biopsy showed the presence of an "open nucleolus" in the muscle cell, which was consistent with virus-infected cells. After 40 days in the hospital, his serum creatinine was 1.62 mg/dL and CPK and Myoglobin were 188 U/L and 168 ng/mL, respectively; therefore, the patient was discharged. CONCLUSIONS SARS-CoV-2 infection resulted in severe rhabdomyolysis with AKI requiring acute HD. Since SARS-CoV-2 infection can trigger sickle-related complications like rhabdomyolysis, the presence of SCT needs to be ascertained in African patients.


Subject(s)
Acute Kidney Injury , COVID-19 , Rhabdomyolysis , Sickle Cell Trait , Acute Kidney Injury/complications , Humans , Male , Renal Dialysis/adverse effects , Rhabdomyolysis/complications , SARS-CoV-2 , Sickle Cell Trait/complications
3.
EuropePMC;
Preprint in Portuguese | EuropePMC | ID: ppcovidwho-327893

ABSTRACT

Objetivo: identificar as informações relevantes para a tomada de decisão da mulher pelo Parto Domiciliar Planejado e discutir como a emergência da COVID19 pode interferir nesse processo. Método: pesquisa qualitativa descritivo-exploratória, com 14 puérperas que se interessaram pelo parto domiciliar no percurso de escolha pelo local de parto. A coleta de dados foi realizada através de entrevistadas semiestruturadas e seis documentos informativos fornecidos pelas mulheres, no período de fevereiro a abril de 2019. Com base na análise de conteúdo os dados foram analisados com o auxílio do software ATLAS.ti, versão 8.0. Resultados: Há critérios de inclusão para parir em casa, os quais dizem respeito a condições obstétricas da mulher bem como às condições de bancar o financiamento particular dessa escolha. Pelo menos um profissional habilitado para a assistência ao parto atende o parto em domicílio, sendo que o mesmo realiza o acompanhamento desde o pré-natal ao pós-parto e está preparado para agir em caso de intercorrências e transferência. Conclusão: As informações geradas sobre o Parto Domiciliar Planejado são essenciais para auxiliar a mulher na tomada de decisão pelo local de parto no contexto da Pandemia do COVID19.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310444

ABSTRACT

Background: COVID-19 infection has put enormous pressure on the healthcare systems worldwide and especially on Intensive Care Units (ICUs). In this particular situation, a modified snorkeling mask into a mask for non-invasive continuous positive airway pressure (nCPAP) and non-invasive ventilation (NIV), with the help of 3D printers, has been proposed for clinical use. We designed a bench study to compare a Helmet (H), a Full face mask (RFF) and a modified full face snorkeling mask (MFF) for delivering nCPAP and NIV in pressure support mode (PSV).MethodsA mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort (Pmus), were determined relative to the preset CPAP level. NIV was applied in PSV at two simulated respiratory rates and two cycling-off flow thresholds. During the bench study we measured the variables defining patient-ventilator interaction and performance. ResultsDuring nCPAP, the MFF presented significantly lower values of ΔPawi and ∆Pawe compared to the other interfaces tested (H and RFF). During NIV, the MFF demonstrated a better patient-ventilator interaction compared to RFF, as shown by significantly shorter Time press and Delay trexp (p<0.01), but no significant differences were found in terms of Delaytr insp and Time sync between the interfaces tested. At RR 20sim, the MFF presented the shorter ΔPtrigger (p<0.01), moreover during all the conditions tested the MFF showed the longer PTP 200, 300 and 500 compared to RFF (p<0.01). A major limitation of MFF is that during NIV with this interface it is possible to reach at maximum 18 cmH 2 O of peak inspiratory pressure. Over this pressure value, the presence of air leaks determined important asynchrony phenomena. For this reason, our test was limited to one pressure support and PEEP set (PS 10 cmH 2 O and PEEP 8 cmH 2 O).ConclusionsThe modified full face snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergency situations.

5.
Pulmonology ; 2021 Jun 08.
Article in English | MEDLINE | ID: covidwho-1260845

ABSTRACT

PURPOSE: The aim of this bench study is to compare the standard NIV and nCPAP devices (Helmet, H; Full face mask, FFM) with a modified full face snorkeling mask used during COVID-19 pandemic. METHODS: A mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort, were determined relative to the preset CPAP level. NIV was applied in Pressure Support Mode at two simulated respiratory rates and two cycling-off flow thresholds. During the bench study, we measured the variables defining patient-ventilator interaction and performance. RESULTS: During nCPAP, the tested interfaces did not show significant differences in terms of ∆Pawi and ∆Pawe. During NIV, the snorkeling mask demonstrated a better patient-ventilator interaction compared to FFM, as shown by significantly shorter Pressurization Time and Expiratory Trigger Delay (p < 0.01), but no significant differences were found in terms of Inspiratory Trigger Delay and Time of Synchrony between the interfaces tested. At RR 20sim, the snorkeling mask presented the lower ΔPtrigger (p < 0.01), moreover during all the conditions tested the snorkeling mask showed the longer Pressure Time Product at 200, 300, and 500 ms compared to FFM (p < 0.01). A major limitation of snorkeling mask is that during NIV with this interface it is possible to reach maximum 18 cmH2O of peak inspiratory pressure. CONCLUSIONS: The modified snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergencies.

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