The child's experience of becoming ill with COVID-19.

OBJECTIVE: To understand the experience of children when they become ill with COVID-19. METHOD: Qualitative-descriptive and exploratory study, guided by the World Health Organization's concept of Quality of Life. Twenty-four children participated, aged between seven and nine years, 11 months and 29 days, diagnosed with COVID-19. Data were collected through semi-structured interviews and underwent deductive thematic analysis. RESULTS: The children understood what COVID-19 is, its high lethality and transmissibility, and its forms of contagion and prevention. COVID-19 has been identified as something negative. The experience of children becoming ill with COVID-19 was permeated by changes in their routines, especially due to having activities limited to the home, emotional changes, and physical symptoms due to infection with the virus. CONCLUSION: The children understood the seriousness of the pandemic and identified the changes that had occurred. They also expressed understanding about the disease and its control. Knowing children's experience of illness can guide care actions aimed at them, recognizing that children's adequate understanding of what they experience can contribute to coping with illness and their participation in control actions.

Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia?

Community acquired pneumonia (CAP) is a prevalent infectious disease often requiring hospitalization, although its diagnosis remains challenging as there is no gold standard test. In severe CAP, clinical and radiologic criteria have poor sensitivity and specificity, and microbiologic documentation is usually delayed and obtained in less than half of sCAP patients. Biomarkers could be an alternative for diagnosis, treatment monitoring and establish resolution. Beyond the existing evidence about biomarkers as an adjunct diagnostic tool, most evidence comes from studies including CAP patients in primary care or emergency departments, and not only sCAP patients. Ideally, biomarkers used in combination with signs, symptoms, and radiological findings can improve clinical judgment to confirm or rule out CAP diagnosis, and may be valuable adjunctive tools for risk stratification, differentiate viral pneumonia and monitoring the course of CAP. While no single biomarker has emerged as an ideal one, CRP and PCT have gathered the most evidence. Overall, biomarkers offer valuable information and can enhance clinical decision-making in the management of CAP, but further research and validation are needed to establish their optimal use and clinical utility.

Human responses in adolescents with oncological disease: a scoping review protocol.

INTRODUCTION: The classification of human responses to health conditions or life processes, assuming that human responses are the way that a person responds, referring to the individual's experiences, feelings, perceptions, behaviours and physical reactions, can be an exercise that, although challenging, is central to nursing diagnoses and, consequently, to nursing practice. It is necessary to gather and organise the existing knowledge about the human responses in adolescents with cancer, starting from the moment of diagnosis, due to the specificities inherent to this stage of human development. A scoping review is an appropriate method to use in order to map the existing knowledge on human responses in adolescents with oncological diseases experienced since the diagnosis. INCLUSION CRITERIA: Will encompass all types of studies, including 'grey literature' that centres on human responses related to adolescents aged 10-19 years with oncological diseases. There will be no restrictions based on the type of cancer, disease stage or other contextual factors, whether in home or healthcare settings. METHODS AND ANALYSIS: The review will be conducted following the guidelines outlined by the Joanna Briggs Institute for scoping reviews. The search will encompass the following databases: CINAHL Complete (EBSCOhost), Cochrane Database of Systematic Reviews (EBSCOhost), MEDLINE Complete (EBSCOhost), Nursing and Allied Health Collection: Comprehensive (EBSCOhost), Cochrane Clinical Answers (EBSCOhost Answers), Latin American and Caribbean Literature on Health Sciences (LILACS) and 'grey literature' sources accessible through the Scientific Open Access Repositories of Portugal (RCAAP). A three-step search strategy will be implemented. Titles and abstracts will undergo analysis by two independent reviewers. Articles selected for a full-text review will be organised. The results will be presented in tables and narratively summarised. ETHICS AND DISSEMINATION: Ethics approval and patient consent for publication are not necessary. Findings will be disseminated through publication in scientific journals and through conference presentations. REVIEW REGISTRATION NUMBER: EXUB4. Registration was made in the Open Science Framework (OSF).

Airway and Respiratory Devices in the Prevention of Ventilator-Associated Pneumonia.

Ventilator-associated pneumonia (VAP) is the most common ICU-acquired infection among patients under mechanical ventilation (MV). It may occur in up to 50% of mechanically ventilated patients and is associated with an increased duration of MV, antibiotic consumption, increased morbidity, and mortality. VAP prevention is a multifaceted priority of the intensive care team. The use of specialized artificial airways and other devices can have an impact on the prevention of VAP. However, these devices can also have adverse effects, and aspects of their efficacy in the prevention of VAP are still a matter of debate. This article provides a narrative review of how different airway and respiratory devices may help to reduce the incidence of VAP.

The child's experience of becoming ill with COVID-19 / La experiencia del niño al enfermarse con COVID-19 / A experiência da criança sobre o seu adoecimento por COVID-19

ABSTRACT Objective: To understand the experience of children when they become ill with COVID-19. Method: Qualitative-descriptive and exploratory study, guided by the World Health Organization's concept of Quality of Life. Twenty-four children participated, aged between seven and nine years, 11 months and 29 days, diagnosed with COVID-19. Data were collected through semi-structured interviews and underwent deductive thematic analysis. Results: The children understood what COVID-19 is, its high lethality and transmissibility, and its forms of contagion and prevention. COVID-19 has been identified as something negative. The experience of children becoming ill with COVID-19 was permeated by changes in their routines, especially due to having activities limited to the home, emotional changes, and physical symptoms due to infection with the virus. Conclusion: The children understood the seriousness of the pandemic and identified the changes that had occurred. They also expressed understanding about the disease and its control. Knowing children's experience of illness can guide care actions aimed at them, recognizing that children's adequate understanding of what they experience can contribute to coping with illness and their participation in control actions.

RESUMEN Objetivo: Conocer la experiencia de los niños cuando enferman de COVID-19. Método: Estudio cualitativo descriptivo y exploratorio, guiado por el concepto de Calidad de Vida de la Organización Mundial de la Salud. Participaron 24 niños, con edades entre siete y nueve años, 11 meses y 29 días, diagnosticados con COVID-19. Los datos fueron recolectados a través de entrevistas semiestructuradas y sometidos a análisis temático deductivo. Resultados: Los niños entendían lo qué es la COVID-19, su alta letalidad y transmisibilidad y sus formas de contagio y prevención. La COVID-19 ha sido identificada como algo negativo. La experiencia de los niños enfermando por COVID-19 estuvo permeada por cambios en sus rutinas, especialmente por tener actividades limitadas al hogar, cambios emocionales y síntomas físicos por la infección con el virus. Conclusión: Los niños comprendieron la gravedad de la pandemia e identificaron los cambios que se habían producido. También expresaron comprensión sobre la enfermedad y su control. Conocer la experiencia de enfermedad de los niños puede orientar las acciones de cuidado dirigidas a ellos, reconociendo que la comprensión adecuada de lo que viven los niños puede contribuir al enfrentamiento de la enfermedad y su participación en las acciones de control.

RESUMO Objetivo: Conhecer a experiência de crianças em seu adoecimento por COVID-19. Método: Estudo qualitativo descritivo e exploratório, guiado pelo conceito de Qualidade de Vida da Organização Mundial de Saúde. Participaram 24 crianças, com idades entre sete e nove anos, 11 meses e 29 dias, diagnosticadas com COVID-19. Os dados foram coletados mediante entrevista semiestruturada e submetidos à análise temática dedutiva. Resultados: As crianças compreendiam o que é a COVID-19, a sua alta letalidade e transmissibilidade e ainda suas formas de contágio e prevenção. A COVID-19 foi identificada como algo negativo. A experiência de adoecimento de crianças por COVID-19 foi permeada por mudanças em suas rotinas, sobretudo por ter as atividades limitadas ao domicílio, alterações emocionais e sintomas físicos devido à infecção pelo vírus. Conclusão: As crianças compreenderam a gravidade da pandemia e identificaram as mudanças ocorridas. Também manifestaram entendimento sobre a doença e o seu controle. Conhecer a experiência de adoecimento de crianças pode orientar ações de cuidado direcionadas a elas, reconhecendo que entendimento adequado da criança sobre o que ela vivencia pode contribuir para o enfrentamento do adoecimento e para sua participação nas ações de controle.

Pneumococcus beyond an Austrian syndrome - A case report.

Austrian syndrome is a rare entity characterized by Osler's triad: endocarditis, pneumonia and meningitis, caused by Streptococcus pneumoniae (Austrian, 1957 [1]). This aggressive syndrome is associated with high morbidity and mortality, often due to the involvement of the heart valves and their destruction (Nogué et al., 2019 [2], Araji et al., 2008 [3]). We present a case of Austrian syndrome in a splenectomised elderly patient with an unusual presentation: septic arthritis complicated by endocarditis, septic cerebral emboli, meningitis and pneumonia. Despite appropriate therapy, the prognosis remained poor and the patient died at day 7.