Use of podcasts for health education: a scoping review.

OBJECTIVES: to map the scientific evidence related to the characteristics, themes, and outcomes of using health education podcasts aimed at individuals over 18 years of age in intra or extrahospital environments. METHODS: a scoping review, based on the Joanna Briggs Institute method, conducted in 11 databases, including studies from 2004 to 2022. RESULTS: 11 studies were selected, categorized, highlighting the characteristics, evaluated outcomes, areas, and conditions of podcast application, indicating it as an effective tool for promoting behavioral change, health promotion, and social interaction, demonstrating its potential to improve well-being, quality of life, and user/client autonomy. CONCLUSIONS: the use of podcasts proves to be an effective, innovative, and low-cost tool, with a significant social impact, being effective for behavioral change, satisfaction, and social interaction. However, the lack of comprehensive studies on podcast development methodologies represents challenges to be overcome.

Use of podcasts for health education: a scoping review / Uso de podcasts para educación en salud: una revisión de alcance / Uso de podcasts para educação em saúde: uma revisão de escopo

ABSTRACT Objectives: to map the scientific evidence related to the characteristics, themes, and outcomes of using health education podcasts aimed at individuals over 18 years of age in intra or extrahospital environments. Methods: a scoping review, based on the Joanna Briggs Institute method, conducted in 11 databases, including studies from 2004 to 2022. Results: 11 studies were selected, categorized, highlighting the characteristics, evaluated outcomes, areas, and conditions of podcast application, indicating it as an effective tool for promoting behavioral change, health promotion, and social interaction, demonstrating its potential to improve well-being, quality of life, and user/client autonomy. Conclusions: the use of podcasts proves to be an effective, innovative, and low-cost tool, with a significant social impact, being effective for behavioral change, satisfaction, and social interaction. However, the lack of comprehensive studies on podcast development methodologies represents challenges to be overcome.

RESUMEN Objetivos: mapear las evidencias científicas relacionadas con las características, temáticas y resultados del uso de podcasts de educación en salud dirigidos a individuos mayores de 18 años en entornos intra o extrahospitalarios. Métodos: revisión de alcance, basada en el método del Joanna Briggs Institute, realizada en 11 bases de datos, incluyendo estudios de 2004 a 2022. Resultados: se seleccionaron 11 estudios, categorizados y destacando las características, resultados evaluados, áreas y condiciones de aplicación del podcast, señalándolo como una herramienta eficaz para promover el cambio de comportamiento, la promoción de la salud y la interacción social, evidenciando su potencial para mejorar el bienestar, la calidad de vida y la autonomía de los usuarios/clientes. Conclusiones: el uso del podcast demuestra ser una herramienta eficaz, innovadora y de bajo costo, con un impacto social significativo, siendo eficaz para el cambio de comportamiento, la satisfacción y la interacción social. Sin embargo, la falta de estudios exhaustivos sobre las metodologías de desarrollo de podcasts representa desafíos a superar.

RESUMO Objetivos: mapear as evidências científicas relacionadas às características, temáticas e desfechos do uso de podcasts de educação em saúde direcionados para indivíduos maiores de 18 anos nos ambientes intra ou extrahospitalares. Métodos: revisão de escopo, baseando-se no método do Joanna Briggs Institute, realizada em 11 bases de dados, incluindo estudos de 2004 a 2022. Resultados: foram selecionados 11 estudos, categorizados e destacando as características, desfechos avaliados, áreas e condições de aplicação do podcast, apontando-o como uma ferramenta eficaz para promover a mudança comportamental, a promoção da saúde e a interação social, evidenciando seu potencial para melhorar o bem-estar, qualidade de vida e autonomia dos usuários/clientes. Conclusões: o uso do podcast demonstra ser uma ferramenta eficaz, inovadora e de baixo custo, com impacto social significativo, sendo eficaz para mudança comportamental, satisfação e interação social. No entanto, a falta de estudos abrangentes sobre as metodologias de desenvolvimento de podcasts representam desafios a serem superados.

Early Six-Minute Walk Test May Predict Midterm Outcomes Following Coronary Artery Bypass Grafting.

OBJECTIVE: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. METHODS: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. RESULTS: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). CONCLUSION: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

Early Six-Minute Walk Test May Predict Midterm Outcomes Following Coronary Artery Bypass Grafting

ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

[Adherence to antiplatelet and statin therapy by patients with acute coronary syndrome following discharge]. / Adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo tras el alta.

OBJECTIVE: To assess levels of medication adherence to antiplatelet and statins therapy among acute coronary syndrome (ACS) patients 30 days after hospital discharge and identify the main barriers to medication adherence and the main sociodemographic and clinical variables associated with treatment adherence. METHOD: This was a quantitative longitudinal study. Patients admitted to hospital with ACS were included. Initially, data collection was conducted using a semi-structured interview during the hospital stay. Thirty days after hospital discharge, the Brief Medication Questionnaire was applied by phone to assess treatment adherence. Descriptive statistics were used and tests were applied to analyze the association between medication adherence and clinical and sociodemographic data. RESULTS: One hundred and sixty-two patients were assessed. The Brief Medication Questionnaire test showed that 49.3% presented probable low adherence to treatment. Marital status, household income and alcohol intake showed an association with medication adherence. CONCLUSIONS: The findings of the present study indicate high rates of probable nonadherence to medication among ACS patients 30 days after hospital discharge, this information could help nurses to choose specific nursing interventions that could improve adherence in patients' daily routines.

Adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo tras el alta / Adherence to antiplatelet and statin therapy by patients with acute coronary syndrome following discharge

Objetivo: Evaluar los niveles de adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo (SCA) a los 30 días tras el alta hospitalaria e identificar las principales barreras y las principales variables sociodemográficas y clínicas asociadas con la adherencia al tratamiento.Método:Estudio longitudinal cuantitativo. Se incluyó a pacientes ingresados en un hospital con SCA. Inicialmente, la recolección de datos se realizó mediante una entrevista semiestructurada durante la estancia hospitalaria. A los 30 días tras el alta hospitalaria se aplicó el Brief Medication Questionnarie por teléfono, para evaluar la adherencia al tratamiento. Se utilizó estadística descriptiva y se aplicaron pruebas para analizar la asociación entre la adherencia a la medicación y los datos clínicos y sociodemográficos.Resultados: Ciento sesenta y dos pacientes fueron evaluados. El Brief Medication Questionnarie mostró que el 49,3% presentaba probable baja adherencia al tratamiento. El estado civil, el ingreso familiar y el consumo de alcohol tuvieron asociación con la adherencia a la medicación.Conclusiones: Los hallazgos del presente estudio indican altas tasas de probable falta de adherencia a la medicación por los pacientes con SCA a los 30 días tras el alta hospitalaria. Esta información podría ayudar a las enfermeras a elegir intervenciones específicas que puedan mejorar la adherencia en las rutinas diarias del paciente.

Objective: To assess levels of medication adherence to antiplatelet and statins therapy among acute coronary syndrome (ACS) patients 30 days after hospital discharge and identify the main barriers to medication adherence and the main sociodemographic and clinical variables associated with treatment adherence.Method: This was a quantitative longitudinal study. Patients admitted to hospital with ACS were included. Initially, data collection was conducted using a semi-structured interview during the hospital stay. Thirty days after hospital discharge, the Brief Medication Questionnaire was applied by phone to assess treatment adherence. Descriptive statistics were used and tests were applied to analyze the association between medication adherence and clinical and sociodemographic data.Results: One hundred and sixty-two patients were assessed. The Brief Medication Questionnaire test showed that 49.3% presented probable low adherence to treatment. Marital status, household income and alcohol intake showed an association with medication adherence.Conclusions: The findings of the present study indicate high rates of probable nonadherence to medication among ACS patients 30 days after hospital discharge, this information could help nurses to choose specific nursing interventions that could improve adherence in patients’ daily routines.

Intervenções de enfermagem na reabilitação de pessoas com intestino neurogênico: revisão integrativa / Intervenciones de enfermería en la rehabilitación de personas con intestino neurogénico: revisión integradora / Nursing interventions in the rehabilitation of people with neurogenic bowel: integrative review

RESUMO Objetivo: identificar quais intervenções de enfermagem são mais eficazes para a reabilitação de pessoas com intestino neurogênico. Método: revisão integrativa da literatura, no período de março de 2016 a dezembro de 2021, nos idiomas inglês, português e espanhol, nas bases de dados eletrônicasCINAHL, Cochrane Library, Embase (Elsevier) e MEDLINE, com os descritores "Neurogenicbowel" and"Nursing". Critérios de inclusão: estudos na íntegra, com conteúdos sobre intervenções de enfermagem para pacientes adultos com intestino neurogênico. Resultados: oito estudos incluídos. As intervenções mais citadas foram adequação dietética e ingestão hídrica(62,5%); uso apropriado de medicamentos (50%); massagem abdominal, retirada manual das fezes e estimulação reto-digital (50%); posicionamento para evacuação, prática de exercícios físicos e estimulação elétrica (25%). Considerações finais: a síntese integrativa dos estudos evidenciou que os resultados mais efetivos são os que associam mais de uma intervenção e que decorrem da avaliação individualizada e sistemática realizada pelo enfermeiro.

RESUMEN Objetivo: identificar qué intervenciones de enfermería son más eficaces para la rehabilitación de personas con intestino neurogénico. Método: revisión integradora de la literatura, en el período de marzo de 2016 a diciembre de 2021, en los idiomas inglés, portugués y español, en las bases de datos electrónicas CINAHL, Cochrane Library, Embase (Elsevier) y MEDLINE, con los descriptores "Neurogenicbowel" and "Nursing". Criterios de inclusión: estudios completos, con contenidos sobre intervenciones de enfermería para pacientes adultos con intestino neurogénico. Resultados: ocho estudios incluidos. Las intervenciones más mencionadas fueron adecuación dietética e ingesta hídrica (62,5%); uso apropiado de medicamentos (50%); masaje abdominal, extracción manual de las heces y estimulación recto-digital (50%); posicionamiento para evacuación, práctica de ejercicios físicos y estimulación eléctrica (25%). Consideraciones finales: la síntesis integradora de los estudios evidenció que los resultados más efectivos son los que asocian más de una intervención y que derivan de la evaluación individualizada y sistemática realizada por el enfermero.

ABSTRACT Objective: to identify which nursing interventions are most effective for the rehabilitation of people with neurogenic bowel. Method: integrative literature review, from March 2016 to December 2021, in English, Portuguese and Spanish, in the electronic databases CINAHL, Cochrane Library, Embase (Elsevier) and MEDLINE, with the descriptors "Neurogenic bowel" and "Nursing". Inclusion criteria: studies in full, with contents on nursing interventions for adult patients with neurogenic bowel. Results: eight studies were included. The most cited interventions were dietary adequacy and water intake (62.5%); appropriate use of medications (50%); abdominal massage, manual removal of feces and recto-digital stimulation (50%); positioning for elimination of feces, physical exercise and electrical stimulation (25%). Final considerations: the integrative synthesis of the studies showed that the most effective results are those that associate more than one intervention and that result from the individualized and systematic assessment carried out by the nurses.

Infecção de sítio cirúrgico em pacientes adultos após procedimento cardíaco: revisão integrativa / Surgical site infection in adult patients after heart procedures: an integrative review

RESUMO Objetivo identificar os fatores de risco para infecção do sítio cirúrgico em pacientes após procedimento cardíaco. Métodos revisão integrativa de literatura por meio de busca na Medical Literature Analyses and Retrieval System online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scientific Electronic Library Online, Base de Dados de Enfermagem. A busca dos artigos ocorreu durante o mês de fevereiro de 2022. Resultados 24 artigos foram elegíveis para a revisão. Em todos os estudos a população era majoritariamente composta pelo sexo masculino com idades entre 51 e 70 anos, os quais foram submetidos à Cirurgia de Revascularização do Miocárdio de forma eletiva. As principais comorbidades apresentadas foram diabetes mellitus, hipertensão e obesidade. As taxas de infecção variaram entre 2,4% e 38,9%, sendo identificado como o principal patógeno, o Staphylococcus aureus. Conclusão as principais comorbidades presentes nos pacientes que manifestaram infecção do sítio cirúrgico foram diabetes, hipertensão, obesidade e tabagismo. Os fatores de risco foram sexo, idade e internação pré-operatória prolongada. Antibioticoprofilaxia, tricotomia, descolonização nasal e antissepsia adequada da pele foram as medidas profiláticas mais adotadas. Contribuições para a prática: conhecer o perfil dos pacientes que desenvolveram infecção poderá favorecer o planejamento de ações para controle de riscos.

ABSTRACT Objective to identify the risk factors for surgical site infection in patients after heart procedure. Methods integrative literature review by searching the Medical Literature Analyses and Retrieval System online, Latin American and Caribbean Literature on Health Sciences, Scientific Electronic Library Online, Nursing Database. The search for the articles occurred during the month of February 2022. Results 24 articles were eligible for the review. In all studies, the population was mostly male, aged between 51 and 70 years, who underwent elective myocardial revascularization surgery. The main comorbidities presented were diabetes mellitus, hypertension, and obesity. The infection rates ranged from 2.4% to 38.9%, and the main pathogen identified was Staphylococcus aureus. Conclusion the main comorbidities present in patients who manifested surgical site infection were diabetes, hypertension, obesity, and smoking. The risk factors were gender, age, and prolonged preoperative hospitalization. Antibiotic prophylaxis, trichotomy, nasal decolonization, and adequate skin antisepsis were the most adopted prophylactic measures. Contributions to practice: knowing the profile of patients who developed infection may favor planning risk control actions.

COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience.

INTRODUCTION: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. METHODS: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. RESULTS: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. CONCLUSION: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

COVID-19 in the perioperative period of cardiovascular surgery: the brazilian experience

Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

Inspiratory Muscle Weakness is Related to Poor Short-Term Outcomes for Heart Transplantation

Abstract Introduction: In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT. Methods: Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively. Results: Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute -MIP- was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay. Conclusion: An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.

Assessing Religious Commitment in a Multicultural Inpatient Setting: A Psychometric Evaluation of the 10-item Belief into Action Scale.

Religious and spiritual (R/S) issues impact medical decision-making, particularly among highly R/S populations, for whom existing measures have limitations in identifying levels of R/S commitment. The Belief into Action (BIAc) scale was designed for this purpose and was never tested among hospitalized patients. We interviewed 152 patients (51% men) with a mean age of 48.9 years (SD = 15.2), having either cancer (27%), cardiovascular (26%), rheumatic (21%), or other diseases (26%). Cronbach alpha was .82 and a 3-factor structure (subjective, social, and private religious commitment) was the most robust. Results suggest the BIAc has adequate convergent, divergent, and incremental validity compared to other well-established questionnaires and is appropriate for the inpatient setting.

Inspiratory Muscle Weakness is Related to Poor Short-Term Outcomes for Heart Transplantation.

INTRODUCTION: In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT. METHODS: Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively. RESULTS: Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute |MIP| was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay. CONCLUSION: An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.

Síndrome metabólica em pessoas vivendo com HIV: prevalência e concordância de critérios / Síndrome metabólico en personas que viven con el VIH: prevalencia y concordancia de criterios / Metabolic syndrome in people living with HIV: criteria prevalence and agreement

Resumo Objetivo Identificar a prevalência da síndrome metabólica e a concordância entre os critérios do National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) e da International Diabetes Federation (IDF) em pessoas vivendo com HIV. Métodos Estudo analítico transversal, realizado em cinco serviços especializados em município do interior paulista, de 2014 a 2016, com 340 pessoas vivendo com HIV. Variáveis sociodemográficas e clínicas necessárias para classificação da síndrome metabólica pelos critérios do NCEP-ATPIII e da IDF foram coletadas por meio de entrevistas. Para avaliar a concordância entre os critérios da SM, NCEP-ATPIII e IDF, foi utilizada a estatística first-order agreement coefficient. Para verificar a relação entre a síndrome metabólica e as variáveis do estudo, utilizou-se a regressão de Poisson com variância robusta. Resultados A prevalência da síndrome metabólica foi de 28,5% pelo critério NCEP-ATPIII e 39,3% IDF. As maiores prevalências foram associadas ao sexo feminino e faixas etárias a partir dos 50 anos, enquanto que, no tempo de diagnóstico entre 2 a 10 anos, prevalências menores. A concordância entre os dois critérios foi considerada substancial. Conclusão A concordância substancial entre os critérios IDF e NCEP-ATPIII sugere a possibilidade de intercambio entre eles. Ademais, os resultados sinalizam para a necessidade de atenção especial dos serviços para a avaliação do perfil metabólico e identificação das pessoas vivendo com HIV que possuem alto risco cardiovascular.

Resumen Objetivo Identificar la prevalencia del síndrome metabólico y la concordancia entre los criterios del National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) y de la International Diabetes Federation (IDF) en personas que viven con el VIH. Métodos Estudio analítico transversal, realizado en cinco servicios especializados en un municipio del interior del estado de São Paulo, de 2014 a 2016, con 340 personas que viven con el VIH. Por medio de entrevistas se recopilaron las variables sociodemográficas y clínicas necesarias para la clasificación del síndrome metabólico mediante los criterios del NCEP-ATPIII y de la IDF. Para evaluar la concordancia entre los criterios del SM, NCEP-ATPIII e IDF, se utilizó la estadística first-order agreement coefficient. Para verificar la relación entre el síndrome metabólico y las variables del estudio, se utilizó la regresión de Poisson con varianza robusta. Resultados La prevalencia del síndrome metabólico fue del 28,5 % mediante el criterio NCEP-ATPIII y 39,3 % por la IDF. Las mayores prevalencias se asociaron al sexo femenino y los grupos de edad a partir de los 50 años, mientras que hubo prevalencias menores en el tiempo de diagnóstico entre 2 y 10 años. La concordancia entre los dos criterios fue considerada sustancial. Conclusión La concordancia sustancial entre los criterios IDF y NCEP-ATPIII sugiere la posibilidad de intercambio entre ellos. Además, los resultados señalan la necesidad de una atención especial de los servicios para evaluar el perfil metabólico e identificar a las personas que viven con el VIH con alto riesgo cardiovascular.

Abstract Objective To identify the prevalence of metabolic syndrome and the agreement between the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) in people living with HIV. Methods This is a cross-sectional analytical study, carried out in five specialized services in a city in the interior of São Paulo, from 2014 to 2016, with 340 people living with HIV. Sociodemographic and clinical variables necessary for classification of the metabolic syndrome by the NCEP-ATPIII and IDF criteria were collected through interviews. To assess the agreement between MS, NCEP-ATPIII and IDF criteria, the first-order agreement coefficient statistic was used. To verify the relationship between the metabolic syndrome and the study variables, Poisson regression with robust variance was used. Results The prevalence of metabolic syndrome was 28.5% by the NCEP-ATPIII criterion and 39.3% IDF. The highest prevalence was associated with females and age groups from 50 years old, while, in the time of diagnosis between 2 and 10 years, lower prevalence. The agreement between the two criteria was considered substantial. Conclusion The substantial agreement between the IDF and NCEP-ATPIII criteria suggests the possibility of interchange between them. Moreover, the results signal the need for special attention from services for the assessment of the metabolic profile and identification of people living with HIV who are at high cardiovascular risk.

Medication non-adherence in heart transplant patients. / Não adesão medicamentosa nos pacientes transplantados cardíacos.

OBJECTIVE: To measure medication non-adherence in patients after heart transplantation using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) and the Visual Analogue Scale (VAS); to compare the results of biopsies performed with the prevalent comorbidities and survival. METHOD: Quantitative historical cohort. The population consisted of patients undergoing transplantation between 2009 and 2016. RESULTS: Participation of 60 patients. The measurement using the BAASIS was 46.7% of non-adherence and 53.3% of patient adherence. The group with greater difficulty in non-adherence reported up to 2 hours delay of medication intake in relation to the prescribed time (25%), although there was no interruption in medications. The initial diagnosis was Chagas disease (33.3%). The studied comorbidities were systemic arterial hypertension (SAH), diabetes mellitus (DM), dyslipidemia (DLP) and chronic renal failure (CRF). CONCLUSION: Assessment using the BAASIS showed medication non-adherence in 46.7% of heart transplant patients. The VAS according to patients' self-report and nurse's assessment showed high values (93.3% vs 83.3%). The BAASIS tends to address the difficulties reported by patients, when there is a change in doses, delays or anticipations of time and dose.

Cardiovascular involvement in COVID-19: not to be missed.

In December 2019, a striking appearance of new cases of viral pneumonia in Wuhan led to the detection of a novel coronavirus (SARS-CoV2). By analyzing patients with severe manifestations, it became apparent that 20 to 35% of patients who died had preexisting cardiovascular disease. This finding warrants the important need to discuss the influence of SARS-CoV2 infection on the cardiovascular system and hemodynamics in the context of clinical management, particularly during mechanical ventilation. The SARS-CoV2 enters human cells through the spike protein binding to angiotensin-converting enzyme 2 (ACE2), which is important to cardiovascular modulation and endothelial signaling. As ACE2 is highly expressed in lung tissue, patients have been progressing to acute respiratory injury at an alarming frequency during the Coronavirus Disease (COVID-19) pandemic. Moreover, COVID-19 leads to high D-dimer levels and prothrombin time, which indicates a substantial coagulation disorder. It seems that an overwhelming inflammatory and thrombogenic condition is responsible for a mismatching of ventilation and perfusion, with a somewhat near-normal static lung compliance, which describes two types of pulmonary conditions. As such, positive pressure during invasive mechanical ventilation (IMV) must be applied with caution. The authors of this review appeal to the necessity of paying closer attention to assess microhemodynamic repercussion, by monitoring central venous oxygen saturation during strategies of IMV. It is well known that a severe respiratory infection and a scattered inflammatory process can cause non-ischemic myocardial injury, including progression to myocarditis. Early strategies that guide clinical decisions can be lifesaving and prevent extended myocardial damage. Moreover, cardiopulmonary failure refractory to standard treatment may necessitate the use of extreme therapeutic strategies, such as extracorporeal membrane oxygenation.

Cardiovascular involvement in COVID-19: not to be missed

Abstract In December 2019, a striking appearance of new cases of viral pneumonia in Wuhan led to the detection of a novel coronavirus (SARS-CoV2). By analyzing patients with severe manifestations, it became apparent that 20 to 35% of patients who died had preexisting cardiovascular disease. This finding warrants the important need to discuss the influence of SARS-CoV2 infection on the cardiovascular system and hemodynamics in the context of clinical management, particularly during mechanical ventilation. The SARS-CoV2 enters human cells through the spike protein binding to angiotensin-converting enzyme 2 (ACE2), which is important to cardiovascular modulation and endothelial signaling. As ACE2 is highly expressed in lung tissue, patients have been progressing to acute respiratory injury at an alarming frequency during the Coronavirus Disease (COVID-19) pandemic. Moreover, COVID-19 leads to high D-dimer levels and prothrombin time, which indicates a substantial coagulation disorder. It seems that an overwhelming inflammatory and thrombogenic condition is responsible for a mismatching of ventilation and perfusion, with a somewhat near-normal static lung compliance, which describes two types of pulmonary conditions. As such, positive pressure during invasive mechanical ventilation (IMV) must be applied with caution. The authors of this review appeal to the necessity of paying closer attention to assess microhemodynamic repercussion, by monitoring central venous oxygen saturation during strategies of IMV. It is well known that a severe respiratory infection and a scattered inflammatory process can cause non-ischemic myocardial injury, including progression to myocarditis. Early strategies that guide clinical decisions can be lifesaving and prevent extended myocardial damage. Moreover, cardiopulmonary failure refractory to standard treatment may necessitate the use of extreme therapeutic strategies, such as extracorporeal membrane oxygenation.

Myocardial oxygen consumption in the bed bath and shower bath in patients with acute coronary syndrome.

BACKGROUND: Bed and shower hygiene measures are performed by the nursing staff in patients admitted with Acute Coronary Syndrome (ACS). Few studies have evaluated the difference in energy consumption between the two types of bath. OBJECTIVES: To analyse and compare the variation in Heart Rate (HR), Systolic Blood Pressure (SBP) and rate-pressure-product (RPP) between bed and shower bath in ACS patients. DESIGN: Quantitative, analytical, prospective study. SETTINGS: This study was conducted in a Coronary Intensive Care Unit, including patients over 18 years admitted for ACS in Killip classes I and II. MAIN OUTCOME MEASURES: The level of myocardial oxygen consumption was assessed by calculating the RPP before, immediately after and 5 minutes after the first bed bath and the first shower bath. Differences in mean RPP before, during and 5 minutes after each body hygiene were compared using the paired-samples Student's t-test. RESULTS: Seventy patients were included. No important clinical variation was found in HR, SBP and RPP during bed bath and during shower bath. The comparison of HR, SBP and RPP between bed bath and shower showed no statistically significant difference. CONCLUSION: Bed bath and shower bath did not significantly increase energy expenditure in patients with acute coronary syndrome and there was no difference in energy expenditure between the two types of body hygiene.

Adherence to antiplatelet and statin therapy by patients with acute coronary syndrome following discharge. / Adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo tras el alta.

OBJECTIVE: To assess levels of medication adherence to antiplatelet and statins therapy among acute coronary syndrome (ACS) patients 30 days after hospital discharge and identify the main barriers to medication adherence and the main sociodemographic and clinical variables associated with treatment adherence. METHOD: This was a quantitative longitudinal study. Patients admitted to hospital with ACS were included. Initially, data collection was conducted using a semi-structured interview during the hospital stay. Thirty days after hospital discharge, the Brief Medication Questionnaire was applied by phone to assess treatment adherence. Descriptive statistics were used and tests were applied to analyze the association between medication adherence and clinical and sociodemographic data. RESULTS: One hundred and sixty-two patients were assessed. The Brief Medication Questionnaire test showed that 49.3% presented probable low adherence to treatment. Marital status, household income and alcohol intake showed an association with medication adherence. CONCLUSIONS: The findings of the present study indicate high rates of probable nonadherence to medication among ACS patients 30 days after hospital discharge, this information could help nurses to choose specific nursing interventions that could improve adherence in patients' daily routines.

Accuracy of the Defining Characteristics of Fatigue in Patients with Heart Failure as Identified by the 6-Minute Walking Test.

PURPOSE: Identify the prevalence of the nursing diagnosis (ND) Fatigue in patients with heart failure (HF) and to analyze the accuracy of its defining characteristics (DCs). METHODS: 50 patients were assessed for Fatigue through a distance ambulated <300m during the Six-Minute Walking Test (6MWT) and the report of insufficient energy. Sensitivity, specificity, positive and negative predictive values were calculated for the DCs associated with Fatigue. FINDINGS: The prevalence of Fatigue was 48%. No DCs were sensitive and specific for determining Fatigue. CONCLUSIONS: There were no DCs accurate enough to infer Fatigue. IMPLICATIONS FOR PRACTICE: A distance ambulated <300m during the 6MWT should be included as a DC of Fatigue.