Infection epidemiology, preventive measures and principles of best practices involving the skin and dressing of patients with a ventricular assist device: A scoping review.

BACKGROUND: Specific knowledge of several domains for managing care in the driveline externalization area may be necessary for the broader application of left ventricular assist devices. OBJECTIVES: This study aimed to map the recommendations for adult patients undergoing left ventricular assist device implantation. DESIGN: This scoping review, is being registered in the Open Science Framework under DOI https://doi.org/10.17605/OSF.IO/Q76B3 (https://osf.io/q76b3/). METHOD: Left ventricular assist device coordinators and nurse specialists in dermatology and stomatherapy conducted a scoping review limited to the period between 2015 and 2022. The results of this scoping review will be discussed and presented separately in 3 articles. This third article synthesizes research evidence on the epidemiology of device infections, infection preventive measures, local skin care and dressings in adult patients with left ventricular assist devices. RESULTS: The initial search resulted in 771 studies. Sixty nine met the eligibility criteria and were included in the scoping review. Eighteen articles addressing the epidemiology of device infections, infection preventive measures, and local skin and dressing care that answered the question of this article were included. The most common bacterial pathogens reported have been Gram-positive bacteria, typically Staphylococcus species. With respect to infection preventive measures, there are evidence gaps in local skin care and transmission system dressings. CONCLUSION: The driveline still remains the most common type of device infection. There exists imperfect knowledge on the standardization of care with the dressing and the area of skin for left ventricular assist device patients. Furthermore, there is a methodological fragility of the studies. These elements imply an opportunity for future research on these subjects. IMPLICATIONS FOR CLINICAL PRACTICE: This review provides an overview of the principles of best practices involving the skin and dressing of patients with a ventricular assist device without local dermatological diseases or infectious diseases. The central figure of an experienced professional can make a difference.

Cultural adaptation and validation of the Ghent global IAD monitoring tool (GLOBIAD-M) for Brazilian Portuguese.

BACKGROUND: Incontinence-associated dermatitis (IAD) poses a significant challenge for individuals experiencing incontinence, characterized by irritative contact dermatitis due to prolonged exposure to urine and/or faeces. OBJECTIVE: This study aimed to culturally adapt the Ghent Global IAD Monitoring Tool - GLOBIAD-M to Brazilian Portuguese and to assess the adapted version's measurement properties quality. METHOD: A clinimetric study was conducted, comprising cultural adaptation and psychometric assessment. Cultural adaptation followed international guidelines, while psychometric properties were evaluated for content validity, inter-rater reliability, and correlation with other variables (thermography). Inter-rater reliability was assessed through clinical and photographic evaluations. The study samples included linguists and, IAD specialists, nurses, and adult patients with IAD according to the cultural adaptation or psychometric evidence assessment. RESULT: The process of cultural adaptation resulted in a cumulative coefficient of variation ratio (CVR) of 0.66. Subsequently, the study included 57 patients and 57 nurses for clinical assessments, totalling 166 evaluations of IAD. The inter-rater reliability among nurses was deemed satisfactory, with a Gwet coefficient of 0.77. Moreover, out of 215 photographic assessments conducted by 54 nurses, there was a 92.1 % concurrence in the categorization of IAD. Furthermore, thermography analysis revealed significant temperature differences between healthy individuals and those with IAD, particularly in patients categorized under IAD Cat. 1B, showing a difference of 1.90 °C. CONCLUSION: and Impact on Clinical Practice: The results confirm the availability of the GLOBIAD-M in its Brazilian Portuguese version. This tool will allow health professionals to obtain a standardized IAD classification and monitoring in Brazil, enhancing its diagnostic accuracy and aiding clinical decision-making.

Chemical and genetic characterization of lipopeptides from Bacillus velezensis and Paenibacillus ottowii with activity against Fusarium verticillioides.

Introduction: The fungus Fusarium verticillioides significantly threatens maize crops in tropical soils. In light of this, biological control has emerged as a promising strategy to reduce fungicide costs and environmental risks. In this study, we aimed to test the antifungal activity of cell-free supernatant (CFS) from three Bacillus velezensis (CT02, IM14, and LIS05) and one Paenibacillus ottowii (LIS04) against F. verticillioides, thereby contributing to the development of effective biocontrol measures. Methods: The research employed a comprehensive approach. The antifungal activity of the bacterial strains was tested using cell-free supernatant (CFS) from three Bacillus velezensis (CT02, IM14, and LIS05) and one Paenibacillus ottowii (LIS04). The UPLC-MS evaluated the CFS to identify the main bioactive molecules involved in the inhibitory effect on F. verticillioides. Scanning electron microscopy (SEM) was used to assess the impact of CFS on spores and hyphae, and genome sequencing was conducted to identify the genes involved in biological control. These robust methodologies ensure the reliability and validate our findings. Results: The CFS of the four strains demonstrated significant inhibition of fungal growth. The UPLC-MS analysis revealed the presence of lipopeptides with antifungal activity, including surfactin and fengycins A and B expressed by the three strains of Bacillus velezensis and iturin A expressed by strains LIS05 and IM14. For Paenibacillus ottowii, fusaricidins, ABCDE, and five previously unreported lipopeptides were detected. Scanning electron microscopy (SEM) showed that treatments with CFS led to significant distortion and breakage of the F. verticillioides hyphae, in addition to the formation of cavities in the membrane. Genome mining confirmed the presence of genes coding for the lipopeptides identified by UPLC-MS, including the gene for iturin in CTO2. Genomic sequencing revealed that CT02, IM14, and LIS05 belong to different strains of Bacillus velezensis, and LIS04 belongs to Paenibacillus ottowii, a species recently described. Discussion: The four bacterial strains, including three novel strains identified as Bacillus velezensis and one as the recently described species Paenibacillus ottowii, demonstrate significant potential as biocontrol agents for managing fungal disease. This finding underscores the novelty and potential impact of our research.

Effects of antimicrobials over sessile and planktonic microbiota associated with an industrial cooling water system.

The bacterial community from a cooling water system was investigated through culture-dependent and independent strategies, and the responses of planktonic and sessile bacteria (grown in glass slides and stainless-steel coupons) to antimicrobials of industrial and clinical use were assessed. The morphotypes with higher biofilm-forming potential were Pseudoxanthomonas sp., Rheinheimera sp., Aeromonas sp. and Staphylococcus sp., and the first also exhibited lower susceptibility to all antibiotics and biocides tested. 16S rRNA high throughput sequencing indicated that Pseudomonadota (77.1% on average, sd 11.1%), Bacteroidota (8.4, sd 5.7%), and Planctomycetota (3.0, sd 1.3%) were the most abundant phyla. KEGG orthologs associated with antibiotics and biocide resistance were abundant in all samples. Although the minimum inhibitory and bactericidal concentrations were generally higher for biofilms, morphotypes in planktonic form also showed high levels of resistance, which could be associated with biofilm cells passing into the planktonic phase. Overall, monochloramine was the most effective biocide.

Exploring the effect of wound related pain on psychological stress, inflammatory response, and wound healing.

AIMS AND OBJECTIVES: The relationship between pain and poor healing is intricate, potentially mediated by psychological stress and aberrations in inflammatory response. The purpose of this study was to examine the biopsychosocial model of pain by assessing the relationships between pain, stress, inflammation and healing in people with chronic wounds. DESIGN: This was a 4-week prospective observational study to explore the relationship of pain, stress, inflammation and wound healing in a convenience sample of patients with chronic wounds in a chronic care hospital in Canada. METHODS: Only subjects over 18 with chronic wounds were recruited into the study. Chronic wounds were defined by the duration of wounds for more than 4 weeks of various aetiologies including wounds caused by pressure injuries, venous disease, arterial insufficiency, surgery or trauma and diabetic neuropathy. Participants were evaluated for pain by responding to the Brief Pain Inventory-Short Form, the McGill Pain Questionnaire-Short Form and the Leeds Assessment of Neuropathic Symptoms and Signs scale. Stress was measured by the Perceived Stress Scale (PSS). All wounds were assessed with the Pressure Ulcer Scale for Healing tool. The levels of matrix metalloproteinases were analysis by obtaining wound fluid from all participants. RESULTS: A total of 32 individuals with chronic wounds participated in the study. Correlation analysis indicated pain severity was positively and significantly related to pain interference, McGill Pain Questionnaire scores, neuropathic pain and matrix metalloproteinase levels. Logistic regression was used to determine the predictors for high or low perceived stress. The only significant variable that contributed to the stress levels was BPI-I. Results suggested that participants who experienced higher levels of pain interference also had an increased odds to report high level of stress by 1.6 times controlling for all other factor in the model. CONCLUSION: Pain is a complex biopsychosocial phenomenon affecting quality of life in people with chronic wounds. Results of this study identified a significant relationship between pain, stress and wound healing.

CONSTIPATION SCORING SYSTEM VALIDATED FOR THE PORTUGUESE LANGUAGE (ÍNDICE DE GRAVIDADE DA CONSTIPAÇÃO INTESTINAL): IS IT RELIABLE IN ASSESSING THE SEVERITY OF INTESTINAL CHRONIC CONSTIPATION IN OUR POPULATION?

BACKGROUND: There is a lack of valid and specific tools to measure chronic constipation severity in Brazil. AIMS: To validate the Constipation Scoring System for Brazilian spoken Portuguese. METHODS: Translation, cultural adaptation, and validation itself (reliability and convergent and divergent validation). Translation: definitive version from the original version's translation and evaluation by specialists. Cultural adaptation: score content analysis of the definitive version, as an interview to patients. Interobserver reliability: application by two researchers on the same day. Intraobserver reliability: same researcher at different times, in a 7-day interval. Divergent validation: non-constipated volunteers. Convergent validation: two groups, good response to clinical treatment and refractory to treatment. RESULTS: Cultural adaptation: 81 patients, 89% female, with mean age of 55 and seven years of schooling, and overall content validity index was 96.5%. Inter and intraobserver reliability analysis: 60 patients, 86.7% female, mean age of 56 and six years of schooling, and the respective intraclass correlation coefficients were 0.991 and 0.987, p<0.001. Divergent validation: 40 volunteers, 25 male, mean age of 49 years, and the mean global score was 2. Convergent validation of patients with good response to clinical treatment: 47 patients, 39 female, mean age of 60 and six years of schooling, and the pre- and post-treatment scores were 19 and 8, respectively (p<0.001). Convergent validation of refractory to clinical treatment patients: 75 patients, 70 female, mean age of 53 and seven years of schooling, and the global average score was 22. CONCLUSIONS: The Constipation Scoring System (Índice de Gravidade da Constipação Intestinal) validated for the Brazilian population is a reliable instrument for measuring the severity of intestinal chronic constipation.

Perioperative interventions for the prevention of surgical wound infection in adult patients undergoing left ventricular assist devices implantation: A scoping review.

BACKGROUND: Surgical wound infection is the most frequent type of care health associated infection. Lack of knowledge about the prevention of surgical wound infection in patients undergoing left ventricular assist device implantation could significantly undermine the potential benefits of surgical intervention. OBJECTIVES: This study aimed to map the recommendations for adult patients undergoing left ventricular assist device implantation. DESIGN: This is a scoping review, being registered in the Open Science Framework under DOI https://doi.org/10.17605/OSF.IO/Q76B3 (https://osf.io/q76b3/). METHOD: Left ventricular assist device coordinators and nurse specialists in dermatology and stomatherapy conducted a scoping review in Scopus, The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), limited to the period between 2015 and 2022. The results of this scoping review will be discussed and presented in separate articles. This paper will synthesize research evidence on the perioperative topic. RESULTS: The initial searches resulted in 771 studies. Sixty nine met the eligibility criteria and were included in the scoping review. Eight articles addressing the perioperative topic that answered the question of this article were included. CONCLUSION: Although this scoping review included heterogeneous, and scarce studies with left ventricular assist device patients. As such, there are many promising future research directions for this topic. IMPLICATIONS FOR CLINICAL PRACTICE: Infection surveillance should be an integral part of left ventricular assist device implantation programs in health care institutions. Velvet completely buried in subcutaneous tissues reduces transmission system infection. Triple tunnel method reduces transmission system infection risk.

Comprehensive high-performance thin-layer chromatography analysis of Monteverdia ilicifolia leaf and its adulterants.

The leaves of Monteverdia ilicifolia (syn. Maytenus ilicifolia) are widely used in traditional South American medicine to treat gastrointestinal problems such as gastritis and ulcers. Several herbal products containing the leaves of M. ilicifolia can be found in the market. However, other species with similar leaf morphology are confounding materials, e.g. Monteverdia aquifolia (Celastraceae), Citronella gongonha (Cardiopteridaceae), Jodina rhombifolia (Santalaceae), Sorocea bonplandii (Moraceae) and Zollernia ilicifolia (Fabaceae). This study aimed to identify M. ilicifolia and distinguish it from its potential adulterants using high-performance thin-layer chromatography (HPTLC) technique. Comprehensive HPTLC analysis revealed specific fingerprints that can be used to assess the minimum content of epicatechin and the quality of commercial espinheira-santa samples. The results of the study demonstrated that the HPTLC method is capable of detecting adulterations and distinguishing M. ilicifolia from all confounding materials in commercial products available on the market, showing that most of the products are of poor quality due to adulterations.

Efeito da Tele-enfermagem no Processo Adaptativo de Pessoas Com Estomia Intestinal: Ensaio Clínico / Effect of Telenursing on the Adaptive Process of People With Intestinal Stoma: Clinical Trial / Efecto de la Teleenfermería en el Proceso Adaptativo de Personas Con Estomía Intestinal: Ensayo Clínico

Objetivo:Analisar o efeito da tele-enfermagem no processo adaptativo de pessoas com estomia intestinal. Método: Ensaio clínico randomizado, unicego. Aplicou-se a escala de verificação do nível de adaptação da pessoa com estomia, e formaram-se dois grupos. O grupo controle recebeu atendimento convencional com profissionais do centro de referência, e o grupo intervenção obteve o acompanhamento convencional associado à intervenção complementar via telefone (três chamadas telefônicas realizadas no 20º, 40º e 60º dia após contato inicial). Ao final da intervenção, os participantes foram avaliados novamente pela escala. O recrutamento ocorreu desde o primeiro contato e contou com uma amostra de 16 participantes no grupo intervenção e 17 no grupo controle. Resultados: Notou-se semelhança nos níveis de adaptação no baseline entre os dois grupos, entretanto dados do pós-intervenção demonstraram diferença significante dos grupos no decorrer do estudo e menores valores das médias do grupo controle comparados às medidas do grupo intervenção, indicando maior nível de adaptação no grupo intervenção. Conclusão: O estudo verificou o efeito da tele-enfermagem no processo adaptativo da pessoa com estomia e sugere benefícios no acompanhamento complementar via tele-enfermagem no nível de adaptação de pessoas com estomia de tempo ≤ 12 meses de cirurgia.

Objective: To analyze the effect of telenursing on the adaptive process of people with intestinal ostomy. Method: Randomized, single-blind clinical trial. The verification scale of the level of adaptation of the person with ostomy was applied, and two groups were formed. The control group received conventional care with professionals from the reference center, and the intervention group received conventional follow-up associated with the complementary intervention via telephone (three phone calls on the 20th, 40th and 60th day after initial contact). At the end of the intervention, the participants were evaluated again through the scale. Recruitment occurred from the first contact and had a sample of 16 participants in the intervention group and 17 in the control group. Results: There was a similarity in the levels of adaptation at baseline between the two groups. However, post-intervention data showed a significant difference between the groups during the study and lower values of the means of the control group compared to the measures of the intervention group, demonstrating a higher level of adaptation in the intervention group. Conclusion: The study verified the effect of telenursing on the adaptive process of the person with a stoma and suggests benefits in complementary monitoring via telenursing at the level of adaptation of people with a stoma after ≤ 12 months of surgery.

Objetivo:Analizar el efecto de la teleenfermería en el proceso adaptativo de personas con ostomía intestinal. Método: Ensayo clínico aleatorizado, simple ciego. Se aplicó la Escala de Verificación del Nivel de Adaptación de la Persona con Ostomía y se formaron dos grupos, el grupo control recibió atención convencional con profesionales del centro de referencia y el grupo intervención recibió seguimiento convencional asociado a la intervención complementaria vía telefónica (3 llamadas telefónicas los días 20, 40 y 60 después del contacto inicial). Al final de la intervención, los participantes fueron evaluados nuevamente mediante la escala. El reclutamiento se produjo desde el primer contacto y contó con una muestra de 16 participantes en el grupo de intervención y 17 en el grupo control. Resultados: Hubo similitud en los niveles de adaptación al inicio del estudio entre los dos grupos, sin embargo, los datos posteriores a la intervención mostraron una diferencia significativa entre los grupos durante el estudio y verificaron valores más bajos de las medias del grupo control en comparación con el medidas del grupo de intervención, demostrando un mayor nivel de adaptación en el grupo de intervención. Conclusión: El estudio verificó el efecto de la teleenfermería en el proceso adaptativo de la persona con estoma y sugiere beneficios en el seguimiento complementario a través de la teleenfermería a nivel de adaptación de la persona con estoma después de ≤ 12 meses de la cirugía

Deficiencies in reporting inclusion/exclusion criteria and characteristics of patients in randomized controlled trials of therapeutic interventions in pressure injuries: a systematic methodological review.

Wound care is a complex procedure and the related research may include many variables. Deficiencies in the sample inclusion and exclusion criteria may limit the generalizability of randomized controlled trials (RCTs) for wound patients in the real world. This study aimed to evaluate deficiencies in reporting the inclusion and exclusion criteria and the characteristics of patients in RCTs of pressure injuries (PI) therapeutic interventions. We conducted a systematic methodological review in which 40 full text RCTs of PI treatment interventions published in English, from 2008 to 2020, were identified. Data on the general characteristics of the included RCTs and data about inclusion/exclusion criteria and characteristics of patients were collected. The inclusion/exclusion criteria were categorized into five domains (definition of disease, precision, safety, ethical/legal and administrative). Study duration (in weeks) was 8.0 (quartile 1: 2.0; quartile 3: 48.0); only 5.0% of the trials mentioned race, skin colour or ethnicity, and 37.5% reported the duration of the wound. Only 9 (22.5%) studies reported the drugs that the included patients were using and 10 (25.0%) RCTs reported adverse events. The presence of the five domains was observed only in 12.5% of RCTs and only 12 (30.0%) had the precision domain. Much more research is required in systematic assessments of the external validity of trials because there is substantial disparity between the information that is provided by RCTs and the information that is required by clinicians. We concluded that there are deficiencies in reporting of data related to inclusion/exclusion criteria and characteristics of patients of RCTs assessing PI therapeutic interventions.

Exploring the mycobiota of bromeliads phytotelmata in Brazilian Campos Rupestres.

The phytotelmata is a water-filled tank on a terrestrial plant, and it plays an important role in bromeliad growth and ecosystem functioning. Even though previous studies have contributed to elucidate the composition of the prokaryotic component of this aquatic ecosystem, its mycobiota (fungal community) is still poorly known. In the present work, ITS2 amplicon deep sequencing was used to examine the fungal communities inhabiting the phytotelmata of two bromeliads species that coexist in a sun-exposed rupestrian field of Southeastern Brazil, namely Aechmea nudicaulis (AN) and Vriesea minarum (VM). Ascomycota was the most abundant phylum in both bromeliads (57.1 and 89.1% in AN and VM respectively, on average), while the others were present in low abundance (< 2%). Mortierellomycota and Glomeromycota were exclusively observed in AN. Beta-diversity analysis showed that samples from each bromeliad significantly clustered together. In conclusion, despite the considerable within-group variation, the results suggested that each bromeliad harbor a distinct fungi community, what could be associated with the physicochemical characteristics of the phytotelmata (mainly total nitrogen, total organic carbon, and total carbon) and plant morphological features.

Oxidized Regenerated Cellulose Versus Calcium Alginate in Controlling Bleeding From Malignant Wounds: A Randomized Controlled Trial.

BACKGROUND: There is no consensus on the best intervention for topical management of bleeding in malignant wounds. Although surgical hemostatic dressings are recommended, the use of calcium alginate (CA) is frequent among practitioners. OBJECTIVE: The aim of this study was to evaluate the hemostatic efficacy of oxidized regenerated cellulose (ORC) and CA dressing in the management of bleeding from malignant wounds resulting from breast cancer. METHODS: This was a randomized open clinical trial. The outcomes measured were total time to hemostasis and the number of hemostatic products used. RESULTS: Sixty-one patients were potentially eligible for the study, 1 did not consent, and 32 were assessed to be ineligible, resulting in a sample of 28 who were randomized to 2 study groups. Total time to hemostasis was 93.8 seconds in the ORC group, with an average of 30.1 seconds (95% confidence interval, 18.6-189 seconds), and 67 seconds in the CA group, with an average of 30.4 seconds (confidence interval, 21.7 seconds to imprecise upper limit). The main difference was 26.8 seconds. Kaplan-Meier log-rank test, and Cox model showed no statistical significance (P = 0.894). A total of 18 hemostatic products were used in the CA group and 34 in the ORC group. No adverse effects were identified. CONCLUSIONS: Although no significant differences were identified in terms of time, more hemostatic products were used in the ORC group, highlighting the effectiveness of CA. IMPLICATIONS FOR PRACTICE: Calcium alginate may be the first choice in the management of bleeding in malignant wounds, favoring nursing in the most immediate hemostatic actions.

Cultural Adaptation and Validation of the Ostomy Skin Tool to the Brazilian Portuguese.

PURPOSE: To adapt the Ostomy Skin Tool (discoloration, erosion, and tissue overgrowth) to the Brazilian culture and to analyze psychometric properties of the adapted version. DESIGN: Psychometric (methodologic) evaluation of the instrument. SUBJECTS AND SETTING: Three ostomy/enterostomal therapy nurses evaluated the extent and severity of peristomal skin conditions in a sample of 109 adults 18 years or older with peristomal skin complications. These participants were receiving care in an ambulatory care center in outpatient health services in Sao Paulo and Curitiba, Brazil. In addition, interobserver reliability was measured using a group of 129 nurse participants who attended the Brazilian Congress of Stomatherapy held from November 12 to 15, 2017, in Belo Horizonte, a city located in the state of Minas Gerais, Brazil. Nurse participants assessed the descriptions of peristomal skin complications of the Portuguese version, using the same photographs used in the original DET score, purposely placed out of original order. METHODS: The study was performed in 2 stages. The instrument was translated into Brazilian Portuguese by 2 bilingual translators, and back-translated into English. The back-translated version was sent to one of the developers of the instrument for additional evaluation. During stage 2, content validity was evaluated by 7 nurses with expertise in ostomy and peristomal skin care. Convergent validity was evaluated by correlating the severity of peristomal skin complications to pain intensity. Discriminant validity was evaluated based on type and time of ostomy creation, presence of retraction, and preoperative stoma site marking. Finally, interrater reliability was evaluated using standardized photograph evaluation reproduced in the same sequence as the original English language version of the instrument, along with paired scores from assessment of adults living with an ostomy generated by an investigator and nurse data collectors. RESULTS: The Content Validity Index for the Ostomy Skin Tool was 0.83. Levels of mild agreements were obtained for the nurses' observations in the evaluation of peristomal skin complications using standardized photographs (κ= 0.314). In contrast, moderate to almost perfect agreements were obtained when scores were compared in the clinical setting (κ= 0.48-0.93, according to the domains). Positive correlations between the instrument and pain intensity (r = 0.44; P = .001) indicate convergent validity of the adapted version of the Ostomy Skin Tool. In contrast, analysis of discriminant validity was mixed and definitive conclusions about this form of construct validity cannot be made based on this study. CONCLUSION: This study supports convergent validity and interrater reliability of the adapted version of the Ostomy Skin Tool.

Topical therapy for pain management in malignant fungating wounds: A scoping review.

AIMS AND OBJECTIVES: To map and synthesise the existing literature on topical therapies for malignant fungating wounds pain management and the gaps involved. BACKGROUND: Most cancer patients with malignant fungating wounds suffer from wound-related pain, affecting their quality of life. Unfortunately, even though pain is a relevant symptom in cancer and palliative care, little is currently known about topical treatments' availability and impact on pain management. DESIGN: A scoping review following JBI® methodology METHODS: Searches were performed in CINAHL, LILACS, Embase, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR and grey literature, in English, Portuguese and Spanish, with no time limit. Two authors independently reviewed all citations and a third was called in case of divergence, and studies in adults with malignant fungal wounds reporting topical pain interventions were included. In addition, a data extraction tool for synthesis and thematic analysis was developed. This study followed the PRISMA-ScR Checklist. RESULTS: Seventy publications were selected from 796 records retrieved from databases. The studies mainly included non-systematic reviews and case studies with only six clinical trials. According to the narrative synthesis, twenty therapies were identified, including the use of wound dressings (58.6%), analgesic drugs (55.7%), topical antimicrobials (25.7%), skin barriers (15.7%), cryotherapy (5.7%) and negative pressure wound therapy (4.3%). Therapies were recommended to be applied to the wound bed or the periwound skin. In 68.5% of the studies, a standardised assessment for pain was not described. CONCLUSIONS: Topical therapies applied to malignant fungating wounds or periwound areas had been examined for pain management. However, their effectiveness was analysed in a few interventional studies, indicating the need for further primary studies to inform evidence-based practice. IMPLICATION FOR PRACTICE: Highlighted topical therapies for clinical practice consideration are opioids, anaesthetics and antimicrobials, with positive results described in randomised clinical trials. This study did not include patients.

Constipation scoring system validated for the portuguese language (índice de gravidade da constipação intestinal): is it reliable in assessing the severity of intestinal chronic constipation in our population? / O instrumento constipation scoring system validado para a língua portuguesa (índice de gravidade da constipação intestinal): é confiável na avaliação da gravidade da constipação intestinal crônica em nossa população?

ABSTRACT BACKGROUND: There is a lack of valid and specific tools to measure chronic constipation severity in Brazil. AIMS: To validate the Constipation Scoring System for Brazilian spoken Portuguese. METHODS: Translation, cultural adaptation, and validation itself (reliability and convergent and divergent validation). Translation: definitive version from the original version's translation and evaluation by specialists. Cultural adaptation: score content analysis of the definitive version, as an interview to patients. Interobserver reliability: application by two researchers on the same day. Intraobserver reliability: same researcher at different times, in a 7-day interval. Divergent validation: non-constipated volunteers. Convergent validation: two groups, good response to clinical treatment and refractory to treatment. RESULTS: Cultural adaptation: 81 patients, 89% female, with mean age of 55 and seven years of schooling, and overall content validity index was 96.5%. Inter and intraobserver reliability analysis: 60 patients, 86.7% female, mean age of 56 and six years of schooling, and the respective intraclass correlation coefficients were 0.991 and 0.987, p<0.001. Divergent validation: 40 volunteers, 25 male, mean age of 49 years, and the mean global score was 2. Convergent validation of patients with good response to clinical treatment: 47 patients, 39 female, mean age of 60 and six years of schooling, and the pre- and post-treatment scores were 19 and 8, respectively (p<0.001). Convergent validation of refractory to clinical treatment patients: 75 patients, 70 female, mean age of 53 and seven years of schooling, and the global average score was 22. CONCLUSIONS: The Constipation Scoring System (Índice de Gravidade da Constipação Intestinal) validated for the Brazilian population is a reliable instrument for measuring the severity of intestinal chronic constipation.

RESUMO RACIONAL: No Brasil há escassez de instrumentos específicos e validados para a avaliação da gravidade da constipação intestinal crônica. OBJETIVOS: Validar o instrumento Constipation Scoring System para pacientes com constipação crônica. MÉTODOS: Tradução, adaptação cultural e validação propriamente dita. Tradução: versão definitiva a partir de traduções do original avaliadas por especialistas. Adaptação cultural: avaliação do conteúdo por entrevista a pacientes. Confiabilidade interobservadores: entrevista por dois pesquisadores no mesmo dia. Confiabilidade intraobservador: duas entrevistas pelo mesmo pesquisador (intervalo de 7 dias). Validação divergente: voluntários não constipados. Validação convergente: dois grupos, boa resposta e refratários ao tratamento clínico. RESULTADOS: Adaptação cultural: 81 pacientes, sendo 89% do sexo feminino, com média de idade de 55 anos e 7 anos de escolaridade. O índice de validade de conteúdo global foi de 96,5%. Confiabilidade interobservadores e intraobservador: 60 pacientes, sendo 86,7% do sexo feminino, com média de idade de 56 anos e 6 anos de escolaridade. O coeficiente de correlação intraclasse foi de 0,991 e 0,987 (p<0,001), respectivamente. Validação divergente: 40 voluntários, sendo 62,5% do sexo masculino, com média de idade de 49 anos e pontuação média: 0. Validação convergente dos pacientes com boa resposta do tratamento clínico: 47 pacientes, sendo 83% do sexo feminino, com média de idade de 60 anos e 6 anos de escolaridade. Os índices pré e pós-tratamento foram 19 e 8 (p<0,001), respectivamente. Validação convergente dos pacientes refratários ao tratamento clínico: 75 pacientes sendo 93% do sexo feminino, com média de idade de 53 anos e 7 anos escolaridade. A pontuação média foi 22. CONCLUSÕES: O Constipation Scoring System validado para população brasileira (Índice de Gravidade da Constipação Intestinal), é instrumento confiável para a aferição da gravidade da constipação intestinal crônica.

Diagnóstico de imagem radiológica como protocolo de certificação na prevenção de eventos adversos após sondagem naso/oro enteral / Diagnosis of radiological imaging as a certification protocol in the prevention of adverse events after naso/enteral oro probing / Diagnóstico de la imagen radiológica como protocolo de certificación en la prevención de eventos adversos tras el sondeo naso/enteral oro

Objetivo. Apontar para a forma como a sonda nasoenteral serve a várias finalidades, entre as quais estão a própria alimentação enteral, a administração de drogas, como meio de contraste ou carvão ativado, para fins de aspiração do conteúdo do estômago para descomprimir o estômago de fluido, ar ou sangue, para reduzir o risco de vômito ou aspiração e para outros fins. Método: Revisão de literatura, descritiva exploratória, escolhidas, pois descreve, discute e analisa de forma ampla a literatura publicada sobre o tema, sob o ponto de vista teórico ou contextual a respeito da relevância do diagnóstico por imagem radiológica nestes casos. Resultados: Deve-se garantir a segurança do paciente, para isso é essencial confirmar que a sonda foi introduzida de maneira correta e está no devido local (estômago ou parte do intestino), uma vez que a sonda pode inadvertidamente ter sido inserida nos pulmões, o que pode passar desapercebido em pacientes de alto risco. Conclusão: Deve-se usar a sonda naso/oro para terapia nutricional, além de se prevenir eventos adversos para que o processo seja efetivo.

Objective. Point out how the nasoenteral tube serves various purposes, among which are enteral feeding itself, administration of drugs such as contrast medium or activated charcoal, for the purpose of aspiration of stomach contents to decompress the stomach of fluid, air or blood, to reduce the risk of vomiting or aspiration, and for other purposes. Method: Literature review, descriptive and exploratory, chosen because it describes, discusses and analyzes widely the published literature on the subject, from a theoretical or contextual point of view regarding the relevance of radiological imaging diagnosis in these cases. Results: Patient safety must be ensured, for this it is essential to confirm that the tube has been inserted correctly and is in the right place (stomach or part of the intestine), since the tube may have been inadvertently inserted into the lungs, which may go unnoticed in high-risk patients. Conclusion: The naso/oro tube should be used for nutritional therapy, in addition to preventing adverse events for the process to be effective

Objetivo. Señalar cómo la sonda nasoenteral sirve para varios fines, entre los que se encuentran la alimentación enteral en sí, la administración de fármacos como medio de contraste o carbón activado, con el fin de aspirar el contenido del estómago para descomprimir el estómago de líquido, aire o sangre, para reducir la riesgo de vómito o aspiración, y para otros fines. Método: Revisión bibliográfica, descriptiva y exploratoria, elegida porque describe, discute y analiza ampliamente la literatura publicada sobre el tema, desde un punto de vista teórico o contextual respecto a la relevancia del diagnóstico por imágenes radiológicas en estos casos. Resultados: Se debe garantizar la seguridad del paciente, para ello es fundamental confirmar que la sonda se ha insertado correctamente y está en el lugar correcto (estómago o parte del intestino), ya que la sonda puede haber sido introducida inadvertidamente en los pulmones, que puede pasar desapercibido en pacientes de alto riesgo. Conclusión: La sonda naso/oro debe ser utilizada para la terapia nutricional, además de prevenir eventos adversos para que el proceso sea efectivo.

Percepção de alunos de fonoaudiologia e pedagogia acerca das experiências e práticas de leitura e escrita de textos pertencentes ao gênero acadêmico / Perception of speech therapy and education students about their experiences and practices in reading and writing academic genre texts

RESUMO Objetivo Analisar a percepção de alunos dos cursos de Fonoaudiologia e de Pedagogia a respeito de suas experiências e práticas de leitura e escrita de textos pertencentes ao gênero do discurso na esfera acadêmica. Método Pesquisa de caráter quanti-qualitativo, de corte transversal e do tipo analítico. Para o levantamento dos dados, foi aplicado um questionário com perguntas que abrangiam a relação dos alunos com a leitura e com a escrita de textos pertencentes ao gênero acadêmico e as dificuldades enfrentadas no uso desse gênero do discurso. Resultados Muitos alunos supõem que apresentam alguma dificuldade no uso dos gêneros discursivos usados na universidade, o que pode indicar lacunas no trabalho com a linguagem escrita nos níveis de ensino que antecederam sua entrada no Ensino Superior. Alguns discentes referiram que se sentem culpados por não acompanharem, de forma efetiva, as atividades de leitura e de escrita propostas em seus respectivos cursos universitários, subentendendo que isso se deve a um distúrbio inerente aos mesmos. Conclusão Apesar do aumento do número de alunos no Ensino Superior, muitos ainda sentem-se excluídos da vida acadêmica, especialmente, por não usarem, de maneira proficiente, textos próprios deste nível de ensino. Cabe à Universidade e a todos os atores envolvidos na formação superior promoverem ações que considerem o direito a educação de todos os alunos.

ABSTRACT Purpose to analyze the perception of Speech-Therapy and Education undergraduates regarding their experiences and practices in reading and writing texts from academic discourse genres. Methods It´s a mixed crosscut study, with data collected by the application of a semi-structured questionnaire with open and closed questions about students' relation towards reading and writing of academic texts, their difficulties in the use of these genres and how they cope with such difficulties. Results The results show that a significant number of the students assume that they have some difficulty in reading and writing these discourse genres in academic settings, which may be an indication of gaps in working with reading and writing during previous educational levels. Some of these students even blame themselves for not effectively following the reading and writing proposals in higher education, implying that this is due to an intrinsic disorder. Conclusion The data allow us to state that, despite the increase in the number of students in higher education, many still feel excluded from academic life, especially for not using academic discourse genres in a proficient way. It is the University responsibility, along with all actors involved in higher education, to promote actions that consider the right to education for all students.

Prevalence of pressure injury and associated factors in hospitalized adult patients with cancer.

INTRODUCTION: Hospitalized cancer patients experience limitations in their daily activities resulting from the severity of their condition. Such changes alter patients' sensory perception and hinder their mobility, thus predisposing them to the development of PI. OBJECTIVE: The goal of this study was to analyze the prevalence of PI and associated factors in hospitalized cancer patients. MATERIALS AND METHODS: This observational, epidemiological, cross-sectional, descriptive study was carried out in the inpatient and ICU settings of an oncological hospital in São Paulo, Brazil. RESULTS: A total of 341 patients who met the inclusion criteria and agreed to participate in the study were interviewed and assessed. Data obtained in the interviews were analyzed for logistic regression analysis. Pressure injury prevalence was 10% (34 patients). The use of disposable diapers was significantly associated with the development of PI, with a 6.077 increased chance of PI in such patients in the ICU setting. In this epidemiologic study of 341 hospitalized cancer patients, the prevalence of PI was 10%. The use of disposable diapers was the only factor associated with the presence of PI after logistic regression analysis. CONCLUSION: Knowing the risk factors of this specific population was essential to implement actions and optimize indications of disposable diaper use. There is an absence of epidemiologic records due to limited publications available on the subject; creating a program to prevent PI development within the inpatient, assisted population.

Topical application of a cream containing nanoparticles with vitamin E for radiodermatitis prevention in women with breast cancer: A randomized, triple-blind, controlled pilot trial.

PURPOSE: Most topical agents for radiodermatitis prevention are not based on its pathophysiology, mainly caused by the indirect effects of radiation from reactive oxygen species release. Therefore, this study aimed to evaluate the effect of vitamin E-containing nanoparticle cream as an antioxidant for radiodermatitis prevention. METHOD: A randomized, triple-blind, parallel pilot study conducted in an Oncology Hospital including 40 adult women with breast cancer, and healthy skin, submitted to radiotherapy, divided into three groups: Intervention (12; 30%) receiving cream with nanoparticles containing vitamin E; Control 1 (14; 35%) cream without nanoparticles or vitamin E; Control 2 (14; 35%) cream with nanoparticles without vitamin E. Incidence, grade and time to onset of radiodermatitis were primary outcomes; health-related quality of life, reported symptoms, and breast temperature were secondary outcomes. RESULTS: All patients were followed until the end of the study. All had radiodermatitis. There were no significant differences between the study groups regarding radiodermatitis grade, health-related quality of life, and breast temperatures. A protective effect of vitamin E-containing nanoparticle cream was identified regarding the onset time of radiodermatitis in patients who did not receive a boosted radiation dose (p = .03) and the occurrence of mild inframammary erythema (p = .04). Itching was reported by 90% of the women. The definitive calculated sample is 108 volunteers. There were no identified side effects. CONCLUSIONS: A potential protective effect of a cream containing vitamin E nanoparticles was observed. This pilot study presents initial evidence about the role of a nanoencapsulated antioxidant in preventing radiodermatitis. TRIAL REGISTRATION: No. RBR-784F3Y; UTN-U1111-1201-5923.

Perception of speech therapy and education students about their experiences and practices in reading and writing academic genre texts. / Percepção de alunos de fonoaudiologia e pedagogia acerca das experiências e práticas de leitura e escrita de textos pertencentes ao gênero acadêmico.

PURPOSE: to analyze the perception of Speech-Therapy and Education undergraduates regarding their experiences and practices in reading and writing texts from academic discourse genres. METHODS: It´s a mixed crosscut study, with data collected by the application of a semi-structured questionnaire with open and closed questions about students' relation towards reading and writing of academic texts, their difficulties in the use of these genres and how they cope with such difficulties. RESULTS: The results show that a significant number of the students assume that they have some difficulty in reading and writing these discourse genres in academic settings, which may be an indication of gaps in working with reading and writing during previous educational levels. Some of these students even blame themselves for not effectively following the reading and writing proposals in higher education, implying that this is due to an intrinsic disorder. CONCLUSION: The data allow us to state that, despite the increase in the number of students in higher education, many still feel excluded from academic life, especially for not using academic discourse genres in a proficient way. It is the University responsibility, along with all actors involved in higher education, to promote actions that consider the right to education for all students.

OBJETIVO: Analisar a percepção de alunos dos cursos de Fonoaudiologia e de Pedagogia a respeito de suas experiências e práticas de leitura e escrita de textos pertencentes ao gênero do discurso na esfera acadêmica. MÉTODO: Pesquisa de caráter quanti-qualitativo, de corte transversal e do tipo analítico. Para o levantamento dos dados, foi aplicado um questionário com perguntas que abrangiam a relação dos alunos com a leitura e com a escrita de textos pertencentes ao gênero acadêmico e as dificuldades enfrentadas no uso desse gênero do discurso. RESULTADOS: Muitos alunos supõem que apresentam alguma dificuldade no uso dos gêneros discursivos usados na universidade, o que pode indicar lacunas no trabalho com a linguagem escrita nos níveis de ensino que antecederam sua entrada no Ensino Superior. Alguns discentes referiram que se sentem culpados por não acompanharem, de forma efetiva, as atividades de leitura e de escrita propostas em seus respectivos cursos universitários, subentendendo que isso se deve a um distúrbio inerente aos mesmos. CONCLUSÃO: Apesar do aumento do número de alunos no Ensino Superior, muitos ainda sentem-se excluídos da vida acadêmica, especialmente, por não usarem, de maneira proficiente, textos próprios deste nível de ensino. Cabe à Universidade e a todos os atores envolvidos na formação superior promoverem ações que considerem o direito a educação de todos os alunos.