Translation, cross-cultural adaptation, reliability and validity of the Brazilian Portuguese version of the 'Fit to Dance?' survey.

BACKGROUND: The 'Fit to Dance?' survey has been used in a number of studies to understand the health and wellbeing of dancers. These data have not been collected in Brazil as there is no validated questionnaire available in Brazilian Portuguese, culturally validated in Brazil with a scope as broad and comprehensive as that of 'Fit to Dance?'. OBJECTIVE: Translate into Brazilian Portuguese and culturally validate the questionnaire 'Fit to Dance?' in Brazil. METHODS: This was a validity and reliability study of the Brazilian Portuguese version of the 'Fit to Dance?' SURVEY: The stages of the research were: translation into the target language (Brazilian Portuguese), translation synthesis, translation validation and cross-cultural adaptation by a committee of experts in Dance Medicine and Science (DMS), reverse translation into English, pilot study (test/retest), and final version of the questionnaire. RESULTS: The questionnaire was applied to 21 dancers of different dance genres, with an age average of 25 ± 7.0 years. Cronbach's alpha (0.705), ICC (0.984) and Kappa (0.794) results reached adequate values. CONCLUSION: The Brazilian Portuguese version of the questionnaire 'Fit to Dance?' is effective, has adequate levels of validity and reliability, and can be used to report injuries and aspects of health and well-being of Brazilian dancers.

Quality of child and adolescent care transitions considering the presence of chronic disease.

OBJECTIVES: to analyze the quality of child and adolescent care transitions from hospital to home, considering the presence of chronic disease. METHODS: quantitative, cross-sectional study, carried out from February to September 2019 in two hospitals in the south of Brazil. We used an instrument to characterize participants and the Care Transitions Measure (CTM-15) for the legal tutors of children and adolescents that were discharged from the institutions. RESULTS: the general mean of the quality of transition of care was 87.9 (SD=13.4), in a scale from 0 to100). We found a significant difference in the quality of transition of care when comparing patients with and without chronic disease (90.0 and 84.3; p=0.001). CONCLUSIONS: we found the quality of the transition of care to be satisfactory, with better results for patients with chronic disease. This can help understand the most impactful aspects in the transition of care, especially in regard to children health.

Continuity of care for children with chronic conditions: mixed methods research.

OBJECTIVE: To analyze the continuity of care for children with chronic conditions from the transition from hospital to home. METHOD: Parallel-convergent mixed-methods research, with a cross-sectional study and Grounded Theory. A characterization instrument and the Care Transitons Measure were applied to 201 legal guardians of children with chronic conditions, and semi-structured interviews were conducted with 35 participants (among professionals and guardians). Data were combined by integration. RESULTS: The efforts of the hospital team to promote continuity of care after discharge from the transition from hospital to home impact on the quality-of-care transition perceived by caregivers, with a mean of 89.5 (standard deviation = 12.5) points. However, the absence of formal mechanisms to guide the transition of care makes it difficult to achieve continuity of care in the health network. CONCLUSION: Continuity of care for children is hindered by barriers, against which hospital care professionals seek individual strategies to overcome them. It is essential to establish institutional actions and public policies aiming at the transition of care to promote continuity of care.

Multiple hepatic infarctions secondary to diabetic ketoacidosis: A case report.

BACKGROUND: Hepatic infarctions (HI) are ischemic events of the liver in which a disruption in the blood flow to the hepatocytes leads to focal ischemia and necrosis. Most HI are due to occlusive events in the liver's blood vessels, but non-occlusive HI may occur. They are associated with disruption of microvasculature, such as in diabetic ketoacidosis. While HI usually presents as peripheral lesions with clear borders, irregular nodular lesions may occur, indistinguishable from liver neoplasms and presenting a diagnostic challenge. CASE SUMMARY: We report a case of multiple extensive HI in a patient with poorly controlled diabetes mellitus, who first presented to the emergency room with diabetic ketoacidosis. He then developed jaundice, thrombocytopenia, and a marked elevation of serum aminotransferases. An ultrasound of the liver showed the presence of multiple irregular lesions. Further investigation with a computerized tomography scan confirmed the presence of multiple hypoattenuating nodules with irregular borders and heterogeneous appearance. These lesions were considered highly suggestive of a primary neoplasm of the liver. While the patient was clinically stable, his bilirubin levels remained persistently elevated, and he underwent an ultrasound-guided percutaneous biopsy of the largest lesion. Biopsy results revealed extensive ischemic necrosis of hepatocytes, with no signs of associated malignancy. Three months after the symptoms, the patient showed great improvement in all clinical and laboratory parameters and extensive regression of the lesions on imaging exams. CONCLUSION: This case highlights that diabetic ketoacidosis can cause non-occlusive HI, possibly presenting as nodular lesions indistinguishable from neoplasms.

Continuity of care for children with chronic conditions: mixed methods research / Continuidad de la atención a niños con enfermedades crónicas: investigación con métodos mixtos / Continuidade do cuidado de crianças com condições crônicas: pesquisa de métodos mistos

ABSTRACT Objective: To analyze the continuity of care for children with chronic conditions from the transition from hospital to home. Method: Parallel-convergent mixed-methods research, with a cross-sectional study and Grounded Theory. A characterization instrument and the Care Transitons Measure were applied to 201 legal guardians of children with chronic conditions, and semi-structured interviews were conducted with 35 participants (among professionals and guardians). Data were combined by integration. Results: The efforts of the hospital team to promote continuity of care after discharge from the transition from hospital to home impact on the quality-of-care transition perceived by caregivers, with a mean of 89.5 (standard deviation = 12.5) points. However, the absence of formal mechanisms to guide the transition of care makes it difficult to achieve continuity of care in the health network. Conclusion: Continuity of care for children is hindered by barriers, against which hospital care professionals seek individual strategies to overcome them. It is essential to establish institutional actions and public policies aiming at the transition of care to promote continuity of care.

RESUMEN Objetivo: Analizar la continuidad de los cuidados de los niños con enfermedades crónicas desde la transición del hospital al domicilio. Método: Investigación de métodos mixtos paralelo-convergentes, con un estudio transversal y la teoría fundamentada en datos. Se aplicó un instrumento de caracterización y la Care Transitons Measure a 201 tutores legales de niños con enfermedades crónicas, y se realizaron entrevistas semiestructuradas a 35 participantes (entre profesionales y tutores). Los datos se combinaron por integración. Resultados: Los esfuerzos del equipo del hospital en la promoción de la continuidad de los cuidados tras el alta de la transición del hospital al domicilio repercuten en la calidad de la transición asistencial percibida por los tutores, con una media de 89,5 (desviación estándar = 12,5) puntos. Sin embargo, la ausencia de mecanismos formales para guiar la transición de la atención dificulta la consecución de la continuidad asistencial en la red sanitaria. Conclusión: La continuidad del cuidado de los niños se ve dificultada por las barreras, frente a las cuales los profesionales de la atención hospitalaria buscan estrategias individuales para superarlas. Es fundamental el establecimiento de acciones institucionales y políticas públicas para la transición del cuidado a la promoción de la continuidad del cuidado.

RESUMO Objetivo: Analisar a continuidade do cuidado de crianças com condições crônicas a partir da transição do hospital para o domicílio. Método: Pesquisa de métodos mistos paralelo-convergente, com um estudo transversal e uma Teoria Fundamentada nos Dados. Foram aplicados um instrumento de caracterização e o Care Transitons Measure a 201 responsáveis legais por crianças com condições crônicas, e realizadas entrevistas semiestruturadas com 35 participantes (dentre profissionais e responsáveis). Os dados foram combinados por integração. Resultados: Os esforços da equipe hospitalar em promover a continuidade do cuidado após a alta a partir da transição do hospital para o domicílio impactam sobre a qualidade da transição do cuidado percebida pelos responsáveis, com média de 89,5 (desvio padrão = 12,5) pontos. Contudo, a ausência de mecanismos formais que orientem a transição do cuidado dificulta o alcance da continuidade do cuidado na rede de saúde. Conclusão A continuidade do cuidado de crianças é dificultada por barreiras, frente às quais os profissionais da atenção hospitalar buscam estratégias individuais para superá-las. É fundamental o estabelecimento de ações institucionais e políticas públicas visando à transição do cuidado para promoção da continuidade do cuidado.

Mortalidade brasileira por câncer de cavidade oral / Mortality in brazil from oral cavity cancer

OBJETIVO: Caracterizar o perfil de mortalidade por câncer de cavidade oral. MÉTODOS: Estudo transversal, descritivo e retrospectivo construído por meio de dados obtidos na plataforma do Departamento de Informática do Sistema Único de Saúde (DATASUS) em um recorte de 5 anos (2012-2017). O nível de significância considerado foi de 5%. RESULTADOS: No período analisado, foram registradas 151.573 internações no Brasil por câncer de cavidade oral. Do total, 72,7% pertenciam ao sexo masculino. CONCLUSÃO: O conhecimento do perfil de mortalidade por câncer de cavidade oral permitiu refletir acerca do modelo de atenção por meio de uma abordagem sistematizada, com o intuito de gerar desfechos mais favoráveis na saúde pública. (AU)

OBJECTIVE: To characterize the oral cavity cancer mortality. METHODS: This is a cross-sectional, descriptive and retrospective study constructed using data obtained from the Brazilian Informatics Department of the National Unified System platform, analyzed in a 5-year cut (2012-2017). The level of significance considered was 5%. RESULTS: In the period analyzed, 151.573 hospitalizations were recorded in Brazil for oral cavity cancer. Of the total, 72.7% were male. CONCLUSION: The knowledge of the oral cavity cancer mortality profile allowed the reflection on the care model through a systematized approach, aiming to generate more favorable outcomes in public health. (AU)

Adverse Reactions to Radiopharmaceuticals: A Survey Based on Clinical Cases Using Criteria of Systematic Review.

Adverse reactions to radiopharmaceuticals are still not reported worldwide. However, the type of reaction may be severe and cause death. A review of the literature was performed using some criteria of a systematic review established by the Cochrane Collaboration. The results showed that there are a large number of adverse reactions to radiopharmaceuticals. Nuclear medicine staff must be aware of the possibility of adverse reaction with radiopharmaceuticals and find time to share this information with the radiopharmacist and the national pharmacovigilance system.

A Rare Case of Relapsed Pediatric Acute Promyelocytic Leukemia with Skin Involvement by Myeloid Sarcoma.

BACKGROUND Acute promyelocytic leukemia (APL) is a very rare leukemia in children. Extramedullary involvement by APL has been reported in between 3-5% of cases, mainly associated with cases of relapse. A rare case of relapse of APL in a 9-year-old child is presented with skin involvement with myeloid sarcoma. CASE REPORT A 9-year-old male child was admitted to the Oncology Service of the hospital complaining of fever, progressive fatigue, oral petechiae with severe bleeding in the oral cavity. Bone marrow examination showed some promyelocytes. Flow cytometry showed 86% immature myeloid cells with the t(15;17) translocation, and molecular analysis showed expression of the PML/RARa fusion protein, which confirmed the diagnosis of APL. The patient completed a course of daunorubicin, cytarabine, and AII trans-retinoic acid (ATRA) with complete remission. After six months, the patient was re-admitted to hospital with a violaceous lesion on the scalp, with relapse of APL. Histological and immunohistochemistry of the lesion involving the skin of the scalp showed a myeloid sarcoma invading the dermis. CONCLUSIONS Myeloid sarcoma, also called granulocytic sarcoma, is an extramedullary tumor of immature myeloid cells, which very rarely presents in children with APL. The mechanisms that lead to myeloid sarcoma in children with APL and the possible association with ATRA therapy remain to be investigated.

Blastic Plasmacytoid Dendritic Cell Neoplasm with Pulmonary Involvement and Atypical Skin Lesion.

BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematodermic malignancy neoplasm with highly aggressive course and poor prognosis. This disease typically presents with cutaneous involvement as the first manifestation, with subsequent or simultaneous spread to bone marrow and peripheral blood.  CASE REPORT Here, we report the case of a 51-year-old woman who presented a violaceus skin lesion on the lateral region of the right thigh, weight loss, fever, and lymphadenopathies. Computed tomography (CT) displayed thoracic and abdominal lymph node and alveolar bleeding. Flow cytometry from circulating blastic cells was compatible with BPDCN (CD4+, CD56+ and CD123+). She underwent 5 cycles of hyper-CVAD alternating with high-dose methotrexate and cytarabine, but the patient died due to alveolar bleeding and sepsis. CONCLUSIONS We report a rare case of BPDCN characterized by an aggressive course, presence of atypical skin lesion, a finding suggestive of pulmonary infiltration, and nonresponse to induction chemotherapy, leading to late diagnosis and therapeutic management. Because of the late recognition of the skin lesion, neoplastic cells infiltrated the dermis and spread as the disease progressed rapidly to a fatal course.