MRI is a Reliable Method for Measurement of Critical Shoulder Angle and Acromial Index.

Objective The objectives of this study are to compare absolute values of acromial index (AI) and critical shoulder angle (CSA) obtained in both radiographs and magnetic resonance image (MRI) of the shoulder; and to compare the interobserver and intra-observer agreement for AI and CSA values measured in these image modalities. Methods Patients who had medical indication of investigating shoulders conditions through radiographs and MRI were included. Images were taken to two fellowship-trained shoulder surgeons, which conducted measurements of AI and CSA in radiographs and in MRI. Twelve weeks after the first evaluation, a second evaluation was conducted. Inter- and intra-observer reliability was presented as an Intraclass Correlation Coefficient (ICC) and agreement was classified according to Landis & Koch criteria. The differences between two measurements were evaluated using Bland-Altman plots. Results 134 shoulders in 124 subjects were included. Mean intra-observer ICC for CSA in X-rays and in MRI were 0.936 and 0.940, respectively; for AI, 0.908 and 0.022. Mean inter-observer ICC for CSA were 0.892 and 0.752 in X-rays and MRI respectively; for AI, ICC values were 0.849 and 0.685. All individual analysis reached statistical power ( p < 0.001). Mean difference for AI values measured in X-rays and in MRI was 0.01 and 0.03 for observers 1 and 2, respectively. Mean difference for CSA values obtained in X-rays and MRI was 0.16 and 0.58 for observers 1 and 2, respectively. Conclusion Both MRI and X-rays provided high intra- and interobserver agreement for measurement of AI and CSA. Absolute values found for AI and CSA were highly correlated in both image modalities. These findings suggest that MRI is a suitable method to measure AI and CSA. Level of Evidence II , Diagnostic Study.

MRI is a Reliable Method for Measurement of Critical Shoulder Angle and Acromial Index / A ressonância magnética é um método confiável para medida do ângulo crítico do ombro e do índice acromial

Abstract Objective The objectives of this study are to compare absolute values of acromial index (AI) and critical shoulder angle (CSA) obtained in both radiographs and magnetic resonance image (MRI) of the shoulder; and to compare the interobserver and intra-observer agreement for AI and CSA values measured in these image modalities. Methods Patients who had medical indication of investigating shoulders conditions through radiographs and MRI were included. Images were taken to two fellowship-trained shoulder surgeons, which conducted measurements of AI and CSA in radiographs and in MRI. Twelve weeks after the first evaluation, a second evaluation was conducted. Inter- and intra-observer reliability was presented as an Intraclass Correlation Coefficient (ICC) and agreement was classified according to Landis & Koch criteria. The differences between two measurements were evaluated using Bland-Altman plots. Results 134 shoulders in 124 subjects were included. Mean intra-observer ICC for CSA in X-rays and in MRI were 0.936 and 0.940, respectively; for AI, 0.908 and 0.022. Mean inter-observer ICC for CSA were 0.892 and 0.752 in X-rays and MRI respectively; for AI, ICC values were 0.849 and 0.685. All individual analysis reached statistical power (p< 0.001). Mean difference for AI values measured in X-rays and in MRI was 0.01 and 0.03 for observers 1 and 2, respectively. Mean difference for CSA values obtained in X-rays and MRI was 0.16 and 0.58 for observers 1 and 2, respectively. Conclusion Both MRI and X-rays provided high intra- and interobserver agreement for measurement of AI and CSA. Absolute values found for AI and CSA were highly correlated in both image modalities. These findings suggest that MRI is a suitable method to measure AI and CSA. Level of Evidence II, Diagnostic Study.

Resumo Objetivo Os objetivos deste estudo foram comparar os valores absolutos do índice acromial (IA) e do ângulo crítico do ombro (ACO) obtidos em radiografias e ressonâncias magnéticas (RM) do ombro e comparar a concordância interobservador e intraobservador dos valores de IA e ACO medidos nessas modalidades de imagem. Métodos Pacientes com indicação médica de investigação de doenças dos ombros por meio de radiografias e RM foram incluídos no estudo. As imagens foram levadas para dois cirurgiões de ombro treinados que realizaram medidas de IA e ACO em radiografias e RM. Doze semanas após a primeira avaliação, uma segunda avaliação foi realizada. A confiabilidade inter e intraobservador foi apresentada como coeficiente de correlação intraclasse (CCI) e a concordância foi classificada segundo os critérios de Landis e Koch. As diferenças entre duas medidas foram avaliadas por meio de gráficos de Bland-Altman. Resultados Cento e trinta e quatro ombros de 124 indivíduos foram incluídos no estudo. O CCI intraobservador médio para ACO em radiografias e RM foi 0,936 e 0,940, respectivamente; para IA, foi 0,908 e 0,022. O CCI interobservador médio para ACO foi 0,892 e 0,752 em radiografias e RM, respectivamente; para IA, os valores de CCI foram 0,849 e 0,685. Todas as análises individuais apresentaram poder estatístico (p < 0,001). A diferença média dos valores de IA em radiografias e RM foi 0,01 e 0,03 para os observadores 1 e 2, respectivamente. A diferença média dos valores de ACO em radiografias e RM foi 0,16 e 0,58 para os observadores 1 e 2, respectivamente. Conclusão Tanto a RM quanto as radiografias tiveram alta concordância intra e interobservador para medida de IA e ACO. Os valores absolutos de IA e ACO foram altamente correlacionados em ambas as modalidades de imagem. Esses achados sugerem que a RM é um método adequado para determinação de IA e ACO. Nível de Evidência II, Estudo Diagnóstico.

Disseminated Mucor indicus infection in a marmoset (Callithrix sp.).

Mucormycosis is rarely described in Platyrrhines. Herein, we describe the pathologic and molecular features of a gastric and hepatic infection by Mucor indicus in a marmoset (Callithrix sp.).

Genomic characterization of a multi-drug resistant, CTX-M-65-producing clinical isolate of Salmonella Infantis isolated in Brazil.

A multi-drug resistant, CTX-M-65 producing Salmonella Infantis was identified from a patient in Brazil. Whole genome sequencing followed by hybrid assembly (short and long reads) indicated the presence of blaCTX-M-65 in a pESI-like megaplasmid in this ST32 isolate and phylogenetic analysis showed high similarity with IncFIB S. Infantis isolates from food and poultry in the USA.

Virtual Reality Exposure Treatment in Phobias: a Systematic Review.

We compare the relative efficacy of virtual reality therapy exposure (VRET) versus in vivo therapy exposure among individuals suffering from phobias. A systematic search was completed up to 03 April 2020, using the following databases: ACM Digital Library, ResearchGate, IEEE, Science Direct, MIT PressJournals, Center for Direct Scientific Communication (CCSD) and Mary Ann Liebert Publishers. Five authors searched the databases using the following terms: Virtual Reality, Phobia, Mental health, Computing, Therapy, HMD, CAVE, Virtual ambient, in virtuo, Avoidance, Exposure, VRET, in vivo, Anxiety, Agoraphobia, Social Phobia, Stimuli, Cognitive-behaviour. All studies that evaluate the effect of in virtuo exposure towards phobia rehabilitation were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 30 articles were selected. Data extracted included the number of samples, amount of sessions, study variables that may affect the final outcome, therapy technology. The data provided was synthesized using a meta-analysis based on the results. The results demonstrated a positive outcome of Virtual Reality Exposure Treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. The findings suggest that for some specific phobias treatment, Virtual Reality Exposure Treatment does not reach the in vivo exposure level of immersion and presence. Further research is needed to perform studies with higher-dimension samples, since many papers report a low sample size and that is probably why many of them have inconclusive results.

O papel do símbolo na psicossomática psicanalítica / The function of the symbol in the psychoanalytical psychosomatic

Num artigo anterior, discuti as origens da psicossomática relacionada à medicina na Grécia antiga. Identifiquei que o resgate freudiano do símbolo e seu acesso pela interpretação, que estava presente em Hipócrates, foi levado às doenças orgânicas por Groddeck. Porém, o esquecimento das teses de Groddeck e a fundação da psicossomática por Alexander tiraram a importância do símbolo da ciência psicossomática. A presente pesquisa teve por objetivo investigar se os desdobramentos da psicanálise pós-freudiana permitem encontrar um papel para o símbolo na psicossomática. Para isso foi empregada uma investigação dos textos e do contexto de Pierre Marty e seus adeptos, Donald W. Winnicott, Lacan e Joyce MacDougall. Compreendeu-se que, embora os conceitos de pensamento operatório de Marty, Alexitimia de Sifneos, falso self de Winnicott e holofrase e afânise de Lacan apontem para uma ausência simbólica nos pacientes psicossomáticos, alguns indícios dos conceitos de Winnicott e Lacan e, especialmente, as teses de Joyce McDougall apontam para registros pré-linguísticos que permitem uma compreensão do conteúdo das afecções psicossomáticas.(AU)

In my last article, I disserted about the origins of the psychosomatic in relation with the ancient Greece. I identified the Freudian rescued of the symbol and its access from the interpretation, which was present in Hippocrates and taken by Groddeck to the organic diseases. However, the forgetting of the thesis of Groddeck and the foundation of psychosomatic for Alexander have taken out the importance of the symbol from the psychosomatic science. This research intended investigates if the increases of the post-Freudian psychoanalysis let it find a function to the symbol in the psychosomatic. Therefore, it has done an investigation of the texts and context of Pierre Marty and his adepts, Donald W. Winnicott, Lacan and Joyce McDougall. It figured out that even the concepts operatory thought of Marty, alexitimy of Sifneos, false self of Winnicott, holofrase and afanise of Lacan point to a missed symbol in the psychosomatic patients, some hints of the concepts of Winnicott and Lacan, and, specially, the thesis of Joyce McDougall explain to pre-linguistic registers, which allow to comprehend the content of the psychosomatic diseases.(AU)

Catálogo CIPE® para pacientes adultos em processo de neurorreabilitação / ICNP® catalog for adult patients in Neurorehabilitation process

Introdução: A neurorreabilitação é identificada, como um importante componente no processo saúde-doença de pessoas com deficiência, condição cada vez mais complexa e diversificada. O Processo de Enfermagem é uma ferramenta metodológica que deve ser utilizada para direcionar os cuidados prestados a essa população e para utilizá-la é recomendado o uso de uma terminologia unificada, capaz de possibilitar, aos enfermeiros codificar, armazenar e recuperar a informação em um formato que possa ser útil e aplicável na assistência ao paciente. Objetivo: construir um Catálogo de conceitos da Classificação Internacional para a Prática de Enfermagem (CIPE®) na neurorreabilitação de adultos. Método: Trata-se de um estudo metodológico desenvolvido em quatro etapas: composição dos enunciados de diagnósticos / resultados e intervenções de enfermagem; construção de definições operacionais para os enunciados dos diagnósticos / resultados de enfermagem; validação de conteúdo dos enunciados e das definições operacionais dos diagnósticos/resultados de enfermagem e dos enunciados das intervenções de enfermagem junto a enfermeiros especialistas na área; organização do Catálogo de acordo com o Modelo de Adaptação de Roy. Resultados: Foram construídos 1490 enunciados, sendo 394 diagnósticos/resultados de enfermagem e 1090 intervenções de enfermagem. Validou-se quanto ao conteúdo 266 diagnósticos/resultados de enfermagem e 540 intervenções. Os enunciados foram alocados nos modos do Modelo de Adaptação de Roy, sendo 20 diagnósticos/resultados e as intervenções de enfermagem no modo desempenho de papel, 10 diagnósticos/resultados e suas intervenções de enfermagem no modo interdependência; 52 no modo autoconceito e, 184 no modo fisiológico. Conclusão: desenvolveu-se um Catálogo CIPE® para Adultos em processo de neurorreabilitação à luz do modelo teórico de adaptação de Roy. Diagnósticos / resultados e intervenções de enfermagem foram propostos e validados e para ajudar o raciocínio clínico do enfermeiro. Este foi julgado como refletindo as demandas que a população pode apresentar durante o processo de neurorreabilitação e seu uso dará suporte à documentação sistemática do cuidado clínico de enfermagem, usando a CIPE® como terminologia de referência. A CIPE® tem sido considerada uma classificação versátil pois se adapta às muitas realidades e singularidades da prática de enfermagem. Neste sentido, acredita-se que esse Catálogo possa ser usado por enfermeiros reabilitadores na sua prática, padronizando a linguagem empregada e contribuindo com o processo de tomada de decisão clínica.(AU)

Introduction: Neurorehabilitation is identified as an important component in the healthdisease process of people with disabilities, an increasingly complex and diversified condition. The Nursing Process is a methodological tool that should be used to direct the care provided to this population and to use it, it is recommended to use a unified terminology, capable of enabling nurses to code, store and retrieve information in a format which may be useful and applicable in patient care. Objective: to construct a Catalog of concepts of the International Classification for Nursing Practice (CIPE®) in adult neuro-rehabilitation. Method: It is a methodological study developed in four stages: composition of the statements of diagnoses / results and nursing interventions; construction of operational definitions for statements of nursing diagnoses / results; validation of contents of statements and operational definitions of nursing diagnoses / results and statements of nursing interventions with specialist nurses in the area; organization of the Catalog according to Roy's Adaptation Model. Results: A total of 1490 statements were constructed, being 394 nursing diagnoses / results and 1096 nursing interventions. 266 nursing diagnoses / results and 540 interventions were validated. The statements were allocated in the Roy Adaptation Model modes, with 20 diagnoses / results and the nursing interventions in paper performance mode, 10 diagnoses / results and their nursing interventions in the interdependence mode; 52 in the self-concept mode, and 184 in the physiological mode. Conclusions: a CIPE® Catalog for Adults in the process of neurorehabilitation was developed in light of Roy's theoretical model of adaptation. Diagnoses / outcomes and nursing interventions were proposed and validated and should enhance the nurses' clinical reasoning. This was judged as reflecting the demands that the population may present during the neuro-rehabilitation process and its use will support the systematic documentation of clinical nursing care, using CIPE® as a reference terminology. CIPE® has been considered a versatile classification because it adapts to the many realities and singularities of nursing practice. In this sense, it is believed that this Catalog can be used by rehabilitation nurses in their practice, standardizing the language used and contributing to the clinical decision-making process.(AU)

Diagnósticos e interevenções de Enfermagem para o componente sentidos da Teoria de Roy, aplicados a adultos em neurorreabilitação / Nursing diagnoses and interventions for the senses component of Roy's Theory, applied to adults in neurorehabilitation

Objetivo: elaborar e validar enunciados de diagnósticos e intervenções de enfermagem para o componente Sentidos do Modo Fisiológico de Roy, para pacientes adultos em neurorreabilitação. Metodologia: trata-se de estudo metodológico, que envolveu diferentes métodos de coleta, organização e análise de dados. Resultados: foram elaborados 18 diagnósticos de enfermagem, sendo validados 14 com suas respectivas intervenções de enfermagem. Conclusão: a construção de subconjuntos de diagnósticos, resultados e intervenções de enfermagem CIPE® nas diversas especialidades clínicas é uma necessidade e uma recomendação do Conselho Internacional de Enfermeiras.

Objective: To elaborate and validate statements of nursing diagnoses and interventions for the component Senses of Physiological Mode of Roy’s theory for patients in neurorehabilitation. Methodology: This is a methodological study, which involved different methods of data collection, organization and analysis. Results: 18 nursing diagnoses were elaborated and 14 were validated with their respective nursing interventions. Conclusion: The construction of subgroups of ICNP® nursing diagnoses, outcomes and interventions in the various clinical specialties is a necessity and a recommendation of the International Council of Nurses.

Objetivo: Desarrollar y validar los enunciados de diagnósticos e intervenciones de enfermería para el componente Sentidos del Modo fisiológico de la teoría de Roy, para pacientes adultos en neurorrehabilitación. Metodología: Se trata de un estudio metodológico, que involucró a diferentes métodos de recopilación, organización y análisis de datos. Resultados: fueran elaborados 18 diagnósticos de enfermería, de los cuales fueran validados 14 diagnósticos con sus respectivas intervenciones de enfermería. Conclusión: La construcción de los subconjuntos de diagnóstico, resultados e intervenciones de enfermería de la ICNP® en las diversas especialidades clínicas es una necesidad y una recomendación del Consejo Internacional de Enfermeras(os).

Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms.

OBJECTIVE: to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease. METHOD: a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification. RESULTS: a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention. CONCLUSION: the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification.

Nursing interventions for rehabilitation in Parkinson's disease: cross mapping of terms / Intervenções de Enfermagem para a reabilitação na doença de Parkinson: mapeamento cruzado de termos / Intervenciones de Enfermería para la rehabilitación en la enfermedad de Parkinson: mapeo cruzado de términos

ABSTRACT Objective: to perform a cross-term mapping of nursing language in the patient record with the Nursing Interventions Classification system, in rehabilitation patients with Parkinson's disease. Method: a documentary research study to perform cross mapping. A probabilistic, simple random sample composed of 67 records of patients with Parkinson's disease who participated in a rehabilitation program, between March of 2009 and April of 2013. The research was conducted in three stages, in which the nursing terms were mapped to natural language and crossed with the Nursing Interventions Classification. Results: a total of 1,077 standard interventions that, after crossing with the taxonomy and refinement performed by the experts, resulted in 32 interventions equivalent to the Nursing Interventions Classification (NIC) system. The NICs, "Education: The process of the disease.", "Contract with the patient", and "Facilitation of Learning" were present in 100% of the records. For these interventions, 40 activities were described, representing 13 activities by intervention. Conclusion: the cross mapping allowed for the identification of corresponding terms with the nursing interventions used every day in rehabilitation nursing, and compared them to the Nursing Interventions Classification.

RESUMO Objetivo: realizar o mapeamento cruzado de termos da linguagem de Enfermagem, com o sistema de Classificação das Intervenções de Enfermagem, em prontuários de pacientes com doença de Parkinson em reabilitação. Metodologia: estudo de pesquisa documental, para realização de mapeamento cruzado. Amostra probabilística, do tipo aleatória simples, composta por 67 prontuários de pacientes com doença de Parkinson que participaram de programa de reabilitação, entre março de 2009 e abril de 2013. Pesquisa realizada em três etapas onde foram mapeados os termos de Enfermagem em linguagem livre e cruzados com o sistema de Classificação das Intervenções de Enfermagem. Resultados: foram identificadas 1.077 intervenções normalizadas que, após o cruzamento com a taxonomia e o refinamento feito pelos especialistas, resultaram em 32 intervenções equivalentes ao sistema de Classificação das Intervenções de Enfermagem. "Ensino: Processo da doença", "Contrato com o Paciente" e "Facilitação da Aprendizagem" estiveram presentes em 100% dos prontuários. Para essas, foram descritas 40 atividades, representando 13 atividades por intervenção prescrita. Conclusão: o mapeamento cruzado permitiu levantar os termos correspondentes às Intervenções de Enfermagem utilizados no cotidiano dos enfermeiros de reabilitação e compará-los ao sistema de Classificação das Intervenções de Enfermagem.

RESUMEN Objetivo: realizar el mapeo cruzado de términos del lenguaje de Enfermería con el Sistema de Clasificación de las Intervenciones de Enfermería en historias clínicas de pacientes con enfermedad de Parkinson en rehabilitación. Método: estudio de investigación documental para realización de mapeo cruzado. Muestra probabilística de tipo aleatoria simple, compuesta por 67 historias clínicas de pacientes con enfermedad de Parkinson que participaron del programa de rehabilitación entre marzo de 2009 y abril de 2013. Investigación realizada en tres etapas donde fueron mapeados los términos de Enfermería en lenguaje libre y cruzados con el sistemas de Clasificación de Intervenciones de Enfermería. Resultados: se identificaron 1077 intervenciones normalizadas que, después del cruzamiento con la taxonomía y el refinamiento hecho por los especialistas, resultaron en 32 intervenciones equivalentes al sistema de Clasificación de Intervenciones de Enfermería. "Enseñanza: Proceso de la enfermedad", "Contrato con el paciente" y "Facilitación del aprendizaje" estuvieron presentes en 100% de las historias clínicas. Para éstas, se describieron 40 actividades, representando 13 actividades por cada intervención prescripta. Conclusión: el mapeo cruzado permitió encontrar los términos correspondientes a las Intervenciones en Enfermería utilizados en el día a día de los enfermeros de rehabilitación y compararlos con el sistema de Clasificación de Intervenciones de Enfermería.

[Terms of international classification for Nursing Practice in motor and physical rehabilitation]. / Termos da Classificação Internacional para a Prática de Enfermagem em reabilitação físico-motora.

OBJECTIVE: To validate terms of nursing language especially for physical-motor rehabilitation and map them to the terms of ICNP(®) 2.0. METHOD: A methodology research based on document analysis, with collection and analysis of terms from 1,425 records. RESULTS: 825 terms were obtained after the methodological procedure, of which 226 had still not been included in the ICNP(®) 2.0. These terms were distributed as follows: 47 on the Focus axis; 15 on the Judgment axis; 31 on the Action axis; 25 on the Location axis; 102 on the Means axis; three on the Time axis; and three on the Client axis. All non-constant terms in ICNP(®) have been validated by experts, having reached an agreement index ≥0.80. CONCLUSION: The ICNP(®) is applicable and used in nursing care for physical-motor rehabilitation.

Terms of international classification for Nursing Practice in motor and physical rehabilitation / Términos de la Clasificación Internacional para la Práctica de Enfermería en Rehabilitación físico-motora / Termos da Classificação Internacional para a Prática de Enfermagem em reabilitação físico-motora

OBJECTIVE To validate terms of nursing language especially for physical-motor rehabilitation and map them to the terms of ICNP® 2.0. METHOD A methodology research based on document analysis, with collection and analysis of terms from 1,425 records. RESULTS 825 terms were obtained after the methodological procedure, of which 226 had still not been included in the ICNP® 2.0. These terms were distributed as follows: 47 on the Focus axis; 15 on the Judgment axis; 31 on the Action axis; 25 on the Location axis; 102 on the Means axis; three on the Time axis; and three on the Client axis. All non-constant terms in ICNP® have been validated by experts, having reached an agreement index ≥0.80. CONCLUSION The ICNP® is applicable and used in nursing care for physical-motor rehabilitation. .

OBJETIVO Validar los términos del lenguaje especial de enfermería en rehabilitación físico-motora y mapearlos con los términos de la CIPE® 2.0. MÉTODO Investigación metodológica basada en análisis documental, con recolección y análisis de términos de 1.425 fichas. RESULTADOS Después del procedimiento metodológico, fueron obtenidos 825 términos, de los que 226 todavía no figuraban en la CIPE® 2.0 y que fueron distribuidos de la siguiente manera: 47 en el eje foco; 15 en el eje juicio; 31 en el eje acción; 25 en el eje ubicación; 102 en el eje medios; tres en el eje tiempo; y tres en el eje cliente. Todos los términos no obrantes en la CIPE® fueron validados por los expertos, habiendo alcanzado índice de concordancia ≥ 0,80. CONCLUSIÓN La CIPE® es aplicable y utilizada en la asistencia de enfermería en rehabilitación físico-motora. .

OBJETIVO Validar os termos da linguagem especial de enfermagem em reabilitação físico-motora e mapeá-los com os termos da CIPE® 2.0. MÉTODO Pesquisa metodológica baseada em análise documental, com coleta e análise de termos de 1.425 prontuários. RESULTADOS Após o procedimento metodológico, obteve-se 825 termos, dos quais 226 ainda não constavam na CIPE® 2.0 e que foram assim distribuídos: 47 no eixo foco; 15 no eixo julgamento; 31 no eixo ação; 25 no eixo localização; 102 no eixo meios; três no eixo tempo; e três no eixo cliente. Todos os termos não constantes na CIPE® foram validados pelos especialistas, havendo atingido índice de concordância ≥ 0,80. CONCLUSÃO A CIPE® é aplicável e utilizada na assistência de enfermagem em reabilitação físico-motora. .

[Validation of nursing interventions for patients with spinal cord injury and impaired physical mobility]. / Validação de intervenções de enfermagem para pacientes com lesão medular e mobilidade física prejudicada.

This is a descriptive study that aimed to validate the nursing interventions proposed in the Nursing Interventions Classification for the diagnosis of Impaired physical mobility in adults with sequels of spinal cord injury, based on opinions of experts in rehabilitation about each intervention proposed. The sample consisted of 54 nurses who were asked about how they consider the interventions for the nursing diagnosis. A questionnaire was administered to nurses who work at the Sarah Network of Rehabilitation Hospitals. Among the 46 interventions studied, 17 (37%) were considered essential and should be implemented; others 15 (32.6%) were considered complementary, and 14 (30.4%) should not be used and could be discarded. Nursing interventions not described in the classification and suggested by 22 nurses (40.7%) were: Care with Orthoses: Maintenance; and Care with Orthoses: Prevention.

Validação de intervenções de enfermagem para pacientes com lesão medular e mobilidade física prejudicada / Validation of nursing interventions for patients with spinal cord injury and impaired physical mobility / Validación de intervenciones de enfermería para pacientes con lesiones de médula espinal y problemas de movilidad física

Estudo descritivo, que objetivou validar as intervenções propostas na Classificação das Intervenções de Enfermagem para o diagnóstico de Mobilidade física prejudicada em adultos com lesão medular, a partir das opiniões de enfermeiros experts em reabilitação. A amostra foi composta por 54 enfermeiros que foram questionados sobre o quanto julgavam essenciais as intervenções para a solução daquele diagnóstico. Um questionário foi aplicado junto aos enfermeiros que trabalham na Rede Sarah de Hospitais de Reabilitação. Dentre as 46 intervenções pesquisadas, 17 (37%) foram consideradas essenciais e deveriam ser implementadas; outras 15 (32,6%) foram consideradas complementares e 14 (30,4%) não deveriam ser utilizadas e poderiam ser descartadas. As intervenções de enfermagem não descritas na classificação e sugeridas por 22 enfermeiros (40,7%) foram: Cuidado com Órteses: Manutenção; e Cuidado com Órteses: Prevenção.

This is a descriptive study that aimed to validate the nursing interventions proposed in the Nursing Interventions Classification for the diagnosis of Impaired physical mobility in adults with sequels of spinal cord injury, based on opinions of experts in rehabilitation about each intervention proposed. The sample consisted of 54 nurses who were asked about how they consider the interventions for the nursing diagnosis. A questionnaire was administered to nurses who work at the Sarah Network of Rehabilitation Hospitals. Among the 46 interventions studied, 17 (37%) were considered essential and should be implemented; others 15 (32.6%) were considered complementary, and 14 (30.4%) should not be used and could be discarded. Nursing interventions not described in the classification and suggested by 22 nurses (40.7%) were: Care with Orthoses: Maintenance; and Care with Orthoses: Prevention.

Estudio descriptivo que tuvo como objetivo validar las intervenciones propuestas en la Clasificación de Intervenciones de enfermería para el diagnóstico de la Movilidad física disminuida en adultos con lesión de la médula espinal, según las opiniones de expertos en enfermería de rehabilitación. La muestra estuvo conformada por 54 enfermeras a quién se preguntó o que pensaban sobre las intervenciones esenciales para la solución de ese diagnóstico. Los datos fueron recogidos mediante un cuestionario aplicado a enfermeras que trabajan en la Red Sarah de Hospitales de Rehabilitación. Entre las 46 intervenciones estudiadas, 17 (37%) se consideran esenciales y deben ser implementadas, otras 15 (32,6%) fueron consideradas complementarias y 14 (30,4%) no se deben utilizar y podrían ser descartadas. Las intervenciones de enfermería no descritas en la clasificación y sugeridas por 22 enfermeras (40,7%) fueron las siguientes: Cuidado con Órteses: Manutención; y Cuidado con Órteses: Prevención.

[Autonomic dysreflexia and nursing interventions for patients with spinal cord injury]. / Disreflexia autonômica e intervenções de enfermagem para pacientes com lesão medular.

This retrospective study, performed in 2009, aimed to identify nursing diagnoses and interventions for the care of patients with spinal cord injury. Data were collected from the nursing records of 465 patients with SCI undergoing rehabilitation. The nursing diagnosis Risk for autonomic dysreflexia was identified in 271 clinical records (58, 3%). Approximately 80 patients developed autonomic dysreflexia, with a predominance in young men around 35.7 years old, who had experienced a trauma as the main cause of the injury. Their neurological injury level was at the sixth thoracic vertebra or above. Nursing interventions were arranged in two groups, one focused on prevention and the other on treatment. An intervention guide was developed and can be used by nurses in their clinical practice of rehabilitation and can be included into information systems. The removal of the stimulus which causes autonomic dysreflexia was identified as the most effective therapy and the best intervention.

Disreflexia autonômica e intervenções de enfermagem para pacientes com lesão medular / Autonomic dysreflexia and nursing interventions for patients with spinal cord injury / Disreflexia autonómica e intervenciones de enfermería para pacientes con lesión medular

O presente trabalho trata-se de estudo retrospectivo realizado em 2009 que objetivou identificar diagnósticos e intervenções de enfermagem para o cuidado de pacientes com lesão medular (LM). Os dados foram coletados de 465 prontuários de pacientes com LM em processo de reabilitação. Identificou-se o diagnóstico de enfermagem Risco para disreflexia autônomica em 271 (58,3%) prontuários, dos quais 80 pacientes desenvolveram disreflexia autônomica. Predominaram homens jovens, com idade média de 35,7 anos, sendo o trauma a principal causa da LM e o nível neurológico igual ou acima da sexta vértebra torácica. As intervenções de enfermagem foram organizadas em dois grupos, um voltado para a prevenção da disreflexia autonômica e outro, para seu tratamento. Desenvolveu-se um guia de intervenções para uso na prática clínica de enfermeiros reabilitadores e para inserção em sistemas de informação. Ressalta-se a importância da retirada do estímulo causador da disreflexia autonômica como terapêutica mais eficaz e como melhor intervenção na prática de enfermagem.

This retrospective study, performed in 2009, aimed to identify nursing diagnoses and interventions for the care of patients with spinal cord injury. Data were collected from the nursing records of 465 patients with SCI undergoing rehabilitation. The nursing diagnosis Risk for autonomic dysreflexia was identified in 271 clinical records (58, 3%). Approximately 80 patients developed autonomic dysreflexia, with a predominance in young men around 35.7 years old, who had experienced a trauma as the main cause of the injury. Their neurological injury level was at the sixth thoracic vertebra or above. Nursing interventions were arranged in two groups, one focused on prevention and the other on treatment. An intervention guide was developed and can be used by nurses in their clinical practice of rehabilitation and can be included into information systems. The removal of the stimulus which causes autonomic dysreflexia was identified as the most effective therapy and the best intervention.

Estudio retrospectivas realizado en 2009 objetivando identificar diagnósticos e intervenciones de enfermería para el cuidado del paciente con lesión medular (LM). Datos colectados de 465 historias clínicas de pacientes con LM en rehabilitación. Se identificó el diagnóstico de enfermería Riesgo para disreflexia autonómica en 271 (58,3%) historias clínicas; 80 de tales pacientes desarrollaron Disreflexia autonómica. Predominaron hombres jóvenes, media etaria de 35,7 años, constituyéndose el trauma como causa principal de LM y nivel neurológico igual o por sobre sexta vértebra torácica. Las intervenciones de enfermería se organizaron en dos grupos: uno orientado a prevención de la disreflexia autonómica y otro para su tratamiento. Se desarrolló una guía de intervenciones para uso en práctica clínica de enfermeros rehabilitadores y para incorporación a sistemas de información. Se destaca la importancia de retirar el estímulo que provoca la disreflexia autonómica como terapéutica más eficaz y como mejor intervención en la práctica de enfermería.

Analysis of the normative conditions of oral health, depression and serotonin-transporter-linked promoter region polymorphisms in an elderly population.

AIM: To investigate the association between depression, the normative conditions of oral health and serotonin-transporter-linked promoter region (5-HTTLPR) polymorphisms in a community-dwelling elderly sample. METHODS: Elderly adults living in a community (n=200) were submitted to an oral clinical examination. Depression was assessed using the 15-item Geriatric Depression Scale. The 5-HTTLPR was analyzed by polymerase chain reaction-restriction fragment length polymorphism. Associations between the biomarkers and clinical covariates were assessed by bivariate and multivariate statistical tests. Statistical significance was set at P<0.05. RESULTS: The prevalence of dental caries, periodontal disease, edentulism and oral mucosal lesions was 51.2%, 20.8%, 58.0% and 21.5%, respectively. The prevalence of depression was 21.5%. A higher frequency of the S allele was recorded in older individuals with depression (P=0.017). The present findings showed no significant association between depression and the normative conditions of oral health. The observed allelic polymorphisms were 44% S and 56% L, respectively. Genotypic variants were 33.5% LL, 45.0% SL and 21.5% SS. Individuals carrying the SS genotype showed a significantly high prevalence of periodontal disease (prevalence ratio=3.077, CI 95%=1.008-9.393, P=0.048). CONCLUSION: The present findings suggest that depressive community-dwelling older individuals did not show any association with alterations of oral health normative conditions. However, the SS genotypic polymorphic variant of 5-HTTLPR seems to contribute to the occurrence of periodontal disease in the elderly.

Nicotinic acid induces antinociceptive and anti-inflammatory effects in different experimental models.

Although in vitro studies have shown that nicotinic acid inhibits some aspects of the inflammatory response, a reduced number of in vivo studies have investigated this activity. To the best of our knowledge, the effects induced by nicotinic acid in models of nociceptive and inflammatory pain are not known. Per os (p.o.) administration of nicotinic acid (250, 500 or 1000 mg/kg, -1 h) inhibited the first and the second phases of the nociceptive response induced by formalin in mice. Nicotinic acid (250 or 500 mg/kg, -1 and 3 h) also inhibited the mechanical allodynia induced by carrageenan in rats, a model of inflammatory pain. However, in a model of nociceptive pain, exposure of mice to a hot-plate, nicotinic acid was devoid of activity. In addition to inhibiting the nociceptive response in models of inflammatory pain, nicotinic acid (250 or 500 mg/kg, p.o., -1 and 3 h) inhibited paw edema induced by carrageenan in mice and rats. Picolinic acid (62.5 or 125 mg/kg, p.o., -1 h), a nicotinic acid isomer, inhibited both phases of the nociceptive response induced by formalin, but not paw edema induced by carrageenan in mice. The other nicotinic acid isomer, isonicotinic acid, was devoid of activity in these two models. In conclusion, our results represent the first demonstration of the activity of nicotinic acid in experimental models of nociceptive and inflammatory pain and also provide further support to its anti-inflammatory activity. It is unlikely that conversion to nicotinamide represents an important mechanism to explain the antinociceptive and anti-inflammatory activities of nicotinic acid. The demonstration of new activities of nicotinic acid, a drug that has already been approved for clinical use and presents a positive safety record, may contribute to raise the interest in conducting clinical trials to investigate its usefulness in the treatment of painful and inflammatory diseases.

Antinociceptive and anti-inflammatory activities of nicotinamide and its isomers in different experimental models.

Although there is evidence for the anti-inflammatory activity of nicotinamide, there is no evaluation of its effects in models of nociceptive and inflammatory pain. In addition, there is no information about the potential anti-inflammatory and antinociceptive activities of the nicotinamide isomers, picolinamide and isonicotinamide. Per os (p.o.) administration of nicotinamide (1000 mg/kg, -1h) inhibited the first and second phases of the nociceptive response induced by formalin in mice. In the model of nociceptive pain, exposure of mice to a hot-plate (50°C), nicotinamide (1000 mg/kg, -1h) also presented antinociceptive activity. Nicotinamide (500 mg/kg, -1 and 3h) also inhibited the mechanical allodynia induced by carrageenan in rats, a model of inflammatory pain. In addition to inhibiting the nociceptive response, nicotinamide (500 or 1000 mg/kg, -1 and 3h) inhibited the paw edema induced by carrageenan in mice and rats. P.o. administration of picolinamide (125 mg/kg, -1h) and isonicotinamide (500 or 1000 mg/kg, -1h) inhibited the second phase of the nociceptive response induced by formalin in mice. The paw edema induced by carrageenan in mice was also inhibited by isonicotinamide (500 or 1000 mg/kg, -1h) and picolinamide (125 mg/kg, -1h and 3h). The results represent the first demonstration of the activity of nicotinamide and its isomers in models of nociceptive and inflammatory pain and provide support to their anti-inflammatory activity. The demonstration of new activities for nicotinamide is important as it may contribute to expand its use in the treatment of other pathological conditions.

Carbonyl oxides reactions from geraniol-trans-(3,7-dimethylocta-2,6-dien-1-ol), 6-methyl-5-hepten-2-one, and 6-hydroxy-4-methyl-4-hexenal ozonolysis: kinetics and mechanisms.

A density functional theory (DFT) study of the mechanisms of carbonyl oxide reactions from geraniol-trans, 6-methyl-5-hepten-2-one, and 6-hydroxy-4-methyl-4-hexenal ozonolysis is presented. The geometries, energies, and harmonic vibrational frequencies of each stationary point were determined by B3LYP/6-31(d,p) and BH&HLYP/cc-pVDZ methods. According to the calculations, the ozonolysis reactions are initiated by the formation of van der Waals (VDW) complexes to yield primary ozonides, which rapidly open to carbonyl oxide compounds. These carbonyl oxide compounds react to form dioxanes and hydroperoxides. The hydroperoxides react by isomerization to form stable products. Glyoxal and methyl-glyoxal have been identified as the final product from geraniol-trans, 6-methyl-5-hepten-2-one, and 6-hydroxy-4-methyl-4-hexenal ozonolysis. Our results are in good agreement with the experimental studies.