Gastric schwannoma: Two case reports and review of the literature.

Gastric schwannomas are rare, slow-growing tumors whose clinical presentation is nonspecific. These are mostly benign, with a low probability of malignant transformation and an excellent prognosis. We present 2 cases of gastric schwannomas with distinct clinical features and imaging patterns, whose therapeutic approach differed. Case 1 is a 73-year-old woman with a voluminous subepithelial lesion in the greater gastric curvature, with predominantly endoluminal growth. Clinically the patient presented with nonspecific abdominal complaints and underwent complete surgical excision. Case 2 is a 69-year-old woman with an exophytic lesion adjacent to the gastric antrum, diagnosed incidentally and managed conservatively, with imaging follow-up, for the last 5 years and stable ever since. This article aims to focus on this rare disease, illustrating its main imaging findings, particularly in magnetic resonance imaging, along with pathological correlation, as well as reviewing the literature, discussing the differential diagnosis, and exploring clinical management and prognosis.

Segurança do paciente: proposta de protocolo de enfermagem para avaliar e identificar riscos em unidade de urgência e emergência

Objetivo: relatar a experiência de elaboração de uma proposta de protocolo de enfermagem para avaliar e identificar riscos em unidade de urgência e emergência. Métodos: estudo do tipo relato de experiência, desenvolvido no contexto das aulas práticas supervisionadas do componente curricular Enfermagem em Urgência e Emergência, ministrado no Curso de Graduação em Enfermagem da Universidade do Estado do Pará, no segundo semestre de 2015. Aplicou-se a Metodologia da Problematização com o Arco de Maguerez, tendo como cenário um hospital de pronto-socorro do município de Belém, Pará, Brasil. Utilizando a classificação padronizada da North American Nursing Diagnosis Association, foram eleitos os diagnósticos de enfermagem "risco de choque", "risco de queda", "risco de aspiração" e "risco de infecção", por sua predominância observada entre os pacientes atendidos. Resultados: a proposta compunha-se de nove laudas e seis seções primárias: definições; finalidades; abrangência; justificativa; procedimentos operacionais para avaliar os riscos; e identificação dos riscos, cujo conteúdo foi normalizado segundo as orientações da Associação Brasileira de Normas Técnicas para trabalhos acadêmicos. A experiência corroborou ganhos multilaterais, pois contemplou os estudantes, os docentes e o cenário de prática. Considerações Finais: ancorado na Metodologia da Problematização, o processo ensino-aprendizagem conduziu os estudantes a adotarem, na sua prática diária, postura e atitude crítico-reflexivas em torno da segurança do paciente, da atuação da equipe de enfermagem e da educação em enfermagem.

Hepatic Actinomycosis Mimicking Malignancy After Pancreaticoduodenectomy: A Case Report.

Abdominal actinomycosis is a rare disease caused by a Gram-positive bacillus (Actinomyces). Liver manifestation is rare and, in patients with a history of cancer, differential diagnosis with secondary malignant disease can be difficult. Microbiological result is necessary for a correct diagnosis, though not always possible in preoperative workout. The authors present a case of hepatic actinomycosis that mimicked oncological disease and led to a more aggressive surgical approach.

Fatores associados ao enfrentamento da pandemia da COVID-19 por pessoas idosas com comorbidades / Factors associated with coping with the COVID-19 pandemic by older adults with comorbidities / Factores asociados al afrontamiento de la pandemia COVID-19 por adultos mayores con comorbilidades

Objetivo: identificar fatores associados ao enfrentamento da pandemia da COVID-19 por pessoas idosas com e sem comorbidades. Método: estudo descritivo, transversal, com pessoas idosas (n=569), entre 60 e 80 anos, com ou sem comorbidades, nas cinco regiões do Brasil. Coleta de dados com questionário virtual e análise com base na estatística descritiva e inferencial. Resultados: os resultados mostram que 351, (61,68%), referem comorbidade. Houve associação significativa entre os grupos nas variáveis: faixa etária (p=0,017), realizar alguma atividade laboral (p≤0,001), pensamento da possibilidade de ser infectado pelo novo coronavírus (p≤0,001), concordar com medidas de prevenção adotadas para o distanciamento social (p≤0,001), se informar por outro meio de comunicação além da televisão (p≤0,001). Conclusão e implicações para a prática: os idosos com comorbidades pensam na possibilidade de ser infectado pelo novo coronavírus, concordam mais com as medidas de distanciamento social e se informam mais. Nesse sentido, indica-se a realização de pesquisas com ênfase nos idosos sem comorbidade, para direcionar melhor os cuidados de saúde em tempos de pandemias

Objective: to identify factors associated to coping with the COVID-19 pandemic by older adults with and without comorbidities. Method: a descriptive, cross-sectional study with older adults (n=569), aged between 60 and 80 years old, with or without comorbidities, in the five Brazilian regions. Data collection with virtual questionnaire and analysis based on descriptive and inferential statistics. Results: the results show that 351 (61.68%) refer to comorbidity. There was a significant association between the groups in the following variables: age group (p=0.017), performing some work activity (p≤0.001), thinking about the possibility of being infected by the new coronavirus (p≤0.001), agreeing with prevention measures adopted for social distancing (p≤0.001), informing yourself by other means of communication besides television (p≤0.001). Conclusion and implications for the practice: the older adults with comorbidities think about the possibility of being infected by the new coronavirus, agree more with the social distancing measures and get more information. To such an effect, it is recommended to carry out research studies with an emphasis on the older adult without comorbidity, to better target health care in pandemic times

Objetivo: identificar factores asociados al afrontamiento de la pandemia COVID-19 en adultos mayores con y sin comorbilidades. Método: estudio descriptivo, transversal con personas mayores (n=569), entre 60 y 80 años, con o sin comorbilidades, en las cinco regiones de Brasil. La recolección de datos se realizó con cuestionario virtual y el análisis mediante estadística descriptiva e inferencial. Resultados: los resultados muestran que 351 personas, (61,68%), refieren a comorbilidades. Hubo asociación significativa entre grupos en las variables: grupo de edad (p=0,017), realizar alguna actividad laboral (p≤0,001), pensar en la posibilidad de estar infectado por el nuevo coronavirus (p≤0,001), acuerdo con las medidas preventivas adoptadas para el distanciamiento social (p≤0.001), informarse por otros medios de comunicación además de la televisión (p≤0.001). Conclusión e implicaciones para la práctica: los adultos mayores con comorbilidades piensan en la posibilidad de estar contagiados por el nuevo coronavirus, están más de acuerdo con las medidas de distanciamiento social y obtienen más información. En este sentido, se recomienda realizar una investigación con énfasis en los adultos mayores sin comorbilidades, para orientar mejor la atención sanitaria en tiempos de pandemia

Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report.

Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.

Coronary arterial development is regulated by a Dll4-Jag1-EphrinB2 signaling cascade.

Coronaries are essential for myocardial growth and heart function. Notch is crucial for mouse embryonic angiogenesis, but its role in coronary development remains uncertain. We show Jag1, Dll4 and activated Notch1 receptor expression in sinus venosus (SV) endocardium. Endocardial Jag1 removal blocks SV capillary sprouting, while Dll4 inactivation stimulates excessive capillary growth, suggesting that ligand antagonism regulates coronary primary plexus formation. Later endothelial ligand removal, or forced expression of Dll4 or the glycosyltransferase Mfng, blocks coronary plexus remodeling, arterial differentiation, and perivascular cell maturation. Endocardial deletion of Efnb2 phenocopies the coronary arterial defects of Notch mutants. Angiogenic rescue experiments in ventricular explants, or in primary human endothelial cells, indicate that EphrinB2 is a critical effector of antagonistic Dll4 and Jag1 functions in arterial morphogenesis. Thus, coronary arterial precursors are specified in the SV prior to primary coronary plexus formation and subsequent arterial differentiation depends on a Dll4-Jag1-EphrinB2 signaling cascade.

Epidemiology of hepatitis B virus infection in people living in poverty in the central-west region of Brazil.

BACKGROUND: People living in poverty (PLP) are highly vulnerable to hepatitis B virus (HBV) infection. This study aimed to investigate the epidemiology of HBV infection in PLP in the metropolitan region of Goiânia, Goiás State, in the Central-West Region of Brazil. METHODS: A cross-sectional study was conducted from August to December 2016 in adults aged ≥12 years living in poverty. The following serological markers for HBV were investigated: hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (total anti-HBc), IgM anti-HBc, and hepatitis B surface antibody (anti-HBs), which were detected by enzyme-linked immunosorbent assay (ELISA). Poisson regression analysis with robust variance was performed to verify the factors associated with HBV exposure. RESULTS: The study included 378 participants. The overall prevalence rate of HBV (any viral marker) was 9.8% (95% confidence interval [CI], 7.2-13.2). The prevalence rate of HBsAg in combination with total anti-HBc was 0.8% (95% CI, 0.3-2.4), total anti-HBc in combination with anti-HBs was 7.7% (95% CI, 5.4-10.9), and total anti-HBc alone was 1.3% (95% CI, 0.5-3.0) in the population. Furthermore, isolated positivity for anti-HBs was identified in only 25.4% (95% CI, 21.3-30.0) of the participants. Multiple regression analysis revealed that age (adjusted prevalence ratio [APR], 1.04; 95% CI, 1.01-1.07), female sex (APR, 2.18; 95% CI, 1.01-4.73), sexual intercourse under the influence of alcohol (APR, 2.49; 95% CI, 1.36-7.06), and exposure to Treponema pallidum (APR, 3.10; 95% CI, 1.36-7.06) were associated with HBV exposure. CONCLUSION: There was a high prevalence of HBV exposure in PLP in the Central-West Region of Brazil, indicating significant viral spread of the infection. Additionally, there was low serological evidence of immunisation against hepatitis B, indicating that a large proportion of the participants in this study are susceptible to the infection. The results support the need for public health policies that facilitate access to the existing healthcare services in hard-to-reach groups with special regard to immunisation programmes against hepatitis B.

NEW BOWEL PREPARATION TECHNIQUE FOR COLONOSCOPY: CLINICAL TRIAL COMPARING AQUANET AND MANNITOL.

BACKGROUND: Fifty-five percent of Americans aged 50-65 are submitted to colonoscopy. For over 65-year, this number increases to 64%. In Brazil, it is forecast that the population submitted to colonoscopy will grow, even though inadequate preparation is still a major problem. AIM: To analyze the quality of a new intestinal preparation technique, Aquanet EC-2000®, compared to oral Mannitol solution. METHODS: This prospective longitudinal study enrolled 200 patients with indication for colonoscopy. The sample was randomly allocated to two groups of 100; one group received Aquanet EC-2000® to prepare for colonoscopy and the other Mannitol solution. The Boston scale was used to analyze the results. RESULTS: As expected both preparations produced similar results with the bowel cleansing of the different regions of the colon being classified as Boston scale 3 (excellent) in most patients (p>0.05). CONCLUSION: The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.

New bowel preparation technique for colonoscopy: clinical trial comparing aquanet and mannitol / Nova técnica de preparo intestinal para colonoscopia: estudo clínico comparativo entre aquanet e manitol

ABSTRACT Background: Fifty-five percent of Americans aged 50-65 are submitted to colonoscopy. For over 65-year, this number increases to 64%. In Brazil, it is forecast that the population submitted to colonoscopy will grow, even though inadequate preparation is still a major problem. Aim: To analyze the quality of a new intestinal preparation technique, Aquanet EC-2000®, compared to oral Mannitol solution. Methods: This prospective longitudinal study enrolled 200 patients with indication for colonoscopy. The sample was randomly allocated to two groups of 100; one group received Aquanet EC-2000® to prepare for colonoscopy and the other Mannitol solution. The Boston scale was used to analyze the results. Results: As expected both preparations produced similar results with the bowel cleansing of the different regions of the colon being classified as Boston scale 3 (excellent) in most patients (p>0.05). Conclusion: The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.

RESUMO Racional: Cinquenta e cinco por cento dos norte-americanos entre 50-65 anos fazem colonoscopia. Acima de 65 anos o número foi de 64%. No Brasil, estima-se crescente aumento da população submetida à colonoscopia, apesar da preparação inadequada ainda ser um grande problema. Objetivo: Analisar e comparar a qualidade do novo método de preparo intestinal por meio do Aquanet EC-2000® frente ao uso de solução oral de Manitol. Método: Por randomização 200 pacientes foram divididos em dois grupos de 100. Um recebeu Aquanet EC-2000® e o outro Manitol. O presente estudo seguiu modelo prospectivo longitudinal por meio da seleção de 200 pacientes com indicação à colonoscopia, formando dois grupos de 100. Para analisar os resultados foi utilizada a escala de Boston. Resultados: Ambos os preparos foram estatisticamente significativos com p<0,05. A escala 3 de Boston foi a mais frequente para ambos os métodos.Além disso, na estatística aplicada às diferentes regiões do cólon para ambos os procedimentos as proporções observadas concordaram com o esperado (3-excelente). Conclusão: Os resultados do preparo intestinal utilizando Aquanet EC-2000® foram semelhantes aos do Manitol.

Experiências de uma ONG na promoção de direitos e saúde trans em São Paulo / Experiences of a NGO with promoting trans rights and health care in São Paulo

Este artigo procura expor as ações realizadas pelo Instituto Cultural Barong junto à transexuais, visando à promoção de seus direitos, incluindo o de saúde e prevenção de IST/HIV. São relatadas as estratégias de promoção de informações por meio do desenvolvimento de materiais educativos, exposições, ações de campo e inclusive cursos produzidos para este público, procurando atender suas necessidades, locais de circulação de trabalho ou sociabilidade, linguagem e demandas. As estratégias foram consideradas de sucesso pela sua adesão e receptividade comprovada no público e ambientes integrados.

Hematopoietic stem cell transplantation in a severe refractory Crohn's disease patient with intestinal stoma: a case report.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) can be used in the treatment of patients with refractory Crohn's disease (CD) when no alternative treatment is available. However, HSCT increases the risk of infections, in particular during the aplasia of mobilization and conditioning. Moreover, intestinal stomas in CD augment the risk of morbidity in immunocompromised patients and under aplastic conditions. The objective of this report was to describe the results of the first year after HSCT in a CD patient with an intestinal stoma. METHODS: The patient was assessed in respect to disease symptoms and endoscopic findings before the procedure and 30, 90, 180, and 365 days after HSCT. RESULTS: No complications were observed during mobilization and conditioning with sufficient CD34+ cells being harvested in just one apheresis session. Toxicity was restricted to the hematological series. Scores of all the CD indexes and the quality of life of the patient improved. However, two of three endoscopic scores remained unchanged even though improvements were found in the appearance of the lesions. CONCLUSION: HSCT may be an alternative treatment for refractory CD in patients with an intestinal stoma, and a priori, carefully selected patients with stomas should not be excluded as candidates for this procedure.

Qualifying information on deaths and serious injuries caused by road traffic in five Brazilian capitals using record linkage.

INTRODUCTION: Road traffic crashes (RTC) are an important public health problem, accounting for 1.2 million deaths per year worldwide. In Brazil, approximately 40,000 deaths caused by RTC occur every year, with different trends in the Federal Units. However, these figures may be even greater if health databases are linked to police records. In addition, the linkage procedure would make it possible to qualify information from the health and police databases, improving the quality of the data regarding underlying cause of death, cause of injury in hospital records, and injury severity. OBJECTIVE: This study linked different data sources to measure the numbers of deaths and serious injuries and to estimate the percentage of corrections regarding the underlying cause of death, cause of injury, and the severity injury in victims in matched pairs from record linkage in five representative state capitals of the five macro-regions of Brazil. METHODS: This cross-sectional, population-based study used data from the Hospital Information System (HIS), Mortality Information System (MIS), and Police Road Traffic database of Belo Horizonte, Campo Grande, Curitiba, Palmas, and Teresina, for the year 2013 for Teresina, and 2012 for the other capitals. RecLink III was used to perform probabilistic record linkage by identifying matched pairs to calculate the global correction percentage of the underlying cause of death, the circumstance that caused the road traffic injury, and the injury severity of the victims in the police database. RESULTS: There was a change in the cause of injury in the HIS, with an overall percentage of correction estimated at 24.4% for Belo Horizonte, 96.9% for Campo Grande, 100.0% for Palmas, and 33.2% for Teresina. The overall percentages of correction of the underlying cause of death in the MIS were 29.9%, 11.9%, 4.2%, and 33.5% for Belo Horizonte, Campo Grande, Curitiba, and Teresina, respectively. The correction of the classification of injury severity in police database were 100.0% for Belo Horizonte and Teresina, 48.0% for Campo Grande, and 51.4% for Palmas after linkage with hospital database. The linkage between mortality and police database found a percentage of correction of 29.5%, 52.3%, 4.4%, 74.3 and 72.9% for Belo Horizonte, Campo Grande, Palmas, Curitiba and Teresina, respectively in the police records. CONCLUSIONS: The results showed the importance of linking records of the health and police databases for estimating the quality of data on road traffic injuries and the victims in the five capital cities studied. The true causes of death and degrees of severity of the injuries caused by RTC are underestimated in the absence of integration of health and police databases. Thus, it is necessary to define national rules and standards of integration between health and traffic databases in national and state levels in Brazil.

Dental enamel as biomarker for environmental contaminants in relevant industrialized estuary areas in São Paulo, Brazil.

Heavy metal contamination is a long-standing and very well-known public health problem, and its exposure can cause damage to several organs of human body, especially on the central nervous system of young children and teenagers. The aim of this article is to evaluate lead, cadmium, and manganese contamination in 125 children from 6 to 13 years old living in contaminated areas during the period from 2006 to 2009 (São Vicente, Cubatão Downtown, Bertioga and Cubatão Pilões/Água Fria). This estuary area is the most important example of environmental degradation by chemicals from industrial sources. This is a cross-sectional study through clinical examinations and dental enamel tests. All mothers from these children lived in the area since before the pregnancy. Lead, cadmium, and manganese levels (µg/g) were measured on dental enamel samples through graphite furnace atomic absorption spectrometry, searching for the occurrence of heavy metals. The mean lead concentrations were 139.48 µg/g in Cubatão Pilões/Água Fria, 170.45 µg/g in Cubatão Downtown, 213.52 µg/g in São Vicente, and 151.89 µg/g in Bertioga. The mean cadmium concentrations were 10.83 µg/g in Cubatão Pilões/Água Fria, 12.58 µg/g in Cubatão Downtown, 10.92 µg/g in São Vicente, and 14.57 µg/g in Bertioga. The mean manganese concentrations were 23.49 µg/g in Cubatão Pilões/Água Fria, 30.90 µg/g in Cubatão Downtown, 41.46 µg/g in São Vicente, and 42.00 µg/g in Bertioga. Dental surface enamel may be used as an efficient biomarker of past environmental exposure to lead, manganese, and cadmium which are associated to well-known sources of heavy metal contamination. The results suggest that the evaluated children were exposed to sources of lead, cadmium, and manganese since before their conceptions. Although Bertioga initially was chosen as a control area of this study, it was also was verified to have heavy metal contamination on examined children.

Analysis of poultry transit, notification systems and legislation in the state of Sergipe, 2008-2012 / Análise do trânsito de aves, dos sistemas de notificação e da legislação no estado de Sergipe entre 2008 e 2012

The purpose of this study was to assess the transit of poultry, as well as the inspection on the outbreak of diseases, by addressing the issues concerning the system of the National Program on Poultry Sanity and its legal resolutions. The data on the animal transportation and the occurrence of the diseases were collected from the official services. A legislation-based assessment was also carried out for the period from 2008 to 2012 in the state of Sergipe, Brazil. Results showed an intense transit of poultry in just about all towns of the state in the period under study, especially in chicken farms where less number of poultry is bred: from 5,000 to 15,000. Besides, 64% of poultry transportation was found to be intermunicipal. The state of Sergipe has received poultry particularly from the states of Pernambuco (49.87%), Bahia (20.85%), Minas Gerais (5.94%), Paraíba (5.16%), and Goiás (5.05%). The number of transit indicates an increase in transit over the years. In addition, three of six municipalities which saw these diseases (Estância, São Cristóvão and Itaporanga d'Ajuda) are responsible for a great part of the poultry transit. Results also showed that the majority of activities of the State Program on Poultry Sanity would be carried out in the municipalities where a larger poultry marketing flow takes place, thereby seeking to record a greater number of notifications on the diseases and, then, carry out the surveillance activities. Therefore, regarding the poultry transit, it is recommended to do a mapping of the risk regions for poultry diseases, as well as studies about the epidemiological characterization of the municipalities of the state of Sergipe.(AU)

O objetivo deste estudo foi avaliar o trânsito de aves, sua fiscalização e o surgimento de enfermidades, abordando questões referentes ao sistema do Programa Nacional de Sanidade Avícola e suas determinações legais. Dessa forma, compilaram-se dados do serviço oficial sobre o trânsito dos animais e a ocorrência de doenças, realizando-se também uma avaliação da legislação vigente entre 2008 e 2012, no estado do Sergipe. Observou-se no período averiguado um intenso trânsito de aves em quase toda a totalidade dos municípios, principalmente entre granjas que alojam pequenas quantidades de aves (5.000 a 15.000), e 64% do total do transporte de aves ocorreu entre municípios do Estado. Os estados fornecedores de aves para Sergipe foram sobretudo Pernambuco (49,87%), Bahia (20,85%), Minas Gerais (5,94%), Paraíba (5,16%) e Goiás (5,05%). O número de guias de trânsito emitidas aponta um crescimento do trânsito ao longo dos anos. Verificaram-se que três municípios (Estância, São Cristóvão e Itaporanga d'Ajuda), dos seis acometidos por enfermidades, são aqueles responsáveis por grande parte do trânsito realizado. O estudo mostrou que para os municípios sergipanos, nos quais acontece maior fluxo de comercialização avícola, seriam indicadas mais das ações do Programa Estadual de Sanidade Avícola, com a finalidade de registrar maior número de notificações de enfermidades e, consequentemente, exercer ações de vigilância. Assim, quanto ao trânsito animal, recomendam-se a adoção de um mapeamento das regiões de risco sanitário para as enfermidades de aves e a realização de estudos sobre a caracterização epidemiológica dos municípios de Sergipe.(AU)

Playing in hospital toy libraries: support for childrenand their families / O Brincar nas brinquedotecas hospitalares: apoio às criançase suas famílias / Jugando en hospitales, ludotecas: atención a niños y sus familias

This article focuses on the contribution of hospital toy libraries as playingsupport for children and their families. It refers to empirical studies which demonstratethe relationship between play and development, health and well-being of the child. Itpoints out to the large negative impact that poverty brings to health and the seriousconsequences with health problems, and refers to the contribution of the public andprivate toy libraries in the support of families, providing healthy living spaces, lendingtoys, promoting educational support to children and professional training courses forparents. The article emphasizes the mind-body dynamic integration and the benefit ofplay for sick and hospitalized children and their adherence to treatment, since thehospitalization experience, alongside with being sick with any pathology, is a crisis situationfor children and their parents. It brings international data on research and experiencereports about toy libraries in pediatric healthcare environments and their support forchildren and their families. There is also a brief description about the Brazilian experiencewith toy libraries in public and private healthcare environment areas, and its low butcontinuing growth(AU)

Este artigo aborda a contribuição das brinquedotecas hospitalares comosuporte às crianças e suas famílias, através do brincar. Refere-se a estudos e pesquisasque demonstram a relação entre o brincar e desenvolvimento, à saúde e o bem-estarinfantil. Destaca o grande impacto negativo que a pobreza traz à saúde e às sériasconsequências a problemas de saúde e, nesse sentido, a contribuição que asbrinquedotecas, públicas e particulares, vem dando suporte às famílias, disponibilizandoespaços saudáveis de convivência, emprestando brinquedos, promovendo apoio escolaràs crianças e cursos de formação profissional para pais. O artigo enfatiza a integraçãodinâmica corpo-mente e o benefício do brincar para crianças doentes e hospitalizadase sua aderência ao tratamento, uma vez que a experiência da hospitalização, além doestarem doente conduz a, uma situação crítica para ela e para a sua família. Refere-se a pesquisas e experiências internacionais sobre brinquedotecas em ambientes de saúde e sua contribuição para crianças e familiares. Descreve brevemente a experiênciabrasileira das brinquedotecas da área da saúde, públicas e privadas em sua lenta,masascendente trajetória(AU)

Este artículo analiza la contribución de las ludotecas hospitalarias comoapoyo a los niños y sus familias, a través del juego. Considera varios estudios einvestigaciones que demuestran la relación entre el juego y el desarrollo, la salud y elbienestar del niño. Se destaca el gran impacto negativo de la pobreza sobre salud , enespecial en los niños, así como la contribución de las ludotecas públicas y privadas enrelación al apoyo de las familias, proporcionando espacios de convivencia saludables,préstamo de juguetes, promoviendo el apoyo escolar para niños, así como cursos deformación profesional para los padres. El artículo pone de relieve la integración dinámicacuerpo-mente y los beneficios del jugar para niños enfermos y hospitalizados, asícomo la influencia en la adherencia al tratamiento, una vez que la experiencia de lahospitalización además del estar enfermo, lleva a una situación crítica para el niño ypara su familia. Se considera las investigaciones y las experiencias internacionalessobre las ludotecas en ambientes de salud y su contribución en los niños y sus familias.Describe brevemente la experiencia brasileña de ludotecas en el área de la salud enambientes públicos y privados y su lenta pero ascendente tendencia(AU)

O Brincar como instrumento de resgate do cotidiano da criança hospitalizada / Play as an instrument for redeeming the day-to-day of a hospitalized child / El jugar como rescate del cotidiano del niño hospitalizado

O artigo analisa o cotidiano e o funcionamento de uma brinquedoteca emhospital pediátrico de uma cidade de médio porte do Paraná frente a possíveis relaçõesde poder existentes no ambiente hospitalar em questão. Segundo de Foucault e Certeauo cotidiano é compreendido como espaço onde os micro poderes são, ao mesmo tempo,exercidos e burlados pelos sujeitos. A pesquisa é de natureza qualitativa e a metodologiaadotada é o Estudo de Caso. É realizada a triangulação de técnicas e fontes sendo elasa observação de campo, a realização de entrevistas a análise documental. Os dadosrevelam que o espaço e o tempo do hospital são marcados pelas exigências médicas e aexistência da brinquedoteca passa ainda por um tenso processo para ser totalmenteaceita e reconhecida. A brinquedoteca tem contribuído por meio do livre brincar e deoutras modalidades expressivas para que as crianças resgatem atividades de seu dia-adia,exerçam seu direito de expressão, escolha e convivência com outras crianças,assim como para que os pais vivenciem o período da hospitalização de forma maispositiva. A constatação pelas equipes de saúde da importância da brinquedoteca para obem estar emocional e físico das crianças tem contribuído para o reconhecimento daimportância do espaço e do tempo de Brincar para a recuperação da Saúde e a adesãoao tratamento, o que nos remete à importância dos sujeitos que atuam no cotidiano emquestão para conseguir que este se torne mais flexível e socializado(AU)

The article analyzes the everyday and the functioning of a pediatric hospitaltoy library in a midsize city of Paraná facing possible power relations existing in thehospital environment in question. According to Foucault and Certeau, the everyday isunderstood as a space where the micro powers are, at the same time, exercised andteased by the subjects. This research is qualitative in nature and the methodologyadopted is the Case Study. A triangulation of techniques is used, as well as sources such as field observation, conducting interviews and documentary analysis. The datashow that space and time in the hospital are marked by medical requirements, and theexistence of a toy library is still undergoing a tense process in order to become entirelyaccepted and recognized. The toy library has contributed through free play and otherexpressive modalities for children to redeem their day-to-day activities, exercise theirright of expression, choice and coexistence with other children, and for parents toexperience the hospitalization period more positively. The verification by the healthstaff of the importance of the toy library for the emotional and physical well-being ofchildren has contributed to the recognition of the importance of space and time forplaying, for the recovery of health and treatment adherence which points to to theimportance of the subjects who act in the everyday at issue so it may become moreflexible and socialized(AU)

Este trabajo analiza el funcionamiento y la cotidianidad de una ludotecaubicada en un hospital pediátrico de una ciudad de porte medio del estado de Paranáfrente a posibles relaciones de poder en la institución. Segundo de Foucault y Certeause entiende cotidianidad como un espacio en el cual los micro poderes son al mismotiempo ejercidos y eludidos por los sujetos. La investigación es de carácter cualitativoy la metodología adoptada es el estudio de caso. Es realizado a través del cruzamientode técnicas y fuentes tales como la observación de campo, realización de entrevistasy análisis de documentos. Los datos muestran que el espacio y el tiempo en el hospitalestán marcados por las necesidades médicas y la existencia de una ludoteca aun estápasando por un proceso complejo para ser aceptada y reconocida plenamente. Laludoteca ha contribuido a través del juego libre y otras modalidades expresivas paraque los niños rescaten sus actividades del día a día, ejersan su derecho de la expresión,la elección y la convivencia con otros niños. Para que los padres experimenten elperíodo hospitalización de manera más positiva. El hallazgo por parte de los equiposde la salud sobre la importancia de la ludoteca para el bienestar emocional y físico delos niños ha contribuido al reconocimiento de la importancia del espacio y el tiempo dereproducción para la recuperación de la salud y la adherencia al tratamiento.Eso llevaa la importancia de las personas que actúan en el cotidiano referido para conseguirque este elemento sea más flexible y socializado(AU)

Depressão, ansiedade e suporte social em profissionais de enfermagem / Depression, anxiety and social support in nursing professionals

Esta pesquisa investiga a correlação entre depressão e ansiedade e a percepção de suporte social em 39 profissionais de enfermagem. Utilizou-se a Escala Beck de Depressão, (BDI), o Inventário Beck de Ansiedade, (BAI), a Escala de Percepção de Suporte Social, (EPSS) e um questionário sociodemográfico clínico. Os dados revelaram sintomas leves de ansiedade em 15% e depressão em 18% dos participantes e escore médio de percepção de suporte social emocional de 2,61 (DP = 0,78), e suporte prático de 2,28 (DP = 0,69). Constatou-se correlação significante positiva entre os dados da BAI e do BDI e negativa entre os da EPSS e da BAI, entre a EPSS e o BDI Total e o BDI S1 (e entre a EPSS Prático e o BDI Total e BDI S1. Os resultados sugerem que a percepção de suporte social tenha efeitos mediadores na proteção de saúde, frente às condições adversas de trabalho do profissional de enfermagem.(AU)

This research investigates the correlation between anxiety and depression levels and the perception of social support in 39 nursing professionals. The Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI); the Perceived Social Support Scale (EPSS) and a socio-demographic-clinical questionnaire were applied. Data indicated anxiety symptoms in 15% and depression in 18% of the participants, an average score of emotional social support perception 2.61 (DP=0.78), and practical support of 2.28 (DP=0.69). A significant positive relation was verified between the scores BAI and BDI, and negative between EPSS and BAI, between EPSS and the total BDI and BDI S1, and between Practical EPSS and the total BDI and BDI S1. Results indicate that the perception of social support has mediating effects in health protection, against possible adverse working conditions of the nursing professional.(AU)

Depressão, ansiedade e suporte social em profissionais de enfermagem / Depression, anxiety and social support in nursing professionals

Esta pesquisa investiga a correlação entre depressão e ansiedade e a percepção de suporte social em 39 profissionais de enfermagem. Utilizou-se a Escala Beck de Depressão, (BDI), o Inventário Beck de Ansiedade, (BAI), a Escala de Percepção de Suporte Social, (EPSS) e um questionário sociodemográfico clínico. Os dados revelaram sintomas leves de ansiedade em 15% e depressão em 18% dos participantes e escore médio de percepção de suporte social emocional de 2,61 (DP = 0,78), e suporte prático de 2,28 (DP = 0,69). Constatou-se correlação significante positiva entre os dados da BAI e do BDI e negativa entre os da EPSS e da BAI, entre a EPSS e o BDI Total e o BDI S1 (e entre a EPSS Prático e o BDI Total e BDI S1. Os resultados sugerem que a percepção de suporte social tenha efeitos mediadores na proteção de saúde, frente às condições adversas de trabalho do profissional de enfermagem...

This research investigates the correlation between anxiety and depression levels and the perception of social support in 39 nursing professionals. The Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI); the Perceived Social Support Scale (EPSS) and a socio-demographic-clinical questionnaire were applied. Data indicated anxiety symptoms in 15% and depression in 18% of the participants, an average score of emotional social support perception 2.61 (DP=0.78), and practical support of 2.28 (DP=0.69). A significant positive relation was verified between the scores BAI and BDI, and negative between EPSS and BAI, between EPSS and the total BDI and BDI S1, and between Practical EPSS and the total BDI and BDI S1. Results indicate that the perception of social support has mediating effects in health protection, against possible adverse working conditions of the nursing professional...