Effects of vitamin D levels during pregnancy on prematurity: a systematic review protocol.

INTRODUCTION: Prematurity is an urgent public health problem worldwide. Recent studies associate maternal hypovitaminosis D during pregnancy with an increased risk of prematurity. However, the evidence on this association remains inconclusive, and there is lack of consensus in the literature. The exact mechanism by which low vitamin D levels may increase the risk of preterm birth is not yet fully understood. Nevertheless, it is known that vitamin D may play a role in maintaining a healthy pregnancy by regulating inflammation and immunomodulation by acting on the maternal and fetal immune systems. Inflammation and immune dysregulation are both associated with preterm birth, and low vitamin D levels may exacerbate these processes. The results of this review may have important implications for clinical practice and public health policy, particularly regarding vitamin D supplementation during pregnancy. METHODS AND ANALYSIS: A systematic review of the literature will be conducted. The search will be performed in electronic databases: CINAHL; MEDLINE; Cochrane Central Register of Controlled Trials; Cochrane Library; Academic Search Complete; Information Science and Technology Abstracts; MedicLatina; SCOPUS; PubMed; and Google Scholar, with the chronological range of January 2018 to November 2022. The search strategy will include the following Medical Subject Headings or similar terms: 'Vitamin D'; '25-hydroxyvitamin D'; 'Hypovitaminosis D'; 'Pregnancy'; 'Pregnant women'; 'Expectant mother'; 'Prematurity'; 'Premature birth'; 'Premature delivery'; 'Preterm birth'; and 'Preterm labour'. This review will include quantitative primary studies, both experimental (clinical trials) and observational (cohort, cross-sectional, and case-control). The quality of each selected study and the results obtained will be assessed by two reviewers separately, using the Cochrane risk of bias tool for evaluating randomised clinical trials or the Newcastle Ottawa Scale for non-randomised studies, following the respective checklist. In case of disagreement, a third reviewer will be consulted. ETHICS AND DISSEMINATION: This study does not involve human subjects and therefore does not require ethics approval. The results will be disseminated through publication in a peer-reviewed scientific journal and through conference presentations. All changes made to the protocol will be registered in PROSPERO, with information on the nature and justification for the changes made. PROSPERO REGISTRATION NUMBER: CRD42022303901.

C-Reactive Protein Is Associated with Physical Fitness in Breast Cancer Survivors.

Background: Physical fitness (PF) is an expression of the physiological functioning of multiple body components. PF is an important prognostic factor in terms of cardiovascular mortality, cancer mortality, and all-cause mortality. PF has been related to some biomarkers in the general population but not in breast cancer survivors (BCS). Purpose: To evaluate the effects of PF on biomarkers potentially related to physical activity (PA) in a sample of BCS. Methods: Cross-sectional study. A total of 84 BCS (mean age 54) who had finished their treatment were recruited. Different components of PF were evaluated, namely body composition (anthropometry), cardiorespiratory fitness (one-mile walk test), muscular (handgrip and sit-to-stand timed test), and motor (gait speed) components. Sexual hormones, inflammation, and insulin resistance biomarkers were measured. Results: C-Reactive Protein (CRP) was associated with every component of physical fitness: cardiorespiratory fitness (p-value = 0.002), muscular (sit-to-stand timed test, p-value = 0.002) and motor (gait speed, p-value = 0.004) components, and body composition (body mass index, p-value = 0.003; waist, p-value < 0.000; and waist-to-hip index, p-value = 0.012). CRP also was associated with "poor physical condition," a constructed variable that encompasses all components of physical fitness (p-value < 0.001). Insulin was associated with cardiorespiratory fitness and gait speed (p-values = 0.002 and 0.024, respectively). Insulin-like Growth Factor-1 was negatively associated with waist perimeter and waist-to-hip ratio. Conclusions: CRP can also be considered an indicator of poor PF in BCS. Implications for cancer survivors: in case of elevation of CRP indicating cardiovascular risk, health professionals should recommend lifestyle changes to improve BCS physical condition.

Prevalence and correlates of cancer-related fatigue in breast cancer survivors.

PURPOSE: To identify potential correlates of cancer-related fatigue (CRF) after curative breast cancer (BC) treatment. The hypothesis was that fatigue would be more severe among women treated with cardiotoxic drugs, with poor physical condition and those who exercised less. METHODS: Observational cross-sectional design. Fatigue was evaluated through PERFORM Questionnaire (multi-item, multi-dimensional). Patient-reported assessments and objective information regarding clinical data, physical activity (PA) and physical condition were analysed as potential correlates of CRF. RESULTS: One hundred eighty women who remained free of disease were recruited. The prevalence of fatigue interfering with quality of life was 43%. Weight, resting and recovery heart rate were positively associated with fatigue. Age and time from diagnosis were negatively associated. Previous therapies, objectively assessed weekly PA, cardiorespiratory condition, muscular strength and adherence to Mediterranean diet were not associated with CRF. CONCLUSIONS: CRF is a prevalent problem after BC treatment. Objectively assessed PA, cardiorespiratory fitness and muscular strength did not predict CRF. The association of heart rate and fatigue deserves a further insight. Future research should include longitudinal studies and determination of biomarkers. IMPLICATIONS FOR CANCER SURVIVORS: BC survivors, especially younger and overweight women, should be informed about fatigue as a potential persistent symptom through all stages of the cancer trajectory and into survivorship. They also should be routinely screened for CRF.

Cancer-related Fatigue in Breast Cancer Survivors: A Review.

Fatigue has been the most distressing and frequent symptom in breast cancer (BC) survivors after treatment. Although fatigue can occur in other cancer survivors, women with a history of BC might share some distinctive features. The present study aimed to recapitulate the knowledge about risk factors and correlates of cancer-related fatigue (CRF) in BC survivors after oncologic therapy. An electronic data search was conducted in PubMed using the terms "fatigue," "breast," "cancer," and "survivors." Records were included if they were original articles, available in English, had used a quantitative scale, had > 100 participants, and had excluded women with BC relapse. BC survivors were required to have finished their treatments ≥ 2 months before, except for hormonal therapy. The physiopathology and other interventions were considered beyond the scope of our review. The correlates were subsequently classified into 7 main categories: (1) sociodemographic data, (2) physical variables, (3) tumor- and treatment-related variables, (4) comorbidities, (5) other symptoms, (6) psychological issues, and (7) lifestyle factors. Fatigue was consistently greater in younger, obese, and diabetic women. Women reporting fatigue often communicated symptoms such as pain, depression, insomnia, and cognitive dysfunction. Coping strategies such as catastrophizing could play an important role in the persistence of fatigue. However, tumor characteristics, previous treatments received, and physical activity were not consistently reported. CRF was a strong predictor of the quality of life of BC survivors after treatment. In conclusion, we found CRF was a frequent and serious symptom that severely affects the quality of life of BC survivors after treatment. Health practitioners require more awareness and information about CRF.

Sepsis neonatal em díade mãe-filho de minoria étnica: estudo de caso / Sepsis neonatal en el binomio madre-hijo de minoría étnica: estudio de caso / Neonatal sepsis in mother-child dyad of ethnic minority: a case study

Resumo Objetivo Este trabalho objetivou descrever os diagnósticos e as intervenções de enfermagem na díade mãe-filho coerentes com a situação sepsis neonatal aplicando-se a taxonomia NANDA-I. Métodos trata-se de uma pesquisa do tipo de estudo de caso, realizada com recém-nascido internado às 72h de vida em serviço de neonatologia e com sua mãe que o acompanhou durante o internamento. Dados recolhidos em dezembro 2017. Os princípios éticos foram acautelados. Resultados A díade vive em condição social de minoria étnica, chamando a atenção para contextos sociais frágeis na área materno-infantil. Os dados sociodemográficos evidenciam precaridade na habitação, no planeamento da família, na vigilância pré-natal e nos papeis de género. A avaliação de enfermagem inicial concretizou-se em sete diagnósticos. Na criança: 1) padrão respiratório ineficaz (0032), 2) risco de glicémia instável (00179); 3) icterícia neonatal (00194); 4) risco de volume de líquidos deficiente (00028). Na mãe: 1) controle ineficaz da saúde (00078); 2) amamentação interrompida (00105); 3) disposição para tomada de decisão melhorada (00184). Definiram-se resultados esperados e intervenções de enfermagem que tiveram sucesso. A díade teve alta aos dez dias de internamento. Conclusão Programas de inclusão social e de assistência a minorias étnicas podem diminuir a morbilidade materno-infantil.

Resumen Objetivo Este trabajo tiene el objetivo de describir los diagnósticos y las intervenciones de enfermería en el binomio madre-hijo coherentes con la situación de sepsis neonatal, mediante la aplicación de la taxonomía NANDA-I. Métodos Se trata de una investigación de tipo estudio de caso, realizada con recién nacidos internados a las 72 horas de vida en el servicio de neonatología y con su madre que lo acompañó durante la internación. Datos recolectados en diciembre de 2017. Los principios éticos fueron garantizados. Resultados El binomio vive en condición social de minoría étnica y llama la atención en contextos sociales frágiles en el área materno-infantil. Los datos sociodemográficos muestran precariedad en la vivienda, en la planificación familiar, en el control prenatal y en los papeles de género. La evaluación de enfermería inicial se realizó en siete diagnósticos. En el niño: 1) patrón respiratorio ineficaz (0032), 2) riesgo de glucemia inestable (00179), 3) ictericia neonatal (00194), 4) riesgo de déficit de volumen de líquidos (00028). En la madre: 1) gestión ineficaz de la propia salud (00078), 2) interrupción de la lactancia materna (00105), 3) disposición para mejorar la toma de decisiones (00184). Se definieron resultados esperados e intervenciones de enfermería que tuvieron éxito. El binomio recibió el alta a los diez días de internación. Conclusión Programas de inclusión social y de asistencia a minorías étnicas pueden reducir la morbilidad materno-infantil.

Abstract Objective This paper aimed to describe the nursing diagnoses and interventions in the mother-child dyad consistent with the neonatal sepsis situation by applying the NANDA-I taxonomy. Methods This is a case study research, conducted with a newborn hospitalized at 72 hours of life in a neonatology service and with his mother who followed him up during hospitalization. Data collected in December 2017. Ethical principles have been observed. Results The dyad lives in the social condition of an ethnic minority, drawing attention to fragile social contexts in the area of mother and child. Sociodemographic data show poor housing, family planning, prenatal surveillance and gender roles. The initial nursing assessment was based on seven diagnoses. In children: 1) ineffective breathing pattern (0032); 2) risk for unstable blood glucose level (00179); 3) neonatal jaundice (00194); 4) risk of poor fluid volume (00028). In mothers: 1) ineffective health control (00078); 2) interrupted breastfeeding (00105); 3) willingness for improved decision-making (00184). Expected outcomes and successful nursing interventions were defined. The dyad was discharged at ten days of hospitalization. Conclusion Social inclusion and ethnic minority care programs may decrease maternal and child morbidity.

Profiling Lung Cancer Patients Using Electronic Health Records.

If Electronic Health Records contain a large amount of information about the patient's condition and response to treatment, which can potentially revolutionize the clinical practice, such information is seldom considered due to the complexity of its extraction and analysis. We here report on a first integration of an NLP framework for the analysis of clinical records of lung cancer patients making use of a telephone assistance service of a major Spanish hospital. We specifically show how some relevant data, about patient demographics and health condition, can be extracted; and how some relevant analyses can be performed, aimed at improving the usefulness of the service. We thus demonstrate that the use of EHR texts, and their integration inside a data analysis framework, is technically feasible and worth of further study.

¿Puede la calidad del cuidado del paciente oncológico ser mejorada?: resultados de la puesta en marcha de una línea de atención telefónica en la enfermería oncológica / Can quality care of the oncology patient be improved? Results of the introduction of a healthcare help line in Oncological Nursing

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