Long term remission of portopulmonary hypertension with liver transplantation in a patient with cirrhosis associated to autoimmune hepatitis.

Portopulmonary hypertension is an uncommon complication of portal hypertension, running a progressive course with a negative prognosis. Reports in pediatric patients are scarce with short follow up. We describe the case of decompensated cirrhosis who developed PoPH and resolved with liver transplantation, remaining asymptomatic after ten years of follow up.

Ion Binding Properties of a Naturally Occurring Metalloantibody.

LT1009 is a humanized version of murine LT1002 IgG1 that employs two bridging Ca ions to bind its antigen, the biologically active lipid sphingosine-1-phosphate (S1P). We crystallized and determined the X-ray crystal structure of the LT1009 Fab fragment in 10 mM CaCl and found that it binds two Ca in a manner similar to its antigen-bound state. Flame atomic absorption spectroscopy (FAAS) confirmed that murine LT1002 also binds Ca in solution and inductively-coupled plasma-mass spectrometry (ICP-MS) revealed that, although Ca is preferred, LT1002 can bind Mg and, to much lesser extent, Ba.

Systematization of nursing care and the formation of professional identity.

The aim of this study is to explore arguments that broaden the understanding of possible links between the organization of nursing care and the structuring of professional identity. For that purpose, some aspects related to these themes are addressed, highlighting issues regarding differences in the concepts of the organization of nursing care and the nursing process, as well as the performance of this activity and its possible impact on the establishment of its relationship with the professional identity. Emphasis is given to the need to stimulate the debate on the subject by nursing professionals involved in the training of human resources and the provision of care, as well as in class entities, in order to deepen understanding of these concepts as significant elements for strengthening our professional identity.

Respiratory Nursing Diagnoses: Presenting Evidence for Identification of the Defining Characteristics in Neonatal and Pediatric Populations.

Purpose: To identify and summarize clinical data supporting selection of nursing diagnoses related to the respiratory system for pediatric and neonatal populations.

Method: A literature review conducted in indexed publications was used.

Findings: The final sample consisted of 13 studies conducted in children with cardiac disease, respiratory infection, and asthma with nursing diagnoses such as ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance.

Attenuation of a select agent-excluded Burkholderia pseudomallei capsule mutant in hamsters.

Burkholderia pseudomallei is a Tier 1 select agent and potential bioweapon. Given it is potential to cause a lethal respiratory disease, research with fully virulent B. pseudomallei is conducted in Biosafety Level 3 (BSL-3) laboratory spaces.

Comprehensive identification of virulence factors required for respiratory melioidosis using Tn-seq mutagenesis.

Respiratory melioidosis is a disease presentation of the biodefense pathogen, Burkholderia pseudomallei, which is frequently associated with a lethal septicemic spread of the bacteria. We have recently developed an improved respiratory melioidosis model to study the pathogenesis of Burkholderia pseudomallei in the lung (intubation-mediated intratracheal [IMIT] inoculation), which more closely models descriptions of human melioidosis, including prominent septicemic spread from the lung and reduced involvement of the upper respiratory tract. We previously demonstrated that the Type 3 Secretion System cluster 3 (T3SS3) is a critical virulence determinant for B.

Type 3 secretion system cluster 3 is a critical virulence determinant for lung-specific melioidosis.

Burkholderia pseudomallei, the bacterial agent of melioidosis, causes disease through inhalation of infectious particles, and is classified as a Tier 1 Select Agent. Optical diagnostic imaging has demonstrated that murine respiratory disease models are subject to significant upper respiratory tract (URT) colonization. Because human melioidosis is not associated with URT colonization as a prominent presentation, we hypothesized that lung-specific delivery of B.

Intubation-mediated intratracheal (IMIT) instillation: a noninvasive, lung-specific delivery system.

Respiratory disease studies typically involve the use of murine models as surrogate systems. However, there are significant physiologic differences between the murine and human respiratory systems, especially in their upper respiratory tracts (URT). In some models, these differences in the murine nasal cavity can have a significant impact on disease progression and presentation in the lower respiratory tract (LRT) when using intranasal instillation techniques, potentially limiting the usefulness of the mouse model to study these diseases.

The process of palliative sedation as viewed by physicians and nurses working in palliative care in Brazil.

Objective: Our aim was to describe the process of palliative sedation from the point of view of physicians and nurses working in palliative care in Brazil.

Method: Ours was a descriptive study conducted between May and December of 2011, with purposeful snowball sampling of 32 physicians and 29 nurses working in facilities in Brazil that have adopted the practice of palliative care.

Results: The symptoms prioritized for an indication of palliative sedation were dyspnea, delirium, and pain.

[Educational intervention for self-management of continuous drainage in the postoperative period of mastectomy].

This study assessed how well patients who had undergone breast cancer surgery monitored their continuous drainage system after receiving one-to-one instructions at the Mastology Outpatient Clinic of Hospital São Paulo at Federal University of São Paulo. Participants were 79 women who had undergone breast cancer surgery between May 2009 and March 2010, and were using a drain. It was found that the self-care training that the patients received in addition to the strategy used in that training, had a positive effect on their self-monitoring of the continuous drainage, which prevented the drain from clogging, evinced by the percentage of patients who maintained the permeability of the drainage system (84.

[Clinical Nurse Specialist: a model of advanced nursing practice in pediatric oncology in Brazil].

The objective of this paper is to report the experience of implementing a model of advanced nursing practice that integrates a clinical nurse specialist into the nursing staff. The authors describe the concept of this model and the process of its implementation in a pediatric oncology reference institution in the city of São Paulo, Brazil. The main result achieved in evaluating the clinical nurse specialist was strengthening of the role of the nurse as a reference professional for the articulation of the various demands of care in assisting the child, adolescent or young adult with cancer and his/her family.

The influence of the initiation of an exercise programme on seroma formation and dehiscence following breast cancer surgery.

Aims And Objectives: To verify whether early (first post-operative day) or late initiation (after removal of the continuous suction drain) of a functional rehabilitation exercise programme influences the incidence of seroma formation and dehiscence for women after breast cancer surgery.

Background: Benefits of early implementation of an exercise programme initiated with women in the first days following breast cancer surgery are widely known. However, the safe initiation of the exercises is still a controversial issue and some authors correlate early initiation of the exercises with an increase in seroma formation.

[The strict sense nursing postgraduation in Brazil: advances and perspectives].

Nursing is a specific field of knowledge and social practice that has been consolidated and strengthened as science. In Brazil, it has been developed due to the increase and qualification of strict sense post-graduate programs. This study aims to present a historical review of the strict sense post-graduate nursing courses in Brazil and to reflect on their evolution, progress, challenges and future perspectives.

Validation of the concept risk for decreased cardiac output.

Objectives: to validate the concept "risk for decreased cardiac output".

Method: Six of the eight steps suggested in the technique developed by Walker & Avant were adopted to analyze the concept of the phenomenon under study and the proposal made by Hoskins was used for content validation, taking into account agreement achieved among five experts.

Results: the concept "decreased cardiac output" was found in the nursing and medical fields and refers to the heart's pumping capacity while the concept "risk" is found in a large number of disciplines.

[Professional practice of nurses who care for cancer patients in general hospitals].

The present article discusses a qualitative study which aimed to understand the typical of nurses' professional practice caring for patient with cancer in general hospitals. In order to find out the reasons that motivate nurse's action, and to put in evidence what is original, significant, specific and typical about this phenomenon, we have taken into consideration the premises of the philosopher Alfred Schütz, which provide us with subsidies to unveil them. The data collected through semi-structured interviews reported that nurses admit not having the required theoretical knowledge and experience or enough practice to take care of a cancer patient.

Application of a domicile-based exercise program for shoulder rehabilitation after breast cancer surgery.

The aim of this study was to evaluate the effectiveness of an exercise program for the recuperation of the range of motion (ROM) of the shoulder. This is a quasi-experimental study developed at the Mastology Outpatient Clinic of the Federal University of São Paulo - Brazil, from August 2006 to June 2008, with 64 breast cancer patients undergoing surgery. The intervention consisted of: preoperative evaluation of the ROM, verbal and written guidance, demonstration and implementation of the exercises and revaluation at the outpatient follow-up appointments until the 105(th) postoperative day (PO).

[Illness perception: an evaluation to be conducted by nurses].

Illness perception is understood as the way individuals understand and cope with their disease. The objective of this paper was to identify articles in literature developed by nurses on disease perception, and the instruments available to assess it. An integrative literature review was performed, which identified nine papers that related to the perception of the disease with Health Education, Coping, Treatment adherence and quality of life.

[Pressure ulcers in surgery patients: incidence and associated factors].

Pressure ulcers are an important perioperatory care quality indicator This is a longitudinal case series study, performed with the following objectives: to estimate the incidence of pressure ulcers in patients submitted to medium and large surgeries; rate them according to the stage and location; verify the association with the variables: gender, age, body mass index (BMI), co-morbidities, surgical position, duration of surgery, anesthesia type and use of positioning devices, with presence or absence of pressure ulcers. Data collection took place in 2007 in São Paulo, with 199 patients, 20.6% of which presented pressure ulcers, and most (98.

[Educative programs based on self-management: an integrative review].

The objective was to identify definitions and/or explanations of the term self-management in educative programs that aim its development. The authors also aimed to describe the educative plans and results of the educative programs analyzed. As a methodology we used integrative review, with 15 published articles (2002 the 2007).

Antineoplastic agents extravasation from peripheral intravenous line in children: a simple strategy for a safer nursing care.

Purpose: The antineoplastic agents infusion through peripheral lines may lead to several adverse events such as extravasation that is one of the most severe acute reactions of this sort of treatment. The extravasation prevention and management must be part of a safe and evidence-based nursing care. Due to this fact, two algorithms were developed with the purpose of guiding nursing care to children who undergo chemotherapy through peripheral line.

Nursing interventions in the clinical practice of an intensive care unit.

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping.

The meaning of neutropenia and homecare needs according to caregivers of children with cancer.

This study aimed to understand the meanings caregivers attributed to the process of caring for a neutropenic child at home and know their needs for orientation related to care for these children. This descriptive study was carried out at the Pediatric Oncology Institute through semi-structured interviews, involving eleven caregivers. Data were organized according to the content analysis technique and interpreted according to Social Representations theory.

Properties of honey from ten species of Peruvian stingless bees.

Honey produced by ten stingless bee species (Melipona crinita, M. eburnea, M. grandis, M.

Development and evaluation of standardized protocol to prevent nasoenteral tube obstruction in cardiac patients requiring enteral nutrition with restricted fluid volumes.

Aims And Objectives: This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency.

Background: Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge.