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Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.
NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.
In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.
To synthesise current evidence on physiotherapists’ use of electronic health records (EHRs), with a focus on the determinants of adoption, implementation processes and associated implementation outcomes.
A systematic review employing a narrative synthesis approach.
PubMed, Cochrane, Scopus and Web of Science, covering all records from the inception of each database to 10 May 2024.
Studies conducted in physiotherapy clinical settings and using the International Classification of Functioning, Disability and Health (ICF).
Two authors independently screened articles and assessed methodological quality. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for qualitative and for cohort studies, the Mixed Methods Appraisal Tool for mixed-methods studies and the JBI Critical Appraisal Checklist for analytical cross-sectional studies.
From 3820 records screened, 9 observational studies met inclusion criteria. Key factors influencing EHR adoption included organisational readiness, perceived usefulness, managerial support and training availability. Implementation patterns clustered into three domains: recorded content, ICF framework integration and record quality. Reported outcomes focused on care quality metrics and evidence of clinical effectiveness.
Persistent challenges in physiotherapy EHR use were identified, notably in data quality, completeness and alignment with the ICF framework. Improving EHR practices is crucial to improve clinical assessment and support digital health integration. However, limited evidence and methodological heterogeneity remain key limitations.
CRD42023420267.
by Janaína de Pina Carvalho, Sarah Nascimento Silva, Tália Santana Machado de Assis, Endi Lanza Galvão, Mayra Soares Moreira, Mônica Viegas Andrade, Kenya Valéria Micaela de Souza Noronha, Gláucia Cota
Cutaneous leishmaniasis (CL) is a neglected infectious disease with a global distribution and a known health-related quality of life (HRQoL) impact. However, no utility-based HRQoL assessments for CL patients are available. The aim of this study was to quantitatively assess the health-related quality of life among patients with CL attending a Brazilian reference center. A retrospective interview-based longitudinal study was conducted using the EQ-5D-3L/VAS to assess the current health status during active disease, and retrospectively before the onset of disease symptoms. In addition, socioeconomic data were collected via a standardized questionnaire, and sociodemographic and clinical data were collected directly from medical records. A total of 143 patients with a mean age of 52 (±17) years were included, 73% of whom were men. The mean utility score before the onset of CL symptoms was 0.858. Comparison of responses related to health status before and after disease onset revealed significant losses (pDespite parents’ efforts, many children have nutrient-poor diets with insufficient fruit and vegetable consumption. Parents significantly influence children’s eating habits at home through their food parenting practices. Although previous systematic reviews have explored food parenting practices, they were conducted some time ago. Therefore, it is timely to investigate the relationship between autonomy-supportive practices and fruit/vegetable consumption in children aged 2 to 12.
The systematic review and meta-analysis protocol will be conducted by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The databases PubMed, Scopus, Web of Science, PsycINFO, EMBASE, LILACS and Google Scholar will be searched with no restrictions on publication year, country or language. In addition to the databases, the search will be supplemented by manual searches of reference lists from the included articles. Studies that assess at least one parental autonomy-supportive food practice and its relationship with fruit and vegetable consumption in healthy children aged 2 to 12 years will be included. Results will be organised in tables and figures. A meta-analysis will be conducted if data availability permits. Risk of bias will be assessed using Joanna Briggs Institute tools. All steps will be conducted independently by two reviewers.
Findings from this review will be important for understanding the influence of parental autonomy-supportive food practices on children’s fruit and vegetable consumption, potentially informing health practices that promote healthy eating habits from childhood. No ethical approval is required for this review, and we plan to publish the findings in a peer-reviewed journal.
CRD42023442680.
Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.
Introducción: La pandemia ha debilitado el vínculo entre las personas con hipertensión arterial y/o diabetes mellitus y el sistema de salud. Objetivo: reflexionar sobre los desafíos del manejo de la hipertensión arterial y la diabetes mellitus en la atención primaria de salud en tiempos de pandemia por COVID-19. Metodología: Se trata de un estudio teórico-reflexivo, cuya fundamentación se dio mediante la realización de una revisión narrativa de la literatura. La trayectoria teórico-metodológica se estructuró a través de la fenomenología interpretativa. Resultados: La coexistencia de problemas estructurales, operativos y de gestión se encuentran entre las principales razones para la no superación de los desafíos revelados para mantener prácticas de atención efectivas a pacientes con enfermedades crónicas, frente a la pandemia de COVID-19. De los desafíos estructurales enumerados, se destacan la insuficiencia tecnológica, la debilidad de los dispositivos efectivos y los profesionales poco calificados. En el contexto operativo, se destacó el aumento de la demanda de asistencia. Y, en cuanto al manejo, el cribado y seguimiento de estas enfermedades siguen siendo retos a superar. Consideraciones finales: las reflexiones planteadas pueden ser útiles para el establecimiento de procesos de gestión más eficaces, en el contexto de la atención primaria de salud, para la atención dirigida a personas con enfermedades crónicas.
The evidence on products for the prevention of radiodermatitis is limited. The primary objective was to analyse the effectiveness of the spray skin protectant ‘non-burning barrier film’ in the prevention of radiodermatitis with moist desquamation in patients with the anal canal and rectal cancer followed in nursing consultations compared to a standardised moisturiser based on Calendula officinalis and Aloe barbadensis. Single-blind randomised clinical trial. The study was performed in a hospital in Rio de Janeiro, Brazil, with 63 patients undergoing anal canal and rectal cancer treatment, randomised into one of the following two groups: an experimental group, which used a spray skin protectant and a control group, which used a moisturiser. Data were collected using an initial and subsequent evaluation form and were assessed using descriptive and inferential analyses. Participants who used the spray skin protectant had a lower chance of presenting radiodermatitis with moist desquamation and a longer time without this outcome when compared to the control group. The overall incidence of radiodermatitis was 100%, with 36.5% being severe. Furthermore, 17.5% of participants discontinued radiotherapy due to radiodermatitis. There were no differences between the groups regarding the severity of radiodermatitis and the number of patients who discontinued radiotherapy. The skin protectant was effective in preventing radiodermatitis with moist desquamation amongst patients with anal canal and rectal cancer.
To assess the proportions and associated factors of different post-discharge referrals among adolescents treated in the emergency department after a suicide attempt.
Observational, cross-sectional retrospective study.
We conducted a study using the medical records of 140 adolescents treated for a suicide attempt between January 2015 and May 2023 in a Brazilian emergency department, focusing on post-discharge referrals, defined as discharge without referral, unaddressed referral and referral addressed to the network. Associations between the outcomes and other variables were analysed using a Poisson regression model.
Discharges without referrals prevailed, followed by addressed and unaddressed referrals. Regression models showed associations between post-discharge and age, prior continuous use of psychotropic medications, location of care, continued suicidal ideation at discharge and evaluation by a multi-professional team.
A high number of adolescents were discharged from emergency departments without co-ordination with the mental health network, and the involvement of the multi-professional team was positively associated with addressed referrals.
This study informs healthcare professionals by raising awareness of their practices in discharging adolescents after suicide attempts in emergency departments, with the possibility of improving care quality and reducing the likelihood of readmission.
STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).
No patient or public contribution.
Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.
Rev Enferm;39(5): 8-13, 2016 May. . [Artículo]
FreshRSS 