Enfermería pediátrica

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection or transfusion of contaminated blood or blood products, sharing unsterilized injection equipment that was previously used by an infected person and maternal-fetal transmission during pregnancy, at birth or through breastfeeding. Transmission of HIV from an infected patient to a health-care worker has been documented after parenteral or mucous membrane exposure to blood. Oral manifestations are one of the earliest clinical indicators of HIV infection which is independent of CD4 status has a prognostic value. By the way, screening of the AIDS associated manifestations in the oral cavity is a noninvasive and feasible approach, these oral lesions should be used to help diagnose, prevent and intervene in the progression of HIV infection to AIDS. This review includes studies that investigate the impact of HIV infection on personal life and importance of oral lesion in early diagnosis of HIV infection in children. Articles were identified through searches of PubMed MEDLINE from 1970 to 2015, using the MESH based key words.

Introducción: Las enfermedades con diagnóstico no especificado son denominadas enfermedades huérfanas; definidas como aquellas por las que el enfermo puede encontrarse en peligro de muerte o de invalidez crónica y tienen una prevalencia de 1 caso por cada 5,000 personas. El Proceso de Atención de Enfermería (PAE) permite proporcionar una atención integral al sujeto de cuidado con estas patologías y su familia. Objetivo: Brindar cuidado holístico de enfermería a lactante con enfermedad huérfana, bajo el modelo de adaptación de Sor Callista Roy. Metodología: La selección del sujeto de cuidado se realiza en terapia de neurodesarrollo en febrero de 2015; con previo consentimiento informado de la madre se inicia análisis de caso en modalidad de seguimiento domiciliario, haciendo uso del método proceso de atención de enfermería bajo el enfoque del modelo de adaptación de Sor Callista Roy. Resultados:Al finalizar el proceso de atención de enfermería propuesto se pudo observar en la lactante y su familia: el mejoramiento de las respuestas ineficaces detectadas con el modelo de Callista Roy, evidenciado por el aumento de peso, el fortalecimiento de los vínculos familiares, la generación de un ambiente social y recreativo positivo para la lactante y la motivación en la búsqueda de ayuda profesional en situaciones de conflicto de decisiones.Conclusiones: Mediante las intervenciones realizadas, se pudo evidenciar el progreso de la lactante durante el periodo de seguimiento. La articulación del método proceso de atención de enfermería, teorías de enfermería y las herramientas North American Nursing Diagnosis Association (NANDA), Nursing Outcomes Classification (NOC), Nursing Interventions Classification (NIC) NNN, permite un manejo holístico a los niños con enfermedades huérfanas. [Portilla-Ordoñez SB, Villarreal-Peñaloza AF, Abreu-Peralta P. Proceso de atención de enfermería a lactante con enfermedad huérfana, bajo el modelo de Callista Roy. MedUNAB 2016; 19(2): 151-160]

Introduction: Diseases with unspecified diagnosis are called orphan diseases; these are defined as those for which the patient may be in mortal danger or chronic disability, and have a prevalence of 1 case every 5,000 people. The Nursing Care Process allows providing a comprehensive care to the patient with these pathologies and his/her family. Objective: To provide a holistic nursing care to an infant with an orphan disease, under the Callista Roy's adaptation model. Methodology: The patient selection is carried out during the neurodevelopmental therapy in February of 2015; with the baby's mother authorization, the case analysis in mode of home follow-up starts by using the Nursing Care Process method (NCP) under the approach the Callista Roy's adaptation model. Results: At the end of the proposed Nursing Care Process, it could be observed and detected the improvement of ineffective responses by implementing Callista Roy's model with the infant and her mother, due to the fact that the baby gained weight; also she could strengthen her family ties because of the generation of a positive social and recreational environment, her mother was motivated to seek professional help in decision-making situations. Conclusions: By the interventions made, the progress of the infant during the follow-up period could be verified. The articulation of the Nursing Care Process method, Nursing theories and North American Nursing Diagnosis Association (NANDA), Nursing Outcomes Classification (NOC), Nursing Interventions Classification (NIC) NNN tools allow a holistic management of children with orphan diseases. [Portilla-Ordoñez SB, Villarreal-Peñaloza AF, Abreu-Peralta P. Nursing Care Process of an infant with an orphan disease under the Callista Roy's model. MedUNAB 2016; 19(2): 151-160]

Introdução: As doenças com o diagnóstico não especificado são chamadas doenças órfãs; definidas como aquelas em que o paciente pode estar em risco de vida ou invalidez crônica e tem uma prevalência de 1 caso por cada 5.000 pessoas. O Processo do cuidado na Enfermagem pode proporcionar uma atenção integral ao sujeito com estas patologias e a sua família. Objetivo: prestar o cuidado holístico de enfermagem para crianças com doença órfã sob o modelo de adaptação da irmã Callista Roy. Metodologia: A seleção do sujeito do cuidado é feita na terapia do desenvolvimento neurológico em fevereiro de 2015, com o consentimento informado da mãe; a análise do caso começou com o monitoramento em casa, usando o método do processo dos cuidados de enfermagem (PAE), sob a adaptação do modelo de abordagem da Irmã Callista Roy.  Resultados: No final do processo proposto dos cuidados de enfermagem, foi possível observar na criança e sua família; que melhorou as respostas ineficazes detectadas como modelo de Callista Roy, foi visível no aumento de peso, no fortalecimento dos laços familiares, na geração do ambiente social e recreativo positivo para a criança e a motivação para buscar ajuda profissional em situações de conflito e toma de decisões. Conclusões: Através de intervenções feitas, foi possível evidenciar o progresso da criança durante o período de monitoramento. Ao combinar o método, Processo do Cuidado de Enfermagem, as teorias da Enfermagem e as ferramentas NNN, permitiram ocuidado holístico das crianças com doenças órfãs. [Portilla-Ordoñez SB, Villarreal-Peñaloza AF, Abreu Peralta P. O processo do cuidado em Enfermagem, à crianças lactante com doença órfã, sob o modelo de Callista Roy. MedUNAB 2016; 19(2): 151-160]

Dyshidrotic eczema, also known as dyshidrotic dermatitis or pompholyx, is characterized by pruritic, tense, deep-seated vesicles mainly on the palms and lateral surfaces of the fingers. In the chronic phase, scaling, desquamation, fissuring, and, sometimes, lichenification may be seen. The peak age of onset is between 20 and 30 years of age. The sex incidence is approximately equal. Most cases are idiopathic. Predisposing factors include atopy, contact allergens, contact irritants, dermatophyte infection, allergy to ingested metal, hyperhidrosis, prolonged use of protective gloves, intravenous immunoglobulin, psychological stress, and smoking. Although the disease is benign, it tends to run a chronic and relapsing course. Successful treatment requires a systemic multipronged approach that consists of avoidance of triggering factors, optimal skin care, pharmacotherapy during acute exacerbations, and education of patients/caregivers. Ultrapotent topical corticosteroids are the mainstay of pharmacotherapy.

Introducción. El sarcoma de Ewing se define como una neoplasia ósea de alta agresividad y su origen se atribuye a una patología de tipo endotelial vascular, caracterizándose como un tumor formado por células redondas indiferenciadas. Se ha descrito su presentación en lugares como el sistema nervioso central y paravertebral. Respectivamente afectando a niños y adolescentes. El objetivo de este trabajo es implementar el Proceso de Atención de Enfermería a sujeto de cuidado adolescente con diagnóstico médico de Sarcoma de Ewing. Metodología. Caso clínico de enfermería con un período de seguimiento de 3 meses a sujeto de cuidado con diagnóstico médico de Sarcoma de Ewing mediante la aplicación de la teoría del logro de las metas de Imogene King y la implementación del Proceso de Atención de Enfermería, correlacionando la taxonomía diagnóstica de la North American Nursing Diagnosis Association (NANDA), describiendo los resultados esperados de la Nursing Outcomes Classification (NOC) y la implementación de las intervenciones descritas en la Nursing Interventions Classification (NIC) respectivamente, en relación con los resultados esperados. Resultados. Se plantea el Proceso de Atención de Enfermería con diagnóstico de enfermería: Deterioro de la movilidad física; con el resultado de enfermería: Movimiento articular e intervenciones de enfermería: Terapia de ejercicios: Movilidad articular. Evidenciándose la mejoría de la fuerza muscular del sujeto de cuidado. Conclusión. Mediante las intervenciones realizadas se evidenció el progreso del sujeto de cuidado. La relación del Proceso de Atención de Enfermería, teoría de enfermería y las herramientas de diagnóstico, objetivo e intervenciones de enfermería permitieron el manejo holístico del sujeto de cuidado. Cómo citar: Alvarado-Alvarado AL, Hernández-Mogollón RA, Bustamante-Gil CA, Rodríguez-Herrera R. Caso clínico de enfermería:Implementación del modelo del logro de las metas a sujeto con diagnóstico de Sarcoma de Ewing. MedUNAB. 2020;23(3):471-482. doi: https://doi.org/ 10.29375/01237047.3739

Introduction. An Ewing Sarcoma is defined as a highly aggressive bone tumor. Its origin is attributed to a vascular endothelial pathology and it is characterized as a tumor made of undifferentiated round cells. Its presence has been described in places, such as the central nervous and paravertebral system. It equally affects children and adolescents. Objective. To implement Nursing Assistance Processes to adolescent patients with Ewing Sarcoma medical diagnoses. Methodology. A clinical case in nursing with a 3-month monitoring period on patients with Ewing sarcoma medical diagnoses. It is performed by applying Imogene King’s Theory of Goal Attainment and implementing the Nursing Assistance Process, correlating the diagnostic taxonomy of the North American Nursing Diagnosis Association, describing the expected results of the Nursing Outcomes Classifications and implementing the interventions described in the Nursing Interventions Classification, respectively, when it comes to the expected results. Results. The Nursing Assistance Process is posed with a nursing diagnosis: Deterioration of physical mobility; with the nursing result: Joint movement and nursing interventions: Exercise therapy: Joint mobility. Improvement in the patient’s muscular strength is evident. Conclusion. The patient’s progress due to the performed interventions was evident. The Nursing Assistance Process, theory of nursing and diagnostic tools, as well as nursing goals and interventions, allowed comprehensively handling the patient. Cómo citar: Alvarado-Alvarado AL, Hernández-Mogollón RA, Bustamante-Gil CA, Rodríguez-Herrera R. Caso clínico de enfermería:Implementación del modelo del logro de las metas a sujeto con diagnóstico de Sarcoma de Ewing. MedUNAB. 2020;23(3):471-482. doi: https://doi.org/ 10.29375/01237047.3739

Introdução. O sarcoma de Ewing é definido como uma neoplasia óssea altamente agressiva e sua origem é atribuída a uma patologia do tipo endotelial vascular, caracterizada como um tumor formado por células redondas indiferenciadas. Foi descrito seu aparecimento em locais como o sistema nervoso central e paravertebral. Afeta respectivamente crianças e adolescentes. Objetivo. Implementar um Processo de Assistência de Enfermagem a um sujeito do cuidado, adolescente, com diagnóstico médico de Sarcoma de Ewing. Métodos. Caso clínico de enfermagem com seguimento de 3 meses a um sujeito do cuidado com diagnóstico médico de Sarcoma de Ewing por meio da aplicação da teoria do alcance de metas de Imogene King e da implementação do Processo de Assistência de Enfermagem, correlacionando a taxonomia diagnóstica da North American Nursing Diagnosis Association (NANDA), descrevendo os resultados esperados da Nursing Outcomes Classification e a implementação das intervenções descritas na Nursing Intervention Classification respectivamente, em relação aos resultados esperados. Resultados. Propõe-se o Processo de Assistência de Enfermagem com diagnóstico de enfermagem: Deterioro da mobilidade física; com resultado de enfermagem: Movimento articular; e intervenções de enfermagem: Terapia por exercício: Mobilidade articular. Foi evidente a melhora na força muscular do sujeito do cuidado. Conclusão. Por meio das intervenções realizadas foi evidente a evolução do sujeito do cuidado. A relação do Processo de Assistência de Enfermagem, teoria de enfermagem e as ferramentas diagnósticas, objetivo e intervenções de enfermagem possibilitaram o manejo holístico do sujeito do cuidado. Cómo citar: Alvarado-Alvarado AL, Hernández-Mogollón RA, Bustamante-Gil CA, Rodríguez-Herrera R. Caso clínico de enfermería:Implementación del modelo del logro de las metas a sujeto con diagnóstico de Sarcoma de Ewing. MedUNAB. 2020;23(3):471-482. doi: https://doi.org/ 10.29375/01237047.3739

Shabanzadeh et al (1) claim in their title that “Male circumcision does not result in inferior perceived male sexual function.” Yet such a categorical conclusion does not follow from the data and analysis presented in the paper itself. As the authors state, there was “considerable clinical heterogeneity in circumcision indications and procedures, study designs, quality and reporting of results” in the studies they reviewed, which precluded an objective, quantitative assessment. Inadequate follow-up periods of only 1-2 years in the prospective studies imply that their results cannot be generalized beyond that range. In addition, “Risks of observer and selective reporting bias were present in the included studies …  only half of the studies included validated questionnaires and some studies reported only parts of questionnaires.”

Although severe anaphylatic reactions are rare, allergic or immediate hypersensitivity reactions to natural rubber latex (NRL) have been reported in children with increasing frequency in the last few years. Indubitably, every-day rubber has been employed in thousands and thousands of products for over a century, while recently NRL allergy has been recognized as a substantial medical problem. Children with spina bifida undergoing multiple surgical procedures, as well healthy babies, appear at high risk for NRL allergy, with life-threatening reactions reported during surgery or while playing with balloons. Skin prick testing is the preferred diagnostic method, especially in the prick by prick version. During procedures, Parents of children with latex allergy should take caution that their babies avoid contact with rubber products, and a latex-free environment. Since minimal contacts with NRL products may produce reactions, the primary treatment for latex allergy is avoidance. The cross-reactions regarding the latex-fruit syndrome have recently widened the number of possible reactions.

Objective
Cow’s milk (CM) allergy (CMA) is a disease of infancy, usually appearing in the first months of life. Symptoms triggered by CM at first introduction are not completely defined. The evaluation of infants for possible CMA is one of the more common problems encountered by pediatricians. Purpose of this study was to investigate the prevalence of severe reaction to CM and clinical manifestation triggered by CM administration in the nurseries.
Materials and Methods
The series includes 143 prospectively studied CM-allergic babies.
Results
At the first introduction of CM, at the age of 1-8 months (median 4 months) all infants had immediate symptoms. The babies were probably sensitized during the first days of life. Particularly sensitizing appears to be the exposure to CM formulas in the neonatal nursery.
Discussion
Little doses of allergens are more sensitizing than larger ones. We provide clear evidence of the immunological effects of oral antigen administration during the neonatal period, and discuss the possible critical allergen transmission to the nursing baby via breast milk (BM).

Background
Normal newborns have a limited immunocompetence therefore they need breast milk (BM), which represent an excellent immune protection for the neonate during the critical period of intestinal vulnerability, owing to a great variety of functionally interactive immunological, antibacterial, antiviral, anti-inflammatory and immuno-modulating factors. Evidence suggests that the protection afforded by BM to the recipient infant is greatest when breastfeeding is exclusive and of substantial duration. BM is not always available, but it is not surprising that cow’s milk (CM) can induce a whole spectrum of allergic manifestations, even life-threatening or fatal, especially a minute CM amount, in addition to sensitize genetically atopy-prone infants.

Considerations
For both pediatricians and allergists the management of infants with CM allergy (CMA) is a challenge. In the first years of life of many children CM represents the primary source of nutrients with high biological value insuring almost the whole dietary supply of proteins, carbohydrates, and
fat: its high nutritional value and low cost should be noted. Children with CMA older than two years can avoid CM without nutritional loss if the nutrients necessary to cover daily requirements are provided by other foods. In the first years of life, dietary treatment of CMA is necessary for
evident reasons. Accordingly, the choice of an adequate CM substitute among several hypoallergenic formulas is mandatory for infants with CMA.

Conclusion
In this paper we will discuss the nutritional adequacy, the immunogenicity and the allergenicity of the available CM substitutes, including soy-protein, home-made, meat-based, hydrolysate, goat and mare, and amino acid-derived formulas, as well as the challenges posed by both
genetically modified foods (GMFs), and bovine spongiform encephalopathy (BSE). According to recent data, the above formulas can be also useful for feeding “high risk” babies, when BM is unavailable for the prevention of atopic diseases, and the stopping of the atopic march.

La epidemia del VIH/SIDA continúa siendo un problema de salud pública a pesar de los esfuerzos intersectoriales en el contexto mundial. Los jóvenes están en el centro de la epidemia; más de la mitad de las nuevas infecciones por el VIH que se producen en la actualidad afectan a personas entre 15 y 24 años de edad, período en el que la mayoría de los individuos inician su vida sexual y están enfrentados a otros factores de vulnerabilidad tales como la falta de competencia para el ejercicio de una sexualidad responsable, la baja percepción del riesgo, las presiones de grupo, el alto número de parejas sexuales, el abuso de alcohol y sustancias psicoactivas, el desconocimiento de los derechos sexuales y reproductivos y la deficiente e inadecuada información sobre transmisión y prevención de las infecciones de transmisión sexual como el VIH y el SIDA. Para la sociedad es urgente encontrar la forma de detener la propagación y conseguir la manera más adecuada para abordar el tema con los jóvenes. En este artículo se exponen las conclusiones de algunos estudios que muestran la situación mundial, programas de prevención, factores de riesgo y factores protectores de la epidemia VIH/SIDA en la población joven.
ABSTRACT The HIV/AIDS epidemic remains a public health problem despite the intersectioral efforts worldwide. Young people are at the centre of the epidemic; more than half of new HIV infections currently affect people between 15 and 24 years of age, when the majority of individuals start their sexual activity, and when they are faced with other vulnerability factors such as the lack of competence for living a responsible sexuality, low perception of risk, peer-pressure, high number of sexual partners, alcohol and psychoactive substance abuse, sexual and reproductive rights unawareness and poor and inadequate information on transmission and prevention of STDs such as HIV / AIDS infections. For our society it is critical to find ways for containing the spread of the epidemic and achieve the most appropriate way to deal with it in young people. This article presents the conclusions of some studies showing the global situation, prevention programs, risk factors and protective factors for the HIV/ AIDS epidemic in young people.

Atopic dermatitis (AD) together with asthma and allergic rhinitis, is the most typical manifestation of an atopic constitution. Atopic dermatitis has been known since ancient times: Job probably suffered from it. Aetius de Amida in 534BC was the first to report a skin condition closely resembling AD. But the first ‘scientific’ description of childhood AD, together with advice on its treatment, is found in the first textbook of Pediatrics of the Western world “Libellus de Aegritudinibus Infantium” (Handbook of Diseases of children) by the Italian doctor Paolo Bagellardo, published in 1472. In a chapter on the skin, the author advises physicians to lubricate the skin and prevent scratching in children affected by this skin disorder.
Atopic dermatitis is associated with patchy, characteristically distributed areas of cutaneous eczema, with intense itching and subsequent lichenification of the skin. Cutaneous automic dysfunction (increased vasoconstriction) and xerosis (dryness of the skin) commonly occur in the affected patients. In addition, profound immunological dysregulation with various immune alterations has been described in affected patients. Most patients produce IgE antibodies to a number of food and inhalants allergens.

Introducción:

Las prácticas culturales son parte de una comunidad y definitivamente influirán en el cuidado de la salud de sus integrantes; por tanto, la enfermera debe valorar estas prácticas antes de brindar la educación sanitaria a los padres sobre los cuidados postvacunales.

Objetivo:

Describir la educación sanitaria que brinda el profesional de enfermería y las prácticas culturales de las madres en una zona altoandina de Perú, frente a las reacciones adversas postvacunales del lactante menor.

Métodos:

Estudio cualitativo, con diseño etnográfico, con una muestra de 25 participantes.

Resultados:

Educación sanitaria y prácticas culturales ante la fiebre, el dolor y eritema postvacunal.

Conclusión:

El profesional de enfermería educa sobre los cuidados postvacunales y enfatiza el uso de paracetamol para controlar la fiebre; pero al tratar de respetar las costumbres de las madres, indica que usen la rodaja de papa, los pañitos de manzanilla, la leche materna, el ungüento de vick vaporub, alrededor de la zona donde fue inyectada la vacuna; existiendo un riesgo potencial que no se logre el efecto deseado.

Palabras clave : Educación sanitaria; prácticas culturales; vacunación; efectos adversos; lactante; enfermería.

RESUMEN:
Objetivos: Identificar la relación existente entre el grado de estrés y el nivel de satisfacción, y analizar qué aspectos influyen en la percepción de estrés general en los padres y madres con hijos ingresados en UCIN.
Método. Estudio descriptivo transversal realizado sobre una muestra de 24 madres/padres. Como instrumentos de evaluación se utilizaron un cuestionario de variables sociobiodemográficas elaborado “ad hoc”, la escala de estrés parental: Unidad de Cuidado Intensivo Neonatal (PSS: NICU) y el cuestionario sobre la calidad de la atención hospitalaria (SERVQHOS).
Resultados. Se observan diferencias estadísticamente significativas entre algunas variables sociobiodemográficas y las dimensiones de la escala PSS: NICU y del cuestionario SERVQHOS. Las variables que mejor predijeron el estrés general fueron las dimensiones Aspecto y comportamiento del recién nacido (AC) y papel de la madre (PM) (R2 = 0,357; F (2,21) = 5,822; p = 0,010).
Conclusiones. Promover una adecuada comunicación entre los profesionales y los padres/madres con hijos ingresados en una UCIN, hace que aumente en ellos el grado de satisfacción; sin embargo, esto no provoca una disminución del estrés general. Las variables que más influyen sobre los niveles de estrés general son las alteraciones en el aspecto/comportamiento del bebé y el papel de la madre.

Objective: To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain. Method: This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis. Results: The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident. Conclusion: The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families.