Efic��cia da auriculoterapia na redu����o de ansiedade em estudantes de enfermagem

Este Ensaio Cl��nico Randomizado simples-cego verificou n��veis de ansiedade dos estudantes de Enfermagem de n��vel m��dio da Escola de Enfermagem S��o Joaquim, do Hospital Benefic��ncia Portuguesa, e a efic��cia da auriculoterapia na redu����o desses n��veis. Foi aplicado o Invent��rio de Ansiedade Tra��o-Estado no in��cio, ap��s 8 e 12 sess��es e no follow-up (quinze dias). A amostra foi composta por 71 indiv��duos divididos em tr��s grupos: Controle sem interven����o (25), Auriculoterapia (24), e Placebo (22). Resultados: Na an��lise de vari��ncia (ANOVA) houve diferen��a estatisticamente significativa pelo Post Hoc entre os grupos controle/auriculoterapia na segunda (p=0.000), terceira (p=0.012) e quarta avalia����es (p=0.005); e entre grupos placebo/controle, somente na 2�� avalia����o (p=0.003). A auriculoterapia com os pontos Shenmen e Tronco Cerebral foi mais eficaz para a diminui����o dos n��veis de ansiedade em estudantes de Enfermagem (20,97%), em compara����o com os pontos sham (13,74%), por��m, estudos com amostragem mais representativa se fazem necess��rios.

Canto Gregoriano: redutor de ansiedade de m��es com filhos hospitalizados

OBJETIVO: Verificar a presen��a de altera����o do estado de ansiedade das m��es de crian��as hospitalizadas com a audi����o de canto Gregoriano. M��TODOS: Pesquisa descritiva, explorat��ria, correlacional com an��lise quantitativa, quase experimental. A coleta dos dados foi realizada no per��odo de julho de 2009 a fevereiro de 2010. A amostra inicial foi de 71 m��es e destas 28 conclu��ram todas as etapas da pesquisa. RESULTADOS: O uso do canto Gregoriano diminuiu o estado de ansiedade das m��es de crian��as hospitalizadas em um hospital pedi��trico de aten����o quatern��ria acomodadas em quartos individuais. CONCLUS��O: �� necess��rio investigar os poss��veis efeitos do canto Gregoriano em outros ambientes do hospital e em outras formas de acomoda����o do cliente.

Efic��cia da auriculoterapia para estresse segundo experi��ncia do terapeuta: ensaio cl��nico

OBJETIVO: Ensaio cl��nico objetivou avaliar a efic��cia da auriculoterapia com agulhas semipermanentes sobre n��veis de estresse na equipe de Enfermagem de um hospital-escola, entre janeiro e julho de 2010. M��TODOS: Quarenta e nove pessoas foram randomizadas em tr��s grupos: grupo 1 (controle), grupo 2 (terapeutas menos experientes) e grupo 3 (terapeutas mais experientes). Os sujeitos receberam oito sess��es nos pontos Shen Men, Rim e Tronco Cerebral tendo sido avaliados no in��cio, com quatro e oito, sess��es e follow-up (15 dias). RESULTADOS: A ANOVA constatou diferen��as estatisticamente significativas entre os resultados antes e depois entre os grupos na 3�� avalia����o (F=3,404/p=0,042) e follow-up (F=4,106/p=0,023). Tais diferen��as foram entre grupo 1/3 na 3�� avalia����o (p=0,036) e follow-up (p=0,033). Resultado marginalmente significante foi encontrado no follow-up entre grupo 1/2 (p=0, 059). CONCLUS��O: A auriculoterapia com terapeutas mais experientes reduziu eficazmente o estresse em profissionais de Enfermagem, no entanto, considera-se a necessidade de mais estudos com este procedimento.

Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality

Carcinoma de c��lulas escamosas em gl��ndula mam��ria de gata dom��stica

Background: In the feline species, 80% to 93% of neoplasias in the mammary gland are malignant, being the majority carcinomas. Among them, there is the mammary squamous cell carcinoma, which amounts to a very rare neoplasm in the domestic cat, with considerable potential for malignancy. This study aimed to report a case of squamous cell mammary carcinoma in the feline species. Case: A female cat, mixed breed, ten years old, presented history of skin lesion. The cat had been spayed two years before, but with previous administration of contraceptives. At the physical examination, it was observed ulcer between the caudal abdominal mammary glands. The occurrence of skin or mammary neoplasia was conceived. The following complementary tests were requested: complete blood count, serum biochemical profi le (renal and hepatic), chest radiographs, abdominal ultrasound, and incisional biopsy of the ulcerated region periphery, followed by classic histopathology. The lesion histopathology was compatible with squamous cell carcinoma of the mammary gland. Due to such a diagnosis, bilateral mastectomy was recommended. The material obtained during the surgical procedure was sent for anatomopathological analysis. Microscopically, surgical margins infi ltration and a regional lymph node were verifi ed. The owner was advised of the need for complementary therapies and medical monitoring of the cat. However, there was no return. It is noteworthy that the animal���s physical and laboratory examinations showed no neoplasia in other regions, being the squamous cell carcinoma of the mammary gland considered primary. Discussion: The malignant mammary neoplasia genesis in feline species, in general, seems to be related to steroid hormones. The ovariectomized females are less likely to develop the disease when compared to intact cats, but there is no protective effect of surgery on those spayed after two years of age regarding the appearance of the neoplasia. Thus, at the time the reported patient was ovariectomized, this effect no longer occurred. The synthetic progestins regularly used to prevent estrus increase by three times the risk of breast carcinomas onset. In humans, there is no clear defi nition of the etiology and pathogenesis of mammary squamous cell carcinoma. However, it has been suggested its association with extreme forms of squamous metaplasia present in pre-existing mammary adenocarcinoma, besides cysts, chronic infl ammations, abscesses and mammary gland adenofi bromas. In a hypothetical way, this etiology could also be related to the feline mammary carcinoma, although, for the case at issue, the exogenous and endogenous hormonal infl uence should not be excluded. It has been reported that mammary squamous cell carcinomas in cats are classifi ed in grades II and III (ie, moderately and poorly differentiated, respectively). Thus, they are considered tumors with more unfavorable prognosis. However, the monitoring of the clinical course, in order to evaluate possible recurrence of the neoplasia and metastases to distant sites, was not possible as the animal under discussion did not return. The squamous cell carcinoma is the most common skin tumor in feline species, despite the primary location in the mammary gland. It is, therefore, important to differentiate squamous cell carcinoma originated in the breast from histological types derived from skin. The description of this special and rare feline mammary carcinoma is important due to its particular characteristics and potential for malignancy.

Il monitoraggio della qualit�� di vita e dei bisogni di pazienti oncologici e caregiver: il caso ANT

La Fondazione ANT rappresenta una delle pi�� ampie esperienze al mondo di assistenza socio-sanitaria gratuita a domicilio ai malati di tumore, tramite ��quipe di specialisti costituite da medici, psicologi e infermieri. La patologia oncologica ha un enorme impatto sul benessere dei pazienti. Un modo per raggruppare i diversi sintomi di disagio psicologico �� utilizzare il concetto di distress, che sarebbe importante monitorare in modo semplice e veloce. Primo studio: 66 pazienti oncologici (40% uomini; et�� media 54 anni) in cure palliative domiciliari. Il 79% dei pazienti ha mostrato livelli clinicamente significativi di distress. Il 55% dei partecipanti allo studio ha riportato alti livelli di ansia, e l'81% dei pazienti ha riportato alti livelli di depressione. Dall'analisi delle curve ROC il singolo item del Distress Thermometer, con un cut-off maggiore o uguale a 4, �� stato in grado di rilevare il 97% dei soggetti con punteggi clinici di ansia e depressione, quindi pu�� essere utilizzato anche come uno strumento di screening precoce rapido ed affidabile per i disturbi dell'umore. I familiari sono la prima risorsa dei malati di tumore, e l'identificazione dei loro bisogni �� utile per individuare chi ha maggiore necessit�� di aiuto ed in quali aree. Secondo studio: 115 caregiver di pazienti oncologici (37% uomini; et�� media 52 anni). Di seguito i bisogni pi�� frequenti. Salute psicofisica: ���preoccupazioni circa il/la paziente��� (72%), ansia (53%) e rabbia (52%). Informazioni: ���come prendersi cura del paziente��� (64%), ���terapie alternative e/o complementari��� (64%) e ���come gestire lo stress��� (57%). Servizi e strutture sanitarie: ���un operatore di riferimento���, (65%), ���cure infermieristiche a domicilio��� (62%), ���indicazioni su servizi ospedalieri��� (57%), ed ���assistenza per caregiver, ad esempio consulenza psicologica��� (55%). Il monitoraggio dei bisogni consentirebbe un'ottimizzazione dell'assistenza, prevenendo situazioni che potrebbero compromettere il benessere della famiglia e la qualit�� dell'assistenza fornita al paziente.

The in vitro evidence for an effect of high homeopathic potencies--a systematic review of the literature

OBJECTIVE: Systematic assessment of the in vitro research on high potency effects. METHOD: Publications of experiments were collected through databases, experts, previous reviews, citation tracking. Inclusion criteria: stepwise agitated dilutions <10(-23); cells or molecules from human or animal. Experiments were assessed with the modified SAPEH score. RESULTS: From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and 2/3 of those 18 that scored 6 points or more and controlled contamination. Nearly 3/4 of all replications were positive. Design and experimental models of the reviewed experiments were inhomogenous, most were performed on basophiles. CONCLUSIONS: Even experiments with a high methodological standard could demonstrate an effect of high potencies. No positive result was stable enough to be reproduced by all investigators. A general adoption of succussed controls, randomization and blinding would strengthen the evidence of future experiments.

Dietary factors in the modulation of inflammatory bowel disease activity.

CONTEXT: As patients look to complementary therapies for management of their diseases, it is important that the physician know the effectiveness and/or lack of effectiveness of a variety of dietary approaches/interventions. Although the pathogenesis of the inflammatory bowel diseases (ulcerative colitis and Crohn's disease) is not fully understood, many suspect that diet and various dietary factors may play a modulating role in the disease process. EVIDENCE ACQUISITION: The purpose of this article is to present some of what is known about various dietary/nutritional factors in inflammatory bowel disease, with inclusion of evidence from various studies regarding their putative effect. MedLINE was searched (1965-present) using combinations of the following search terms: diet, inflammatory bowel disease, Crohn's disease, and ulcerative colitis. Additionally, references of the articles obtained were searched to identify further potential sources of information. EVIDENCE SYNTHESIS: While much information is available regarding various dietary interventions/supplements in regard to inflammatory bowel disease, the lack of controlled trials limits broad applicability. Probiotics are one of the few interventions with promising results and controlled trials. CONCLUSION: While there are many potential and promising dietary factors that may play a role in the modulation of inflammatory bowel disease, it is prudent to await further controlled studies before broad application/physician recommendation in the noted patient population.

Role of Ashwangandha (Withania Somnifera) in Immune Modulation: Proposed Influence in Immune-Regulation

The immune system evolved to protect organisms from an infinite variety of disease-causing agents but to avoid harmful responses to self. However, such a powerf~dl efense mechanism requires regulation. Immune regulation includes homeostatic and cellmediated targeted mechanisms to the activation, differentiation and function of antigen-triggered immuno-competent cells and irnmunoregulatory cells. The regulation of the immune system has been a major challenge for the management of autoimmune disorders, tumor immunity, infectious diseases and organ transplants. However, irnmuno-modulatory procedures used by modern medicine to induce immunoregulatory function have deleterious side effects. Ashwangandha (Withania somnifera), an herb used in Ayurvedic medicine is being tested and used in experimental and clinical cases with potential immuno-modulatory functions without any side effects. Here we propose future usages of Ashwangandha for immuno-regulatory function in translational research.

Ayurvedic Approach to Rheumatologic Disorders

In Ayurvedic texts rheumatologic diseases are described under 'Sandhgat Roga", the diseases of joints. Although many of the diseases under this category resemble rheurnatologic diseases classified under western medicine, the approach to differential diagnosis may be different. For greater understanding of Ayurvedic concept of rheurnatologic diseases only few diseases are discussed here. The case presentation of Amavafa provides greater understanding of how Ayurvedic differential diagnosis is made in context of its western counterpart, the rheumatoid arthritis.