Priscila Costa

Salivary Interleukin-6, Matrix Metalloproteinase-8, and Osteoprotegerin in Patients With Periodontitis and Diabetes

BACKGROUND Diabetes and periodontitis produce a protein discharge that can be reflected in saliva. This study evaluates the salivary concentrations of interleukin (IL)-6, matrix metalloproteinase (MMP)-8, and osteoprotegerin (OPG) in patients with periodontitis with type 2 diabetes. METHODS Whole saliva samples were obtained from 90 subjects who were divided into four groups: healthy (control; n = 22), untreated periodontitis (UPD; n = 24), diabetes mellitus (DM; n = 20), and UPD + DM (n = 24) groups. Clinical and metabolic data were recorded. Salivary IL-6, MMP-8, and OPG concentrations were determined by a standard enzyme-linked immunosorbent assay. RESULTS The UPD and UPD + DM groups exhibited higher salivary IL-6 than the control and DM groups (P <0.01). The salivary MMP-8 concentrations in all diseased groups (UPD, DM, and UPD + DM) were higher than in the control group (P <0.01). The salivary OPG concentrations in the DM group were higher than in the UPD and control groups (P <0.05). In the UPD + DM group, salivary IL-6 was correlated with glycated hemoglobin (HbA1c) levels (r = 0.60; P <0.05). The regression analysis indicated that the number of remaining teeth, clinical attachment level, and IL-6 might have influenced the HbA1c levels in patients with diabetes. CONCLUSIONS Salivary IL-6 concentrations were elevated in patients with periodontitis with or without diabetes. Salivary MMP-8 and OPG concentrations were elevated regardless of periodontal inflammation in patients with diabetes. Therefore, periodontitis and diabetes are conditions that may interfere with protein expression and should be considered when using saliva for diagnoses.

Inflammation markers in healthy and periodontitis patients: a preliminary data screening

Advances in diagnostic research are moving towards methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. The purpose of this study was to evaluate whether differences in the serum levels of inflammatory biomarkers are differentially expressed in healthy and periodontitis patients. Twenty-five patients (8 healthy patients and 17 chronic periodontitis patients) were enrolled in the study. A 15 mL blood sample was used for identification of the inflammatory markers, with a human inflammatory flow cytometry multiplex assay. Among 24 assessed cytokines, only 3 (RANTES, MIG and Eotaxin) were statistically different between groups (p<0.05). In conclusion, some of the selected markers of inflammation are differentially expressed in healthy and periodontitis patients. Cytokine profile analysis may be further explored to distinguish the periodontitis patients from the ones free of disease and also to be used as a measure of risk. The present data, however, are limited and larger sample size studies are required to validate the findings of the specific biomarkers.

Práticas de manejo do cateter central de inserção periférica em uma unidade neonatal

El estudio tuvo como objetivo describir el manejo de los Cateteres Centrales de Insercion Periferica instalados en los recien nacidos internados en una unidad neonatal de cuidados intensivos de un hospital privado, despues de la adopcion del protocolo institucional. Fue realizado un estudio cuantitativo, descriptivo y exploratorio con recolecta de datos prospectiva. Fueron analizados datos de 45 cateteres instalados. El retiro electivo ocurrio en el 63,8% de los cateteres instalados y complicaciones ocurrieron en 30,8% de los cateteres. Las complicaciones mas frecuentes fueron rotura (15,4%), oclusion (11%) y traccion accidental (4,4%). En 33% de los cateteres instalados no hubo registro de los curativos. Concluyese que las complicaciones estuvieron relacionadas con el cuidado del cateter, siendo necesaria la capacitacion de los profesionales, asi como nuevos instrumentos para registrar la asistencia clinica de enfermeria relacionada al manejo del cateter.The study aimed to describe the management of Peripherally Inserted Central Catheters insertion in neonates admitted at a neonatal intensive care unit of a private hospital, after implementation of the institutional protocol. An exploratory, quantitative descriptive study with prospective data collection was carried out. Data of 45 catheters insertion were analyzed. The rate of catheters with elective removal was 63.8%, and catheters complications rate was 30.8%. The most frequently complications were rupture (15.4%), occlusion (11%) and accidental dislodgement (4.4%). No records about the catheter dressings were observed in 33% of catheters insertion. One conclude that the complications were related to care practices of the catheter, requiring professional training and new tools to record the care provided in relation to the catheters management.

TRADUÇÃO E ADAPTAÇÃO DO PREMATURE INFANT PAIN PROFILE PARA A LÍNGUA PORTUGUESA

The study aimed to translate and to adapt a version of the Premature Infant Pain Profile into the Brazilian Portuguese language. This is a cross-sectional and methodological study for the validation of a translated version of a tool. The process was conducted in four stages: initial translation, synthesis, back-translation, and analysis by experts. Four independent versions of the instrument translated into Brazilian Portuguese were produced. Based on these initial translations, a synthesis version was developed. Two back-translated versions were independently produced, and none showed major differences compared to the original instrument. An expert committee reviewed the summary version and the back-translations with respect to semantic and idiomatic equivalence. The committee considered the translation into Brazilian Portuguese as appropriate. Therefore, the Perfil de Dor no Recem-Nascido Pre-termo was considered adapted to Brazilian Portuguese, for research purposes and for clinical practice. It will contribute to the internationalization of research results in Brazil. DESCRIPTORS: Neonate. Pain. Pain assessment. Nursing.The study aimed to translate and to adapt a version of the Premature Infant Pain Profile into the Brazilian Portuguese language. This is a cross-sectional and methodological study for the validation of a translated version of a tool. The process was conducted in four stages: initial translation, synthesis, back-translation, and analysis by experts. Four independent versions of the instrument translated into Brazilian Portuguese were produced. Based on these initial translations, a synthesis version was developed. Two back-translated versions were independently produced, and none showed major differences compared to the original instrument. An expert committee reviewed the summary version and the back-translations with respect to semantic and idiomatic equivalence. The committee considered the translation into Brazilian Portuguese as appropriate. Therefore, the Perfil de Dor no Recem-Nascido Pre-termo was considered adapted to Brazilian Portuguese, for research purposes and for clinical practice. It will contribute to the internationalization of research results in Brazil. DESCRIPTORS: Neonate. Pain. Pain assessment. Nursing.

Dimensionamento da dor durante a instalação do cateter central de inserção periférica em neonatos

OBJETIVO: Medir la intensidad del dolor durante la instalacion del cateter central de insercion periferica, comparando el momento de la puncion venosa con la progresion del cateter. METODOS: Estudio descriptivo exploratorio con recoleccion prospectiva de los datos realizado en la unidad neonatal de un hospital-escuela de gran porte de la ciudad de Sao Paulo. Se evaluo la respuesta dolorosa al procedimiento de insercion del cateter en 28 neonatos, utilizandose la escala Premature Infant Pain Profile (PIPP) en las etapas de pre-puncion (15 segundos), puncion venosa (30 segundos) y progresion del cateter (30 segundos). RESULTADOS: El puntaje PIPP mayor o igual a siete, indicativo de dolor moderado a intenso ocurrio en 13 RN (59,1%) en la primera puncion venosa y 10 RN (45,5%) en la progresion del cateter del grupo que no recibio analgesico o sedativo. CONCLUSION: Los resultados apuntan que es necesario adoptar medidas analgesicas, ya que los neonatos internados en la unidad de terapia intensiva neonatal son frecuentemente sometidos a procedimientos invasores y dolorosos.

Prevalence and reasons for non-elective removal of peripherally inserted central catheter in neonates

This is a cross sectional study conducted with 67 newborns admitted at the neonatal intensive care unit of a private hospital in São Paulo, between July and December 2010, who underwent 84 Peripherally Inserted Central Catheter (PICC line) placement procedures. The aim was to describe the prevalence and reasons of non-elective removal of the catheter. Data was collected from medical records and institutional forms related to PICC placement. The mean of corrected gestational age of the neonates was 32.8 weeks, weight 1671.6 g and postnatal age 9.4 days. The non-elective removal was observed in 33 (39.3%) catheters, 18.1% due to occlusion, 9.5% rupture, 7.1% extremity edema, 6.0% suspected infection, 1.2% accidental dislodgement 1.2% poor extremity perfusion and 1.2% due to extravasation. The prevalence and the reasons of non-elective removal indicated that strategies to prevent avoidable complications related to PICC are necessary.Estudo transversal, realizado com 67 recem-nascidos internados em uma Unidade de Terapia Intensiva Neonatal de um hospital privado de Sao Paulo, entre julho e dezembro de 2010, submetidos a 84 insercoes de Cateteres Centrais de Insercao Periferica (CCIP). Os objetivos foram descrever a prevalencia de remocao nao eletiva do cateter e seus motivos. Os dados foram coletados de prontuarios medicos e do formulario de registro de informacoes sobre o cateter. A media de idade gestacional corrigida dos neonatos foi 32,8 semanas, peso 1.671,6 g e idade pos-natal 9,4 dias. A remocao nao eletiva ocorreu em 33 (39,3%) cateteres, 13,1% por obstrucao, 9,5% ruptura, 7,1% edema do membro, 6% suspeita de infeccao, 1,2% tracao acidental, 1,2% ma perfusao e 1,2% extravasamento. A prevalencia e os motivos de remocao nao eletiva indicaram a necessidade de estrategias para a prevencao de complicacoes evitaveis relacionadas ao CCIP.

TRANSLATION AND ADAPTATION OF THE PREMATURE INFANT PAIN PROFILE INTO BRAZILIAN PORTUGUESE 1

The study aimed to translate and to adapt a version of the Premature Infant Pain Profile into the Brazilian Portuguese language. This is a cross-sectional and methodological study for the validation of a translated version of a tool. The process was conducted in four stages: initial translation, synthesis, back-translation, and analysis by experts. Four independent versions of the instrument translated into Brazilian Portuguese were produced. Based on these initial translations, a synthesis version was developed. Two back-translated versions were independently produced, and none showed major differences compared to the original instrument. An expert committee reviewed the summary version and the back-translations with respect to semantic and idiomatic equivalence. The committee considered the translation into Brazilian Portuguese as appropriate. Therefore, the Perfil de Dor no Recem-Nascido Pre-termo was considered adapted to Brazilian Portuguese, for research purposes and for clinical practice. It will contribute to the internationalization of research results in Brazil. DESCRIPTORS: Neonate. Pain. Pain assessment. Nursing.The study aimed to translate and to adapt a version of the Premature Infant Pain Profile into the Brazilian Portuguese language. This is a cross-sectional and methodological study for the validation of a translated version of a tool. The process was conducted in four stages: initial translation, synthesis, back-translation, and analysis by experts. Four independent versions of the instrument translated into Brazilian Portuguese were produced. Based on these initial translations, a synthesis version was developed. Two back-translated versions were independently produced, and none showed major differences compared to the original instrument. An expert committee reviewed the summary version and the back-translations with respect to semantic and idiomatic equivalence. The committee considered the translation into Brazilian Portuguese as appropriate. Therefore, the Perfil de Dor no Recem-Nascido Pre-termo was considered adapted to Brazilian Portuguese, for research purposes and for clinical practice. It will contribute to the internationalization of research results in Brazil. DESCRIPTORS: Neonate. Pain. Pain assessment. Nursing.

Analgesia and sedation during placement of peripherally inserted central catheters in neonates

This study aimed to characterize the analgesia and sedation strategies in neonates having a peripherally inserted central catheter (PICC) placed, and to relate it to the number of venipunctures, duration of procedure and catheter tip position. This was a cross-sectional study with prospective data collection, conducted in a neonatal intensive care unit of a private hospital in the city of Sao Paulo, during the period from August 31, 2010 to July 1, 2011, which evaluated 254 PICC insertions. The adoption of analgesic or sedative strategies occurred in 88 (34.6%) catheter placements and was not related to the number of venipunctures, duration of procedure or catheter tip position. Intravenous administration of midazolam, in 47 (18.5%), and fentanyl, in 19 (7.3%), catheter insertions were the most frequent strategies. Wider adoption of analgesic strategies is recommended before, during and after the procedure.This study aimed to characterize the analgesia and sedation strategies in neonates having a peripherally inserted central catheter (PICC) placed, and to relate it to the number of venipunctures, duration of procedure and catheter tip position. This was a cross-sectional study with prospective data collection, conducted in a neonatal intensive care unit of a private hospital in the city of São Paulo, during the period from August 31, 2010 to July 1, 2011, which evaluated 254 PICC insertions. The adoption of analgesic or sedative strategies occurred in 88 (34.6%) catheter placements and was not related to the number of venipunctures, duration of procedure or catheter tip position. Intravenous administration of midazolam, in 47 (18.5%), and fentanyl, in 19 (7.3%), catheter insertions were the most frequent strategies. Wider adoption of analgesic strategies is recommended before, during and after the procedure.

Management practices of peripherally Inserted central Catheter at a neonatal unit

El estudio tuvo como objetivo describir el manejo de los Cateteres Centrales de Insercion Periferica instalados en los recien nacidos internados en una unidad neonatal de cuidados intensivos de un hospital privado, despues de la adopcion del protocolo institucional. Fue realizado un estudio cuantitativo, descriptivo y exploratorio con recolecta de datos prospectiva. Fueron analizados datos de 45 cateteres instalados. El retiro electivo ocurrio en el 63,8% de los cateteres instalados y complicaciones ocurrieron en 30,8% de los cateteres. Las complicaciones mas frecuentes fueron rotura (15,4%), oclusion (11%) y traccion accidental (4,4%). En 33% de los cateteres instalados no hubo registro de los curativos. Concluyese que las complicaciones estuvieron relacionadas con el cuidado del cateter, siendo necesaria la capacitacion de los profesionales, asi como nuevos instrumentos para registrar la asistencia clinica de enfermeria relacionada al manejo del cateter.The study aimed to describe the management of Peripherally Inserted Central Catheters insertion in neonates admitted at a neonatal intensive care unit of a private hospital, after implementation of the institutional protocol. An exploratory, quantitative descriptive study with prospective data collection was carried out. Data of 45 catheters insertion were analyzed. The rate of catheters with elective removal was 63.8%, and catheters complications rate was 30.8%. The most frequently complications were rupture (15.4%), occlusion (11%) and accidental dislodgement (4.4%). No records about the catheter dressings were observed in 33% of catheters insertion. One conclude that the complications were related to care practices of the catheter, requiring professional training and new tools to record the care provided in relation to the catheters management.

Measuring pain in neonates during placement of central line catheter via peripheral insertion

OBJETIVO: Medir la intensidad del dolor durante la instalacion del cateter central de insercion periferica, comparando el momento de la puncion venosa con la progresion del cateter. METODOS: Estudio descriptivo exploratorio con recoleccion prospectiva de los datos realizado en la unidad neonatal de un hospital-escuela de gran porte de la ciudad de Sao Paulo. Se evaluo la respuesta dolorosa al procedimiento de insercion del cateter en 28 neonatos, utilizandose la escala Premature Infant Pain Profile (PIPP) en las etapas de pre-puncion (15 segundos), puncion venosa (30 segundos) y progresion del cateter (30 segundos). RESULTADOS: El puntaje PIPP mayor o igual a siete, indicativo de dolor moderado a intenso ocurrio en 13 RN (59,1%) en la primera puncion venosa y 10 RN (45,5%) en la progresion del cateter del grupo que no recibio analgesico o sedativo. CONCLUSION: Los resultados apuntan que es necesario adoptar medidas analgesicas, ya que los neonatos internados en la unidad de terapia intensiva neonatal son frecuentemente sometidos a procedimientos invasores y dolorosos.