Abstract Introduction: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. Aim: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). Methods: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Results: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. Conclusion: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Resumo Introdução: Doença renal crônica (DRC) é definida como um declínio progressivo das funções renais. Na infância, os principais fatores desencadeantes são anomalias congênitas dos rins e trato urinário (CAKUT) e glomerulopatias. Respostas inflamatórias apresentam desafios para diagnóstico e estadiamento, o que justifica estudos sobre biomarcadores/índices. Objetivo: Definir índices de contagem de células sanguíneas e verificar sua associação com etiologia e estadiamento da DRC pediátrica. Os índices incluídos foram: Razão Neutrófilo-Linfócito (NLR), Razão Neutrófilo-Linfócito Derivada (dNLR), Razão Linfócito-Monócito (LMR), Índice de Resposta à Inflamação Sistêmica (SIRI), Índice Agregado de Inflamação Sistêmica (AISI) e Índice de Inflamação Imune Sistêmica (SII). Métodos: Determinamos índices em 52 pacientes pediátricos com DRC e 33 controles saudáveis por cálculo matemático. Pacientes com DRC foram separados em cinco grupos conforme etiologia e estadiamento: Grupo IA: glomerulopatias em estágio 1 ou 2; IB: glomerulopatias em estágio 3 ou 4; IIA: CAKUT em estágio 1 ou 2; IIB: CAKUT em estágio 3 ou 4; e III: estágios 3 ou 4 de outras etiologias. Além disso, combinamos todos os pacientes com DRC em um grupo (IV). Grupo V foi um grupo controle saudável. Resultados: Observamos valores menores de LMR nos grupos IB e IIB comparados ao grupo V (p=0,047; p=0,031, respectivamente). Encontramos valores maiores de SIRI para o grupo III versus grupo V (p=0,030). Não houve diferença para outros índices quando os grupos foram comparados dois a dois. Conclusão: Os índices LMR e SIRI apresentaram resultados promissores na avaliação da inflamação, pois correlacionaram-se com as etiologias da DRC e, principalmente, com o estadiamento desses pacientes.

ABSTRACT Objective: This study aimed to translate, and perform a cross-cultural adaptation, and validation of the Vancouver Symptom Score (VSS) for bladder and bowel dysfunction (BBD) for Brazilian children and adolescents Materials and Methods: Six steps were performed for the translation and cross-cultural adaptation: (1) translation, (2) synthesis of translations, (3) back-translation, (4) pre-final version of the translated instrument, (5) pilot test and degree of comprehensibility and (6) elaboration of the Brazilian version of the VSS. For validation, the Brazilian Dysfunctional Voiding Score (DVSS) questionnaire was used. Results: Validation was performed on a sample of 107 children and adolescents with a mean age of 9.2 ± 2.84 years, presenting BBD and 107 without BBD (control group-CG). There was a positive correlation (r = 0.91, 95% CI 0.88 to 0.93, p < 0.0001) between total VSS score and total DVSS score. VSS was higher in patients with BBD (p < 0.0001). The internal consistency estimated by Cronbach's alpha was 0.87 for patients with BBD. The VSS showed excellent diagnostic accuracy in detecting cases, with an area under the ROC curve of 98% (95% CI 0.96 to 0.99, p < 0.001). A cut-off value of >11 points produced a sensitivity of 100% (95% CI 96.4% to 100%) and a specificity of 91.8% (95% CI 85.1% to 95.6%). Conclusion: The translated, cross-culturally adapted, and validated VSS for the Brazilian population is a reliable and valid tool to identify symptoms of BBD in children and adolescents aged five to 16 years, whose first language is Brazilian Portuguese.

Abstract Introduction: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. Aim: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). Methods: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Results: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. Conclusion: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Resumo Introdução: Doença renal crônica (DRC) é definida como um declínio progressivo das funções renais. Na infância, os principais fatores desencadeantes são anomalias congênitas dos rins e trato urinário (CAKUT) e glomerulopatias. Respostas inflamatórias apresentam desafios para diagnóstico e estadiamento, o que justifica estudos sobre biomarcadores/índices. Objetivo: Definir índices de contagem de células sanguíneas e verificar sua associação com etiologia e estadiamento da DRC pediátrica. Os índices incluídos foram: Razão Neutrófilo-Linfócito (NLR), Razão Neutrófilo-Linfócito Derivada (dNLR), Razão Linfócito-Monócito (LMR), Índice de Resposta à Inflamação Sistêmica (SIRI), Índice Agregado de Inflamação Sistêmica (AISI) e Índice de Inflamação Imune Sistêmica (SII). Métodos: Determinamos índices em 52 pacientes pediátricos com DRC e 33 controles saudáveis por cálculo matemático. Pacientes com DRC foram separados em cinco grupos conforme etiologia e estadiamento: Grupo IA: glomerulopatias em estágio 1 ou 2; IB: glomerulopatias em estágio 3 ou 4; IIA: CAKUT em estágio 1 ou 2; IIB: CAKUT em estágio 3 ou 4; e III: estágios 3 ou 4 de outras etiologias. Além disso, combinamos todos os pacientes com DRC em um grupo (IV). Grupo V foi um grupo controle saudável. Resultados: Observamos valores menores de LMR nos grupos IB e IIB comparados ao grupo V (p=0,047; p=0,031, respectivamente). Encontramos valores maiores de SIRI para o grupo III versus grupo V (p=0,030). Não houve diferença para outros índices quando os grupos foram comparados dois a dois. Conclusão: Os índices LMR e SIRI apresentaram resultados promissores na avaliação da inflamação, pois correlacionaram-se com as etiologias da DRC e, principalmente, com o estadiamento desses pacientes.

RESUMO A infecção pelo Toxoplasma gondii pode causar manifestações oculares tanto após a sua forma congênita quanto a sua forma adquirida. Reportamos aqui dois casos de toxoplasmose congênita sintomática com envolvimento ocular em irmãos não gêmeos, com intervalo de 2 anos entre gestações. A transmissão vertical da toxoplasmose em gestações sucessivas, outrora considerada impossível, é um evento plausível mesmo em indivíduos imunocompetentes.

ABSTRACT Toxoplasma gondii infection can cause ocular manifestations after acquired and congenital disease. We report two cases of symptomatic congenital toxoplasmosis with ocular involvement in non-twin siblings, with a 2-year interval between pregnancies. Vertical transmission of toxoplasmosis in successive pregnancies, which was once considered impossible, is now found to be plausible even in immunocompetent subjects.

ABSTRACT Objective: Primary monosymptomatic nocturnal enuresis (PMNE) is a prevalent condition in childhood, and the pathophysiology is multifactorial. This study investigated the relationship between the toilet training process (TT) and PMNE in children and adolescents. Patients and Methods: A case-control study was carried out from 2015 to 2020. The presence of PMNE was identified according to International Children's Continence Society criteria. A semi-structured questionnaire was applied to assess TT. Results: The study included 103 children and adolescents with PMNE and 269 participants with normal psychomotor development without PMNE (control group [CG]). Readiness signals were more remembered and less frequent in participants with PMNE (p=0.001) when compared to control group. No differences were found between the groups regarding the onset age of the daytime TT (p= 0.10), the nocturnal TT (p=0.08), the acquisition of daytime continence (p=0.06), and the type of equipment used for the TT (p=0.99). The use of Child-Oriented approach in group of children with enuresis was lower than in controls [87.4% (90/103) versus 94% (250/266)], respectively (OR= 0.44, 95% CI 0.21-0.94, p = 0.039). Conclusions: The age of onset of TT, acquisition of daytime continence, and the type of equipment were not associated with higher occurrence of PMNE. On the other hand, the Child-Oriented approach was a protective factor for the occurrence of PMNE.

ABSTRACT BACKGROUND: Acute kidney injury (AKI) is a frequent complication during the postoperative period following liver transplantation. Occurrence of AKI in intensive care unit (ICU) patients is associated with increased mortality and higher costs. OBJECTIVE: To evaluate occurrences of moderate or severe AKI among patients admitted to the ICU after liver transplantation and investigate characteristics associated with this complication. DESIGN AND SETTING: Single-center retrospective cohort study in a public hospital, Belo Horizonte, Brazil. METHODS: Forty-nine patients admitted to the ICU between January 2015 and April 2017 were included. AKI was defined from a modified Kidney Disease Improving Global Outcomes (KDIGO) score (i.e. based exclusively on serum creatinine levels). RESULTS: Eighteen patients (36.7%) developed AKI KDIGO 2 or 3; mostly KDIGO 3 (16 out of the 18 patients). Lactate level within the first six hours after ICU admission (odds ratio, OR: 1.3; 95% confidence interval, CI: 1.021-1.717; P = 0.034) and blood transfusion requirement within the first week following transplantation (OR: 8.4; 95% CI: 1.687-41.824; P = 0.009) were independently associated with development of AKI. Patients with AKI KDIGO 2 or 3 underwent more renal replacement therapy (72.2% versus 3.2%; P < 0.01), had longer hospital stay (20 days versus 15 days; P = 0.001), higher in-hospital mortality (44.4% versus 6.5%; P < 0.01) and higher mortality rate after one year (44.4% versus 9.7%; P = 0.01). CONCLUSION: Need for blood transfusion during ICU stay and hyperlactatemia within the first six postoperative hours after liver transplantation are independently associated with moderate or severe AKI. Developing AKI is apparently associated with poor outcomes.

Resumo Objetivo: Relatar o caso de um paciente pediátrico com hidronefrose bilateral devido à obstrução da junção vesicoureteral (OJVU) que foi tratado não cirurgicamente e discutir a abordagem desta anomalia. Descrição do caso: Um menino de 25 meses de idade foi encaminhado sem queixas para consulta devido à ultrassonografia pré-natal que mostrou rins com cistos. Ele estava sob profilaxia antibiótica. Nenhum histórico familiar de doença renal e/ou distúrbios hereditários foi relatado. A ultrassonografia renal (USR) aos 2 dias de vida mostrou hidronefrose bilateral, descartando assim a possibilidade de doença renal cística. A cintilografia renal dinâmica (DTPA) mostrou uma retenção acentuada do marcador no sistema pielocalicial bilateralmente, com pouca resposta ao diurético. O paciente foi mantido em profilaxia antibiótica, quando uma nova USR apresentou dilatação ureteral bilateral, estenose abrupta na região de transição ureterovesical (calibre 0,2 cm), hidronefrose bilateral moderada e leve espessura cortical renal, confirmando o diagnóstico de OJVU. Aos 2 anos e 10 meses de idade, a DTPA mostrou hidronefrose e estase ureteral em ambos os rins secundárias à estenose no nível da junção vesicoureteral (JVU), com preservação da função renal e grau lento de esvaziamento. Optamos por uma abordagem não cirúrgica. A USR aos 10 anos de idade mostrou melhora significativa de todos os parâmetros, com diâmetro transverso ureteral de 9 mm, JVU preservada, e desenvolvimento renal bilateral adequado à idade. Comentários: A OJVU é uma das principais causas de hidronefrose pré-natal e pode desencadear uma deterioração da função renal. Seu tratamento ainda é controverso, mas deve levar em consideração a importância do acompanhamento clínico e da avaliação seriada por imagem.

Abstract Objective: To report the case of a pediatric patient with bilateral hydronephrosis due to vesicoureteral junction obstruction (VUJO) that was treated non-surgically and to discuss the approach of this anomaly. Case Description: A 25-month-old boy was referred without complaints for consultation due to prenatal ultrasound showing kidneys with cysts. He was under antibiotic prophylaxis. No family history of kidney disease and/or inherited disorders was reported. Renal ultrasound (RUS) at 2 days of life showed bilateral hydronephrosis, thus ruling out the possibility of kidney cystic disease. Dynamic renal scintigraphy (DTPA) showed marked retention of the marker in the pyelocaliceal system bilaterally, with little response to diuretic drug. He was maintained under antibiotic prophylaxis, when a new RUS showed bilateral ureteral dilatation, abrupt stenosis in the ureterovesical transition region (0.2 cm caliber), moderate bilateral hydronephrosis, and slight renal cortical thickness, confirming the diagnosis of VUJO. At 2 years and 10 months of age, DTPA showed hydronephrosis and ureteral stasis in both kidneys secondary to stenosis at the vesicoureteral junction (VUJ) level, with preservation of kidney function and slow degree of emptying. We opted for a non-surgical approach. RUS at 10 years of age showed significant improvement of all parameters, with ureteral transverse diameter of 9 mm, preserved VUJ, and age-appropriate bilateral kidney development. Comments: VUJO is a major cause of prenatal hydronephrosis and can trigger a deterioration of kidney function. Its treatment is still controversial but should take into account the importance of clinical follow-up and serial imaging evaluation.

Resumo Introdução: Estudos têm mostrado que o sistema renina angiotensina aldosterona (SRAA) e a inflamação estão relacionados à progressão da lesão renal. O objetivo deste estudo foi avaliar moléculas do SRAA e o Ligante 2 de Quimiocina com Motivo C-C (CCL2) em 82 pacientes com doença renal crônica (DRC). Métodos: Os pacientes foram divididos em dois grupos: pacientes diagnosticados com DRC e pacientes sem diagnóstico de DRC. Foram determinadas a taxa de filtração glomerular (TFG) e a relação albumina/creatinina (RAC), assim como os níveis plasmáticos de angiotensina-(1-7) [Ang-(1-7)], enzima conversora de angiotensina (ECA)1, ECA2 e níveis plasmáticos e urinários de CCL2. Resultados: Os níveis plasmáticos de CCL2 foram significativamente mais altos em pacientes com DRC em comparação com o grupo controle. Pacientes com TFG mais baixa apresentaram níveis plasmáticos mais elevados de ECA2 e CCL2 e menor relação ECA1/ECA2. Pacientes com valores de RAC mais altos apresentaram níveis plasmáticos de ECA1 mais elevados. Conclusão: Pacientes com DRC mostraram maior atividade de ambos os eixos do SRAA, o clássico e o alternativo, e níveis plasmáticos mais altos de CCL2. Portanto, os níveis plasmáticos de moléculas do SRAA e CCL2 parecem ser marcadores prognósticos promissores e até mesmo alvos terapêuticos para a DRC.

Abstract Introduction: Studies have shown that the renin angiotensin aldosterone system (RAAS) and inflammation are related to kidney injury progression. The aim of this study was to evaluate RAAS molecules and chemokine (C-C motif) ligand 2 (CCL2) in 82 patients with chronic kidney disease (CKD). Methods: Patients were divided into two groups: patients diagnosed with CKD and patients without a CKD diagnosis. Glomerular filtration rate (GFR) and albumin/creatinine ratio (ACR) were determined, as well as plasma levels of angiotensin-(1-7) [Ang-(1-7)], angiotensin-converting enzyme (ACE)1, ACE2, and plasma and urinary levels of CCL2. Results: CCL2 plasma levels were significantly higher in patients with CKD compared to the control group. Patients with lower GFR had higher plasma levels of ACE2 and CCL2 and lower ratio ACE1/ACE2. Patients with higher ACR values had higher ACE1 plasma levels. Conclusion: Patients with CKD showed greater activity of both RAAS axes, the classic and alternative, and higher plasma levels of CCL2. Therefore, plasma levels of RAAS molecules and CCL2 seem to be promising prognostic markers and even therapeutic targets for CKD.

RESUMO Objetivo comparar o absenteísmo da enfermagem hospitalar, antes e durante a pandemia da COVID-19. Método estudo transversal. Compilaram-se os registros de afastamento do trabalho da enfermagem de um hospital universitário sul-brasileiro nos meses de março, abril e maio de 2019 (n=622) e no mesmo período em 2020 (n=475). Os dados foram analisados por estatística descritiva e analítica. Resultados nos dois períodos, foram equânimes as frequências de afastamentos de mulheres (98,4%; 98,3%), com idade entre 40 e 49 anos (47,9%; 44,8%) e atuantes em enfermarias para adultos (30,7%; 29,2%). O absenteísmo-doença foi a causa prevalente (48,4%; 48%). O número absoluto de casos de afastamento foi maior no período pré-pandemia, contudo, o tempo em dias e horas perdidas, bem como a taxa de absenteísmo (13,9; 18,6%), foram significativamente mais elevados (p-valor<0,001) no período de pandemia vigente. Conclusão a pandemia de COVID-19 impactou na elevação do absenteísmo da enfermagem hospitalar.

ABSTRACT Objective to compare absenteeism in Hospital Nursing before and during the COVID-19 pandemic. Method cross-sectional study. It involved compilation of the records of absence from Nursing work at a university hospital in southern Brazil in March, April and May 2019 (n=622) and during the same period in 2020 (n=475). The data were analyzed by means of descriptive and analytical statistics. Results both periods presented the same absence frequencies in women (98.4%; 98.3%), aged between 40 and 49 years old (47.9%; 44.8%) and working in wards for adults (30.7%; 29.2%). Absenteeism-Disease was the most prevalent cause (48.4%; 48%). The absolute number of absence cases was higher in the pre-pandemic period; however, the time in days and hours lost, as well as the absenteeism rate (13.9; 18.6%), was significantly higher (p-value<0.001) in the current pandemic period. Conclusion the COVID-19 pandemic exerted an impact on the increase in Hospital Nursing absenteeism.

RESUMEN Objetivo comparar el ausentismo en el área de Enfermería hospitalaria, antes y durante la pandemia de COVID-19. Método estudio transversal. Se compilaron los registros de ausencias laborales en el área de Enfermería de un hospital universitario del sur de Brasil durante los meses de marzo, abril y mayo de 2019 (n=622) y en el mismo período del año 2020 (n=475). Los datos se analizaron por medio de estadística descriptiva y analítica. Resultados en ambos períodos, las frecuencias en términos de ausencias laborales fueron equivalentes en mujeres (98,4%; 98,3%), de entre 40 y 49 años (47,9%; 44,8%) y que desempeñaban sus funciones en salas para adultos (30,7%; 29,2%). Ausentismo/Enfermedad fue la causa prevalente (48,4%; 48%). La cantidad absoluta de casos de ausencias laborales fue mayor durante el período previo a la pandemia; sin embargo, el tiempo en días y horas perdidas, así como el índice de ausentismo (13,9; 18,6%), fueron significativamente más elevados (valor-p<0,001) durante el período de pandemia actual. Conclusión la pandemia de COVID-19 repercutió en el aumento del ausentismo en el área de Enfermería hospitalaria.

Abstract Filling materials should be restricted to the root canal space. However, sometimes it is impossible to control the apical extrusion, in this case, the fate of the filling material and the result of the treatment will depend on its physicochemical properties and biocompatibility. Objective To evaluate the tissue response and bone repair capacity of endodontic sealers that were implanted in the calvaria of Wistar rats, forming the groups (n=16): AH Plus and Sealer Plus, compared to the clot group. Methodology On days 30 and 60, the animals were euthanized, the calvaria was removed and processed for hematoxylin-eosin, immunohistochemistry for collagen type I, Picrosirus red and microtomographic analysis. Data were subjected to ANOVA and Tuckey tests (p<0.05). Results At 30 days, all groups showed an intense inflammatory reaction (p>0.05). At 60 days, the AH Plus and Sealer Plus maintained an intense inflammatory infiltrate compared to the clot group (p<0.05). We observed immunopositive areas for type I collagen in all groups at 30 days and 60 days (p>0.05). We observed more red collagen fibers for the Sealer Plus compared to the clot group at 30 days (p<0.05). Considering the total fibers, the clot group at 30 days compared to 60 days after surgery showed an increase in the amount of matrix (p<0.05). There were no statistical differences between groups for green and yellow fibers (p>0.05). Regarding morphometric parameters, at 30 days, the newly formed bone volume and number of bone trabeculae were higher in the groups with sealers compared to the clot group (p<0.05). At 60 days, AH Plus and Sealer Plus showed greater bone neoformation compared to the clot group (p<0.05). Conclusions Despite AH Plus and Sealer Plus induced an intense inflammatory reaction, they can be considered biocompatible materials, since they allowed bone repair.

RESUMO Objetivo compreender à luz do Modelo de Sistemas de Betty Neuman, a experiência de uma mulher-mãe a vivenciar uma situação de cancro; identificar as necessidades da mulher-mãe e prescrever intervenções de enfermagem em linguagem classificada. Método estudo de caso do tipo qualitativo, de uma mulher-mãe de um adolescente, a vivenciar cancro. Colheita de dados realizada em Coimbra, Portugal, em 2021, através de entrevista semiestruturada, apoiada por um guião fundamentado no Modelo de Betty Neuman. Tratamento de dados realizado com base na análise de conteúdo categorial. Resultados a análise do discurso da mãe possibilitou identificar categorias concordantes com as variáveis do modelo: fisiológicas, psicológicas, socioculturais, espirituais e desenvolvimentais. As dificuldades mais expressas pela mãe foram o medo, alterações provocadas pela doença e o desempenho do papel parental. Os diagnósticos de enfermagem foram definidos com base nos focos “aceitação do estado de saúde”, “medo”, “papel parental” e “coping familiar”, associando-os às respetivas intervenções de enfermagem. As intervenções focaram-se no apoio e na educação. Conclusão o modelo teórico contribuiu para compreender e identificar as necessidades da mãe a experienciar o cancro parental, facilitando a prescrição de intervenções de enfermagem em linguagem classificada. O modelo mostrou-se pertinente para futuras intervenções em pais a vivenciar situações semelhantes.

ABSTRACT Objective to understand, in the light of Betty Neuman’s Systems Model, the experience of a woman-mother with cancer, and identify the woman-mother’s needs and prescribe nursing interventions in classified language. Method a qualitative case study of a woman-mother of a teenager experiencing cancer. Data collection carried out in Coimbra, Portugal, in 2021, through a semi-structured interview, supported by a script based on Betty Neuman’s Systems Model. Data processing performed based on categorical content analysis. Results the analysis of a mother’s speech made it possible to identify categories in agreement with the model variables: physiological, psychological, sociocultural, spiritual and developmental. The difficulties most expressed by the mother were fear, changes caused by the disease and parental role performance. The nursing diagnoses were defined based on the focuses “acceptance of health status”, “fear”, “parental role” and “family coping”, associating them with the respective nursing interventions. Interventions focused on support and education. Conclusion the theoretical model contributed to understanding and identifying the needs of a mother experiencing parental cancer, facilitating the prescription of nursing interventions in classified language. The model proved to be relevant for future interventions in parents experiencing similar situations.

RESUMEN Objetivo comprender, a la luz del Modelo de Sistemas de Betty Neuman, la experiencia de una mujer-madre que vive una situación de cáncer, e identificar las necesidades de la mujer-madre y prescribir intervenciones de enfermería en lenguaje clasificado. Método estudio de caso cualitativo de una mujer-madre de un adolescente en proceso de cáncer. Recopilación de datos realizada en Coimbra, Portugal, en 2021, a través de una entrevista semiestructurada, apoyada en un guión basado en el Modelo Betty Neuman. El procesamiento de datos fue realizado en base al análisis de contenido categórico. Resultados el análisis del discurso de la madre permitió identificar categorías de acuerdo con las variables del modelo: fisiológicas, psicológicas, socioculturales, espirituales y de desarrollo. Las dificultades más expresadas por la madre fueron el miedo, los cambios provocados por la enfermedad y el desempeño del rol parental. Los diagnósticos de enfermería fueron definidos a partir de los enfoques “aceptación del estado de salud”, “miedo”, “rol de los padres” y “afrontamiento familiar”, asociándolos a las respectivas intervenciones de enfermería. Las intervenciones centradas en el apoyo y la educación. Conclusión el modelo teórico contribuyó a la comprensión e identificación de las necesidades de las madres con cáncer parental, facilitando la prescripción de intervenciones de enfermería en lenguaje clasificado. El modelo demostró ser relevante para futuras intervenciones en padres que experimentan situaciones similares.

Abstract Based on an extensive analysis of public databases, we provide an overview of the global scientific output and describe the dynamics of the profound changes in the scientific enterprise during the last decades. The analysis included the scientific production of 53 countries over the 1996-2018 period. During this period, the production of articles per year has tripled. There was a strong correlation between the growth of the global gross domestic product and the increase in the number of articles (R2 = 0.973, P<0.001). Six countries showed a robust increment of their scientific production and are currently among the top 20 in the ranking of world scientific production (China, India, South Korea, Brazil, Turkey, and Iran). The mean annual growth rate was about 12.7% for these six countries. The share of the global scientific production of these countries increased from 7% in 1996 to 27.8% in 2018. Conversely, the participation of the 10 most traditional countries has dropped from 73% to 45% during the same period. In conclusion, we believe that our findings may contribute to further studies aiming to evaluate the impact and changes of the scientific endeavor over the next years in light of the forthcoming new world framework.

RESUMO Objetivo: descrever e analisar experiência de um adolescente a vivenciar cancro parental, fundamentado no Modelo Teórico do Ajuste dos Adolescentes ao Cancro Parental, e prescrever intervenções de enfermagem em linguagem classificada. Método: estudo de caso único, tipo qualitativo, de adolescente de 16 anos de idade a vivenciar cancro da mãe. Analisou-se uma entrevista semiestruturada, baseada em um roteiro concetualizado pelo modelo teórico selecionado. Tratamento de dados ocorreu através de análise de conteúdo. Obteve-se autorização da Comissão de Ética TI 25/2020. Resultados: a análise da entrevista do adolescente permitiu identificar categorias concordantes com as variáveis do modelo. As dimensões de ajuste psicossocial e sintomas de resposta ao estress, como performance acadêmica e sintomas somáticos, foram reconhecidas no processo de ajuste do adolescente. As intervenções de enfermagem serão focadas na educação e apoio. Conclusão o modelo teórico contribuiu para avaliar as necessidades do adolescente a vivenciar cancro parental, permitindo prescrever intervenções de enfermagem em linguagem classificada que considerem variáveis moderadoras e mediadoras, promovendo-se o ajuste. O modelo demonstrou ser adequado para futuras intervenções a adolescentes a experienciar situações semelhantes.

ABSTRACT Objective: To describe and analyze the experience of an adolescent experiencing parental cancer, based on A Model of Children’s Adjustment to Parental Cancer, and to prescribe nursing interventions in classified language. Method: This is a single case study, qualitative, of a 16-year-old adolescent experiencing maternal cancer. We analyzed a semi-structured interview, based on a script conceptualized by the selected theoretical model. Data processing took place through content analysis. Authorization was obtained from the Research Ethics Committee TI 25/2020. Results: The analysis of the adolescent’s interview allowed identifying categories in agreement with the model variables. Psychosocial adjustment dimensions and stress response symptoms, such as academic performance and somatic symptoms, were recognized in the adolescent’s adjustment process. Nursing interventions will focus on education and support. Conclusion: The theoretical model contributed to assess the needs of adolescents experiencing parental cancer, allowing nursing interventions to be prescribed in classified language that consider moderating and mediating variables, promoting adjustment. The model proved to be suitable for future interventions for adolescents experiencing similar situations.

RESUMEN Objetivo: Describir y analizar la experiencia de un adolescente con cáncer en los padres, a partir del Modelo Teórico de Adaptación del Adolescente al Cáncer en los Padres, y prescribir intervenciones de enfermería en lenguaje clasificado. Método: Estudio de caso único, cualitativo, de una adolescente de 16 años con cáncer materno. Se analizó una entrevista semiestructurada, a partir de un guión conceptualizado por el modelo teórico seleccionado. El procesamiento de datos se llevó a cabo a través del análisis de contenido. Se obtuvo autorización del Comité de Ética TI 25/2020. Resultados: El análisis de la entrevista adolescente permitió la identificación de categorías de acuerdo con las variables del modelo. En el proceso de ajuste del adolescente se reconocieron dimensiones de ajuste psicosocial y síntomas de respuesta al estrés, como rendimiento académico y síntomas somáticos. Las intervenciones de enfermería se centrarán en la educación y el apoyo. Conclusión: El modelo teórico contribuyó para evaluar las necesidades de los adolescentes que experimentan cáncer en los padres, permitiendo que las intervenciones de enfermería sean prescritas en un lenguaje clasificado que considere variables moderadoras y mediadoras, promoviendo el ajuste. El modelo demostró ser adecuado para futuras intervenciones con adolescentes en situaciones similares.

Resumo A idade avançada atua como fator de risco para infecção grave por coronavírus 2 da Síndrome de Angústia respiratória aguda (Sars-CoV-2). Em contrapartida, crianças comumente apresentam curso clínico mais brando da Doença do coronavírus 2019 (covid-19). Entretanto, há associação entre covid-19 e Síndrome Inflamatória Multissistêmica em Crianças (MIS-C). Nesses casos, os pacientes apresentam pior evolução. Além disso, em presença de comorbidades, como doença renal crônica (DRC), a população adulta cursa com pior prognóstico. Este estudo objetivou, por meio de uma revisão narrativa, avaliar se a DRC contribuiu para pior prognóstico na covid-19 em pacientes pediátricos. Os estudos analisados mostraram ausência de casos graves, nenhum óbito e rápida recuperação tanto em crianças com DRC quanto nos pacientes pediátricos previamente hígidos. Contudo, alguns pacientes com MIS-C necessitaram de internação em unidade de terapia intensiva e houve registro de óbitos, mas não foi possível relacionar a ocorrência de MIS-C com presença de DRC. Por outro lado, nos adultos, a DRC associou-se a risco aumentado de infecção grave por Sars-CoV-2, com maior índice de óbitos. As discrepâncias entre os grupos etários podem se dever a diferenças no sistema imunológico e no sistema renina-angiotensina, com maior expressão de ECA2 nas crianças. Nos pacientes em imunossupressão, ainda não foi determinado se este tratamento apresenta efeitos benéficos ou maléficos no curso da covid-19, com atual recomendação de se reduzir a dose de alguns medicamentos. Concluindo, não foi possível associar a DRC em crianças a piores prognósticos de covid-19, sendo necessários estudos com amostras mais significativas.

Abstract Advanced age is a risk factor for severe infection by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Children, however, often present with milder manifestations of Coronavirus Disease 2019 (COVID-19). Associations have been found between COVID-19 and multisystem inflammatory syndrome in children (MIS-C). Patients with the latter condition present more severe involvement. Adults with comorbidities such as chronic kidney disease (CKD) are more severely affected. This narrative review aimed to look into whether CKD contributed to more severe involvement in pediatric patients with COVID-19. The studies included in this review did not report severe cases or deaths, and indicated that pediatric patients with CKD and previously healthy children recovered quickly from infection. However, some patients with MIS-C required hospitalization in intensive care units and a few died, although it was not possible to correlate MIS-C and CKD. Conversely, adults with CKD reportedly had increased risk of severe infection by SARS-CoV-2 and higher death rates. The discrepancies seen between age groups may be due to immune system and renin-angiotensin system differences, with more pronounced expression of ACE2 in children. Immunosuppressant therapy has not been related with positive or negative effects in individuals with COVID-19, although current recommendations establish decreases in the dosage of some medications. To sum up with, CKD was not associated with more severe involvement in children diagnosed with COVID-19. Studies enrolling larger populations are still required.

Abstract The world is looking forward to a prompt response by the scientific community in order to overcome the first pandemic of the 21st century. This study aimed to provide an overview of scientific output on COVID-19 during its first year. We assembled information regarding 60,830 articles related to COVID-19 indexed in the WoS database from January 24 to December 13, 2020. Only 4 countries accounted for about 60% of the articles (USA, China, Italy, and England) and 12 countries accounted for about 95% of the world scientific output on COVID-19 (USA, China, Italy, England, India, Canada, Germany, Spain, Australia, Brazil, Iran, and Turkey). 25 research centers around the world contributed with more than 500 papers on COVID-19. Papers were scattered throughout 6,133 journals, with 12 journals with > 250 articles. 20 articles (0.03%) have already received more than the 1,000 citations. The response of the scientific endeavor to this acute global public health emergency has been fast and robust. The overview provided by the analysis of the scientific response to the pandemic may contribute to further studies aiming to evaluate the impact and changes in the scientific endeavor for the next years in light of the forthcoming new world framework.