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Background: New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features. Methods: A prospective cross-sectional study enrolled post-COVID-19 condition patients (i.e. who had persisting COVID-19-related symptoms over 30 days since their first positive laboratory test), whose COVID-19 diagnosis had been supported by RT-PCR of oral/nasopharyngeal swab or serology. They underwent in-person evaluations with a structured interview, pain and quality-of-life-related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. Results: The present study included 226 individuals, 177 (78.3%) of whom presented over 3 months since their first COVID-19 symptom. New-onset pain occurred in 170 (75.2%) participants and was chronic in 116 (68.2%). A chronic course was associated with COVID-19-related hospitalization, new-onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality-of-life levels. Probable NP occurred in only 7.6% new-onset pain patients, and was associated with pain chronification, new-onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS-CoV-2 vaccination. Previous CP was reported by 86 (38.1%) individuals and had aggravated after the infection in 66 (76.7%) of them, which was associated with orthostatic hypotension. Conclusions: Post-COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. Significance: COVID-19-related pain usually follows a chronic course and is non-neuropathic. Its possible courses and phenotypes are associated with distinct clinical and epidemiological features. This suggests differing underlying mechanisms, which may have significant prognostic and therapeutic implications.

Objective: To present a proposal for a clinical protocol for the conservative treatment of urge urinary incontinence. Method: Experience report based on existing scientific evidence and clinical experience of authors who perform nursing consultations for people with urge urinary incontinence, outlined in accordance with the Brazilian Ministry of Health’s proposal for the elaboration of clinical protocols. Results: A clinical protocol was proposed with nursing diagnosis and interventions based on the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classifications (NIC), with systematized steps to verify the presence of related factors or conditions associated with the diagnosis, namely: hyperactive pelvic floor, anxiety, constipation, urinary tract infection, low fluid intake, inadequate sanitary behavior, diabetes mellitus, pelvic organ prolapse, high consumption of potential bladder irritants and persistence of symptoms. Soon after, the actions that should be implemented by the nurse were described in detail. Conclusion: It is considered that the flow and detailing of the actions presented can be adopted by nurses in order to identify and treat people with urge urinary incontinence, thus minimizing the prevalence of the problem and promoting the quality of life of these people.

Sinopsis Introducción: El 14,5% de los pacientes con cáncer desarrolla heridas neoplásicas malignas (HNM), caracterizadas como friables, exudativas, fétidas, sangrantes y dolorosas. Algunos estudios reportan que todos los pacientes con HNM experimentan dolor, pero hay escasez de evidencia científica para fundamentar su tratamiento. Objetivo: Mapear y examinar la evidencia existente sobre terapias tópicas para manejar el dolor en pacientes adultos con HNM. Método: Se diseñó un protocolo de revisión de alcance, de acuerdo con la metodología del Joanna Briggs Institute (JBI). Serán consultadas las bases de datos CINAHL, LILACS, Embase, Scopus, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR y la literatura gris, para la búsqueda de estudios publicados y no publicados en inglés, portugués y español. La selección estará a cargo de, al menos, dos revisores. La síntesis de los resultados será narrativa, con gráficos y tablas. Se incluirán estudios cualitativos, cuantitativos y revisiones, que describan el uso de terapias tópicas para el dolor en pacientes con HNM. Conclusión: Este estudio permitirá clasificar y discutir las terapias tópicas disponibles, y recomendar futuros estudios primarios.

Objective:report the case of a critical patient with COVID-19 and show the main findings related to the injury considered acute skin failure (ASF), as well as perform his differential diagnosis with preventable pressure injury (PI). Method: observational, longitudinal, case report type study, developed in a hospital in São Paulo, in the intensive care unit (ICU) exclusively for people diagnosed with COVID-19. Data were collected from a single patient between March and September 2020. Results: A patient with complications from COVID-19 developed a skin lesion, initially defined as PI and later reclassified as ASF. The following findings corroborated the diagnosis: prolonged invasive mechanical ventilation, respiratory, renal and cardiac insufficiency and sepsis of respiratory focus. In addition, other aggravating factors, such as the use of vasoactive drugs, hemodynamic instability with intolerance to minimal repositioning, prolonged fasting and disseminated intravascular coagulopathy associated with coronavirus infection. Conclusion: the report shows that there are difficulties for the differential diagnosis between ASF and PI in clinical practice. This is a new concept, and it is essential that health professionals recognize the main factors associated with the appearance of ASF, many of which are also related to the development of PI, highlighting the need for individualized analysis of these injuries, and ensuring the implementation of interventions for prevention and treatment.

Objetivo:relatar o caso de um paciente crítico com COVID-19 e mostrar os principais achados relacionados à lesão considerada Acute skin failure (ASF), bem como realizar seu diagnóstico diferencial com lesão por pressão (LP) evitável. Método: estudo observacional do tipo relato de caso, desenvolvido em um hospital de São Paulo, na unidade de terapia intensiva (UTI) exclusiva a pessoas diagnosticadas com COVID-19. Os dados foram coletados de um único paciente, entre os meses de março e setembro de 2020. Resultados: paciente com complicações da COVID-19 evoluiu com lesão de pele, inicialmente definida como LP e posteriormente reclassificada como ASF. Os seguintes achados corroboraram o diagnóstico: ventilação mecânica invasiva prolongada, insuficiências respiratória, renal e cardíaca e sepse de foco respiratório. Além disso, outros fatores agravantes, como o uso de droga vasoativa, instabilidade hemodinâmica com intolerância ao mínimo reposicionamento, jejum prolongado e coagulopatia intravascular disseminada associada à infecção pelo coronavírus. Conclusão: o relato mostra que existem dificuldades para o diagnóstico diferencial entre ASF e LP na prática clínica. Trata-se de conceito novo, sendo fundamental que o profissional de saúde reconheça os principais fatores associados ao aparecimento da ASF, muitos dos quais também estão relacionados ao desenvolvimento das LP, ressaltando a necessidade de análise individualizada dessas lesões, e garantia da implementação de intervenções adequadas para prevenção e tratamento.

espanolLa internet puede ser una fuente de apoyo social que ayuda a mejorar las competencias parentales. Se objetivo analizar el panorama internacional de los estudios acerca de apoyo social en linea entre cuidadores de ninos y jovenes. El estudio consis te en una Revision Integrativa de la Literatura en Red (RILR), que aborda a la literatura como una red asociativa de variables y la analiza basada en la Teoria de los Grafos. La busqueda se realizo en dos bases de datos y los estudios fueron filtrados a pa rtir de dos pruebas de relevancia. Se recuperaron 36 estudios, cuyos resultados fueron convertidos en 53 variables que fueron categorizadas segun sus relaciones. Considerando la recurrencia de relaciones entre las variables, se concluye que “Participacion en grupos en linea” favorece “Apoyo social”, “Conexion con otras personas en la misma situacion” y lo surgimiento de un “Sentido de comunidad”. Otros hallazgos son discutidos basados en las medidas de red. EnglishThe Internet may be a source of social support that promotes the improvement of parental competency. The objective of this study was to analyze the internation al panorama regarding research on online social support among caregivers of children and youth. This study comprises a Networked Integrative Review of Literature (NIRL) that approaches the literature as an associative network of variables and analyzes it b ased on the Theory of Graphs. Data search was conducted in two databases and the studies were filtered based on two relevance tests. This NIRL comprises 36 articles, whose results were converted into 53 variables that were categorized according to their re lationship. Considering the recurrence of relationships among the variables, it is concluded that “Participation in online groups” promotes “Social support”, “Connection to other people in the same situation” and the emergence of a “Sense of Community”. Ot her findings are discussed based on the network measures. portuguesA Internet pode ser uma fonte de apoio social que auxilia no aprimoramento de competencias parentais. Objetivou - se analisar o panorama internacional das pesquisas que investigaram apoio social online entre cuidadores de criancas e jovens. O estudo consiste em uma Revisao Integrativa em Rede da Literatura (RIRL) que aborda a literatura como uma rede de associacao de variaveis e a analisa com base na Teoria dos Grafos. A busca ocorreu em duas bases de d ados e os estudos foram filtrados por meio de dois testes de relevância. Foram resgatados 36 artigos, cujos resultados foram convertidos em 53 variaveis, que foram categorizadas conforme suas relacoes. Considerando - se a recorrencia de relacoes entre as var iaveis, conclui - se que “Participacao em grupos online” favorece o “Apoio social”, a “Conexao com outras pessoas na mesma situacao” e o surgimento do “Senso de comunidade”. Outros achados sao discutidos de acordo com as medidas de redes.

Diferentes estratégias para divulgação de uma nova ferramenta de comunicação e interação em saúde, voltada para pessoas com deficiência, foram aplicadas no Facebook® com o objetivo de identificar quais estratégias de divulgação aplicadas ao Facebook® promoveram mais acessos à rede social D Eficiência e caracterizar seus usuários. Estudo quantitativo, descritivo e longitudinal, com dados extraídos do gerenciador de métricas do Facebook . A divulgação com busca ativa foi superior a passiva, sendo responsável por 91,4% (n=4.519) dos acessos, via celular (71%) por mulheres (81%). Publicações com hiperlink e imagens foram mais engajadoras. O Facebook® mostrou-se como uma ferramenta eficaz por atingir números expressivos de pessoas, e deve ser considerado na divulgação de novas tecnologias. Para tal, é necessário criar conteúdos atrativos e busca ativa de usuários. Estudos complementares devem continuar a avaliação dessa estratégia, com análise da divulgação orgânica e divulgação com impulsionamento pago.

O uso da internet e das redes sociais virtuais pelas pessoas com deficiência é crescente, uma vez que pode induzir a formação de redes de apoio, compartilhamento de experiências e obtenção de informações. Nesse sentido, existe uma preocupação por parte dos pesquisadores em desenvolver ferramentas virtuais, que proporcionem uma experiência virtual acessível às pessoas com deficiências (PcD), associadas à segurança, privacidade dos dados e usabilidade. A avaliação da usabilidade, em sites e tecnologias destinadas à PcD, aumenta os acessos e o engajamento. Diante disso, o objetivo deste estudo foi analisar estratégias de divulgação e avaliar a usabilidade da rede social virtual D Eficiência (RSVD) na perspectiva de seus usuários. Trata-se de uma pesquisa quantitativa, exploratória e descritiva, composta por duas etapas: a primeira longitudinal, com objetivo de analisar os resultados das estratégias de divulgação sobre o número de acessos e cadastros que a RSVD; a segunda etapa transversal, com objetivo de avaliar a usabilidade da RSVD na perspectiva dos seus usuários. Na primeira etapa os dados foram coletados e analisados por meio do gerenciador de métrica (Google Analytics), já na segunda etapa os dados foram coletados por meio de um questionário virtual de usabilidade, previamente validado. Foram realizadas análises descritivas e correlacionais. A divulgação presencial recebeu 426 acessos num período de 74 dias, desses acessos 285 se converteram em usuários da RSVD, já a divulgação online, num período de 18 dias, recebeu 4519 acessos, desses 1067 se converteram em usuários da RSVD. De modo geral, as divulgações, num período de quatro meses, proporcionaram à página da RSVD, 4945 acessos, procedentes do estado de São Paulo (56%), acessados pelo celular (71%), por pessoas do sexo feminino (81%), com média de idade de 41 anos. Na segunda etapa, a amostra foi composta por 110 participantes usuários da RSVD, com predominância das pessoas com deficiência (51,8%), sendo a lesão medular a deficiência mais relatada (33,3%), do sexo feminino (68,2%), com média de idade de 39 anos, com nível superior de escolaridade (37,2%), empregadas (44,5%), com renda familiar média de até cinco salários mínimos (21,8%), procedentes da região sudeste (67,2%), que acessam a RSVD pelo computador (64,5%). A RSVD foi considerada excelente ou boa (82,7%), útil (93%), com ótimo visual (85%), de linguagem compreensível (86,4%) e de fácil navegação (87,3%). Apenas 10 participantes relataram problemas ao utilizar a RSVD, relacionados à lentidão no carregamento das páginas. Os achados desse estudo contribuíram para as melhorias e atualizações da RSVD. Ambas as estratégias de divulgação foram positivas e complementares entre si, uma vez que tornaram a RSVD mais difundida tanto qualitativamente, quanto quantitativamente na internet. Assim, é recomendável a realização de divulgações que envolvam esses tipos de estratégias interligadas para a divulgação de novas tecnologias, tanto para alcançar a população alvo, quanto para proporcionar experiências qualitativas provenientes do contato entre pesquisadores e participantes. A RSVD mostrou-se como uma ferramenta virtual promissora, avaliada positivamente por seus usuários, que cumpre o objetivo de oferecer acesso à informação de qualidade, com segurança e de forma interativa The use of the Internet and virtual social networks by people with disabilities is increasing, since it can lead to the formation of support networks, sharing of experiences and obtaining information. In this sense, there is a concern on the part of the researchers to develop virtual tools, which provide an accessible virtual experience for people with disabilities, associated with security, data privacy and usability. The evaluation of usability, in websites and technologies for people with disabilities, increases access and engagement. Therefore, the objective of this study was to analyze strategies for dissemination, access and evaluate the usability of the virtual social network D Eficiência (VSND) from the perspective of its users. This is a quantitative, exploratory and descriptive research, composed of two stages: the first longitudinal, with the objective of analyzing the results of the dissemination strategies on the number of accesses and registrations that the VSND received in a period of 4 months; the second transversal step, with the objective of evaluating the usability of VSND from the perspective of its users. In the first stage, the data were collected and analyzed through a metric manager (Google Analytics), and in the second stage the data were collected through a validated usability virtual questionnaire. Descriptive and correlational analyzes were performed. The in-person disclosure received 426 accesses in a period of 74 days, of which 285 accesses were converted to VSND users, and the online disclosure, in a period of 18 days, received 4519 accesses, of which 1067 were converted to VSND users. In general, the disclosures, in a period of 4 months, provided the VSND page with 4945 accesses, coming from the state of São Paulo (56%), accessed by cell phone (71%), female people (81%), with a mean age of 41 years. In the second stage, the sample consisted of 110 VSND users, with a predominance of people with disabilities (51.8%), the most commonly diagnosed spinal cord injury being female (33.3%) (68, 2%), with a mean age of 39 years, with a higher educational level (37.2%), employed (44.5%), with an average family income of up to five minimum wages (21.8%) southeast (67.2%), who accessed the VSND by computer (64.5%). VSND was considered excellent or good (82.7%), useful (93%), with good visual (85%), language comprehensible (86.4%) and easy navigation (87.3%). Only 10 participants reported problems using VSND, related to slow loading of pages. The findings of this study contributed to the improvements and updates of VSND. Both strategies of dissemination were positive and complementary among themselves, since they have made VSND more widespread both qualitatively and quantitatively on the internet. Thus, it is advisable to carry out divulgations that involve these types of interlinked strategies for the development of social media on the Internet, both for the greater reach of the target population and to provide qualitative experiences from the direct contact between researchers and participants. VSND has shown itself to be a promising virtual tool, evaluated positively by its users, which fulfills the objective of offering access to information, safely, interactively, with scientifically substantiated content, made available by moderators

PURPOSE The purpose of this study was to describe and compare factors that affect urinary tract infection (UTI) rates in people with spina bifida (SB) and neurogenic bladder dysfunction before and following initiation of intermittent catheterization (IC). DESIGN A quantitative, descriptive, correlational study. SUBJECTS AND SETTING The study included people who were from Germany, a high-income nation, and Brazil, a middle-income nation. Brazilian participants were recruited from a public rehabilitation hospital in the state of Minas Gerais. German participants were drawn from different regions of the country. The study sample included 200 participants; participants were either individuals diagnosed with SB and neurogenic bladder dysfunction and using IC, or caregivers of persons using IC for bladder management. METHODS Data were collected through a survey questionnaire developed for urological follow-up of SB patients. A translated and validated version of the form was used to collect data in Germany. To evaluate annual episodes of UTI, we considered the number of symptomatic UTI before and after IC. RESULTS Participants from Brazil were significantly younger than German patients (median age 9 vs 20 years, P < .001). Brazilians predominately used assisted catheterization (63.0%), whereas most Germans performed self-catheterization (61.0%). Use of IC greatly reduced the incidence of UTI in both groups (mean 2.8 episodes per year before IC vs mean 1.1 episodes after starting IC, P < .001). Women had a higher number of UTI, both before and after IC, but enjoyed greater reduction in UTI after initiating IC than men. Self-catheterization also promoted a greater reduction of UTI than assisted IC (P = .022). CONCLUSIONS Intermittent catheterization reduced annual episodes of UTI in both samples despite differences in catheterization technique. Patients practicing and performing self-catheterization achieved a greater reduction than those who relied on assisted IC. Comparative studies among additional countries with varying median income levels are needed to better understand the needs of individuals with SB and their families, and to plan and implement safe nursing interventions.

We began the preparation of this guideline with the training of the authors using the methodology employed by the Oxford Centre for Evidence-Based Medicine, for the development of clinical guidelines for the Programa Diretrizes da Associacao Medica Brasileira-AMB (Brazilian Medical Association's Guideline Program-BMA). Articles were reviewed from the MEDLINE (PubMed) database and other research sources, on an open-ended basis. The search strategy used was based on structured questions in the P.I.C.O. form (from the initials of "Patient", "Intervention", "Control", and "Outcome").