Background Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension. Methods In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. Results Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure >200 mmH2O was present in 11 patients and, in six of these, > 250 mmH2O. 6/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache. Conclusions In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue.
Dantas CC, Leite JL, Lima SBS, Stipp MAC. Grounded theory -conceptual and operational aspects: a method possible to be applied in nursing research Rev Latino-am Enfermagem 2009 julho-agosto; 17(4):573-9.
This is a descriptive
Este estudo tem como objetivo identificar os fatores de risco para infecção relacionados com o uso de cateter venoso em clientes com HIV/Aids hospitalizados. Utilizou-se uma abordagem quantitativa de natureza descritiva. Foi desenvolvido com 24 clientes HIV positivos que faziam uso de dispositivos intravenosos internados num Hospital Universitário do Rio de Janeiro. Da análise dos dados emergiram as seguintes categorias: tipo de cateter, tipo de medicação e gravidade da doença. Os resultados denotaram que 92,10% utilizavam cateter venoso periférico; e 75,00% tinham imunodeficiência grave. No que se refere aos grupos medicamentosos com ação leucopênica e/ou mielossupressora utilizados por essa clientela, observou-se que o mais freqüente é o grupo dos anti-retrovirais (n=6). Conclui-se, portanto, que a identificação, avaliação e controle dos fatores de risco fornecem subsídios para que o Enfermeiro proporcione um cuidado individualizado e de qualidade a pacientes com funcionamento imunológico comprometido.
1 Recorte del tesis del doctorado, investigación apoyada por la Marina del Brasil, realizada por la Escuela de Salud del Hospital Naval Marcílio Dias, delineada con vistas a su futura implantación en el ámbito militar y consecuentemente, civil;
BackgroundPrevious studies have successfully used augmented reality (AR) as an aid to exposure‐based treatments for anxiety disorders. However, to the best of our knowledge, none of these studies have measured the physiological correlates of the fear response, relying solely on self‐reports and behavioral avoidance tests.MethodsAs the physiological defensive reactivity pattern impacts on the treatment effectiveness, we tested the feasibility of an AR system integrated in a mobile and wearable device for assessing the psychophysiological mechanisms (heart rate) involved in fear responses in real‐life contexts. Specific phobia was used as a model given its prototypical defensive hyperreactivity toward the feared stimulus (spiders to spider phobics, in the current study).ResultsThe results showed that the stimuli presented using AR were able to induce physiological alterations in the participants, which were specific depending on the stimulus type (fear or neutral) and on the participants’ level of spider fear (phobic and control group). These physiological correlates of the fear response were reflected both in the intensity of heart rate (in relation to the baseline) and in the time needed to react and recover after the stimulus exposure. Finally, we tested a theoretical model that showed that the physiological responses of phobic individuals when facing their phobic stimulus only explained its own data.ConclusionsWe argue in favor of the system's feasibility at capturing and quantifying the physiological dimension of fear‐related responses, which may be of great value for diagnostic and treatment purposes in anxiety disorders, namely specific phobia.
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