Notes

Mouth supervision associated with berberine represses macrophage activation-associated benign prostatic hyperplasia: a pivotal participation of the NF-κB.
 The present article presents a literature review concerning the microbiota of breast milk and the influence of epigenetics in the susceptibility to COVID-19.

 A literature review.

 Breastfeeding transfers microbiota, nutrients, diverse white blood cells, prebiotics, hormones, and antibodies to the baby, which provide short- and long-term immunological protection against several infectious, gastrointestinal, and respiratory illnesses. The little evidence available shows that breast milk very rarely carries the SARS-CoV-2 virus, and even in those cases, it has been discarded as the source of contagion.

 The reviewed studies show evidence of a beneficial effect of breastfeeding and highlights its importance on the current pandemic due to the immune reinforcement that it provides. Breastfed individuals showed better clinical response due to the influence on the microbiota and to the nutritional and immune contribution provided by breast milk, compared with those who were not breastfed.
 The reviewed studies show evidence of a beneficial effect of breastfeeding and highlights its importance on the current pandemic due to the immune reinforcement that it provides. Breastfed individuals showed better clinical response due to the influence on the microbiota and to the nutritional and immune contribution provided by breast milk, compared with those who were not breastfed.
 To assess the influence of oxidative stress on the gene expression of nitric oxide synthases (NOS 3 and NOS 2) and, hence, the cardiovascular responses in preeclampsia.

 This was a case control study in which patients with preeclampsia (PE group) and normal pregnancy controls (NP group) were included according to the guidelines of the American College of Obstetricians and Gynecologists (ACOG). The serum levels of malondialdehyde (MDA), total antioxidant capacity, and nitric oxide (NO) were estimated, and the heart rate and mean arterial pressure were recorded. The gene profiling of NOS3 and NOS2 was performed through real-time polymerase chain reaction (RT-PCR). The statistical analysis was performed using the Student
-test, and values of
 < 0.05 were considered statistically significant.

 The serum levels of malondialdehyde were increased (
 < 0.0001), and the total antioxidant capacity was reduced in the PE group (
 = 0.034), indicating oxidative stress. In the PE group, the mean arterial pressure was significantly higher (
 < 0.0001), but the serum levels of NO did not show a statistically significant reduction (
= 0.20). The gene expression profiling of NOS3 and NOS2 revealed a down regulation in the PE group by 8.49 and 51.05 times respectively.

 Oxidative stress may lead to endothelial dysfunction, which could result in increased mean arterial pressure. Nitric oxide may play a role in this mechanism, but interactions with other vasoactive /biological substances cannot be overlooked, as the gene expression of NOS3 and NOS2 has been reduced.
 Oxidative stress may lead to endothelial dysfunction, which could result in increased mean arterial pressure. Nitric oxide may play a role in this mechanism, but interactions with other vasoactive /biological substances cannot be overlooked, as the gene expression of NOS3 and NOS2 has been reduced.Percutaneous mechanical assist devices are used in patients with cardiogenic shock. The purpose of this article is to familiarize critical care nurses with the various types of percutaneous mechanical assist devices, including the intra-aortic balloon pump, the Impella device, extracorporeal membrane oxygenation, and the TandemHeart device. Each type of device requires specific nursing care. In a patient with cardiogenic shock, the monitoring, care, and interventions provided by an experienced critical care nurse can make the difference between survival and death.
Untreated postoperative urinary retention (POUR) leads to bladder overdistension. Treatment of POUR involves urinary catheterization, which predisposes patients to catheter-associated urinary tract infections. The hospital's rate of POUR after lobectomy was 21%, exceeding the Society of Thoracic Surgeons' benchmark of 6.4%. Nurses observed that more patients were being catheterized after implementation of a newly revised urinary catheter protocol.

To reduce the incidence of POUR by implementing a thoracic surgery-specific nurse-led voiding algorithm.

Experts validated the voiding algorithm that standardized postoperative assessment. It was initiated after general thoracic surgery among 179 patients in a thoracic surgery stepdown unit of a large Magnet hospital. After obtaining verbal consent from patients, nurses collected demographic and clinical data and followed the algorithm, documenting voided amounts and bladder scan results. Descriptive statistics characterized the sample and the incidence of POUR. Associations were determined between demographic and clinical factors and POUR status by using the t test and χ2 test.

The POUR-positive group and the POUR-negative group were equivalent with regard to demographic and clinical factors, except more patients in the POUR-positive cohort had had a lobectomy (P = .05). The rate of POUR was 8%. Society of Thoracic Surgeons reports revealed a rapid and sustained reduction in the hospital's rates of POUR after lobectomy from 21% to 3%.

The use of this nurse-led voiding algorithm effectively reduced and sustained rates of POUR.
The use of this nurse-led voiding algorithm effectively reduced and sustained rates of POUR.
Corrected QT (QTc) interval prolongation is a type of ventricular tachyarrhythmia. Recommendations for QTc interval monitoring for critical care nurses are limited and variable.

The intensive care unit at the study institution had no policies for QTc interval monitoring. A quality improvement initiative for identifying and monitoring at-risk patients was begun.

A QTc interval monitoring protocol was developed according to current recommendations for electrocardiogram monitoring and input from experts. Nursing staff received education on the QTc monitoring protocol. Numbers of patients with indications for monitoring were collected for 60 days before and 60 days after implementation. The rate of protocol adherence was collected for 60 days after implementation. Aknowledge assessment was administered to nurses at baseline, immediately after education, and 4 months after education.

Before protocol implementation, 537 patients had indications for monitoring. No QTc intervals were documented by nurses. After protocol implementation, 544 patients had indications for monitoring. Protocol adherence was higher during day shifts than during night shifts (45.3% and 38.4%, respectively). Of 170 documented QTc prolongation events, 26 (15%) were reported to physicians. Nurses' knowledge significantly improved after education and was retained 4 months after education (correct responses to assessment questions 59% at baseline, 96% immediately after education, and 86% at 4 months after education).

This QTc interval monitoring protocol improved nurses' ability to identify and monitor patients with increased risk of QTc interval prolongation. Adherence was less than desired, suggesting that further protocol revisions are required.
This QTc interval monitoring protocol improved nurses' ability to identify and monitor patients with increased risk of QTc interval prolongation. Adherence was less than desired, suggesting that further protocol revisions are required.
Traumatic stress occurs in children when their coping mechanisms are overwhelmed by exposure to traumatic events or situations. Estimates indicate that as many as 80% of ill and injured children experience traumatic stress after such exposure. Critically ill or injured children are especially at risk for the development of traumatic stress, including acute stress reaction and posttraumatic stress disorder.

To explore the phenomenon of traumatic stress disorders in critically ill or injured children to assist bedside nurses in decreasing the severity of short- and long-term consequences in this patient population.

This article presents types of traumatic stress, risk factors for the development of traumatic stress, clinical findings in children and adolescents, and nursing strategies for preventing and managing traumatic stress in pediatric patients. Critical care and acute care nurses are in an excellent position to assess children for symptoms of acute stress reaction and posttraumatic stress disorder during or after a stay in the intensive care unit, to implement strategies to prevent or ease the symptoms of acute stress reaction and posttraumatic stress disorder, and to make appropriate referrals for children and their families after exposure to traumatic stressors.
This article presents types of traumatic stress, risk factors for the development of traumatic stress, clinical findings in children and adolescents, and nursing strategies for preventing and managing traumatic stress in pediatric patients. Critical care and acute care nurses are in an excellent position to assess children for symptoms of acute stress reaction and posttraumatic stress disorder during or after a stay in the intensive care unit, to implement strategies to prevent or ease the symptoms of acute stress reaction and posttraumatic stress disorder, and to make appropriate referrals for children and their families after exposure to traumatic stressors.
The number of reported cases with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine-induced subacute thyroiditis (SAT) and Graves' disease (GD) is growing. However, active debate continues about managing such side effects and the safety of repeat or booster doses of the vaccines in such cases.

This study aims to present long-term clinical follow-up of SARS-CoV-2 vaccine-induced SAT or GD cases and provide data regarding the safety of revaccinations.

Patients diagnosed with SARS-CoV-2 vaccine-induced SAT or GD were included. Data regarding the long-term clinical follow-up of SARS-CoV-2 vaccine-induced SAT and GD cases and outcomes of repeat or booster SARS-CoV-2 vaccinations were documented. The literature, including cases of SARS-CoV-2 vaccine-induced SAT or GD, was reviewed.

Fifteen patients with SARS-CoV-2 vaccine-induced SAT and 4 with GD were included. Pfizer/BioNTech COVID-19 vaccine (BNT162b2) was associated with symptoms in a majority of cases with SAT and all with GD. selleck inhibitor Median time from vaccination to symptom onset was 7 and 11.5 days, respectively, while 7 and 2 patients required medical treatment in SAT and GD groups, respectively. Remission was documented in 10 SAT patients, with a median time to remission of 11.5 weeks. No exacerbation/recurrence of SAT occurred in 7 of 9 patients who received a repeat vaccination dose, while symptoms of SAT worsened following the second vaccination in 2 cases. None of the patients experienced severe side effects that could be associated with revaccinations.

Revaccinations appear to be safe in patients with SARS-CoV-2 vaccine-induced SAT cases, while more evidence is needed regarding SARS-CoV-2 vaccine-induced GD.
Revaccinations appear to be safe in patients with SARS-CoV-2 vaccine-induced SAT cases, while more evidence is needed regarding SARS-CoV-2 vaccine-induced GD.
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