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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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ORIGINAL ARTICLE09-20-2024
Risk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
Abstract
ORIGINAL ARTICLERisk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
DOI 10.1590/0034-7167-2023-0127
Views0ABSTRACT
Objectives:
to evaluate the risk of postoperative complications in cardiac patients.
Methods:
an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.
Results:
the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).
Conclusions:
preoperative risk assessment promotes qualified care to reduce postoperative complications.
Keywords:Cardiac Surgical ProceduresCardiovascular DiseasesCardiovascular NursingPostoperative ComplicationsRisk AssessmentSee more -
EXPERIENCE REPORT09-20-2024
Researchers’ experience in data collection with families of femicide victims
Revista Brasileira de Enfermagem. 2024;77(4):e20230119
Abstract
EXPERIENCE REPORTResearchers’ experience in data collection with families of femicide victims
Revista Brasileira de Enfermagem. 2024;77(4):e20230119
DOI 10.1590/0034-7167-2023-0119
Views0See moreABSTRACT
Objectives:
to describe researchers’ experience in collecting data from families of femicide victims.
Methods:
this descriptive, qualitative study took the form of an experience report and was conducted in Manaus, Amazonas, Brazil. It involved documentary consultation, training researchers, scheduling and conducting interviews, and using a field diary to record the researchers’ perceptions and experiences.
Results:
the descriptions and photographs of the crime scene were both distressing and impactful for the researchers. The mementos of the victims (including clothing, objects, and childhood photos) shown by their families were deeply moving. Identifying with these experiences facilitated listening to the stories told by the relatives. It was essential to maintain a non-judgmental attitude, acknowledge the loss, provide support for the suffering, and demonstrate a willingness to help.
Final Considerations:
the experience encompassed both theoretical and methodological aspects that were planned and executed in data collection, fostering the development of skills and sensitivity towards the cases. Beyond knowledge and preparation, researchers are expected to exhibit ethical conduct and empathetic capacity.
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ORIGINAL ARTICLE09-20-2024
Factors associated with preventable infant mortality in 2020: a Brazilian population-based study
Revista Brasileira de Enfermagem. 2024;77(4):e20230072
Abstract
ORIGINAL ARTICLEFactors associated with preventable infant mortality in 2020: a Brazilian population-based study
Revista Brasileira de Enfermagem. 2024;77(4):e20230072
DOI 10.1590/0034-7167-2023-0072
Views0ABSTRACT
Objectives:
to identify factors associated with preventable infant deaths, classified as neonatal and post-neonatal.
Methods:
this is an epidemiological and population-based study relating to 2020. Data from the Mortality Information System (MIS) and the preventability classification proposed in the Brazilian Health System List of Causes of Deaths Preventable by Interventions were used.
Results:
prematurity, living in the North and Northeast regions and the occurrence of the event at home were associated with preventable neonatal deaths. To the avoidable post-neonatal component, death outside the hospital, low maternal education and children of brown or yellow color/race were associated.
Conclusions:
the main risk factor associated with preventable deaths was prematurity, in the case of neonatal death. Low maternal education and occurrence outside the hospital were associated with post-neonatal deaths.
Keywords:Epidemiological StudiesHealth Care QualityHealth Information SystemsInfant MortalityVital StatisticsSee more -
EDITORIAL09-09-2024
Potential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
Abstract
EDITORIALPotential of Artificial Intelligence in Evidence-Based Practice in Nursing
Revista Brasileira de Enfermagem. 2024;77(5):e770501
DOI 10.1590/0034-7167.2024770501
Views0Evidence-based practice (EBP) has established itself as a fundamental pillar in nursing, driving effective clinical decision-making based on high-quality scientific research. The primary goal of EBP is to ensure that patients receive the most appropriate and safe care, based on the best available evidence. In this context, knowledge synthesis methods are essential tools for EBP, […]See more -
REVIEW09-06-2024
Parents’ or legal guardians’ beliefs and attitudes about childhood vaccination: a scoping review
Revista Brasileira de Enfermagem. 2024;77(4):e20240126
Abstract
REVIEWParents’ or legal guardians’ beliefs and attitudes about childhood vaccination: a scoping review
Revista Brasileira de Enfermagem. 2024;77(4):e20240126
DOI 10.1590/0034-7167-2024-0126
Views0See moreABSTRACT
Objective:
to map scientific evidence about perceptions, beliefs, knowledge and attitudes of parents or legal guardians of children under 5 years of age regarding routine childhood vaccination.
Methods:
a scoping review, conducted in accordance with the JBI framework. The searches were carried out in the PubMed/MEDLINE, Web of Science, Scopus and LILACS databases. A total of 5,535 studies were returned and 77 were selected, which met the inclusion criteria.
Results:
perceptions related to interaction with healthcare professionals and services, with family organization and structure, with social interaction and public policies, cultural, religious and personal beliefs, knowledge about vaccination schedule, vaccination and immunization process and sources of information are the main factors mapped and which can positively or negatively influence parents’ or legal guardians’ attitudes towards vaccinating children.
Conclusions:
the findings allow us to identify factors related to parents’ perception and beliefs about childhood vaccination.
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ORIGINAL ARTICLE09-06-2024
Construction and validation of an instrument for event-related sterility of processed healthcare products
Revista Brasileira de Enfermagem. 2024;77(4):e20240021
Abstract
ORIGINAL ARTICLEConstruction and validation of an instrument for event-related sterility of processed healthcare products
Revista Brasileira de Enfermagem. 2024;77(4):e20240021
DOI 10.1590/0034-7167-2024-0021
Views0See moreABSTRACT
Objective:
To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products.
Methods:
This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing.
Results:
Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable.
Conclusion:
The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products.
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ORIGINAL ARTICLE09-06-2024
Reflective practice of nurse residents in the teaching-learning process in teaching hospitals
Revista Brasileira de Enfermagem. 2024;77(4):e20230540
Abstract
ORIGINAL ARTICLEReflective practice of nurse residents in the teaching-learning process in teaching hospitals
Revista Brasileira de Enfermagem. 2024;77(4):e20230540
DOI 10.1590/0034-7167-2023-0540
Views0See moreABSTRACT
Objective:
To analyze reflective practice in the teaching-learning process of nurses in residency programs in teaching hospitals in Minas Gerais, Brazil.
Methods:
Case study, based on the reflective practice framework, conducted in two teaching hospitals. Observation and interviews were conducted with first and second-year residents, and five participants were included for in-depth analysis, with their data subjected to frequency distribution analysis and Critical Discourse Analysis.
Results:
In 519 observed activities, elements of reflection were identified in 22.2%, especially active listening and expression of doubts. Discourses indicated practice as the best moment for teaching-learning due to its potential to generate reflections. Learning by doing and case discussion were considered potential strategies for reflective learning.
Conclusion:
Know-in-action reflection was evidenced as the predominant formative aspect for residents, with few opportunities for reflection on reflection-in-action.
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ORIGINAL ARTICLE09-06-2024
Middle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
Revista Brasileira de Enfermagem. 2024;77(4):e20230516
Abstract
ORIGINAL ARTICLEMiddle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults
Revista Brasileira de Enfermagem. 2024;77(4):e20230516
DOI 10.1590/0034-7167-2023-0516
Views0See moreABSTRACT
Objective:
To construct a middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults.
Methods:
A methodological study for the validation of a nursing diagnosis based on a Middle-Range Theory, carried out in six stages: definition of the approach; definition of theoretical-conceptual models; definition of main concepts; development of a pictorial scheme; construction of propositions; establishment of causal relationships and evidence for practice. The theory construction was operationalized through an integrative review and supported by Roy’s adaptation model.
Results:
Three essential attributes were identified; 10 antecedents; 7 clinical consequences; a pictogram, 9 propositions, and 11 causal relationships and evidence for practice.
Conclusion:
The middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults was constructed, expanding the understanding of this phenomenon, to be applied in clinical practice by nurses.
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EXPERIENCE REPORT02-03-2023
Quality management in the COVID-19 pandemic: nursing action plan
Revista Brasileira de Enfermagem. 2023;76:e20220272
Abstract
EXPERIENCE REPORTQuality management in the COVID-19 pandemic: nursing action plan
Revista Brasileira de Enfermagem. 2023;76:e20220272
DOI 10.1590/0034-7167-2022-0272
Views0See moreABSTRACT
Objectives:
to describe the implementation of a nursing action plan to face the pandemic of COVID 19 in a University Hospital in the state of Rio de Janeiro. Methods: this is an experience report, in which two management tools were used: the Ishikawa Diagram to identify problems and the 5W2H spreadsheet to outline the actions according to the situations presented.
Results:
four categories were listed in two groups: 1- Actions of the Nurse Manager in the Organization of Logistics, Infrastructure and Care: materials and environment; and 2- Nursing Human Resources Management and Continuing Education: method and human resources.
Final Considerations:
the plan developed showed the role of nursing management, with the search for best care practices, development of protocols, carrying out multi-professional training and management of supplies.
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ORIGINAL ARTICLE01-30-2023
Development and content validity of a website for patients with coronary artery disease
Revista Brasileira de Enfermagem. 2023;76(1):e20220302
Abstract
ORIGINAL ARTICLEDevelopment and content validity of a website for patients with coronary artery disease
Revista Brasileira de Enfermagem. 2023;76(1):e20220302
DOI 10.1590/0034-7167-2022-0302
Views0ABSTRACT
Objectives:
to develop and analyze content validity evidence of a website for patients with coronary artery disease.
Methods:
a methodological study, carried out in the phases: Definition – determined contents for inclusion in the website, architecture and design; Implementation – subjects included in the website; Assessment – website submitted to analysis by 13 experts and eight laypersons regarding organization, content and design, on a scale of 1 (no agreement) to 4 (complete agreement). Items that reached Content Validity Ratio (CVR) higher than the established critical values and Content Validity Index greater than 0.80 were considered valid.
Results:
eight domains related to secondary prevention in coronary heart disease were included on the website. Critical CVR and adequate CVI were obtained according to professional and lay experts.
Conclusions:
the website was developed, achieving adequate content validity evidence, and can be used as an educational tool for this population.
Keywords:Computer Communication NetworksCoronary Artery DiseaseHealth EducationSecondary PreventionValidation StudySee more -
ORIGINAL ARTICLE01-30-2023
Development and validation of an instrument for the evaluation of HIV care in Primary Health Care
Revista Brasileira de Enfermagem. 2023;76(1):e20220247
Abstract
ORIGINAL ARTICLEDevelopment and validation of an instrument for the evaluation of HIV care in Primary Health Care
Revista Brasileira de Enfermagem. 2023;76(1):e20220247
DOI 10.1590/0034-7167-2022-0247
Views0See moreABSTRACT
Objective:
To develop and validate an instrument to evaluate the decentralization process of care for People Living with HIV in Primary Health Care.
Method:
Methodological study, developed in four stages: elaboration of the logical model based on the triad Structure-Process-Outcomes; development of the instrument; content validation by expert judges and technical reviewers; and semantic validation. Online questionnaires were used, and the Kappa index was used for analysis.
Results:
The instrument with 68 items and 8 factors was submitted to validation by expert judges who recommended the exclusion of 3 items and the alteration of 2 factors. In the validation by technical reviewers, 2 items were excluded and 6 factors were highlighted; the agreement index was ≥0.75. In the semantic validation, 87.3% of the judges answered “totally agree” for the items presented.
Conclusion:
The instrument is validated for its content, has 63 items and has the potential to assess the care provided for people living with HIV in Primary Health Care.
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REVIEW01-30-2023
Transition from parents to caregivers of a child with type 1 Diabetes Mellitus: a scoping review
Revista Brasileira de Enfermagem. 2023;76(1):e20220201
Abstract
REVIEWTransition from parents to caregivers of a child with type 1 Diabetes Mellitus: a scoping review
Revista Brasileira de Enfermagem. 2023;76(1):e20220201
DOI 10.1590/0034-7167-2022-0201
Views0See moreABSTRACT
Objectives:
to map and summarize the existing scientific evidence on parents’ transition experience to exercise the caregiver role of a child with 1DM, identifying gaps in knowledge of this experience.
Methods:
a scoping review was carried out based on JBI methodology, in two databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
we included 31 articles. From the studies, constitutive elements of parents’ transition experience to caregiver role of a child with 1DM were found, which focused on the nature of the experience, the feelings and emotions experienced, the hindering conditions, the facilitating conditions, the strategies used by parents and the results or effects obtained.
Final considerations:
the transition process’ characterizing elements were identified, but not a theoretical explanation of it. Additional research should be carried out in order to allow a deeper understanding of this process.
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ORIGINAL ARTICLE01-30-2023
Continued breastfeeding and work: scenario of maternal persistence and resilience
Revista Brasileira de Enfermagem. 2023;76(1):e20220191
Abstract
ORIGINAL ARTICLEContinued breastfeeding and work: scenario of maternal persistence and resilience
Revista Brasileira de Enfermagem. 2023;76(1):e20220191
DOI 10.1590/0034-7167-2022-0191
Views0See moreABSTRACT
Objectives:
to understand the challenges in mothers’ daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding.
Methods:
a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021.
Results:
themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding.
Final Considerations:
women’s experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children’s food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.
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ORIGINAL ARTICLE01-30-2023
Acurácia do diagnóstico de enfermagem desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
Abstract
ORIGINAL ARTICLEAcurácia do diagnóstico de enfermagem desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
DOI 10.1590/0034-7167-2022-0174
Views0RESUMEN
Objetivos:
analizar la precisión de indicadores clínicos de limpieza ineficaz de las vías aéreas en pacientes de unidades de cuidados intensivos adulto.
Métodos:
estudio de precisión diagnóstica en unidad de cuidados intensivos de hospital universitario en noreste brasileño. Muestra de 104 pacientes hospitalizados entre junio y octubre de 2019.
Resultados:
prevalencia de limpieza ineficaz de las vías aéreas del 36,54%. Indicadores con alta especificidad; ausencia de tos (0,8326), ortopnea (0,6817), ruidos respiratorios adventicios (0,8175) y ruidos respiratorios disminuidos (0,8326). Indicadores clínicos con alta sensibilidad y especificidad; cambio en la frecuencia respiratoria (0,9999) y cambio en el patrón de respiración (0,9999).
Conclusiones:
seis indicadores clínicos proporcionaron identificación precisa de la limpieza ineficaz de las vías aéreas; cambio en la frecuencia respiratoria y cambio en el patrón de respiración fueron los más precisos para pacientes críticos. Nuestros hallazgos contribuyen a inferencias diagnósticas precisas y la prevención de complicaciones respiratorias en estos pacientes.
Keywords:Diagnóstico de EnfermagemEnfermagemGestão de DadosSistema RespiratórioUnidades de Terapia IntensivaSee more -
ORIGINAL ARTICLE01-30-2023
Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
Abstract
ORIGINAL ARTICLEAccuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients
Revista Brasileira de Enfermagem. 2023;76(1):e20220174
DOI 10.1590/0034-7167-2022-0174
Views0See moreABSTRACT
Objectives:
to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients.
Methods:
diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019.
Results:
the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999).
Conclusions:
six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.
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