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Fungal infections in neonatal intensive care units (NICU) are mainly related to Candida species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify Candida species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. C. parapsilosis complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (Candida parapsilosis complex) were resistant to amphotericin B, two (Candida famata [currently Debaryomyces hansenii] and Candida guilliermondii [currently Meyerozyma guilliermondii]) was resistant to micafungin, and six (Candida parapsilosis complex, Candida guilliermondii [=Meyerozyma guilliermondii], Candida viswanathi, Candida catenulata [currently Diutina catenulata] and Candida lusitaniae [currently Clavispora lusitaniae]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. Candida spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.
Assuntos
Antifúngicos , Candida , Infecção Hospitalar , Etanol , Mãos , Testes de Sensibilidade Microbiana , Fatores de Virulência , Humanos , Mãos/microbiologia , Antifúngicos/farmacologia , Fatores de Virulência/genética , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candida/genética , Candida/patogenicidade , Etanol/farmacologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Candidíase/microbiologia , Pessoal de Saúde , Técnica de Amplificação ao Acaso de DNA Polimórfico , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Unidades de Terapia Intensiva Neonatal , Farmacorresistência Fúngica , Géis , Desinfecção das MãosRESUMO
Objective: To determine the epidemiological profile of patients treated at a philanthropic hospital specialized in Orthopedics and Traumatology, located in a significant urban center, and evaluate the efficacy of initial empirical antibiotic treatment. Methods: Patients diagnosed with hand infections from September 2020 to September 2022 were included, excluding cases related to open fractures or post-surgical infections and those with incomplete medical records. The chi-square test was performed using STATISTICA ® software to correlate various variables. Results: A total of 34 patients participated, including 24 men and 10 women, with an average age of 41.9 years. Most male patients had Diabetes Mellitus, HIV, and drug addiction, and they resided in urban areas. Half of the patients did not report any apparent trauma. The most common infectious agent was Staphylococcus aureus*. Nearly 62% of patients required a change in the initial antibiotic regimen, with Penicillin being the most frequently substituted medication. Beta-lactam antibiotics and Quinolones were the most effective. Conclusion: These results suggest the importance of carefully evaluating the epidemiological profile of patients with acute hand infections and improving initial empirical treatment to ensure appropriate and effective therapy. Level of Evidence IV, Cross-Sectional Observational Study.
Objetivo: Determinar o perfil epidemiológico de pacientes atendidos em um hospital filantrópico referência em Ortopedia e Traumatologia localizado em um centro urbano importante, e avaliar a eficácia do tratamento antibiótico empírico inicial. Métodos: Foram incluídos pacientes com diagnóstico de infecção na mão, atendidos no período de setembro de 2020 a setembro de 2022, excluindo-se casos relacionados a fraturas expostas ou pós-cirúrgicas e aqueles com prontuários incompletos. Realizou-se o teste do qui-quadrado, utilizando o software STATISTICA ® para correlacionar diversas variáveis. Resultados: Participaram do estudo 34 pacientes, sendo 24 homens e 10 mulheres, com média de idade de 41,9 anos. A maioria era de homens, com alta incidência de diabetes mellitus, HIV e drogadição, que residiam em áreas livres. Metade não relatou trauma evidente. O agente infeccioso mais comum foi o Staphylococcus aureus. Aproximadamente 62% dos pacientes precisaram de troca do esquema inicial de antibióticos, sendo a penicilina o medicamento mais frequentemente substituído. Os antibióticos beta-lactâmicos e quinolonas foram os mais eficientes. Conclusão: Esses resultados sugerem a importância de avaliar cuidadosamente o perfil epidemiológico dos pacientes com infecções agudas na mão e aprimorar o tratamento empírico inicial para garantir uma terapia adequada e eficaz. Nível de Evidência IV, Estudo Observacional Transversal.
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Research-based education at the undergraduate level is ideal for fostering the training of future scientists. In an undergraduate Developmental Biology course, this learning strategy requires the availability of model species and enough research reagents, not only for technique training but also for the development of student original projects. This might be challenging in most countries, where resources are limited. Hence, there is a need to develop low-cost solutions for use in the classroom. In this study, we describe the optimization and use of two low-cost protocols in zebrafish embryos for hands-on practical sessions and project-based learning in a Developmental Biology undergraduate course in Ecuador. These protocols were designed for the practical and experimental learning of vertebrate meroblastic cleavage, gastrulation, and neural crest differentiation. The proposed protocols have been previously described in the literature and use silver nitrate and alcian blue, two relatively inexpensive reagents, to label cell membranes and cartilage. The silver nitrate protocol allows the study of cell contact formation during cleavage and the identification of cellular changes during gastrulation, including yolk internalization and epiboly. The alcian blue staining allows the analysis of cranial mesenchymal differentiation into cartilage. These protocols are ideal for practical sessions due to their ease of application, quick results, adaptability to the class schedule, and robustness in the hands of beginning researchers. Finally, these protocols are adaptable for research-based class projects.
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Nitrato de Prata , Peixe-Zebra , Humanos , Animais , Equador , Azul Alciano , Biologia do DesenvolvimentoRESUMO
ABSTRACT Objective: To determine the epidemiological profile of patients treated at a philanthropic hospital specialized in Orthopedics and Traumatology, located in a significant urban center, and evaluate the efficacy of initial empirical antibiotic treatment. Methods: Patients diagnosed with hand infections from September 2020 to September 2022 were included, excluding cases related to open fractures or post-surgical infections and those with incomplete medical records. The chi-square test was performed using STATISTICA ® software to correlate various variables. Results: A total of 34 patients participated, including 24 men and 10 women, with an average age of 41.9 years. Most male patients had Diabetes Mellitus, HIV, and drug addiction, and they resided in urban areas. Half of the patients did not report any apparent trauma. The most common infectious agent was Staphylococcus aureus*. Nearly 62% of patients required a change in the initial antibiotic regimen, with Penicillin being the most frequently substituted medication. Beta-lactam antibiotics and Quinolones were the most effective. Conclusion: These results suggest the importance of carefully evaluating the epidemiological profile of patients with acute hand infections and improving initial empirical treatment to ensure appropriate and effective therapy. Level of Evidence IV, Cross-Sectional Observational Study.
RESUMO Objetivo: Determinar o perfil epidemiológico de pacientes atendidos em um hospital filantrópico referência em Ortopedia e Traumatologia localizado em um centro urbano importante, e avaliar a eficácia do tratamento antibiótico empírico inicial. Métodos: Foram incluídos pacientes com diagnóstico de infecção na mão, atendidos no período de setembro de 2020 a setembro de 2022, excluindo-se casos relacionados a fraturas expostas ou pós-cirúrgicas e aqueles com prontuários incompletos. Realizou-se o teste do qui-quadrado, utilizando o software STATISTICA ® para correlacionar diversas variáveis. Resultados: Participaram do estudo 34 pacientes, sendo 24 homens e 10 mulheres, com média de idade de 41,9 anos. A maioria era de homens, com alta incidência de diabetes mellitus, HIV e drogadição, que residiam em áreas livres. Metade não relatou trauma evidente. O agente infeccioso mais comum foi o Staphylococcus aureus. Aproximadamente 62% dos pacientes precisaram de troca do esquema inicial de antibióticos, sendo a penicilina o medicamento mais frequentemente substituído. Os antibióticos beta-lactâmicos e quinolonas foram os mais eficientes. Conclusão: Esses resultados sugerem a importância de avaliar cuidadosamente o perfil epidemiológico dos pacientes com infecções agudas na mão e aprimorar o tratamento empírico inicial para garantir uma terapia adequada e eficaz. Nível de Evidência IV, Estudo Observacional Transversal.
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Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus, representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia, Acinetobacter baumanii, Pseudomonas aeruginosa, Pseudomonas gessardi, Pantoea septica, Serratia marcescens, and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons' hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings.
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Traditional lab classes in microbiology are common in several educational institutions, which can provide a learning experience disconnected from the myriad of experiments performed in research laboratories. Attempting to promote an authentic learning opportunity of the functioning of a bacteriology research laboratory, we developed the "Real-Lab-Day," a multimodal learning experience to develop competencies, abilities, critical analysis, and teamwork skills for undergraduate students. Students were divided into groups and assigned to research laboratories to be mentored by graduate students, to design and carry out scientific assays. Undergraduate students were introduced to methods such as cellular and molecular assays, flow cytometry, and fluorescence microscopy, as tools to address scientific questions about bacterial pathogenicity, bacterial resistance, and other topics. To consolidate their learning, students created and presented a poster in a rotational panel of peer learning. The perceived learning and interest in microbiology research were improved by the Real-Lab-Day experience, and >95% of the students approved the Real-Lab-Day as a teaching tool in microbiology. Students exposed to a research laboratory had a positive experience with the teaching method, and over 90% saw it as beneficial to improve their understanding of the scientific concepts discussed during lectures. Likewise, their interest in pursuing a career in microbiology was stimulated by the Real-Lab-Day experience. In conclusion, this educational initiative depicts an alternative methodology to connect students to the research and offers an opportunity to be in close contact with experts and graduate students, who gain teaching experience.
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Currículo , Educação de Graduação em Medicina , Humanos , Aprendizagem , Estudantes , Instituições Acadêmicas , Educação de Graduação em Medicina/métodos , Microbiologia/educaçãoRESUMO
Abstract Background Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. Objectives To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. Methods A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. Results A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). Study limitations The number of treated cases and socioeconomic profile was limited to a vulnerable population group. Conclusion HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.
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Fundamento: mejorar la higiene de las manos de manera eficaz y sostenida se consigue mediante la aplicación de múltiples medidas para abordar diferentes obstáculos, así como barreras conductuales, es por ello que se hace necesario crear medios que permitan su aprendizaje. Objetivo: diseñar medios de enseñanza que contribuyan al aprendizaje de la higiene de manos tanto en estudiantes de Lic. en Enfermería como en la comunidad. Métodos: se desarrolló una investigación cualicuantitativa, durante el período de estudio de junio 2018 a julio 2021. Los escenarios fueron el Círculo Infantil Marineritos del Sur, Escuela Primaria Guerrillero Heroico y la Universidad de Ciencias Médicas en el municipio de Cienfuegos. Se realizaron grupos de discusión en los tres escenarios, de lo cual emergieron las categorías capacitación y medios de enseñanza, que fueron creados y validados por la metodología de Barraza. Resultados: se diseñó una página web, una aplicación para móvil, juegos didácticos para los niños y trípticos. Todos fueron validados satisfactoriamente. Conclusiones: el diseño de medios de enseñanza, sustentados científicamente, se corresponde con las necesidades de los estudiantes la carrera de Licenciatura en Enfermería y de la comunidad para el logro de los conocimientos teóricos y prácticos en la adherencia a la técnica correcta de higiene de manos.
Summary: Introduction: The improvement of effective and sustained hand hygiene is achieved through the application of multiple measures to address different obstacles, as well as behavioral barriers, which is why it is necessary to create means that allow the learning of it, in such a way. In this sense, the objective is to design teaching means that contribute to the learning of hand hygiene both in Nursing students and in the community, Method; a qualitative-quantitative investigation was developed, Results the qualitative phase was evidenced when a discussion group was carried out from which the category training and teaching aids emerged, which allowed the design of a web page, a mobile application, didactic games for children and triptychs, and the quantitative phase when said teaching aids were validated by the Barraza methodology.
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Assistive technology can help people with disabilities to use computers more effectively and can enable them to access the same information and resources as people without disabilities. To obtain more insight into the factors that can bring about the design of an Emulator of Mouse and Keyboard (EMKEY) to higher levels of user satisfaction, an experimental study was conducted in order to analyse its effectiveness and efficiency. The experimental study involved 27 participants (Mage = 20.81, SD = 1.14) who performed three experimental games under different conditions (using the mouse and using EMKEY with head movements and voice commands). According to the results, the use of EMKEY allowed for the successful performance of tasks such as matching stimuli (F(2,78) = 2.39, p = 0.10, η2 = 0.06). However, the execution times of a task were found to be higher when using the emulator to drag an object on the screen (t(52,1) = -18.45, p ≤ 0.001, d = 9.60). These results indicate the effectiveness of technological development for people with upper limb disabilities; however, there is room for improvement in terms of efficiency. The findings are discussed in relation to previous research and are based on future studies aimed at improving the operation of the EMKEY emulator.
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Pessoas com Deficiência , Tecnologia Assistiva , Humanos , Interface Usuário-Computador , Computadores , Extremidade SuperiorRESUMO
BACKGROUND: Hand eczema (HE) is a highly prevalent, recurrent, and multifactorial disease. It encompasses a group of eczematous diseases that affect the hands, etiologically classified into irritant contact dermatitis (ICD), allergic contact dermatitis (ACD) and atopic dermatitis (AD). Few epidemiological studies in Latin America have investigated the characteristics of patients with this condition and the origin of the disease. OBJECTIVES: To analyze the profile of patients diagnosed with HE submitted to patch tests aiming to determine its etiology. METHODS: A retrospective descriptive study was carried out on epidemiological data and patch tests of patients with HE treated at a tertiary hospital in the city of São Paulo from January 2013 to December 2020. RESULTS: A total of 173 patients were studied, whose final diagnosis was 61.8% of ICD, 23.1% of ACD and 5.2% of AD, with diagnostic overlap in 42.8% of the cases. The main positive and relevant patch tests were: Kathon CG (42%), nickel sulfate (33%), and thiuram mix (18%). STUDY LIMITATIONS: The number of treated cases and socioeconomic profile was limited to a vulnerable population group. CONCLUSION: HE is a diagnosis in which overlapping etiologies are frequent, with the main sensitizers identified in ACD being Kathon CG, nickel sulfate and thiuram mix.
Assuntos
Dermatite Alérgica de Contato , Dermatite Atópica , Dermatite Irritante , Eczema , Humanos , Estudos Retrospectivos , Tiram , Testes do Emplastro , Brasil/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Eczema/diagnóstico , Eczema/epidemiologia , Eczema/induzido quimicamente , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Dermatite Irritante/diagnóstico , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Alérgenos/efeitos adversosRESUMO
AIM: To present our experience on osteosarcomas of the hands and review the existing literature pertaining osteosarcomas in this extremely rare location. METHODS: and results: Seven cases of osteosarcomas of the hands were reviewed, and a literature search of all primary osteosarcomas of the hands was performed. All tumors occurred in adults (mean age, 41 years) and were located mainly around the metacarpophalangeal joints. All patients presented with localized long-lasting pain as main symptom. The mean size at diagnosis was 33 mm. Three tumors were low-grade central osteosarcomas, 1 low-grade central chondroblastoma-like osteosarcoma and 3 high-grade osteosarcomas. All tumors were positive for mouse double-minute 2 homolog (MDM2) immunohistochemistry. Three cases yielded results with fluorescence in-situ amplification for MDM2 (12q15)/CEP12. At last follow-up, one patient with a high-grade osteosarcoma was dead of disease. The literature review revealed similar demographic and site distribution of osteosarcomas within the hands than our series and an unusually high proportion of low-grade central and parosteal osteosarcomas when compared to the proportion of these infrequent neoplasms in the whole skeleton. CONCLUSIONS: osteosarcomas of hands present in older individuals compared to the population affected by conventional osteosarcomas of all sites. Importantly from a diagnostic, therapeutic and prognostic points of view, around 40% of osteosarcomas of the hands are low-grade osteosarcomas of the central or parosteal types.
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Neoplasias Ósseas , Osteossarcoma , Animais , Camundongos , Neoplasias Ósseas/patologia , Osteossarcoma/patologia , Prognóstico , Imuno-HistoquímicaRESUMO
Nowadays there is a concern to improve the quality of education by including an interdisciplinary approach of concepts and their integration in the curriculum of scientific disciplines. The development of microbial fuel cells as a potential alternative for production of renewable energies gives undergraduate students the challenge of integrating interdisciplinary concepts in a hot topic of global interest as alternative energies. We present a laboratory experiment that has been part of a third-year undergraduate course in biology where students gained experience in assembling microbial fuel cells and the understanding of how they work. In this process, the students could integrate biological, biochemical, and electric concepts. In addition, the acquisition of manual skills and experimental design decisions are important for the development of future professionals.
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Fontes de Energia Bioelétrica , Humanos , Avaliação Educacional , Currículo , Estudantes , Estudos InterdisciplinaresRESUMO
OBJECTIVES: This randomized controlled trial evaluated the stress, anxiety, and burnout of professionals exposed to complementary spiritist therapy (CST), which consists in therapeutic resources as prayer, Spiritist passe, fluidic water and spiritual education or control. METHODS: Seventy-six professionals were randomized to CST or control: to maintain the routine for 5 weeks. The ISSL scale, anxiety and depression Beck's indices, Maslach instrument, subjective well-being and WHOQOL-BREF were used at baseline and five-week. Blood count and cytokine dosage were collected at baseline, one-week and five-week. Analysis using the intention to treat approach. RESULTS: The means of variation of stress (exhaustion phase) between baseline and five-week were -1.50 ± 3.31 in the CST and 0.72 ± 3.50 in the control (p=0.036), effect size for CST group was d=0.65, which is considered medium effect. CST showed decrease in emotional exhaustion and negative affects, and increase in lymphocytes, erythrocyte parameters and platelets between the baseline and five-week (p<0.05). Reduction in IL-1ß and increase in total lymphocyte count were observed with 2-3 sessions per week, but that does not maintain when the number of sessions is decreased. Participants receiving ≥7 sessions reduced emotional exhaustion, depersonalization and stress, and improved hematological parameters throughout the study (p<0.05). CONCLUSIONS: CST may be effective in reducing stress (exhaustion phase) compared to control. Higher frequency of interventions promotes better psychic state, evidenced by large effect size for emotional exhaustion in burnout, and improves hematological parameters of professionals.
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Terapias Espirituais , Humanos , Ansiedade/terapia , Emoções , Hospitais Públicos , Esgotamento PsicológicoRESUMO
Objetivo: Determinar la validez y confiabilidad de la escala CIBISA para la autoevaluación del aprendizaje práctico de estudiantes de enfermería. Material y Método: Estudio instrumental, transversal, con estudiantes de enfermería que estuvieron realizando prácticas clínicas, en el que se analizaron las propiedades psicométricas de la escala CIBISA, tales como la validación de contenido y consistencia interna a través del cálculo de V de Aiken y posteriormente Análisis factorial confirmatorio (AFC), respectivamente. Finalmente, se calculó la confiabilidad de la escala. Resultados: Se obtuvo una V de Aiken de 0,9. Asimismo, los valores de asimetría y curtosis del ítem 1 y 28 superaron el valor +/- 1,5. Los índices de bondad de ajuste del modelo original mostraron valores deficientes; por lo que, a través de la técnica de modificación de índices se eliminaron los ítems 8, 10, 18, 21, 25, 28, 13 y 26 donde los índices de bondad de ajuste mostraron que el modelo de 20 ítems era satisfactorio (χ2 = 4776,826; df= 190; p= 0,000; CFI= 0,938; TLI= 0,930; RMSEA= 0,080 y SRMR< 0,080). La confiabilidad de la escala presenta un coeficiente α de Cronbach= 0,91. Conclusión: La escala CIBISA de 20 ítems es válida y confiable para medir la autoevaluación del aprendizaje práctico del estudiante de enfermería.
Objective: To determine the validity and reliability of the CIBISA scale for the self-assessment of practical learning of nursing students. Material and Method: Instrumental, cross-sectional study, with nursing students who were doing clinical practices, in which the psychometric properties of the CIBISA scale were analyzed, such as the validation of content and internal consistency through the calculation of Aiken's V and subsequently confirmatory factor analysis (CFA), respectively. Finally, the reliability of the scale was calculated. Results: Aiken's V of 0.9 was obtained. Likewise, the values of asymmetry and kurtosis of item 1 and 28 exceeded the value +/- 1.5. The goodness of fit indices of the original model showed deficient values; Therefore, through the index modification technique, items 8, 10, 18, 21, 25, 28, 13 and 26 were eliminated, where the goodness-of-fit indices showed that the 20-item model was satisfactory (χ2= 4776.826; df= 190; p= 0.000; CFI= 0.938; TLI= 0.930; RMSEA= 0.080 and SRMR< 0.080). The reliability of the scale presents a Cronbach's α coefficient=0.91. Conclusion: The 20-item CIBISA scale is valid and reliable to measure the self-assessment of practical learning of nursing students.
Objetivo: Determinar a validade e confiabilidade da escala CIBISA para a autoavaliação da aprendizagem prática de estudantes de enfermagem. Material e Método: Estudo instrumental, transversal, com estudantes de enfermagem que realizavam práticas clínicas, no qual foram analisadas as propriedades psicométricas da escala CIBISA, como a validação de conteúdo e consistência interna através do cálculo do V de Aiken e posteriormente confirmatório análise fatorial (CFA), respectivamente. Por fim, calculou-se a confiabilidade da escala. Resultados: Obteve-se V de Aiken de 0,9. Da mesma forma, os valores de assimetria e curtose dos itens 1 e 28 ultrapassaram o valor +/- 1,5. Os índices de qualidade de ajuste do modelo original apresentaram valores deficientes; portanto, através da técnica de modificação do índice, os itens 8, 10, 18, 21, 25, 28, 13 e 26 foram eliminados, onde os índices de qualidade de ajuste mostraram que o modelo de 20 itens foi satisfatório (χ2= 4776,826; df= 190; p= 0,000; CFI= 0,938; TLI= 0,930; RMSEA= 0,080 e SRMR< 0,080). A confiabilidade da escala apresenta coeficiente α de Cronbach= 0,91. Conclusão: A escala CIBISA de 20 itens é válida e confiável para medir a autoavaliação da aprendizagem prática de estudantes de enfermagem.
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Já é sabido que a higiene das mãos é a principal arma na prevenção de doenças infecciosas dentro e fora dos hospitais. No caso do vírus SARSCoV-2, a higienização das mãos é essencial, tendo em vista a possibilidade de contaminação pelo contato direto com as gotículas respiratórias ou pelo contato indireto. Existem no mercado diversas opções de produtos antissépticos disponíveis para uso pela população. No entanto, nenhum é 100% eficaz em todas as situações. Dentre esses diversos produtos disponíveis, o etanol 70% é o mais utilizado para a aplicação nas mãos, sendo veiculado na forma farmacêutica gel para facilitar a aplicação. As formas farmacêuticas gel contendo etanol 70% podem ser industrializadas ou manipuladas. Quando essas formulações são manipuladas, elas são isentas de registro na Agência de Vigilância Sanitária (ANVISA), não sendo exigidos nem mesmo os testes de segurança e eficácia que são exigidos para o registro de produtos industrializados. Para os manipulados, são realizados apenas os testes de descrição, aspecto, características organolépticas (cor e odor) pH e peso. Desta forma, a realização deste trabalho teve como objetivo avaliar a qualidade, incluindo características físico-químicas de amostras de álcool em gel manipuladas na cidade de Irecê-Ba, e compará-las com um produto industrializado de marca conhecida. Foram analisados os aspectos e características organolépticas, determinação do potencial de hidrogênio (pH), densidade, espalhabilidade, viscosidade, estabilidade (resistência a centrifugação) e teor alcoólico de 4 amostras (2 amostras industrializadas, denominadas A e B adquiridas em diferentes farmácias de manipulação da cidade, e 2 amostras magistrais, denominadas de amostra C e D. Sendo assim, observou-se que nenhuma das amostras se enquadraram nos parâmetros estabelecidos, como o pH mais ácido, densidade e viscosidade fora do padrão, diferentes comportamentos de espalhabilidade e teor alcoólico abaixo do ideal, apontando inconformidades que afetam a qualidade e ação do produto. Os resultados encontrados nesse estudo possibilitam concluir que as amostras de álcool gel de origem magistral apresentaram-se muito semelhante em termos de qualidade aos produtos industrializados. Portanto, entende-se que, apenas uma elaboração de leis não seja suficiente para garantir a qualidade e segurança do produto, se faz necessário uma fiscalização mais rigorosa e elaboração de leis mais qualificadas.
It is already known that hand hygiene is the main weapon in the prevention of infectious diseases inside and outside hospitals. In the case of the SARSCoV-2, hand hygiene is essential, in view of the possibility of contamination through direct contact with respiratory droplets or through indirect contact. There are several options of antiseptic products available on the market for use by the population. However, none are 100% effective in all situations. Among these different products available, 70% ethanol is the most used for application in the hands, being conveyed in the pharmaceutical form of a gel to facilitate the application. The pharmaceutical gel forms containing 70% ethanol can be industrialized or manipulated. When these formulations are manipulated, they are exempt from registration with the Health Surveillance Agency (ANVISA), not even requiring the safety and efficacy tests that are required for the registration of industrialized products. For manipulated products, only tests of description, appearance, organoleptic characteristics (color and odor), pH and weight are carried out. Thus, this work aimed to evaluate the quality, including physicochemical characteristics of alcohol gel samples handled in the city of Irecê-Ba, and compare them with an industrialized product of a known brand. The organoleptic aspects and characteristics, determination of the hydrogen potential (pH), density, spreadability, viscosity, stability (resistance to centrifugation) and alcohol content of 4 samples (2 industrialized samples, called A and B acquired in different compounding pharmacies) were analyzed of the city, and 2 magisterial samples, called sample C and D. Therefore, it was observed that none of the samples fit the established parameters, such as more acidic pH, non-standard density and viscosity, different spreadability behaviors and content alcohol below ideal, pointing out nonconformities that affect the quality and action of the product. The results found in this study make it possible to conclude that the samples of magistral alcohol gel were very similar in terms of quality to the industrialized products. Therefore, it is understood that just drafting laws is not enough to guarantee the quality and safety nce of the product, more rigorous inspection and the elaboration of more qualified laws are necessary.
Ya se sabe que la higiene de las manos es la principal arma en la prevención de enfermedades infecciosas dentro y fuera de los hospitales. En el caso del SARSCoV- 2, la higiene de las manos es esencial, ante la posibilidad de contaminación por contacto directo con gotitas respiratorias o por contacto indirecto. Existen varias opciones de productos antisépticos disponibles en el mercado para uso de la población. Sin embargo, ninguno es eficaz al 100% en todas las situaciones. Entre estos diferentes productos disponibles, el etanol al 70% es el más utilizado para aplicación en las manos, siendo vehiculado en la forma farmacéutica de gel para facilitar la aplicación. Las formas farmacéuticas en gel que contienen 70% de etanol pueden ser industrializadas o manipuladas. Cuando estas formulaciones son manipuladas, están exentas de registro en la Agencia de Vigilancia Sanitaria (ANVISA), no exigiendo ni siquiera las pruebas de seguridad y eficacia que se exigen para el registro de productos industrializados. Para los productos manipulados, sólo se realizan pruebas de descripción, apariencia, características organolépticas (color y olor), pH y peso. Así, este trabajo tuvo como objetivo evaluar la calidad, incluyendo las características fisicoquímicas de muestras de alcohol gel manipuladas en la ciudad de Irecê-Ba, y compararlas con un producto industrializado de marca conocida. Se analizaron los aspectos y características organolépticas, determinación del potencial de hidrógeno (pH), densidad, untabilidad, viscosidad, estabilidad (resistencia a la centrifugación) y grado alcohólico de 4 muestras (2 muestras industrializadas, denominadas A y B adquiridas en diferentes farmacias de composición) de la ciudad, y 2 muestras magistrales, denominadas muestra C y D. Así, se observó que ninguna de las muestras se ajustaba a los parámetros establecidos, tales como pH más ácido, densidad y viscosidad no estándar, diferentes comportamientos de untabilidad y contenido alcohólico por debajo del ideal, señalando no conformidades que afectan a la calidad y acción del producto. Los resultados encontrados en este estudio permiten concluir que las muestras de alcohol magistral en gel fueron muy similares en términos de calidad a los productos industrializados. Por lo tanto, se entiende que la mera elaboración de leyes no es suficiente para garantizar la calidad y seguridad nce del producto, siendo necesaria una inspección más rigurosa y la elaboración de leyes más cualificadas.
RESUMO
"Homeopatia" é uma palavra de origem grega, introduzida por Hahnemann, onde homóis significa "semelhante" e pathos significa "sofrimento, doença". Considerado modelo terapêutico voltado ao indivíduo e não à doença. A relevância clínica da doença e o sucesso terapêutico motiva a realização do trabalho que relata um caso de paciente com distúrbio de pele raro, tratado com Sulphur e Petroleum. Os sintomas relatados pela paciente foram transformados em linguagem repertorial, elegendo-se as rubricas e respeitando as leis de hierarquização. O processo de repertorização ocorre de forma digital e com análise comparativa à matéria médica respeitando os processos de similitude. O sucesso da terapêutica pode ser observado pela evolução positiva da lesão descrita na queixa principal, e o reequilíbrio de sua homeostase, melhorando os aspectos emocional, físico e social.
"Homeopathy" is a word of Greek origin, introduced by Hahnemann, where homóis means "similar" and pathos means "suffering, disease". Considered a therapeutic model aimed at the individual and not the disease. The clinical relevance of the disease and the therapeutic success motivated the work that reports a case of a patient with a rare skin disorder, treated with Sulfur and Petroleum. The symptoms reported by the patient were transformed into repertory language, choosing the rubrics and respecting the hierarchical laws. The repertorization process takes place digitally and with comparative analysis to the materia medica respecting the similarity processes. The success of the therapy can be observed by the positive evolution of the lesion described in the main complaint, and the rebalancing of her vital energy, improving her emotional, physical and social aspects.
Assuntos
Humanos , Feminino , Adolescente , Medicamento Homeopático , Terapêutica Homeopática , Ceratodermia Palmar e Plantar/tratamento farmacológico , Urticária Crônica Induzida , Petróleo , Sulphur/uso terapêuticoRESUMO
OBJECTIVE: to evaluate the effectiveness of triamcinolone Hexacetonide (TH) Intra-Articular Injection (IAI) in hand Interphalangeal Joints (IP) of Osteoarthritis (OA) patients to improve pain and joint swelling; improve function, goniometry, and grasping force, and assess IAI influence on radiographic evolution over 1-year. METHODS: A randomized, double-blind study. 60 patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH+Lidocaine (LD) (TH/LD group) or just LD (LD group). Patients were assessed blindly for 1-year, at baseline and 1, 4, 8, 12, and 48 weeks. The following variables were assessed: articular pain and swelling, AUSCAN and COCHIN functional questionnaires, grip and pinch strength, goniometry, perception of improvement, acetaminophen consumption, and simple radiography. Repeated-measures ANOVA test was used to analyze the intervention response. RESULTS: Sixty patients completed the follow-up. There were nine missed assessments. 97% were women; mean age of 61-years (SD = 8.2), and approximately 5-years of disease (SD = 3.6). Half of the patients present radiographic classification Kellgren and Lawrence (KL) grades I and II, and the other half grades III and IV. The two groups evolved similarly at 48-weeks. TH/LD group had a better evaluation in joint swelling and acetaminophen consumption (p = 0.04 and p < 0.001, respectively) at 48-weeks. Radiographically there was no statistical difference between groups (KL, p = 0.564; erosive OA, p = 0.999; worsening, p = 0.573). CONCLUSION: The IAI IP hands OA is effective for the improvement of joint swelling and decrease of analgesic consumption and does not influence the radiographic evolution of the injected joint.
Assuntos
Osteoartrite do Joelho , Osteoartrite , Acetaminofen , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Dor , Resultado do Tratamento , Triancinolona Acetonida/análogos & derivadosRESUMO
The assessment of regional bone mineral density (BMD) has proved to be useful for illustrating the impact of focal bone demineralization diseases on bone mass. In these scenario, a common practice is to compare the affected limb with the contralateral limb. However, there are no studies comparing BMD differences between dominant vs nondominant limbs at these sites. In addition, most studies have assessed BMD in specific ROIs (regions of interests) instead of in the whole limb. The purpose of our study was to compare the BMD of dominant vs nondominant hands and feet in healthy individuals, using both the whole limb software and specific ROIs. We performed a cross-sectional analysis on untrained women and men over 18 years of age who volunteered to participate. BMD (g/cm2), bone area (cm2) and BMC (bone mineral content) (g) were measured by Lunar Prodigy DXA (GE Healthcare, Madison, WI, USA), using 2 different approaches: whole limb/region software and specific ROIs. A total of 42 subjects (11 men and 31 women) were included. Mean age was 44.19 ± 10.49 years. BMD was greater in the dominant in comparison with the nondominant hand. The difference was 0.014 (95% CI, 0.009-0.018) for the whole hand BMD, 0.023 (95% CI, 0.003-0.044) for ROI 1, and 0.016 (95% CI, 0.003-0.029) for ROI 2. No significant differences were found between dominant and nondominant foot BMD, using the whole limb software and specific ROIs. To our knowledge, this is the first study to explore the differences in BMD, bone area and BMC in terms of limb dominance, supporting the usefulness of DXA as an accurate and objective complementary diagnostic or follow-up tool in focal bone demineralization diseases.
Assuntos
Densidade Óssea , Osso e Ossos , Masculino , Feminino , Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Absorciometria de Fóton , Estudos Transversais , Extremidade SuperiorRESUMO
El síndrome antisintetasa es una miopatía inflamatoria idiopática (MII) de origen autoinmune, poco frecuente, que se caracteriza por la presencia de autoanticuerpos antisintetasa ARNt (generalmente anti-Jo1), asociado frecuentemente a miositis, enfermedad pulmonar intersticial, poliartritis, manos de mecánico y fenómeno de Raynaud. Se reporta el caso de una mujer de 45 años de edad que presenta este síndrome con características fenotípicas de dermatomiositis y responde de forma favorable luego de la administración del tratamiento con glucocorticoides asociado a metotrexato.
Anti-synthetase syndrome is a rare autoimmune inflammatory myopathy characterized by autoantibodies against tRNA synthetases (most commonly anti-Jo1) with clinical features that include myositis, interstitial lung disease, polyarthritis, mechanic's hands and Raynaud's phenomenon. We report a 45-year-old woman who presented with dermatomyositis phenotypical features and a significant improvement with corticosteroids and metotrexate treatment.
Assuntos
Feminino , Miopia , Artrite , Pneumopatias , MiositeRESUMO
El síndrome antisintetasa es una miopatía inflamatoria idiopática (MII) de origen autoinmune, poco frecuente, que se caracteriza por la presencia de autoanticuerpos antisintetasa ARNt (generalmente anti-Jo1), asociado frecuentemente a miositis, enfermedad pulmonar intersticial, poliartritis, manos de mecánico y fenómeno de Raynaud. Se reporta el caso de una mujer de 45 años de edad que presenta este síndrome con características fenotípicas de dermatomiositis y responde de forma favorable luego de la administración del tratamiento con glucocorticoides asociado a metotrexato.
Anti-synthetase syndrome is a rare autoimmune inflammatory myopathy characterized by autoantibodies against tRNA synthetases (most commonly anti-Jo1) with clinical features that include myositis, interstitial lung disease, polyarthritis, mechanic's hands and Raynaud's phenomenon. We report a 45-year-old woman who presented with dermatomyositis phenotypical features and a significant improvement with corticosteroids and metotrexate treatment.