Infecção hospitalar em pacientes cirúrgicos de hospital universitário

Analisar fatores intercorrentes e a incidência da infecção em pacientes operados no Hospital Universitário da UFRN. Métodos: Foram estudados, através de protocolo previamente estabelecido, 3.120 pacientes internados que se submeteram a procedimentos cirúrgicos no período de janeiro de 1999 a outubro de 2002. Resultados: O índice de infecção hospitalar foi de 5,9%, e a topografia de maior incidência foi a ferida operatória (3,7%). Infecção respiratória ocorreu em 1,2%, urinária em 0,6% e bacteremia em 0,1%. O índice de infecção comunitária foi de 9,2%, predominando infecção urinária (5%) e respiratória (2,1%). Quanto ao grau de contaminação das feridas operatórias, as feridas limpas (1479) apresentaram infecção em 2,9%, as feridas limpascontaminadas (1277) em 6,0% dos casos, as feridas contaminadas (270) em 15,1%, e as ferida infectadas (94) resultaram em infecção em 30,75% dos casos. Conclusão: Concluiu-se que a incidência de infecção cirúrgica foi compatível com os índices na literatura mundial. A partir desses dados, ratifica-se a importância de medidas de controle de infecção hospitalar de forma sistemática, como vem sendo realizado no hospital onde o estudo foi realizado

Corpo e Velhice: um estudo da qualidade de vida de idosos da Vila Vicentina Júlia Freire em João Pessoa

The aim of this study was to follow the daily routine of elderly individuals residing at the Vila Vicentina Júlia Freire (VVJF) nursing home in João Pessoa, Brazil, observing and analyzing as much as possible, the way in which they live in a group and how they deal, through personal experiences, with their own body image and with that of others. The results were obtained from information considered relevant, according to the perspectives of the residents themselves, contained in narratives of their history and related to their quality of life. Our interest lays in how they coped with changes in their bodies at old age and adapted to the challenges of this new phase. To obtain this information, with significant expressions, we used the Narrative Interview (NI) as a research tool in order to redeem their life experience and develop an understanding of their impressions about the life experience at the current nursing home. We selected, among the housed, ten subjects - actors - to appear as a sample of the group together. The design of our sample had a hybrid model, combining two types: random sample (probability) and an intentional sample (not probability). After recording transcripts and ensuring that all the subjects showed common interests that were relevant to the group, we chose three categories for analysis as follows: a. the elderly as seen by themselves and by others; b. religiosity as a moral factor; c. intimacy and relationships. Our choice was based on the importance of the theme as a multidisciplinary topic in the quality of life of populations. The subjects, chosen as spokespersons for the VVJF, spoke, among other things, about the way in which they viewed the world, their own body and how they experienced the environment and their fellow residents, in an attitude of reflection and criticism that confirms the lucidity of an old age conditioned to an elderly institution. The method allowed us to investigate our subjects from a multidisciplinary point of view. We suggest other studies in assorted areas of the human sciences, having as principle, man at the center of all our scientific questionings. The paradigm that the elder is, necessarily, unhappy in his sheltered has been, in this job, broken through the testimonies collected, establishing multiple perspectives of the analyzed subjects by their respective narrative records. Involving the participation of researchers with major in Administration, Communication and Law, this study filled, in this aspect, the requirements of the multidisciplinarity of the Program of Pos-Graduation in Health Science

Juventude e consumo emocional nas redes sociais da internet. Análise das marcas: Coca-Cola, Pepsi, BlackBerry, Nokia, Riachuelo e C&A

In The paradoxical happiness , Gilles Lipovetsky elects five major paradigmatic models that command the pleasure and happiness in our societies. Starting with the paradigmatic models of penia (where it is emphasized the existential dissatisfaction supplied by the consumption and where advertising has a special place, bombarding consumers and creating consumer needs, in addition to selling a lifestyle rather than the products themselves), and narcissus (model constructed on the basis of self-exaltation and abdication of the social and political) intends to examine the relationship between the consumption exercised by young people and the advertising displayed on social networking sites, focusing on the social media Facebook, observing the virtual fan pages of the following brands: Coca-Cola; Pepsi; BlackBerry, Nokia, Riachuelo and C&A and their relationships with their consumers

Vitamin C and endogenous cortisol in foreign-body inflammatory response in pacus

O objetivo deste trabalho foi avaliar o efeito da suplementação com vitamina C no aumento da atividade de macrófagos e células gigantes multinucleadas (CGM), em pacus mantidos em duas densidades de estocagem. O experimento foi realizado em parcelas subdivididas, em arranjo fatorial 2x2x3 com: 0 e 500 mg kg-1 de vitamina C; densidade de estocagem de 5 e 20 kg m-3; e tempos de avaliação de 3, 6 e 12 dias após o implante subcutâneo (DPI) de lamínulas de vidro. Foram determinados o número de macrófagos e de CGM, bem como os níveis de cortisol e glicose no plasma. O número de macrófagos e de CGM com 2 a 5 núcleos foi significativamente maior nos peixes suplementados com vitamina C, à densidade 5 kg m-3, aos 3 DPI, em relação aos não suplementados. Constatou-se menor quantidade de macrófagos e CGM em peixes com baixa concentração plasmática de cortisol. A suplementação com 500 mg de vitamina C por quilograma de ração beneficia a atividade de macrófagos em inflamações do tipo corpo estranho, e a elevada concentração de cortisol circulante tem efeito supressor nesta resposta.

Assistência aos portadores de úlceras venosas: proposta de protocolo

Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference

Aproveitamento de subprodutos da industrialização do escargot

The waste in the industries of escargot processing is very big. This is composed basically of escargot meat out of the commercialization patterns and the visceras. In this context, there is a need to take advantage to the use of these sub-products. A possibility should be drying them and transforming them in a certain form to be reused. Than, the present work has the objective of studying the reutilization of the sub-products of the escargot industrialization for by means of drying process. The samples were transformed in pastes, through a domestic processor for approximately 1 minute and compacted in trays of aluminum without perforations with three different heights (5 mm, 10 mm and 15 mm). The drying was accomplished in a tray dryer with air circulation and transverse flow at a speed of 0,2 m/s and three temperature levels (70°C, 80°C and 90ºC). A drying kinetics study was accomplished for the obtained curves and for the heat and mass transfer coefficients using experimental procedures based in an experimental planning of 22 factorial type. Microbiological and physiochemical analysis were also accomplished for the in nature and the dehydrated sub-products. In the drying process, it was observed the great importance of the external resistances to the mass transfer and heat in the period of constant tax influenced by the temperature. The evaporation taxes indicated a mixed control of the mass transfer for the case of the thickest layers. As already expected, the drying constant behavior was influenced by the temperature and thickness of the medium, increasing and decreasing. The statistical analysis of the results, in agreement with the factorial planning 22, showed that the fissures, the shrinking of the transfer area and the formation of a crust on the surface might have contributed to the differences between the practical results and the linear model proposed. The temperature and the thickness influenced significantly in the answers of the studied variables: evaporation tax and drying constant. They were obtained significant statistical models and predictive ones for evaporation tax for the meat as well as for the visceras

Aplicação de ultrassons no deslocamento de petróleo em meio poroso

The objective of this study was to evaluate the displacement of petroleum/diesel solutions, at different concentrations, observing the effect of ultrasonic vibrations in fluids present in porous media to obtain an increase in oil production. The bubbles produced by ultrasound implode asymmetrically in the rock, generating liquid jets with high speed, displacing the oil present in porous media. The oil/diesel solutions were prepared with concentrations ranging from 20 g/L to 720 g/L in oil in relation to diesel and its viscosities were obtained in a Brookfield Rheometer RS2000, with temperature ranging from 25 to 55 °C. After, calculations were performed to obtain the activation energy data for oil/diesel solutions. For oil recovery experiments, cylindrical samples of porous rock (core samples), with resin around the perimeter and its two circular bases free to allow the passage of fluids, were first saturated with 2% KCl solution and after with oil solutions. The results of oil extraction were satisfactory for all studied solutions, being obtained up to 68% partial displacement with saline solution injection. The ultrasound system was used after saline injection, increasing oil displacement, with oil extractions ranging from 63% to 79%. During the experiments, it was observed the warming of core samples, helping to reduce the viscosity of more concentrated systems, and consequently enhancing the percentage of advanced recovery for all studied solutions

Upregulation of soluble and membrane-bound human leukocyte antigen G expression is primarily observed in the milder histopathological stages of chronic hepatitis C virus infection

Chronic hepatitis C virus (HCV) infection is a worldwide health problem that may evolve to cirrhosis and hepatocellular carcinoma. Incompletely understood immune system mechanisms have been associated with impaired viral clearance. The nonclassical class I human leukocyte antigen G (HLA-G) molecule may downregulate immune system cell functions exhibiting well-recognized tolerogenic properties. HCV genotype was analyzed in chronic HCV-infected patients. Because HLA-G expression may be induced by certain viruses, we evaluated the presence of HLA-G in the liver microenvironment obtained from 89 biopsies of patients harboring chronic HCV infection and stratified according to clinical and histopathological features. Overall, data indicated that HCV genotype 1 was predominant, especially subgenotype 1a, with a prevalence of 87%. HLA-G expression was observed in 45(51%) liver specimens, and it was more frequent in milder stages of chronic hepatitis (67.4%) than in moderate (27.8%; p = 0.009) and severe (36.0%; p = 0.021) stages of the disease. Altogether, these results suggest that the expression of HLA-G in the context of HCV is a complex process modulated by many factors, which may contribute to an immunologic environment favoring viral persistence. However, because the milder forms predominantly expressed HLA-G, a protective role of this molecule may not be excluded. (C) 2012 American Society for Histocompatibility and Immunogenetics. Published by Elsevier B.V. All rights reserved.

Propagação de danos em sistemas cooperativos: propriedades termodinâmicas

High-precision calculations of the correlation functions and order parameters were performed in order to investigate the critical properties of several two-dimensional ferro- magnetic systems: (i) the q-state Potts model; (ii) the Ashkin-Teller isotropic model; (iii) the spin-1 Ising model. We deduced exact relations connecting specific damages (the difference between two microscopic configurations of a model) and the above mentioned thermodynamic quanti- ties which permit its numerical calculation, by computer simulation and using any ergodic dynamics. The results obtained (critical temperature and exponents) reproduced all the known values, with an agreement up to several significant figures; of particular relevance were the estimates along the Baxter critical line (Ashkin-Teller model) where the exponents have a continuous variation. We also showed that this approach is less sensitive to the finite-size effects than the standard Monte-Carlo method. This analysis shows that the present approach produces equal or more accurate results, as compared to the usual Monte Carlo simulation, and can be useful to investigate these models in circumstances for which their behavior is not yet fully understood

Influência do tratamento periodontal sobre os níveis da proteína c-reativa ultrassensível em pacientes com insuficiência renal crônica em fase de prétransplante

The present study evaluated the influence of non-surgical periodontal treatment on the levels of C- reactive protein (hsCRP) in patients with chronic renal failure (CRF) in pretransplant. We conducted a controlled and randomized trial to evaluate the periodontal condition and plasma concentrations of hsCRP, albumin and transferrin in 56 dialysis patients divided into two groups: experimental and control. The study was conducted at the dental clinic of Family and Community Health s Unit (USFC), located in Onofre Lopes University Hospital (HUOL), Federal University of Rio Grande do Norte (UFRN), from December 2010 to November 2011. Severe periodontitis was the type of periodontal disease more common, affecting 78.6% of patients. Periodontal conditions, evaluated through the means of probing depth, clinical attachment level, bleeding index and plaque index, proved to be uniform for both groups at the initial examination. There were no differences in levels of inflammatory markers between the two groups. The analysis of the concentrations of hsCRP allowed classifying study participants as at high risk of developing cardiovascular disease. After completion of periodontal treatment in the experimental group, there was a statistically significant reduction of the mean of all periodontal parameters assessed; however this improvement of periodontal health was not accompanied by changes in the levels of hsCRP, albumin and transferrin in the evaluation time. Given this, the periodontal treatment did not promote the reduction of systemic inflammatory burden and risk of cardiovascular complications in patients with CRF

Caracterização e aplicação de vermicultura natural e quimicamente modificada na adsorção de azul de metileno

Chemical modification of clays has been extremely studied in the search for improvements of their properties for use in various areas, such as in combating pollution by industrial effluents and dyes. In this work, the vermiculite was chemically modified in two ways, characterized and evaluated the adsorption of methylene blue dye. First was changed with the addition of a surfactant (hexadecyltrimethylammonium bromide, BHTA) making it an organophilic clay and then by adding an acid (HCl) by acid activation. Some analyzes were performed as X-ray fluorescence (FRX), X-ray diffraction (DRX), adsorption isotherms of methylene blue dye, infrared (FTIR) , scanning electron microscopy (SEM), thermal gravimetric analysis and spectroscopy energy dispersive (EDS). Analysis by FRX of natural vermiculite indicates that addition of silicon and aluminum, clay presents in its structure the magnesium, calcium and potassium with 16 % organic matter cations. The DRX analyzes indicated that the organic vermiculite was an insertion of the surfactant in the space between the lamellae, vermiculite and acid partial destruction of the structure with loss of crystallinity. The adsorption isotherms of methylene blue showed that there was a significant improvement in the removal of dye to the vermiculite with the addition of cationic surfactant hexadecyltrimethylammonium bromide and treatment with acid using HCl 2 mol/L. In acid vermiculites subsequently treated with surfactant, the adsorption capacity increased with respect to natural vermiculite, however was much lower compared vermiculite modified with acid and surfactant separately. Only the acidic vermiculite treated with surfactant adjusted to the Langmuir model. As in the infrared spectrometry proved the characteristics of natural vermiculite. In the organic vermiculite was observed the appearance of characteristic bands of CH3, CH2, and (CH3)4N. Already on acid vermiculite, it was realized a partial destruction with decreasing intensity of the characteristic band of vermiculite that is between 1074 and 952 cm-1. In the SEM analysis, it was observed that there was partial destruction to the acid treatment and a cluster is noted between the blades caused by the presence of the surfactant. The TG shows that the higher mass loss occurs at the beginning of the heating caused by the elimination of water absorbed on the surface between layers. In the organic vermiculite also observed a loss of mass between 150 and 300 °C caused decomposition of the alkylammonium molecules (surfactants)

A Novel Diagnostic Target in the Hepatitis C Virus Genome

BackgroundDetection and quantification of hepatitis C virus (HCV) RNA is integral to diagnostic and therapeutic regimens. All molecular assays target the viral 5'-noncoding region (59-NCR), and all show genotype-dependent variation of sensitivities and viral load results. Non-western HCV genotypes have been under-represented in evaluation studies. An alternative diagnostic target region within the HCV genome could facilitate a new generation of assays.Methods and FindingsIn this study we determined by de novo sequencing that the 3'-X-tail element, characterized significantly later than the rest of the genome, is highly conserved across genotypes. To prove its clinical utility as a molecular diagnostic target, a prototype qualitative and quantitative test was developed and evaluated multicentrically on a large and complete panel of 725 clinical plasma samples, covering HCV genotypes 1-6, from four continents (Germany, UK, Brazil, South Africa, Singapore). To our knowledge, this is the most diversified and comprehensive panel of clinical and genotype specimens used in HCV nucleic acid testing (NAT) validation to date. The lower limit of detection (LOD) was 18.4 IU/ml (95% confidence interval, 15.3-24.1 IU/ml), suggesting applicability in donor blood screening. The upper LOD exceeded 10(-9) IU/ml, facilitating viral load monitoring within a wide dynamic range. In 598 genotyped samples, quantified by Bayer VERSANT 3.0 branched DNA (bDNA), X-tail-based viral loads were highly concordant with bDNA for all genotypes. Correlation coefficients between bDNA and X-tail NAT, for genotypes 1-6, were: 0.92, 0.85, 0.95, 0.91, 0.95, and 0.96, respectively; X-tail-based viral loads deviated by more than 0.5 log10 from 5'-NCR-based viral loads in only 12% of samples (maximum deviation, 0.85 log10). The successful introduction of X-tail NAT in a Brazilian laboratory confirmed the practical stability and robustness of the X-tail-based protocol. The assay was implemented at low reaction costs (US$8.70 per sample), short turnover times (2.5 h for up to 96 samples), and without technical difficulties.ConclusionThis study indicates a way to fundamentally improve HCV viral load monitoring and infection screening. Our prototype assay can serve as a template for a new generation of viral load assays. Additionally, to our knowledge this study provides the first open protocol to permit industry-grade HCV detection and quantification in resource-limited settings.

Clinical evaluation of the bicoronal flap in the treatment of facial fractures. Retrospective study of 132 patients

The aim of the present study was to evaluate the postoperative complications of bicoronal flaps used to treat facial fractures. One hundred and thirty two patients that received bicoronal flaps for the treatment of upper and middle third facial fractures were called for clinical and radiographic examination. Minimum follow-up was 1 year and all patients had charts with adequate information about their perioperative care pertinent to the study. Results showed as complications hypoesthesia (17%), partial unilateral frontal motor deficit (11%), infection (3%), hypertrophic scars (3%), varying degrees of alopecia (18%), seroma or hematoma in the immediate postoperative period (5%). The flap provided wide surgical access to the upper and middle facial thirds with very few serious complications, most frequently allowing good aesthetic results. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.

Deep barcode divergence in Brazilian freshwater fishes: the case of the Sao Francisco River basin

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Testing the ecomorphological hypothesis in a headwater riffles fish assemblage of the rio São Francisco, southeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)