Avalia����o de hansenianos tratados com esquema alternativo dose ��nica ROM (rifampicina, ofloxacina e minociclina), ap��s sete a nove anos

INTRODU����O: Em 1997, ap��s a realiza����o de estudo multic��ntrico, duplo cego e randomizado, em nove centros de tratamento de hansen��ase na Índia, o Minist��rio da Sa��de adotou o esquema alternativo dose ��nica ROM para casos de les��o ��nica, paucibacilar, sem nervo perif��rico afetado, ��ndice bacilosc��pico negativo, em Centros de Refer��ncia da doen��a no Brasil. O estudo se prop��s a avaliar a efetividade do esquema ROM em pacientes tratados no per��odo de 1997 a 1999 no Servi��o de Dermatologia da Santa Casa de Vit��ria. M��TODOS: Foram selecionados e tratados com o esquema ROM, 54 pacientes das formas indeterminada e tubercul��ide. Estes pacientes foram convocados de mar��o a outubro de 2006 para reavalia����o cl��nica. RESULTADOS: Vinte e nove pacientes avaliados (85,2%; IC95%: 70-100,4) estavam curados, cinco (14,7%; IC95%: 7,4-22,0) recidivaram e 20 pacientes n��o retornaram; por��m, n��o havia outra notifica����o de reingresso ao tratamento no banco de dados da Secretaria Estadual de Sa��de. CONCLUS��ES: O estudo evidenciou taxa de cura de 90,8% e taxa bruta de recidiva de 9,2%, ap��s per��odo de sete a nove anos da dose ROM. O tratamento alternativo ROM demonstrou melhor efetividade para les��o ��nica menor que quatro cent��metros e aparecimento h�� menos de cinco anos.

Differentiation between Candida albicans and Candida dubliniensis using hypertonic Sabouraud broth and tobacco agar

INTRODUCTION: Opportunistic fungal infections in immunocompromised hosts are caused by Candida species, and the majority of such infections are due to Candida albicans. However, the emerging pathogen Candida dubliniensis demonstrates several phenotypic characteristics in common with C. albicans, such as production of germ tubes and chlamydospores, calling attention to the development of stable resistance to fluconazole in vitro. The aim of this study was to evaluate the performance of biochemistry identification in the differentiating between C. albicans and C. dubliniensis, by phenotyping of yeast identified as C. albicans. METHODS: Seventy-nine isolates identified as C. albicans by the API system ID 32C were grown on Sabouraud dextrose agar at 30��C for 24-48h and then inoculated on hypertonic Sabouraud broth and tobacco agar. RESULTS: Our results showed that 17 (21.5%) isolates were growth-inhibited on hypertonic Sabouraud broth, a phenotypic trait inconsistent with C. albicans in this medium. However, the results observed on tobacco agar showed that only 9 (11.4%) of the growth-inhibited isolates produced characteristic colonies of C. dubliniensis (rough colonies, yellowish-brown with abundant fragments of hyphae and chlamydospores). CONCLUSIONS: The results suggest that this method is a simple tool for screening C. albicans and non-albicans yeast and for verification of automated identification.

Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

INTRODUCTION: Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. METHODS: A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. RESULTS: The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 �� 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5%) or with 2 protease inhibitors (28.8%). It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively). Moreover, when the combination of zidovudine/ lamivudine was used, the patients were less compliant (χ2 = 4.468, 1 degree of freedom, p = 0.035). CONCLUSIONS: The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.

Interven����o educativa junto de um grupo de enfermeiros de um servi��o de medicina : impacto na pr��tica da terap��utica inalat��ria

RESUMO: O presente estudo, enquadra-se, no dom��nio do exerc��cio profissional dos enfermeiros e na forma����o em servi��o destes profissionais e teve por objectivo avaliar, num grupo de enfermeiros de um servi��o de medicina, o impacto de uma interven����o educativa na melhoria dos procedimentos a executar na pr��tica da terap��utica inalat��ria. A amostra do estudo (amostra por conveni��ncia) foi constitu��da por oito enfermeiros do servi��o de medicina do Hospital Curry Cabral (idades compreendidas entre os 24 a 43 anos de idade), sem anterior forma����o espec��fica na ��rea da terap��utica inalat��ria, mas com experiencia profissional pr��via com doentes respirat��rios. O estudo decorreu em dois momentos de avalia����o: avalia����o 0 (antes da interven����o educativa) e avalia����o 1 (ap��s a interven����o educativa). Entre estes dois momentos, foi ministrada, a todos os enfermeiros, uma ac����o de forma����o sobre terap��utica inalat��ria, com componente te��rico-pr��tica. Antes e depois da interven����o educativa foram aplicados dois instrumentos: para avalia����o dos conhecimentos te��ricos, construi-se e aplicou-se, um question��rio de auto-avalia����o de conhecimentos sobre terap��utica inalat��ria ao grupo dos enfermeiros, e para avalia����o dos conhecimentos pr��ticos e execu����o de procedimentos, uma grelha de observa����o da demonstra����o da t��cnica de inala����o com tr��s dispositivos inalat��rios: MDI, MDI com c��mara expansora ACE e DPI turbohaler��. Os resultados do estudo mostraram que o grupo dos enfermeiros da nossa amostra detinha j�� alguns conhecimentos de car��cter te��rico, de ��mbito geral, sobre a terap��utica inalat��ria, mas conhecimentos pouco s��lidos, nomeadamente no que concerne aos f��rmacos utilizados por via inalat��ria. Verificou-se, ainda, um deficiente dom��nio de conte��dos de car��cter mais espec��fico e pr��tico sobre terap��utica inalat��ria, por exemplo a import��ncia de determinados procedimentos - agita����o do inalador, tempo de pausa entre cada inala����o, cuidados de manuten����o da c��mara expansora, higieniza����o da cavidade bucal ap��s a inala����o dos corticoster��ides. Quanto �� observa����o da t��cnica de inala����o, o grupo dos enfermeiros revelou algumas lacunas, quer relativamente �� t��cnica de inala����o com MDI, quer do MDI com c��mara expansora, observando-se a execu����o de passos incorrectos e mesmo omiss��o de passos por parte dos enfermeiros, antes da interven����o educativa.N��o nos foi poss��vel realizar a observa����o da t��cnica de inala����o com dispositivo de p�� seco turbohaler��, dado que nenhum dos enfermeiros da nossa amostra se sentiu capaz de manusear de forma correcta este dispositivo, antes e ap��s a forma����o. Em termos globais, achamos que a forma����o dada sobre terap��utica inalat��ria, mostrou melhorar os conhecimentos te��ricos e pr��ticos dos enfermeiros neste ��mbito. Esta melhoria ficou claramente demonstrada no aumento do n��mero de respostas correctas dadas pelos enfermeiros no question��rio efectuado, ap��s a forma����o. Do mesmo modo, ap��s a forma����o, registou-se uma melhoria consider��vel dos conhecimentos espec��ficos e pr��ticos, no que concerne �� import��ncia de determinados procedimentos na pr��tica da terap��utica inalat��ria - agita����o do inalador, tempo de pausa entre cada inala����o, cuidados de manuten����o da c��mara expansora, higieniza����o da cavidade bucal ap��s a inala����o dos corticoster��ides - observando-se, um maior n��mero de respostas correctas assinaladas no question��rio. Em contrapartida, os conhecimentos sobre f��rmacos administrados por via inalat��ria, ficaram um pouco aqu��m das expectativas, pois o n��mero de respostas correctas dadas pelos enfermeiros ap��s a forma����o n��o foi significativo. Poderemos mesmo dizer que, a ac����o de forma����o com maior grau de especificidade sobre f��rmacos n��o se revelou eficaz e gerou at�� alguma ���confus��o��� neste grupo de enfermeiros, parecendo que os conhecimentos anteriores sobre f��rmacos por via inalat��ria n��o estariam consolidados antes da forma����o. De igual modo, ap��s a forma����o, registou-se no grupo dos enfermeiros do estudo uma melhoria na performance da t��cnica de inala����o com o MDI e MDI com a c��mara expansora. Os enfermeiros do estudo, n��o s�� corrigiram os passos ou itens de avalia����o da t��cnica inalat��ria, anteriormente executados incorrectamente, mas tamb��m, mostraram um melhor conhecimento dos passos ou itens de avalia����o da t��cnica de inala����o, com menor n��mero de passos ou itens de avalia����o omissos, ap��s a forma����o. Em contrapartida, a ac����o de forma����o, no que diz respeito ao dispositivo de p�� seco turbohaler��, n��o cumpriu o seu objectivo, dado que nenhum dos enfermeiros da amostra foi capaz de demonstrar a t��cnica de inala����o com este dispositivo, antes e ap��s a forma����o. Poderemos dizer que, n��o sendo um dispositivo da sua pr��tica cl��nica, os enfermeiros n��o sentiram necessidade de adquirir estes conhecimentos. Em s��ntese, podemos concluir que na sua globalidade, a forma����o dada (com informa����o actualizada sobre as orienta����es mais adequadas neste dom��nio) e o treino formal dos enfermeiros neste ��mbito, foi bastante proveitoso, uma vez que, mostrou melhorar os conhecimentos te��ricos e pr��ticos na pr��tica da terap��utica inalat��ria do grupo de enfermeiros doservi��o de medicina. Real��a-se, no entanto, a import��ncia de uma forma����o adequada, sentida como ��til pelos enfermeiros, faseada, ligada �� pr��tica dos profissionais e alternando com momentos de exerc��cio profissional. Os conhecimentos e os procedimentos dos enfermeiros dever��o ainda ser monitorizados e avaliados ao longo do tempo, para a detec����o de eventuais desvios que a rotina pode introduzir e para levantamento de novas necessidades de forma����o.-------------------ABSTRACT: This study fits in the domain of in-service training of professional nurses. It was aimed to assess the impact of an educational intervention and the consequent improvement of the practice of inhalation therapy in a group of nurses from a medical service The study sample (convenience sample) was consituted by eight nurses from the medical service, Hospital Curry Cabral (aged 24-43 years) without previous special training in the field of inhalation therapy, but with prior experience with patients with respiratory diseases. The study ran in two moments of evaluation: evaluation 0 (before the educational intervention) and evaluation 1 (post-intervention). Between these two moments, a training program about therapeutic inhalation was administered to all nurses, with a double component of theory and practice. Before and after the educational intervention two evaluation tools were applied: for the assessment of theoretical knowledge, the nurses had to fill a self-assessment questionnaire and in order to evaluate their knowledge related to procedural skills as well as their performance, they were observed (and their behaviour recorded on a check-list) during a demonstration of three inhalation techniques with devices: metered dose inhaler, metered dose inhaler with a spacer device ACE�� and device turbohaler�� The study results showed that the group of nurses in our sample had already some knowledge of theoretical nature (general scope of the inhalation therapy) but little solid knowledge, particularly in regard to drugs used in inhalation. In fact, a relatively weaker knowledge was registerd in what concerns specific and practical knowledge about inhalation therapy, for example, the importance of certain procedures - shaking the inhaler, pause between each inhalation, maintenance care of spacer device, mouth cavity hygiene after inhalation of corticosteroids. As for the observation of the inhaler technique, it was found that the group of nurses had a poor inhalation technique, in what concerns inhalation technique with MDI or MDI with spacer device, with a performance with several incorrect steps, or even omission of steps by nurses before the educational intervention. Finally, as the observation technique of the dry powder device turbohaler ��, we were unable to analyze the observation concerning this device, since none of the nurses in our sample, wast able to handlle it correctly, before and after training.In general terms, we found that the training given on inhalation therapy had a positive impact either in the theorical or the pratical knowledge on inhalation therapy (higher number of correct answers after training). Similarly, after training, there was the considerable improvement of specific and practical skills, namely the importance of certain procedures in the practice of inhalation therapy - shaking the inhaler, pause time between each inhalation, maintenance care of spacer device, sanitizing the buccal cavity after inhalation of corticosteroids. In contrast, knowledge about drugs administered by inhalation, were slightly below expectations, showing a lower number of correct answers given by the nurses after training. The training seemed to be a factor of "confusion" for this group of nurses, whose prior knowledge in this domais was not probably very solid to begin with. After training, the group of nurses in the study improved the performance of inhalation technique with MDI and MDI with spacer device. They not only correcty performed the steps or itens for the assessment of inhalation technique, previously performed incorrectly, but also showed a better understanding of the steps or itens for assessing the inhalation technique, with fewer steps missing (after training). In contrast, training with regard to the device turbohaler �� dry powder, was also below expectations, given that none of the nurses in the sample was able to demonstrate inhaler technique with this device before and after training. This was probably due to the fact that, the nurses did not feel the need to acquire this knowledge and the related practice. In summary, we can say that, overall, the training (with updated information on the appropriate policies in this field) showed an improvement in knowledge and performance in the practice of inhalation therapy. It is however crucial to underline the importance of in-service adequate training programmes, perceived as useful by the nurses, developped in different phases, linked to the nurses��� practice and combining with professional practices. The nurses��� knowledge and skills should also be further monitorized and evaluated in order to detect deviations introduced by the rotinization of procedures and to identify new training needs.

Serologic survey of hantavirus in a rural population from the northern State of Mato Grosso, Brazil

INTRODUCTION: Hantavirus is a genus of ribonucleic acid (RNA) viruses included in the family Bunyaviridae. Hantaviruses are rodent-borne zoonoses that, in the last 18 years, became an emergent public health problem in the Americas, causing a severe cardiopulmonary syndrome. This disease has no specific treatment and has a high case fatality. The transmission of hantavirus to man occurs by inhaling aerosols of rodent excreta. The aim of this study was to determine the prevalence of antibodies to hantavirus in the population of the rural settlement of Tupã in the county of Marcelândia, state of Mato Grosso, Brazil. METHODS: The participants of the serologic survey were visited at their homes and selected randomly among the settlement population. Blood samples of the participants were collected by venopuncture. The serum samples were tested by an IgG-ELISA using an N recombinant protein of Araraquara hantavirus as antigen, using the protocol previously established by Figueiredo et al. RESULTS: IgG antibodies to hantavirus were detected in 7 (13%) of the 54 participants. The positivity was higher among men. It was observed that there was an association of seropositivity to hantavirus within the participants born in the south of Brazil. CONCLUSIONS: The results suggest that, in this rural area, everyone is exposed to the same risk of becoming infected with hantavirus, and, therefore, there is a need to intensify surveillance activities and education of the local people to prevent this viral infection.

Impact of an intervention in the use of sequential antibiotic therapy in a Brazilian university hospital

INTRODUCTION: Sequential antibiotic therapy (SAT) is safe and economical. However, the unnecessary use of intravenous (IV) administration usually occurs. The objective of this work was to get to know the effectiveness of an intervention to implement the SAT in a teaching hospital in Brazil. METHODS: This was a prospective and interventional study, historically controlled, and was conducted in the Hospital de Clínicas, Universidade Federal de Uberlândia, State of Minas Gerais, Brazil, a high complexity teaching hospital having 503 beds. In each of the periods, from 04/04/05 to 07/20/05 (pre-intervention) and from 09/24/07 to 12/20/07 (intervention), 117 patients were evaluated. After the pre-intervention period, guidelines were developed which were implemented during the intervention period along with educational measures and a reminder system added to the patients' prescription. RESULTS: In the pre-intervention and intervention periods, the IV antibiotics were used as treatment for a average time of 14.8 and 11.8 days, respectively. Ceftriaxone was the antibiotic most prescribed in both periods (23.4% and 21.6% respectively). Starting from the first prescription of antibiotics, the average length of hospitalization time was 21.8 and 17.5 days, respectively. The SAT occurred only in 4 and 5 courses of treatment, respectively, and 12.8% and 18.8% of the patients died in the respective periods. CONCLUSIONS: Under the presented conditions, the evaluated intervention strategy is ineffective in promoting the exchange of the antibiotic administration from IV to oral treatment (SAT).

Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the N��cleo de Medicina Tropical, Bel��m, State of Par��, Brazil

IntroductionThis study investigated the occurrence of Strongyloides stercoralis infestation and coinfection with HTLV-1/2 in Bel��m, Brazil.MethodsS. stercoralis was investigated in stool samples obtained from individuals infected with HTLV-1/2 and their uninfected relatives.ResultsThe frequency of S. stercoralis was 9% (9/100), including six patients infected with HTLV-1 (14.3%), two patients infected with HTLV-2 (11.1%), and one uninfected relative. Two cases of hyperinfestation by S. stercoralis were characterized as HTLV-1.ConclusionsThese results support the need for the routine investigation of S. stercoralis in patients with HTLV-1, in an attempt to prevent the development of severe forms of strongyloidiasis.

Chemical composition and antifungal activity of essential oil from Eucalyptus smithii against dermatophytes

ABSTRACT INTRODUCTION: In this study, we evaluated the chemical composition of a commercial sample of essential oil from Eucalyptus smithii R.T. Baker and its antifungal activity against Microsporum canis ATCC 32903, Microsporum gypseum ATCC 14683, Trichophyton mentagrophytes ATCC 9533, T. mentagrophytes ATCC 11480, T. mentagrophytes ATCC 11481, and Trichophyton rubrum CCT 5507. METHODS: Morphological changes in these fungi after treatment with the oil were determined by scanning electron microscopy (SEM). The antifungal activity of the oil was determined on the basis of minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values. RESULTS: The compound 1,8-cineole was found to be the predominant component (72.2%) of the essential oil. The MIC values of the oil ranged from 62.5μg��mL−1 to >1,000μg��mL−1, and the MFC values of the oil ranged from 125μg��mL−1 to >1,000μg��mL−1. SEM analysis showed physical damage and morphological alterations in the fungi exposed to this oil. CONCLUSIONS: We demonstrated the potential of Eucalyptus smithii essential oil as a natural therapeutic agent for the treatment of dermatophytosis.

A Índia e a ��frica-Subsariana: O Paradigma da Energia

Com aproximadamente 1.2 mil milh��es de habitantes, a Índia �� o segundo pa��s e a democracia mais populosa do mundo. Em termos energ��ticos, �� o quarto maior consumidor de energia e o quarto maior importador mundial de petr��leo. O desenvolvimento econ��mico que se verificou na d��cada de 90 fez acentuar um dos principais desafios com que a Índia se depara actualmente que �� o de garantir fontes de energia para atender ��s necessidades da sua popula����o. Para fazer face �� depend��ncia das importa����es do petr��leo no M��dio Oriente (62%) e fornecer energia segura ��s popula����es, as empresas indianas t��m procurado diversificar as suas fontes de abastecimento no mercado externo. �� neste contexto que a ��frica-Subsariana passou a ter uma import��ncia estrat��gica para a Índia, como uma regi��o com capacidade de apoiar esta estrat��gia de diversifica����o de fontes de importa����o. O objecto de estudo desta disserta����o �� a rela����o entre a Índia e a ��frica-Subsariana no sector da energia e dos seis objectivos definidos podemos referir, por exemplo, que pretendemos identificar os pa��ses da ��frica-Subsariana com que a Índia tem vindo a investir no sector energ��tico e quais as formas contratuais a que t��m recorrido. Nesta perspectiva, procura-se apresentar as linhas gerais da pol��tica energ��tica indiana, do passado ao presente, identificando os problemas e inefici��ncias que a levaram a investir no mercado dos pa��ses da ��frica-Subsariana, sobre o papel que a pol��tica externa indiana desempenha, no dom��nio da energia, na rela����o Indo - ��frica-Subsariana e ,por ��ltimo, explicar o amadurecimento da rela����o entre a Índia e ��frica ao longo dos anos. A escolha desta tem��tica ganha pertin��ncia na medida em que a energia �� um tema que tem grande import��ncia nos estudos das rela����es internacionais e no com��rcio internacional mas tamb��m porque o conceito de seguran��a energ��tica tem ganho visibilidade nos ��ltimos anos devido �� crescente depend��ncia dos pa��ses face aos recursos energ��ticos. Assim, a an��lise desta tem��tica permitir-nos-�� compreender de que forma �� que a Índia tem feito chegar a energia, um bem essencial, �� sua sociedade

Hypertension in employees of a University General Hospital

PURPOSE: To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables. METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position. RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of >140 and/or >90 mm Hg at the moment of the measurement). Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P <.05) in physicians, nursing staff, and "others", respectively. The univariate analysis showed a significant odds ratio for the male gender, age >50 years, work unit being the Institute of Radiology and the Administration Building, educational level <elementary school, length of work >10 years, and body mass index >30 kg/m��. The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index. CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income) should be better advised of prevention and early diagnosis of hypertension by means of special programs.

Plantas nativas de uso en medicina popular en el Paraguay. Parte III

La quimioterapia has sido un gran adelanto en Farmacologia, pero las secuelas de las racciones adversas han despertado una tendencia a volver a lo natural, especialmente hacia el reino vegetal, esto nos estimul�� a la orientaci��n de nuestra investigaci��n para iniciar esta labor. En la primera y segunda parte se identificaron un total de 100 especues, la identificaci��n ha comprobado que los ejemplares pertenecen a distintas familias y sus usos para combatir diveresas afecciones. Se indentificaron en esta tercera parte outras 50 especies. Se recopilaron datos sobre el uso de plantas que curar afecciones, luego se procedieron a la herborizaci��n e identificaci��n de las especies, cuyos ejemplares se conservan en el herbario de la Facultad de Ciencias Qu��micas de la Universidad nacional de Asunci��n. La identifica��on bot��nica y la recopilaci��n de sus usos populares, servir��n de base para posteriores investigaciones fitoqu��micas y farmacol��gicas que es nuestro prop��sito.

Infec����es urin��rias adquiridas no hospital : resultados de um estudo de coorte realizado num servi��o de medicina interna

RESUMO - Introdu����o: As infec����es associadas aos cuidados de sa��de s��o um importante problema de sa��de p��blica. Entre elas, as infec����es urin��rias s��o as mais frequentes associando���se a elevados custos e morbilidade. Pretende���se caracterizar as ITU adquiridas no Hospital (ITUaH) ocorridas num servi��o de Medicina Interna de um hospital portugu��s. M��todos: Efectuou���se um estudo de coorte (hist��rica) para determina����o da incid��ncia da ITUaH e da bacteri��ria assintom��tica. Analisaram-se os dados correspondentes a uma amostra aleat��ria sistem��tica de 388 doentes, representativa dos 3492 admiss��es ocorridas, em 2014, nesse Servi��o. Resultados: A taxa de incid��ncia global de ITUaH foi de 6,2% (24/388; IC 95%:[3,8--���8,6%]). Ocorreram 19,76 ITU por mil dias de cateter vesical (ITUaCV) e 4,17 ITUaCV por mil dias de internamento. A taxa de incid��ncia de ITUaCV foi de 4% (15/388; IC 95%:[2%--���6%]). Oitenta por cento destas infec����es ocorreram em doentes sem indica����o para a algalia����o. Um quarto dos doentes desta coorte foram algaliados (24,7%; IC 95%: [20%--���29%]), n��o se verificando indica����o para o procedimento em 36,5% dos casos. Os principais factores de risco para a algalia����o identificados foram a depend��ncia total (OR: 24,47; IC 95%: [5,50--��� 108,87]; p<0,001) a depend��ncia grave (OR:11,43; IC 95% [2,56--���50,93]; p=0,001) (escala de Barthel) e a carga de doen��a (OR: 1,19; IC 95% [1,03--���1,38]; p=0,017) (��ndice de comorbilidade de Charlson). Foram utilizados CV em 759 dias dos 3591 dias de internamento quantificados neste estudo (21%). A Taxa de incid��ncia de Bacteri��ria Assintom��tica (BA) foi de 4,4% (IC 95%:[2--���6%]). Cerca de 60% (10/17) desses doentes foram submetidos a tratamento contrariamente ��s recomenda����es cl��nicas actuais. Conclus��es: Este estudo evidencia a necessidade de implementa����o de estrat��gias de preven����o, das quais se destaca a redu����o do n��mero de algalia����es. O tratamento da BA deve ser evitado.