Mantenimiento de catéteres venosos periféricos durante más de 4 dias. En busca de la mejor evidencia

Antecedentes: Desde 1981, los Centers for Disease Control and Prevention (CDC) recomiendan sustituir los catéteres venosos periféricos cada 3-4 días para disminuir el riesgo de flebitis, infección y bacteriemia de catéter. Objetivo: El objetivo de esta revisión sistemática es determinar la efectividad de esta intervención mediante la evaluación de la evidencia científica disponible. Material y método: Se realizó una exploración de diferentes bases de datos electrónicas y se revisaron manualmente varios índices desde 1981 a 200l. Para identificar los trabajos más relevantes y descartar los de menor calidad se empleó un sistema de evaluación cualitativa que permitió la discriminación de tres grupos de estudios, de mayor a menor calidad metodológica y, por tanto, de riesgo de sesgo. Resultados y conclusiones: De los originales captados, 12 fueron sometidos a valoración crítica. Un 33% se clasificó como metodológicamente insuficiente y un 41% obtuvo una puntuación intermedia, con lo que sus resultados debían interpretarse con cautela. Los trabajos cualitativamente más significativos no demuestran que sea necesario sustituir de forma rutinaria los catéteres venosos periféricos, como recomiendan los CDC.

Determinación del volumen gástrico residual: en busca de la mejor evidencia

Introducción: La determinación del volumen gástrico residual es una práctica frecuente en pacientes críticos, pero hay falta de consenso acerca de la conveniencia de reintroducir o desechar el contenido gástrico aspirado (CGA). Objetivo: Determinar el grado de evidencia científica acerca de la eficacia de 2 intervenciones-reintroducción/rechazo- del CGA en pacientes críticos. Material y métodos: Revisión sistemática de la evidencia disponible acerca de la conveniencia de reintroducir o desechar el CGA. Proceso: a) establecimiento de los criterios de inclusión/exclusión; b) determinación de la estrategia de búsqueda (palabras clave e itinerarios); c) vaciado de las bases de datos: MEDLINE, CINAHL, CUIDEN, IME, SCIELO y COCHRANE. Búsqueda por método indirecto y vaciado manual de índices; d) lectura crítica independiente y contrastada, utilizando la plantilla CASPe, y e) contraste de resultados del análisis crítico. Resultados: Los itinerarios de búsqueda generan más de 800 referencias que, una vez depuradas, permiten seleccionar 54. Después de su lectura, sólo 4 se centran realmente en cuestiones relacionadas con la reintroducción/rechazo del CGA: 2 revisiones, un estudio observacional y un ECA de muestra pequeña. La heterogeneidad de estos estudios no permite emplear técnicas de metaanálisis. Por ello se analizan por separado los resultados de cada estudio. Mediante este proceso se obtiene un resultado final que demuestra un bajo grado de evidencia científica. Conclusiones: Hay escasa evidencia científica acerca de la conveniencia, la seguridad y los beneficios de ambas intervenciones. Es difícil establecer un protocolo de cuidados, por lo que se planteó realizar un estudio experimental para establecer las indicaciones y contraindicaciones de ambas intervenciones.

A Eterna Busca do Indivisível: do Átomo Filosófico aos Quarks e Léptons

The fascinating search of the inner boundaries of the Universe, has been entangled, since the birth of greek philosophy 25 centuries ago, with the main epistemological changes in the History of Science. This paper does not intend to present a systematic description of the discovery of the elementary particles. By stressing the main achievements of the knowledge of matter's structure and their dependence on symmetry arguments, it is argued that even considering profound differences in each historical period, there is a paradgima of atom shared by Chemistry and Particle Physics. This text could help High School Teachers of Chemistry and Physics, as well as motivate them, in the challenge of explaining to their pupils how the idea of atom evolved.

Algoritmo genético em química

Genetic algorithm is an optimization technique based on Darwin evolution theory. In last years its application in chemistry is increasing significantly due the special characteristics for optimization of complex systems. The basic principles and some further modifications implemented to improve its performance are presented, as well as a historical development. A numerical example of a function optimization is also shown to demonstrate how the algorithm works in an optimization process. Finally several chemistry applications realized until now is commented to serve as parameter to future applications in this field.

Uma visão das tendências e perspectivas em eletrocromismo: a busca de novos materiais e desenhos mais simples

Some aspects of electrochromism phenomena are presented in this review paper. A deep literature revision about the subject dealing with materials and device configurations developed in the last years, is presented. Great efforts of the scientific community have been done in this field. On the other hand, new electrochomic devices based on reversible deposition of metals are specially emphasized here. These devices present many advantages such as simple operation and construction and they have also shown high cycling rates. These factors make them suitable for application in display industry. In this way, many concepts used in the developement of electrodeposition baths are very useful for the improvement of these new devices; specially, all knowledge about the use of additives for modifying films microstructure and morfology.

Identificação de substâncias em análise toxicológica sistemática utilizando um sistema informatizado para cálculo de parâmetros cromatográficos e busca em bases de dados

In spite of the availability of large databases of chromatographic data on several standardized systems, one major task in systematic toxicological analysis remains, namely how to handle the experimental data and retrieve data from the large available databases in a meaningful and productive way. To achieve this purpose, our group proposed an Internet-based tool using previously published STA databases, which interlaboratorial reproducibility tests have already evaluated. The developed software has the capability to calculate corrected chromatographic parameters, after the input of data obtained with standard mixtures of calibrators, and search the databases, currently incorporating TLC, color reactions, GC and HPLC data. At the end of the process, a list with candidate substances and their similarity indexes is presented.

Imobilização de enzimas em suportes cromatográficos: uma ferramenta na busca por substâncias bioativas

The development and characterization of bioreactors or IMER (immobilized enzyme reactors) as research tools are important in the scope of medicinal chemistry and constitute an alternative for the rational development of drugs. This approach does not require highly purified enzymes or a great amount of protein, but increase the enzymatic stability against heat, organic solvents and pH, without too much loss of catalyst activity. Immobilized enzyme reactors (IMER) can be used for the accomplishment of high efficiency screening on-line and, thus inhibitors can be quickly identified. Here, we emphasize the development of IMER by use of different methods of immobilization and chromatographic supports. Their applications, in different areas of research, are also fully discussed.

Em busca da sustentabilidade: células solares sensibilizadas por extratos naturais

The present work reports the use of anthocyanins extracted from mulberry (Morus Alba L.), raspberry (Rubus Idaeus L.) and blueberry (Vaccinium myrtillus L.) as sensitizers in dye-sensitized solar cells. The conversion efficiency of these devices is dependent on the extracts employed and can be rationalized in terms of their composition and spectral properties. Solar cells sensitized by the mulberry extract showed the highest efficiency among the fruits investigated. Moreover, a 16 cm² active area solar cell with the mulberry extract has presented fair good efficiency of conversion for natural dye-based solar cells, besides stability over twenty weeks, showing perspectives for developing these low cost devices with a commercial viability.

Em busca da conservação ambiental: a contribuição da percepção ambiental para a formação e atuação dos profissionais da Química

Planet transformations caused by human intervention in the last 200 years are largely due to chemical impact. Therefore, this study aimed to identify and analyze the environmental perception of undergraduate students and lecturers in the Chemistry course of the Federal University of Lavras, accounting for the topics "Environmental Definition" and "Relationship between Chemistry and Environment". Two thematic axes for discussion were proposed using theories of Social Representation and Environmental Complexity, with the aim of stimulating the conservationist reasoning and actions. Such axes were proposed to give support to the education of chemists at the undergraduate level.

Constantes de acidez de ácidos dipróticos a partir de titulações potenciométricas: ilustração dos princípios do cálculo através da construção de um algoritmo muito simples

This work describes the creation of an very simple calculation algorithm, based in basic chemical and mathematic principles, for the calculation of weak diprotic acid dissociation constants as, for example, amino acids, from potentiometric titrations. For an easier understanding of the algorithm the logical reasoning of this calculus is schematized in a diagram of blocks. In the second part of the work the algorithm is applied to an Excel calculation sheet to determine the dissociation constants of Nicotinic Acid and Glycine, from the respective potentiometric titration curves. The values obtained using this algorithm are compared with those estimated by Hyperquad2008 (program generally used for this type of calculus) and also with the values of a stability constants database.

Desenvolvimento de um algoritmo para identificação e correção de spikes em espectroscopia Raman de imagem

Raman imaging spectroscopy is a highly useful analytical tool that provides spatial and spectral information on a sample. However, CCD detectors used in dispersive instruments present the drawback of being sensitive to cosmic rays, giving rise to spikes in Raman spectra. Spikes influence variance structures and must be removed prior to the use of multivariate techniques. A new algorithm for correction of spikes in Raman imaging was developed using an approach based on comparison of nearest neighbor pixels. The algorithm showed characteristics including simplicity, rapidity, selectivity and high quality in spike removal from hyperspectral images.

Anemia falciforme: desafios e avanços na busca de novos fármacos

Sickle Cell Disease (SCD) is a disease characterized by a punctual mutation (GTG - GAG) in the sixth codon of the gamma globin gene leading to a substitution of glutamic acid by a valine in the β chain of hemoglobin. Despite the huge progress on the molecular knowledge of the disease in recent years, few therapeutic resources were developed. Currently, the treatment is mainly done with the anticancer agent hydroxyurea. This review summarizes current knowledge about possible targets and new approaches to the discovery new compounds to treat the symptoms of SCD.

Ozonólise: a busca por um mecanismo

The ozonolysis reaction is widely used in the academy and in industry. The first reports about the existence of the ozone molecule were made over 200 years ago. Several ideas and assumptions were made to understand the chemical properties of the ozone molecule and the ozonolysis mechanism. The intent of this paper is not to be an extensive review about ozone chemistry or ozonolysis reactions, but to highlight how the rational process was developed and how conclusions were drawn at a time with limited instrumentation.

Aquele que busca a Deus, o incrédulo e o honnête-homme: natureza e sobrenatureza nestes três tipos de homem

A intenção deste trabalho será de compreender a idéia de desnaturação, apresentada no fragmento La 427, no contexto da classificação pascaliana dos tipos de pessoa. A desnaturação é aí definida como uma perda do amor-próprio. Ora, se o amor-próprio, motor da busca da felicidade, define a natureza do homem decaído, fica o problema de compreender o paradoxal elogio ao amor-próprio levado a cabo por Pascal, neste fragmento, através da idéia de desnaturação.

A Educação Médica entre mapas e âncoras: a aprendizagem significativa de David Ausubel, em busca da Arca Perdida

O processo de aprendizagem tem motivado, desde a Antigüidade, intensos debates. Dentre as diferentes teorias propostas tem ganho relevância, nos séculos XX e XXI, a concepção cognitivista de David Ausubel, na qual se assume que os mecanismos do aprender são mais eficientes em situações nas quais o estudante consegue, utilizando conhecimentos prévios, agregar e incorporar significado aos novos conteúdos, evitando-se, assim, que esse conhecimento recém-incorporado seja armazenado, por meio de associações ineptas, à estrutura cognitiva. No âmbito da educação médica, diante das imperiosas mudanças necessárias para a formação de um profissional que aprenda a aprender, a aprendizagem significativa permite uma genuína contextualização dos conhecimentos necessários à prática médica, facultando, portanto, um aprendizado mais efetivo e permitindo a atuação em um contexto complexo e interdisciplinar. Em conformidade com o exposto, o presente manuscrito objetiva apresentar a teoria da aprendizagem significativa, discutindo elementos da incorporação deste conceito à educação médica.