Profile of Fournier gangrene patients using hyperbaric oxygen therapy as an adjuvant treatment

Objective: Evaluating the results obtained from hyperbaric oxygen therapy (HBOT) as an adjuvant treatment in Fournier's Gangrene (GF). Casuistic and Method: Cross-sectional, retrospective, and descriptive study based on the analysis of physical records of patients with GF submitted to hyperbaric oxygen therapy through the hyperbaric chamber from February 2008 to May 2018, assisted at the hyperbaric oxygen therapy clinic, in Bauru, SP. The data collected were age, gender, etiology, comorbidities, lesion location and extension, total session number, and mortality. Result: It totaled 38 patients, 76% male, with a mean age of 55.6 years. Among the patients, 17 (44.7%) were discharged, 18 (47.4%) discontinued treatment before termination, and three (8.21%) deaths occurred. The main etiology was an abscess and the main predisposing comorbidities were diabetes mellitus and hypertension. The location and extension lesion with the most affected areas were in the scrotal region, followed by the perineal region. Conclusion: The results of this study demonstrated that the effect of HBOT as an adjuvant treatment has an advantage in the treatment of GF resulting in considerable patient medical discharge and low mortality.Objetivo: Avaliar os resultados obtidos da oxigenoterapia hiperbárica (OHB) como tratamento adjuvante na Gangrena de Fournier (GF). Casuística e Método: Estudo transversal, retrospectivo e descritivo baseado na análise de prontuários físicos de pacientes portadores de GF submetidos a oxigenoterapia hiperbárica, através da câmara hiperbárica no período de fevereiro de 2008 a maio de 2018, atendidos em uma clínica de oxigenoterapia hiperbárica na cidade de Bauru, SP. Os dados coletados foram: idade, sexo, etiologia, comorbidades, localização e extensão da lesão, número total de sessão e mortalidade. Resultado: Trinta e oito pacientes foram analisados, sendo 76% do sexo masculino, com média de idade de 55,6 anos. Entre os pacientes, 17 (44,7%) obtiveram alta médica, 18 (47,4%) interromperam o tratamento antes do término e ocorreram três (8,21%) óbitos. A principal etiologia foi o abcesso e os principais comorbidades predisponentes foram a diabetes mellitus e a hipertensão arterial. A localização e extensão com áreas mais afetadas foram na região escrotal, seguida pela região perineal. Conclusão: Os resultados deste estudo demostraram que o efeito da OHB como tratamento adjuvante oferece vantagem no tratamento da GF, resultando em considerável alta médica dos pacientes e baixa mortalidade

Conocimiento sobre hepatitis B, estado de vacunación y medidas de bioseguridad entre profesionales de enfermería

Backgound and Objectives: Hepatitis B is an important global public health problems. The contamination can occur in any individual, however, health professionals, especially those in the nursing area, are more exposed. Hepatitis B is an occupational disease whose prevention is accessible, without cost in Brazil and mandatory for all healthcare professionals by vaccination. Thus, the present study aimed to verify the vaccination status of the nursing professionals, and yours knowledge about contamination risks with hepatitis B virus (HVB), as well about the biosafety measures to avoid these risks. Methods: A descriptive and cross-sectional study was carried out in a public hospital in the city of Bauru/SP, with nursing professionals. It was applied a questionnaire, between January to March 2015, containing aspects related to the vaccination status, knowledge about HBV and biosafety. Results: From 107 nursing professionals at the institution, 96 (89.8%) accepted to participate in the study, of them 84.3% were with complete vaccination, 3.2% were incomplete and 12.5% did not know their vaccination status. More than 90.0% knew the ways to avoid HVB transmission and had received information about biosafety and waste disposal, but only 81.2% used personal protective equipment (PPE) in their activities. Conclusion: The results indicate that although the nursing professionals knew how to avoid the HBV contamination, they still remains exposed to a hight risk of, and so is necessary to sensitize and awareness about the importance of adopting safe practices and immunization, leading to a behavior modification. KEYWORDS: Nursing Team. Immunization Coverage. Hepatitis B. Occupational Disease. Exposure to Biological Agents.Antecedentes y objetivos: La hepatitis B constituye un importante problema de salud pública mundial. Cualquier individuo puede contagiarse, aunque los profesionales de salud, particularmente los enfermeros, son los más expuestos. La hepatitis B es una enfermedad profesional con modo de prevención accesible gratuito y obligatorio para todos los profesionales de salud mediante vacunación. El presente estudio objetivó verificar estado de vacunación, conocimiento de contagio por el virus de la hepatitis B (HBV) y adopción de medidas de bioseguridad para evitar tales riesgos en profesionales de enfermería. Métodos: Estudio descriptivo, transversal, desarrollado en hospital público de Bauru/SP, incluyendo a todos los profesionales de enfermería. Fue aplicado, entre enero y marzo de 2015, un cuestionario incluyendo aspectos relacionados al estado de vacunación, conocimiento sobre HBV y bioseguridad. Resultados: De los 107 profesionales de enfermería de la institución, 96 (89,8% aceptaron participar de la investigación; de ellos, 84,3% poseían vacunación completa, 3,2% incompleta y 12,5% desconocía su estado de vacunación. Más del 90% conocía las formas de transmisión del HBV y había recibido indicaciones sobre las medidas de bioseguridad y eliminación de residuos, sin embargo solamente 81,2% utilizaba equipo de protección personal (EPP) en sus actividades. Conclusión: Los resultados expresan que, aunque el grupo de enfermería conociese cómo evitar la contaminación por HBV, aún así continuaba expuesto a un elevado riesgo, demostrándose la necesidad de hacer reconsiderar y concientizar a dichos profesionales sobre la importancia de la adopción de prácticas seguras e inmunización, apuntando a un cambio de comportamiento. Descritores: Grupo de Enfermería; Cobertura de Vacunación; Hepatitis B; Exposición a Agentes Biológicos

Efficacy of ethyl alcohol and quaternary ammonium in hospital medical equipment disinfection

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusion: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment

Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusions: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment.Antecedentes y objetivos: Los ambientes hospitalarios pueden albergar microorganismos patógenos y oportunistas, siendo el proceso de limpieza y desinfección importante para el control de las Infecciones relacionadas a la Asistencia a la Salud (IRAS). Así, el objetivo de este trabajo evaluar comparar la eficacia del alcohol etílico y del cuaternario de amonio en el proceso de desinfección de equipos médicos hospitalarios previamente contaminados con Staphylococcus aureus (S. aureus). Métodos: la descontaminación de 10 equipos médicos hospitalarios contaminados con una suspensión de S. aureus ATCC 25923. La descontaminación ocurrió con alcohol etílico en las concentraciones de 46,2%, 70% y 99% y con el cuaternario de amonio de 1ª y de 5ª generación. Después de la descontaminación, se tomaron muestras de la superficie de los equipos para cultivo bacteriano. Resultados: se verificó crecimiento bacteriano en el 80% de los equipos descontaminados con alcohol 46,2% y 99%. No hubo crecimiento bacteriano en la superficie de los equipos descontaminados con alcohol 70% y cuaternarios de amonio. Conclusión: los procesos de desinfección con alcohol 70% y cuaternario de amonio de 1ª y 5ª generación fueron eficaces en el control del S. aureus, comprobando la acción efectiva de estos productos en la desinfección de los equipos médicos hospitalarios.Justificativa e Objetivo: Os ambientes hospitalares podem albergar micro-organismos patogênicos e oportunistas, sendo o processo de limpeza e desinfecção importante para o controle das Infecções relacionadas à Assistência à Saúde (IRAS). Assim, o objetivo deste trabalho foi avaliar a eficácia do álcool etílico e do quaternário de amônio no processo de desinfecção de equipamentos médicos hospitalares previamente contaminados com Staphylococcus aureus (S. aureus). Método: descontaminação de 10 equipamentos médicos hospitalares contaminados com uma suspensão de S. aureus ATCC 25923. A descontaminação ocorreu com álcool etílico nas concentrações de 46,2%, 70% e 99% e com o quaternário de amônio de 1ª e de 5ª geração. Após a descontaminação, foram colhidas amostras da superfície dos equipamentos para cultura bacteriana. Resultados: foi verificado crescimento bacteriano em 80% dos equipamentos descontaminados com álcool 46,2% e 99%. Não houve crescimento bacteriano na superfície dos equipamentos descontaminados com álcool 70% e quaternários de amônio. Conclusão: os processos de desinfecção com álcool 70% e quaternário de amônio de 1ª e 5ª geração foram eficazes no controle do S. aureus, comprovando a ação efetiva destes produtos na desinfecção dos equipamentos médicos hospitalares

Level of knowledge about Hepatitis B, vaccination status and biosafety measures of nursing professionals

Backgound and Objectives: Hepatitis B is an important global public health problems. The contamination can occur in any individual, however, health professionals, especially those in the nursing area, are more exposed. Hepatitis B is an occupational disease whose prevention is accessible, without cost in Brazil and mandatory for all healthcare professionals by vaccination. Thus, the present study aimed to verify the vaccination status of the nursing professionals, and yours knowledge about contamination risks with hepatitis B virus (HVB), as well about the biosafety measures to avoid these risks. Methods: A descriptive and cross-sectional study was carried out in a public hospital in the city of Bauru/SP, with nursing professionals. It was applied a questionnaire, between January to March 2015, containing aspects related to the vaccination status, knowledge about HBV and biosafety. Results: From 107 nursing professionals at the institution, 96 (89.8%) accepted to participate in the study, of them 84.3% were with complete vaccination, 3.2% were incomplete and 12.5% did not know their vaccination status. More than 90.0% knew the ways to avoid HVB transmission and had received information about biosafety and waste disposal, but only 81.2% used personal protective equipment (PPE) in their activities. Conclusion: The results indicate that although the nursing professionals knew how to avoid the HBV contamination, they still remains exposed to a hight risk of, and so is necessary to sensitize and awareness about the importance of adopting safe practices and immunization, leading to a behavior modification. KEYWORDS: Nursing Team. Immunization Coverage. Hepatitis B. Occupational Disease. Exposure to Biological Agents

THE RELEVANCE OF NUTRITIONAL STATUS AND HISTOPATHOLOGICAL FINDINGS ON THE INFECTIOUS PROCESS OF BALB/C MICE INOCULATED WITH Lacazia loboi

O objetivo do estudo foi avaliar os efeitos da desnutrição protéico-calórica em camundongos isogênicos da linhagem BALB/c inoculados com Lacazia loboi, empregando parâmetros nutricionais e histopatológicos. Foram constituídos quatro grupos: G1- inoculados com restrição dietética; G2- não inoculados com restrição dietética; G3- inoculados sem restrição dietética; G4- não inoculados sem restrição dietética. Após instalada a desnutrição, os animais foram inoculados via intradérmica no coxim plantar e após quatro meses foram sacrificados para remoção do coxim plantar, fígado e baço. A infecção não exerceu grande influência no peso corporal dos camundongos. O peso do fígado e baço apresentou redução nos grupos desnutridos em comparação aos grupos nutridos. A lesão macroscópica, a viabilidade e o número total de fungos dos coxins plantares dos camundongos inoculados revelaram aumento no G3 quando comparado com o G1. Em relação à análise histopatológica dos coxins plantares observou-se aumento da celularidade global na composição do granuloma no G3 em relação ao G1, com grande número de macrófagos e células gigantes multinucleadas, discretos números de linfócitos estavam presentes em G3 e aumentados no G1. Os resultados sugerem que existe grande interação entre nutrição e doença de Jorge Lobo.The aim of this study was to evaluate the effects of the protein-calorie malnutrition in BALB/c isogenic mice infected with Lacazia loboi, employing nutritional and histopathological parameters. Four groups were composed: G1: inoculated with restricted diet, G2: not inoculated with restricted diet, G3: inoculated with regular diet, G4: not inoculated with regular diet. Once malnutrition had been imposed, the animals were inoculated intradermally in the footpad and after four months, were sacrificed for the excision of the footpad, liver and spleen. The infection did not exert great influence on the body weight of the mice. The weight of the liver and spleen showed reduction in the undernourished groups when compared to the nourished groups. The macroscopic lesions, viability index and total number of fungi found in the footpads of the infected mice were increased in G3 when compared to G1. Regarding the histopathological analysis of the footpad, a global cellularity increase in the composition of the granuloma was observed in G3 when compared to G1, with large numbers of macrophages and multinucleated giant cells, discrete numbers of lymphocytes were present in G3 and an increase was observed in G1. The results suggest that there is considerable interaction between Jorge Lobo's disease and nutrition

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

AbstractBackground Jorge Lobo’s disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet.Methods DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet.Conclusion These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay

Nutritional status and immune response in murine experimental Jorge Lobo's disease

There are no studies investigating the role of nutritional status and immunity associated with Jorge Lobo's disease. The objective of this study was to evaluate the effects of protein-calorie malnutrition on the immune response of BALB/c mice inoculated with Lacazia loboi. In this study,the animals were divided into four groups: G1: inoculated with restricted diet, G2: not inoculated with restricted diet, G3: inoculated with regular diet, G4: not inoculated with regular diet. The animals of groups G1 and G2 were submitted to malnutrition for 20 days and once installed the animals were inoculated intradermally into the footpad. After 4 months, they were euthanised for the isolation of peritoneal lavage cells and removal of the footpad. The production of IL-2, IL-4, IL-10, IL-12, IFN-γ, TNF-α, H2 O2 and nitric oxide (NO) was evaluated in the peritoneal lavage cells. The footpad was evaluated regarding the size of macroscopic lesions, number of fungi and viability index. The results showed that the infection did not exert great influence on the body weight of the mice and previous malnutrition was an unfavourable factor for viability index, number of fungi, macroscopic lesion size in the footpad and production of H2 O2 , NO, IL-12, IL-10 and IFN-γ, suggesting that malnutrition significantly altered fungal activity and peritoneal cells. The results suggest considerable interaction between nutrition and immunity in Jorge Lobo's disease