DIMENSIÓN DE PERSONAL DE ENFERMERÍA EN LA UNIDAD DE CUIADADOS SEMIINTENSIVOS DE UN HOSPITAL UNIVERSITARIO DE CURITIBA

Estudo descritivo-exploratório, cujo objetivo foi dimensionar o número de profissionais de enfermagem no Centro de TerapiaSemi-Intensiva (CTSI) de um hospital universitário. Os resultados do Nursing Activities Score (NAS) aplicado a 96 pacientes evidenciaram quea carga de trabalho junto a pacientes críticos neurológicos e semicríticos clínicos é maior, e menor para pacientes críticos cardiológicos. Acomplexidade e a intensidade do cuidado não sofrem influência da idade, mas das condições clínicas e da dependência do paciente em relação àEnfermagem. O atendimento das necessidades de cuidado dos pacientes requer 41% de profissionais de enfermagem a mais para o CTSI. O altoÍndice de Segurança Técnica para a Unidade deve-se principalmente pela jornada de trabalho de trinta horas semanais. O NAS é um instrumentogerencial que possibilita adequar o número de profissionais às reais necessidades de cuidado dos pacientes, a fim de que este seja realizado demodo seguro e com a qualidade almejada.Es un estudio descriptivo y exploratorio, cuyo objetivo fue hazer la dimensión de los profesionales de enfermería enCentro de Cuidado Semiintensivo de un hospital universitario. Los resultados del Nursing Activities Score (NAS) aplicado a 96pacientes evidenciaron que la carga de trabajo con pacientes críticos neurológicos y semicríticos clínicos es mayor, y menor parapacientes críticos cardiológicos. La complejidad y la intensidad del cuidado no tienen influencia de la edad, pero de las condicionesclínicas y de la dependencia del paciente en relación a la enfermería. Para el atendimiento de las necesidades de cuidado de los pacientesson necesarios 41% de profesionales de enfermería a más para el Centro de Cuidado. El gran Índice de Seguridad Técnica para la unidadse debe principalmente a la jornada laboral de treinta horas semanales. El NAS é um instrumento gerencial que posibilita adecuar elnúmero de profesionales a las reales necesidades de cuidado de los pacientes, a fin de que sea realizado de modo seguro y con la cualidadeansiada.This descriptive-exploratory research aimed to estimate the nursing workload in a Semi-Intensive Care Center (SICC) ofa university hospital. The results obtained by the Nursing Activities Score (NAS), applied to 96 inpatients, showed that the workloadis higher to critical neurological inpatients and to semi-critical clinical ones, and lower to cardiac critical inpatients. The complexity andthe intensity of their care were not influenced by age, but by their clinical conditions and dependence on nursing staff. In order to meetpatients’ caring needs at the SICC, that would request 41% more nurses. The high Technical Safety Index is due to the 30-hour workingperiod weekly with two dayoffs. NAS is an important managerial instrument which enables to adequate the number of professionalsto inpatients’ real caring needs, so that safe and qualified care is delivered

Survey of pyrethroid and organophosphate resistance in Brazilian field populations of Rhipicephalus (Boophilus) microplus: Detection of C190A mutation in domain II of the para-type sodium channel gene

AbstractThe cattle tick Rhipicephalus (Boophilus) microplus causes expressive damage to livestock in Brazil and other countries. Its control is becoming more difficult due to the development of resistance in populations. Early detection of resistance can help in developing effective control strategies. This study evaluated the susceptibility of R. microplus to cypermethrin and chlorpyriphos and was the first attempt to identify the mechanism of resistance (target site insensitivity) in cattle tick populations from Minas Gerais state (Southeastern Brazil). Engorged female ticks were collected from 10 ranches within the state of Minas Gerais, and susceptibility was evaluated with the larval packet test (LPT) using technical grade cypermethrin and chlorpyriphos. It was possible to analyze LPT results of seven populations. Target site insensitivity was investigated in all 10 isolates by using molecular approaches for detection of the T2134A substitution within the domain III S6 segment and the C190A in the domain II S4-5 linker from the para-type sodium channel gene. LPT showed that all seven populations were resistant to cypermethrin with resistance ratio (RR) ranging from 16.0 to 25.0 and 85.7% were resistant to chlorpyriphos (RR=2.2–15.6). Although the T2134A mutation was not detected, the C190A mutation was highly prevalent, being present in 82–100% of the alleles sampled in field populations. A significant correlation was found between the LC50 values for cypermethrin and the frequency of the C190A mutation suggesting that it might be responsible for the phenotypic resistance detected

Serological survey of leptospirosis in horses with historical displacement through different geographic regions in Brazil

Leptospirosis has worldwide occurrence and shows higher incidence in tropical areas. Equines can present several serovars according to geographic region and it is important analyze de possible contribution of animal displacement on the Leptospira spp. strains occurrence. This research aimed to conduct a serological investigation in an equine regiment belonging to the Brazilian Army Guard Cavalry, resident in an urban area of Rio de Janeiro municipality, but with history of displacement between different regions in Brazil. A microscopic agglutination test was performed in a serum bank of 197 horses using 29 Leptospira spp. strains. The test showed 94.92% positivity, with 90.36% of the animals presenting a positive result for two or more serovars. Higher titers (?1:400) could be detected in 54.31% of horses for at least one serovar, whereas seropositivity for more than one bacterial type occurred mostly at lower titers (<1:400). All animals were clinically healthy. Occurrence of serogroup Icterohaemorraghiae in urban areas was confirmed; however, equine serovars Bratislava and Australis presented low frequencies. The serovars Hardjo, Wolffi, and Canicola were detected, and indicated the presence of ruminants and dogs as reservoirs in proximity in some of the places frequented by the animals. It is suggested that travel history has contributed to the high frequency found and a possible greater contact with different types of Leptospira spp. Therefore, veterinarians should consider the history of geographic displacement and other animal species coexistence with horses when conducting their clinical investigation

Serological survey of leptospirosis in horses with historical displacement through different geographic regions in Brazil

Leptospirosis has worldwide occurrence and shows higher incidence in tropical areas. Equines can present several serovars according to geographic region and it is important analyze de possible contribution of animal displacement on the Leptospira spp. strains occurrence. This research aimed to conduct a serological investigation in an equine regiment belonging to the Brazilian Army Guard Cavalry, resident in an urban area of Rio de Janeiro municipality, but with history of displacement between different regions in Brazil. A microscopic agglutination test was performed in a serum bank of 197 horses using 29 Leptospira spp. strains. The test showed 94.92% positivity, with 90.36% of the animals presenting a positive result for two or more serovars. Higher titers (?1:400) could be detected in 54.31% of horses for at least one serovar, whereas seropositivity for more than one bacterial type occurred mostly at lower titers (&lt;1:400). All animals were clinically healthy. Occurrence of serogroup Icterohaemorraghiae in urban areas was confirmed; however, equine serovars Bratislava and Australis presented low frequencies. The serovars Hardjo, Wolffi, and Canicola were detected, and indicated the presence of ruminants and dogs as reservoirs in proximity in some of the places frequented by the animals. It is suggested that travel history has contributed to the high frequency found and a possible greater contact with different types of Leptospira spp. Therefore, veterinarians should consider the history of geographic displacement and other animal species coexistence with horses when conducting their clinical investigation.Leptospirosis has a worldwide occurrence and shows higher incidence in tropical areas. Equines can present several serovars according to geographic region and it is important to analyze the possible contribution of animal displacement on the Leptospira spp. strains occurrence. This research aimed to conduct a serological investigation in an equine regiment belonging to the Brazilian Army Guard Cavalry, resident in an urban area of Rio de Janeiro municipality, but with a history of displacement between different regions in Brazil. A microscopic agglutination test was performed in a serum bank of 197 horses using 29 Leptospira spp. strains. The test showed 94.92% positivity, with 89.84% of the animals presenting a positive result for two or more serovars. Higher titers (?1:400) could be detected in 57.22% of horses for at least one serovar, whereas seropositivity for more than one bacterial type occurred mostly at lower titers (&lt;1:400). All animals were clinically healthy. The occurrence of serogroup Icterohaemorraghiae in urban areas was confirmed; however, equine serovars Bratislava and Australis presented low frequencies. The serovars Hardjo, Wolffi, and Canicola were detected and indicated the presence of ruminants and dogs as typical reservoirs in proximity to the equines. It is suggested that travel history has contributed to the high frequency found and possible greater contact with different types of Leptospira spp. Therefore, veterinarians should consider the history of geographic displacement and other animal species’ coexistence with horses when conducting their clinical investigation

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline