GRADO DE CONOCIMIENTO Y PRACTICAS DE MEDIDAS DE BIOSEGURIDAD EN INTERNOS DE OBSTETRICIA EN SALA DE PARTOS HOSPITAL REGIONAL HERMILIO VALDIZAN HUANUCO 2017

La investigación se efectuó con el título “Grado de conocimiento y prácticas de medidas de bioseguridad en internos de obstetricia en sala de partos Hospital Regional Hermilio Valdizan Huánuco 2017”, problema principal Cuál es el grado de conocimiento y prácticas de medidas de bioseguridad, el objetivo general Determinar si existe a relación entre el grado de conocimiento y la práctica de medidas de bioseguridad. Estudio de investigación es de tipo descriptivo correlacional, descriptivo. Población de 45 internos.llegando a los siguientes resultados: Las edades correspondientes a los 22 a 24 años, representando los 64 %, el sexo de mayor porcentaje el sexo femenino con el 91%, 96% de la población es de la zona urbana, el 73%, pertenece a la religión católica, concepto que tienen sobre las normas de bioseguridad un 69% conjunto de medidas y normas preventivas, destinadas a mantener el control de factores de riesgo laborales procedentes de agentes biológicos, físicos o químicos, los principios de bioseguridad el 40% barreras protectoras, universalidad y control de infecciones, momento de lavado de las manos que el 55% debe ser siempre, antes y después de atender al paciente, Si tiene una herida y tiene que atender a un paciente que acción se debe de realizar? El 51% refiere Proteger con gasa, esparadrapo de inmediato y utilizar guantes dosis de vacuna Hepatitis B el 64% son dos dosis, uso de mascarillas, que un 69% que se tenga contacto con los pacientes, pasos del proceso de tratamiento de materiales contaminados el 46% manifestó que son: Descontaminación, cepillado, enjuague, secado, esterilización y/o desinfección,el material descartable el 98% se elimina en un recipiente especial, color de bolsa a usar en caso de material biocontaminado, el 44 % debe ser en bolsa de color rojo, el 100% que los guantas una vez utilizados se desechan, secreción que se manipulan durante la atención a pacientes, el 87% refirió orina, deposiciones y sangre, cuidado de paciente si es o no infectado que un 40% que se debe tener el mismo cuidado, accidente punzocortante el 56% se debe lavar con agua, jabón uso de antiséptico y notificar el caso a epidemiologia para el tratamiento preventivo, vías de trasmisión de los agentes patógenos, que un 56% refirió la vía aérea.Tesi

QUANDO O JORNAL SE TORNA MULTIPLATAFORMA: análise das capas de O Liberal no impresso e no digital

Este artigo tem o objetivo de analisar as características pertinentes à capa do jornal O Liberal no impresso e no digital, com foco na apresentação visual. A pesquisa de caráter exploratório combinou as seguintes técnicas qualitativas: pesquisa bibliográfica, coleta de dados e análise. A análise foi realizada tendo como base a edição do dia três de julho de 2019 dos jornais impresso e digital, com base nas seguintes categorias: nome do jornal, diagramação, editorias, manchetes, disposição das notícias, imagens estáticas e em movimento, cores, tipografia, links e publicidade. Concluiu-se que há um diálogo entre os dois produtos, embora eles demonstrem independência na apresentação visual.   PALAVRAS-CHAVE: Jornalismo impresso; Jornalismo Digital; Multiplataforma; Capas; O Liberal.     ABSTRACT This article aims to analyze the main characteristics related to the cover of the newspaper O Liberal in its print and digital versions, focusing on visual presentation. The exploratory research combined the following qualitative techniques: bibliographic research, data collection and analysis. The analysis was conducted based on the print and digital edition of the newspaper in July 3, 2019, regarding the following categories: newspaper name, layout, editorials, headlines, news layout, still and moving images, colors, typography , links and advertising. It was concluded that there is a dialogue between the two products, although they demonstrate independence in the visual presentation.   KEYWORDS: Printed journalism; Digital journalism; Multiplataform; Covers; O Liberal.     RESUMEN Este artículo tiene como objetivo analizar las características relacionadas a la portada del periódico O Liberal en forma impresa y digital, con un enfoque en la presentación visual. La investigación exploratoria combinó las siguientes técnicas cualitativas: investigación bibliográfica, recopilación y análisis de datos. El análisis se realizó basada en la edición del 3 de julio de 2019 de los periódicos impresos y digitales, basados en las siguientes categorías: nombre del periódico, diagramación, editoriales, titulares, diseño de noticias, imágenes fijas y en movimiento, colores, tipografía, enlaces y publicidad. Se concluyó que existe un diálogo entre los dos productos, aunque demuestren independencia en la presentación visual.   PALABRAS CLAVE: Periodismo impreso; Periodismo digital; Multiplataforma; Portadas; O Liberal..&nbsp

PERCEPÇÃO DOS PROFISSIONAIS DE SAÚDE ACERCA DA SÍNDROME METABÓLICA

O objetivo desse estudo foi compreender a percepção dos profissionais de saúde acerca da Síndrome Metabólica. Trata-se de uma pesquisa qualitativa, descritiva, exploratória e de campo, realizada com profissionais de saúde lotados em dois Centros de Saúde da Comunidade do município de Palmas/Tocantins, por meio de entrevista utilizando questionário semiestruturado, sendo analisado pelo método de Análise de Conteúdo. Conforme semelhança das falas foi agrupado para análise das entrevistas as categorias profissionais de enfermagem e medicina, agente comunitário de saúde e técnico de enfermagem, visto que o primeiro grupo destacou mais a fundo sobre o tema e demonstrou menos estranheza acerca do termo, porém ainda sem aprofundamento conforme a literatura. Para o mesmo fim, os resultados foram divididos em categorias, sendo elas: Conceito e diagnóstico; tratamento; fatores de risco e; ações de prevenção. Os profissionais de nível superior demonstraram maior compreensão acerca da SM, porém ainda se nota necessidade de maior esclarecimento sobre o assunto para que a importância desta condição seja reconhecida. Desta forma haverá uma prestação de assistência adequada aos pacientes, evitando o surgimento de novos casos de síndrome metabólica e que doenças crônicas se instalem, causando consequências econômicas e sociais para o país

Ascorbic acid reduces Ropivacaine-induced myotoxicity in cultured human osteoporotic skeletal muscle cells

Background: Osteoporosis is a worldwide health issue. Loss of bone mass is a potential risk factor for fragility fractures, and osteoporotic fractures place a considerable burden on society. Bone and muscle represent a functional unit in which the two tissues are intimately interconnected. Ropivacaine is a potent local anesthetic used in clinical practice for intraoperative anesthesia and postoperative pain management, in particular for hip surgery. When injected, Ropivacaine can diffuse locally through, in particular in surrounding skeletal muscle tissue, causing dose-dependent cytotoxicity, oxidative stress and myogenesis impairment. Based on those evidences, we focused our attention on Ropivacaine-induced cytotoxicity on cultured human myoblasts. Methods: Primary human myoblasts and myotubes from healthy subjects, osteoarthritic and osteoporotic patients (OP) were cultured in the presence of Ropivacaine. In some experiments, ascorbic acid (AsA) was added as a potent antioxidant agent. Cell viability and ROS levels were evaluated to investigate the myotoxic activity and Real-Time PCR and Western blot analysis carried out to investigate the expression of proliferation and myogenic markers. Results: A dose-dependent decrease of cell viability was observed after Ropivacaine exposure in both OP myoblasts and myotubes cultures, whereas those effects were not observed in the presence of Propofol, a general anesthetic. The adding of AsA reduced Ropivacaine negative effects in OP myoblast cultures. In addition, Ropivacaine exposure also increased ROS levels and upregulated Nox4 expression, an enzyme primarily implicated in skeletal muscle ROS generation. AsA treatment counteracted the oxidant activity of Ropivacaine and partially restored the basal condition in cultures. Positive myogenic markers, such as MyoD and Myf5, were downregulated by Ropivacaine exposure, whereas myostatin, a negative regulator of muscle growth and differentiation, was upregulated. The phenotypic deregulation of myogenic controllers in the presence of Ropivacaine was counteracted by AsA treatment. Conclusions: Our findings highlight the oxidative stress-mediated myotoxic effect of Ropivacaine on human skeletal muscle tissue cell cultures, and suggest treatment with AsA as valid strategy to mitigate its negative effects and allowing an ameliorated functional skeletal muscle recovery in patients undergoing hip replacement surgery for osteoporotic bone fracture

Overweight and obesity of children in a brazilian elementary school: a comparison of three references

Introduction: In the diagnosis of overweight and obesity based on body mass index in children and adolescents, several national and international anthropometric references are recommended. However, there is a divergence in the estimated prevalence of overweight and obesity among the references. Objective: To identify the prevalence of overweight and obesity and to analyse the magnitude of agreement among the three references. Methods: A cross-sectional study with 975 students from the early grades of elementary school. The prevalence of overweight and obesity were estimated according to the criteria of the World Health Organization (WHO), the International Obesity Task Force (IOTF) and Conde and Monteiro. The Kappa weighted index was calculated to assess the agreement magnitude among the three references. Results: The highest prevalence of overweight and obesity was estimated by the Conde and Monteiro and WHO references, respectively. Overall, the IOTF revealed lower a magnitude of prevalence than the two other references. The agreement among the references identified by the Kappa index had a range of 0.66 to 0.94. Conclusion: Despite the satisfactory agreement among the three references, this research highlighted the differing magnitudes of the prevalence of overweight and obesity. This fact limits the ability to make comparisons among populations and impairs the development of overweight and obesity prevention actions

Disease Reactivation after Fingolimod Discontinuation in Pregnant Multiple Sclerosis Patients

Recent studies estimated an incidence of 4-25% of disease rebound after withdrawal of fingolimod (FTY) for any reason, but specific data on disease reactivation after FTY withdrawal due to pregnancy are limited. The aim of the study was to evaluate the frequency and predictors of disease reactivation in patients who stopped FTY for pregnancy. A multicentre retrospective cohort study was conducted in four Italian MS centres in 2013-2019. Both planned and unplanned pregnancies were included. The annualized relapse rate (ARR) was calculated before FTY treatment, during FTY treatment, during pregnancy and during the year after delivery. In total, 27 patients (mean age 29 years) were included. The ARR 1 year before FTY treatment was 1.3. Patients were exposed to FTY for a median of 2.9 years. The ARR was 0.04 during the last year before conception (p < 0.001 compared with the ARR before FTY treatment). Eleven patients became pregnant after a mean of 88 days following FTY discontinuation, whereas 16 patients stopped FTY after pregnancy confirmation. Relapses were observed in 22% of patients during pregnancy and in 44% in the postpartum period. ARR increased both during pregnancy (0.49; p = 0.027) and in the first year after delivery (0.67; p < 0.001) compared to the last year before pregnancy. Compared with radiological assessment before pregnancy, more patients showed new or enlarging T2 lesions (63% vs 30%; p = 0.02) and gadolinium-enhancing lesions (44% vs 0; p = 0.0001) on brain Magnetic Resonance Imaging. Relapses during pregnancy were the only significant predictor for postpartum relapses (OR 1.9, 95% CI 1.11-3.1). One case of spontaneous abortion and no cases of abnormal foetal development were observed. Despite adequate and prolonged control of disease activity, women who discontinue FTY because of pregnancy are at risk for disease reactivation. In patients who relapsed during pregnancy, the initiation of high-efficacy disease modifying drugs (DMDs) soon after delivery is advisable to prevent postpartum relapses

AIRO Breast Cancer Group Best Clinical Practice 2022 Update

Introduction: Breast cancer is the most common tumor in women and represents the leading cause of cancer death. Radiation therapy plays a key-role in the treatment of all breast cancer stages. Therefore, the adoption of evidence-based treatments is warranted, to ensure equity of access and standardization of care in clinical practice.Method: This national document on the highest evidence-based available data was developed and endorsed by the Italian Association of Radiation and Clinical Oncology (AIRO) Breast Cancer Group.We analyzed literature data regarding breast radiation therapy, using the SIGN (Scottish Intercollegiate Guidelines Network) methodology (www.sign.ac.uk). Updated findings from the literature were examined, including the highest levels of evidence (meta-analyses, randomized trials, and international guidelines) with a significant impact on clinical practice. The document deals with the role of radiation therapy in the treatment of primary breast cancer, local relapse, and metastatic disease, with focus on diagnosis, staging, local and systemic therapies, and follow up. Information is given on indications, techniques, total doses, and fractionations.Results: An extensive literature review from 2013 to 2021 was performed. The work was organized according to a general index of different topics and most chapters included individual questions and, when possible, synoptic and summary tables. Indications for radiation therapy in breast cancer were examined and integrated with other oncological treatments. A total of 50 questions were analyzed and answered.Four large areas of interest were investigated: (1) general strategy (multidisciplinary approach, contraindications, preliminary assessments, staging and management of patients with electronic devices); (2) systemic therapy (primary, adjuvant, in metastatic setting); (3) clinical aspects (invasive, non-invasive and micro-invasive carcinoma; particular situations such as young and elderly patients, breast cancer in males and cancer during pregnancy; follow up with possible acute and late toxicities; loco-regional relapse and metastatic disease); (4) technical aspects (radiation after conservative surgery or mastectomy, indications for boost, lymph node radiotherapy and partial breast irradiation).Appendixes about tumor bed boost and breast and lymph nodes contouring were implemented, including a dedicated web application. The scientific work was reviewed and validated by an expert group of breast cancer key-opinion leaders.Conclusions: Optimal breast cancer management requires a multidisciplinary approach sharing therapeutic strategies with the other involved specialists and the patient, within a coordinated and dedicated clinical path. In recent years, the high-level quality radiation therapy has shown a significant impact on local control and survival of breast cancer patients. Therefore, it is necessary to offer and guarantee accurate treatments according to the best standards of evidence-based medicine

INDICAÇÕES DA CIRURGIA DE FRENECTOMIA LINGUAL – UMA REVISÃO DE LITERATURA

The short lingual frenulum, also called ankyloglossia, can generate changes that make it necessary to correct the abnormality. This correction is carried out through surgeries that aim to completely remove the frenumum, enabling the return of normal functions. Objectives: Collect information about ankyloglossia, as well as its characterists. Method: The proposed work is a literature review, the results obtained were through Reading artiches, summaries and case reports, in the period from 2010 to 2022, avaliable in the scielo, pubmed, virtual library, databases in health (VHL), collection+index base and LILACS. Providing a review of the most current information on the topic. Results: When well indicated thround an accurate diagnosis, performing lingual frenectomy can result a good prognosis for improving the movement of the lingual muscles and improving the patient´s diction. Final considerations: When done well, improvements in speech, swallowing, sucking and tongue position can be noticed moments after surgery. Furthermore, a minimally painful an quick recovery with the help of laser therapy makes frenectomy a more conveniente procedure peasee of mind for patients.O freio lingual curto também denominado por anquiloglossia, pode gerar alterações que se façam necessário a correção da anormalidade, essa correção é realizada por meio de cirurgias que tem como objetivo a remoção completa do freio, possibilitando a volta das funções normais. Objetivos: Fazer o levantamento de informações sobre a anquiloglossia, assim como suas caracteristicas. Métodos: O trabalho proposto trata-se de uma revisão da literatura, os resultados obtidos foram através da leitura de artigos, resumos e relatos de casos, no período de tempo de 2010 a 2022, disponíveis nas bases de dados Scielo, Pubmed, Biblioteca Virtual em Saúde (BVS), Acervo+ Index base e LILACS. Proporcionando uma revisão das informações mais atuais sobre o tema. Resultados: Quando bem indicada através de um diagnóstico preciso, a realização da frenectomia lingual, pode resultar em um bom prognóstico para melhoria do movimento da musculatura lingual e no aperfeiçoamento da dicção do paciente. Considerações finais: Quando bem executada, a melhora da fala, deglutição, sucção e posição lingual já podem ser notadas em instantes após a cirurgia. Além disso, uma recuperação minimamente dolorosa e rápida com auxílio de laserterapia tornam a frenectomia um procedimento mais tranquilo por parte dos pacientes