Identificação de bactérias em ambulâncias: riscos assistenciais à segurança do paciente

The aim was to identify microorganisms through the microbial cultivation of bacteria inside ambulances in two municipalities in Baixada Fluminense, in the State of Rio de Janeiro, and to test the sensitivity of these microorganisms to antimicrobials. Samples were obtained from nine specific points inside 6 ambulances. They were inoculated onto salt and blood mannitol agar and were analyzed using matrix-assisted laser desorption and ionization techniques. The sensitivity of seven samples was tested using the disk diffusion method on Muller-Hinton agar. Of the fifty-two samples collected, thirty-one (59.6%) were positive for some genus of bacteria, two (3.80%) were not recognized by MALDI and nineteen (36.6%) were negative. Infection prevention and control practices need to be reinforced, as contamination can result in possible complications for patients.Objetivou-se identificar microrganismos por meio do cultivo microbiano de bactérias do interior de ambulâncias em dois municípios da Baixada Fluminense, no Estado do Rio de Janeiro, e testar a sensibilidade desses microrganismos a antimicrobianos. Amostras foram obtidas de nove pontos específicos do interior de 6 ambulâncias. Elas foram inoculadas no ágar manitol salgado e de sangue, e foram analisadas por meio de técnica de ionização e dessorção a laser assistida por matriz. Foi testada a sensibilidade de sete amostras com o método de difusão em disco em ágar Muller-Hinton. Das cinquenta e duas amostras coletadas, trinta e uma (59,6%) positivaram para algum gênero de bactéria, duas (3,80%) não foram reconhecidas pelo MALDI e dezenove (36,6%) negativaram. É preciso que sejam reforçadas as práticas de prevenção e controle de infecções, dado que a contaminação pode resultar em possíveis complicações para os pacientes

Periradicular lesions in HIV-infected patients attending the faculty of dentistry: clinical findings, socio-demographics status, habits and laboratory data - seeking an association

OBJECTIVE: The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status. METHOD: One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth were evaluated for the presence of periradicular lesions, caries lesions, coronal restorations, pulp cavity exposure and endodontic treatment. RESULTS: The prevalence of periradicular lesions was 46%. There were no significant differences between individuals with or without periradicular lesions with respect to their socio-demographic status, habits, laboratory data and route of HIV infection. However, the presence of a periradicular lesion was statistically correlated with the number of teeth with endodontic treatment (p = 0.018), inadequate endodontic treatment (p = 0.025), images suggesting pulp cavity exposure (p = 0.002) and caries lesions (p = 0.001). CONCLUSIONS: The prevalence of periradicular lesions in HIV-infected individuals was 46% and was not related to HIV infection

Úlceras Aftosas Recorrentes e sua possível associação ao estresse

Aphthous lesions are considered the most common oral mucosal disease known to humans beings, its regular presentation is round lesions, clearly defined, painful ulcers with shallow necrotic center, raised margins, and erythematous haloes. Up to now, no evidence of any single etiologic factor has been reported, however lots of studies consider stress a predisposing factor for its pathogenesis. Trying to reach a connection between both situations, this paper pains a literature review about the effects of stress in immune dysfunction, and its possible role in aphthous lesions pathogenesis.A lesão de afta é considerada a alteração mais comum da mucosa oral em humanos e se caracteriza por uma lesão circular, claramente definida, dolorosa, com centro necrótico, bordas elevadas e halo eritematoso. Até hoje, não ocorreu a caracterização de um agente etiológico especifico para essa afecção. No entanto, várias são as referências, na literatura, que consideram o estresse um dos fatores predisponentes para sua patogenia. Visando a estabelecer uma correlação entre esses processos, este trabalho teve como objetivo realizar uma revisão da literatura sobre os efeitos do estresse no sistema imunológico e a possível atuação desse sistema na origem das lesões de afta

Recall Rates of Patients in Endodontic Treatments: A Critical Review

The number of patients that return for recall appointments has great importance to validate endodontic treatment outcomes. The purpose of this review was to investigate the rate of return on recall and the main factors that influence this rate of return. A literature review was performed in the PubMed database for the years from 1978 to 2017, using the following keywords: recall rate, endodontic treatment, endodontic retreatment, apical surgery. The inclusion criteria were: prospective studies in English, and in vivo research with humans, which included patient return rates. A total of 35 studies that fulfilled the established criteria were selected. The percentage of patients who returned on recall was 56%. More female patients (60%) attended the recall appointments than male (40%). The three main reasons for not returning were: patients did not observe the follow-up appointment (490), not returning due to a lack of interest (99) and   changing their address (222). The age of the patients attending the appointments varied from 28.6 to 62 years old, with the highest percentage of patients that returned ranging from 40 to 52.5 years old. According to the literature the optimal rate of return for follow-up treatment should be greater than 80%, for the validity of the research. However, the reality presented in the studies is far from ideal. Many studies do not even mention these rates of return in their methodologies or in their results, which may mask the true treatment success rates.Keywords: Endodontic Recall; Follow-up; Recal

Trauma in Primary Teeth at a Specialized Service Center: Retrospective Cohort

Objective: To evaluate the factors associated with the occurrence of dental trauma in children up to six years of age and describe the results of clinical follow-up and possible sequelae. Material and Methods: A retrospective study was carried out with data collected from the dental records of 96 pediatric patients up to 6 years old with traumatized primary teeth who sought care from the. Pediatric Dental Trauma project of a private university in the city of Rio de Janeiro from July 2014 to July 2017, and who had clinical and radiographic follow-up for up to three months as of their initial visit. Results: 96 children (58.3% boys and 41.7% girls) included who presented 166 traumatized primary teeth. Intrusion was the most observed type of trauma and in 45.8% of cases, the care occurred one-week post trauma. The maxillary central incisors were the most affected teeth (97.6%). The prognosis of the dental elements with more than 3 months of follow-up was considered favorable, and 59.6% of the teeth did not present any clinical or radiological sequelae. Oral hygiene instruction and monitoring were the most common approaches. Conclusion: The prevalence of dental trauma in the present study was high and occurred mainly in domestic settings. The upper central incisors were the teeth that suffered the most injuries. The presence of patients at follow-up visits was an important factor for the positive result in most cases

Can habits and behaviors predict colonization by community-associated MRSA in patients admitted to a Brazilian hospital?

This study aimed to identify factors associated with colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in adult patients admitted to a Brazilian hospital. This is a cross-sectional study, in which patients underwent a nasal swab and were asked about hygiene behavior, habits, and clinical history. Among the 702 patients, 180 (25.6%) had S. aureus and 21 (2.9%) MRSA. The factors associated with MRSA colonization were attending a gym (OR 4.71; 95% CI; 1.42 – 15.06), smoking habit in the last year (OR 2.37; 95% CI; 0.88 – 6.38), previous hospitalization (OR 2.18; CI 95%; 0.89 – 5.25), and shared personal hygiene items (OR 1.99; 95% CI; 0.71 – 5.55). At the time of admission, colonization by CA-MRSA isolates was higher than that found in the general population. This can be an important public health problem, already endemic in hospitals, whose factors such as those associated with habits (smoking cigarettes) and behaviors (team sports practice and activities in gyms) have been strongly highlighted. These findings may help developing infection control policies, allowing targeting patients on higher-risk populations for MRSA colonization

ATUAÇÃO DA ENFERMAGEM NA CONSERVAÇÃO DA SAÚDE DE MULHERES EM SITUAÇÃO DE VIOLÊNCIA

RESUMO A violência contra a mulher é um fenômeno complexo que provoca efeitos negativos sobre sua saúde. O princípio da Teoria de Enfermagem de Levine é manter ou recuperar uma pessoa (a mulher que vivencia a violência) para um estado de saúde (longe da violência). OBJETIVO: analisar, pela ótica da Teoria de Enfermagem de Levine, o atendimento da enfermeira às mulheres que sofreram violência. MÉTODO: pesquisa qualitativa e descritiva realizada na Estratégia de Saúde da Família do Rio de Janeiro – Brasil, com 11 enfermeiras que prestaram atendimento às mulheres em situação de violência, com base em entrevistas utilizando roteiro de perguntas semiestruturado. Pesquisa aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio de Janeiro e Secretaria Municipal de Saúde. Os depoimentos foram analisados pelo método do Discurso do Sujeito Coletivo. RESULTADOS: a análise das entrevistas resultou em quatro ideias centrais referentes a: conservação de energia, integridade estrutural, pessoal e social das mulheres. CONCLUSÃO: o cuidado precisa possibilitar conservação de energia, por meio da atenção integral às mulheres, e não apenas focado na violência. Enfatizaram questões como acolhimento e acesso à unidade de saúde, resgatando vínculos dessa mulher com membros da rede social

Instagram como instrumento de educação em saúde e cidadania para transexuais: relato de experiência

The aim of this study is to reflect on the power of Instagram© as an instrument of education in health and citizenship. This is an experience report of an extension project aimed at the LGBT population, with an emphasis on transgender people in which it analyzes Instagram© as a means of disseminating knowledge. Educational posts were made on the platform, related to meeting the demands in nursing care for the LGBT population, with a focus on transsexuals. Currently the “Transligado” profile has 341 followers, 40 publications, following the direction of health education. This was generated from meetings, studies related to engagement in social media and adaptation of the language of the scientific environment to a dynamic format that is sensitive to the different audiences that the platform reaches. Thus, as an extension project, it fulfills the triad assistance, teaching and research. Its relevance is justified by the difficulty, lack of knowledge and prejudice among Nursing professionals about the health and care demands of transgender people, thus hindering access to health and quality care for this population.O objetivo deste estudo é refletir sobre a potência do Instagram© como instrumento de educação em saúde e cidadania. Trata-se de um relato de experiência de um projeto extensionista voltado para a população LGBT, com ênfase nas pessoas transexuais em que analisa o Instagram© como meio de disseminação de conhecimento. Foram realizadas postagens de cunho educativo na plataforma, relativas ao atendimento das demandas no cuidado de enfermagem para a população LGBT, com foco nos transexuais. Atualmente o perfil “Transligado” possui 341 seguidores, 40 publicações, seguindo a direção da educação em saúde. Isso foi gerado a partir de reuniões, estudos referentes à engajamento em mídias sociais e adaptação da linguagem do meio científico para um formato dinâmico e sensível aos diferentes públicos que a plataforma alcança. Assim, enquanto projeto extensionista, cumpre a tríade assistência, ensino e pesquisa. Sua relevância é justificada pela dificuldade, desconhecimento e preconceito entre profissionais de Enfermagem acerca das demandas de saúde e cuidados das pessoas transexuais, dificultando assim o acesso à saúde e o atendimento de qualidade à essa população