ERRORES DE DOSIS RELACIONADOS A PROCEDIMIENTOS EN ENFERMERÍA EN LA INFUSIÓN INTRAVENOSA DE ANTIMICROBIANOS

A infusão de subdoses de antimicrobianos pode ser extremamente importante, pois interfere no desenvolvimentode resistência microbiana. O objetivo desse estudo foi analisar os erros de dose relacionados à infusão de antimicrobianospor via endovenosa. Trata-se de um estudo exploratório, realizado em uma unidade clínico-cirúrgica de um hospitalpúblico em Fortaleza-Ceará. Foram realizadas 174 observações de infusão de antimicrobianos com detecção de 59 errosligados a dose menor do que a prescrita. Deste total (59) predominaram administrações de doses menores por resíduo nosdispositivos de infusão em 47,5% (28). Os antimicrobianos mais frequentemente envolvidos nos erros foram: ceftriaxona12 prescrições, ciprofloxacino 11 prescrições e vancomicina 8 prescrições. Os dados despertam para necessidade da açãoconjunta da equipe de saúde na elaboração de rotinas para a infusão de antimicrobianos e para a educação continuada detécnicos e auxiliares na obediência a infusões completas das soluções para maior segurança terapêutica do paciente.The infusion of subdoses of antimicrobials may be extremely important, because it interferes in the microbialresistance development. The aim of this study was to analyze the errors related to dose infusion of intravenous antimicrobials.This is an exploratory study, conducted in a medical-surgical unit in a public hospital in Fortaleza- Ceará. 174 observationswere made on antibiotics infusion with detection of 59 errors related to lower dose than the ones prescribed. Of this total(59) in 47,5% (28) predominated administration of low doses related to the residue in infusion devices. The antimicrobialagents most frequently involved in errors were ceftriaxone (12 prescriptions), ciprofloxacin (11) and vancomycin (08prescriptions). Data point out to the need of a joint action of the health team in the development of routines for antibioticsinfusion and for the continuing education of technicians and assistants towards the obedience regarding completeinfusion of solutions in order to increase the patient security regarding infusion therapy.La infusión de subdosis de antimicrobianos puede ser extremamente importante, pues interfiere en el desarrollode resistencia microbiana. El objetivo de este estudio fue analizar los errores de dosis relacionados con la infusión deantimicrobianos por vía intravenosa. Se trata de un estudio exploratorio, realizado en una unidad clínico-quirúrgica de unhospital público en Fortaleza- Ceará. Fueron realizadas 174 observaciones de infusión de antimicrobianos con detecciónde 59 errores relacionados a la dosis menor de la prescrita. Del total (59) predominaron administraciones de dosis menorespor residuo en los dispositivos de infusión en 47,5% (28). Los antimicrobianos más frecuentemente envueltos en loserrores fueron: ceftriaxona 12 prescripciones, ciprofloxacina 11 prescripciones y vancomicina 08 prescripciones. Los datosdespiertan la necesidad de acción conjunta del equipo de salud en la elaboración de rutinas para la infusión de losantimicrobianos y para la educación continuada de técnicos y auxiliares en la obediencia a infusiones completas de lassoluciones para mayor seguridad terapéutica del paciente

Recomendações para oxigenoterapia domiciliar prolongada da Sociedade Brasileira de Pneumologia e Tisiologia (2022)

Some chronic respiratory diseases can cause hypoxemia and, in such cases, long-term home oxygen therapy (LTOT) is indicated as a treatment option primarily to improve patient quality of life and life expectancy. Home oxygen has been used for more than 70 years, and support for LTOT is based on two studies from the 1980s that demonstrated that oxygen use improves survival in patients with COPD. There is evidence that LTOT has other beneficial effects such as improved cognitive function, improved exercise capacity, and reduced hospitalizations. LTOT is indicated in other respiratory diseases that cause hypoxemia, on the basis of the same criteria as those used for COPD. There has been an increase in the use of LTOT, probably because of increased life expectancy and a higher prevalence of chronic respiratory diseases, as well as greater availability of LTOT in the health care system. The first Brazilian Thoracic Association consensus statement on LTOT was published in 2000. Twenty-two years later, we present this updated version. This document is a nonsystematic review of the literature, conducted by pulmonologists who evaluated scientific evidence and international guidelines on LTOT in the various diseases that cause hypoxemia and in specific situations (i.e., exercise, sleep, and air travel). These recommendations, produced with a view to clinical practice, contain several charts with information on indications for LTOT, oxygen sources, accessories, strategies for improved efficiency and effectiveness, and recommendations for the safe use of LTOT, as well as a LTOT prescribing model.Algumas doenças respiratórias crônicas podem evoluir com hipoxemia e, nessas situações, a oxigenoterapia domiciliar prolongada (ODP) está indicada como opção terapêutica com o objetivo principal de melhorar a qualidade e a expectativa de vida desses pacientes. O oxigênio domiciliar é usado há mais de 70 anos, e a ODP tem como base dois estudos da década de oitenta que demonstraram que o uso de oxigênio melhora a sobrevida de pacientes com DPOC. Existem evidências de que a ODP tem outros efeitos benéficos como melhora da função cognitiva e da capacidade de exercício e redução de hospitalizações. A ODP está indicada para outras doenças respiratórias que cursam com hipoxemia, segundo os mesmos critérios estabelecidos para a DPOC. Tem sido observado aumento no uso da ODP provavelmente pela maior expectativa de vida, maior prevalência de doenças respiratórias crônicas e maior disponibilidade de ODP no sistema de saúde. O primeiro consenso sobre ODP da Sociedade Brasileira de Pneumologia e Tisiologia foi publicado em 2000; após 22 anos, apresentamos esta versão atualizada. Este documento é uma revisão não sistemática da literatura, realizada por pneumologistas que avaliaram evidências científicas e diretrizes internacionais sobre ODP nas diversas doenças que cursam com hipoxemia e em situações específicas (exercício, sono e viagens aéreas). Estas recomendações, tendo em vista a prática clínica, oferecem diversos quadros com informações sobre indicações, fontes de oxigênio, acessórios e estratégias para melhor eficiência, efetividade e uso seguro da ODP, assim como um modelo para sua prescrição

Effects of Brazil's political crisis on the science needed for biodiversity conservation

The effects of Brazil’s political crisis on science funding necessary for biodiversity conservation are likely to be global. Brazil is not only the world’s most biodiverse nation, it is responsible for the greater part of the Amazon forest, which regulates the climate and provides rain to much of southern South America. Brazil was a world leader in satellite monitoring of land-use change, in-situ biodiversity monitoring, reduction in tropical-forest deforestation, protection of indigenous lands, and a model for other developing nations. Coordinated public responses will be necessary to prevent special-interest groups from using the political crisis to weaken science funding, environmental legislation and law enforcement. Keywords: Brazil, biodiversity, climate change, governance, fundin

Efeitos da aspirina em baixa dosagem sobre a medida da glico-hemoglobina em pacientes com diabete melito tipo 2

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Derivation and external validation of a simple prediction model for the diagnosis of type 2 Diabetes Mellitus in the Brazilian urban population

A risk score model was developed based in a population of 1,224 individuals from the general population without known diabetes aging 35 years or more from an urban Brazilian population sample in order to select individuals who should be screened in subsequent testing and improve the efficacy of public health assurance. External validation was performed in a second, independent, population from a different city ascertained through a similar epidemiological protocol. The risk score was developed by multiple logistic regression and model performance and cutoff values were derived from a receiver operating characteristic curve. Model`s capacity of predicting fasting blood glucose levels was tested analyzing data from a 5-year follow-up protocol conducted in the general population. Items independently and significantly associated with diabetes were age, BMI and known hypertension. Sensitivity, specificity and proportion of further testing necessary for the best cutoff value were 75.9, 66.9 and 37.2%, respectively. External validation confirmed the model`s adequacy (AUC equal to 0.72). Finally, model score was also capable of predicting fasting blood glucose progression in non-diabetic individuals in a 5-year follow-up period. In conclusion, this simple diabetes risk score was able to identify individuals with an increased likelihood of having diabetes and it can be used to stratify subpopulations in which performing of subsequent tests is necessary and probably cost-effective.FAPESP Fundacao de Amparo a Pesquisa do Estado de Sao Paulo[07/54138-2

The PIP4K2 inhibitor THZ-P1-2 exhibits antileukemia activity by disruption of mitochondrial homeostasis and autophagy

The treatment of acute leukemia is challenging because of the genetic heterogeneity between and within patients. Leukemic stem cells (LSCs) are relatively drug-resistant and frequently relapse. Their plasticity and capacity to adapt to extracellular stress, in which mitochondrial metabolism and autophagy play important roles, further complicates treatment. Genetic models of phosphatidylinositol-5-phosphate 4-kinase type 2 protein (PIP4K2s) inhibition have demonstrated the relevance of these enzymes in mitochondrial homeostasis and autophagic flux. Here, we uncovered the cellular and molecular effects of THZ-P1-2, a pan-inhibitor of PIP4K2s, in acute leukemia cells. THZ-P1-2 reduced cell viability and induced DNA damage, apoptosis, loss of mitochondrial membrane potential, and the accumulation of acidic vesicular organelles. Protein expression analysis revealed that THZ-P1-2 impaired autophagic flux. In addition, THZ-P1-2 induced cell differentiation and showed synergistic effects with venetoclax. In primary leukemia cells, LC-MS/MS-based proteome analysis revealed that sensitivity to THZ-P1-2 is associated with mitochondrial metabolism, cell cycle, cell-of-origin (hematopoietic stem cell and myeloid progenitor), and the TP53 pathway. The minimal effects of THZ-P1-2 observed in healthy CD34+ cells suggest a favorable therapeutic window. Our study provides insights into the pharmacological inhibition of PIP4K2s targeting mitochondrial homeostasis and autophagy, shedding light on a new class of drugs for acute leukemia

Dismantling Brazil's science threatens global biodiversity heritage

In the middle of a political and fiscal crisis, the Brazilian government is applying successive budget cuts, including in science funding. Recent cuts radically affect research programs on biodiversity that are crucial components for the design and monitoring of public policies for nature conservation and sustainable development. We analyze the consequences of such cuts on the Research Program on Biodiversity (PPBio), the largest biodiversity research network in Brazil (626 researchers, nine networks in all Brazilian biomes). Brazil holds a substantial part of the world's biodiversity and of tropical forests that play a significant role for regional and global climate stability. If underfunding is maintained, the dismantling of the Brazilian PPBio will have consequences that go beyond biodiversity knowledge itself but affect society as a whole. Brazil will likely fail to reach the National Targets for Biodiversity 2011–2020, and it will be difficult to fulfill the restoration target of the Brazilian NDC and to advance with the sustainable development goals. © 2017 Associação Brasileira de Ciência Ecológica e Conservaçã

Núcleos de Ensino da Unesp: artigos 2010: volume 4: as disciplinas escolares, os temas transversais e o processo de educação

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Comentarios a una sentencia anunciada : el proceso Lula

El centenar de textos que conforman este libro -escritos por un movimiento de prestigiosos/as juristas y abogados- desgranan el procedimiento al que fue sometido Lula. En la opinión de las y los autores de los artículos las normas no fueron observadas, y su inobservancia llevó a que se dictaminase una decisión injusta. Frases del estilo "Voy a tomar una decisión revolucionaria, dejando de lado la ley, porque por la ley no se puede condenarlo de ninguna manera”, dichas en los juicios por las más altas autoridades judiciales militares y civiles, hoy son conocidas gracias a quienes se abocaron al trabajo de escuchar los audios de aquellas sesiones, nutriendo las reflexiones que argumentan sobre el imperativo de la hora: restablecer el estado de derecho y absolver al presidente Lula Da Silva