Usabilidade de um sistema de monitoramento das internações em pronto-socorro

OBJECTIVE To develop and evaluate the usability of the admission monitoring system in an emergency room. METHODS This applied research intends to develop a software product and evaluate its usability. The development followed four stages: systematic review, structuring of the system framework, construction of system forms, and evaluation of the information generated. In the evaluation, the experts simulated the use of the system by inserting data from a fictitious medical record. We measured usability using the System Usability Scale (SUS). Scores and scores were calculated individually and globally. We propose these evaluation standards: worst case scenario, poor, average, good, excellent, and best-case scenario. RESULTS The Sistema de Informação e Monitoramento das Internações em Pronto-Socorro (SIMIPS - Information and Monitoring System for Emergency Room Admissions) monitors the epidemiological profile of admissions to the emergency room, time management, clinical deterioration, incidence of adverse events, and human resource management. The usability of SIMIPS, evaluated by 17 experts, reached the SUS Score 86.5 (best case scenario), and some suggestions for modifications were accepted. CONCLUSIONS We consider SIMIPS an easy-to-use tool, with real importance in the management of emergencies in view of overcrowding and congestion problems faced in Brazil.OBJETIVO Desenvolver e avaliar a usabilidade de um sistema de monitoramento das internações em pronto-socorro. MÉTODOS Trata-se de uma pesquisa aplicada, com desenvolvimento de um produto de software e avaliação de sua usabilidade por enfermeiros especialistas. O desenvolvimento seguiu quatro etapas: revisão sistemática, estruturação do arcabouço do sistema, construção dos formulários do sistema e avaliação das informações geradas. Na avaliação, os especialistas simularam a utilização do sistema com a inserção de dados de um prontuário fictício, e a usabilidade foi medida pelo System Usability Scale (SUS). A pontuação e os escores foram calculados de forma individual e global. O sistema foi avaliado nos padrões: pior imaginável, pobre, mediano, bom, excelente e melhor imaginável. RESULTADOS O Sistema de Informação e Monitoramento das Internações em Pronto-Socorro (SIMIPS) realiza o monitoramento do perfil epidemiológico das internações no pronto-socorro, gestão de tempo, deterioração clínica, incidência de eventos adversos e gestão de recursos humanos. A usabilidade do SIMIPS, avaliada por 17 especialistas, atingiu o Score SUS 86,5 (melhor imaginável), e algumas sugestões de modificações foram acatadas. CONCLUSÕES  O SIMIPS foi avaliado como uma ferramenta de fácil utilização, com real importância na gestão das urgências frente aos problemas de superlotação e congestão, enfrentados no Brasil

First determination of mineral composition of the leaf Chicory (Cichorium intybus L.) used in human nourishment in the Midwest of Brazil and comparasion with dietary reference intakes for children and adults

Introduction: Radicchio (Cichorium intybus L.) is a leaf chicory and is grown as a leaf vegetable which usually has white-veined red or purple leaves and it belongs to the Asteraceae family. In several countries is consumed mainly as salad, but no studies on their elemental composition  has been done, principally in Brazil. Objective: The aim of present work was to measure the macroelements (Na, K, Ca, Mg and P) and microelements (Cr, Cu, Fe, Mn, Mo, Zn, Al, Cd, Ni, Co and Si) in the leaf Chicory used as human nourishment in the Campo Grande, State of Mato Grosso do Sul, Brazil. Method: Chemical digests of samples were prepared using HNO3 and H2O2 and then placed in the microwave digestion system. After digestion, the concentrations of the elements in Leaf Chicory were determined by the technique of Inductively Coupled Plasma - Optical Emission Spectrometer (ICP–OES, Thermo Scientific - iCAP 6000 Series). Results obtained of the concentrations of leaf chicory were compared with the dietary reference intakes. Results: Detected concentration of macroelements in leaf Chicory decreases in the order: K > P > Ca > Mg > Na. As well as the concentration of microelements decreases in the order: Fe > Al > Si > Mn > Zn > Cu > Cr > Ni > Cd > Mo > Co. Leaf Chicory is excellent source of K, Ca, Mg, P, Cr, Cu, Fe, Mn, Mo and Zn for children and adults. On the other hand, leaf chicory is not considered a source of sodium for children and adults. Concentration of K, Cr, Fe, and Al are above the limit recommended limit by FAO/WHO (1984) and others countries. Conclusions: Leaf Chicory has macro and microelements in ample amount; it can be used as an important part of people's diets. Since it not exceed allowable limits set by WHO and FAO, RDA/AI and UL. Competent organs have not evaluated concentrations of elements as Al, Cd, Ni, Co and Si in order to establish a tolerable upper intake level or RDA/AI for human. The lack of studies of adverse effects following excess intake of a nutrient does not mean that adverse effects do not occur. Keywords: Leaf Chicory; Radicchio; Inductively Coupled Plasma Mass Spectrometry (ICP-OES)

Effective killing of bacteria under blue-light irradiation promoted by green synthesized silver nanoparticles loaded on reduced graphene oxide sheets

Graphene oxide (GO) materials loaded with silver nanoparticles (AgNPs) have drawn considerable attention due to their capacity to efficiently inactivate bacteria though a multifaceted mechanism of action, as well as for presenting a synergetic effect against bacteria when compared to the activity of AgNPs and GO alone. In this investigation, we present an inexpensive and environmentally-friendly method for synthesizing reduced GO sheets coated with silver nanoparticles (AgNPs/r-GO) using a coffee extract solution as a green reducing agent. The physical and chemical properties of the produced materials were extensively characterized by scanning electron microscopy (SEM), field-emission gun transmission electron microscopy (FEG-TEM), ultraviolet and visible absorption (UV–Vis), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), inductively coupled plasma-optical emission spectroscopy (ICP-OES) and ion release determination. The results demonstrated that AgNPs/r-GO composites were successfully produced, revealing the formation of micrometer-sized r-GO sheets decorated by AgNPs of approximately 70 nm diameter. Finally, bactericidal and photobactericidal effects of the AgNPs/r-GO composites were tested against Staphylococcus aureus, in which the results showed that the composites presented antimicrobial and photoantimicrobial activities. Moreover, our results demonstrated for the first time, to our knowledge, that an efficient process of bacterial inactivation can be achieved by using AgNPs/r-GO composites under blue light irradiation as a result of three different bacterial killing processes: (i) chemical effect promoted by Ag+ ion release from AgNPs; (ii) photocatalytic activity induced by AgNPs/r-GO composites, enhancing the bacterial photoinactivation due to the excited-Plasmons of the AgNPs when anchored on r-GO; and (iii) photodynamic effect produced by bacterial endogenous photosensitizers under blue-light irradiation. In summary, the present findings demonstrated that AgNPs/r-GO can be obtained by a non-toxic procedure with great potential for biomedical-related applications

ESPECTRO ESTRUTURAL DO DESENVOLVIMENTO REGIONAL NAS MICRORREGIÕES DE VALENÇA, ILHÉUS-ITABUNA E PORTO SEGURO, ESTADO DA BAHIA

O artigo faz parte de uma proposta de trabalho inicial que visa aproveitar a base de dados da Superintendência de Desenvolvimento Econômico e Social do Estado da Bahia em estudos e textos de reflexão sobre o panorama de desenvolvimento regional no Estado. Os dados disponíveis permitem a elaboração em diferentes níveis de agregação no plano geoespacial, cultural, social, econômico e ambiental, de espectros sobre a economia regional. Nesta perspectiva, neste primeiro instante, o objetivo visou à realização de uma abordagem estrutural do padrão de desenvolvimento das microrregiões de Valença, Ilhéus-Itabuna e Porto Seguro, todos componentes das Regiões Econômicas Litoral e Extremo Sul. A metodologia adotada constou da delimitação dos espaços microrregionais e seus respectivos municípios, e, através de procedimentos de tabulação e descrição, a análise em agregado de alguns indicadores da atividade produtiva. Recorreu-se para isso, às informações da atividade agrícola, em termos de culturas permanentes e temporárias, área colhida, valor da produção, consumo de energia elétrica, financiamentos agropecuários e tributos federais e estaduais arrecadados e distribuídos nos anos 2000 e 2001. Os resultados obtidos conduziram à conclusão de que, atrelado à questão distributiva e ao problema de concentração das atividades econômicas existe um conjunto relevante de variáveis que provavelmente determina o padrão desigual de desenvolvimento regional. Observou-se uma elevada concentração no padrão de consumo regional de energia e diferenças marcantes nos valores médios dos agregados usados nas comparações. A microrregião de Porto Seguro composta de 21 municípios foi a que apresentou o melhor padrão geral de desenvolvimento regional

Identification of macroelements and microelements in the leaves of the Synadenium grantii Hook used as medicinal plant in the Brazil

Introduction: The Synadenium grantii Hook species is a medicinal plant of the Euphorbiaceae family and is popularly known in the Midwest regions of Brazil as leitosinha or janaúba. All the parts of Synadenium grantii Hook as stem, latex, leaves and flowers are used for the treatments of various disease, but no elemental composition has been done. Objective: The aim of present work was to measure the macroelements (K, Mg, Mo and P) and microelements (Cr, Cu, Fe, Mn, Mo, Zn, Si, Ni, Co, Cd and Al) in the leaves of medicinal plant Synadenium grantii Hook used in the treatment of diseases by rural and urban communities of the Campo Grande, State of Mato Grosso do Sul, Brazil. Method: The chemical digestions of samples were prepared utilizing HNO3 and H2O2 and microwave digestion system Speedwave Berghof, Germany. After digestion, the concentrations of the elements in leaves were determined by technique of Inductively Coupled Plasma – Optical Emission Spectrometer (ICP-OES) with a Dual Plasma (Thermo Scientific – iCAP 6000 Series) Results: Results demonstrated that the Synadenium grantii leaves are source of K but aren't the best source of Na and P. Its leaves are rich in elements such as Mg, Cr, Cu, Fe, Mn, Mo and Zn. The leaves of Synadenium grantii showed a high content of Mg values tolerable upper intake level. However, Fe, Na, P, Mn, Mo and Zn are below the values tolerable upper intake level. The leaves of this plants have elements as Ni, Cu, Cr, Cd above the permissible limit set by WHO and FAO. Conclusions: The gaps in knowledge about the level of contents in the Synadenium grantii was completed in this work and would serve as a tool for deciding the dosage of prepared from this plant with medicinal and nutritional purposes. Brazil should create legal standards for the use of medicinal plants based on internationally practiced requirements. Keywords: Medicinal plants, Synadenium grantii, inductively coupled plasma mass spectrometry

CCR2-deficient mice are protected to sepsis by the disruption of the inflammatory monocytes emigration from the bone marrow

Abstract: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Inflammatory monocytes are recruited to both the infection site and vital organs during sepsis; however, the mechanisms that orchestrate their migration, as well as the participation of these cells in systemic inflammation and vital organ damage, are still not fully elucidated. In this context, we described that CCR2-deficient mice had diminished migration of inflammatory monocytes from bone marrow to the circulation and subsequently to the site of infection and vital organs during cecal ligation and puncture (CLP)-induced polymicrobial sepsis. The reduction in the migration of inflammatory monocytes to the infection site was accompanied by a significant increase in the number of neutrophils in the same compartment, which seemed to counterbalance the absence of inflammatory monocytes in controlling microbial growth. Indeed, wild-type (WT) and CCR2-deficient mice under CLP presented similar control of infection. However, the CCR2-deficient mice were more resistant to sepsis, which was associated with a decrease in inflammatory mediators and organ damage biomarkers. Furthermore, the systemic adoptive transfer of CCR2-WT or CCR2-deficient inflammatory monocytes into CCR2-deficient mice equally increased the susceptibility to sepsis, demonstrating the deleterious role of these cells in the periphery even when CCR2 is absent. Thus, despite the host-protective role of inflammatory monocytes in controlling infection, our results demonstrated that the mechanism by which CCR2 deficiency shows protection to CLP-induced sepsis is due to a decrease of inflammatory monocytes emigration from bone marrow to the circulation and vital organs, resulting in the reduction of organ damage and systemic cytokine production

The ethanolic extract of Salvia lachnostachys Benth is not maternotoxic, does not alter reproductive performance, but has teratogenic potential

Abstract Salvia lachnostachys Benth is native to Brazil and has anti-inflammatory, anti-arthritic, cytotoxic, antitumor, and antihyperalgesic activities. The population, including pregnant women, consume this plant to treat pain, inflammation, flu, spasms, insomnia, and depression, mainly. There are no safety reports on the use of this plant during pregnancy. The present study aimed to evaluate the effects of S. lachnostachys ethanolic extract (EESl) on reproductive performance, embryofetal development, and DNA integrity of pregnant female mice. Pregnant females were randomly divided into three experimental groups (n = 10): The Control group was treated with a vehicle, and treatment groups were administered with EESl at 100 and 1000 mg/kg, respectively. Treatment occurred by gavage throughout the gestational period until day 18. Afterward, reproductive performance, embryofetal development, and DNA integrity parameters were evaluated. The results indicated that EESl did not alter any reproductive performance parameters. However, it changed embryofetal outcome through reduced placental weight (EESl 100 mg/kg), decreased fetal weight (EESl 100 and 1000 mg/kg), and increased frequency of small for gestational age fetuses (EESl 1000 mg/kg). In addition, EES1 increased the frequency of external, visceral, and skeletal malformations. Because of the above, it is considered that EESl is not maternotoxic, does not alter reproductive performance, but does alter embryofetal development. Its use in the gestational period is not indicated due to its teratogenic potential