Conocimiento sobre hepatitis B, estado de vacunación y medidas de bioseguridad entre profesionales de enfermería

Backgound and Objectives: Hepatitis B is an important global public health problems. The contamination can occur in any individual, however, health professionals, especially those in the nursing area, are more exposed. Hepatitis B is an occupational disease whose prevention is accessible, without cost in Brazil and mandatory for all healthcare professionals by vaccination. Thus, the present study aimed to verify the vaccination status of the nursing professionals, and yours knowledge about contamination risks with hepatitis B virus (HVB), as well about the biosafety measures to avoid these risks. Methods: A descriptive and cross-sectional study was carried out in a public hospital in the city of Bauru/SP, with nursing professionals. It was applied a questionnaire, between January to March 2015, containing aspects related to the vaccination status, knowledge about HBV and biosafety. Results: From 107 nursing professionals at the institution, 96 (89.8%) accepted to participate in the study, of them 84.3% were with complete vaccination, 3.2% were incomplete and 12.5% did not know their vaccination status. More than 90.0% knew the ways to avoid HVB transmission and had received information about biosafety and waste disposal, but only 81.2% used personal protective equipment (PPE) in their activities. Conclusion: The results indicate that although the nursing professionals knew how to avoid the HBV contamination, they still remains exposed to a hight risk of, and so is necessary to sensitize and awareness about the importance of adopting safe practices and immunization, leading to a behavior modification. KEYWORDS: Nursing Team. Immunization Coverage. Hepatitis B. Occupational Disease. Exposure to Biological Agents.Antecedentes y objetivos: La hepatitis B constituye un importante problema de salud pública mundial. Cualquier individuo puede contagiarse, aunque los profesionales de salud, particularmente los enfermeros, son los más expuestos. La hepatitis B es una enfermedad profesional con modo de prevención accesible gratuito y obligatorio para todos los profesionales de salud mediante vacunación. El presente estudio objetivó verificar estado de vacunación, conocimiento de contagio por el virus de la hepatitis B (HBV) y adopción de medidas de bioseguridad para evitar tales riesgos en profesionales de enfermería. Métodos: Estudio descriptivo, transversal, desarrollado en hospital público de Bauru/SP, incluyendo a todos los profesionales de enfermería. Fue aplicado, entre enero y marzo de 2015, un cuestionario incluyendo aspectos relacionados al estado de vacunación, conocimiento sobre HBV y bioseguridad. Resultados: De los 107 profesionales de enfermería de la institución, 96 (89,8% aceptaron participar de la investigación; de ellos, 84,3% poseían vacunación completa, 3,2% incompleta y 12,5% desconocía su estado de vacunación. Más del 90% conocía las formas de transmisión del HBV y había recibido indicaciones sobre las medidas de bioseguridad y eliminación de residuos, sin embargo solamente 81,2% utilizaba equipo de protección personal (EPP) en sus actividades. Conclusión: Los resultados expresan que, aunque el grupo de enfermería conociese cómo evitar la contaminación por HBV, aún así continuaba expuesto a un elevado riesgo, demostrándose la necesidad de hacer reconsiderar y concientizar a dichos profesionales sobre la importancia de la adopción de prácticas seguras e inmunización, apuntando a un cambio de comportamiento. Descritores: Grupo de Enfermería; Cobertura de Vacunación; Hepatitis B; Exposición a Agentes Biológicos

Efficacy of ethyl alcohol and quaternary ammonium in hospital medical equipment disinfection

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusion: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment

Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusions: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment.Antecedentes y objetivos: Los ambientes hospitalarios pueden albergar microorganismos patógenos y oportunistas, siendo el proceso de limpieza y desinfección importante para el control de las Infecciones relacionadas a la Asistencia a la Salud (IRAS). Así, el objetivo de este trabajo evaluar comparar la eficacia del alcohol etílico y del cuaternario de amonio en el proceso de desinfección de equipos médicos hospitalarios previamente contaminados con Staphylococcus aureus (S. aureus). Métodos: la descontaminación de 10 equipos médicos hospitalarios contaminados con una suspensión de S. aureus ATCC 25923. La descontaminación ocurrió con alcohol etílico en las concentraciones de 46,2%, 70% y 99% y con el cuaternario de amonio de 1ª y de 5ª generación. Después de la descontaminación, se tomaron muestras de la superficie de los equipos para cultivo bacteriano. Resultados: se verificó crecimiento bacteriano en el 80% de los equipos descontaminados con alcohol 46,2% y 99%. No hubo crecimiento bacteriano en la superficie de los equipos descontaminados con alcohol 70% y cuaternarios de amonio. Conclusión: los procesos de desinfección con alcohol 70% y cuaternario de amonio de 1ª y 5ª generación fueron eficaces en el control del S. aureus, comprobando la acción efectiva de estos productos en la desinfección de los equipos médicos hospitalarios.Justificativa e Objetivo: Os ambientes hospitalares podem albergar micro-organismos patogênicos e oportunistas, sendo o processo de limpeza e desinfecção importante para o controle das Infecções relacionadas à Assistência à Saúde (IRAS). Assim, o objetivo deste trabalho foi avaliar a eficácia do álcool etílico e do quaternário de amônio no processo de desinfecção de equipamentos médicos hospitalares previamente contaminados com Staphylococcus aureus (S. aureus). Método: descontaminação de 10 equipamentos médicos hospitalares contaminados com uma suspensão de S. aureus ATCC 25923. A descontaminação ocorreu com álcool etílico nas concentrações de 46,2%, 70% e 99% e com o quaternário de amônio de 1ª e de 5ª geração. Após a descontaminação, foram colhidas amostras da superfície dos equipamentos para cultura bacteriana. Resultados: foi verificado crescimento bacteriano em 80% dos equipamentos descontaminados com álcool 46,2% e 99%. Não houve crescimento bacteriano na superfície dos equipamentos descontaminados com álcool 70% e quaternários de amônio. Conclusão: os processos de desinfecção com álcool 70% e quaternário de amônio de 1ª e 5ª geração foram eficazes no controle do S. aureus, comprovando a ação efetiva destes produtos na desinfecção dos equipamentos médicos hospitalares

Level of knowledge about Hepatitis B, vaccination status and biosafety measures of nursing professionals

Backgound and Objectives: Hepatitis B is an important global public health problems. The contamination can occur in any individual, however, health professionals, especially those in the nursing area, are more exposed. Hepatitis B is an occupational disease whose prevention is accessible, without cost in Brazil and mandatory for all healthcare professionals by vaccination. Thus, the present study aimed to verify the vaccination status of the nursing professionals, and yours knowledge about contamination risks with hepatitis B virus (HVB), as well about the biosafety measures to avoid these risks. Methods: A descriptive and cross-sectional study was carried out in a public hospital in the city of Bauru/SP, with nursing professionals. It was applied a questionnaire, between January to March 2015, containing aspects related to the vaccination status, knowledge about HBV and biosafety. Results: From 107 nursing professionals at the institution, 96 (89.8%) accepted to participate in the study, of them 84.3% were with complete vaccination, 3.2% were incomplete and 12.5% did not know their vaccination status. More than 90.0% knew the ways to avoid HVB transmission and had received information about biosafety and waste disposal, but only 81.2% used personal protective equipment (PPE) in their activities. Conclusion: The results indicate that although the nursing professionals knew how to avoid the HBV contamination, they still remains exposed to a hight risk of, and so is necessary to sensitize and awareness about the importance of adopting safe practices and immunization, leading to a behavior modification. KEYWORDS: Nursing Team. Immunization Coverage. Hepatitis B. Occupational Disease. Exposure to Biological Agents

Contribuição das moléculas de antígeno de histocompatibilidade leucocitária (HLA) para a contratura de Dupuytren em uma população do Sudeste do Brasil

Objetivo: O objetivo deste estudo foi investigar o fenótipo do HLA em pacientes com contratura de Dupuytren (CD) para verificar a correlação desses alelos com os fatores de risco para o desenvolvimento da CD na população brasileira. Métodos: Este foi um estudo de caso-controle de 25 pacientes com CD e 443 indivíduos saudáveis sem histórico de doenças associadas ao HLA. As tipagens classe I e classe II do HLA foram feitas utilizando o método iniciador de sequências específicas da reação em cadeia da polimerase. Resultados: O fenótipo HLA-B*18 foi observado em 32% dos pacientes e 10,5% do grupo controle. Contudo, os valores de p não permaneceram significativos após correção. Discussão: Apesar de termos observado um aumento na tendência de os pacientes com CD terem o alelo HLA-B*18, os resultados não foram estatisticamente significativos após correção. Esse alelo foi maior em pacientes de etnia italiana e/ou espanhola, locais com frequências superiores a 18% e 14%, respectivamente. São necessárias investigações adicionais com uma coorte maior de pacientes com CD para confirmar o possível papel do HLA nessa doença

Citocinas e proteínas de fase aguda do soro como marcadores de regressão da resposta inflamatória ao tratamento da tuberculose pulmonar Cytokines and acute phase serum proteins as markers of inflammatory regression during the treatment of pulmonary tuberculosis

OBJETIVO: Analisar o padrão de citocinas pró- e antiinflamatórias e da resposta de fase aguda (RFA) como marcadores de resposta ao tratamento da tuberculose pulmonar. MÉTODOS: Determinação dos níveis de interferon-gama (IFN-&#947;), tumor necrosis factor-alpha (TNF-&#945;, fator de necrose tumoral-alfa), interleucina-10 (IL-10) e transforming growth factor-beta (TGF-&#946;, fator transformador de crescimento-beta), pelo método ELISA, em sobrenadante de cultura de células mononucleares do sangue periférico e monócitos, assim como dos níveis de proteínas totais, albumina, globulinas, alfa-1-glicoproteína ácida (AGA), proteína C reativa (PCR) e velocidade de hemossedimentação (VHS) em 28 doentes com tuberculose pulmonar, em três tempos: antes (T0), aos três meses (T3) e aos seis meses (T6) de tratamento, em relação aos controles saudáveis, em um único tempo. RESULTADOS: Os pacientes apresentaram valores maiores de citocinas e RFA que os controles em T0, com diminuição em T3 e diminuição (TNF-&#945;, IL-10, TGF-&#946;, AGA e VHS) ou normalização (IFN-&#947; e PCR) em T6. CONCLUSÕES: PCR, AGA e VHS são possíveis marcadores para auxiliar no diagnóstico de tuberculose pulmonar e na indicação de tratamento de indivíduos com baciloscopia negativa; PCR (T0 > T3 > T6 = referência) pode também ser marcador de resposta ao tratamento. Antes do tratamento, o perfil Th0 (IFN-&#947;, IL-10, TNF-&#945; e TGF-&#946;), indutor de e protetor contra inflamação, prevaleceu nos pacientes; em T6, prevaleceu o perfil Th2 (IL-10, TNF-&#945; e TGF-&#946;), protetor contra efeito nocivo pró-inflamatório do TNF-&#945; ainda presente. O comportamento do IFN-&#947; (T0 > T3 > T6 = controle) sugere sua utilização como marcador de resposta ao tratamento.<br>OBJECTIVE: To evaluate the pattern of pro-inflammatory cytokines, anti-inflammatory cytokines and the acute phase response (APR) as markers of the response to treatment of pulmonary tuberculosis. METHODS: Twenty-eight patients with pulmonary tuberculosis were evaluated at three time points: pretreatment (T0), treatment month 3 (T3) and treatment month 6 (T6). Levels of interferon-gamma (IFN-&#947;), tumor necrosis factor-alpha (TNF-&#945;), interleukine-10 (IL-10) and transforming growth factor-beta (TGF-&#946;) were determined using ELISA in the supernatant of peripheral blood mononuclear cell and monocyte culture. Levels of total protein, albumin, globulins, C-reactive protein (CRP), alpha-1-acid glycoprotein (AAG) and erythrocyte sedimentation rate (ESR) were also determined. All of these parameters were also evaluated, only once, in a group of healthy controls. RESULTS: In relation to controls, patients presented cytokine levels and APR that were higher at T0, lower at T3 and either lower (TNF-&#945;, IL-10, TGF-&#946;, AAG and ESR) or normal (IFN-&#947; and CRP) at T6. CONCLUSIONS: For individuals with negative smear sputum microscopy, CRP, AAG and ESR are potential markers of pulmonary tuberculosis and of the need for treatment; CRP (T0 > T3 > T6 = reference) can also be a marker of treatment response. In the patients, the Th0 profile (IFN-&#947;, IL-10, TNF-&#945; and TGF-&#946;), inducer of and protector against inflammation, predominated at T0, whereas the Th2 profile (IL-10, TNF-&#945; and TGF-&#946;), protecting against the harmful pro-inflammatory effect of the remaining TNF-&#945;, predominated at T6. The behavior of IFN-&#947; (T0 > T3 > T6 = controls) suggests its use as a marker of treatment response