Short peripheral venous catheters contamination and the dangers of bloodstream infection in Portugal: an analytic study

Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients’ well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.’s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% β-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter’s lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.info:eu-repo/semantics/publishedVersio

Application of Perinatal Derivatives on Oncological Preclinical Models: A Review of Animal Studies.

The increasing cancer incidence has certified oncological management as one of the most critical challenges for the coming decades. New anticancer strategies are still needed, despite the significant advances brought to the forefront in the last decades. The most recent, promising therapeutic approaches have benefitted from the application of human perinatal derivatives (PnD), biological mediators with proven benefits in several fields beyond oncology. To elucidate preclinical results and clinic outcomes achieved in the oncological field, we present a narrative review of the studies resorting to animal models to assess specific outcomes of PnD products. Recent preclinical evidence points to promising anticancer effects offered by PnD mediators isolated from the placenta, amniotic membrane, amniotic fluid, and umbilical cord. Described effects include tumorigenesis prevention, uncontrolled growth or regrowth inhibition, tumor homing ability, and adequate cell-based delivery capacity. Furthermore, PnD treatments have been described as supportive of chemotherapy and radiological therapies, particularly when resistance has been reported. However, opposite effects of PnD products have also been observed, offering support and trophic effect to malignant cells. Such paradoxical and dichotomous roles need to be intensively investigated. Current hypotheses identify as explanatory some critical factors, such as the type of the PnD biological products used or the manufacturing procedure to prepare the tissue/cellular treatment, the experimental design (including human-relevant animal models), and intrinsic pathophysiological characteristics. The effective and safe translation of PnD treatments to clinical practice relies on the collaborative efforts of all researchers working with human-relevant oncological preclinical models. However, it requires proper guidelines and consensus compiled by experts and health workers who accurately describe the methodology of tissue collection, PnD isolation, manufacturing, preservation, and delivery to the final user

Nurse-led interventions to promote hospitalized patients’ adherence to hand hygiene: narrative review

Background: during the hospital admission, nurses play a fundamental role in the adherence to hand hygiene (HH) measures by patients and their families, enhancing the quality and safety of care. Objective: synthesize the latest scientific evidence regarding nurse-led interventions focused on hospitalized patients’ adherence to HH and its impact on preventing Healthcare-Associated Infections (HAIs). Methodology: following the PICOD mnemonic, a narrative review was conducted in MEDLINE (via PubMed), CINAHL (via EBSCO), and Cochrane Library. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. Results: seven studies were included for review, published between 2016 and 2018. Three central themes emerged: i) nurse-led interventions that promote patients’ adherence to HH; ii) patients’ HH adherence and HAIs prevention; iii) the importance of person-centered nursing care in this scope. Conclusion: isolated interventions do not lead to adequate behavioural changes. Although educational interventions are the most common actions used by nurses, visual cues, distribution of informational material, provision of HH material, and creation of specific moments for HH are complementary strategies that enhance the efficiency and quality of the intervention

Localização subcelular do novo fotossensibilizador em células do melanoma ocular através de microscopia confocal

Introdução: O melanoma ocular é o objetivo de várias investigações em medicina e medicina veterinária devido à baixa taxa de resposta aos tratamentos conservadores convencionais1. A terapia fotodinâmica (PDT) é uma terapia mais conservadora para os tecidos não neoplásicos, que induz e ativa as vias de morte celular nos tecidos neoplásicos alvo2,3. O fotossensibilizador, luz e oxigenio são os três componentes vitais não tóxicos da reação fotodinâmica. Quando o fotossensibilizador é ativado por uma fonte de luz (600-800 nm), ocorre a produção de espécies reativas de oxigenio (ROS) que exerce efeito terapêutico sobre a neoplasia2. A oxidação irreversível leva à morte da célula tumoral por apoptose, necrose e autofagia2. A morte celular pode ser ativada pela via extrínseca, que envolve recetores da membrana plasmática, ou pela via intrínseca, em que a mitocôndria tem um papel central2,3. A localização subcelular dos fotossensibilizadores constitui o local de dano primário da terapia fotodinâmica e é determinante nas vias de atuação ativadas pela reação fotodinâmica3. Recentemente, desenvolvemos um grupo de novas clorinas, que são fotossensibilizadores muito eficazes em células de melanoma2,3,4. Dessa forma o objetivo do trabalho foi avaliar a localização subcelular (núcleo e mitocôndria) da nova clorina em células do melanoma ocular. Métodos: Células da linha celular de melanoma ocular (MP-41) cultivadas em meio RPMI com 25% de FBS, foram semeadas em placas de 24 poços com lamelas esterilizadas. As células foram incubadas com 500 nM da nova clorina (derivado dihidroximetilo de 4,5,6,7-tetra-hidropirazolo[1,5-a]piridina fundido com tetrafenilclorina) por 24 h. Após este período, as culturas foram submetidas a duas lavagens com PBS, de modo a remover todo o fotossensibilizador no exterior das células, e procedeu-se à marcação dos organelos. As células que foram marcadas com o corante nuclear Hoechst 33252 (blue) e incubadas com uma solução de 5 μg/ml da sonda em PBS durante 15 minutos no escuro. As culturas celulares que foram marcadas com a sonda mitocondrial MitoTracker® Green FM foram incubadas com uma solução de 200 nM da sonda em PBS durante 30 minutos, a 37ºC, no escuro. Após as incubações com as respetivas sondas as células foram lavadas com PBS as lamelas foram montadas sobre lâminas e observadas ao microscópio confocal (Carl Zeiss MicroImaging LSM710, objetiva 40X) e fotografadas. As imagens foram analisadas no software ImageJ e a colocalização avaliada pelo coeficiente de correlação de Pearson. Resultados: Os estudos de localização subcelular confirmaram a internalização celular do novo fotossensibilizador. A média para coeficiente de Pearson foi -0,114 para colocalização núclear, certificando a existência 43% de correlação negativa, para as imagens analisadas, demostrando que não ocorre internalização nuclear do novo fotossensibilizador. No que respeita a mitocôndria, verificou-se a existência de 66%, correlação de Pearson positiva, que foi igual a média 0,366 para as imagens analisadas, demostrando que ocorre internalização mitocondrial do novo fotossensibilizador. Conclusão: Verificou-se que o novo fotossensibilizador é captado pelas células de melanoma ocular e que se acumula nas mitocôndrias, mas não penetra no núcleo celular

Open-Air Cold Plasma Device Leads to Selective Tumor Cell Cytotoxicity

The need for effective and safe therapies for cancer is growing as aging is modifying its epidemiology. Cold atmospheric plasma (CAP) has gained attention as a potential anti-tumor therapy. CAP is a gas with enough energy to ionize a significant fraction of its constituent particles, forming equal numbers of positive ions and electrons. Timely-resolved output voltage measurement, emission spectroscopy, and quantification of reactive species (RS) in plasma-activated media (PAM) were performed to characterize the physical and chemical properties of plasma. To assess the cytotoxicity of cold atmospheric plasma in human tumors, different cell lines were cultured, plated, and exposed to CAP, followed by MTT and SRB colorimetric assays 24 h later. Human fibroblasts, phenotypically normal cells, were processed similarly. Plasma cytotoxicity was higher in cells of breast cancer, urinary bladder cancer, osteosarcoma, lung cancer, melanoma, and endometrial cancer. Cytotoxicity was time-dependent and possibly related to the increased production of hydrogen peroxide in the exposed medium. Sixty seconds of CAP exposure renders selective effects, preserving the viability of fibroblast cells. These results point to the importance of conducting further studies of the therapy with plasma

Innovative Educational Approach in Healthcare-Associated Infection Prevention and Control. Results of a European Study

Prevent and control healthcare-associated infections (HAIs) is a priority in healthcare assistance, not only due to present COVID-19 pandemic. Annually, around 3.2 million patients are affected by one of these infections and it is estimated that without controlling them, by 2050, 10 million more people could die every year, with especial relevance among elderly with infectious situations representing a third of mortality in people over 65 years old. Higher Education Institutions (HEI) in healthcare area have an important role in this panorama, by preparing students to be future professionals, stimulating them to have an innovative and entrepreneurial approach to today’s real-life challenges. A mixed-methods research was conducted, at European level (in Portugal, Finland, Poland and Spain), to facilitate learning of good practices on HAIs prevention and control while developing innovative solutions. 1475 participants were enrolled, from all partner HEI: 79 professors and mentors were interviewed (individual or focus group), 1326 final year nursing students made a self-report inventory (application of InovSafeCare Scale) and 70 students participated on focus group (agile piloting of the Model). The result of this research is a pedagogical model that mixes dimensions and methods that take nursing students closer to the demands of HAIs prevention and control and capacitates them to transfer knowledge to work settings with an innovative and entrepreneurial perspective – the InovSafeCare Model.info:eu-repo/semantics/publishedVersio

PROCES KSZTAŁCENIA W ZAKRESIE PROFILAKTYKI I KONTROLI ZAKAŻEŃ ZWIĄZANYCH Z OPIEKĄ ZDROWOTNĄ W EUROPEJSKICH INSTYTUCJACH SZKOLNICTWA WYŻSZEGO – BADANIE JAKOŚCIOWE

[EN] Healthcare-associated infections (HCAIs) affect the lives of patients through prolonged stay in hospital, illness, or even death, incurring signifi cant costs to both healthcare systems and society. Research shows that during a stay in a hospital, approximately 20% to 30% of patients are diagnosed with at least one infection. Openness, fi ne interpersonal and communication skills as well as adequate opportunities for training courses for healthcare staff contribute to promoting HCAI/HAI prevention. HCAI/HAI-related education should contribute to widening knowledge and mastering practical skills. It is assumed that lecturers, professional instructors, and coordinators create a signifi cant foundation for professional development and social interactions by applying interactive pedagogical models. [POL] Zakażenia związane z opieką zdrowotną (Healthca- re associated infections, HCAI) wpływają na życie pacjentów poprzez przedłużony pobyt w szpitalu, chorobę, a nawet śmierć, powodując znaczne koszty zarówno dla systemów opieki zdrowotnej, jak i spo- łeczeństwa. Badania pokazują, że podczas pobytu w szpitalu u około 20% do 30% pacjentów diagnozuje się co najmniej jedną infekcję Otwarte podejście, wysokie umiejętności interpersonalne i komu- nikacyjne, a także odpowiednie możliwości szkoleń dla personelu medycznego przyczyniają się do promowania profi laktyki HCAI/ HAI. Kształcenie w zakresie HCAI/HAI powinno przyczynić się do poszerzenia wiedzy i opanowania praktycznych umiejętności. Zakłada się, że wykładowcy, profesjonalni instruktorzy, koordy- natorzy tworzą istotne podstawy rozwoju zawodowego i interakcji społecznych poprzez stosowanie interaktywnych modeli pedago- gicznych

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries

[EN] Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.info:eu-repo/semantics/publishedVersio

Nursing Students’ Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals’ education and training. This study intended to measure nursing students’ perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students’ adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students’ adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.info:eu-repo/semantics/publishedVersio