CATETER VENOSO CENTRAL DE INSERÇÃO PERIFÉRICA E TROMBOSE: EXPERIÊNCIA EM HOSPITAL DE ALTA COMPLEXIDADE

Objetivo: descrever as variáveis associadas à trombose nos pacientes com cateter venoso central de inserção periférica.Método: estudo de coorte, retrospectivo, com dados coletados em 2016, no sistema de informação Research Eletronic Data Capture de um hospital de alta complexidade em São Paulo, Brasil.Resultados: o paciente crítico foi o que mais apresentou trombose (77,3%). O paciente que tinha o cateter venoso central de inserção periférica com ocupação do vaso sanguíneo maior que 33%, quando puncionado mais de uma vez (15,4%), evoluiu com trombose. Referente à área de punção, não houve resultado significativo já que 96,2% dos pacientes estavam com o cateter na zona ideal de punção no braço.Conclusão: a incidência de pacientes com Cateter Venoso Central de Inserção Periférica que evoluíram com trombose foi de 1,2%, considerada baixa em comparação com outros estudos, contribuindo para fortalecer as políticas de boas práticas para o sucesso da terapia intravenosa com seu uso.Objective: to describe the variables associated with thrombosis in patients with peripherallyinserted central venous catheters.Method: a retrospective cohort study with data collected in 2016, in the Research Electronic Data Capture information system of a high-complexity hospital in São Paulo, Brazil.Results: the critical patient was the one who presented more thrombosis (77.3%). The patient who had a peripherally-inserted central venous catheter taking more than 33% of the blood vessel, when punctured more than once (15.4%), evolved with thrombosis. Regarding the puncture area, there was no significant result since 96.2% of the patients had the catheter in the ideal puncture zone in the arm.Conclusion: the incidence of patients with Peripherally-Inserted Central Venous Catheters who evolved with thrombosis was 1.2%, considered low compared to other studies, contributing to strengthen the policies of good practices for the success of the intravenous therapy with its use.Objetivo: describir las variables asociadas a la trombosis en pacientes con un catéter venosocentral de inserción periférica.Método: estudio de cohorte, retrospectivo, realizado con datos recolectados en el año2016, en el sistema de información Research Eletronic Data Capture de un hospital de altacomplejidad en San Pablo, Brasil.Resultados: los pacientes críticos fueron los que presentaron más casos de trombosis (77,3%).Cuando se realizó más de una punción (15,4%) en pacientes en los que el catéter venoso centralde inserción periférica ocupaba más del 33% del vaso sanguíneo, el cuadro clínico evolucionócon trombosis. En relación al área de punción, no se registró un resultado significativo, puestoque el 96,2% de los pacientes tenía el catéter en la zona ideal de punción en el brazo.Conclusión: la incidencia de pacientes con un Catéter Venoso Central de Inserción Periféricaque evolucionaron con trombosis fue del 1,2%, considerada baja en comparación con otrosestudios, lo que contribuye a fortalecer las políticas de buenas prácticas para el buen resultadode la terapia intravenosa con su uso

A GESTÃO DEMOCRÁTICA NA LEI DE DIRETRIZES E BASES DA EDUCAÇÃO APÓS A LEI N° 14.644, DE 2 DE AGOSTO DE 2023

Este artigo analisa as principais implicações para o tema da gestão democrática do ensino público – com ênfase na educação básica – após o advento da Lei n° 14.644, de 2 de agosto de 2023, que alterou dispositivos da Lei de Diretrizes e Bases da Educação Nacional (LDB) acerca do tema, especialmente no que se refere aos Conselhos Escolares. Nesse sentido, após uma introdução acerca da centralidade do conceito de gestão democrática em consonância com o tema da própria democracia para compreensão da dinâmica decisória no interior das escolas de educação básica brasileiras, o artigo apresenta as principais alterações legislativas operadas na LDB com o advento da Lei n° 14.644, de 2 de agosto de 2023, para, ao final, e valendo-se do apoio de alguns nomes da teoria educacional brasileira, esmiuçar tais alterações com destaque para (1) a necessidade de ressignificação do papel e das atribuições da figura da direção escolar, e para (2) o protagonismo dos Conselhos Escolares em matéria de gestão democrática das instituições escolares de educação básica no contexto da autonomia que a lei lhes confere

Cine–Picc: Satisfaction and Knowledge Following a Video and Hands-on Training on Peripherally Inserted Central Catheter Care

Objective: This study evaluated the knowledge and satisfaction of a nursing staff regarding the care of PICC before and after a combined training strategy consisting of video watching followed by hands-on practice; Methods: A cross-sectional and prospective study with data collection held at a public University Hospital from March to May 2018 and March 2019. The participants answered a pre-test about PICC, watched a video on PICC care and maintenance, watched a hands-on sessions and answered a pos-test. Results: A total of 520 professionals participated, in which 87.4% were from the nursing staff. A pre-test was answered by 211 and 203 answered the post-test questions. The satisfaction research covered a total of 97% satisfied respondents. Conclusions: Results indicate that the change from the traditional training model to an active educational approach reached a larger number of participants, showing up an innovative pedagogical tool in the training of critical and reflexive professionals.Objective: This study assessed the knowledge and satisfaction of a nursing staff regarding peripherally inserted central catheter (PICC) care before and after a combined training strategy consisting of a video and hands-on practice. Methods: A cross-sectional and prospective study with data collection held at a public university hospital from March 2018 to May 2018 and in March 2019. Participants answered a pre-test about PICC lines, watched a video on PICC care and maintenance, attended hands-on sessions, and answered a post-test. Results: A total of 520 professionals participated in the study, of which 87.4% were from the nursing staff. The pre-test was answered by 211 individuals and the post-test questions were answered by 203 people. The satisfaction research showed 97% of satisfied respondents. Conclusions: Our results indicate that a change from the traditional training model to an active educational approach reached more participants, representing an innovative pedagogical tool in the training of critical and reflexive professionals

Cine–PICC : satisfaction and knowledge following a video and hands-on training on peripherally inserted central catheter

Introduction: This study assessed the knowledge and satisfaction of a nursing staff regarding peripherally inserted central catheter (PICC) care before and after a combined training strategy consisting of a video and hands-on practice. Methods: A cross-sectional and prospective study with data collection held at a public university hospital from March 2018 to May 2018 and in March 2019. Participants answered a pre-test about PICC lines, watched a video on PICC care and maintenance, attended hands-on sessions, and answered a post-test. Results: A total of 520 professionals participated in the study, of which 87.4% were from the nursing staff. The pre-test was answered by 211 individuals and the post-test questions were answered by 203 people. The satisfaction research showed 97% of satisfied respondents. Conclusions: Our results indicate that a change from the traditional training model to an active educational approach reached more participants, representing an innovative pedagogical tool in the training of critical and reflexive professionals

Nontuberculous mycobacteria in milk from positive cows in the intradermal comparative cervical tuberculin test: implications for human tuberculosis infections

Although the tuberculin test represents the main in vivo diagnostic method used in the control and eradication of bovine tuberculosis, few studies have focused on the identification of mycobacteria in the milk from cows positive to the tuberculin test. The aim of this study was to identify Mycobacterium species in milk samples from cows positive to the comparative intradermal test. Milk samples from 142 cows positive to the comparative intradermal test carried out in 4,766 animals were aseptically collected, cultivated on Lowenstein-Jensen and Stonebrink media and incubated for up to 90 days. Colonies compatible with mycobacteria were stained by Ziehl-Neelsen to detect acid-fast bacilli, while to confirm the Mycobacterium genus, conventional PCR was performed. Fourteen mycobacterial strains were isolated from 12 cows (8.4%). The hsp65 gene sequencing identified M. engbaekii (n=5), M. arupense (n=4), M. nonchromogenicum (n=3), and M. heraklionense (n=2) species belong to the Mycobacterium terrae complex. Despite the absence of M. tuberculosis complex species in the milk samples, identification of these mycobacteria highlights the risk of pathogen transmission from bovines to humans throughout milk or dairy products, since many of mycobacterial species described here have been reported in pulmonary and extrapulmonary diseases both in immunocompetent and immunocompromised people

Clinical and echocardiographic predictors of left ventricular remodeling following anterior acute myocardial infarction

OBJECTIVES: Coronary artery disease is the primary cause of death and is responsible for a high number of hospitalizations worldwide. Ventricular remodeling is associated with worse prognosis following ST-segment elevation myocardial infarction (STEMI) and is a risk factor for ventricular dysfunction and heart failure. This study aimed to identify the predictors of ventricular remodeling following STEMI. Additionally, we evaluated the clinical, laboratory, and echocardiographic characteristics of patients with anterior wall STEMI who underwent primary percutaneous intervention in the acute phase and at 6 months after the infarction. METHODS: This prospective, observational, and longitudinal study included 50 patients with anterior wall STEMI who were admitted to the coronary care unit (CCU) of a tertiary hospital in Brazil between July 2017 and August 2018. During the CCU stay, patients were evaluated daily and underwent echocardiogram within the first three days following STEMI. After six months, the patients underwent clinical evaluation and echocardiogram according to the local protocol. RESULTS: Differences were noted between those who developed ventricular remodeling and those who did not in the mean±standard deviation levels of creatine phosphokinase MB isoenzyme (CKMB) peak (no remodeling group: 323.7±228.2 U/L; remodeling group: 522.4±201.6 U/L; p=0.008) and the median and interquartile range of E/E’ ratio (no remodeling group: 9.20 [8.50–11.25] and remodeling group: 12.60 [10.74–14.40]; p=0.004). This difference was also observed in multivariate logistic regression. CONCLUSIONS: Diastolic dysfunction and CKMB peak in the acute phase of STEMI can be predictors of ventricular remodeling following STEMI

Chitosan microparticles loaded with essential oils inhibit duo-biofilms of Candida albicans and Streptococcus mutans

Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. Objective: This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. Methodology: Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. Results: CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. Conclusion: This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries

An HST/ACS investigation of the spatial and chemical structure and sub-structure of NGC 891, a Milky Way analogue

We present a structural analysis of NGC891, an edge-on galaxy that has long been considered to be an analogue of the Milky Way. Using starcounts derived from deep HST/ACS images, we detect the presence of a thick disk component in this galaxy with vertical scale height 1.44+/-0.03 kpc and radial scale length 4.8+/-0.1 kpc, only slightly longer than that of the thin disk. A stellar spheroid with a de Vaucouleurs-like profile is detected from a radial distance of 0.5 kpc to the edge of the survey at 25 kpc; the structure appears to become more flattened with distance, reaching q = 0.50 in the outermost halo region probed. The halo inside of 15 kpc is moderately metal-rich (median [Fe/H] ~ -1.1) and approximately uniform in median metallicity. Beyond that distance a modest chemical gradient is detected, with the median reaching [Fe/H] ~ -1.3 at 20 kpc. We find evidence for subtle, but very significant, small-scale variations in the median colour and density over the halo survey area. We argue that the colour variations are unlikely to be due to internal extinction or foreground extinction, and reflect instead variations in the stellar metallicity. Their presence suggests a startling conclusion: that the halo of this galaxy is composed of a large number of incompletely-mixed sub-populations, testifying to its origin in a deluge of small accretions.Comment: 21 pages, 16 figures, accepted for publication in MNRA

Total parathyroidectomy in a large cohort of cases with hyperparathyroidism associated with multiple endocrine neoplasia type 1: experience from a single academic center

Most cases of sporadic primary hyperparathyroidism present disturbances in a single parathyroid gland and the surgery of choice is adenomectomy. Conversely, hyperparathyroidism associated with multiple endocrine neoplasia type 1 (hyperparathyroidism/multiple endocrine neoplasia type 1) is an asynchronic, asymmetrical multiglandular disease and it is surgically approached by either subtotal parathyroidectomy or total parathyroidectomy followed by parathyroid auto-implant to the forearm. In skilful hands, the efficacy of both approaches is similar and both should be complemented by prophylactic thymectomy