Importância da interação entre comunidade e graduando, para uma formação humanizada: relato de experiência / Importance of interaction between community and undergraduate, for humanized training: experience report

Durante a vivência acadêmica, as universidades conectam seus futuros profissionais para assistência à comunidade, tendo em vista uma formação centrada na humanização dos pacientes. O programa de monitoria para a clínica interdisciplinar no tratamento de feridas, do Centro Universitário do Espírito Santo (UNESC), não se limita apenas ao campo teórico, abrangendo muito a prática com o corpo social e possibilita essa experiência com a comunidade de forma humanizada. Objetivo: Relatar a inter-relação com a sociedade durante o tempo de monitoria, como isso é importante para a capacitação de excelência, e também como essa humanização contribui para tratamento e evolução do paciente. Metodologia: O estudo consiste em um relato de experiência de um dos monitores da clínica de feridas durante um semestre de monitoria, apresentando caráter descritivo. Resultados e Discussão: Durante a vivência notou-se o quão importante é enxergar esse lado humano do paciente, não se preocupando apenas com suas queixas. Agindo desse modo, teve como resultado pacientes mais felizes, engajados com o tratamento e gostando de estar naquele ambiente, por mais doloroso que fosse o real motivo. Considerações finais: É vital para o graduando aprender a lapidar sua abordagem com o paciente, atuando de maneira holística. Essa interação entre universidade e corpo social é de fundamental importância para desenvolver profissionais que saiam ainda mais capacitados para o mercado de trabalho, principalmente quando se trata de profissionais da área da saúde, possibilitando mesclar assistência e atendimento, com o processo de ensino-aprendizado das práticas de saúde.(AU)

During their academic experience, universities connect their future professionals to assist the community, with a view to training centred on the humanization of patients. The monitoring program for the interdisciplinary wound care clinic at the Centro Universitário do Espírito Santo (UNESC) is not just limited to the theoretical field, but also encompasses a lot of practice with the social body and enables this experience with the community in a humanized way. Objective: To report on the interrelationship with society during the monitoring period, how important this is for the training of excellence, and also how this humanization contributes to the treatment and evolution of the patient. METHODOLOGY: The study consists of a report on the experience of one of the wound clinic monitors during a semester of monitoring, and is descriptive in nature. Results and Discussion: During the experience, we noticed how important it is to see the human side of the patient, not just worrying about their complaints. Acting in this way resulted in happier patients, engaged with the treatment and enjoying being in that environment, no matter how painful the real reason.Final considerations: It is vital for undergraduates to learn how to refine their approach to patients, acting in a holistic way. This interaction between the university and society is of fundamental importance for developing professionals who are even more qualified for the job market, especially when it comes to health professionals, making it possible to merge assistance and care with the teaching-learning process of health practices.(AU)

Durante su experiencia académica, las universidades vinculan a sus futuros profesionales con la asistencia a la comunidad, con vistas a una formación centrada en la humanización de los pacientes. El programa de acompañamiento de la clínica interdisciplinaria de cuidado de heridas del Centro Universitario do Espírito Santo (UNESC) no se limita apenas al campo teórico, sino que abarca mucha práctica con el cuerpo social y posibilita esta experiencia con la comunidad de forma humanizada. Objetivo: Informar sobre la interrelación con la sociedad durante el período de seguimiento, cuán importante es esto para la formación de excelencia, y también cómo esta humanización contribuye al tratamiento y evolución del paciente. Metodología: El estudio consiste en un informe sobre la experiencia de uno de los monitores de la clínica de heridas durante un semestre de monitorización, y es de naturaleza descriptiva. RESULTADOS Y DISCUSIÓN: Durante la experiencia, nos dimos cuenta de lo importante que es ver el lado humano del paciente, no sólo preocuparse por sus quejas. Actuar de esta manera resultó en pacientes más felices, comprometidos con el tratamiento y disfrutando de estar en ese ambiente, por más doloroso que sea el motivo real.Consideraciones finales: Es fundamental que los estudiantes universitarios aprendan a perfeccionar su abordaje con los pacientes, actuando de forma holística. Esta interacción entre la universidad y la sociedad es de fundamental importancia para el desarrollo de profesionales aún más cualificados para el mercado de trabajo, especialmente cuando se trata de profesionales de la salud, haciendo posible la fusión de la asistencia y el cuidado con el proceso de enseñanza-aprendizaje de las prácticas de salud.(AU)

Práticas Avançadas de Enfermagem ­ PAE / Advanced Nursing Practices ­ ANP

Trata de nota técnica sobre Práticas Avançadas de Enfermagem (PAE) no Brasil, elaborada por comissão e submetida à aprovação do plenário do Conselho Federal de Enfermagem (Cofen). O documento aborda conceitos, ações, implementação e regulação das práticas avançadas de Enfermagem, expandindo os limites do escopo da atuação do enfermeiro e reforçando a sua prática clínica. (AU)

This is a technical note on Advanced Nursing Practices (ANP) in Brazil, prepared by a committee and submitted for approval by the plenary of the Federal Nursing Council (Cofen). The document addresses concepts, actions, implementation and regulation of advanced nursing practices, expanding the limits of the scope of nurses' work and reinforcing their clinical practice. (AU)

Esta es una nota técnica sobre las Prácticas Avanzadas de Enfermería (PAE) en Brasil, elaborada por un comité y sometida a la aprobación del plenario del Consejo Federal de Enfermería (Cofen). El documento aborda los conceptos, acciones, implementación y reglamentación de las prácticas avanzadas de enfermería, ampliando los límites del ámbito de actuación de las enfermeras y reforzando su práctica clínica. (AU)

Culturable microbiological profile of a non-sterile drugs pharmaceutical production environment

Abstract For places where non-sterile drug production occurs, regulatory bodies recommend monitoring of the environmental bioburden. This procedure provides information regarding possible microbiological risks to which the products may be exposed, so that subsequent action measures may be implemented. The aim of the present work was to quantify and characterize the microorganisms present in Grade D (ISO 8) cleanrooms of a Brazilian pharmaceutical industry, identifying any possible seasonal climatic influences on these environments. Sampling was performed by surface and air monitoring, over 12 months during the year 2019, in rooms that were in operation. For both sampling methods, no statistically significant differences in bacteria and fungi counts were found between months or seasonal periods. Microorganisms that presented higher incidence included Staphylococcus epidermidis (15%) and Micrococcus spp. (13%), common to the human microbiota, and the fungi Cladosporium sp. (23%) and Penicillium sp. (21%), typical of the external environment. The results showed that microbial contamination in the Grade D cleanrooms was within the permissible maximum levels and remained similar throughout the year. Microbiological quality control in the clean areas of the pharmaceutical industry investigated was considered effective, with regular maintenance being necessary to keep bioburden levels controlled.

Detection of arboviruses in Aedes aegypti through transovarian analysis: A study in Goiânia, Goiás

Abstract Background: Arboviral diseases are a group of infectious diseases caused by viruses transmitted by arthropods, mainly mosquitoes. These diseases, such as those caused by the dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), and yellow fever (YFV) viruses, have a significant impact worldwide. In this context, entomological surveillance plays a crucial role in the control and prevention of arboviruses by providing essential information on the presence, distribution, and activity of vector mosquitoes. Based on entomological surveillance, transovarian transmission provides information regarding the maintenance and dissemination of arboviruses. The objective of this study was to detect these arboviruses in Goiânia, Goiás, and analyze the occurrence of transovarian transmission. Methods: Aedes aegypti eggs were collected from different regions of Goiânia and cultivated under controlled laboratory conditions until the emergence of adult mosquitoes. Adult females were grouped into pools containing their heads and thoraxes. These pools were subsequently evaluated using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) assay. Results: A total of 157 pools (N=1570) were analyzed, with two pools testing positive for CHIKV and one pool testing positive for ZIKV, indicating that the offspring resulting from transovarian transmission are potentially infectious. Conclusions: In summary, the demonstration of the vertical transmission mechanisms of CHIKV and ZIKV in A. aegypti serves as an alert to health authorities, as these diseases are still underreported, and their primary urban vector has likely acquired this capacity, contributing to the dissemination of these infections.

Maternal health surveillance panel: a tool for expanding epidemiological surveillance of women's health and its determinants / Painel de vigilância da saúde materna: uma ferramenta para ampliação da vigilância epidemiológica da saúde das mulheres e seus determinantes

ABSTRACT Objective: To present the methodology used in the development of two products for maternal health surveillance and its determinants and discuss their possible uses. Methods: Based on a theoretical model of the determinants of maternal death and databases of Brazilian health information systems, two free products were developed: an interactive panel "surveillance of maternal health" and an educational material "Aparecida: a story about the vulnerability of Brazilian women to maternal death", both available on the website of the Brazilian Obstetric Observatory. Results: More than 30 indicators were calculated for the period 2012-2020, containing information on socioeconomic conditions and access to health services, reproductive planning, prenatal care, delivery care, conditions of birth and maternal mortality and morbidity. The indicators related to severe maternal morbidity in public hospitalizations stand out, calculated for the first time for the country. The panel allows analysis by municipality or aggregated by health region, state, macro-region and country; historical series analysis; and comparisons across locations and with benchmarks. Information quality data are presented and discussed in an integrated manner with the indicators. In the educational material, visualizations with national and international data are presented, aiming to help in the understanding of the determinants of maternal death and facilitate the interpretation of the indicators. Conclusion: It is expected that the two products have the potential to expand epidemiological surveillance of maternal health and its determinants, contributing to the formulation of health policies and actions that promote women's health and reduce maternal mortality.

RESUME Objetivo: Apresentar a metodologia utilizada no desenvolvimento de dois produtos para a vigilância da saúde materna e seus determinantes e discutir as suas possíveis utilizações. Métodos: A partir de modelo teórico dos determinantes do óbito materno e bases de dados dos sistemas de informação em saúde brasileiros, foram desenvolvidos dois produtos gratuitos: um painel interativo denominado "Vigilância da saúde materna" e um material educativo chamado "Aparecida: uma história sobre a vulnerabilidade da mulher brasileira à morte materna", ambos disponíveis no site do Observatório Obstétrico Brasileiro. Resultados: Foram calculados mais de 30 indicadores para o período 2012-2020, contendo informações sobre condições socioeconômicas e de acesso a serviços de saúde, planejamento reprodutivo, assistência pré-natal, assistência ao parto, condições de nascimento e mortalidade e morbidade materna. Destacam-se os indicadores relacionados à morbidade materna grave em internações públicas, calculados pela primeira vez para o país. O painel permite análises por município ou agregadas por região de saúde, unidade da federação, macrorregião e país; análises de série histórica; e comparações entre localidades e com padrões de referência. Dados de qualidade da informação são apresentados e discutidos de forma integrada aos indicadores. No material educativo, visualizações com dados nacionais e internacionais são apresentadas, visando auxiliar na compreensão dos determinantes do óbito materno e facilitar a interpretação dos indicadores. Conclusão: Espera-se que os produtos tenham o potencial de ampliar a vigilância epidemiológica da saúde materna e seus determinantes, contribuindo para a formulação de políticas e ações de saúde que promovam a saúde das mulheres e reduzam a mortalidade materna.

Luz UVC como estratégia de desinfecção do ar e superfícies hospitalares / Luz UV-C como estrategia de desinfección del aire y superficies hospitalarias / UVC light as a strategy for disinfection of hospital air and surfaces

Resumo Objetivo Avaliar a eficácia antimicrobiana de um dispositivo fixo emissor de luz UV-C na desinfecção de diferentes superfícies do ambiente hospitalar e sua eficácia antifúngica na qualidade do ar. Métodos Estudo quase-experimental realizado em uma unidade de internação hospitalar, que utilizou o Bioamostrador de ar Andersen® de seis estágios para análise do ar; e na avaliação das superfícies, utilizaram-se três suspensões de microrganismos (Acinetobacter sp. MDR, Escherichia coli e Klebsiella pneumoniae produtora de KPC) para contaminar o ambiente. Para ambos foram feitas coletas pré (controle) e pós-acionamento da luz UV-C (teste). Resultados Na avaliação do ar houve uma redução importante da contagem de colônias após a luz UV-C e não foram encontrados fungos patogênicos ou toxigênicos em nenhum dos dois momentos. Em relação à desinfecção das superfícies, nenhum crescimento bacteriano foi observado após a intervenção da luz, demonstrando 100% de inativação bacteriana nas condições testadas. Conclusão A utilização da tecnologia com emissão de luz UV-C fixa foi eficaz e pode ser considerada uma intervenção promissora para protocolos de desinfecção de superfícies hospitalares.

Resumen Objetivo Evaluar la eficacia antimicrobiana de un dispositivo fijo emisor de luz UV-C para la desinfección de diferentes superficies del ambiente hospitalario y su eficacia antifúngica en la calidad del aire. Métodos Estudio cuasi experimental realizado en una unidad de internación hospitalaria, en que se utilizó el biomuestreador de aire Andersen® de seis etapas para el análisis del aire. En el análisis de las superficies, se utilizaron tres suspensiones de microorganismos (Acinetobacter sp. MDR, Escherichia coli y Klebsiella pneumoniae productora de KPC) para contaminar el ambiente. En ambos se tomó una muestra antes (control) y después de accionar la luz UV-C (prueba). Resultados En el análisis del aire hubo una reducción importante del recuento de colonias después de la luz UV-C y no se encontraron hongos patógenos ni toxigénicos en ninguno de los dos momentos. Con relación a la desinfección de las superficies, no se observó ningún crecimiento bacteriano después de la intervención de la luz, lo que demuestra un 100 % de inactivación bacteriana en las condiciones analizadas. Conclusión El uso de la tecnología con emisión de luz UV-C fija fue eficaz y puede ser considerada una intervención prometedora para protocolos de desinfección de superficies hospitalarias.

Abstract Objective To evaluate a fixed UV-C light emitting device for its antimicrobial effectiveness in the disinfection of distinct surfaces and its antifungal effectiveness on air quality in the hospital environment. Methods This quasi-experimental study was conducted in a hospital inpatient unit, in which a six-stage air Biosampler (Andersen®) was used for air analysis. In the evaluation of surfaces, three suspensions of microorganisms (Acinetobacter sp. multidrug-resistant, Escherichia coli, and KPC-producing Klebsiella pneumoniae) were used to contaminate the environment. In both evaluations, pre- (control) and post-activation of UV-C light (test) collections were made. Results In the air evaluation, an important reduction was observed in the colony count after irradiation with UV-C light, and pathogenic or toxigenic fungi were not found in either of the two moments. Regarding the disinfection of surfaces, no bacterial growth was observed after the application of UV-C light, showing 100% bacterial inactivation under the tested conditions. Conclusion The use of fixed UV-C light emission technology was effective and can be considered a promising intervention for hospital surface disinfection protocols.

Pressão arterial invasiva: o YouTube é uma plataforma que compartilha informações confiáveis para enfermeiros? / Invasive blood pressure: is Youtube a platform for sharing controlled information for nurses? / Presión arterial invasiva: ¿es Youtube una plataforma para compartir información controlada para enfermeras?

Objetivo: identificar a qualidade e confiabilidade das informações sobre a pressão arterial invasiva abordadas em vídeos do YouTube. Método: pesquisa descritiva e exploratória com vídeos do YouTube sobre pressão arterial invasiva, identificados em busca única no dia 23 de fevereiro de 2023. Os vídeos foram organizados em uma lista de reprodução e submetidos à análise utilizando a ferramenta Discern Questionnaire para a qualidade educacional do vídeo e a Journal of American Medical Association Benchmarks para a confiabilidade e qualidade da informação e realizada análise estatística descritiva simples. Resultados: elencou-se 62 vídeos publicados há dois anos, dos quais 93,55% apresentaram qualidade educacional dos vídeos ruim, 6,45% moderada, demonstrando 70,97% baixa confiabilidade das informações e 32,25% citaram informações incompatíveis com a ciência. Conclusão: os vídeos encontrados na plataforma do YouTube apresentaram lacunas relacionados ao conteúdo de pressão arterial invasiva demonstrando não ser uma fonte confiável de respaldo para aprendizado do enfermeiro.

Objective: to identify the quality and reliability of information on invasive blood pressure covered in YouTube videos. Method: descriptive and exploratory research with YouTube videos on invasive blood pressure, identified in a single search on February 23, 2023. The videos were organized into a playlist and subjected to analysis using the Discern Questionnaire tool for the educational quality of the video and the Journal of American Medical Association Benchmarks for reliability and quality of information and performed simple descriptive statistical analysis. Results: 62 videos published two years ago were listed, of which 93.55% presented poor educational quality, 6.45% moderate, 70.97% demonstrated low reliability of information and 32.25% cited information incompatible with science. Conclusion: The videos found on the You Tube platform presented gaps related to the content of invasive blood pressure, demonstrating that it is not a reliable source of support for nurses' learning.

Objetivos:identificar la calidad y confiabilidad de la información sobre presión arterial invasiva cubierta en videos de YouTube. Método: investigación descriptiva y exploratoria con videos de YouTube sobre presión arterial invasiva, identificados en una única búsqueda el 23 de febrero de 2023. Los videos fueron organizados en una lista de reproducción y sometidos a análisis mediante la herramienta Discernir Cuestionario para la calidad educativa del video y la Journal of American Medical Association Se tomaron puntos de referencia para la confiabilidad y calidad de la información y se realizó un análisis estadístico descriptivo simple. Resultados: Se enumeraron 62 videos publicados hace dos años, de los cuales el 93,55% presentó mala calidad educativa, el 6,45% moderada, el 70,97% demostró baja confiabilidad de la información y el 32,25% citó información incompatible con la ciencia. Conclusión: Los videos encontrados en la plataforma You Tube presentaron lagunas relacionadas al contenido de presión arterial invasiva, demostrando que no es una fuente confiable de apoyo para el aprendizaje de los enfermeros.

Surveillance system for Healthcare-associated endophthalmitis at state level in a middle-income country: preliminary results / Sistema de vigilância epidemiológica para endoftalmites em nível estadual em um país de renda média: resultados preliminares

ABSTRACT Purpose: To describe the implementation pro cess and the preliminary results of a surveillance system for healthcare-associated endophthalmitis. Methods: This is a case study of the implementation of a surveillance system for healthcare-associated endophthalmitis. The system for healthcare-associated endophthalmitis is a structured system that enables surveillance of cases of healthcare-associated endophthalmitis after intraocular procedures, developed and coordinated by the Division of Hospital Infection at the State Health Department, São Paulo, Brazil. The implementation process included a pilot phase, followed by a scaling-up phase. Data were reported monthly to the Division of Hospital Infection by participating healthcare facilities that performed intraocular procedures in the state of São Paulo, Brazil, from September 2017 to December 2019. Results: Among the 1,483 eligible healthcare facilities, 175 engaged in the study (participation rate of 11.8%), reporting 222,728 intraocular procedures performed, of which 164,207 were cataract surgery and 58,521 were intravitreal injections. The overall incidence rate of endophthalmitis was reported to be 0.05% (n=105; 80 cases after cataract surgery and 25 cases after intravitreal injections). The incidence rates for healthcare facilities ranged from 0.02% to 4.55%. Most cases were caused by gram-positive bacteria, mainly Staphylococcus spp. In 36 (46.2%) of the cases, there was no bacterial growth; no sample was collected in 28 (26.7%) cases. This system for healthcare-associated endophthalmitis enabled the identification of an outbreak of four cases of endophthalmitis after intravitreal injections. Conclusion: The system for healthcare-associated endophthalmitis proved to be operationally viable and efficient for monitoring cases of endophthalmitis at the state level.

RESUMO Objetivo: Descrever o processo de implementação e os resultados preliminares de um sistema de vigilância epidemiológica para endoftalmites associada à assistência à saúde. Métodos: Trata-se de um estudo de caso de implementação de um sistema de vigilância epidemiológica para endoftalmites. O sistema de vigilância epidemiológica para endoftalmites é um sistema estruturado que possibilita a vigilância de casos de endoftalmite associados à assistência à saúde após procedimentos oftalmológicos invasivos, desenvolvido e coordenado pela Divisão de Infecção Hospitalar da Secretaria de Estado da Saúde, São Paulo, Brasil. O processo de implementação incluiu uma fase piloto, seguida pela fase de expansão. Os dados foram enviados mensalmente à Divisão de Infecção Hospitalar pelos estabelecimentos de saúde participantes que realizaram procedimentos oftalmológicos no estado de São Paulo, Brasil no período de setembro de 2017 a dezembro de 2019. Resultados: Entre os 1.483 estabelecimentos de saúde elegíveis, 175 participaram do estudo (taxa de adesão de 11,8%), relatando 222.728 procedimentos oftalmológicos realizados, sendo 164.207 cirurgias de catarata e 58.521 injeções intravítreas. A taxa de incidência global de endoftalmite relatada foi de 0,05% (n=105; 80 casos após cirurgia de catarata e 25 casos após injeção intravítrea). As taxas de incidência entre os estabelecimentos de saúde variaram de 0,02% a 4,55%. A maioria dos casos foi causada por bactérias gram-positivas, principalmente Staphylococcus spp. Em 36 (46,2%) casos não houve crescimento bacteriano; nenhuma amostra foi coletada em 28 (26,7%) casos. O sistema de vigilância epidemiológica para endoftalmites possibilitou a identificação de um surto de quatro casos de endoftalmite após injeção intravítrea. Conclusão: O sistema de vigilância epidemiológica para endoftalmites mostrou-se operacionalmente viável e eficiente para o monitoramento de casos de endoftalmite em nível estadual.

Temporal trends in vaccination coverage in the first year of life in Brazil / Tendência temporal das coberturas vacinais no primeiro ano de vida no Brasil

ABSTRACT Objective: The aim of this study was to analyze the temporal trends in vaccination coverage (VC) during the first year of life of children in Brazil. Methods: Data on VC for the first year of life from 2011 to 2020 for Bacille Calmette-Guerin (BCG), hepatitis B, polio, pentavalent, and triple viral vaccines at the national, regional, and state levels were obtained from the Information System of the National Immunization Program. Trends were analyzed using Prais-Winsten generalized linear regression models and average annual percent change (APC) estimates. Results: Decreasing trends were observed for the BCG (APC −3.58%; p<0.05), pentavalent (APC −4.10%; p<0.05), polio (APC −2.76%; p<0.05), and triple viral (APC −2.56%; p<0.05) vaccines in the country. Hepatitis B vaccine was the only vaccine that displayed stationary behavior (APC −4.22%; p>0.05). During the study period, no increasing trends were observed in any territory or vaccine. Conclusions: This study shows a recent significant reduction and decreasing trends in VC during the first year of life of children in Brazil, indicating the need for interventions to curb this ongoing phenomenon and to recover acceptable VC rates in the country.

RESUMO Objetivo: Analisar a tendência temporal da cobertura vacinal (CV) em crianças com idade menor ou igual a um ano no Brasil. Métodos: Foram empregados dados da CV no primeiro ano de vida de 2011 a 2020 referentes às vacinas BCG, hepatite B, poliomielite, pentavalente e tríplice viral, obtidos do Sistema de Informação do Programa Nacional de Imunizações (SI-PNI). Os dados estão agregados em nível nacional, regional e estadual. Para a análise de tendência foi utilizado o modelo de regressão linear generalizado de Prais-Winsten e foi calculada a variação percentual média anual (APC). Resultados: As tendências de CV para as vacinas BCG (APC −3,58%; p<0,05), pentavalente (APC −4,10%; p<0,05), poliomielite (APC −2,76%; p<0,05) e tríplice viral (APC −2,56%; p<0,05) foram decrescentes no país. Apenas para a CV da vacina contra hepatite B foi identificado comportamento estacionário (APC −4,22%; p>0,05). Nenhum território ou vacina apresentou tendência crescente para cobertura vacinal no período estudado no Brasil. Conclusões: Este estudo alerta sobre a redução expressiva das CV no primeiro ano de vida nos últimos anos no Brasil e sua tendência decrescente, sendo imperativa a adoção de intervenções com o fim de frear o fenômeno em curso e de resgatar níveis aceitáveis de CV no país.

Monitoramento e avaliação da cobertura vacinal da vacina contra febre amarela: revisão integrativa / Monitoreo y evaluación de la cobertura vacunal de la vacuna contra la fiebre amarilla: revisión integradora / Monitoring and evaluation of vaccination coverage of the yellow fever vaccine: integrative review

Objetivo: descrever as estratégias de monitoramento e avaliação da cobertura vacinal de vacina contra febre amarela (FA) no Brasil. Método: revisão integrativa nas bases Lilacs, BDENF, Medline e SciELO. Utilizou-se operadores booleanos e de truncamento para construir a estratégia de busca a partir das palavras chaves.: Monitoramento; Avaliação; Cobertura vacinal; Febre amarela. Cinco artigos foram selecionados. Resultados: Identificou-se estratégias de monitoramento da cobertura vacinal da vacina contra FA (ex.: cálculos de cobertura vacinal e de doses aplicadas; Monitoramento Rápido de Coberturas Vacinais, entre outras). Assim como estratégias de avaliação (ex.: alcance de meta da cobertura preconizada; número de casos confirmados de FA, entre outras).Conclusão: Além do alcance do objetivo, com construção de um quadro-síntese, pôde-se observar limitação do número de artigos encontrados e incipiência na elaboração de estudos nesta área.

Objective: to describe strategies for monitoring and evaluating vaccination coverage of yellow fever (YF) vaccine in Brazil. Method: integrative review in the Lilacs, BDENF, Medline and SciELO databases. Boolean and truncation operators were used to build the search strategy based on the keywords: Monitoring; Assessment; Vaccination coverage; Yellow fever. Five articles were selected. Results: strategies for monitoring vaccination coverage of the YF vaccine were identified (e.g. calculations of vaccination coverage and doses applied; Rapid Monitoring of Vaccination Coverage, among others). As well as evaluation strategies (e.g. reaching the coverage target recommended; number of confirmed cases of AF, among others). Conclusion: in addition to achieving the objective, with the construction of a summary table, it was possible to observe a limitation in the number of articles found and a lack of development in studies in this area.

Objetivos:describir estrategias para el seguimiento y evaluación de la cobertura vacunal de la vacuna contra la fiebre amarilla (FA) en Brasil. Método: revisión integrativa en las bases Lilacs, BDENF, Medline y SciELO. Se utilizaron operadores booleanos y de truncamiento para construir la estrategia de búsqueda basada en las palabras clave: Monitoreo; Evaluación; Cobertura de vacunación; Fiebre amarilla. Se seleccionaron cinco artículos. Resultados: se identificaron estrategias para el seguimiento de la cobertura vacunal de la vacuna contra la FA (ej., cálculos de cobertura vacunal y dosis aplicadas; Monitoreo Rápido de la Cobertura Vacunal, entre otros). Así como estrategias de evaluación (ej. alcanzar la meta de cobertura recomendada; número de casos confirmados de FA, entre otros). Conclusión: además de lograr el objetivo, con la construcción de un cuadro resumen, se puede observar una limitación en el número de artículos encontrados y una incipiencia en el desarrollo de estudios en esta área.

Age as a predictive factor for reduced intracranial compliance in patients with headache / Idade como fator preditor de complacência intracraniana reduzida em pacientes com cefaleia

Abstract Background Increased intracranial pressure (ICP) consists of a set of signs and symptoms related to changes in intracranial compliance (ICC) and ICP. Objective This study presents a retrospective analysis of patients who underwent non-invasive monitoring of ICC based on complaints of headache, correlating decreased brain compliance and increased intracranial pressure. Methods Noninvasive ICC monitoring was performed using a Brain4care device, which contains a strain gauge and a recorder connected to a mechanical device that touches the scalp surface in the frontoparietal area lateral to the sagittal suture. This tool monitors the ICP by identifying small changes in skull measurements that are caused by pressure variations, i.e., skull deformation is associated with the detection of changes in mean ICP. A clinical evaluation of 32 patients with complaints of headache occurred from the analysis of their medical records. Results Of the 32 patients initially chosen, it was possible to complete the analysis of 18 due to the availability of data in the medical records. From the non-invasive monitoring of the ICC, the following data were collected: time-to-peak, P2/P1 ratio, age, and gender. From the statistical analysis of age and P2/P1 ratio, it was noted that as age increases, ICC tends to decrease regardless of sex (p < 0.05). Conclusion This study concluded that there is a correlation between changes in intracranial compliance and headache complaints in outpatients. There was also a relationship between age and decreased intracranial compliance but without a specific pain pattern.

Resumo Antecedentes O aumento da pressão intracraniana (PIC) consiste em um conjunto de sinais e sintomas relacionados a mudanças na complacência intracraniana (CIC) e na PIC. Objetivo Este estudo apresenta uma análise retrospectiva de pacientes que foram submetidos ao monitoramento não invasivo da CIC com base em queixas de cefaleia, correlacionando a diminuição da complacência cerebral e o aumento da pressão intracraniana. Métodos O monitoramento não invasivo da CIC foi realizado utilizando um dispositivo Brain4Care, que contém um medidor de tensão e um gravador conectado a um dispositivo mecânico que toca a superfície do couro cabeludo na área frontoparietal lateral à sutura sagital. Esta ferramenta monitora a PIC identificando pequenas alterações nas medidas do crânio que são causadas por variações de pressão, ou seja, a deformação do crânio está associada à detecção de alterações na PIC média. Uma avaliação clínica de 32 pacientes com queixas de cefaleia ocorreu a partir da análise de seus prontuários médicos. Resultados Dos 32 pacientes inicialmente escolhidos, foi possível concluir a análise de 18 devido à disponibilidade de dados nos prontuários médicos. A partir do monitoramento não invasivo da CIC, foram coletados os seguintes dados: time-to-peak, relação P2/P1, idade e sexo. Da análise estatística de idade e relação P2/P1, observou-se que à medida em que a idade aumenta, a CIC tende a diminuir independentemente do sexo (p < 0,05). Conclusão Este estudo concluiu que existe uma correlação entre as mudanças na CIC e a queixa de cefaleia em pacientes ambulatoriais. Houve também uma relação entre idade e diminuição da CIC, mas sem um padrão de dor específico.

Recognize the epidemiological and geospatial profile of the Mobile Emergency Care Service: a strategy to optimize response time

Epidemiological, cross-sectional, descriptive, retrospective study of a quantitative nature, to trace the epidemiological and geospatial profile of the occurrences assisted by the Mobile Emergency Care Service. For that purpose, secondary data from the documents of the Mobile Emergency Care Service of a city in the interior of Rio Grande do Norte were used, considering the frequency of the variables: sex, age group, nature of occurrences, days of the week, ambulance sent, removal inter-hospital care and patient destination. Of the 363 occurrences, most were due to clinical causes, followed by traumatic, psychiatric, and gynecological/obstetric causes, with an emphasis on cardiovascular diseases and transport accidents. aged 19 to 59 years and over 60 years, with the Basic Support Unit providing the majority of care. Among the calls for clinical causes, women stood out, while for traumatic and psychiatric causes, men. The information contributes to the organization and planning of the service and the understanding of the morbidity profile. The geographic distribution highlights the need for integration between health agencies, for the institution of preventive actions, and the redirection of human and financial resources.

Estudio epidemiológico, transversal, descriptivo, retrospectivo, de carácter cuantitativo que tiene como objetivo trazar el perfil epidemiológico y geoespacial de los incidentes atendidos por el Servicio Móvil de Atención de Urgencias. Para ello se utilizan datos secundarios de dos documentos del Servicio Móvil de Atención de Emergencias de un municipio del interior de Rio Grande do Norte; considera la frecuencia de las variables: sexo, edad, naturaleza de los eventos, días de la semana, ambulancia enviada, retiro interhospitalario y destino del paciente. De los 363 sucesos, la mayoría se debió a causas clínicas, seguidas de causas traumáticas, psiquiátricas y ginecológicas/obstétricas, incluidas las enfermedades cardiovasculares y los accidentes de transporte. La frecuencia de ocurrencia fue ligeramente mayor en individuos masculinos con predominio de mujeres y edades entre los 19 y 59 años y mayores de 60 años; la Unidad Básica de Apoyo fue la responsable de la mayoría de los servicios. Entre los lesionados por causas clínicas destacan las mujeres, mientras que los hombres tienen causas traumáticas y psiquiátricas. Esta información contribuye a la organización y planificación de los servicios y a la comprensión del perfil de morbilidad. La distribución geográfica resalta la necesidad de integración entre las organizaciones de salud para implementar acciones preventivas y redireccionar recursos humanos y financieros.

Research progress in therapy drug monitoring of levetiracetam / 中国药房

Levetiracetam （LEV） is the second generation of broad-spectrum anti-epileptic drug. LEV has the advantages of rapid absorption， short half-life， precise efficacy， good tolerance and few drug interactions. In order to improve the clinical efficacy of LEV， and reduce the occurrence of adverse reactions， children， pregnant women， the elderly， and patients with renal insufficiency should receive therapeutic drug monitoring （TDM）. Clinically， the samples are usually plasma or serum， and the TDM methods are mostly immunoassay or chromatography. There is currently no consensus on the effective concentration range of LEV， and the correlation between plasma concentration and adverse reactions is also unclear. The main factors affecting LEV plasma concentration include age， pregnancy， and patient compliance. How to interpret TDM results and adjust dosage based on the results will be the focus of future work.

Monitoring and risk assessment of total α and β radioactivity levels in drinking water in the nine districts of metropolitan Chongqing in 2019-2021 / 公共卫生与预防医学

Objective To investigate the radioactivity levels of total α and total β in drinking water in nine districts of Chongqing City from 2019 to 2021, and to provide reference for the risk monitoring of drinking water in the metropolitan areas of Chongqing. Methods The total α and total β radioactivity levels in water samples were determined by the comparative measurement method and the thin source deposit method in GB/T5750.13-2006 “Standard Examination Methods for Drinking Water-Radiological Parameters”. The monitoring results were assessed according to GB5749-2006 “Standards for Drinking Water Quality” and the fourth edition of the WHO Guidelines for Drinking Water Quality. Results From 2019 to 2021, the total α activity concentration of the water samples measured in the nine districts of metropolitan Chongqing ranged from 0.002 to 0.039 Bq /L, and the total β activity concentration ranged from 0.015 to 0.190 Bq /L. There was no significant difference in the activity concentration (tα=0.545, Pα=0.591; tβ=-1.438, Pβ=0.163>0.05). From 2019 to 2021, the average value of total α radioactivity decreased year by year and its activity value was relatively low, indicating a low health risk. However, the average value of total β radioactivity increased year by year, which should be paid attention to. Conclusion The total α and total β radioactivity in water samples measured in the present study are lower than the standard recommended limits. The estimated annual average effective dose of radiation caused by drinking water is 0.005-0.010 mSv, which is lower than the limit of 0.1 mSv recommended by WHO, and this radioactivity level will not have an impact on the health of residents. However, the total β radioactivity level of the monitoring points in Banan and Shapingba is relatively high compared to other jurisdictions, and further tracking and monitoring should be carried out.

Clinical treatment and management of invasive fungal disease in recipients of solid organ transplantation / 器官移植

With widespread application of solid organ transplantation (SOT), the incidence of postoperative invasive fungal disease (IFD) in SOT recipients has been increased year by year. In recent years, the awareness of preventive antifungal therapy for SOT recipients has been gradually strengthened. However, the problem of fungal resistance has also emerged, leading to unsatisfactory efficacy of original standardized antifungal regimens. Drug-drug interaction and hepatorenal toxicity induced by drugs are also challenges facing clinicians. In this article, the characteristics of drug-drug interaction and hepatorenal toxicity among triazole, echinocandin and polyene antifungal drugs and immunosuppressants were reviewed, and postoperative preventive strategies for IFD in different types of SOT recipients and treatment strategies for IFD caused by infection of different pathogens were summarized, aiming to provide reference for physicians in organ transplantation and related disciplines.

Investigation of patients’preferences regarding therapeutic drug monitoring of mycophenolic acid in solid organ transplantation / 中国药房

OBJECTIVE To investigate the preferences of patients who underwent solid organ transplantation regarding therapeutic drug monitoring （TDM） of mycophenolic acid （MPA） and explore the factors influencing patients’ decision-making process， so as to provide support for the development of individualized medication guidelines for MPA and improvement of clinical decision-making. METHODS The cross-sectional study was used to design the questionnaire on the patients’ preferences to accept MPA TDM， and involved patients who underwent solid organ transplantation and received MPA treatment at two tertiary hospitals in Beijing from April 14， 2022， to June 27， 2022. The Likert 5-level scoring method was used to score the patients’ preferences to accept MPA TDM， the influencing factors and their correlation of the patients’ preferences to accept MPA TDM were analyzed by Pearson correlation analysis and binary Logistic regression analysis， and the nonparametric test and chi-square test were used to rank and analyze the consistency of the factors affecting patients’ preference decision. RESULTS A total of 140 questionnaires were collected， and the effective recovery rate was 77.35%. The average preference score of 140 patients to receive MPA TDM was （4.01±0.65）， and the overall preference value was high. There were 116 （82.86%） patients agreed or strongly agreed with MPA TDM. Significant differences were observed in preference scores between patients who had previously undergone MPA TDM and those who had never undergone it （[ 4.30±0.53） scores vs. （3.80±0.65） scores， P＜0.001]. Additionally， patients’ preference scores were significantly influenced by their understanding level and attention level （P＜0.001）. The ranking of factors contributing to decision-making exhibited consistency （P＜0.001）. The factors were ranked in descending order of clinical efficacy， safety， comfortability， economy and time cost. CONCLUSIONS The patients who underwent solid organ transplantation hold high preferences towards MPA TDM. The primary factors influencing their decisions are their prior experience， understanding level， and attention level.

Actualización sobre la resistencia antimicrobiana en instituciones de salud de nivel III y IV en Colombia entre enero del 2018 y diciembre del 2021

Introducción. El comportamiento de la resistencia antimicrobiana es fundamental en el mejoramiento y ajuste de los programas de optimización de uso de antimicrobianos, la implementación de las guías terapéuticas y las precauciones que limitan la transmisión cruzada de bacterias resistentes entre pacientes. Desde el inicio del 2020, la pandemia del SARS-CoV-2 desafió profundamente al sistema de salud y, según algunos reportes, aumentó las tasas de resistencia antimicrobiana. Objetivo. Describir el comportamiento de la resistencia antimicrobiana en los microrganismos más frecuentes en veinte hospitales colombianos durante el periodo 2018-2021. Materiales y métodos. Se trata de un estudio descriptivo basado en la información microbiológica reportada por veinte instituciones de salud de nivel III y IV, entre enero de 2018 y diciembre de 2021, en doce ciudades de Colombia, las cuales hacen parte del "Grupo para el estudio de la resistencia nosocomial en Colombia", liderado por la Universidad El Bosque. La identificación de género y especie de los microorganismos más frecuentes, junto con su perfil de resistencia frente a antibióticos marcadores, se determinaron mediante el análisis de los datos vía WHONET. Resultados. En general, los 10 microorganismos más frecuentes analizados a lo largo de los 4 años no presentaron cambios estadísticamente significativos en sus perfiles de resistencia durante los cuatro años del periodo evaluado, de 2018 a 2021. En contraste, Pseudomonas aeruginosa aumentó su resistencia frente a piperacilinatazobactam y carbapenémicos, lo cual fue estadísticamente significativo. Conclusiones. Los cambios en la resistencia antimicrobiana en estos años no han sido estadísticamente significativos, excepto para P. aeruginosa, bacteria que mostró un incremento en las tasas de resistencia a piperacilina-tazobactam y carbapenémicos.

Introduction. Antimicrobial resistance surveillance is a fundamental tool for the development, improvement, and adjustment of antimicrobial stewardship programs, therapeutic guidelines, and universal precautions to limit the cross-transmission of resistant bacteria between patients. Since the beginning of 2020, the SARS-CoV-2 pandemic profoundly challenged the health system and, according to some reports, increased the rates of antimicrobial resistance. Objective. To describe the behavior of antimicrobial resistance of the most frequent bacterial pathogens in twenty Colombian hospitals from January 2018 to December 2021. Materials and methods. We conducted a descriptive study based on the microbiological information recorded from January 2018 to December 2021 in twenty levels III and IV health institutions in twelve Colombian cities. We identified the species of the ten most frequent bacteria along with their resistance profile to the antibiotic markers after analyzing the data through WHONET. Results. We found no statistically significant changes in most pathogens' resistance profiles from January 2018 to December 2021. Only Pseudomonas aeruginosa had a statistically significant increase in its resistance profile, particularly to piperacillin/ tazobactam and carbapenems. Conclusions. The changes in antimicrobial resistance in these four years were not statistically significant except for P. aeruginosa to piperacillin/tazobactam and carbapenems.

Aplicación móvil para el seguimiento del crecimiento y cuidado nutricional del bebé en hogares colombianos

Introducción: El predominio y asequibilidad actual de los teléfonos móviles inteligentes han permitido una amplia difusión de variedad de aplicaciones a nivel mundial para el monitoreo del crecimiento y del estado nutricional de los lactantes. No obstante, la mayoría de estos recursos no son lo suficientemente completos para proveer una interfaz amigable de seguimiento del crecimiento, combinada con una adecuada educación parental en materia de nutrición y alimentación complementaria. Objetivos: Este trabajo pretende presentar el desarrollo y evaluación de la aplicación propuesta "Baby Home", con el fin de estudiar su potencial como herramienta digital de apoyo a padres y cuidadores en el cuidado nutricional de sus niños desde el hogar. Materiales y métodos: Baby Home integra una interfaz de seguimiento interactivo del crecimiento del bebé con una serie de contenidos educativos alimentarios, posibilitando al usuario consultar las prácticas recomendadas según el estado nutricional estimado de su bebé. Un conjunto de 7 jueces expertos fue reunido para evaluar la validez de estos contenidos consignados en la aplicación. Posteriormente, se llevó a cabo un estudio de prueba piloto con 8 madres participantes, las cuales aportaron en las fortalezas y debilidades de las funcionalidades propuestas. Resultados: la aplicación desarrollada muestra una aprobación positiva por los especialistas consultados y una aceptación satisfactoria entre las madres participantes gracias a su diseño amigable y funcionalidades de fácil uso. Los recursos visuales implementados prueban ser adecuados para la apropiación de los contenidos alimentarios y el empoderamiento del usuario en torno a los cuidados nutricionales que requieren sus niños. Conclusiones: Baby Home se ubica como un soporte práctico y accesible para el cuidado nutricional del lactante, otorgando seguridad y confianza al usuario en la alimentación de su niño y disponiendo la posibilidad de detectar oportunamente problemas de crecimiento.

Introduction: The current prevalence and affordability of smartphones have enabled a broad diffusion of a variety of mobile applications worldwide for monitoring infant's growth and nutritional status. However, most of these resources are not comprehensive enough to provide a user-friendly interface for growth tracking combined with proper parental education on nutrition and complementary feeding. Objectives: This work aims to present the development and evaluation of the proposed application "Baby Home", in order to study its potential as a digital tool for supporting parents and caregivers in the nutritional care of their children from home. Materials and methods: Baby Home integrates an interactive baby growth monitoring interface with a collection of educational content on infant feeding, allowing the user to check the recommended practices based on the estimated nutritional status of their baby. A panel of seven expert judges was assembled to evaluate the validity of these contents included in the application. Subsequently, a pilot study was carried out with eight participating mothers who contributed to the strengths and weaknesses of the proposed functionalities. Results: The developed application received positive feedback by the consulted specialists and a satisfactory acceptance within the participating mothers thanks to its friendly design and easy-to-use functionalities. The implemented visual resources proved to be well suited for the user's appropriation of feeding contents and their empowerment regarding the nutritional care required by their children. Conclusions: Baby Home is positioned as a practical and accessible support for the nutritional care of infants, providing safeness and confidence to the user in their child's feeding and the possibility of timely detection of growth problems.

Riesgo de Caídas y Parámetros de Marcha en Personas Mayores de la Comunidad: ¿Cuáles son los Indicadores de Función y Disfunción del Movimiento? / Risk of Falls and Gait Parameters in Community Elderly: What Are the Indicators of Movement Function and Dysfunction?

Introducción. La población de personas mayores (PM) en Chile presenta un incremento sostenido con importantes tasas de fragilidad y riesgo de caídas (RC). El desempeño de marcha permite valorarlo mediante parámetros mecánicos y fisiológicos. Nos preguntamos, ¿cuáles podrían ser los más relevantes para estimar RC en condiciones de marcha confortable (MC) y máxima (MM)? Objetivo. Identificar los principales parámetros de marcha que podrían explicar RC en PM autovalentes de la comunidad. Métodos. Estudio observacional y transversal en el cual participaron 53 PM autovalentes de la comuna de Talca, Chile (edad 71±7años; IMC 29,1±3,4 kg/m2). Se solicitó a los participantes la ejecución de MC (n=53) y posteriormente MM (n=36). Ambas modalidades fueron desarrolladas en un circuito elíptico de 40m durante 3min. El RC se categorizó como: "sin riesgo", "riesgo dinámico" según prueba timed up and go (TUG) positiva, "riesgo estático" según estación unipodal (EUP) positiva y "riesgo mixto" con ambas pruebas positivas. Para la visualización de la variación gráfica en el morfoespacio de los individuos según RC, se realizó un análisis de componentes principales (ACP) mediante el Programa RStudio, utilizando 6 variables cinemáticas: i) velocidad promedio de marcha (VPM), ii) cadencia, iii) máximo despeje del pie (MDP), iv) coeficiente de variación (%CV) del MDP, v) longitud de zancada (LZ) y vi) %CV de la LZ. Además de 2 variables fisiológicas: i) % frecuencia cardiaca de reserva utilizada (%FCRu) y ii) el índice de costo fisiológico según la relación entre FC y VM (latidos/metros). Resultados. Para MC las dimensiones del ACP explican el 56% de la variabilidad de los datos, siendo los indicadores de seguridad de RC la VM, cadencia, LZ y MDP. La variabilidad de marcha explica RC mixto y el ICF junto al %FCRu se asocian a RC dinámico. En condiciones de MM, el ACP explica 60% de la variabilidad de datos, donde las PM sin RC se asocian con VM, LZ y MDP. Por su parte, la variabilidad del MDP se vincula con RC dinámico y las variables fisiológicas con el RC mixto. Conclusiones. Los parámetros de marcha que mejor explican una marcha segura y eficiente son cinemáticos de la fase de balanceo, mientras que la variabilidad y el costo fisiológico se asocian como indicadores de RC dinámico y mixto.

Background. Introduction: The elderly population (EP) in Chile is experiencing a sustained increase with significant rates of frailty and risk of falls (RF). Gait performance can be assessed using mechanical and physiological parameters. We wonder, which ones could be the most relevant to estimate RF in self-selected walking speed (SSWS) and maximum walking speed (MWS) conditions? Objective. Identify the main gait parameters that could explain RF in self-sufficient elderly individuals from the community. Methods. This observational and cross-sectional study included 53 self-sufficient elderly individuals from the commune of Talca, Chile (age 71±7 years; BMI 29.1±3.4 kg/m2). Participants were asked to perform SSWS (n=53) and subsequently MWS (n=36). Both modalities were conducted on a 40m elliptical circuit for 3 minutes. RF was categorized as: "no risk," "dynamic risk" based on a positive timed up and go test, "static risk" based on a positive one-legged stance test, and "mixed risk" with both tests positive. To visualize the graphical variation in the morphospace of individuals according to RF, a principal component analysis (PCA) was conducted using RStudio, utilizing 6 kinematic variables: i) walking speed (WS), ii) cadence, iii) maximum foot clearance (MFC), iv) coefficient of variation (%CV) of MFC, v) stride length (SL), and vi) %CV of SL. In addition to 2 physiological variables: i) % of reserve heart rate used (%RHRu) and ii) the physiological cost index based on the relationship between heart rate and WS (heartbeats/meters). Results. For SSWS, the PCA dimensions explained 56% of the data variability, with gait safety indicators such as WS, cadence, SL, and MFC explaining RF. Gait variability explains mixed RF, while the physiological cost index and %RHRu are associated with dynamic RF. In MWS conditions, PCA explains 60% of the data variability, where the elderly persons without RF are associated with WS, SL, and MFC. On the other hand, MFC variability is related to dynamic RF, and physiological variables are associated with mixed RF. Conclusions. The gait parameters that best explain safe and efficient walking are kinematic parameters of the swing phase, while variability and physiological cost are indicators of dynamic and mixed RF.

Reutilización de barrera de tela de algodón estéril en la práctica clínica: estudio observacional longitudinal / Reusing sterile cotton fabric barriers in the clinical practice: an observational and longitudinal study / Reuso de barreira estéril de tecido de algodão na prática clínica: estudo longitudinal observacional

Objetivo: analizar las características de barrera física y biológica de los campos de algodón utilizados como sistema de barrera estéril después de ser sometidos a múltiples usos y procesos en la práctica clínica. Método: estudio observacional longitudinal de seguimiento y evaluación de tela 100% algodón, utilizada como sistema de barrera estéril en un hospital de mediano porte. Se recolectaron muestras antes del uso (después de tres lavados) y después de tres, seis, nueve, 12 y 15 meses de uso y se evaluaron el número, grosor e integridad de los hilos, peso, absorción de agua y penetración húmeda de microorganismos. Resultados: después de 85 lavados, no cambió el número de hilos, aumentó el número de fibras deshilachadas y el volumen de agua absorbida. La prueba microbiológica mediante la metodología estándar alemana obtuvo un resultado negativo y la de penetración húmeda de microorganismos no mostró cambios significativos con el tiempo, a pesar de que una fracción de células microbianas pasó a través de las muestras de doble capa. Conclusión: las propiedades físicas de la tela 100% algodón utilizada como sistema de barrera estéril cambiaron con el uso/procesamiento; sin embargo, no interfirieron significativamente con los resultados obtenidos en las pruebas realizadas a la barrera microbiológica hasta los 85 lavados.

Objective: to analyze the physical and biological barrier characteristics of cotton fields used as a sterile barrier system after multiple use and processing cycles in the clinical practice. Method: an observational and longitudinal study to monitor and evaluate 100% cotton fabric used as a sterile barrier system in a medium-sized hospital. Samples were collected before use (after three washes) and at three, six, nine, 12 and 15 months of use and evaluated for the number, thickness and integrity of threads, weight, water absorption and wet penetration by microorganisms. Results: after 85 washes, the number of threads remained unchanged, and the shredded fibers and the water volume absorbed were increased. The microbiological test using the German standard methodology obtained a negative result and wet penetration by microorganisms did not show significant changes over time, although a percentage of the microbial cells passed through the double-layer samples. Conclusion: the physical properties of 100% cotton used as a sterile barrier system changed with use/processing cycles; however, these alterations did not significantly interfere with the results obtained by the tests performed on the microbiological barrier up to 85 washes.

Objetivo: analisar as características de barreira física e biológica de campos de algodão, que são utilizados como sistema de barreira estéril, após múltiplos usos e processamentos na prática clínica. Método: estudo longitudinal observacional de acompanhamento e de avaliação de tecido 100% algodão que foi utilizado como sistema de barreira estéril em um hospital de médio porte. Amostras foram coletadas antes do uso (após três lavagens) e com três, seis, nove, 12 e 15 meses de uso e avaliadas quanto ao número, à espessura e à integridade dos fios, peso, absorção de água e penetração úmida de micro-organismos. Resultados: após 85 lavagens, o número de fios permaneceu inalterado, porém aumentaram-se as fibras desfiadas e o volume de água absorvido. O teste microbiológico utilizando metodologia padrão alemão obteve resultado negativo; já o de penetração de úmida de micro-organismos não apresentou mudanças significativas ao longo do tempo, embora uma fração das células microbianas tenham passado pelas amostras de dupla camada. Conclusão: as propriedades físicas do tecido 100% algodão, utilizado como sistema de barreira estéril, alteraram com usos/processamentos; entretanto essas não interferiram significativamente nos resultados obtidos pelos testes realizados na barreira microbiológica até 85 lavagens.