ABSTRACT
Objective: To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. Method: Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. Results: No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). Conclusion: Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient. .
Objetivo: Evaluar la seguridad de la ejecución de las técnicas tradicional y protegida de la recolección de aspirado traqueal e identificar la concordancia cualitativa y cuantitativa de los resultados de los cultivos microbiológicos entre estas técnicas. Método: Investigación clínica, prospectiva, comparativa, ciega simple. La muestra fue constituida por 54 pacientes mayores de 18 años que fueron sometidos a ventilación mecánica invasiva durante 48 horas o más y con sospecha de Neumonía Asociada a la Ventilación Mecánica. Las dos técnicas fueron implementadas en el mismo paciente, una inmediatamente posterior a la otra. El orden de ejecución de las técnicas fue aleatorio, hecho por un software especializado. Resultados: No hubo eventos significativos en la disminución de la saturación de oxígeno, inestabilidad hemodinámica y hemorragias traqueo bronquiales (p<0,05) y aunque ocurrieron diferencias en algunas cepas, hubo concordancia cualitativa y cuantitativa entre las técnicas (p<0,001). Conclusión: El uso de la técnica protegida no ofrece ninguna ventaja sobre la técnica tradicional y la aplicación de ambas técnicas es segura para el paciente. .
Objetivo: Avaliar a segurança da execução das técnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiológicas entre as técnicas. Método: Pesquisa clínica, prospectiva, comparativa, simples-cega. A amostra foi constituída de 54 pacientes com idade ≥18 anos, submetidos à ventilação mecânica invasiva por período ≥48 horas e com suspeita de Pneumonia Associada à Ventilação Mecânica. As duas técnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execução aleatória, segundo randomização por software especializado. Resultados: Não ocorreram eventos significativos de queda da saturação de oxigênio, instabilidade hemodinâmica e hemorragias traqueobrônquicas (p<0,05) e, embora tenham ocorrido divergências em algumas cepas, houve concordância qualitativa e quantitativa entre as técnicas (p<0,001). Conclusão: A utilização da técnica protegida não proporciona vantagem em detrimento da tradicional e a execução de ambas as técnicas foi segura para o paciente. .
Subject(s)
Female , Humans , Male , Middle Aged , Body Fluids/microbiology , Specimen Handling/methods , Trachea , Prospective Studies , Single-Blind Method , Specimen Handling/adverse effectsABSTRACT
Background and Aim: In a clinical microbiology laboratory, heat fixed slide smears are commonly transported from one place to another for staining with different stains and also for onsite proficiency testing of laboratory technicians for accreditation of the laboratories. These smears are frequently handled without gloves by the staff in developing countries. Therefore, this study was conducted to check the survivability of tubercle bacilli on smears after physical and chemical treatments. Methods: A total of 196 AFB positive smears were analyzed. Of these, 116 were stained with Ziehl Neelsen (ZN), 60 with cold Kinyoun and 10 were unstained but heat fixed and 10 were neither stained nor heat fixed. The last 20 smears served as controls. The ZN and Kinyoun stained smears were 0-1.5-year-old and stored at room temperature in slide boxes, while control smears were freshly prepared. All smears were prepared from sputum samples positive for acid fast bacilli. All four sets were subjected to slide culture to see if mycobacteria could survive and grow in any. For slide culture, a new and safe device was used, which is designed for three in one purpose: cell cultivation, direct observation of the growth under microscope and cell harvesting inside the closed tube. The slide smears were directly dipped into this tube that contained liquid culture medium. The tubes were incubated at 370C for four weeks. The growth, if any, was confirmed by MPT-64 rapid test and subculture on LJ slants. Results: No growth was observed in ZN and Kinyoun stained slide smears. However, significant growth was observed in both control sets; the unstained non heat fixed as well as heat fixed slide smears. Conclusions: The results of our study indicate that tubercle bacilli remain viable even after heat fixation and carry risk of infection by contact. However, stained smears are safe for handling and storage.
Subject(s)
Coloring Agents/diagnosis , Hot Temperature/diagnosis , Humans , Laboratories, Hospital , Laboratories, Hospital/standards , Medical Laboratory Personnel , Mycobacterium tuberculosis/isolation & purification , Rosaniline Dyes/diagnosis , Safety Management , Specimen Handling/adverse effects , Specimen Handling/methods , Sputum/microbiology , Staining and Labeling/methods , Tuberculosis/prevention & control , Tuberculosis/transmissionABSTRACT
A carqueja-amarga [Baccharis trimera (Asteraceae)] é uma espécie originária do centro-sul da América do Sul. Análises qualitativas e quantitativas foram realizadas utilizando-se a técnica de CG-MS, para avaliar o efeito de diferentes formas de beneficiamento pós-colheita de drogas vegetais constituídas de partes aéreas de carqueja na composição química do óleo essencial, bem como verificar variações na composição quando conservado a -6ºC, durante 8 meses. O armazenamento da droga pulverizada reduziu significativamente o teor de óleo essencial, o que não aconteceu na droga fragmentada. Os teores dos constituintes majoritários espatulenol e ledol não foram influenciados pelo tratamento pós-colheita, embora tenham apresentado variações distintas redução nas concentrações de ledol e aumento nos teores de espatulenol. Verificou-se que as drogas fragmentadas podem ser armazenadas por até 12 meses e pulverizadas no momento da extração, não conferindo redução no teor de óleo essencial, nem dos constituintes químicos. O armazenamento a -6ºC por até oito meses, provocou variações quantitativas em alguns constituintes minoritários, tais como a-guaieno, b-selineno, germacreno B e espatulenol.
"Carqueja-amarga" [Baccharis trimera (Asteraceae)] is a species from the central south of South America. Qualitative and quantitative analyses were performed using the technique gas chromatography coupled to mass spectrometry to evaluate the effect of different post-harvest processing forms of drugs constituted of parts of "carqueja" on the chemical composition of its essential oil. The variation in the chemical composition of the essential oil stored at -6ºC for up to eight months was also evaluated. Storage of powdered drug significantly reduced the essential oil content, which was not observed for fragmented drug. The concentration of the major constituents of "carqueja" essential oil, spathulenol and ledol, was not affected by the post-harvest treatment, although they presented distinct variations, with ledol concentrations reducing and spathulenol concentrations increasing. We found that fragmented drugs can be stored for up to 12 months and powdered at the moment of extraction, without reducing the concentration of the essential oil or its chemical constituents. Storage at -6ºC for eight months caused quantitative variations in some minor constituents of the essential oil such as a-guaiene, b-selinene, germacrene B and espathulenol.
Subject(s)
Crop Production , Baccharis/chemistry , Plant Extracts/pharmacokinetics , Oils, Volatile , Asteraceae/chemistry , Drug Synergism , Specimen Handling/adverse effects , Plants, Medicinal , Evaluation Studies as Topic , Evaluation Studies as TopicABSTRACT
En la actualidad la práctica médica se apoya cada vez más en lo resultados de las pruebas de laboratorio para precisar los diagnósticos, tratamiento y evolución de los pacientes, por lo que es determinante la calidad en la toma de las muestras. Para valorar la eficacia en esta actividad, se realizó una investigación descriptiva y transversal sobre la labor de enfermería en la toma de las muestras de heces fecales para realizar los análisis seriados de Copa Cónica indicado a los pacientes ingresados por sospecha o valoración de Fasciolasis Hepatica. Participaron en la investigación 5 enfermeros y la misma se realizó en el período comprendido desde enero a julio de 2002. Como instrumentos para la recolección de datos se utilizó una encuesta que se aplicó a los enfermeros seleccionados y las historias clínicas de los pacientes. Todas las encuestas reflejaron dificultades en la recolección de las cantidades de heces necesarias para este examen lo que coincidió con lo señalado por el personal de laboratorio. Se produjo un incremento del costo de estadía por paciente que pudo estar relacionado con la demora en la recogida de muestras debido a una insuficiente coordinación entre el personal involucrado. Estos resultados permitieron perfeccionar el proceso de toma de muestras para Copa Cónica mediante la introducción de cambios organizativos que propiciaron ventajas asistenciales y económicas(AU)
At the present time the medical practice leans on more and more in that of the laboratory tests to specify the diagnoses, treatment and the patients' evolution, for what is decisive the quality in the taking of the samples. To value the effectiveness in this activity, he/she was carried out a descriptive and traverse investigation on the infirmary work in the taking of the samples of fecal grounds to carry out the analyses suitable seriados of Conical Glass to the patients entered by suspicion or valuation of Hepatic Fasciolasis. They participated in the investigation 5 male nurses and the same one was carried out in the period understood from January to July of 2002. As instruments for the gathering of data a survey was used that was applied to the selected male nurses and the clinical histories of the patients. All the surveys reflected difficulties in the gathering of the quantities of necessary grounds for this exam what coincided with that pointed out by the laboratory personnel. An increment of the demurrage cost took place for patient that could be related with the delay in the collection of samples due to an insufficient coordination among the involved personnel. These results allowed to perfect the process of taking of samples for Conical Glass by means of the introduction of organizational changes that you/they propitiated assistance and economic advantages(AU)
Subject(s)
Humans , Male , Female , Adult , Specimen Handling/adverse effects , Data Collection/methods , Fasciola hepatica , Laboratory Personnel , Nursing Care/methods , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
La bioseguridad es una parte importante del conocimiento práctivo de todos los profesionales de laboratorio clínicos. Debe focalizarse la atención en la reducción del manipuleo de especímenes biológicos, en la reducción de los materiales biológicos peligrosos para el personal de laboratorio y en el mejoramiento del rotulado y envasado de los materiales biopeligrosos. En este artículo, los temas de bioseguridad se discuten en relación al diseño de sistemas analíticos, su utilización y su mantenimiento
Subject(s)
Humans , Containment of Biohazards/methods , Laboratories , Laboratories, Hospital/standards , Security Measures/standards , Blood , Containment of Biohazards/standards , Medical Waste Disposal/standards , Equipment Safety/standards , Occupational Risks , Specimen Handling/adverse effects , Specimen Handling/standards , Hematologic Tests/adverse effects , Hematologic Tests/standardsABSTRACT
Hemos observado que el traslado de las muestras de sangre para el análisis de gases y equilibrio ácido-base desde diferentes servicios del hospital hacia el laboratorio de gases, no se hace en el tiempo correspondiente ni en las condiciones adecuadas debido a una serie de factores, siendo uno de los más importantes el déficit de personal. Se trabajó con 50 pacientes adultos hospitalarios en el Servicio de Medicina del Hospital Clínico de la Universidad de Chile, a los que se les hubiese solicitado el examen y que no se les hubiera administrado oxígeno. A cada paciente de una punción se le extrajeron dos muestras de sangre arterial en jeringas de vidrio. Una muestra se trabajó en forma inmediata a su extracción y la otra muestra se deja a temperatura ambiente para ser analizada aproximadamente 30' después de la anterior. Después de los dos análisis podemos concluir que: el 100 por ciento de los exámenes experimentan modificaciones en alguno de sus parámetros. Valores normales en la primera muestra se hacen patológicos a los 30' y a la vez valores patológicos en la primera muestra se hacen normales a los 30 minutos. El 74 por ciento de las muestras que fueron analizadas 30 minutos después de extraídas experimentan modificaciones sobre el 10 por ciento en algunos parámetros y este porcentaje de variación para los pacientes es significativo. Por lo tanto las muestras de sangre para el análisis de gases y equilibrio ácido-base deben ser enviadas al laboratorio inmediatamente después de su extracción previamente introducida en un receptáculo con hielo. Los resultados de las muestras de gases, enviadas en este laboratorio corresponderán a las condiciones clínicas del paciente y los médicos podrán impartir el tratamiento adecuado