Hemocultivos contaminados: bundle para lograr proporciones aceptables / Blood cultures contaminated: bundle to achieve acceptable proportions

Introducción. El problema de la contaminación de los hemocultivos es muy frecuente en establecimientos de atención hospitalaria, da lugar a la administración de antibióticos innecesarios y prolonga la hospitalización. Objetivo principal. Aplicar un bundle para reducir la proporción de contaminación de hemocultivos. Objetivo secundario. Realizar una encuesta anónima para detectar oportunidades de mejora en la técnica de extracción de hemocultivos. Metodología. Diseño del estudio: Estudio cuasi experimental que evaluó la proporción de contaminación de hemocultivos antes y después de implementar un bundle propio. Se determinó la proporción basal de contaminación de hemocultivos (ene-jul 2022), se realizó la intervención (agosto 2022) y se estableció la proporción de contaminación post intervención (sep.-abril 2023). Intervención: Se analizó la estructura, procedimiento y conocimiento del personal mediante una encuesta propia para detectar áreas de mejora. Se capacitó, a los técnicos de laboratorio, sobre el procedimiento de la toma de muestra mediante una simulación utilizando un brazo artificial. Se diseñó un bundle de seis medidas, se adaptó el procedimiento de toma de hemocultivo y se capacitó al personal. Análisis estadístico. Se analizó la proporción de hemocultivos contaminados entre los periodos pre y post utilizando Chi2 y la relación entre la proporción del periodo pre y post vs la literatura (3.00% contaminación aceptable) utilizando test Z para una proporción. Se consideró un p<0.05 como estadísticamente significativa. Se utilizo el software Stata 8. Resultados. Durante el estudio se analizaron un total de 3,965 hemocultivos. De estos, 1,978 corresponden al periodo pre-intervención y 1,987 corresponden al periodo post intervención. Durante la pre-intervención se detectaron 61 hemocultivos contaminados (3.08% vs 3.00% bibliografía, p:0.5866) mientras que en la etapa post intervención fue de 30 hemocultivos contaminados (1.51% vs 3.00% bibliografía, p:0.0000). La proporción de hemocultivos contaminados se redujo a la mitad, 3.08% vs 1.51%, p: 0.001. Se realizó una encuesta anónima pre y post intervención logrando mejoras en la técnica de toma de hemocultivos. Conclusión. La implementación del bundle propio para la extracción de hemocultivos, permitió reducir la proporción de contaminación a la mitad. El análisis de la encuesta nos permitió identificar oportunidades de mejora en la técnica de recolección de muestra de hemocultivos

Introduction: Contamination of blood cultures is very common in hospital care settings and results in the administration of unnecessary antibiotics and prolongs hospitalization. Main goal: Apply a bundle to reduce the rate of contamination of blood cultures. Secondary objective: Conduct an anonymous survey to detect opportunities for improvement in the blood culture extraction technique. Methodology: Study design: Quasi-experimental study that evaluated the proportion of blood culture contamination before and after implementing its own bundle. The baseline proportion of blood culture contamination was determined (Jan-July 2022), the intervention was performed (August 2022) and the post-intervention contamination proportion was established (September-April 2023). Intervention: The structure, procedure and knowledge of the staff was analyzed through an own survey to detect areas for improvement. Laboratory technicians were trained on the sample collection procedure through a simulation using an artificial arm. A bundle of six measures was designed: (hand hygiene with alcohol gel, use of common gloves and sterile gloves during extraction, antisepsis with alcoholic chlorhexidine gluconate, marking of the blood culture bottle up to the filling level, disinfection of the bottle cap). blood culture bottle with 70% alcohol, safety-lok kit with vacuum extraction system). The procedure was adapted and staff trained. Statistic analysis: The proportion of contaminated blood cultures between the pre and post periods was analyzed using Chi2 and the relationship between the proportion of the pre and post period vs the literature (3.00% acceptable contamination) using Z test for a proportion. P<0.05 was considered statistically significant. Stata 8 software was used.Results: A total of 3,965 blood cultures were analyzed during the study. Of these, 1,978 correspond to the pre-intervention period and 1,987 correspond to the post-intervention period. During the pre-intervention, 61 contaminated blood cultures were detected (3.08%) while in the post-intervention stage there were 30 contaminated blood cultures (1.51%). The proportion of contaminated blood cultures was reduced by half, 3.08% vs 1.51%, p: 0.001. An anonymous survey was carried out pre and post intervention, achieving improvements in the technique of taking blood cultures. Conclusion: The implementation of the own bundle for the extraction of blood cultures allowed the contamination rate to be reduced by ha

Frecuencia de síndrome metabólico en adultos mayores de la ciudad El Alto-Bolivia, gestión 2019 / Frequency of metabolic syndrome among elderly people in the city of El Alto, Bolivia, in 2019

INTRODUCCIÓN: el síndrome metabólico es una entidad compleja, compuesta por factores de riesgo cardiaco como: Obesidad, Diabetes. Hipertensión, dislipemia etc. OBJETIVO: determinar la frecuencia de síndrome metabólico en adultos mayores de la ciudad El Alto, durante la gestión 2019. METODOLOGÍA: investigación transversal cuantitativa, se evaluaron a 124 individuos, reclutados en Auki Utas por el gobierno autónomo municipal de El Alto, mediante coordinación con la Unidad de Protección al Adulto Mayor, durante la gestión 2019. Previo consentimiento informado, se determinó antropometría, tensión arterial, toma de muestra de sangre venosa, para procesamiento de pruebas bioquímicas, (glucemia, triglicéridos, colesterol total, HDL colesterol y LDL colesterol). RESULTADOS: el 62% (77/124) de la población estudiada se encuadra dentro del diagnóstico de síndrome metabólico, presentando datos alterados en por lo menos tres de los criterios evaluados. CONCLUSIONES: la población estudiada presenta altos porcentajes de síndrome metabólico, con mayor tendencia a la obesidad e hipertensión, por lo que es importante la promoción y prevención, ya que el sobrepeso y obesidad son factores de riesgo para la resistencia a la insulina, determinante de los demás criterios (marcadores), actividades de promoción y prevención son necesarias en la ciudad de El Alto, para evitar morbimortalidad por síndrome metabólico

INTRODUCTION: metabolic syndrome is a complex entity, composed of cardiac risk factors such as: obesity, diabetes. hypertension, dyslipidemia, etc. OBJECTIVE: determine a baseline regarding metabolic syndrome in older adults in the El Alto city, which can be used in the future to carry out potential preventive interventions. METHODOLOGY: quali-quantitative research, studied 124 individuals, recruited in Auki Utas by the Autonomous Municipal Government of El Alto city, through coordination with the Protection Unit for the Elderly, during the 2019 administration. Prior informed consent, anthropometry was determined blood pressure, venous blood sampling, for processing biochemical tests (blood glucose, triglycerides, cholesterol, HDL and LDL). RESULTS: 62% (77/124) of the studied population falls within the diagnosis of metabolic syndrome, presenting altered data in at least three of the evaluated entities. CONCLUSIONS: the population studied presents high percentages of metabolic syndrome, with a greater tendency to obesity and hypertension, so promotion and prevention is important, since overweight and obesity are risk factors for insulin resistance, a determinant of the other criteria (markers), promotion and prevention activities are necessary in the El Alto city, to avoid morbidity and mortality due to metabolic syndrome

Guia prático de coleta de sangue venoso para obtenção da fibrina rica em plaquetas / Practical guide for collecting venous blood for obtaining platelet rich fibrin

A Fibrina Rica em Plaquetas (PRF) é caracterizada por sua abrangente aplicabilidade na Odontologia. Neste sentido, a venopunção é uma etapa fundamental para sua obtenção. Tal procedimento consiste na identificação das veias superficiais, localizadas na região da fossa antecubital dos membros superiores, para que através da utilização do sistema a vácuo de coleta seja obtido o sangue venoso do paciente. O objetivo deste trabalho é realizar um guia prático abordando cada etapa que compreende a coleta sanguínea para produção do PRF permitindo sua reprodutibilidade de forma segura e eficiente.

Platelet Rich Fibrin (PRF) is characterized by its wide applicability in Dentistry. In this sense, venipuncture is a fundamental step towards obtaining it. Such procedure consists of the identification of superficial veins, located in the region of the antecubital fossa of the upper limbs, so that through the use of the vacuum collection system, the patient's venous blood is obtained. The objective of this work is to carry out a practical guide covering each step that comprises the blood collection for the production of the PRF allowing its reproducibility in a safe and efficient way.

Nivel de conocimiento sobre la extracción de hemocultivos en enfermeras de la Unidad de Cuidados Intensivos / Level of Knowledge about Blood Culture Extractions in Intensive Care Unit Nurses

Introducción: El hemocultivo es una prueba sencilla, pero existe el riesgo de contaminación por un inadecuado procedimiento, en muchas ocasiones puede estar relacionado con la mala praxis del personal de enfermería. Objetivo: Valorar el nivel de conocimientos sobre la técnica de extracción de hemocultivo en enfermeras de una Unidad de Cuidados Intensivos. Métodos: Se realizó estudio descriptivo, transversal, en la Unidad de Cuidados Intensivos del Centro Nacional de Cirugía de Mínimo Acceso, La Habana, en enero 2021. La población estuvo conformada por 12 licenciadas en enfermería, se aplicó un cuestionario de conocimiento con la escala de puntuación: 0-30 puntos (no conocimiento); 31-60 puntos (poco conocimiento); 61-90 puntos (adecuado conocimiento), 91-100 puntos (excelente conocimiento). Se calcularon las frecuencias absolutas, porcentaje, prueba T para una muestra y chi cuadrado. Se utilizó el programa IBM SPSS versión 20 para Windows. Resultados: De la muestra estudiada, 41,70 por ciento consideró que el hemocultivo se realiza a pacientes febriles y el uso de guantes estériles como único medio de protección; 33,30 por ciento hizo referencia al alcohol como antiséptico cutáneo de elección; 58,30 % planteó que se inoculan con diez ml de sangre y 66,70 por ciento afirmó que se debe comenzar por el aeróbico. El promedio de puntuación general fue de 64,25. Conclusiones: Los profesionales de enfermería mostraron un adecuado conocimiento, los guantes estériles fueron el medio de protección más utilizado, destaca el uso de alcohol 76 por ciento para la desinfección de la piel, diez mililitros es el volumen de sangre considerado a inocular en los frascos, existe adherencia a los protocolos de transporte y conservación de la muestra(AU)

Introduction: Blood culture is a simple test, but there is a risk of contamination due to an inadequate procedure, which many times can be related to malpractice of the nursing personnel. Objective: To assess the level of knowledge about the blood culture extraction technique in nurses of an intensive care unit. Methods: A descriptive and cross-sectional study was carried out in the intensive care unit of the National Center for Minimal Access Surgery, Havana, in January 2021. The population consisted of twelve registered nurses. A knowledge questionnaire was applied, which included the following scoring scale: 0-30 points (no knowledge), 31-60 points (little knowledge), 61-90 points (adequate knowledge), 91-100 points (excellent knowledge). Absolute frequencies, percentage, T-test for one sample and chi-square were calculated. The program IBM SPSS (version 20) for Windows was used. Results: Of the sample studied, 41.70 percent considered that blood culture is performed on febrile patients and the use of sterile gloves as the only means of protection. 33.30 percent referred alcohol as the skin antiseptic of choice. 58.30 percent stated that test tube or flask inoculation is completed with 10 mL of blood. 66.70 percent stated that the technique should start with the aerobic. The average overall score was 64.25. Conclusions: Nursing professionals showed adequate knowledge. Sterile gloves were the most used means of protection. The use of 76 percent-alcohol for skin disinfection is relevant. The volume of blood to empty into the flask or sample tube is 10 mL. The protocols for sample preservation and transport are followed(AU)

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

IL-6 levels are associated with clinical status in patients with Myasthenia Gravis / Os níveis de IL-6 estão associados com o status clínico de pacientes com Miastenia Gravis

BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease marked by fluctuating course of muscle weakness. OBJECTIVES: The current study was designed to evaluate plasma levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, and IL17A) in patients with MG and controls and to investigate whether cytokines levels are associated with clinical parameters. This study was conducted at the Neuromuscular Diseases Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brazil. METHODS: Peripheral blood was drawn, and plasma levels of cytokines were measured by cytometric bead array (CBA) in 80 treated patients with MG and 50 controls. The MG Composite (MGC) was used to evaluate muscle weakness and severity of typical motor symptoms of MG. RESULTS: Patients with MG undergoing treatment exhibit lower levels of all evaluated cytokines compared to controls. There was a negative correlation between IL-6 levels and the MG Composite score, indicating that higher levels of IL-6 were associated with better control of the disease. CONCLUSION: This exploratory study suggests that IL-6 is associated with MG clinical status, as assessed by the MGC.

INTRODUÇÃO: A Miastenia Gravis (MG) é uma doença autoimune caracterizada por fraqueza muscular flutuante. OBJETIVOS: avaliar os níveis plasmáticos de citocinas (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, e IL-17A) em pacientes com MG e controles e investigar se essas citocinas estão associadas com parâmetros clínicos. Este estudo foi conduzido no ambulatório de doenças neuromusculares do Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brasil. MÉTODOS: Foi coletado sangue periféricos e os níveis plasmáticos das citocinas foram medidos por citometria em 80 pacientes com MG tratados e em 50 controles. O MG composite (MGC) foi utilizado para avaliar a fraqueza muscular e a gravidade dos sintomas motores típicos da MG. RESULTADOS: Os pacientes com MG em tratamento apresentaram menores níveis de todas as citocinas avaliadas comparados ao controle. Houve uma correlação negativa entre os níveis de IL-6 e o MGC, indicando que altos níveis de IL-6 estão associados com melhor controle da doença. CONCLUSÃO: este estudo exploratório sugere que a IL-6 está associada com o status clínico da MG, quando avaliado pelo MGC.

Blood parameters of crioulo breed horse / Parâmetros sanguíneos de potros da raça Crioula

Plasma levels of hematocrit, total plasma protein, fibrinogen, creatine phosphokinase, aspartate transferase, and lactate were analyzed in blood samples of 85 Crioula breed foals, from birth to two years of age. The animals were divided into age groups: G1 (up to 15 days of age; n=70), G2 (from 16 days to one month of age; n=67), G3 (between one and three months of age; n=75), G4 (between three and six months of age; n=64), G5 (between six and nine months of age; n=59), G6 (between nine and 18 months of age; n=39), and G7 (between 18 months and two years of age; n=17). These groups were statistically analyzed by one-way variance analysis (ANOVA) and Tukey's test. Male and female means were compared by Student's t-test. Hematocrit levels were significantly higher up to 90 days of age and in G7 females. Total plasma proteins increased significantly in groups 3, 4, 6, and 7. The highest fibrinogen levels were found in G1. Yet for creatine phosphokinase, the highest concentrations were detected in G5, whereas those of aspartate aminotransferase in G7. The levels of this enzyme remained similar from 30 days to two years of age. Lactate concentrations were higher in G3. We concluded that the sex of the animal had no significant effect on laboratory test interpretations. By contrast, the age of the animal should be considered since relevant variations were observed with time. Nevertheless, specific tables for each analysis should be consulted for interpretation of results.

Com o propósito de estabelecer valores de hematócrito, proteínas plasmáticas totais, fibrinogênio, creatina quinase , aspartato transferase e lactato em potros da raça Crioula, do nascimento até os dois anos, utilizaram-se amostras sanguíneas de 85 animais, divididos pela estratificação etária: Grupo 1 (G1) Até 15 dias de vida (n=70); grupo 2 (G2), entre 16 dias até um mês (n=67); grupo 3 (G3), entre 1 e 3 meses (n=75); grupo 4 (G4), entre 3 e 6 meses (n=64); grupo 5 (G5), entre 6 e 9 meses (n=59); grupo 6 (G6), entre 9 e 18 meses (n=39); e grupo 7 (G7), entre 18 meses até 2 anos (n=17). Foi realizado estudo estatístico entre os grupos pela análise de variância unidirecional (one-wayANOVA), complementada pelo teste de Tukey. Para comparação das médias entre os sexos utilizou-se o teste t de Student. O hematócrito foi significativamente mais elevado até os 90 dias e nas fêmeas do G7. Para proteínas plasmáticas totais, notou-se aumento significativo nos grupos 3, 4, 6 e 7. Os valores de fibrinogênio foram maiores no G1. A CK apresentou maior concentração no G5 e a AST no G7. A AST assumiu valores semelhantes dos 30 dias até os 2 anos. A concentração de lactato foi mais elevada no G3. Conclui-se que na interpretação dos exames laboratoriais de potros da raça crioula, o gênero não interfere significativamente nos resultados, porém a idade deve ser considerada devido à ocorrência de variações relevantes. Recomenda-se que para interpretação sejam consultadas tabelas específicas para cada análise.

Blood serum stability limit and maximum storage time of bovine samples

Measuring metabolic parameters in the blood has been an indispensable tool for assessing the productive and health status of dairy cows for more than 100 years. The values of laboratory parameters depend on various preanalytical, analytical and postanalytical factors. The most important preanalytical factors are sample transport time and temperature, hemolysis, anticoagulant type, and sample volume. Preanalytical factors can lead to reduced stability of the analyte in the sample, which changes their concentration. Loss of stability changes the time of storage and manipulation of the sample, which determines the criteria for its acceptance or rejection. The two stability indicators are stability limit and maximum permissible instability. A stability limit (SL) is defined as the period of time in which a property variation does not exceed a maximum permissible instability (MPI). The aim of this study was to determine the SL and MPI for each analyte in the blood serum of cows and to determine whether SL differs in the function of the presence of preanalytical errors in the blood sample. Three hundred samples of dairy cow origin in different periods of lactation participated in this research. They were classified into 6 groups of 50 samples: according to the time from sampling to processing in the laboratory (0-4 h, 4-8 h and over 8 h; all transported on dry ice, protected from environmental factors, without preanalytical errors) and according to the presence of preanalytical errors (group with hemolysis, a group transported at ambient temperature and a group with a small sample volume). Each sample was aliquoted in two portions. One portion was left at +4°C and tested once a day for 6 days of sample storage, and the second portion, placed at -20°C, was tested once a month for 6 months. The MPI had a value ranging from 1.51 to 8.4. Metabolic profile analytes with lower MPI values (1.51-3.22) were albumin (ALB), total protein (TPROT), UREA, glucose (GLU), calcium (Ca), and phosphorus (P). Higher MPI values (5.1-8.4) were found for nonesterified fatty acids (NEFA), beta-hydroxybutirate (BHB), cholesterol (CHOL), triglycerides (TGC), total bilirubin (TBIL) and aspartat aminotransferase (AST). For most parameters, we can conclude that their PD% changed faster in storage conditions at +4°C compared to the regime of -20°C. The largest number of biochemical analytes in bovine blood serum shows preserved stability in the first 6 days at +4°C or 6 months at -20°C if transported to the laboratory within 8 h after sampling in ideal conditions and without the action of preanalytical errors. Prolonged transport under ideal conditions or the existence of preanalytical errors such as transport at room temperature, hemolysis or small sample volume shorten the stability of the ALB, NEFA, GLU, UREA and P. Concentration of all analytes decreases during the stability test except for UREA, NEFA, BHB and for CHOL and TGC in some groups. Variations in parameters such as BHB, NEFA, TBIL, AST, and Ca have shown potential clinical significance. At storage conditions at +4°C, clinically significant variations at at least one measurement point were found for AST (7.5% of samples), BHB (6.1% of samples), NEFA (9.9% of samples) and for TBIL (in 7% of samples). This study can help define acceptable delay times and storage conditions for bovine blood samples, which is of great importance because in working with farm animals it is often not possible to take samples in a short time and deliver them to the laboratory, and samples are often burdened with certain preanalytical errors with limited possibilities of re-sampling.(AU)

Effects of Peripheral Blood Different Pretreatment Methods and Preservation Time on RNA Quality / 法医学杂志

OBJECTIVES@#To evaluate the effects of different pretreatment methods and preservation time on RNA quality of peripheral blood samples, and to optimize the preservation method of peripheral blood samples.@*METHODS@#Eight pretreatment methods were used to preprocess the peripheral blood from 3 healthy unrelated individuals and the treated samples were stored at -80 ℃. Total RNA of samples was extracted using Quick-RNATM Miniprep Plus kit. DNA/RNA ShieldTM was added to peripheral blood and total RNA was extracted after preservation at -80 ℃ for 0, 5, 10, 15, 30 and 60 days, respectively. The concentration, purity and integrity of RNA were determined. Statistical analyses were performed by SPSS 22.0 software to compare the differences in RNA yield, purity and integrity among the eight pretreatment methods.@*RESULTS@#In terms of purity, leukocyte pretreated with RNAlaterTM and directly cryopreservation peripheral blood showed the worst purity. The other six methods showed better purity. In terms of yield, blood cells with DNA/RNA ShieldTM came out with the highest yield, followed by peripheral blood with DNA/RNA ShieldTM. In terms of integrity, peripheral blood preserved in PAXgene Blood RNA tube method had the best integrity. Except for peripheral blood pretreated with DNA/RNA ShieldTM and blood cells pretreated with DNA/RNA shieldTM, the other five methods had statistical differences when compared to the method by keeping peripheral blood in PAXgene Blood RNA tube. The purity of RNA stored at six-time gradients ranged from 1.815 to 1.952. With the increase of storage time, RNA yield decreased from 4.516 ng to 1.039 ng, and RNA integrity decreased from 8.533 to 7.150.@*CONCLUSIONS@#According to the results of total RNA's yield, purity and integrity, peripheral blood pretreated with DNA/RNA ShieldTM was the best pretreatment method. After the pretreatment, samples can be preserved for up to 60 days in low temperature.

Clinical assessment of acid-base balance in Netherland Dwarf rabbit / Avaliação clínica do equilíbrio ácido-básico em coelhos Anã Holandês

Pet rabbits have increased their popularity in a lot of countries. However, most of the laboratory profiles in rabbit medicine come from the observations made in rabbit as biomodels or meat production. So that further researches are necessary to obtain reference values for hematology and biochemical profiles in pet rabbits and the different breeds, especially, in relation to acid-base balance. The aim of this report was to offer the mean values of the main parameters connected with acid-base profile in Netherland Dwarf breed. Thirty-five healthy rabbits (15 males and 20 females) were studied. Venous blood sample from lateral saphenous vein was analyzed to measure: haematocrit, haemoglobin, blood urea nitrogen, glucose, blood pH, partial pressure of CO2 (pCO2), total CO2, ions bicarbonate, chloride, sodium, potassium, base excess and anion Gap. Results showed a shorter range that those reported by different researchers. Moreover, differences between genders were showed in pCO2, its values were higher in males. It may be associated with a greater cellular metabolism. Values obtained in this research should be taken into account by veterinary clinicians for this breed in their clinical assessments. Besides, these values provide new results in parameters with few reference values.

A popularidade de coelhos como animais de estimação aumentou em muitos países. No entanto, a maioria dos perfis de laboratório em medicina de coelhos advém das observações de biomodelos animais ou da produção de carne. Assim, são necessárias pesquisas adicionais para obter valores de referência para hematologia e perfis bioquímicos em coelhos de estimação, e das diferentes raças, especialmente, em relação ao equilíbrio ácido-base. O objetivo deste relatório foi oferecer os valores médios dos principais parâmetros ligados ao perfil ácido-base na raça Anã Holandês. Trinta e cinco coelhos saudáveis ​​(15 machos e 20 fêmeas) foram estudados. A amostra de sangue venoso da veia safena lateral foi analisada para mensuração: hematócrito, hemoglobina, nitrogênio ureico sanguíneo, glicose, pH sanguíneo, pressão parcial de CO2 (pCO2), CO2 total, íons bicarbonato, cloreto, sódio, potássio, excesso de base e ânion Gap. Os resultados apresentaram um intervalo menor do que aqueles relatados por diferentes pesquisadores. Além disso, as diferenças entre os gêneros foram mostradas na pCO2, seus valores foram maiores no sexo masculino. Pode estar associado a um maior metabolismo celular. Os valores obtidos nesta pesquisa devem ser levados em consideração pelos clínicos veterinários para esta raça em suas avaliações clínicas. Além disso, esses valores fornecem novos resultados em parâmetros com poucos valores de referencia.

La Donación de Sangre / Blood donation

La donación de sangre es un procedimiento muy común en medicina, por eso tiene relevancia el estudio de las complicaciones frecuentes en los donantes y en especial las asociadas con la ferropenia. El procedimiento reporta beneficios tanto por la utilidad futura del producto como por los efectos favorables para la salud del donante; sin embargo, se han descrito complicaciones recurrentes derivadas tanto de la extracción de sangre total como de sus componentes por separado. En este artículo de revisión se encuentra la información relacionada con los factores de riesgo asociados con esta práctica y las principales complicaciones que pueden aparecer como es la depleción de hierro, con el fin de ilustrar al lector sobre los factores predisponentes en donantes iniciales y habituales. Se concluye que las reacciones más frecuentes son las vasovagales y algunas otras que pueden conllevar a síntomas indeseados, pero es la disminución de los niveles de hierro una de las complicaciones más alarmantes. Hay evidencia de factores como sexo, edad, nivel socioeconómico, dieta y tipo de sangre que favorecen la probabilidad de desarrollar complicaciones por deficiencia de hierro en los donantes.

Blood donation is a very common medical procedure, thus, it is important to review the most frequent complications indonors, especially blood-donation-induced iron deficiency. The procedure is beneficial both for the future usefulness of blood and blood products as well as the favorable health effects for the donors; however, recurrent complications derived from the collection of whole blood and blood components separately, have been described. This review article contains information related to the risk factors associated with this practice and the main complications that may appear, such as iron depletion, in order to enlighten the reader on the predisposing factors among first-time and repeat donors. It was concluded that vasovagal reactions are the most frequent reactions as well as other reactions that can lead to unwanted symptoms, but the decrease in iron levels is one of the most alarming complications. Sex, age, socioeconomic level, diet and blood type have been evidenced as factors that favor the probability of developing complications due to iron deficiency in donors.

Haematology of Mugil curema from the north coast estuary of Santa Catarina state, Brazil / Hematologia de Mugil curema em estuário no litoral norte do estado de Santa Catarina, Brasil

Mugil curema is a teleost fish often found in coastal, estuarine and lagoon regions throughout the Brazilian coast. Blood parameters may be used as health and welfare indicators of the fish, as well as the environment they live in. The aim of this study was to verify the hematologic profile of the M.curema along 18 months in estuary waters from the north coast of the state of Santa Catarina in the south of Brazil. A total of 133 M. curema fish were captured from March 2016 to August 2017. Erythrogram, leukogram, thrombocytogram, hematocrit percentage, hemoglobin dosage, total plasma protein dosage, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and medium corpuscular hemoglobin concentration (MCHC) were analyzed. There was no significant difference (P>0.05) on the total number of erythrocytes between the fish gender. However, there was difference on the hematocrit between males and indefinite gender fish. The influences of temporal and geographical space, among the values of hematological parameters, in the different studies of the Brazilian coast are discussed.. The present research is an important contribution to establish a hematological pattern for M. curema. The local population of the studied fish has a proper behavior in hematological descriptors, which is different from other Brazilian coast studies with the same fish species.

Mugil curema é um peixe teleósteo, abundante em regiões costeiras, estuarinas e lagunares, em todo o litoral brasileiro. Os parâmetros sanguíneos podem ser usados como indicadores da saúde e do bem-estar dos peixes, bem como do ambiente onde estes vivem. O objetivo deste estudo foi verificar o perfil hematológico de M. curema ao longo de 18 meses, em águas estuarinas, no Litoral norte do estado de Santa Catarina, sul do Brasil. Um total de 133 peixes foram capturados, entre março de 2016 e agosto de 2017, para realização de eritrograma, leucograma, trombocitograma, porcentagem de hematócrito, dosagem de hemoglobina, dosagem de proteína plasmática total, volume corpuscular médio (VCM), hemoglobina corpuscular média (HCM) e concentração de hemoglobina corpuscular média (CHCM). Não houve diferença significativa (P>0,05) entre o número total de eritrócitos entre machos e fêmeas. No entanto, houve diferença no hematócrito, entre machos e peixes de sexo indeterminado. As influências do espaço temporal e geográfico, entre os valores dos parâmetros hematológicos, nos diferentes estudos do litoral brasileiro são discutidas. A presente investigação é importante contribuição para o estabelecimento de um padrão hematológico para M. curema. A população local de peixes estudada tem comportamento próprio em descritores hematológicos, diferenciado de outros estudos no litoral brasileiro para a mesma espécie.

Eficácia do uso do álcool etílico 70% na antissépsia da pele antes da coleta de sangue / Efficacy of 70% ethyl alcohol use o9n skin antissepsia before blood collection

Objetivo ­ Quantificar a presença de agentes da flora microbiana da pele de usuários da sala de coleta de uma unidade básica de saúde ­ UBS, assim como verificar a eficácia da antissepsia da pele com o uso do álcool etílico 70% prévia à coleta de sangue. Métodos ­ A coleta da região antecubital do braço dos 40 pacientes selecionados aleatoriamente, foi realizada antes e após antissepsia do local com álcool etílico 70%, com auxílio de um swab embebido em solução fisiológica estéril para posterior transporte e processamento o qual foi realizado no laboratório escola da Universidade Paulista UNIP, campus JK, São José do Rio Preto. Resultados ­ Das 80 amostras (40 antes da antissepsia e 40 depois da antissepsia) coletadas, foi observada uma redução de 87,01% do número de colônias de micro-organismos identificados como cocos e bacilos Gram-positivos, catalase positivos. Conclusão ­ Os resultados da pesquisa permitem concluir que o álcool etílico a 70% é eficaz na antissepsia da pele e que a antissepsia com álcool etílico 70% reduz a flora microbiana da pele conferindo maior segurança e liberdade de riscos ao procedimento prévio à coleta de sangue.

Objective ­ To quantify the presence of agents of the microbial flora of the skin of patients in the collection room of a hospital (UBS) as well as to verify the efficacy of skin antisepsis with the use of 70% ethyl alcohol prior to blood collection. Methods ­ The collection of the antecubital region of the arm of the 40 randomly selected patients was performed before and after site antisepsis with 70% ethyl alcohol, with the aid of a swab soaked in sterile solution for subsequent transportation and processing, which was performed in the laboratory University of São Paulo UNIP, JK campus, São José do Rio Preto. Results ­ From the 80 samples (40 before antisepsis and 40 after antisepsis) collected, a reduction of 87.01% in the number of colonies of microorganisms identified as cocci and gram positive bacilli, catalase positive, was observed. Conclusion ­ The results of the research allow us to conclude that 70% ethyl alcohol is effective in antisepsis of the skin and that antisepsis with 70% ethyl alcohol reduces the microbial flora of the skin giving greater safety and reduced risk to the procedure prior to blood collection

Actividad de las enzimas pancreáticas exocrinas en ratas hembras diabéticas / Activity of exocrine pancreatic enzymes in diabetic female rats

The study designed to evaluated the activity of pancreatic exocrine enzymes in diabetic male rats induced by alloxan. The hyperglycaemia was induced in forty-five rats after fasting of the animals for 24 hours by single intraperitoneal (i.p) injection of Alloxan100mg/kg B.W., three days after injection fasting blood glucose was measured when the concentration higher than 150mg/dL, were considered as hyperglycemic/ diabetes. A total of sixty adult male rats (45 diabetes and 15 non- diabetes) divided in to two groups as follows. The first group serves as control groups (15 animals) will be single i.p injection with distilled water. the second group diabetic groups (45 animals from first experiment) were subdivided into three subgroups as following (15 for each). Group (G1), Group (G2) and Group (G3) serves as 20, 40- and 60-days diabetic animals respectively. The blood samples collection were take through cardiac puncture technique from each rat for each period days for measurement the following parameters: (Serum glucose, total protein, insulin, cholesterol, albumin, triglyceride, LDL-C, HDL-C and VLDL-C) concentration, the rats pancreatic tissue were be taken for measured tissue pancreatic lipase, amylase, and trypsin concentration. The results demonstrate a significant increase in serum glucose concentration and a decrease in serum insulin and total protein in the diabetic group as compared with the control rats' group in all experimental days. The results showed a significant rise in serum total cholesterol concentration within the diabetic group when compared with the control group at day 20 and 60. Meanwhile, a significant increase in serum triglyceride and LDL concentration and a significant decrease in serum HDL concentration within the diabetic group when compared with the control rats group at day 20, 40 and 60. But the serum VLDL concentration depicted a significant increase in the group of diabetic when compared with the control rats group at day 40 and 60. The value of pancreatic tissue protease activity clarified there was a significant decrease of protease action in the group of diabetic rats when compared with the control rats group on both day 20 and day 60. And a significant decrease in amylase activity in the diabetic groups when compared with the group of control rats in both day 20, 40 and day 60. While the results of pancreatic tissue lipase show there were non-significant changes within the diabetics group when compared with the control group. In conclusion, the exocrine pancreatic function is very frequently and severely altered in diabetes mellitus male rats and the metabolic disorder effect of diabetes mellitus was manifested by hyperlipidemic and hypoprotenimic .

Estudio de problemas de enfermedades causados ​​por Salmonella y relación con la fiebre tifoidea / Study of Illness Problems Caused By Salmonella and Relation with Typhoid

There is urgent need to address illness problems caused by Salmonella enteric serotype Typhibacteria. The bacteria are deposited in water or food by human carrier and are then spread to other people in the area. In this research, a blood specimens were collected from typhoid fever patients, and serum levels of IFN-γ and IL-6 during the chronic and acute phase in typhoid patients group was determined according protocol kit and calculation, results were higher levels in chronic phase (137.187 ± 0.703.427 ± 206.545pg/ml respectively) and in acute phase were 128.787 ± 2.522, 137.733 ± 23.424 pg/ml, respectively with highly significant (P ≤ 0.01) than those in healthy control group. Salmonella infects hosts as diversified as human, animal, and plant

Plano de contingência municipal ao Covid 19: Aguiarnópolis-TO / Municipal contingency plan to Covid 19: Aguiarnópolis-TO

Trata de documento com diretrizes para promover a prevenção, proteção à saúde e evitar a transmissão de casos de infecção pelo COVID-19 no município de Aguiarnópolis no estado do Tocantins. Orienta as equipes de saúde quanto à infecção humana por vírus Covid19 e padronizar a rotina nos serviços quanto a identificação, investigação, notificação, e assistência a caso suspeito de Doença Respiratória Aguda pelo 2019 - nCoV, de modo a evitar e/ou mitigar os riscos de transmissão. Capacitar as equipes de saúde quanto as medidas de prevenção de contaminação por Covid 19. Evitar transmissão do vírus para profissionais de saúde, contatos próximos e população em geral. Orientar sobre a conduta na identificação e assistência a paciente suspeito de infecção por coronavírus. Disseminar informações epidemiológicas e sobre a infecção pelo vírus.

It deals with a document with guidelines to promote prevention, health protection and prevent the transmission of cases of infection by COVID-19 in the municipality of Aguiarnópolis in the state of Tocantins. Guides health teams about human infection by Covid virus19 and standardize the routine in services regarding the identification, investigation, notification, and assistance to a suspected case of 2019 Acute Respiratory Disease - nCoV, in order to avoid and / or mitigate the risks transmission. Train health teams on measures to prevent contamination by Covid 19. Avoid transmission of the virus to health professionals, close contacts and the general population. To advise on the conduct in identifying and assisting a patient suspected of having a coronavirus infection. Disseminate epidemiological and virus infection information.

Se trata de un documento con lineamientos para promover la prevención, protección de la salud y prevenir la transmisión de casos de infección por COVID-19 en el municipio de Aguiarnópolis en el estado de Tocantins. Orienta a los equipos de salud sobre la infección humana por virus Covid19 y estandariza la rutina en los servicios en cuanto a la identificación, investigación, notificación y asistencia a un caso sospechoso de Enfermedad Respiratoria Aguda 2019 - nCoV, con el fin de evitar y / o mitigar los riesgos. transmisión. Capacitar a los equipos de salud sobre las medidas para prevenir la contaminación por Covid 19. Evitar la transmisión del virus a profesionales de la salud, contactos cercanos y población en general. Asesorar sobre la conducta en la identificación y asistencia de un paciente sospechoso de tener una infección por coronavirus. Difundir información epidemiológica y sobre infecciones virales.

Il traite d'un document contenant des lignes directrices pour promouvoir la prévention, la protection de la santé et prévenir la transmission des cas d'infection par COVID-19 dans la municipalité d'Aguiarnópolis dans l'état de Tocantins. Guider les équipes de santé sur l'infection humaine par le virus Covid19 et normaliser la routine des services concernant l'identification, l'enquête, la notification et l'assistance d'un cas suspect de maladie respiratoire aiguë 2019 - nCoV, afin d'éviter et / ou d'atténuer les risques transmission. Former les équipes de santé aux mesures de prévention de la contamination par Covid 19. Éviter la transmission du virus aux professionnels de la santé, aux contacts étroits et à la population en général. Donner des conseils sur la conduite à suivre pour identifier et assister un patient suspecté d'avoir une infection à coronavirus. Diffuser des informations épidémiologiques et sur les infections virales.

Utilização da técnica broken needle para punção venosa periférica na assistência a recém-nascidos prematuros / Using the broken needle technique for peripheral venous puncture in assistance to premature newborn / Utilización de la tecnica broken needle para punto venosa periférica en la asistencia a reciénnos prematuros

Objetivo: compreender a utilização da técnica broken needle de punção venosa periférica na prática profissional de assistência a neonatos prematuros. Método: estudo qualitativo realizado por meio de entrevista a profissionais da assistência neonatal submetida à Análise de Conteúdo segundo Bardin. Resultados: foram identificadas as categorias: percepções dos profissionais quanto aos benefícios da técnica broken needle para o neonato; e aprendizado e vivência profissional da técnica broken needle. Conclusão: a transferência do conhecimento de um profissional ao outro favoreceu a incorporação da técnica na instituição. A equipe se preocupa em realizar técnicas que sejam menos agressivas ao neonato e, portanto, realizam a broken needle porque acreditam que seja mais vantajosa e benéfica e não tenha efeitos adversos ao neonato. Os profissionais decidem qual técnica utilizar, levando em consideração as características anatômicas e clínicas do neonato, a sua habilidade e a segurança na execução

Objective: to understand the use of the broken needle technique peripheral venous puncture in the professional practice of assistance to preterm infants. Method: qualitative study conducted through interviews with neonatal care professionals submitted to Content Analysis to Bardin. Results: the following categories were identified: Professional perceptions regarding the benefits of the broken needle technique for the neonate; Learning and professional experience of broken needle technique. Conclusion: the transfer of knowledge from one professional to another favored the incorporation of the technique in the institution. The team is concerned with performing techniques that are less aggressive to the newborn and therefore perform the broken needle because they believe it is more advantageous and beneficial and has no adverse effects on the neonate. The professionals decide which technique to use taking into account the anatomical and clinical characteristics of the neonate, their ability and safety in the execution

Objetivo: comprender el uso de la técnica broken needle de punción venosa periférica en la práctica profesional de asistencia a neonatos prematuros. Método: estudio cualitativo realizado por medio de entrevista a profesionales de la asistencia neonatal sometida al Análisis de Contenido según Bardin. Resultados: se identificaron las categorías: Percepciones de los profesionales en cuanto a los beneficios de la técnica broken needle para el neonato; Aprendizaje y vivencia profesional de la técnica broken needle. Conclusión: la transferencia del conocimiento de un profesional al otro favoreció la incorporación de la técnica en la institución. El equipo se preocupa de realizar técnicas que sean menos agresivas al neonato y, por lo tanto, realizan la técnica porque creen que es más ventajosa y benéfica y no tiene efectos adversos al neonato. Los profesionales deciden qué técnica utilizar teniendo en cuenta las características anatómicas y clínicas del neonato, su habilidad y seguridad en la ejecución

VIDA - Nursing v1. 0 immersive virtual reality in vacuum blood collection among adults / VIDA - Enfermagem v1. 0 realidade virtual imersiva na coleta de sangue a vácuo em adulto / VIDA - Enfermería v1. 0 realidad virtual inmersiva en la recolección de sangre al vacío en adultos

Objective: to develop and validate the first immersive virtual reality simulation addressing vacuum blood collection in adult patients - VIDA-Nursing v1.0. Method: methodological study to validate 14 steps of the vacuum blood collection procedure in adults, designed to develop the immersive virtual reality simulator VIDA-Nursing v1.0. It was assessed by 15 health workers and 15 nursing undergraduate students in terms of visual, interactive, movement simulation reality, teaching and user-friendly aspects. Results: the workers considered 79.6% of the items to be valid, while the students considered 66.7% of the items valid; most of the demands can be implemented in the system by improving future versions. Conclusion: the simulator was considered a promising and innovative tool to teach vacuum blood collection in adults as it can be combined with other resources currently used to introduce this topic and technique in the education of undergraduate nursing students.

Objetivo: desenvolver e validar a primeira versão do simulador de realidade virtual imersiva no procedimento de coleta de sangue a vácuo no paciente adulto - VIDA-Enfermagem v1.0. Método: estudo com delineamento metodológico para validar 14 etapas do procedimento de coleta de sangue a vácuo no adulto, projetadas para o desenvolvimento do simulador de realidade virtual imersiva VIDA-Enfermagem v1.0, o qual foi avaliado por 15 profissionais da saúde e 15 graduandos de enfermagem em relação aos aspectos visual, interativo, realidade de simulação do movimento, pedagógico e esforço de utilização. Resultados: de maneira geral foram considerados válidos 79,6% dos itens avaliados pelos profissionais e 66,7% dos itens avaliados pelos graduandos, sendo que a maioria das necessidades de melhorias do sistema é passível de correção no incremento das próximas versões. Conclusão: o simulador foi considerado como ferramenta promissora e inovadora para o ensino da coleta de sangue a vácuo no adulto, enquanto estratégia a ser combinada com recursos utilizados atualmente na educação de graduandos de enfermagem que estão iniciando o estudo da temática e da técnica.

Objetivo: desarrollar y validar la primera versión del simulador de realidad virtual inmersivo en el procedimiento de recolección de vacío de sangre en pacientes adultos: VIDA-Enfermería v1.0. Método: estudio con diseño metodológico para validar 14 pasos del procedimiento de extracción de sangre al vacío en adultos, diseñado para el desarrollo del simulador inmersivo de realidad virtual VIDA-Enfermería v1.0, que fue evaluado por 15 profesionales de la salud y 15 estudiantes universitarios de enfermería con relación a los aspectos visual, interactiva, realidad de movimiento, pedagógico y esfuerzo de uso. Resultados: en general, el 79.6% de los ítems evaluados por los profesionales y el 66.7% de los ítems evaluados por los estudiantes de pregrado se consideraron válidos, y la mayoría de las necesidades de mejoras del sistema están sujetas a corrección en el incremento de las próximas versiones. Conclusión: el simulador fue considerado como una herramienta prometedora e innovadora para enseñar la extracción de sangre al vacío en adultos, como una estrategia que se combina con los recursos utilizados actualmente en la educación de estudiantes de enfermería que están comenzando a estudiar el tema y la técnica.