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2.
REME rev. min. enferm ; 23: e-1219, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1051145

ABSTRACT

OBJETIVO: analisar o impacto da educação permanente na prevenção e no controle da infecção do trato urinário em pacientes submetidos ao procedimento de cateterismo vesical de demora. MÉTODO: estudo quase experimental do tipo antes e depois, com intervenção educacional sobre os cuidados relacionados a inserção, manutenção e retirada do cateter vesical de demora. Aplicação de escala de 20 questões com 124 enfermeiros e técnicos de Enfermagem para medida do conhecimento. Realizou-se análise da mudança do padrão de comportamento do pré-teste para o pós-teste, por meio de escala global, e análise de covariância, nos quais se ajustou a reta de regressão por categoria profissional. Para analisar o conhecimento e as condutas do procedimento de cateterismo vesical de demora, foram utilizados os testes de Levene para igualdade de variâncias, teste t para amostras independentes, testes inferenciais não paramétricos e teste qui-quadrado. RESULTADOS: na análise global do estudo, partindo das 20 questões consideradas, observou-se que, em média, os técnicos de Enfermagem em comparação aos enfermeiros obtiveram ganho de sete pontos do pré-teste para o pós-teste (≅12,00 para ≅19,00), enquanto os enfermeiros obtiveram 4,0 pontos (≅16 para ≅20,00). CONCLUSÃO: a intervenção educacional aumentou significativamente o conhecimento dos profissionais de saúde sobre o procedimento de cateterismo vesical de demora e colaborou para a redução da taxa de infecção das infecções de trato urinário na instituição, bem como uma evolução no patamar de conhecimento, principalmente dos técnicos de Enfermagem após as intervenções educativas.(AU)


Objective: to analyze the impact of continuing education on the prevention and the control of urinary tract infection in patients undergoing a delayed bladder catheterization procedure. Method: a quasi-experimental study of before and after type with an educational intervention on the care related to insertion, maintenance, and removal of the delayed bladder catheter. We applied a scale of 20 questions with 124 nurses and Nursing technicians to measure their knowledge. We analyzed the change in the behavioral pattern from the pretest to the posttest, by a global scale, and covariance analysis, which adjusted the regression line by professional category. To analyze the knowledge and behaviors of the delayed bladder catheterization procedure, Levene's tests for equality of variance, t-test for independent samples, nonparametric inferential tests, and chi-square tests were used. Results: in the overall analysis of the study, starting from the 20 questions considered, it was observed that, on average, Nursing technicians compared to nurses obtained seven points from the pretest to the posttest (≅12,00 to ≅19,00), while nurses scored 4.0 points (≅16 to ≅20.00). Conclusion: the educational intervention significantly increased...(AU)


Objetivo: analizar el impacto de la educación continua en prevención y control de infecciones del tracto urinario en pacientes sometidos a procedimiento de cateterismo vesical intermitente. Método: estudio cuasi-experimental realizadas antes y después del procedimiento, con intervención educativa sobre cuidados con la inserción, mantenimiento y extracción de la sonda vesical intermitente. Se utilizó una escala de 20 preguntas con 124 enfermeros y técnicos de enfermería para medir el conocimiento. Se analizó el análisis del cambio en el patrón de comportamiento de la prueba previa y de la prueba posterior, mediante una escala global, y análisis de covarianza, que ajustó la línea de regresión por categoría profesional. Para analizar el conocimiento y las conductas del procedimiento de cateterismo vesical intermitente, se emplearon las pruebas de Levene para igualdad de varianzas, prueba t para muestras independientes, pruebas inferenciales no paramétricas y chi-cuadrado. Resultados: en el análisis general del estudio, basado en las 20 preguntas consideradas, se observó que, en promedio, los técnicos de enfermería en comparación con los enfermeros obtuvieron siete puntos más de la prueba previa a la posterior (≅12,00 para ≅19,00), mientras que los enfermeros obtuvieron 4,0 puntos (≅16 para ≅20,00). Conclusión: la intervención educativa aumentó significativamente el conocimiento de los profesionales de la salud sobre el procedimiento de cateterismo vesical intermitente y contribuyó a la reducción de la tasa de infección entre las infecciones del tracto urinario en la institución, así como a aumentar el nivel de conocimiento, especialmente de los técnicos de Enfermería después de las intervenciones educativas.(AU)


Subject(s)
Humans , Urinary Tract Infections/prevention & control , Urinary Catheterization , Education, Nursing, Continuing , Disease Prevention , Education, Continuing
3.
Arch. argent. pediatr ; 116(2): 126-132, abr. 2018. tab, ilus
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-887458

ABSTRACT

Introducción. En los estudios realizados se encontró que la duración de la lactancia tiene un efecto reductor sobre las infecciones frecuentes en los niños durante el período de lactancia. Objetivo. El objetivo de este estudio fue abordar la asociación entre la duración de la lactancia y las enfermedades infecciosas frecuentes en los niños hasta los 5 años de edad para demostrar los efectos protectores de la leche materna. Población y métodos. Se incluyeron 411 lactantes nacidos en Rize, Turquía, entre enero de 2011 y diciembre de 2011. Este estudio de cohorte, prospectivo duró cinco años; en este período, se realizaron 11 entrevistas con cada madre de los lactantes. Se dividió a los lactantes en dos grupos: amamantados durante más y menos de 12 meses, y se estudió la asociación entre la lactancia y las infecciones, como otitis media aguda, gastroenteritis aguda, infección respiratoria aguda e infección urinaria. Resultados. De los 411 nacimientos, se incluyeron 270 lactantes, 193 (71,5%) recibieron lactancia durante más de 12 meses y 77 (28,5%), durante menos de 12 meses. Los lactantes del primer grupo tuvieron menos casos de otitis media aguda y gastroenteritis aguda (n = 77; 28,52%) en comparación con los lactantes amamantados durante menos de 12 meses en el período de cinco años (p < 0,05). Conclusiones. Con este estudio se detectó que la lactancia durante más de 12 meses reduce significativamente las infecciones frecuentes durante la niñez, como la otitis media y la gastroenteritis durante los primeros cinco años de vida.


Introduction.The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. Objective. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. Material and methods. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Results. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). Conclusion. The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Otitis Media/prevention & control , Respiratory Tract Infections/prevention & control , Urinary Tract Infections/prevention & control , Breast Feeding , Gastroenteritis/prevention & control , Otitis Media/etiology , Otitis Media/epidemiology , Respiratory Tract Infections/etiology , Respiratory Tract Infections/epidemiology , Time Factors , Turkey , Urinary Tract Infections/etiology , Urinary Tract Infections/epidemiology , Prospective Studies , Follow-Up Studies , Protective Factors , Gastroenteritis/etiology , Gastroenteritis/epidemiology
4.
Rev. latinoam. enferm. (Online) ; 24: e2678, 2016. graf
Article in English | LILACS (Americas) | ID: biblio-960949

ABSTRACT

Objective to describe strategies used by health professionals on the implementation of the Centers for Disease Control and Prevention guidelines for the prevention of urinary infection related to catheterism. Method systematic review on literature based on data from CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals and Wiley Online Library. A sample of 13 articles was selected. Results studies have highlighted the decrease of urinary tract infection related to catheterism through reminder systems to decrease of people submitted to urinary catheterism, audits about nursing professionals practice and bundles expansion. Conclusion the present review systemizes the knowledge of used strategies by health professionals on introduction to international recommendations, describing a rate decrease of such infection in clinical practice.


Objetivo descrever as estratégias que os profissionais de saúde utilizam na implementação das guidelines emanadas pelo Centers for Disease Control and Prevention na prevenção da infeção do trato urinário associada ao cateterismo. Método revisão de literatura em bases de dados CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals e Wiley Online Library. Selecionou-se uma amostra de 13 artigos. Resultados estudos evidenciam a diminuição da infeção do trato urinário associada ao cateterismo através de: sistemas lembrete para diminuição de pessoas submetidas ao cateterismo urinário; auditorias sobre prática dos profissionais de enfermagem e aplicação de bundles. Conclusão a presente revisão sistematiza o conhecimento das estratégias utilizadas pelos profissionais de saúde na implementação de recomendações internacionais, descrevendo a diminuição da taxa destas infeções na prática clínica.


Objetivo describir las estrategias que los profesionales de la salud utilizan en la implementación de las directrices emitidas por los Centers for Disease Control and Prevention en la prevención de la infección del tracto urinario asociada al cateterismo. Método revisión sistemática de la literatura en las bases de datos CINAHL(r), Nursing & Allied Health Collection, Cochrane Plus Collection, MedicLatina, MEDLINE(r), Academic Search Complete, ACS - American Chemical Society, Health Reference Center Academic, Nursing Reference Center, ScienceDirect Journals y Wiley Online Library. Se seleccionó una muestra de 13 artículos. Resultados los estudios muestran una disminución de la infección del tracto urinario asociada al cateterismo mediante: sistemas recordatorios para la disminución de personas sometidas a cateterismo urinario; auditorías sobre la práctica de los profesionales de enfermería y aplicación de bundles. Conclusión esta revisión sistematiza el conocimiento de las estrategias utilizadas por los profesionales de la salud en la implementación de las recomendaciones internacionales, describiendo la disminución de la tasa de estas infecciones en la práctica clínica.


Subject(s)
Humans , Urinary Tract Infections/prevention & control , Practice Guidelines as Topic , Guideline Adherence/standards , Catheter-Related Infections/prevention & control , Health Personnel
5.
Rev. latinoam. enferm. (Online) ; 24: e2804, 2016. tab, graf
Article in English | LILACS (Americas) | ID: biblio-961026

ABSTRACT

ABSTRACT Objective: to compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter use, and to identify microorganisms in urine cultures and surveillance cultures before and after the implementation of a clinical protocol for intensive care unit patients . Method: urinary tract infection is defined as a positive urine culture > 105 CFU/mL, notified by the hospital infection control service, six months before and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation. The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare-related infections; the goal is patient safety and improving the quality of health services. Results: a negative linear correlation was observed between the later months of implementation and the reduction of reported cases of urinary tract infection, using the Spearman rank order coefficient (p = 0.045), and a reduction in the number of urine culture microorganisms (p = 0.026) using the Fisher exact test. Conclusion: educational interventions with implementation protocols in health institutions favor the standardization of maintenance of the invasive devices, which may reduce colonization and subsequent infections.


RESUMO Objetivo: comparar os resultados da incidência de infecção do trato urinário, por meio da taxa de utilização do cateter vesical de demora e identificar os micro-organismos na urocultura e cultura de vigilância antes e após a implementação de um protocolo assistencial em pacientes internados em unidade de terapia intensiva. Método: definiu-se infecção do trato urinário pacientes com urocultura positiva >105 UFC/mL, notificados pelo Serviço de Controle de Infecção Hospitalar, seis meses antes e após a implementação do protocolo. A amostra foi constituída por 47 pacientes, sendo 28 notificados antes e 19 após. O protocolo, criado na instituição, é baseado no manual do Ministério da Saúde na prevenção de infecções relacionadas à assistência a saúde, como meta a segurança do paciente e o aperfeiçoamento na qualidade dos serviços de saúde. Resultados: foi possível observar uma correlação linear negativa entre os meses posteriores da implementação e a redução dos casos notificados de infecção do trato urinário, pelo teste de Spearman (p=0,045) e redução do número de micro-organismos na urocultura (p=0,026) pelo teste de Fisher. Conclusão: intervenções educativas com implementação de protocolos nas instituições de saúde favorece a padronização da manutenção com dispositivos invasivos podendo reduzir a colonização e posterior casos de infecção.


RESUMEN Objetivo: comparar los resultados de la incidencia de infección del tracto urinario, por medio de la tasa de utilización del catéter vesical de demora e identificar los microorganismos en el urocultivo y cultura de vigilancia antes y después de la implementación de un protocolo asistencial, en pacientes internados en unidad de terapia intensiva. Método: se definió la infección del tracto urinario de pacientes con urocultivo positivo >105 UFC/mL, notificados por el Servicio de Control de Infección Hospitalario, seis meses antes y después de la implementación del protocolo. La muestra estuvo constituida por 47 pacientes, siendo 28 notificados antes y 19 después. El protocolo, creado en la institución, está basado en el manual del Ministerio de la Salud para la prevención de infecciones relacionadas a la asistencia la salud, siendo la meta la seguridad del paciente y el perfeccionamiento de la calidad de los servicios de la salud. Resultados: fue posible observar una correlación linear negativa entre los meses posteriores a la implementación y la reducción de los casos notificados de infección del tracto urinario, por el test de Spearman (p=0,045) y reducción del número de microorganismos en el urocultivo (p=0,026) por el test de Fisher. Conclusión: las intervenciones educativas con implementación de protocolos en las instituciones de la salud favorecen la estandarización de la manutención de dispositivos invasivos, lo que podría reducir la colonización y posterior aparecimiento de casos de infección.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Urinary Tract Infections/prevention & control , Urinary Tract Infections/epidemiology , Clinical Protocols , Incidence , Intensive Care Units
6.
J. pediatr. (Rio J.) ; 91(6,supl.1): S2-S10, nov.-dez. 2015. tab
Article in English | LILACS (Americas) | ID: lil-769808

ABSTRACT

Resumo Objetivo: A infecção do trato urinário (ITU) é a infecção bacteriana mais comum na infância. A ITU pode ser o evento sentinela para alteração renal subjacente. Ainda há muitas controvérsias com relação ao tratamento adequado da ITU. Neste artigo de revisão, discutimos as últimas recomendações para diagnóstico, tratamento, profilaxia e imagiologia da ITU na infância, com base em comprovação e, na sua ausência, no consenso de especialistas. Fonte de dados: Os dados foram coletados após uma revisão da literatura e pesquisa no Pubmed, Embase, Scopus e Scielo. Resumo dos dados: No primeiro ano de vida, as ITUs são mais comuns em meninos (3,7%) do que em meninas (2%). Os sinais e sintomas da ITU são muito inespecíficos, principalmente em neonatos e durante a infância. A febre é o único sintoma em muitos casos. Conclusões: O histórico clínico e exame físico podem sugerir ITU, porém a confirmação deve ser feita por urocultura. Antes da administração de qualquer agente antimicrobiano, deve ser feita coleta de urina. Durante a infância, a coleta de urina adequada é essencial para evitar resultados falso-positivos. O diagnóstico e o início do tratamento imediatos são importantes na prevenção de cicatriz renal de longo prazo. Neonatos febris com ITUs devem ser submetidos a ultrassonografia renal e da bexiga, Agentes antibacterianos intravenosos são recomendados para neonatos e neonatos jovens. Recomendamos também a exclusão de uropatias obstrutivas o mais rapidamente possível e posterior refluxo vesico-ureteral, caso indicado. A profilaxia deve ser considerada em casos de elevada susceptibilidade a ITU e risco elevado de danos renais.


Abstract Objective: Urinary tract infection (UTI) is the most common bacterial infection in childhood. UTI may be the sentinel event for underlying renal abnormality. There are still many controversies regarding proper management of UTI. In this review article, the authors discuss recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, and when this is lacking, based on expert consensus. Sources: Data were obtained after a review of the literature and a search of Pubmed, Embase, Scopus, and Scielo. Summary of the findings: In the first year of life, UTIs are more common in boys (3.7%) than in girls (2%). Signs and symptoms of UTI are very nonspecific, especially in neonates and during childhood; in many cases, fever is the only symptom. Conclusions: Clinical history and physical examination may suggest UTI, but confirmation should be made by urine culture, which must be performed before any antimicrobial agent is given. During childhood, the proper collection of urine is essential to avoid false-positive results. Prompt diagnosis and initiation of treatment is important to prevent long-term renal scarring. Febrile infants with UTIs should undergo renal and bladder ultrasonography. Intravenous antibacterial agents are recommended for neonates and young infants. The authors also advise exclusion of obstructive uropathies as soon as possible and later vesicoureteral reflux, if indicated. Prophylaxis should be considered for cases of high susceptibility to UTI and high risk of renal damage.


Subject(s)
Child , Female , Humans , Infant , Infant, Newborn , Male , Urinary Tract Infections/diagnosis , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Cicatrix/etiology , Cicatrix/prevention & control , Kidney/pathology , Recurrence , Urinary Tract Infections/complications , Urinary Tract Infections/drug therapy , Urinary Tract Infections/prevention & control , Urine Specimen Collection/methods , Urogenital Abnormalities/prevention & control , Urogenital Abnormalities , Vesico-Ureteral Reflux/prevention & control , Vesico-Ureteral Reflux
7.
Rev. méd. Chile ; 143(8): 1001-1004, ago. 2015. graf, tab
Article in Spanish | LILACS (Americas) | ID: lil-762665

ABSTRACT

Background: Flexible cystoscopy is a common test in clinical practice done with or without antibiotic prophylaxis. Aim: To evaluate the efficacy of antibiotic prophylaxis with ciprofloxacin to reduce the incidence of urinary infection. Material and Methods: Prospective, non-randomized observational study that included 60 patients divided into two groups. Group 1 received prophylactic ciprofloxacin 500 mg, one hour prior to the procedure and group 2 did not receive prophylaxis. The presence of bacteriuria, symptoms or signs of urinary infection or attending Emergency rooms or primary care for these symptoms were recorded during the seven days after the cystoscopy. Results: In groups 1 and 2, four and one patients had a positive urine culture, respectively. Only one patient in group 1 consulted in primary care for symptoms. No significant differences in symptoms or signs of urinary infection between groups were observed. Conclusions: In this group of patients, antibiotic prophylaxis with ciprofloxacin 500 mg prior to cystoscopy had no benefit.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Antibiotic Prophylaxis , Anti-Bacterial Agents/therapeutic use , Bacteriuria/prevention & control , Ciprofloxacin/therapeutic use , Cystoscopy/adverse effects , Urinary Tract Infections/prevention & control , Bacteriuria/microbiology , Prospective Studies , Urinary Tract Infections/microbiology
8.
Int. braz. j. urol ; 41(3): 412-424, May-June 2015. tab, ilus
Article in English | LILACS (Americas) | ID: lil-755859

ABSTRACT

ABSTRACTObjective:

To estimate the efficacy of antibiotic prophylaxis to prevent urinary tract infection in patients (both gender) who undergo a cystoscopy with sterile urine.

Materials and Methods:

Search strategy (January 1980-December 2013) in Medline via PubMed, CENTRAL, and EMBASE. Additionally, we searched databases for registered trials and conference abstracts, as well as reference lists of systematic reviews and included studies. Seven published randomized clinical trials (January 1, 1980 to December 31, 2013) were included in quantitative analyses with no language restrictions. Two independent reviewers collected data. Risk of bias was evaluated with the Cochrane Collaboration tool. We performed a fixed effect analyses due to statistical homogeneity. The primary outcome was urinary tract infection and the secondary was asymptomatic bacteriuria. The effect measure was the risk difference (RD) with 95% confidence interval. The planned interventions were: Antibiotic vs placebo; Antibiotic vs no intervention and Antibiotic vs any other intervention.

Results:

3038 patients were found in seven studies. For the primary outcome, we included 5 studies and we found a RR 0.53 CI95% (0.31, 0.90) and a RD-0.012 CI95% (-0.023,-0.002), favoring antibiotic prophylaxis. For asymptomatic bacteriuria we included 6 studies and we found a RR 0.28 CI95% (0.20, 0.39) and a RD-0.055 CI95% (-0.07,-0.039), was found favoring prophylaxis. According to GRADE evaluation, we considered moderate quality of evidence for both outcomes. The subgroup analysis showed that only two studies were classified as having low risk of bias: Cam 2009 and García-Perdomo 2013. They showed no statistical differences (RD-0.009 CI95% -0.03, 0.011).

Conclusions:

Based on studies classified as low risk of bias, we found moderate evidence to not recommend ...


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Cystoscopy/adverse effects , Urinary Tract Infections/prevention & control , Cystoscopy/methods , Publication Bias , Randomized Controlled Trials as Topic , Treatment Outcome , Urinary Tract Infections/drug therapy
9.
Arq. bras. oftalmol ; 78(2): 89-93, Mar-Apr/2015. graf
Article in English | LILACS (Americas) | ID: lil-744287

ABSTRACT

Purpose: To assess the cytotoxicity and genotoxicity of intravitreal adalimumab treatment in an animal experimental model using cytological and molecular techniques. Methods: Eighteen rabbits were randomly assigned to three groups: control, adalimumab treatment, and placebo. Cytotoxicity on retinal cells was evaluated using flow cytometry assays to determine the level of apoptosis and necrosis. Genotoxicity was evaluated by comet assays to assess DNA damage, and quantitative real-time polymerase chain reaction (qPCR) was used to evaluate expression of apoptosis-inducing caspases (8 and 3). Results: No cytotoxicity or genotoxicity was observed in any of the two treatment groups (adalimumab and placebo) following intravitreal administration compared with the control group. Flow cytometry analysis revealed that more than 90% of the cells were viable, and only a low proportion of retinal cells presented apoptotic (~10%) or necrotic (<1%) activity across all groups. Molecular damage was also low with a maximum of 6.4% DNA degradation observed in the comet assays. In addition, no increase in gene expression of apoptosis-inducing caspases was observed on retinal cells by qPCR in both the adalimumab and placebo groups compared with the control group. Conclusion: The use of adalimumab resulted in no detectable cytotoxicity or genotoxicity on retinal cells for up to 60 days upon administration. These results therefore indicate that adalimumab may be a safe option for intravitreal application to treat ocular inflammatory diseases in which TNF-α is involved. .


Objetivo: Acessar a citotoxicidade e genotoxicidade do tratamento intravítreo de adalimumabe em um modelo experimental animal utilizando técnicas citológicas e moleculares. Métodos: Dezoito coelhos foram aleatoriamente selecionados em três grupos: controle, tratamento intravítreo com adalimumabe e placebo. Os efeitos tóxicos nas células da retina foram avaliados através de ensaios de citometria de fluxo, para a determinação de atividade apoptótica e necrótica. A genotoxidade foi avaliada através de ensaios cometa para determinar danos ao DNA e através de PCR em tempo real para avaliar a expressão genética de caspases (8 e 3) promotoras de apoptose celular. Resultados: Não foram detectadas citotoxicidade e genotoxidade nos dois grupos de tratamento, adalimumabe e placebo, em comparação com o controle. A citometria de fluxo determinou que mais de 90% das células eram viáveis após o tratamento, e uma pequena quantidade de células da retina apresentaram apoptose (~10%) ou necrose (<1%) em todos os grupos. O dano molecular também foi baixo com uma degradação no DNA de no máximo 6,4% detectados nos ensaios cometa. Adicionalmente, não foram observados aumentos na expressão genética das caspases que induzem a apoptose através dos ensaios de PCR em tempo real. Conclusão: O tratamento intravítreo com adalimumabe não promoveu nenhuma citotoxicidade e genotoxicidade detectável em células da retina por até sessenta dias. Estes resultados, portanto, indicam que o adalimumabe pode ser uma opção segura para o tratamento de doenças oculares inflamatórias em que o TNFα está envolvido. .


Subject(s)
Humans , Catheter-Related Infections/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Medical Records Systems, Computerized , Population Surveillance/methods , Urinary Tract Infections/prevention & control , Catheter-Related Infections/epidemiology , Cross Infection/epidemiology , Hospitals/statistics & numerical data , Poisson Distribution , Program Evaluation , Pennsylvania/epidemiology , Regression Analysis , Retrospective Studies , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology
10.
Arq. bras. oftalmol ; 78(2): 94-99, Mar-Apr/2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-744300

ABSTRACT

Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to replace the natural lens with an artificial intraocular lens (IOL), which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patient’s visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs. .


Objetivo: A catarata é a principal causa de cegueira e acomete 18 milhões de pessoas no mundo, com maior incidência na população acima de 50 anos. A baixa acuidade visual causada pela catarata gera um impacto negativo na qualidade de vida de pacientes. O tratamento atual é feito por meio de cirurgia com a substituição do cristalino opacificado por uma lente intraocular (LIO) que pode ser monofocal ou multifocal. No entanto, a escolha da lente intraocular deve ser cuidadosamente realizada para garantir maior satisfação dos pacientes Assim, o estudo do comportamento visual desses pacientes pode ser uma ferramenta importante para definir qual o melhor tipo de lente intraocular a ser implantada. O presente estudo propôs a avaliação de uma ferramenta adicional à anamnese na a escolha da lente intraocular. Método: Com o uso de uma câmera programada para realizar o registro automático de fotos, foi documentanda a rotina visual do paciente, a fim de se obterem maiores informações sobre a frequência com que o mesmo utiliza a visão para longe, meia distância ou para perto. Resultados: Os resultados indicaram uma estimativa em porcentagem dessa frequência, sugerindo que a análise dos registros fotográficos da rotina visual de um paciente portador de catarata pode ser de grande ajuda no entendimento do seu comportamento visual e para a escolha da estratégia de reabilitação visual após a cirurgia de catarata e, inclusive, despertar o interesse pela confecção de lentes intraoculares personalizadas de acordo com as necessidades de cada paciente. .


Subject(s)
Humans , Catheter-Related Infections/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Medical Records Systems, Computerized , Population Surveillance/methods , Urinary Tract Infections/prevention & control
11.
Int. braz. j. urol ; 41(1): 46-56, jan-feb/2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-742884

ABSTRACT

Objective To evaluate the safety, efficacy and possible complications of 16-core transrectal prostate biopsies using two doses of ciprofloxacin for prophylaxis of infectious complications. Materials and Methods Sixteen-core prostate biopsies were performed on a number of patients with different signs of potential prostate cancer. Complications were assessed both during the procedure and one week later. After the procedure, urine samples were collected for culture. The rate of post-biopsy complications, hospital visits and hospitalizations were also analyzed. Ciprofloxacin (500 mg) was administered two hours before, and eight hours after the procedure. Results The overall rate of post-biopsy complications was 87.32%, being 5.4% of those considered major complications due to hemorrhage, or to urinary retention. Eight patients required hospital treatment post-biopsy. Fever occurred in just one patient (0.29%). There was no incidence of orchitis, epididymitis, prostatitis, septicemia, hospitalization, or death. The urine culture showed positive results in five patients (2.15%). Conclusion One-day prophylaxis with ciprofloxacin proved to be safe and effective in the prevention of infectious complications following 16-core prostate biopsies. .


Subject(s)
Humans , Male , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Ciprofloxacin/therapeutic use , Postoperative Complications/prevention & control , Prostate/pathology , Prostatic Neoplasms/pathology , Hospitalization , Image-Guided Biopsy/adverse effects , Image-Guided Biopsy/methods , Prospective Studies , Reproducibility of Results , Risk Factors , Time Factors , Treatment Outcome , Urinary Tract Infections/prevention & control , Urine/microbiology
13.
Rev. chil. infectol ; 31(3): 274-279, jun. 2014. tab
Article in Spanish | LILACS (Americas) | ID: lil-716978

ABSTRACT

We conducted a clinical trial to determine the impact of coating surfaces with copper in reducing hospital-acquired infections, mortality associated with nosocomial infections and antimicrobial costs in the UCI. The study took place at Carlos Van Buren Hospital, Valparaíso, Chile. No differences in the frequency of nosocomial infections were found. Not in rates of ventilator-associated pneumonia (p = 0.9), nor in catheter- associated urinary tract infection (p = 0.9) or in central venous catheter associated bacteremia (p = 0.3). There were no differences in infection-free survival (p = 0.9). There were less costs of antimicrobials in patients in which copper was used. The fact that the sample size was not completed could explain that no significant differences in infections were found. Conclusion: The use of copper as a surface in the ICU showed no statistically significant differences in rates of nosocomial infections during the study period, however, these results could be related to the sample size.


Introducción: Las infecciones nosocomiales incrementan la mortalidad y costos en las instituciones de salud. El revestimiento con cobre, de superficies de alto contacto en la unidad clínica en torno a los pacientes, reduce la colonización bacteriana de las mismas. Objetivo: Determinar el impacto del revestimiento de las superficies con cobre en la disminución de las infecciones intrahospitalarias, la mortalidad asociada a las infecciones intrahospitalarias y los costos en antimicrobianos en pacientes hospitalizados en UCI adultos en el Hospital Carlos Van Buren. Pacientes y Métodos: Estudio prospectivo, comparativo, mayo de 2011-mayo de 2012. Asignación aleatoria de pacientes adultos ingresados en UCI, que permanecieran al menos por 24 h en dicha unidad, a unidades de aislamiento recubiertas (n: 7) o no recubiertas con cobre (n: 7). Resultados: Ingresaron al estudio 440 pacientes, 217 pacientes (49,3%) en el grupo sin cobre y 223 en el grupo con cobre (50,7%). No se encontraron diferencias en la frecuencia de infecciones intrahospitalarias en ambos grupos. Tampoco se encontraron diferencias significativas en las tasas de neumonía asociada a ventilación mecánica (p = 0,9), infección urinaria asociada a catéter urinario (p = 0,9) y bacteremias asociada a catéter venoso central (p = 0,3). Tampoco se encontraron diferencias en la sobrevida libre de infección (p = 0,9). Se encontró un gasto menor de antimicrobianos en pacientes atendidos en unidades revestidas con cobre. Durante el período del estudio no se completó el tamaño de muestra y las diferencias no significativas podrían deberse a este hecho. Conclusión: El uso del cobre como revestimiento de las superficies hospitalarias en UCI, mostró diferencia en la tasa de bacteriemia asociada a dispositivos venosos, aunque no significativa, y no mostró diferencia en neumonías e infecciones urinarias. Las diferencias no significativas pueden deberse a que no se completó el tamaño de la muestra. Se observó un mayor gasto de antimicrobianos en pacientes de unidades no cobrizadas, lo que plantea una nueva área de investigación.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Copper , Cross Infection , Infection Control/methods , Bacteremia/economics , Bacteremia/mortality , Bacteremia/prevention & control , Catheterization, Central Venous/adverse effects , Chile/epidemiology , Cross Infection/economics , Cross Infection/mortality , Cross Infection/prevention & control , Fomites/microbiology , Intensive Care Units , Prospective Studies , Pneumonia, Ventilator-Associated/economics , Pneumonia, Ventilator-Associated/mortality , Pneumonia, Ventilator-Associated/prevention & control , Urinary Catheterization/adverse effects , Urinary Tract Infections/economics , Urinary Tract Infections/mortality , Urinary Tract Infections/prevention & control
14.
Rev. Esc. Enferm. USP ; 47(6): 1410-1416, 01/dez. 2013. tab, graf
Article in Portuguese | LILACS (Americas) | ID: lil-700101

ABSTRACT

As infeções do trato urinário associadas à cateterização são muito frequentes no contexto comunitário e hospitalar. Existem atualmente várias recomendações para sua prevenção, contudo, quando abordado o soluto a utilizar no meato urinário previamente à algaliação continuam a persistir dúvidas. Assim, este estudo procurou determinar a eficácia da limpeza do meato urinário com água ou soro fisiológico comparativamente à sua assepsia por meio de uma revisão sistemática com metanálise. Para isso foram seguidos os princípios propostos pelo Cochrane Handbook , a análise crítica realizada por dois investigadores e a análise estatística com recurso ao programa STATA 11.1. Podemos concluir que a limpeza ou desinfeção do meato urinário previamente à cateterização vesical não é estatisticamente significativa (OR=1,07, IC 95%=0,68-1,68, p=0,779), existindo alguma evidência de que a utilização de água/soro fisiológico reduz as taxas de ITU.


Las infecciones del tracto urinario asociadas con cateterismo son muy comunes en el contexto comunitario y hospitalario. Actualmente existen varias recomendaciones para su prevención. Sin embargo, las dudas persisten en la elección del soluto utilizado en el meato urinario antes del cateterismo. Por lo tanto, este estudio trata de determinar la eficacia de la limpieza del meato urinario con agua/solución salina comparativamente con su asepsia, mediante la realización de una revisión sistemática con meta-análisis. Para lo cual, se siguieron los principios propuestos por el Manual Cochrane, el análisis crítico realizado por dos investigadores y el análisis estadístico utilizando el programa STATA 11.1. Podemos concluir que la limpieza o desinfección del meato urinario antes del cateterismo no es estadísticamente significativo (OR=1,07, 95%CI=0,68-1,68, p=0,779) existiendo algunas evidencias de que el uso de agua/solución salina reduce las tasas de ITU.


The urinary tract infections associated with catheterization are very common in hospital and home care contexts. Currently there are several recommendations for its prevention, however, when approaching the kind of solute used in the urinary meatus prior to catheterization doubts continue to persist. Thus this study aimed at determining the effectiveness of cleaning the urinary meatus with water or saline comparing to its sterilization through a systematic review and meta-analysis. In order to do so, the principles proposed by the Cochrane Handbook were followed, a critical analysis was conducted by two researchers and the statistical analysis was performed with the use of STATA 11.1. We concluded that the cleaning or disinfection of the urinary canal prior to bladder catheterization is not statistically significant (OR=1.07, CI 95%=0.68-1.68, p=0.779) and that there is some evidence that the use of water/saline reduces rates of UTI (urinary tract infection).


Subject(s)
Humans , Catheter-Related Infections/prevention & control , Disinfection/standards , Sodium Chloride , Urethra , Urinary Catheterization , Urinary Tract Infections/prevention & control , Water
15.
Rev. latinoam. enferm ; 21(1): 459-468, Jan.-Feb. 2013. tab
Article in English | LILACS (Americas), BDENF | ID: lil-669599

ABSTRACT

OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.


OBJETIVO: buscar as melhores evidências disponíveis na literatura sobre o conhecimento produzido e relacionado à técnica de cateterismo urinário intermitente e de demora, para embasar cientificamente o cuidado de enfermagem prestado ao paciente, submetido ao cateterismo urinário, e prevenir infecção do trato urinário. MÉTODO: a busca foi realizada nas bases de dados PubMed e Cochrane para o desenvolvimento da revisão integrativa. A amostra foi composta por 34 artigos. Esses foram analisados por dois pesquisadores independentes, usando-se instrumento adaptado para verificar o nível de evidência e grau de recomendação, além da utilização da escala de Jadad. RESULTADOS: as evidências disponíveis, relacionadas aos cuidados de enfermagem aos pacientes submetidos ao cateterismo urinário, são: a taxa de infecção no trato urinário não altera com a higienização do períneo com água estéril ou não, com o uso de solução de iodo-povidine ou clorexidine, ou aplicando técnica limpa ou estéril. O uso do cateter intermitente com técnica limpa implica em menores taxas de complicações e infecções em comparação com a de demora. A remoção do cateter em até 24 horas após cirurgia e o uso do cateter impregnado com antimicrobiano e de revestimento hidrofílico reduz a incidência de infecção do trato urinário. CONCLUSÕES: existem controvérsias em relação à técnica de higienização periuretral, tipo de material do cateter e alguns procedimentos para a manutenção e remoção do cateter. Os resultados desta revisão representam atualização das condutas e tomada de decisão do enfermeiro para a prevenção de infecção do trato urinário no cateterismo urinário.


OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la técnica de cateterismo urinario intermitente y de demora para apoyar científicamente el cuidado de enfermería prestado al paciente sometido al cateterismo urinario y precaver infección del trato urinario. MÉTODO: La busca fue realizada en las bases de datos PubMed y Cochrane para el desarrollo de la revisión integrativa. La muestra fue de 34 artículos. Éstos fueron analizados por dos investigadores independientes usando instrumento adaptado para verificar el nivel de evidencia y grado de recomendación, además de la utilización de la escala de Jadad. RESULTADOS: las evidencias disponibles relacionadas a la atención de enfermería a los pacientes sometidos al cateterismo urinario son: la tasa de infección en el trato urinario no altera con la higienización del perineo con agua estéril o no, con el uso de solución de iodo-povidona o clorhexidina; o aplicando técnica aseada o estéril. El uso del catéter intermitente con técnica aseada implica en menores tasas de complicaciones e infecciones en comparación con la de demora. La remoción del catéter en hasta 24 horas pos cirugía y el uso del catéter impregnado con antimicrobiano y de revestimiento hidrofílico reduce incidencia de infección del trato urinario. CONCLUSIONES: existen controversias con relación a la técnica de higienización periuretral, tipo de material del catéter y algunos procedimientos para el mantenimiento y remoción del catéter. Los resultados de esta revisión representan actualización de las conductas y tomada de decisión del enfermero para la prevención de infección del trato urinario en el cateterismo urinario.


Subject(s)
Humans , Urinary Catheterization/methods , Urinary Tract Infections/prevention & control , Urinary Catheterization/adverse effects , Urinary Catheterization/standards , Urinary Tract Infections/etiology
16.
Yonsei Medical Journal ; : 489-493, 2013.
Article in English | WPRIM (Western Pacific) | ID: wprim-149921

ABSTRACT

PURPOSE: Urinary tract infection (UTI) is an ascending infection of fecal uropathogens, urogenital lactobacilli are suggested to play a role in the prevention of UTI. This study was to investigate whether lactobacillus mixture (LM) could prevent the experimental infantile UTI. MATERIALS AND METHODS: The LM were composed of three lactobacillus strains (L. gasseri, L. rhamnosus, and L. reuteri). Mother rats were grouped as lactobacillus (LB) group I (LB I, n=22), II (LB II, n=24) and control (n=20). LB I and LB II were fed with LM (1 mL/day) and control with phosphate-buffered saline (PBS) from late pregnancy through lactation. All newborn rats were breast-fed and their urine and stool were collected at the end of the 3rd week to compare lactobacillus colony. Then, infant rats from LB II were treated with intravesical instillation of LM. Infant rats from LB I and control were instilled with PBS. Twenty-four hours later, experimental UTI was introduced by intravesical instillation of standard E. coli strain. After 72 hours later, the infant rats were sacrificed for histologic examination. RESULTS: Lactobacilli colonies in urine and stool were not statistically different among the three groups. The incidence of pyelonephritis in the LB II was 16.7% (4/24), LB I 72.7% (16.22) and control 75.0% (15/20) (p=0.015). The incidence of cystitis was not significantly different among the three groups. CONCLUSION: The intravesically instilled LM significantly prevented experimental pyelonephritis in infant rats, however, LM administered orally to the pregnant and lactating mother rats did not.


Subject(s)
Animals , Escherichia coli Infections/prevention & control , Lactobacillus , Probiotics/therapeutic use , Rats , Rats, Sprague-Dawley , Urinary Tract Infections/prevention & control
17.
Säo Paulo med. j ; 131(5): 363-363, 2013.
Article in English | LILACS (Americas) | ID: lil-695326

ABSTRACT

BACKGROUND: Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). This is the third update of our review first published in 1998 and updated in 2004 and 2008. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. METHODS: Search methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library) and the Internet. We contacted companies involved with the promotion and distribution of cranberry preparations and checked reference lists of review articles and relevant studies. Date of search: July 2012. Selection criteria: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products for the prevention of UTIs. Data collection and analysis: Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) were calculated where appropriate, otherwise a narrative synthesis was undertaken. Quality was assessed using the Cochrane risk of bias assessment tool. MAIN RESULTS: This updated review includes a total of 24 studies (six cross-over studies, 11 parallel group studies with two arms; five with three arms, and two studies with a factorial design) with a total of 4473 participants. Ten studies were included in the 2008 update, and 14 studies have been added to this update. Thirteen studies (2380 participants) evaluated only cranberry juice/concentrate; nine studies (1032 participants) evaluated only cranberry tablets/capsules; one study compared cranberry juice and tablets; and one study compared cranberry capsules and tablets. The comparison/control arms were placebo, no treatment, water, methenamine hippurate, antibiotics, or lactobacillus. Eleven ...


Subject(s)
Female , Humans , Male , Beverages , Phytotherapy/methods , Plant Preparations/therapeutic use , Urinary Tract Infections/prevention & control , Vaccinium macrocarpon
18.
Iranian Journal of Pediatrics. 2013; 23 (4): 430-438
in English | IMEMR (Eastern Mediterranean) | ID: emr-138349

ABSTRACT

We examined the preventive effect of probiotic and antibiotics versus antibiotics alone, in children with recurrent urinary tract infections [RUTI] in a preliminary randomized clinical trial. Between March 2007 and April 2011, children with the history of RUTI and unilateral vesicoureteral reflux [VUR] were randomly assigned to receive concomitant probiotic and antibiotics [Lactobacillus acidophilus and bifidobacterium lactis, 10[7]/ml, as 0.25 ml/kg three times a day regimen in addition to Nitrofurantoin, 1mg/kg daily [group I]. In group II, all children received conventional prophylactic antibiotics alone [Nitrofurantoin, 1 mg/kg daily]. Randomization was performed via using the random numerals table in a 1:1 manner with stratification by sex, age and grade of reflux. The urine examinations were done monthly and the incidence of UTI was evaluated in these two groups. Forty-one children [age: 8.3 +/- 3.1 years] in group I and 44 children [age: 8.0 +/- 3.0 years] in group II were compared. During the course of three years, 39% in group I and 50% of participants in group II experienced RUTIs [P=0.4]. Incidences of UTI - febrile and afebrile - reduced in both groups without any significant differences after two years of prophylaxis. Also, incidence of afebrile UTIs did not significantly differ [0.51 +/- 1.30 and 0.81 +/- 1.41 respectively, P=0.3]; however, the incidence of febrile UTIs in particular were lower in group I [0.00 +/- 0.00 versus 0.13 +/- 0.40, P=0.03] in the last year. The consumption of probiotic and antibiotics in children with RUTI is safe and more effective in reducing the incidence of febrile UTI in comparison to prophylactic antibiotics alone


Subject(s)
Humans , Female , Male , Urinary Tract Infections/prevention & control , Vesico-Ureteral Reflux/complications , Anti-Bacterial Agents , Antibiotic Prophylaxis , Recurrence
19.
Urology Annals. 2013; 5 (2): 61-74
in English | IMEMR (Eastern Mediterranean) | ID: emr-140316

ABSTRACT

The use of antibiotic prophylaxis to prevent urinary tract infection and bacteremia [sepsis] following endoscopic urologic procedures is a controversial topic. Evidence in the literature revealed that urological instrumentation is associated with increased incidence of urinary tract infection and bacteremia. The aim of this review is to evaluate the effectiveness of antibiotic prophylaxis in reducing the risk of urinary tract infection in patients who had transurethral urological surgeries. We have selected all RCTs of adult population who underwent all different types of transurethral urological surgery, including cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor, and received prophylactic antibiotics or placebo/no treatment. At first, more than 3000 references were identified and reviewed; of which 42 studies with a total of 7496 patients were included in the final analysis. All those trials were analyzing antibiotic prophylaxis versus placebo/ no treatment, and they were significantly favoring antibiotic use in reducing all outcomes, including bacteriuria [RR 0.36, 95% CI 0.29 to 0.46, P 0.0001] with moderate heterogeneity detected [I[2] 48%], symptomatic UTI [RR 0.38, 95% CI 0.28 to 0.51, P 0.0001] with no significant heterogeneity was detected [I[2] 17%], bacteremia [RR 0.43, 95% CI 0.23 to 0.82, P 0.0001] with no noted heterogeneity [I[2] 0%], and fever 38.5 Celsius [RR 0.41, 95% CI 0.23 to 0.73, P 0.003]; also, there was no noted heterogeneity [I[2] 0%]. However, using antibiotic prophylaxis did not reduce the incidence of low grade temperature [RR 0.82, 95% CI 0.61 to 1.11, P 0.20] or in moderate grade temperature [RR 1.03, 95% CI 0.71 to 1.48, P 0.89]. Antibiotic prophylaxis appears to be an effective intervention in preventing urinary tract infections and its sequels following transurethral urological surgeries in patients with preoperative sterile urine


Subject(s)
Humans , Urinary Tract Infections/prevention & control , Bacteremia/prevention & control , Urologic Surgical Procedures , Cystoscopy , Transurethral Resection of Prostate
20.
J. bras. nefrol ; 34(2): 178-183, abr.-jun. 2012.
Article in Portuguese | LILACS (Americas) | ID: lil-643719

ABSTRACT

O trato urinário é o sítio mais comum de infecção bacteriana. As infecções do trato urinário (ITU) recorrentes em mulheres sem anormalidades anatômicas do trato urinário demandam uso frequente e repetido de antibióticos, aumentando a prevalência de micro-organismos resistentes aos antimicrobianos. A possibilidade de abordagem alternativa, com a utilização de vacinas produzidas a partir de bactérias inativadas ou componentes estruturais desses micro-organismos, é uma realidade palpável. Confirmando resultados observados experimentalmente, estudos clínicos controlados têm mostrado redução dos episódios de recorrência, sem efeitos colaterais significativos, com imunoterapia oral ou vaginal. Nesta revisão, foram apresentados os mecanismos de agressão e defesa envolvidos na gênese das infecções urinárias em mulheres com trato urinário normal, a evolução do conhecimento sobre a imunoterapia nas ITU e as vacinas já disponíveis ou em desenvolvimento para o tratamento dessa importante condição clínica.


The urinary tract is the most common site of bacterial infections. Urinary tract infections (UTIs) in women without urinary tract anatomic abnormalities require frequent and repeated use of antibiotics, increasing the prevalence of antimicrobial-resistant microorganisms. The possibility of an alternative approach, with the use of vaccines produced from inactivated bacteria or structural components of these microorganisms, is a reality. Confirming the results observed experimentally, controlled clinical studies of oral or vaginal immunotherapy have shown reductions in the number of episodes of recurrence, without significant side-effects. We reviewed the mechanisms of aggression and defense involved in the pathogenesis of UTIs in women with anatomically normal urinary tracts, the evolution of knowledge about the immunotherapy of UTIs, and the vaccines already available or under development for the treatment of this important clinical condition.


Subject(s)
Humans , Bacterial Vaccines , Bacterial Infections/prevention & control , Urinary Tract Infections/prevention & control
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