A capacidade para o autocuidado do utente em internamento hospitalar: Consequências das precauções baseadas nas vias de transmissão / The patient's ability to self-care in hospital: Consequences of precautions based on transmission routes

As Infeções Associadas a Cuidados de Saúde e o aumento da resistência dos microrganismos aos antimicrobianos são, segundo a Direção Geral da Saúde (2017), problemas interligados e com importância crescente à escala mundial. Para fazer frente a este problema foram desenvolvidas ferramentas como as Precauções Básicas de Controlo de Infeção (PBCI). Estas traduzem regras de boa prática que devem ser adotadas por todos os profissionais na prestação de cuidados de saúde, tendo em vista minimizar o risco de infeção e a transmissão cruzada. Segundo o Healthcare Infection Control Practices Advisory Committee (2019) quando surgem situações para as quais as PBCI não são suficientes para bloquear a via de transmissão do agente infecioso recorre-se às Precauções Baseadas nas Vias de Transmissão (PBVT), que se dividem em transmissão por via aérea, por gotículas e de contacto. A aplicação destas PBVT têm, contudo, descritos efeitos adversos como compromisso do domínio emocional, aumento da frequência de eventos adversos, menor contacto com os profissionais de saúde e maior ocorrência de situações de delirium. Na elaboração desta investigação questiona-se a possibilidade destes efeitos adversos das PBVT interferirem na capacidade do individuo de cuidar de si próprio, ou seja no seu autocuidado. Para responder a esta investigação foi desenvolvido um estudo descritivo e correlacional, com uma abordagem quantitativa. Foi utilizado o índice de Barthel para avaliar a capacidade para o autocuidado dos utentes, além de dados para caracterização e uma entrevista semiestruturada complementar. O estudo desenvolveu-se numa enfermaria de medicina interna onde foram incluídos 224 utentes, dos quais 54 estiveram hospitalizados com prescrição de PBVT e os restantes 170 utentes não foram submetidos ás mesmas. Verificou-se que a maior parte dos utentes apresentou idade igual ou superior a 70 anos, um nível de dependência elevado e não foram alvo da prescrição das PBVT. A PBVT mais frequente foi a de contacto e o microrganismo que mais a justificou foi o MRSA. O foco de infeção mais comum foi o pulmonar. Os utentes alvos da prescrição de PBVT apresentaram médias de orientação e autonomia mais baixas. Como resultados, não se verificou correlação entre aplicação das PBVT e menor progressão na capacidade para o autocuidado e estado de orientação. Este estudo terá duas principais limitações: ser realizado apenas numa enfermaria e ter sido desenvolvido com uma amostra não aleatória e de reduzidas dimensões.

Vehiculation of Methyl Salicylate from Microcapsules Supported on Textile Matrix.

In recent years, textile industries have focused their attention on the development of functional finishing that presents durability and, consequently, controlled release. However, in the case of methyl salicylate microcapsules supported on a textile matrix, studies indicate only the interactions between substrate and microcapsules and the drug delivery system, not applying the release equations. This study reports the mechanism and kinetics of controlled release of microcapsules of gelatin and gum Arabic containing methyl salicylate as active ingredient incorporated into textile matrices. According to the results presented, it was possible to verify that the wall materials participated in the coacervation process, resulting in microcapsules with well-defined geometry, besides promoting the increase of the thermal stability of the active principle. The samples (100% cotton, CO, and 100% polyamide, PA) functionalized with microcapsules released methyl salicylate in a controlled manner, based on the adjustment made by the Korsmeyer-Peppas model, indicating a Fickian mechanism. The influence of temperature was noticeable when the samples were subjected to washing, since with higher temperature (50 °C), the release was more pronounced than when subjected to lower temperature (37 °C). The results presented in this study indicate that the mechanism of backbone release is influenced by the textile matrix and by the durability of the microcapsule during the wash cycles.

Performance Analysis of ToA-Based Positioning Algorithms for Static and Dynamic Targets with Low Ranging Measurements.

Indoor Positioning Systems (IPSs) for emergency responders is a challenging field attracting researchers worldwide. When compared with traditional indoor positioning solutions, the IPSs for emergency responders stand out as they have to operate in harsh and unstructured environments. From the various technologies available for the localization process, ultra-wide band (UWB) is a promising technology for such systems due to its robust signaling in harsh environments, through-wall propagation and high-resolution ranging. However, during emergency responders' missions, the availability of UWB signals is generally low (the nodes have to be deployed as the emergency responders enter a building) and can be affected by the non-line-of-sight (NLOS) conditions. In this paper, the performance of four typical distance-based positioning algorithms (Analytical, Least Squares, Taylor Series, and Extended Kalman Filter methods) with only three ranging measurements is assessed based on a COTS UWB transceiver. These algorithms are compared based on accuracy, precision and root mean square error (RMSE). The algorithms were evaluated under two environments with different propagation conditions (an atrium and a lab), for static and mobile devices, and under the human body's influence. A NLOS identification and error mitigation algorithm was also used to improve the ranging measurements. The results show that the Extended Kalman Filter outperforms the other algorithms in almost every scenario, but it is affected by the low measurement rate of the UWB system.

A wearable sensor network for human locomotion data capture.

A new wearable data capture system for gait analysis is being developed. It consists of a pantyhose with embedded conductive yarns interconnecting customized sensing electronic devices that capture inertial and electromyographic signals and sends aggregated information to a personal computer through a wireless link. The use of conductive yarns to build the myoelectric electrodes and the interconnections of the wired sensors network, as well as the topology and functionality of the sensor modules are presented.

[Minimally invasive surgery in women with recurrent stress urinary incontinence]. / Cirurgia minimamente invasiva na mulher com incontinência urinária de esforço.

OBJECTIVES: Evaluate the efficacy and safety of minimally invasive surgical techniques as second procedure in recurrent stress urinary incontinence (SUI). STUDY DESIGN: We retrospectively analyzed data on patients submitted to this type of surgery after previous surgery failure, since September 2002 to December 2006. Several parameters were evaluated: women's age, symptoms, previous surgery, urodynamics results, procedure technique, complications at short (two months) and medium term (one year) results. RESULTS: Of the 73 analyzed cases, 57 patients had been submitted previously to classic surgery and 16 to minimally invasive surgery. In surgery for recurrent SUI using minimally invasive techniques eight complications were registered (five vaginal perforations, two bladder lacerations and one femoral vein laceration); post-op complications occurred in 13 cases (three urinary retentions, two urinary tract infections, one anaemia and seven vaginal sling erosions). Short-term cure, improvement and failure rates were 69.9%, 28.8% and 1.4%, respectively. At medium term, these rates were of 54.8%, 41.1% and 4.1%, respectively. CONCLUSIONS: Minimally invasive surgery for recurrent SUI is a valid option after previous surgery failure, given the low morbidity and reduced failure rate at short and medium term.

[Pelvic floor muscle training with Plevnik's cones in women with urinary incontinence]. / Reeducação do pavimento pélvico com cones de Plevnik em mulheres com incontinência urinária.

The aim of this study was to evaluate the effectiveness of the pelvic floor muscle training in the stress urinary incontinence. The standard protocol include forty eight treatment sessions all together, for sixteen weeks, three times a week with the using of Plevnik weighted vaginal cones and Kegel exercises. The effectiveness of this method in reducing urine loss was assessed through the "Pad-test" before and after exercises. A cohort of 75 women entered the study, aged between 28 and 66 years old, with mean aged 46 and light to moderate urinary incontinence. The results showed significant improvement with reduction in urine loss and increase in pelvic muscle tone in women that completed the whole treatment course.