Usefulness of oxidative stress biomarkers in native species for the biomonitoring of pesticide pollution in a shallow lake of the Austral Pampas, Argentina.

Pesticide contamination and its adverse effects on native freshwater species continue to be a worldwide major concern, mainly in developing countries. Passive biomonitoring of pesticide pollution in shallow lakes may be achieved by the simultaneous use of fish and wetland plants. Thus, the present study aimed to evaluate the occurrence of current-use pesticides in the surface water of a shallow lake of the Austral Pampas region (Buenos Aires Province, Argentina) surrounded by intensive agricultural activities and its relationship with a battery of biomarkers, including oxidative stress and genotoxicity, in two native species, the fish Oligosarcus jenynsii and the macrophyte Bidens laevis. A total of 26 pesticide residues were analyzed, and the main ones detected were glyphosate and its metabolite aminomethylphosphonic acid (AMPA), chlorpyrifos, and imidacloprid. In O. jenynsii, hydrogen peroxide (H2O2) content in the liver increased with chlorpyrifos occurrence, while malondialdehyde (MDA) levels in the brain and liver increased with the presence of both chlorpyrifos and glyphosate. In B. laevis, H2O2 and MDA levels in leaves and roots increased with AMPA occurrence. Also, leaf H2O2 contents and root MDA levels increased with chlorpyrifos concentration. In contrast, catalase and peroxidase activities in roots decreased with AMPA and chlorpyrifos occurrence. In both species, mainly H2O2 and MDA levels demonstrated their sensitivity to be used as biomarkers in the biomonitoring of current-use pesticide pollution in shallow lakes. Their use may provide information to plan strategies for environmental conservation by government institutions or decision-makers, and to assess the biota health status.

Improved protocol for Bst polymerase and reverse transcriptase production and application to a point-of-care diagnostics system.

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised awareness in the scientific community about the importance of being prepared for sanitary emergencies. Many measures implemented during the COVID pandemic are now being expanded to other applications. In the field of molecular and immunological diagnostics, the need to massively test the population worldwide resulted in the application of a variety of methods to detect viral infection. Besides gold standard reverse transcription quantitative polymerase chain reaction (RT-qPCR), the use of reverse transcription loop-mediated isothermal amplification (RT-LAMP) arose as an alternative and sensitive method to amplify and detect viral genetic material. We have used openly available protocols and have improved the protein production of RT-LAMP enzymes Bst polymerase and HIV-reverse transcriptase. To optimize enzyme production, we tested different protein tags, and we shortened the protein purification protocol, resulting in reduced processing time and handling of the enzymes and, thus, preserved the protein activity with high purity. The enzymes showed significant stability at 4 °C and 25 °C, over 60 days, and were highly reliable when used as a one-step RT-LAMP reaction in a portable point-of-care device with clinical samples. The enzymes and the reaction setup can be further expanded to detect other infectious diseases agents.

Influence of exposure time, physicochemical properties, and plant transpiration on the uptake dynamics and translocation of pharmaceutical and personal care products in the aquatic macrophyte Typha latifolia.

Typha latifolia is widely used as a phytoremediation model plant for organic compounds. However, the dynamic uptake and translocation of pharmaceutical and personal care products (PPCPs) and their relationship with physicochemical properties, such as lipophilicity (LogKow), ionization behavior (pKa), pH-dependent lipophilicity (LogDow), exposure time and transpiration, are scarcely studied. In the current study, hydroponically grown T. latifolia was exposed to carbamazepine, fluoxetine, gemfibrozil, and triclosan at environmentally relevant concentrations (20 µg/L each). Eighteen out of thirty-six plants were exposed to the PPCPs and the other eighteen were untreated. Plants were harvested at 7, 14, 21, 28, 35, and 42 days and separated into root, rhizome, sprouts, stem, and lower, middle, and upper leaf sections. Dry tissue biomass was determined. PPCP tissue concentrations were analyzed by LC-MS/MS. PPCP mass per tissue type was calculated for each individual compound and for the sum of all compounds during each exposure time. Carbamazepine, fluoxetine, and triclosan were detected in all tissues, while gemfibrozil was detected only in roots and rhizomes. In roots, triclosan and gemfibrozil mass surpassed 80% of the PPCP mass, while in leaf carbamazepine and fluoxetine mass represented 90%. Fluoxetine accumulated mainly in the stem and the lower and middle leaf, while carbamazepine accumulated in the upper leaf. The PPCP mass in roots and rhizome was strongly positively correlated with LogDow, while in leaf it was correlated with water transpired and pKa. PPCP uptake and translocation in T. latifolia is a dynamic process determined by the properties of contaminants and plants.

Coating of SPIONs with a Cysteine-Decorated Copolyester: A Possible Novel Nanoplatform for Enzymatic Release.

Superparamagnetic iron oxide nanoparticles (SPIONs) have their use approved for the diagnosis/treatment of malignant tumors and can be metabolized by the organism. To prevent embolism caused by these nanoparticles, they need to be coated with biocompatible and non-cytotoxic materials. Here, we synthesized an unsaturated and biocompatible copolyester, poly (globalide-co-ε-caprolactone) (PGlCL), and modified it with the amino acid cysteine (Cys) via a thiol-ene reaction (PGlCLCys). The Cys-modified copolymer presented reduced crystallinity and increased hydrophilicity in comparison to PGlCL, thus being used for the coating of SPIONS (SPION@PGlCLCys). Additionally, cysteine pendant groups at the particle's surface allowed the direct conjugation of (bio)molecules that establish specific interactions with tumor cells (MDA-MB 231). The conjugation of either folic acid (FA) or the anti-cancer drug methotrexate (MTX) was carried out directly on the amine groups of cysteine molecules present in the SPION@PGlCLCys surface (SPION@PGlCLCys_FA and SPION@PGlCLCys_MTX) by carbodiimide-mediated coupling, leading to the formation of amide bonds, with conjugation efficiencies of 62% for FA and 60% for MTX. Then, the release of MTX from the nanoparticle surface was evaluated using a protease at 37 °C in phosphate buffer pH~5.3. It was found that 45% of MTX conjugated to the SPIONs were released after 72 h. Cell viability was measured by MTT assay, and after 72 h, 25% reduction in cell viability of tumor cells was observed. Thus, after a successful conjugation and subsequent triggered release of MTX, we understand that SPION@PGlCLCys has a strong potential to be treated as a model nanoplatform for the development of treatments and diagnosis techniques (or theranostic applications) that can be less aggressive to patients.

Tools for the investigation of adverse events: scoping review.

OBJECTIVE: To map, in the literature, the risk management tools aimed at investigating health adverse events. METHOD: Scoping review according to the Joanna Brigss Institute, with acronym PCC (Population: hospitalized patients, Concept: tools for the investigation of adverse events, and Context: health institutions) carried out in MEDLINE (OVID), EMBASE, LILACS, Scopus, CINAHL, and gray literature. RESULTS: The search totaled 825 scientific productions, 31 of which met the objective of the study, which consisted of 27 scientific articles and 4 expert consensus. It was possible to carry out a synthesis of the necessary steps for the investigation of adverse events and use of the tools according to the extent of damage. CONCLUSION: The practice of investigating adverse events should be guided by a thorough understanding of contributing factors, a fair culture, and the involvement of senior leadership.

Acessibilidade aos serviços de saúde pública por pacientes com Síndrome Coronariana Aguda: protocolo de escopo / Accessibility to public health services by patients with Acute Coronary Syndrome: a scoping protocol

OBJETIVO: mapear, na literatura científica, como ocorre o acesso à assistência de saúde por pacientes com síndrome coronariana aguda. MÉTODO: protocolo de revisão de escopo com intuito de responder à pergunta: como é a acessibilidade aos cuidados de saúde dos pacientes com Síndrome Coronariana Aguda? As buscas serão efetuadas nas bases de dados BVS, PubMed, CINAHL, EMBASE e literatura cinzenta. Posteriormente, títulos e resumos dos artigos recrutados serão colocados em planilha do Microsoft Excel, os quais serão lidos e analisados por dois revisores independentes, e os estudos duplicados serão removidos. A fase seguinte abrangerá o processo de leitura na íntegra dos artigos previamente selecionados para confirmação da seleção. Os dados extraídos serão expostos em tabela e a análise ocorrerá deforma descritiva, no intuito de melhor apresentar os resultados e atender aos objetivos propostos pela presente pesquisa. Realizou-se o registro deste protocolo no Open Science Framework (OSF), o que foi publicado, conforme DOI:10.17605/OSF.IO/NS9QK.

OBJECTIVE: to map the scientific literature regarding how access to healthcare by patients with acute coronary syndrome occurs. METHOD: a scoping review protocol was designed to answer the question: how the access to healthcare by patients with acute coronary syndrome occurs? The search will be conducted in the VHL, PubMed, CINAHL, EMBASE, and gray literature databases. Subsequently, titles and abstracts of selected articles will be inserted in a Microsoft Excel spreadsheet that will be read and analyzed by two independent reviewers, and duplicate studies will be removed. The next phase will cover the full screening of the articles previously selected to confirm the selection. The extracted data will be presented in a table, and the analysis will descriptively take place to present the results better and meet the objectives proposed by this research. This protocol was registered in the Open Science Framework (OFS): DOI:10.17605/OSF.IO/NS9QK

Tools for the investigation of adverse events: scoping review / Herramientas para investigación de eventos adversos: revisión de alcance / Ferramentas para investigação de eventos adversos: revisão de escopo*

ABSTRACT Objective: To map, in the literature, the risk management tools aimed at investigating health adverse events. Method: Scoping review according to the Joanna Brigss Institute, with acronym PCC (Population: hospitalized patients, Concept: tools for the investigation of adverse events, and Context: health institutions) carried out in MEDLINE (OVID), EMBASE, LILACS, Scopus, CINAHL, and gray literature. Results: The search totaled 825 scientific productions, 31 of which met the objective of the study, which consisted of 27 scientific articles and 4 expert consensus. It was possible to carry out a synthesis of the necessary steps for the investigation of adverse events and use of the tools according to the extent of damage. Conclusion: The practice of investigating adverse events should be guided by a thorough understanding of contributing factors, a fair culture, and the involvement of senior leadership.

RESUMEN Objetivo: Mapeo en la literatura de las herramientas de la gestión de riesgo con énfasis en la investigación de eventos adversos en salud. Método: Revisión de alcance según Joanna Brigss Institute con el acrónimo PCC (Población: pacientes ingresados, Concepto: herramientas para la investigación de eventos adversos y Contexto: instituciones de salud) realizada en las bases de datos MEDLINE (OVID), EMBASE, LILACS, Scopus, CINAHL y literatura gris. Resultados: La búsqueda llegó a un total de 825 producciones científicas, siendo que 31 lograron el objetivo del estudio, el cual fue compuesto por 27 artículos científicos y 4 consensos de expertos. Fue posible realizar una síntesis de las etapas necesarias para la investigación de eventos adversos y utilización de las herramientas de acuerdo con el grado del daño. Conclusión: La práctica de investigación de eventos adversos deberá pautarse en la comprensión exhaustiva de los factores contribuyentes, cultura justa e involucramiento de alto liderazgo.

RESUMO Objetivo: Mapear na literatura as ferramentas da gestão de risco voltadas para investigação de eventos adversos na saúde. Método: Revisão de escopo segundo o Joanna Brigss Institute, com acrônimo PCC (População: pacientes internados, Conceito: ferramentas para a investigação de eventos adversos e Contexto: instituições de saúde), realizada nas bases MEDLINE (OVID), EMBASE, LILACS, Scopus, CINAHL e literatura cinzenta. Resultados: A busca totalizou 825 produções científicas, sendo que 31 atenderam o objetivo do estudo, sendo composta por 27 artigos científicos e 4 consensos de especialistas. Foi possível realizar uma síntese das etapas necessárias para a investigação de eventos adversos e utilização das ferramentas de acordo com o grau do dano. Conclusão: A prática de investigação de eventos adversos deverá ser pautada na compreensão exaustiva dos fatores contribuintes, cultura justa e envolvimento da alta liderança.

Núcleo segurança do paciente: perfil dos recursos humanos no cenário brasileiro / Núcleo Seguridad del Paciente: perfil de los recursos humanos en el contexto brasileño / Patient safety centers: profile of human resources in the Brazilian scenario

Resumo Objetivo Caracterizar o perfil dos profissionais que atuam nos Núcleos de Segurança do Paciente e analisar se existem variáveis correlacionadas à aplicação de ferramentas de investigação de eventos adversos. Métodos Estudo quantitativo, transversal, prospectivo, com 95 profissionais de 24 hospitais públicos e privados, que possuem Núcleos de Segurança do Paciente, das regiões: Sudeste, Centro Oeste, Nordeste e Sul. O recrutamento dos participantes foi operacionalizado em três etapas por videoconferência e a coleta de dados foi realizada através de um formulário estruturado com 14 perguntas fechadas. O programa SPSS (Statistical Package for the Social Science) foi utilizado para análise estatística descritiva. O teste de Spearman foi utilizado para analisar a correlação e significância. Resultados Ressalta-se a predominância de enfermeiros (89,5%) responsáveis pela investigação de eventos adversos nas instituições participantes. Os enfermeiros possuíam idade média de 39,5 anos, 14,3 anos de formação profissional e 9,2 anos de atuação na prática assistencial. Já sobre a especialização, 58,8 % eram pós-graduados em terapia intensiva e 79% formados em gestão da qualidade. A ferramenta mais utilizada para investigação é o Protocolo de Londres (95,8%), além disso, o número de protocolos aplicados apresentou alta variabilidade (CV=0,46). Conclusão Os enfermeiros são os profissionais que atuam nos Núcleos de Segurança do Paciente, ademais, liderando o processo de investigação de eventos adversos; e não foi encontrada nenhuma correlação forte e significativa entre as variáveis quantitativas à aplicação de ferramentas de investigação de eventos adversos.

Resumen Objetivo Caracterizar el perfil de los profesionales que actúan en los Núcleos de Seguridad del Paciente y analizar si existen variables correlacionadas con la aplicación de herramientas de investigación de eventos adversos. Métodos Estudio cualitativo, transversal, prospectivo, con 95 profesionales de 24 hospitales públicos y privados, que tienen Núcleo de Seguridad del Paciente de la región Sudeste, Centro Oeste, Nordeste y Sur. El reclutamiento de los participantes fue realizado en tres etapas por videoconferencia y la recopilación de datos se llevó a cabo mediante un formulario estructurado con 14 preguntas cerradas. Para el análisis estadístico descriptivo se utilizó el programa SPSS (Statistical Package for the Social Science). La prueba de Spearman fue utilizada para analizar la correlación y significación. Resultados Se observa un predominio de enfermeros (89,5 %) responsables de la investigación de eventos adversos en las instituciones participantes. Los enfermeros tenían edad promedio de 39,5 años, 14,3 años de formación profesional y 9,2 años de actuación en la práctica asistencial. Respecto a la especialización, el 58,8 % tenía posgraduación en terapia intensiva y el 79 % estaba formado en gestión de la calidad. La herramienta más usada para la investigación es el Protocolo de Londres (95,8 %) y el número de protocolos aplicados presentó una alta variabilidad (CV=0,46). Conclusión Los enfermeros son los profesionales que actúan en los Núcleos de Seguridad del Paciente y además lideran el proceso de investigación de eventos adversos. No se encontró ninguna correlación fuerte y significativa entre las variables cuantitativas y la aplicación de herramientas de investigación de eventos adversos.

Abstract Objective To characterize the profile of professionals working in the Patient Safety Centers and to analyze whether there are variables correlated to the application of tools for investigating adverse events. Methods Quantitative, cross-sectional, prospective study, with a total of 95 professionals from 24 public and private hospitals, which have Patient Safety Centers from the regions: Southeast, Central-West, Northeast and South. The recruitment of participants was carried out in three stages by videoconference and data collection was carried out using a structured form with 14 closed questions. The SPSS (Statistical Package for the Social Science) software was used for descriptive statistical analysis. The Spearman test was used to analyze the correlation and significance. Results The predominance of nurses (89.5%) responsible for investigating adverse events in the participating institutions is highlighted. The nurses had an average age of 39.5 years old, 14.3 years of professional training and 9.2 years of experience in healthcare practice. Regarding their specialization, 58.8% were post-graduated in intensive care and 79% graduated in quality management. The most used tool for investigation is the London Protocol (95.8%), in addition, the number of applied protocols showed high variability (CV=0.46). Conclusion Nurses are the professionals who work in the Patient Safety Centers, leading the process of investigating adverse events; and no strong and significant correlation was found among the quantitative variables to the application of adverse event investigation tools.

Safety Huddle methodology development in patient safety software: an experience report.

OBJECTIVES: to report the development and implementation of a digital tool developed by a group of nurses and information technology professionals working in healthcare quality management. METHODS: an experience report regarding the development of the Safety Huddle digital model, using the agile Scrum methodology. RESULTS: the first stage was the development of the model proposed by the team of nurses and IT professionals, based on the demand of quality and patient safety leaders in Brazil, and the second phase was the software implementation. FINAL CONSIDERATIONS: the development and implementation of the Safety Huddle contributed to expedite the detection and distribution of actions, in addition to promoting integration among teams, accountability, and empowerment of professionals to foresee and identify issues related to patient safety and face them through action plans.

Safety Huddle methodology development in patient safety software: an experience report / Creación de la metodología Safety Huddle en software para seguridad del paciente: relato de experiencia / Criação da metodologia Safety Huddle em um software para segurança do paciente: relato de experiência

ABSTRACT Objectives: to report the development and implementation of a digital tool developed by a group of nurses and information technology professionals working in healthcare quality management. Methods: an experience report regarding the development of the Safety Huddle digital model, using the agile Scrum methodology. Results: the first stage was the development of the model proposed by the team of nurses and IT professionals, based on the demand of quality and patient safety leaders in Brazil, and the second phase was the software implementation. Final Considerations: the development and implementation of the Safety Huddle contributed to expedite the detection and distribution of actions, in addition to promoting integration among teams, accountability, and empowerment of professionals to foresee and identify issues related to patient safety and face them through action plans.

RESUMEN Objetivos: relatar la creación e implementación de una herramienta electrónica desarrollada por un grupo de enfermeros y profesionales de tecnología de la información actuantes en el área de gestión de calidad en salud. Métodos: relato de experiencia sobre construcción del modelo electrónico del Safety Huddle mediante el método ágil Scrum. Resultados: la primera etapa consistió en construir el modelo propuesto por el equipo de enfermeros y profesionales de tecnología de la información partiendo de la demanda de líderes de calidad y seguridad del paciente en Brasil. En la segunda etapa se implementó el software. Consideraciones finales: la construcción e implementación del Safety Huddle contribuyó a agilizar la detección y distribución de acciones, además de promover la integración entre equipos, la responsabilización y empoderamiento de los profesionales, de modo de prever y/o identificar los problemas relativos a seguridad del paciente y enfrentarlos a partir de un plan de acción.

RESUMO Objetivos: relatar a criação e implantação de uma ferramenta eletrônica desenvolvida por um grupo de enfermeiros e profissionais da tecnologia da informação que atuam na área da Gestão da Qualidade em Saúde. Métodos: trata-se de um relato de experiência sobre a construção do modelo eletrônico do Safety Huddle por meio do método ágil Scrum. Resultados: a primeira etapa foi a construção do modelo proposto pelo time de enfermeiros e profissionais de tecnologia da informação, a partir da demanda de líderes de qualidade e segurança do paciente no Brasil, e a segunda etapa foi a implementação do software. Considerações Finais: a construção e implantação do Safety Huddle contribuiu para agilizar na detecção e distribuição das ações, além de promover a integração entre as equipes, a responsabilização e empoderamento dos profissionais, de modo a antever e/ou identificar os problemas relacionados à segurança do paciente e enfrentá-los a partir de um plano de ação.

Evaluation of the success rates of immediate implant placement in anterior and posterior regions success rates of immediate implant: a retrospective study

Introdution: Immediate implants placement has shown contradictory results inthe posterior region. Objective: The aim of the study was to compare the successrate and predictability of the short-term treatment using immediate implants inanterior and posterior regions. Methods: A total of 1000 dental charts wereanalyzed, of which 43 were included in the study: anterior (n=20) and posterior(n=23). The inclusion criteria were: tooth extraction indication, immediate single-tooth implant placement and at least twelve months of follow-up with functionalimplant. The success rates were based on the criteria I. and II. from the healthscale for dental implants proposed at the International Congress of Oral ImplantDentistry: no pain; no mobility, until 4 mm of bone loss, no exudate. P-value <0.05was considered significant. Results: The total success rate of immediate implantswas 97.7% for immediate implants in function for at least 12 months. The use ofbiomaterial (p=0.03) and temporary prosthesis (p<0.0001) were significantly higherin the anterior group. There was no significant difference in implant failure betweengroups (p=0.47). There was no statistical difference between the groups, consideringage, sex, extraction reason, initial torque immediately following implantplacement, treatment time and implant platform type (p> 0.05). Conclusion: Itmay be concluded that the anterior and posterior regions present a high short-term success rate when the immediate implant technique was used.

Introdução: A utilização de implante imediato em regiões posteriores temapresentado resultados contraditórios. Objetivo: O objetivo deste estudo foicomparar o índice de sucesso e previsibilidade à curto prazo de implantes imediatosinstalados em regiões anterior e posterior. Métodos: Um total de 1000 prontuáriosforam analisados, dos quais 43 foram incluídos neste estudo: Anterior (n=20) eposterior (n=23). Os critérios de inclusão foram: Indicação de extração dentária,instalação de implantes imediatos unitários, no mínimo doze meses de segmentocom implante funcional. Os critérios de sucesso foram baseados na escala desaúde dos implantes dentários do Congresso Internacional de Implantologia Oral,eixo I. e II.: ausência de dor, ausência de mobilidade, ausência de exudato e perdaóssea de até 4 mm. Valor de p<0.05 foi considerado estatisticamente significante.Resultados: O índice de sucesso dos implantes imediatos foi de 97,7% paraimplantes em função por pelo menos 12 meses. O uso de biomaterial (p=0,03) eprótese provisória (p<0,0001) foi significantemente maior em região anterior.Não foi encontrado diferença significante quanto a falha dos implantescomparando os dois grupos (p=0,47). Não houve diferença estatisticamentesignificante entre os grupos, considerando a idade, gênero, motivo da extração,torque inicial, tempo de tratamento e tipo de plataforma do implante (p>0,05).Conclusão: Pode-se concluir que as regiões anterior e posterior apresentaramalta taxa de sucesso a curto prazo quanto a técnica de implante imediato.

Bioacoustic analysis in Scinax hayii (Barbour, 1909) (Anura, Hylidae) at its type locality in Petrópolis, Rio de Janeiro, Brazil.

Scinax hayii was described in 1909 from the municipality of Petrópolis, State of Rio de Janeiro, Brazil. Morphological variation and advertisement calls have been previously reported for other populations across the species distribution (Lutz 1973; Heyer et al. 1990; Cardoso & Andrade 1991; Pombal et al. 1995; Magrini et al. 2011; Abrunhosa et al. 2014). However, no information on calls are available from specimens recorded at the type locality, preventing the correct characterization of the species (Magrini et al. 2011). Here we describe the advertisement call and a second call type of S. hayii from Petrópolis, as a contribution towards a better understanding of the taxonomy of this species.

Functional and Evolutionary Characterization of a UDP-Xylose Synthase Gene from the Plant Pathogen Xylella fastidiosa, Involved in the Synthesis of Bacterial Lipopolysaccharide.

Xylella fastidiosa is a plant-infecting bacillus, responsible for many important crop diseases, such as Pierce's disease of vineyards, citrus variegated chlorosis, and coffee leaf scorch (CLS), among others. Recent genomic comparisons involving two CLS-related strains, belonging to X. fastidiosa subsp. pauca, revealed that one of them carries a frameshift mutation that inactivates a gene encoding an oxidoreductase of the short-chain dehydrogenase/reductase (SDR) superfamily, which may play important roles in determining structural variations in bacterial glycans and glycoconjugates. However, the exact nature of this SDR has been a matter of controversy, as different annotations of X. fastidiosa genomes have implicated it in distinct reactions. To confirm the nature of this mutated SDR, a comparative analysis was initially performed, suggesting that it belongs to a subgroup of SDR decarboxylases, representing a UDP-xylose synthase (Uxs). Functional assays, using a recombinant derivative of this enzyme, confirmed its nature as XfUxs, and carbohydrate composition analyses, performed with lipopolysaccharide (LPS) molecules obtained from different strains, indicate that inactivation of the X. fastidiosa uxs gene affects the LPS structure among CLS-related X. fastidiosa strains. Finally, a comparative sequence analysis suggests that this mutation is likely to result in a morphological and evolutionary hallmark that differentiates two subgroups of CLS-related strains, which may influence interactions between these bacteria and their plant and/or insect hosts.

Características do atendimento pré-hospitalar de pacientes com suspeita ou diagnóstico de síndrome coronariana / Prehospital care characteristics of patients with suspected or diagnosed coronary syndrome / Características de la atención prehospitalaria de los pacientes con sospecha o diagnóstico de síndrome coronario

Objetivo: caracterizar o atendimento pré-hospitalar de pacientes com suspeita clínica ou diagnóstico de síndrome coronariana aguda. Método: estudo retrospectivo, transversal, com abordagem quantitativa, realizado em um serviço móvel de atendimento. Para análise, as informações coletadas foram submetidas à análise estatística com auxílio do Programa SPSS for Windows versão 16.0. Resultados: os 144 (2,39%)prontuários representam todos os casos relacionados à síndrome coronariana aguda, 28 atendimentos por motivo clínico e 116 para transporte de paciente com suspeita clínica ou diagnóstica de síndrome coronariana aguda. O principal desfecho foi o encaminhamento para o plantão cardiológico, representado por 74 casos. Conclusão: novas estratégias necessitam ser implantadas para que melhores resultados no tratamento do infarto agudo do miocárdio possam ser obtidos neste serviço, como a solicitação do eletrocardiograma pelo enfermeiro após a avaliação na chegada ao serviço.

Objective: to characterize the prehospital care of patients with clinical suspicion or diagnosis of acute coronary syndrome. Method: retrospective, cross-sectional study, with quantitative approach, performed at a mobile care service. For analysis, the collected data were subjected to statistical analysis using the SPSS for Windows version 16.0. Results: 144 (2.39%) records represent all cases related to acute coronary syndrome, 28 patients attended for clinical reasons and 116, for patient transportation with clinical suspicion or diagnosis of acute coronary syndrome. The primary outcome was the referral to the cardiology duty, represented by 74 cases. Conclusion: there is need to implement new strategies to obtain better results in the treatment of acute myocardial infarction in this service, such as the request of the electrocardiogram by the nurse after assessing when arriving at the service.(AU)

Objetivo: caracterizar la atención pre-hospitalaria de los pacientes con sospecha clínica o diagnóstico de síndrome coronario agudo. Método: estudio retrospectivo, transversal, con abordaje cuantitativo, realizado en un servicio de atención móvil. Para el análisis, los datos recogidos fueron sometidos a análisis estadístico con el programa SPSS versión 16.0 para Windows. Resultados: 144 (2.39%) representan los registros de todos los casos relacionados con el síndrome coronario agudo, 28 por razones clínicas y 116 para el transporte de pacientes con sospecha clínica o diagnóstico del síndrome coronario agudo. El resultado primario fue la referencia a la cardiología, representado por 74 casos. Conclusión: nuevas estrategias deben ser aplicadas para mejores resultados en el tratamiento del infarto agudo de miocardio en este servicio, como la solicitud del electrocardiograma por la enfermera después de la evaluación en la llegada al servicio.(AU)

Prolaxia de tromboembolismo pulmonar e trombose venosa profunda em pacientes ortopédicos / Prevention of pulmonary thromboembolism and venous thromboembolism in orthopedic pacients

A anticoagulação representa medida fundamental em terapêutica profilática de pacientes submetidos a cirurgia ortopédica e deve ser utilizada de rotina, exceto em casos específicos. Recomenda-se na artroplastia de joelho e quadril a utilização de Heparina de Baixo Peso Molecular (HBPM), Fondaparinux ou Warfarina com doses ajustadas. Em cirurgias de reparação de fraturas pélvicas, Fondaparinux é a droga de escolha, seguida de HBPM, Heparina não-fracionada e Warfarina com doses ajustadas como alternativas. A artroplastia do quadril e reparo de fratura pélvica requerem profilaxia por quatro a cinco semanas.

Anticoagulation is a key measure of prophylactic therapy in patients undergoing orthopedic surgery and should be used routinely, except in specific cases. It is recommended the use of Low Molecular Weight Heparin (LMWH), Fondaparinux or adjusted-dose Warfarin, in knee and hip arthroplasty. In surgical repair of pelvic fractures, Fondaparinux is the choice drug, followed by LMWH, unfractionated heparin and adjusted-doses Warfarin as alternative. Arthroplasty of the hip and pelvic fracture repair requires prophylaxis for four to five weeks, but is not required routinely in patients undergoing knee arthroscopy.

Fratura bilateral do fêmur: relato de caso / Bilateral femoral fractures: case report

As fraturas bilaterais do fêmur tornaram-se mais prevalentes nos últimos anos, principalmente em jovens vítimas de acidentes automobilísticos que envolvem grande dissipação de energia cinética. Esse tipo de lesão acomete outros órgãos e associa-se com óbitos e complicações pós-operatórias, além de raramente ocorrer de forma isolada. Este artigo descreve o trauma de um jovem de 25 anos de idade, vítima de colisão de motocicleta versus árvore, com fraturas femurais, sendo diafisária cominutiva e intraarticular à direita e trocantérica à esquerda. São discutidas as opções terapêuticas das fraturas cominutivas do fêmur por intermédio do uso de placa-ponte (PP) e de haste intramedular (HIM), além de possíveis complicações das fraturas femorais bilaterais.

The bilateral femoral fractures become prevalent in recent years, due to the increasing number of young adults involved in traffic accidents with high kinetic energy. This type of injury affects other organs and is usually associated with death and postoperative complications and rarely occurs in isolation. This article describes the case of a 25-year old male patient, victim of a motorcycle collision against a three with femoral fractures, and diaphyseal comminuted intra-articular fracture and right and left trochanter. It is discussed the treatment options of comminuted fractures of the femur through the use of bridge plates (PP) and intramedullary shafts(HIM), (Shaft or Bridge-Plate), besides the possible complications of bilateral femoral fractures.