[Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests by the SPCPTGI]. / Orientações de Consenso para a Abordagem dos Resultados Alterados nos Testes de Rastreio do Cancro do Colo do Útero pela SPCPTGI.

Cervical cancer is one of the most common types of cancer in women. Cervical cancer screening is needed for the detection and treatment of cervical neoplastic lesions that can evolve to neoplasia and to reduce the incidence of cervical cancer. Recently, changes were made to increase the efficiency of the screening process such as employing the human papilloma virus detection test as the gold standard for cervical cancer screening and acknowledging the importance of adapting clinical practice to consider the risk of developing this neoplasia. Considering this paradigm shift, new clinical practice guidelines are now needed. For this purpose, a group of experts analyzed and discussed the most recent literature, defining recommendations and proposing clinical practice guidelines that focus on risk stratification, diagnostic evaluation, and on the therapeutical approach and follow-up of women with altered screening results. The aim of this article is to guide clinical practice regarding actions to take in face of altered results of cervical cancer screening and, consequently, to improve the secondary prevention of this condition.

O cancro do colo do útero (CCU) é globalmente um dos tipos de cancro mais comum em mulheres. O rastreio do CCU é indispensável para a deteção e tratamento de lesões neoplásicas cervicais que possam evoluir para neoplasia, com o objectivo de reduzir a incidência deste cancro. Nos últimos anos, têm ocorrido alterações que visam o aumento da eficácia do rastreio. Nomeadamente, o uso de teste de deteção do vírus do papiloma humano como método de rastreio primário do CCU e a valorização da importância de adaptar a prática clínica em função do risco de desenvolvimento do CCU. Desta forma, são necessárias novas normas de atuação clínica, que contemplem esta mudança de paradigma. Assim, um grupo de especialistas analisou e discutiu a literatura mais recente, definindo recomendações e propondo normas de prática clínica que se focam na estratificação de risco, avaliação diagnóstica, e na conduta terapêutica e de seguimento de mulheres com resultados dos testes de rastreio alterados. Este trabalho tem como objetivo facilitar a prática clínica em resposta a resultados alterados nos testes e, consequentemente, melhorar a prevenção secundária do CCU.

Composting of winery waste and characteristics of the final compost according to Brazilian legislation.

The waste generated in the production of wine and grape juice is characterized by a high concentration of organic matter, when properly treated, can serve as sustainable strategies for its use and destination, and among these, the production of biocompost. Thus, the objective of this study was to evaluate the process of composting grape marc, sheep manure, and mango leaves, evaluating in the biocompost its physical-chemical, nutritional and microbiological characteristics for use in agriculture. The composting pile assembly followed the proportion of 30% of sheep manure as nitrogenous material and 70% of carbon-rich material (divided into 50% of grape marc and 20% of hose leaves), the initial C/N ratio was 33:1, and the process lasted 120 days according to legislation. When evaluating the results, the process occurred in an accelerated manner, where at 30 days the biocompost was already stabilized, and at the end of the process (120 days) it presented a C/N ratio of 5.85, as well as acceptable levels for the macronutrients K and P, and without risk of phytotoxicity, and could be used as organic fertilizer or as soil conditioner, reducing environmentally inadequate destination and generating savings with their reinsertion in the production chain.

Lipschütz Genital Ulceration as Initial Manifestation of Primary Sjögren's Syndrome.

Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulceration in patients with primary Sjögren's syndrome is infrequent but an established feature of cutaneous involvement. Although gynecological symptoms, such as vulvovaginal dryness, dyspareunia, and pruritus, are common in women with primary Sjögren's syndrome, patients affected by vulvar ulcers are unknown. We describe an exceptional case of necrotic aphthous-type vulvar ulceration as initial presentation of primary Sjögren's syndrome that was possibly triggered by an infectious agent. Successful healing was achieved with oral corticosteroids, despite some loss of labia minora and labia majora as sequelae of the necrotizing process. Reactive acute genital ulcers (Lipschütz ulcers) should be considered as a possible manifestation of many autoimmune/inflammatory disorders, beyond the classic associations such as Behçet's syndrome or Crohn's disease.

ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions-a 7-year experience of a single institution in Portugal.

INTRODUCTION: Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) represents an interpretative challenge in clinical practice. We aimed to evaluate the histological outcome of ASC-H cytology and to evaluate the accuracy of colposcopy in predicting high-grade histological lesions. MATERIALS AND METHODS: Retrospective study of ASC-H cervical cytology results, from January 2010 to December 2016, at a tertiary hospital. Demographic characteristics, colposcopic findings, diagnostic procedures, and histological outcomes were analyzed using SPSS, version 22.0. RESULTS: ASC-H prevalence was 0.25%. Patient mean age was 42.02 ± 12.8 years. The overall incidence of cervical dysplasia of any grade was 83.6% (n = 56) and the incidence of high-grade lesions was 50.8% (n = 34) (including 1 case of in situ adenocarcinoma and 2 cases of squamous cell carcinoma). Among patients with type 1 or 2 transformation zone (TZ), 84.9% (n = 45) had abnormal colposcopic findings, with 62.2% (n = 28) corresponding to grade 2 and 37.8% (n = 17) to grade 1. Colpo-histologic concordance was 85.4% (82.1% for grade 2 lesions and 100% for grade 1 lesions). The sensitivity, specificity, positive predicted value (PPV) and negative predictive value (NPV) was 100%, 75%, 82.1%, and 100%, respectively. The histological study of patients with type 3 TZ revealed 45.8% (n = 11) of high-grade lesions. CONCLUSIONS: ASC-H is strongly associated with high-grade histological lesions. Immediate evaluation of patients with this cytology abnormality is therefore mandatory. Colposcopy, when performed by expert clinicians, has great accuracy in detecting high-grade lesions. Histological evaluation of patients with type 3 TZ is extremely important because almost 50% of patients have this type of lesion.

Cervical cancer in pregnancy: 3 cases, 3 different approaches.

OBJECTIVE: Cervical cancer is one of the most common malignancies in pregnancy and one percent of women diagnosed with cervical cancer are pregnant or postpartum at the time of the diagnosis. We discuss how pregnancy will affect the management of cancer, and cancer will affect the management of the pregnancy. MATERIAL AND METHODS: Three case reports. RESULTS: We report three cases, with three different approaches of pregnant patient with cervical carcinoma stage IB1, diagnosed below-20 weeks gestation. In two cases, the patients decided to continue the pregnancy. CONCLUSIONS: Cervical cancer in pregnancy is a clinical challenge. Once the diagnosis, the stage and the extent of invasive cervical cancer have been established, a multidisciplinary approach is required. Decisions regarding timing of treatment and delivery require careful considerations, as well as the trimester in which the diagnosis is made. Delaying definitive treatment to improve fetal outcome, may carry an additional risk of tumor progression, although a delay in definitive treatment is regarded as feasible. Delayed treatment is safe in patients with small sized, early stage disease, if there is no evidence of disease progression. Neoadjuvant chemotherapy during pregnancy is still controversial. Cesarean delivery followed by radical hysterectomy is recommended. The effect of cervical cancer on pregnancy outcome is still not clear.

Vulvar intraepithelial neoplasia: evaluation of treatment modalities.

OBJECTIVE: The study aimed to evaluate effectiveness and recurrence rate of vulvar intraepithelial neoplasia (VIN) treatment according to treatment modalities as follows: imiquimod (Aldara), laser ablation, laser excision, wide local excision, and skinning vulvectomy. It also aimed to analyze risk factors associated to VIN recurrence. MATERIALS AND METHODS: Between January 1997 and December 2010, 29 women were treated and followed up for VIN in our center. Demographics, risk factors, treatment modality, effectiveness, and recurrence data were recorded retrospectively. Study analysis used Student t test and χ2 test. RESULTS: The median age was 52 years (range = 22-77 years); 52% were smokers, 31% were immunosuppressed, and 34% had concomitant or previous lower genital tract dysplasia. Of all patients, 38% had laser ablation, 31% had laser excision, 24% had wide local excision, and 3% had vulvectomy and imiquimod, with 86.2% overall effectiveness and 20% recurrence (2 laser excision and 2 wide local excision), within a mean of 35 months. CONCLUSIONS: Excisional treatment has diagnostic and treatment advantages in VIN lesions. The goal is to prevent development of invasive vulvar cancer while preserving normal vulvar anatomy and function.

Obstetric outcomes after treatment for cervical intraepithelial neoplasia: six years of experience.

OBJECTIVE: : The purpose of this study was to assess the effect of cervical conization on subsequent pregnancy and delivery outcomes. MATERIALS AND METHODS: : A retrospective case-control study was performed in patients who underwent conization from 2000 to 2005 and had a subsequent delivery. Two case controls were matched for each case studied. The obstetric outcomes of the 2 groups were compared. A subsequent analysis comparing the 2 excisional techniques used was performed. RESULTS: : The study population group included 87 women (29 cases and 58 controls). Overall, the mean gestation age at delivery (38 vs 39 wk, p = .003), prevalence of preterm birth (20.7% vs 5.2%, p = .025), mean birth weight (3,035 vs 3279 g, p = .018), and low birth weight (20.7% vs 1.7%, p = .02) were statistically different among the cases and controls.In the study group (n = 29), large loop excision of the transformation zone was used in 62% (n = 18) and laser was used in 38% (n = 11) of the cases. There was no significant difference in the medium depth of the excised tissue, the prevalence of preterm birth, low birth weight, and the cesarean delivery rate between the 2 techniques. CONCLUSIONS: : Despite the small number of cases, this study indicates that excision of the transformation zone is associated with an increased risk of overall preterm delivery and low-birth weight infants in subsequent pregnancies. No significant difference was found between the 2 cervical excision procedures.

Comparação das imagens radiográficas digitais e convencionais em reabsorções ósseas periodontais / Comparison of the conventional and digital radiographic image in periodontal bone resorption

Objetivo: Analisar os defeitos ósseos periodontais, pela comparação das imagens digitais (utilizando as ferramentas do Digora fmx 2.5) com as convencionais na angulação de -10, 0 e +10º, pela análise de três observadores. Métodos: Para obtenção das imagens foi utilizado um aparelho de Raio-X convencional, com padronização da tomada radiográfica, pela utilização do posicionador do tipo Rinn® e moldagem de resina das superfícies oclusais dos dentes a serem radiografados, nas três incidências radiográficas utilizadas. O contraste e a densidade foram padronizados no emprego do sistema digital Digora, com as exposições dos Raio-X adequadas a cada região. As radiografias convencionais foram realizadas com películas do tipo Insight da marca Kodak nº 2. As imagens digitais foram analisadas no monitor do computador por meio do software do Digora 2.5, utilizando a ferramenta para alterações das imagens padrão, 3D e negativa e as convencionais observadas em um negatoscópio apropriado. Resultados: O resultado estatístico demonstrou diferença significativa na análise entre os observadores, quanto às imagens obtidas, as digitais produziram imagens consideradas de qualidade inferior sem alterações das ferramentas em comparação à radiografia convencional e quando a imagem digital era alterada (brilho, contraste, 3D), a qualidade aumentava significativamente, sendo comparável à produzida pela película convencional. Quanto ao ângulo de incidência do feixe dos Raio-X, não foram detectadas diferenças significativas entre os mesmos, ocorrendo o mesmo quanto ao lado radiográfico. Conclusão: Os métodos radiográficos convencionais e digitais (quando da utilização das ferramentas para alteração das imagens) não demonstraram diferenças estatísticas na efetividade da quantificação dos defeitos ósseos periodontais.

Objective: To assess periodontal bone defects, comparing the digital images (using the tools of Digora® fmx 2.5) with the conventional angle of -10, 0 and 10 degrees, through the three evaluators analysis. Methods: To obtain the images we used a conventional X -ray machine with standardized radiography, using the positioner type Rinn and resin molding of the occlusal surfaces of teeth to be X-ray in three radiographic. The contrast and density were standardized in the use of digital Digora with X-ray exposures appropriate to each region. The radiographs were performed with films Kodak Insight brand 2. Digital images were analyzed on the computer monitor through Digora 2.5 software, using the tool to change the default images, 3D and conventional negative and observed in an appropriate light box. Results: The results of statistical analysis showed significant difference between the observers in the images obtained, the digital images produced poor quality images without changing tools in comparison to conventional radiography and when the digital image was changed (brightness, contrast, 3D), the quality increased significantly, as compared to that produced by conventional film. As the angle of incidence of the x-rays beam, there were no significant differences between them, the same happened on the radiographic side. Conclusion: The conventional and digital radiographic methods (when using the tools to change the images), showed no statistical differences in the effectiveness of the quantification of periodontal bone defects.

Analise comparativa da porcentagem de area preenchida pela obturacao no terco apical dos canais radiculares em tres diferentes tecnicas / Comparative analysis of the percent area occupied by filling material in the apical root canal third using three techniques

Objetivo: Comparar a porcentagem da area preenchida pela guta-percha, nos niveis 2 e 4mm do terco apical de canais mesiais de molares inferiores, nas tecnicas de obturacao: condensacao lateral, McSpadden modificada e sistema TC sem cone principal. Metodo: Quinze raizes mesiais, que totalizaram 30 canais de primeiros e segundos molares inferiores humanos, integros, com dois canais e forames independentes foram utilizadas. Os especimes foram distribuidos randomicamente em tres grupos, instrumentados pela tecnica manual coroa-apice bi-escalonada com uso de brocas gates glidden, e obturados de acordo com as tecnicas avaliadas. Em seguida, as raizes foram seccionadas nos niveis de 2mm e 4mm do forame apical. Os cortes obtidos foram analisados em microscopio opti co no aumento de 80 vezes. Imagens foram feitas com uma maquina digital com o intuito de medir a porcentagem da area do canal obturada com a guta-percha. Para isso, foi utilizado o software Acad 14. Os testes estatisticos de Wilcoxon, Kruskal-Wallis e U de Mann-Whitney foram utilizados com nivel de significancia de 5%. Resultados: Diferencas estatisticamente significantes entre a tecnica TC sem cone principal nos niveis de 2 e 4mm em relacao a Condensacao Lateral e somente no nivel de 2mm em relacao a McSpadden modificada foram observadas. Nao foram encontradas diferencas estatisticamente significantes entre as tecnicas McSpadden modificada e Condensacao lateral. Conclusao: O melhor preenchimento da area apical pelo material obturador guta-percha foi obtido pela tecnica Sistema TC sem cone principal, seguida da McSpadden modificada e Condensacao lateral.

Objecti ve: To compare the percent area filled by gutta-percha in the apical 2 and 4 mm of mesial canals of mandibular molars, using the following filling techniques: lateral condensation, modified McSpadden and TC system without main cone. Method: Fifteen mesial roots of sound human first and second mandibular molars with two canals and independent foramina were used, totalizing 30 canals. The specimens were randomly assigned to three groups, which were prepared by a manual double-flared instrumentation technique using Gates-Glidden drills and filled according to the proposed filling techniques. Next, the roots were sectioned at 2 and 4 mm from the apical foramina. The sections were examined under optical microscopy at ž80 magnification. Images were captured with a digital camera and analyzed with Acad 14 soft ware to measure the percent area of the canal occupied by gutta-percha. Data were analyzed statistically by the Wilcoxon, Kruskal-Wallis and Mann-Whitney-U tests at a significance level of 5%. Results: Statistically significant differences (p<0.05) were found between the TC system without main cone and lateral condensation at 2 and 4 mm, and between the TC system without main cone and the modified McSpadden technique at 2 mm. No statistically significant differences (p>0.05) were found between the modified McSpadden and lateral condensation techniques. Conclusion: The best apical filling by gutta-percha was obtained with the TC system without main cone, followed by the modified McSpadden and the lateral condensation techniques.

Análise da precisão de dois localizadores foraminais de fabricação chinesa e o Root ZX II / Accuracy of two apex locators made in china compared to Root ZX II

Objetivo: Avaliar a precisão e confiabilidade de dois modelos de localizadores apicais de fabricação chinesa (Joypex 5 e Root SW), comparados ao aparelho Root ZX II. Método: Quinze pré-molares superiores e inferiores uni e multirradiculares obtidos no banco de dentes da Universidade Federal de Mato Grosso do Sul, foram utilizados na pesquisa. Após a seleção dos dentes e preparo prévio dos terços cervical e médio dos canais radiculares com brocas de Gates Glidden 2, 3 e 4, foi realizada a medida do comprimento real do dente introduzindo uma lima K#15 dentro do canal e observando a saída da ponta do instrumento no forame maior utilizando um microscópio odontológico no aumento de 20X com iluminação média para melhor visualização. Para realização das medidas eletrônicas um modelo experimental foi confeccionado de maneira que o terço cervical das raízes ficassem fixadas no recipiente plástico e os terços médio e apical dos espécimes ficassem mergulhados em solução de soro fisiológico a 0,9%. Os aparelhos Root ZX II, Joypex 5 e Root SW foram utilizados para determinação do comprimento de trabalho eletrônico e as medidas foram comparadas. Foram utilizadods os testes estatísticos de Kruskal-Wallis e de Dunn's. Resultados: Os três aparelhos provaram ser eficientes, não existindo nenhuma diferença estatística significante (P< 0,05). Conclusão: Os localizadores Root ZX II e os novos aparelhos de fabricação chinesa Joypex 5 e Root SW mostraram-se precisos e confiáveis na determinação de um comprimento de trabalho aceitável para o tratamento endodôntico.

Objective: To evaluate the accuracy and reliability of two models of apex locators made in China (Joypex 5 and Root SW) compared to the Root ZX II equipment. Method: Fifteen single-rooted and multi -rooted maxillary and mandibular premolars obtained from the tooth bank of the Federal University of Mato Grosso do Sul were used in the study. After selection of the teeth, the cervical and middle thirds of the root canals were preflared with Gates Glidden drills #2, 3 and 4. Them, the real tooth length was determined by introducing a #15 K-file into the canals until its tip was seen exiting the larger foramen with the aid of a dental microscope at ž20 magnification under moderate illumination to improve visualization. For the electronic working length determination with Root ZX II, Joypex 5 and Root SW apex locators, an experimental model was prepared in such a way that the cervical third of the roots were fixed in a plastic receptacle and the middle and apical thirds of the specimens remained immersed in saline. The obtained electronic measurements were compared to each other. Kruskal-Wallis and Dunn's tests were used for statistical analysis. Results: The three apex locators were equally efficient, with no statistically significant differences among them (p<0.05). Conclusion: Root ZX II and the two new models of apex locators made in China (Joypex 5 and Root SW) were proven accurate and reliable for providing an acceptable electronic working length determination for the endodontic treatment.

Potassium permanganate oxidation of phenanthrene and pyrene in contaminated soils.

Potassium permanganate, widely used in water treatment, has shown its applicability to reduce PAH contamination in groundwater and soils. The first stage to design a treatment at the site scale is the feasibility study at the bench scale, generally performed by means of batch experiments. The aim of the present contribution was to investigate the influence of two factors on PAH degradation in spiked soils, following the method of factorial designs. These factors were the weight ratio KMnO(4)/PAH and the reaction time. Three factorial designs were performed and batch experiments were run to study the degradation of phenanthrene and pyrene on soils spiked at different concentrations, between 700 and 2100 mg kg(-1). We showed that treatment with potassium permanganate significantly reduced PAH concentration, but pyrene was more recalcitrant than phenanthrene. Both variables had negative main effects and a positive two-factor interaction effect: increasing the weight ratio or the reaction time enhanced PAH degradation but the reduction produced by the two factors was lower than the sum of the individual contributions. The comparison of these results with results that we published previously under comparable conditions showed that Fenton's reagent was more efficient than potassium permanganate.

Phenanthrene and pyrene oxidation in contaminated soils using Fenton's reagent.

Fenton's reagent has shown its applicability to oxidizing these biorefractory organic contaminants. The purpose of this contribution was to investigate the influence of operating parameters on the process efficiency for soil highly contaminated by PAHs. Five variables were selected: pH, reaction time, UV irradiation, hydrogen peroxide concentration and Fe (II) amendment. Their effects on the oxidation of (i) phenanthrene and on (ii) phenanthrene and pyrene present in freshly contaminated soil samples were studied through batch reactor experiments following factorial designs. For phenanthrene oxidation run with a soil contaminated at 700 mg kg(-1), one set of variables enabled us to reach a residual concentration lower than 40 mg kg(-1) (Dutch legislation threshold). The most important factor was the reaction time, followed at a certain distance by UV irradiation, Fe (II), H(2)O(2) concentration and pH, this last variable being the least significant. The possibility of operating without pH adjustment is of importance in the treatment at the field scale. This shows the feasibility of photo-Fenton-like oxidation for the treatment of soil highly contaminated with PAH and the relative importance of the process variables.

Estudo comparativo do selamento apical em canais radiculares obturados pelas técnicas cone único Protaper e termoplástica sistema TC / Comparative study of apical sealing in root canals filled by the Single Cone Protaper and Termoplastic TC Sytem techniques

Objetivo: Avaliar in vitro a microinfiltração apical das técnicas cone único do sistema Protaper e sistema TC sem cone principal. Método: Foram utilizadas 24 raízes disto-vestibulares de molares superiores humanos instrumentadas pelo sistema Protaper (Dentsply-Maillefer, Suíça) e aleatoriamente divididas em dois grupos. Os espécimes foram obturados com as técnicas TC sem cone principal e técnica do cone único, associadas ao cimento AH Plus (Dentsply, Rio de Janeiro, Brasil). Após a impermeabilização, as raízes foram imersas no corante tinta nanquim e submetidas a vácuo por 30 minutos, permanecendo no marcador por sete dias. Para observação dos níveis de infiltração, as amostras foram descalcificadas, desidratadas, diafanizadas e examinadas em lupa estereoscópica. Resultados: A análise estatística U de Mann-Whitney e Friedman demonstrou não haver diferenças estatisticamente significativas entre as técnicas avaliadas. Conclusão: As técnicas estudadas apresentaram microinfiltração apical sem diferenças estatísticas significativas.

Objective: To evaluate in vitro the apical microleakage of different root canal filling techniques: ProTaper single cone and TC System without the use of a master gutta-percha point. Methods: For the present experiment, twenty-four disto-buccal roots obtained from maxillary molars were prepared using the ProTaper system (Dentsply-Maillefer, Suíça) and randomly divided in two groups. Group I was filled according to the single cone technique, while in Group II the TC system was used without a master gutta-percha point. AH Plus (Dentsply, Rio de Janeiro, Brasil) was used as root canal sealer in both groups. After making the roots impermeable with nail varnish, they were immersed in Indian ink and submitted to vacuum for 30 min, remaining in the marker for seven days. After this period, the samples were decalcified, dehydrated, clarified and the infiltration levels were observed under a stereoscopic loupe. Results: Statistical analysis revealed no significant differences between the evaluated techniques. Conclusion: Both techniques evaluated in the present study were unable to avoid apical microleakage, and showed similar results.

Impact of chemical oxidation on soil quality.

Oxidation treatment helps to reduce the polycyclic aromatic hydrocarbon (PAH) load in contaminated soils but it may also have an effect on the soil quality. The impact of permanganate and Fenton oxidation on soil quality is investigated. Soil quality is restricted here to the potential for plant growth. Soil samples were collected from an agricultural field (S1) and a former coking plant (S4). Agricultural soil was spiked with phenanthrene (PHE) and pyrene (PYR) at two concentrations (S2: 700 mg PHE kg(-1), S3: 700 mg PHE kg(-1) and 2100 mg PYR kg(-1)). Soils were treated with both oxidation processes, and analyzed for PAHs and a set of agronomic parameters. A plant germination and growth test was run with rye-grass on treated soils. Results showed that both treatments produced the expected reduction of PAH concentration (from 64% to 97%). Besides, a significant loss of organic C and N, and strong changes in available nutrients were observed. Permanganate treatment increased the specific surface area and the cation exchange capacity in relation to manganese dioxide precipitation, and produced a rise in pH. Fenton oxidation decreased soil pH and increased the water retention capacity. Plant growth was negatively affected by permanganate, related to lower soil permeability and aeration. Both treatments had an effect on soil properties but Fenton oxidation appeared to be more compatible with revegetation.

Extraction and recovery of chromium from electroplating sludge.

This work reports a study of the extraction and recovery of chromium from the wastes (class I dangerous) generated by a galvanic manufacturer. Commercial HCl at room temperature was employed, and the conditions of the extraction process were optimized according to a sequential experimental design, which also included the acid concentration and contact time as variables. The best extraction conditions (80% v/v; 30 min; 97.6% Cr) for the chromic sludge were chosen in order to make the recovery process economically feasible. After each extraction, the residue was submitted to leaching essays, to assess environmental risks. It was found that sludge could be characterized as no longer dangerous. In the recovery study, a simple and low-cost technique was evaluated for selectivity based on an oxidation step with hydrogen peroxide. A 2(3) factorial design to assess the influence of oxidation time (min), temperature ( degrees C) and peroxide amount (mol/L) was employed. The best conditions, yielding a chromium recovery of about 92%, were a time of 60 min, a temperature of 60 degrees C and 2.1 mol/L peroxide. Additional essays revealed that the same result could be obtained with more economic conditions (40 min, 1.4 mol/L peroxide and 60 degrees C). This technique proved not only effective in comparison with existing alternatives, but also low costing.

O conhecimento da equipe de enfermagem sobre cuidados com pacientes suspeitos ou portadores de tuberculose pulmonar - estudo exploratório / The nursing team's knowledge of care for patients suspected of having or diagnosed with pulmonary tuberculosis - an exploratory study

Nursing professionals at health care institutions should be prepared to suspect and identify cases of pulmonary tuberculosis at the earliest possible stage, in view of the risk of their contagion and consequent sickness. The prevention aspects should be valued in the performance of their activities, to the effect of remaining continuously attentive, to adopt safety measures that prevent the intra-hospital transmission of the disease. This study was aimed at identifying the knowledge of nursing team members of protective measures to be deployed in caring for adult patients suspected of having or diagnosed with pulmonary tuberculosis, confined in clinical-surgical and emergency units of a university hospital. This exploratory, transversal onsite study included 280 nursing professionals, comprising nurses (31-11.43%) and nursing assistants (249-88.57%). The material was gathered by applying a questionnaire with closed and open-ended questions. The material gathered was organized and the content analysis was used for the handling of data. The nursing professionals expressed their understanding of the disease and their knowledge of protective measures in the care of patients suspected of having or diagnosed with pulmonary tuberculosis. The study provided means of identifying the needs of nursing professionals focused on biosafety aspects in relation to the performance of their practice, permitting the formulation of subsidies for the continued education service and Hospital Infection Control Service of the Institution (SCIH).

Em instituições de saúde os profissionais da equipe de enfermagem devem estar preparados para a suspeição e identificação dos pacientes com tuberculose pulmonar o mais precoce possível, frente ao risco do seu contágio e adoecimento, valorizando os aspectos de prevenção no desempenho de suas atividades, no sentido de permanecerem atentos continuamente para adotarem medidas de segurança que impeçam a transmissão intrahospitalar da doença. Este estudo teve como objetivo verificar o conhecimento dos elementos da equipe de enfermagem sobre medidas de proteção a serem implantadas ao cuidarem de pacientes adultos suspeitos ou portadores de tuberculose pulmonar, internados em unidades clínico-cirúrgicas e de emergência, de um hospital universitário. Este trabalho, de campo, transversal, exploratório, incluiu 280 profissionais de enfermagem, distribuídos entre enfermeiros (31-11,43%) e auxiliares de enfermagem (249-88,57%). O material foi coletado aplicando um questionário com questões fechadas e abertas. Procedeu-se à organização do material recolhido e para tratamento dos dados utilizou-se a análise de conteúdo. Os profissionais de enfermagem expressaram sua compreensão sobre a doença e seu conhecimento sobre medidas de proteção no cuidado aos pacientes referidos. O estudo permitiu identificar as necessidades dos profissionais de enfermagem focadas nos aspectos da biosegurança em relação ao desempenho da sua prática, permitindo formular subsídios para o serviço de educação continuada e Serviço de Controle de Infecção Hospitalar da Instituição (SCIH).

Seringas: segurança no uso após processo de esterilizaçäo / Syringes: safety in the use after the sterilization process

Diante dos resultados obtidos em trabalhos realizados em Centro de Material Esteilizado e considerando as preocupaçöes manifestadas por alguns enfermeiros sobre esterilizaçäo de seringas de vidro processadas em autoclavaçäo ocorreu-nos oportuno descrever aspectos da nossa experiência. O presente trabalho tem como objetivo relatar detalhes no preparo da esterilizaçäo, na estocagem e teste da esterilidade de seringas de vidro com capacidade de 1,3 ,5,10,20 e 50cc, totalizando 436 amostras