Linkage of routinely collected NHS data to evaluate liaison mental health services: challenges and lessons learned.

Background: Liaison mental health services provide mental health care to patients in acute hospital settings. Evaluation of liaison services is challenging due to their heterogeneous organisation and delivery, high case throughput and varied patient case mix. We aimed to link routinely collected National Health Service data from secondary care settings, chosen for their service characteristics, to data from primary care to evaluate hospital-based liaison mental health services in England. Methods: We planned to compare patients referred to hospital-based liaison services with comparable patients in the same hospital not referred to liaison services and comparable patients in hospitals without any liaison services. We designed and enacted a methodology to link data from: (1) Hospital Episode Statistics, a database controlled by the National Health Service Digital and (2) ResearchOne, a primary care database controlled by The Phoenix Partnership. Results: Obtaining approvals for the steps prespecified in the methodological protocol took 907 days. Enactment following approvals took 385 days. Data supplied from Hospital Episode Statistics contained 181,063 patients from 6 hospitals (mean = 30,177, standard deviation = 28,875.86) who matched the inclusion and exclusion criteria. Data supplied from ResearchOne contained 33,666 (18.6%) of these patients from the 6 hospitals (mean = 5611, standard deviation = 5206.59). Discussion: Time required for approvals and enactment was attributable to slowness of data handling processes within each data holder and to resolution of technical and organisational queries between them. Variation in number of patients for which data was supplied between databases and between hospitals was attributable to coding inconsistencies and to the limited intersection of patient populations between databases and variation in recording practices between hospitals. Conclusion: Although it is technically feasible to link primary and secondary care data, the current system is challenging, complicated, unnecessarily bureaucratic, time consuming and costly. This limits the number of studies that could be conducted with these rich data sources. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number 13/58/08.

Liaison mental health services are based in acute general hospitals and provide assessment and treatment for people who have both physical and mental health problems. Our aim was to use routinely collected National Health Service data to find out whether general hospital patients referred to liaison mental health services have improved outcomes, compared with patients not referred to liaison services, and comparable patients in hospitals where there are no liaison services. The main outcomes were less time spent in hospital and fewer re-admissions to hospital following discharge. We tried to link data from routine National Health Service sources for hospital and primary care, to compare patients referred to liaison mental health services with similar people in each hospital who had not been referred, and similar people in hospitals without any liaison services at all. We planned to find out how long these people stayed in hospital, whether they were re-admitted and how much was their healthcare cost was. We experienced significant difficulties in being able to link the National Health Service data from the different organisations we approached. The whole process was extremely complex, and a delay in one part of the process resulted delays in other parts. We eventually had to abandon the research without obtaining any meaningful data, although the lessons we learnt will be useful for other researchers, so they can avoid experiencing similar problems. Routinely collected National Health Service data from primary care and secondary care can be linked using the approaches we tried, but we were unable to complete the process within the time frame of the research programme, even with time extensions. Current processes need to be streamlined and standardised with designated clear response times for the different organisations.

Evaluation of Claw Lesions in Beef Cattle Slaughtered in Northern Portugal: A Preliminary Study.

Claw diseases have a profound impact on cattle welfare, affecting behaviors such as grazing, rumination, rest, decubitus, and water consumption. This study aimed to assess the prevalence of claw lesions and classify them according to the ICAR Claw Health Atlas (International Committee of Animal Recording) in two slaughterhouses. The influence of claw lesions on carcass weight, classification, and fat deposition was also examined. Involving 343 crossbreed cattle from 103 different extensive or semi-intensive farms, this study found an animal prevalence of claw disorders at 65.8%, with a higher incidence in females (n = 207, 60.35%) compared to males (n = 136, 39.65%). Despite the observed prevalence, claw lesions were not influenced by age or sex (p > 0.05). The main claw lesions identified, including heel horn erosion, double sole, and asymmetric claw, were consistent with the cattle management practices in the study area. These cattle were raised in small, rustic premises with uneven floors, utilizing a mix of manure and plant material as bedding and lacking access to pasture. Also, no negative economic impact was detected concerning carcass weight, classification, or fat deposition. Consequently, it was concluded that the presence of claw lesions in beef cattle raised under the characteristic management of this geographical area does not adversely affect animal health or farm economics.

Experiences of delivering and receiving mental healthcare in the acute hospital setting: a qualitative study.

BACKGROUND: Recent investment in UK liaison psychiatry services has focused on expanding provision for acute and emergency referrals. Little is known about the experiences of users and providers of these services. The aim of this study was to explore the experiences of users of acute liaison mental health services (LMHS) and those of NHS staff working within LMHS or referring to LMHS. A secondary aim was to explore the potential impact of a one-hour service access target on service delivery. METHODS: Cross-sectional qualitative study. Individual interviews were audio-recorded, transcribed verbatim and interpreted using framework analysis. RESULTS: Service users reported mixed experiences of LMHS, with some reporting positive experiences and some reporting poor care. Most service users described the emergency department (ED) environment as extremely stressful and wished to be seen as quickly as possible. Staff described positive benefits of the one-hour access target but identified unintended consequences and trade-offs that affected other parts of the liaison service. CONCLUSIONS: The assessment and treatment of people who attend ED with mental health problems needs to improve and particular attention should be given to the stressful nature of the ED environment for those who are extremely agitated or distressed.

Antimicrobial Effects and Antioxidant Activity of Myrtus communis L. Essential Oil in Beef Stored under Different Packaging Conditions.

The aim of this study was to assess the antimicrobial effects of myrtle (Myrtus communis L.) essential oil (EO) on pathogenic (E. coli O157:H7 NCTC 12900; Listeria monocytogenes ATCC BAA-679) and spoilage microbiota in beef and determine its minimum inhibitory concentration (MIC) and antioxidant activity. The behavior of LAB, Enterobacteriaceae, Pseudomonas spp., and fungi, as well as total mesophilic (TM) and total psychotropic (TP) counts, in beef samples, was analyzed during storage at 2 and 8 °C in two different packaging systems (aerobiosis and vacuum). Leaves of myrtle were dried, its EO was extracted by hydrodistillation using a Clevenger-type apparatus, and the chemical composition was determined using chromatographical techniques. The major compounds obtained were myrtenyl acetate (15.5%), ß-linalool (12.3%), 1,8-cineole (eucalyptol; 9.9%), geranyl acetate (7.4%), limonene (6.2%), α-pinene (4.4%), linalyl o-aminobenzoate (5.8%), α-terpineol (2.7%), and myrtenol (1.2%). Myrtle EO presented a MIC of 25 µL/mL for E. coli O157:H7 NCTC 12900, E. coli, Listeria monocytogenes ATCC BAA-679, Enterobacteriaceae, and E. coli O157:H7 ATCC 35150 and 50µL/mL for Pseudomonas spp. The samples packed in aerobiosis had higher counts of deteriorative microorganisms than samples packed under vacuum, and samples with myrtle EO presented the lowest microbial contents, indicating good antimicrobial activity in beef samples. Myrtle EO is a viable natural alternative to eliminate or reduce the pathogenic and deteriorative microorganisms of meat, preventing their growth and enhancing meat safety.

Behaviour of Escherichia coli O157:H7 and Listeria monocytogenes in Normal and DFD Beef of an Autochthonous Portuguese Breed.

This study was carried out to identify the behaviour of Escherichia coli O157:H7 and of Listeria monocytogenes inoculated in Maronesa breed beef with different ultimate pH (pHu) (Normal and DFD), and stored at two different temperatures (4 and 9 °C), during 28 days post mortem (pm). The main objective was to illustrate the problematic feature of dealing with beef showing high pHu and stored at mild abusive temperatures (9 °C). Beef steaks (ms. longissimus dorsi) were inoculated with low levels (2-3 log CFU/g) of those both pathogens and packed in air, vacuum and three gaseous mixtures with decreasing O2 and increasing CO2 concentrations (MAP70/20, MAP50/40 and MAP30/60). At 4 °C, the growth of E. coli O157:H7 presented the same pattern on Normal and DFD meat. On the contrary, the growth of L. monocytogenes was higher in DFD meat, revealing the effect of the pHu and its psychotropic character. At abusive temperatures, both pathogens grew, achieving high levels in DFD meat. In these cases, the MAP with the highest CO2 concentration (60%) was revealed to be more effective against the development of E. coli O157:H7, therefore, not exceeding levels of 5 log CFU/g at the end of storage, while in L. monocytogenes, it reaches 8 log CFU/g under the same conditions.

The Importance of the Slaughterhouse in Surveilling Animal and Public Health: A Systematic Review.

From the point of public health, the objective of the slaughterhouse is to guarantee the safety of meat in which meat inspection represent an essential tool to control animal diseases and guarantee the public health. The slaughterhouse can be used as surveillance center for livestock diseases. However, other aspects related with animal and human health, such as epidemiology and disease control in primary production, control of animal welfare on the farm, surveillance of zoonotic agents responsible for food poisoning, as well as surveillance and control of antimicrobial resistance, can be monitored. These controls should not be seen as a last defensive barrier but rather as a complement to the controls carried out on the farm. Regarding the control of diseases in livestock, scientific research is scarce and outdated, not taking advantage of the potential for disease control. Animal welfare in primary production and during transport can be monitored throughout ante-mortem and post-mortem inspection at the slaughterhouse, providing valuable individual data on animal welfare. Surveillance and research regarding antimicrobial resistance (AMR) at slaughterhouses is scarce, mainly in cattle, sheep, and goats. However, most of the zoonotic pathogens are sensitive to the antibiotics studied. Moreover, the prevalence at the slaughterhouse of zoonotic and foodborne agents seems to be low, but a lack of harmonization in terms of control and communication may lead to underestimate its real prevalence.

Impact of pre-slaughter factors on welfare of broilers.

Pre-slaughter factors adversely affecting bird welfare were studied at the slaughterhouse. The incidence of dead on arrival (DoA), bruises and dehydration was investigated in 64 different mixed-sex batches of broilers coming from 64 different farms rearing fast-growing genotypes (Ross or Cobb). The effects of catching team, method of catching, time of day for catching and transport, density per cage, transport duration, transport distance, lairage duration and water withdrawal were considered. The average DoA was 0.29%, ranging from 0.02% to 1.89% per batch. DoA rate has a higher probability of increase with the increase in transport distance (t=2.142; P=0.037; estimate=0.009) and with catching the birds after midnight (t=-2.931; P=0.005; estimate=0.022). Longer transport durations for birds caught after midnight as well as longer lairage durations for birds caught after midnight are associated with the increase of DoA rate. Bruises were observed in 3.37% of birds, ranging from 0.43% to 8.29% per batch. Bruises occurred mostly on wings (3.06%), followed by legs (0.19%) and breast (0.12%). A higher percentage of bruises occurred in batches with more birds per transport crate (t=2.185; P=0.029; estimate=0.001). Dehydrated carcasses were observed in 22 out of 64 batches, accounting for 2.68% of condemnations. Signs of dehydration on carcasses were more frequently observed in batches subjected to longer withdrawal durations. Short transport distances, catching the birds before midnight and doing the transport by night are crucial in decreasing the DoA rate. Catching and crating processes seem to be responsible for the increase of percentage of bruises. Pre-slaughter operations should be adequate planned namely, transport and lairage durations, catching period and crating procedure in view to reduce negative effects on animal welfare.

Bridging the mental health treatment gap: effects of a collaborative care intervention (matrix support) in the detection and treatment of mental disorders in a Brazilian city.

OBJECTIVE: To analyse temporal trends in diagnosis and treatment of mental disorders in primary care following implementation of a collaborative care intervention (matrix support). DESIGN: Dynamic cohort design with retrospective time-series analysis. Structured secondary data on medical visits to general practitioners of all study clinics were extracted from the municipal electronic records database. Annual changes in the odds of mental disorders diagnoses and antidepressants prescriptions were estimated by multiple logistic regression at visit and patient-year levels with diagnoses or prescriptions as outcomes. Annual changes during two distinct stages of the intervention (stage 1 when it was restricted to mental health (2005-2009), and stage 2 when it was expanded to other areas (2010-2015)) were compared by adding year-period interaction terms to each model. SETTING: 49 primary care clinics in the city of Florianópolis, Brazil. PARTICIPANTS: All adults attending primary care clinics of the study setting between 2005 and 2015. RESULTS: 3 131 983 visits representing 322 100 patients were analysed. At visit level, the odds of mental disorder diagnosis increased by 13% per year during stage 1 (OR 1.13, 95% CI 1.11 to 1.14, p<0.001) and decreased by 5% thereafter (OR 0.95, 95% CI 0.94 to 0.95, p<0.001). The odds of incident mental disorder diagnoses decreased by 1% per year during stage 1 (OR 0.99, 95% CI 0.98 to 1.00, p=0.012) and decreased by 7% per year during stage 2 (OR 0.93, 95% CI 0.92 to 0.93, p<0.001). The odds of antidepressant prescriptions in patients with a mental disorder diagnosis increased by 7% per year during stage 1 (OR 1.07, 95% CI 1.05 to 1.20, p<0.001); this was driven by selective serotonin reuptake inhibitor prescriptions which increased 14% per year during stage 1 (OR 1.14, 95% CI 1.12 to 1.18, p<0.001) and 9% during stage 2 (OR 1.09, 95% CI 1.08 to 1.10, p<0.001). The odds of incident antidepressant prescriptions did not increase during stage 1 (OR 1.00, 95% CI 0.97 to 1.02, p=0.665) and increased by 3% during stage 2 (OR 1.03, 95% CI 1.00 to 1.04, p<0.001). Changes per year were all significantly greater during stage 1 than stage 2 (p values for interaction terms <0.05), except for antidepressant prescriptions during visits (p=0.172). CONCLUSION: The matrix support intervention may increase diagnosis and treatment of mental disorders when inter-professional collaboration is adequately supported. Competing demands to the primary care teams can subsequently reduce these effects. Future studies should assess clinical outcomes and identify active components and factors associated with successful implementation.

The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study.

BACKGROUND: To describe the clinical activity patterns and nature of interventions of hospital-based liaison psychiatry services in England. METHODS: Multi-site, cross-sectional survey. 18 acute hospitals across England with a liaison psychiatry service. All liaison staff members, at each hospital site, recorded data on each patient they had face to face contact with, over a 7 day period. Data included location of referral, source of referral, main clinical problem, type of liaison intervention employed, staff professional group and grade, referral onto other services, and standard assessment measures. RESULTS: A total of 1475 face to face contacts from 18 hospitals were included in the analysis, of which approximately half were follow-up reviews. There was considerable variation across sites, related to the volume of Emergency Department (ED) attendances, number of hospital admissions, and work hours of the team but not to the size of the hospital (number of beds). The most common clinical problems were co-morbid physical and psychiatric symptoms, self-harm and cognitive impairment. The main types of intervention delivered were diagnosis/formulation, risk management and advice. There were differences in the type of clinical problems seen by the services between EDs and wards, and also differences between the work conducted by doctors and nurses. Almost half of the contacts were for continuing care, rather than assessment. Eight per cent of all referrals were offered follow up with the LP team, and approximately 37% were referred to community or other services. CONCLUSIONS: The activity of LP services is related to the flow of patients through an acute hospital. In addition to initial assessments, services provide a wide range of differing interventions, with nurses and doctors carrying out distinctly different roles within the team. The results show the volume and diversity of LP work. While much clinical contact is acute and confined to the inpatient episode, the LP service is not defined solely by an assessment and discharge function; cases are often complex and nearly half were referred for follow up including liaison team follow up.

[Components of matrix support and collaborative mental health care: a narrative review]. / Componentes do apoio matricial e cuidados colaborativos em saúde mental: uma revisão narrativa.

Collaborative care between mental health and primary care is effective in improving health outcomes. The matrix support has similarities with collaborative care little explored in the literature. This article compares the two models and analyzes the matrix support from evidence on collaborative care. Narrative review. Components of each model (activities and dimensions) were identified and compared. Evidence on collaborative care informed analysis of similar components of matrix support. The dimensions of the matrix support - educational support, specialized care, regulation, co-management - and collaborative care - multiprofessional care, systematic communication, structured care, organizational support - were identified. The main similarity between the models lies in the direct collaborative activities around clinical problems which is related to effectiveness in collaborative care studies. Direct collaborative activities are a positive aspect of matrix support. Structured care and support at the organizational level should be encouraged. Future studies should refine the proposed categories and explore their use for the development of matrix support.

Cuidados colaborativos entre saúde mental e atenção primária são efetivos em melhorar desfechos de saúde. O apoio matricial tem semelhanças com cuidados colaborativos pouco exploradas na literatura. Este artigo compara os dois modelos e analisa o apoio matricial a partir de evidências sobre cuidados colaborativos. Revisão narrativa. Componentes de cada modelo (atividades e dimensões) foram identificados e comparados. Evidências sobre cuidados colaborativos informaram análise de componentes semelhantes do apoio matricial. Foram identificadas dimensões do apoio matricial ­ suporte educacional, cuidado especializado, regulação, cogestão ­ e dos cuidados colaborativos ­ cuidado multiprofissional, comunicação sistemática, cuidado estruturado, suporte organizacional. A principal semelhança entre os modelos está nas atividades colaborativas diretas em torno de problemas clínicos, relacionadas a efetividade em estudos sobre cuidados colaborativos. Atividades colaborativas diretas são ponto positivo do apoio matricial. Cuidado estruturado e suporte em nível organizacional devem ser encorajados. Futuros estudos devem refinar as categorias propostas e explorar seu uso para desenvolvimento do apoio matricial.

Componentes do apoio matricial e cuidados colaborativos em saúde mental: uma revisão narrativa / Components of matrix support and collaborative mental health care: a narrative review

Resumo Cuidados colaborativos entre saúde mental e atenção primária são efetivos em melhorar desfechos de saúde. O apoio matricial tem semelhanças com cuidados colaborativos pouco exploradas na literatura. Este artigo compara os dois modelos e analisa o apoio matricial a partir de evidências sobre cuidados colaborativos. Revisão narrativa. Componentes de cada modelo (atividades e dimensões) foram identificados e comparados. Evidências sobre cuidados colaborativos informaram análise de componentes semelhantes do apoio matricial. Foram identificadas dimensões do apoio matricial - suporte educacional, cuidado especializado, regulação, cogestão - e dos cuidados colaborativos - cuidado multiprofissional, comunicação sistemática, cuidado estruturado, suporte organizacional. A principal semelhança entre os modelos está nas atividades colaborativas diretas em torno de problemas clínicos, relacionadas a efetividade em estudos sobre cuidados colaborativos. Atividades colaborativas diretas são ponto positivo do apoio matricial. Cuidado estruturado e suporte em nível organizacional devem ser encorajados. Futuros estudos devem refinar as categorias propostas e explorar seu uso para desenvolvimento do apoio matricial.

Abstract Collaborative care between mental health and primary care is effective in improving health outcomes. The matrix support has similarities with collaborative care little explored in the literature. This article compares the two models and analyzes the matrix support from evidence on collaborative care. Narrative review. Components of each model (activities and dimensions) were identified and compared. Evidence on collaborative care informed analysis of similar components of matrix support. The dimensions of the matrix support - educational support, specialized care, regulation, co-management - and collaborative care - multiprofessional care, systematic communication, structured care, organizational support - were identified. The main similarity between the models lies in the direct collaborative activities around clinical problems which is related to effectiveness in collaborative care studies. Direct collaborative activities are a positive aspect of matrix support. Structured care and support at the organizational level should be encouraged. Future studies should refine the proposed categories and explore their use for the development of matrix support.

Influence of different housing systems on prevalence of keel bone lesions in laying hens.

The present study aimed to investigate the effect of three housing systems (furnished cages - FC, barns - B, and free-range - FR) on the prevalence and severity of keel bone protrusion and deformations. These health and welfare indicators were measured at the slaughterhouse, using a 4-point scale (0 = absence, 1 = slight, 2 = moderate and 3 = severe). Keel bone deformation was also categorized in relation to the presence of compression over the ventral surface, deviation from a 2D straight plane and deviation from the transverse (C-shaped) or median sagittal (S-shaped) plane. The housing system had a significant effect on prevalence of keel bone deformation (χ2 = 45.465, df = 6, P < 0.001). In FR systems 60.4% of hens presented keel bone deformation, followed by 54.2% in FC and 53.5% in B; however, higher scores for keel bone deformations were more frequent in B systems. Although keel bone protrusion was observed in all laying hen systems, the majority of hens only presented a slight degree (score 1) of protrusion. A positive correlation was obtained for keel bone protrusion and emaciation. The results could be used to initiate detailed investigations into problematic issues that occur during the laying period to improve the health and welfare conditions on farms.

Avaliação do bem-estar no transporte e nos currais de descanso pela ocorrência de lesões em carcaças de suínos abatidos em matadouro / Evaluation of welfare during transport and lairage through the occurrence of lesions in slaughtered pig carcasses

Bem-Estar Animal consiste no estado do animal em sua tentativa de adaptação ao meio ambiente envolvente, podendo ser medido e melhorado com a ação do ser humano. Nos últimos anos o tema “Bem-Estar Animal” tem adquirido importância, resultante das grandes preocupações com o manejo dos animais em vida e constatação da influência que este tem na qualidade da carne post mortem. Este trabalho teve como objetivo determinar o efeito do lote de suínos transportados, respectivo tamanho, tipo de trajeto e do tempo decorrido entre a origem e o abate na ocorrência de lesões, consideradas indicadores mínimos de bem-estar animal em matadouro. Nos matadouros de suínos da região norte de Portugal, foram monitorados 834 animais com relação à ocorrência de lesões compatíveis com lacerações, eritemas cutâneos, hematomas e fraturas, em cinco diferentes lotes. Pela análise global dos dados, verificou-se que as lacerações estavam presentes em 72 por cento dos animais e foi o tipo de lesão mais frequentemente observado. Seguiram-se os eritemas cutâneos em 20 por cento, os hematomas em 11 por cento e as fraturas em apenas 1 por cento dos animais. O tamanho do lote de animais transportados, a duração da viagem e o tempo de permanência no matadouro influenciaram significativamente a ocorrência das lesões monitoradas, nomeadamente lacerações, eritemas e hematomas.

Animal welfare is the state of the animal in its attempts to cope with its environment, and it can be measured and improved by the action of man. Recently, the topic “Animal Welfare” has become more important, resulting from the discovery that the management of animals in life has impact on the post mortem meat quality. This study aimed to determine the effect of transport batch number of pigs transported by batch, type of route and the time elapsed between the exploration and slaughter in the occurrence of lesions, considered as indicators of animal welfare at the slaughterhouse. At one slaughterhouse of pigs located in the northern of Portugal, 834 animals were monitored in order to check the occurrence of lesions consistent with lacerations, erythema, bruising and fractures, from a total of five different transport batches. The global analysis of the data showed that lacerations were present in 72 percent of animals and was the most common type of lesion, followed by erythema, bruises and broken bones presented in 20 percent percent and 1 percent respectively. The size of each batch, the duration of the journey and the time spent in the lairage significantly influenced the occurrence of observed lesions, particularly, lacerations, erythema and bruising.

Avaliação do hipoclorito de sódio e da clorexidina na desinfecção de cones de Guta-Percha / Evaluation of sodium hypochlorite and chlorhexidine in disinfection Gutta-Percha cones

Introdução: O objetivo deste trabalho é avaliar a eficácia, em dois períodos de tempo, do hipoclorito de sódio e da clorexidina na desinfecção de cones de guta-percha. Métodos: Foram utilizados 50 cones de gutapercha previamente contaminados com cepas de bactérias do gênero Enterococcus faecalis (ATCC 29212), em culturas puras. Para o processo de descontaminação, os cones foram divididos em quatro grupos, contendo 10 amostras cada: G1- hipoclorito de sódio (NaOCl) a 5,25% por 30 segundos; G2 - NaOCl a 5,25% por 1 minuto; G3 - clorexidina a 4% por 30 segundos; G4 - clorexidina a 4% por 1 minuto. Após esse período, os cones foram introduzidos individualmente em tubos de ensaio contendo caldo de BHI, mantidos em estufa bacteriológica a 37ºC por 72 horas, quando foi avaliada a presença de contaminação através da turvação do meio. Para o grupo-controle positivo, empregaram-se 2 cones, que foram contaminados e colocados em tubos de ensaio e, para o controle negativo, 8 cones foram apenas descontaminados, sendo colocados 2 cones em cada uma das soluções desinfetantes, por 30 segundos e por 1 minuto. Resultados: Verificou-se a ausência de crescimento bacteriano nos grupos 1, 2, 3 e 4, em todos os períodos experimentais. No controle positivo, houve 100% de contaminação e, no controle negativo, ausência de crescimento bacteriano. Conclusão: As soluções de NaOCl a 5,25% e de clorexidina a 4%, por períodos de tempo de 30 segundos e de 1 minuto, possuem efetividade antimicrobiana contra o Enterococcus faecalis, podendo ser utilizadas na desinfecção de cones de guta-percha nos tempos testados.

Introduction: The aim of this study is to evaluate the efficacy, in two period of time, of sodium hypochlorite and chlorhexidine in disinfection gutta-percha cones. Methods: 50 gutta-percha cones were used, previously contaminated with bacteria of the genus Enterococcus faecalis (ATCC 29212), in pure cultures. For the decontamination process, the cones were divided into four groups, containing 10 samples each: G1- sodium hypochlorite 5,25% for 30 seconds; G2 - sodium hypochlorite 5,25% for 1 minute; G3 - chlorhexidine 4% for 30 seconds; G4 - chlorhexidine 4% for 1 minute. After this period, all cones were immersed individually in test tubes containing Brain Heart Infusion, maintained in bacteriological incubator at 37ºC for 72 hours, when was evaluated the presence of contamination through the turbidity of BHI solution. For the positive control groups, were used 2 gutta-percha cones that were contaminated and placed directly in test tubes and for the negative control group 8 cones were just decontaminated, being placed 2 cones in each disinfectant solution, for 30 seconds and for 1 minute. Results: There was the absence of bacterial growth in groups 1, 2, 3 and 4, in all experimental periods. In the positive control group were verified 100% of contamination and in the negative control tubes wasn't verified the presence of bacterial growth. Conclusion: The solutions of 5,25% sodium hypochlorite and 4% chlorhexidine for 30 seconds and 1 minute have antimicrobial effectiveness against Enterococcus faecalis, which can be used in the disinfection of gutta-percha cones in the time tested.

Neuropsicologia coréia e aids: aspectos clínicos e fisiopatológicos / Chorea and aids: clinical and pathophysiological aspects

As complicações neurológicas em pacientes com AIDS são frequentes, compreendendo infecções oportunistas e neoplasias, que podem coexistir. O aparecimento de movimentos involutários anormais é pouco frequente, no entanto é considerado manifestação muito sugestiva de infecção oportunista, geralmente toxoplasmose. O presente estudo analisa um caso de paciente com AIDS, que apresentou inicialmente hemicoréia e, evolutivamente, observou-se a cessação dos movimentos involuntários, que deram lugar a hemiparesia. Além da avaliação neurológica foi realizado TC de crânio, que revelou lesão em núcleos da base e estruturas adjacentes, nos dois momentos evolutivos. O presente caso confirma a relação entre a manifestação extrapiramidal e a topografia da lesão. Mostra também dados fisiopatológicos referentes ao circuito gânglios da base/extrapiramidal, evidenciados pelos movimentos involuntários e pelo seu desaparecimento com a instalação da hemiparesia.