Risk Factors for Positive Margins in High-Grade Cervical Intraepithelial Neoplasia After Transformation Zone Excision.

OBJECTIVE: The aim of the study was to evaluate risk factors for positive margins on surgical specimens of patients submitted to transformation zone excision (TZE). MATERIALS AND METHODS: We conducted a retrospective study evaluating women submitted to TZE in our center, between 2012 and 2020. Our study population included only women with the diagnosis of high-grade intraepithelial lesion (HSIL) in the pathologic examination of the TZE surgical specimen. Positive margins were defined as the presence of HSIL in the endocervical and/or ectocervical margin of the specimen. Factors evaluated included demographic characteristics, pretreatment Pap smear and human papillomavirus test, colposcopic findings, TZE indication, and pathologic features of the surgical specimen. We performed univariate analysis and logistic regression modeling including variables associated with the outcome of positive margins in the univariate analysis. RESULTS: Our sample included 264 women, with a 15.2% positive margins rate (40 patients). In the univariate analysis, patients with immunocompromised status, HSIL Pap smear, and higher number of quadrants involved in colposcopic examination were more likely to have positive margins. After multivariate analysis, only immunocompromised status was found to be an independent risk factor (odds ratio = 4.94; 95% CI = 1.43-17.15; p < .05). CONCLUSIONS: Immunocompromised status was the sole significant predictor for positive margins in TZE surgical specimens. To our knowledge, this is the first report of immunodepression as a risk factor for positive margins in cervical excisional procedures.

Nurses' Well-Being at Work in a Hospital Setting: A Scoping Review.

The aim of this review was to analyze the scientific evidence about nurses' well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at work, which can influence their well-being. Nurses' well-being at work in a hospital setting is crucial due to its relevance to occupational health, the quality of patient care, and the identification of stress and satisfaction factors. Methods: This systematic review followed the methodological guidelines of the Joanna Briggs Institute (JBI). The databases searched included CINAHL, MEDLINE, Scopus, Cochrane Database of Systematic Reviews, LILACS, Scientific Electronic Library Online (SciELO), and the Open Access Scientific Repositories of Portugal (RCAAP). The following inclusion criteria were defined: studies in Portuguese or English; with abstracts or full texts available; with a publication date from 2018 to 2022; and research containing the identified keywords in the title (TI) or abstract (AB). To organize and synthesize the data, we used a table to extract the significant information from each included study. Results: Eight studies were included, all of them emphasizing the assessment of well-being at work and the manager's intervention to promote this well-being. We found that most studies indicate that nurses are satisfied with their work. There are several factors that can influence this positive level of well-being at work, such as interaction with management, culture, and organizational commitment. It can be concluded that nurse managers have a decisive role in promoting well-being at work.

Monitoring of continuous subcutaneous insulin infusion treatment in Portugal and its implications for diabetes management.

AIMS/HYPOTHESIS: Intensive insulin therapy in the treatment of type 1 diabetes can, in place of multiple daily injections of subcutaneous insulin (MDI), be performed with continuous subcutaneous insulin infusion (CSII) systems. This method allows for better glycemic control and thus reduces the risk of complications of the disease. The aim of this study was to evaluate the results of treatment with CSII in Portugal. METHODS: A retrospective analysis of the records on the national CSII platform was carried out between January 2010 and August 2021. All the registered patients are followed in certified CSII treatment centers in Portugal. Of the 7135 registered patients, 3807 were excluded due to absence of monitoring data. The reasons for treatment were analyzed and a comparison was made between patients with and without CSII. The statistical significance considered was α < 0.05. RESULTS: A total of 3328 patients were included in the study, 1136 under MDI and 2192 under CSII. The main reasons for CSII use were marked glycemic variability (25%) and HbA1c greater than 7% (23%). Patients under CSII had a lower HbA1c (7.7 ± 1.0% vs. 8.0 ± 1.5%, p < 0.001), as well as a lower frequency of episodes of severe hypoglycemia (1.4 vs. 3.3 per 100 patient-years, p < 0.001), and ketoacidosis (1 vs. 2.4 per 100 patient-years, p < 0.001). CONCLUSIONS: The present analysis validates the advantage of using CSII in metabolic control and reduction of acute complications of type 1 diabetes, both severe hypoglycemia and ketoacidosis, in the Portuguese population. CSII therapy is classically associated with an increased risk of ketoacidosis; however, in experienced centers and adequate patient education, the opposite is found.

Novel pollutant-resistant methylotrophic bacteria for use in bioremediation.

Thirty one novel methylotrophic bacterial strains were isolated from a range of soil and sediment sources (both pristine and polluted) under different enrichment regimes. They were characterised physiologically and classified by their 16S rRNA gene sequence. A great taxonomical and phenotypical variety was recovered. Some of the isolates display interesting features of resistance to heavy metals, arsenate or organic pollution and four can be considered real 'super-bugs' for their ability to withstand extremely high concentrations of a variety of pollutants. A description of the 31 strains is presented in this work.

Effect of phenolic aldehydes and flavonoids on growth and inactivation of Oenococcus oeni and Lactobacillus hilgardii.

The aim of this work was to investigate the effect of wine phenolic aldehydes, flavonoids and tannins on growth and viability of strains of Oenococcus oeni and Lactobacillus hilgardii. Cultures were grown in ethanol-containing MRS/TJ medium supplemented with different concentrations of phenolic aldehydes or flavonoids and monitored spectrophotometrically. The effect of tannins was evaluated by monitoring the progressive inactivation of cells in ethanol-containing phosphate buffer supplemented with grape seed extracts with different molecular weight tannins. Of the phenolic aldehydes tested, sinapaldehyde, coniferaldehyde, p-hydroxybenzaldehyde, 3,4-dihydroxybenzaldehyde and 3,4,5-trihydroxybenzaldehyde significantly inhibited the growth of O. oeni VF, while vanillin and syringaldehyde had no effect at the concentrations tested. Lact. hilgardii 5 was only inhibited by sinapaldehyde and coniferaldehyde. Among the flavonoids, quercetin and kaempferol exerted an inhibitory effect especially on O. oeni VF. Myricetin and the flavan-3-ols studied (catechin and epicatechin) did not affect considerably the growth of both strains. Condensed tannins (particularly tetramers and pentamers) were found to strongly affect cell viability, especially in the case of O. oeni VF. In general, this strain was found to be more sensitive than Lact. hilgardii 5 to the phenolic compounds studied. This work contributes to the knowledge of the effect of different phenolic compounds on the activity of wine lactic acid bacteria, which, especially in the case of aldehydes and of different molecular weight fractions of tannins, is very scarce.