An improved protocol for bacteria identification by MALDI-TOF MS directly from positive blood cultures.

FASTinov® developed a rapid antimicrobial susceptibility test that includes the purification of a bacterial suspension directly from positive blood cultures (BC). In order to streamline laboratory workflow, the use of the bacterial suspension obtained through FASTinov® sample prep was tested for identification (ID) by matrix absorption laser deionization-time of flight mass spectrometry (MALDI-TOF MS) (Bruker) in 364 positive BC, and its accuracy assessed comparing with the MALDI-TOF MS ID of the next-day subcultured colonies. FASTinov sample prep was highly reliable for rapid ID directly from BC with proportion of agreement of 94.9% for Gram-positive and 96.3% for Gram-negative bacteria.

Performance of Flow Cytometry-Based Rapid Assay in Detection of Carbapenemase-Producing Enterobacterales.

Carbapenemase-producing Enterobacterales are increasingly being recognized in nosocomial infections. The performance of a flow cytometry-based rapid assay for their detection and differentiation was evaluated. This is a disruptive phenotypic technology, phenotypic and growth-independent, that searches for the lesions produced by drugs acting on cells after a short incubation time. Overall, 180 Gram-negative bacteria were studied, and results were compared with those obtained molecularly by PCR and phenotypically by 'KPC, MBL and OXA-48 Confirm Kit'. This phenotypic method was used as reference for comparison purposes. Susceptibility to carbapenems (imipenem, meropenem, and ertapenem) was determined by standard broth microdilution. Overall, 112 isolates (62.2%) were carbapenemase producers, 41 KPCs, 36 MßLs, and 31 OXA-48, and 4 strains were KPC + MßL co-producers. Sixty-eight isolates were carbapenemase-negative. The percentage of agreement, sensitivity, and specificity were calculated according to ISO 20776-2:2021. The FASTinov assay showed 97.7% agreement with the reference method for carbapenemase detection. Discrepant flow cytometry results were obtained in four isolates compared with both reference and PCR results. The sensitivity and specificity of this new technology were 95.3% and 98.5%, respectively, for KPCs, 97.6% and 99.3% for MßLs, and 96.9% and 98% for OXA-48 detection. In conclusion, we describe a rapid flow cytometry assay with high accuracy for carbapenemase detection and the differentiation of various carbapenemases, which should impact clinical microbiology laboratories and patient management.

Same-day discharge after elective percutaneous closure of patent foramen ovale.

Percutaneous closure of the patent foramen ovale (PFO) is increasingly performed in specific patients with cryptogenic stroke or clinical evidence of a paradoxical embolism. This study was performed to determine the safety of same-day discharge (SDD) following such procedures. This is a prospective, observational study of patients undergoing elective percutaneous PFO closure in a single tertiary center in Portugal between January 2020 and July 2023. AmplatzerTM devices (St. Jude Medical, St. Paul, MN, USA) and NobblestichTM EL (HeartStitch, Inc., Fountain Valley, CA, USA) were used. After 6 months, the following events were looked at: post-procedural paroxysmal atrial fibrillation, stroke, unplanned cardiac re-hospitalization, urgent cardiac surgery, major vascular complications, pericardial effusions, device embolization, and death. We studied 122 consecutive patients (52% female, 68; 48±12 years old) who had elective percutaneous closure with success and no complications. Forty-nine (40%) had SDD. AmplatzerTM devices were used more frequently in the SDD group, while NobblestichTM EL was more common in the overnight group. During the overnight group's follow-up period, there was one non-cardiovascular death; there were no further events. SDD after elective percutaneous closure of PFO was shown to be a safe and successful patient management method, including NobblestichTM, which we describe for the first time. Our results prove the safety of this same-day discharge strategy. We hypothesize that in the near future, in selected cases, PFO closure might become an ambulatory procedure.

Patient Safety Culture in the Context of Critical Care: An Observational Study.

BACKGROUND: A robust safety culture is essential for ensuring high-quality healthcare delivery. From a nursing perspective, especially among critical patients, it fosters ongoing improvement by highlighting areas that need attention. AIMS: This study aimed to evaluate the perception of patient safety culture among nurses within the critical care environment. METHODOLOGY: An observational study was conducted at a central hospital in Portugal employing the Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. RESULTS: The study encompassed 57, nurses predominantly female (73.7%), aged 25-64. Most participants were general nurses (77.2%), with a significant proportion (61.4%) working in the emergency department and possessing an average tenure of 13 years at the facility. The perception of critical patient safety culture (CPSC) was predominantly positive (40.6%), varying by department, with intensive care nurses reporting the highest positivity rates. Teamwork was identified as a strong point, receiving 80.7% positivity, highlighting it as a well-established domain in the CPSC, whereas other domains were recognised as requiring enhancements. CONCLUSIONS: The study pinpointed both strengths and weaknesses within the CPSC, offering a foundation for developing targeted strategies to bolster patient safety culture in critical care settings.

Non-invasive diagnosis of endometriosis in adolescents and young female adults: a systematic review.

STUDY OBJECTIVES: Our aim was to review the evidence concerning the non-invasive diagnosis of endometriosis in adolescents. METHODS: A systematic review was written following the SWiM reporting guidelines. The study research was made across three databases (MEDLINE/PubMed, Scopus, and Web of Science) to identify articles about the adolescent population and the diagnosis of endometriosis through non-invasive methods. The search included the keywords "endometriosis," "adolescents," "diagnosis," "ultrasound," and "MRI." Only English-language articles were considered, and those published prior to 2000 were excluded. The established outcomes focused on clinical symptoms, ultrasound (US), and magnetic resonance imaging (MRI) findings suggestive of endometriosis. RESULTS: We included 26 articles, mostly comprising case series and cross-sectional studies. The pooled analysis involved 2,299 female adolescents (age range 8-25 years old) with clinically suspected, imaged, and/or surgically confirmed endometriosis. The most frequently reported symptom was dysmenorrhea, followed by chronic pelvic pain. Among adolescents clinically suspected of endometriosis undergoing ultrasound (US), 32.8% exhibited at least one sign of endometriosis. Of the 167 patients with ultrasound-diagnosed endometriosis, 48.5% had deep infiltrating endometriosis (DIE), and 45.5% had an endometrioma detected. Three studies assessed MRI findings, revealing that 49.8% presented with signs of endometriosis. CONCLUSIONS: Dysmenorrhea and chronic pelvic pain stand out as key symptoms of adolescent endometriosis. Although their diagnostic accuracy varies, US and MRI have emerged as valuable tools for diagnosing the disease. While the US may have limitations, especially in detecting subtle lesions, MRI shows promise, even in cases with normal previous ultrasounds. Early recognition and proactive diagnosis are crucial for improving the management of endometriosis in adolescents.

Hematocolpos: An Uncommon Cause of Acute Urinary Retention and Hydronephrosis.

Acute urinary retention is uncommon in pediatric age and is usually associated with infection or obstruction of the urinary tract. We present the case of a 12-year-old girl admitted to the emergency room with acute urinary retention and lower urinary tract symptoms. Physical examination revealed abdominal distension and a blue-bulging mass occupying the vaginal introitus. Ultrasound confirmed the diagnosis of hematocolpos and revealed hydronephrosis, caused by compression. Kidney function and urinalysis were normal. A hymen incision and excision of redundant tissue were performed without complications. Hematocolpos is a condition caused by obstructive uterovaginal deformity. Imperforate hymen is responsible for most of the cases and usually manifests as primary amenorrhea and cyclic lower abdominal pain. The diagnosis of hematocolpos can be challenging. However, it is important to consider it in female adolescents without menarche presenting with acute urinary retention.

Epidemiological and clinical trends of imported strongyloidiasis in a referral international health unit, Barcelona, Spain: A 12-year period experience.

BACKGROUND: Imported strongyloidiasis in non-endemic countries has increasingly been diagnosed. The aim of the present study is to describe the main epidemiological and clinical characteristics of patients with imported strongyloidiasis attended in a referral International Health Unit and to detect trend changes over a 12-year period. METHODS: This is an observational retrospective study including all imported strongyloidiasis cases seen at the International Health Unit Vall d'Hebron-Drassanes (Barcelona, Spain) from January 2009 to December 2020. Epidemiological and clinical characteristics from included patients were collected. RESULTS: Overall, 865 cases of imported strongyloidiasis were diagnosed, of whom 472 (54.6 %) were men and mean age was 38.7 (SD 13.4) years. Most cases were diagnosed in migrants (830, 96 %). The distribution of the geographic origin was: Latin America (561, 67.6 %), Sub-Saharan Africa (148, 17.8 %), Asia (113, 13.6 %), North Africa (5, 0.6 %), Eastern Europe (2, 0.2 %), and North America (1, 0.1 %). The main reasons for consultation at the Unit were screening of health status (371, 42.9 %), laboratory test alteration (367, 42.4 %), gastrointestinal symptoms (56, 6.5 %), cutaneous symptoms (26, 3 %), and other clinical symptoms (45, 5.2 %). An increase in the number of cases was observed in the last years of the study period. CONCLUSIONS: Imported strongyloidiasis has increasingly been diagnosed in our referral unit, mostly due to screening strategies implementation. Most of the patients were young migrants coming from Latin America, with no symptoms at the time of diagnosis. The optimization of screening strategies will increase the detection and treatment of cases, reducing potential complications.

Imported schistosomiasis in travelers: Experience from a referral tropical medicine unit in Barcelona, Spain.

BACKGROUND: Acute schistosomiasis occurs most often in travelers to endemic regions. The aim of the study is to describe the epidemiological, clinical and parasitological characteristics of patients with schistosomiasis acquired during an international travel. METHODS: Observational retrospective study including all travel-related schistosomiasis cases seen at the International Health Unit Vall d'Hebron-Drassanes (Barcelona, Spain) from 2009 to 2022. Diagnosis of schistosomiasis was defined by the presence of Schistosoma eggs in stools or urine or the positivity of a serological test. We collected demographic, epidemiological, clinical, parasitological, and therapeutic information. RESULTS: 917 cases of schistosomiasis were diagnosed, from whom 96 (10.5 %) were travel-related. Mean age of the patients was 34.9 years, and 53.1 % were women. Median duration of the travel was 72 days, and geographical areas where travelers had contact with fresh water were Africa (82.3 %), Asia (12.5 %), and South America (5.2 %). Twenty (20.8 %) patients reported having had some clinical symptom, being gastrointestinal symptoms the most frequent. Two patients developed the classical Katayama syndrome. In eleven (11.5 %) cases eggs were observed in urine or feces samples, and 85 (88.5 %) cases were diagnosed by a positive serology. Ninety-one (94.8 %) patients received treatment with praziquantel with different therapeutic schemes. The two patients with Katayama syndrome received concomitant treatment with corticosteroids. CONCLUSIONS: Schistosomiasis in travelers represented 10 % of the overall schistosomiasis cases in our center. Increasing the awareness in the pre-travel advice and implementing specific screening in those travelers at risk (long travelers, contact with fresh water) could reduce the incidence and associated morbidity in this group.

Efficacy of three benznidazole dosing strategies for adults living with chronic Chagas disease (MULTIBENZ): an international, randomised, double-blind, phase 2b trial.

BACKGROUND: Treatment with benznidazole for chronic Chagas disease is associated with low cure rates and substantial toxicity. We aimed to compare the parasitological efficacy and safety of 3 different benznidazole regimens in adult patients with chronic Chagas disease. METHODS: The MULTIBENZ trial was an international, randomised, double-blind, phase 2b trial performed in Argentina, Brazil, Colombia, and Spain. We included participants aged 18 years and older diagnosed with Chagas disease with two different serological tests and detectable T cruzi DNA by qPCR in blood. Previously treated people, pregnant women, and people with severe cardiac forms were excluded. Participants were randomly assigned 1:1:1, using a balanced block randomisation scheme stratified by country, to receive benznidazole at three different doses: 300 mg/day for 60 days (control group), 150 mg/day for 60 days (low dose group), or 400 mg/day for 15 days (short treatment group). The primary outcome was the proportion of patients with a sustained parasitological negativity by qPCR during a follow-up period of 12 months. The primary safety outcome was the proportion of people who permanently discontinued the treatment. Both primary efficacy analysis and primary safety analysis were done in the intention-to-treat population. The trial is registered with EudraCT, 2016-003789-21, and ClinicalTrials.gov, NCT03191162, and is completed. FINDINGS: From April 20, 2017, to Sept 20, 2020, 245 people were enrolled, and 234 were randomly assigned: 78 to the control group, 77 to the low dose group, and 79 to the short treatment group. Sustained parasitological negativity was observed in 42 (54%) of 78 participants in the control group, 47 (61%) of 77 in the low dose group, and 46 (58%) of 79 in the short treatment group. Odds ratios were 1·41 (95% CI 0·69-2·88; p=0·34) when comparing the low dose and control groups and 1·23 (0·61-2·50; p=0·55) when comparing short treatment and control groups. 177 participants (76%) had an adverse event: 62 (79%) in the control group, 56 (73%) in the low dose group, and 59 (77%) in the short treatment group. However, discontinuations were less frequent in the short treatment group compared with the control group (2 [2%] vs 11 [14%]; OR 0·20, 95% CI 0·04-0·95; p=0·044). INTERPRETATION: Participants had a similar parasitological responses. However, reducing the usual treatment from 8 weeks to 2 weeks might maintain the same response while facilitating adherence and increasing treatment coverage. These findings should be confirmed in a phase 3 clinical trial. FUNDING: European Community's 7th Framework Programme.

Transfobia, linchamento virtual e o pensamento antidemocrático no twitter / Transfobia, linchamiento virtual y pensamiento antidemocrático en twitter / Transphobia, virtual lynching and antidemocratic thinking on twitter

Resumo Analisamos um episódio no Twitter de linchamento virtual de um homem trans pela sua participação em campanha publicitária do Dia dos Pais em 2020. Os comentários foram analisados a partir do primado do objeto, fundamentado na Teoria Crítica, nos Estudos sobre a Personalidade Autoritária e em A Dialética do Esclarecimento. Das 461 postagens selecionadas, derivamos 7 categorias: 1. Conservador religioso; 2. Elementos projetivos; 3. Elementos de destrutividade; 4. Preocupação com o sexo; 5. Humor e ironia; 6. Base político-econômica; 7. Defesa da empresa e/ou de Thammy. Pretendemos contribuir científica e criticamente com a compreensão sobre o que fundamenta as relações contemporâneas, em especial no ambiente virtual.

Resumen Analizamos un episodio del linchamiento virtual por su participación en una campaña publicitaria del Día del Padre en 2020. Los comentarios fueron analizados a partir de primacía del objeto, con base en la Teoría Crítica, en los Estudios sobre la Personalidad Autoritaria y en La Dialéctica de la Ilustración. De las 461 publicaciones seleccionadas, derivamos 7 categorías: 1. Conservador religioso; 2. Elementos proyectivos; 3. Elementos de destructividad; 4. Preocupación por el sexo; 5. Humor e ironía; 6. Base político-económica; 7. Defensa de la empresa y/o Thammy. Pretendemos contribuir científicamente y críticamente a la comprensión lo que subyace las relaciones contemporáneas, especialmente en el torno virtual.

Abstract We analyzed an episode on Twitter of the virtual lynching of a trans man for his participation in a Father's Day advertising campaign in 2020. The comments were analyzed based on the primacy of the object, underpinned on Critical Theory, in Studies on the Authoritarian Personality and on The Dialectics of Enlightenment. From the 461 posts, we derived 7 categories: 1 Religious Conservative; 2. Projective elements; 3. Elements of destructiveness; 4. Preoccupation sex; 5. Humor and irony; 6. Political-economic base; 7. Defense of the company and/ or Thammy. We intend to contribute scientifically and critically to the understanding of what underlies contemporary relationships, especially in virtual environment.

Dificuldades enfrentadas pelos usuários para resolubilidade do cuidado oftalmológico na rede de atenção à saúde

Marco contextual: A resolubilidade da assistência à saúde é um conceito associado à resolução final dos problemas trazidos pelos usuários ao serviço de saúde. Objetivo: Conhecer os motivos que dificultam a resolubilidade do cuidado oftalmológico na atenção secundária de atenção à saúde, sob a perspectiva do usuário e identificar sugestões de melhoria para a mesma. Métodos: Trata-se de uma pesquisa quali-quantitativa, realizada com uma amostra não probabilística de 208 pacientes, que receberam indicação de cuidado oftalmológico em unidade de atenção secundária de saúde, de município do interior de São Paulo. As entrevistas foram gravadas, após consentimento dos participantes, transcritas e analisadas utilizando-se a estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: Os motivos que atrasam a resolubilidade do cuidado são inúmeros e estão atrelados à burocracia, falta de recursos humanos e materiais, bem como inexistência da referência e contrarreferência na organização da rede de atenção à saúde. Conclusão: As dificuldades sentidas pelos usuários refletem a falta de organização desse serviço, que além de não priorizar o atendimento aos pacientes diabéticos. também não se compromete com o devido encaminhamento e acompanhamento.

Marco contextual: La capacidad de la atención de salud para resolver problemas es un concepto asociado a la resolución final de los problemas que los usuarios presentan al servicio de salud. Objetivo: Conocer los motivos que dificultan la capacidad del cuidado oftalmológico para resolver problemas en la atención secundaria de salud bajo la perspectiva del usuario, e identificar sugestiones para mejorarla. Métodos: Se trata de una investigación cualitativa-cuantitativa, desarrollada con una muestra no probabilística de 208 pacientes, a quienes fue indicado cuidado oftalmológico en una unidad de atención secundaria del interior de São Paulo. Las entrevistas fueron grabadas, tras el consentimiento de los participantes, transcritas y analizadas mediante la estrategia metodológica del Discurso del Sujeto Colectivo. Resultados: Los motivos que atrasan la capacidad de resolución de problemas del cuidado son innúmeros y están vinculados a la burocracia, falta de recursos humanos y materiales, además de la inexistencia de referencia y contra referencia en la organización de la red de atención. Conclusión: Las dificultades sentidas por los usuarios reflejan la falta de organización de ese servicio, que no solo no prioriza la atención a los pacientes diabéticos, pero tampoco se compromete con el encaminamiento y seguimiento necesario.

Contextual framework: The problem-solving ability of healthcare is a concept associated with the final resolution of the problems the users bring to the health service. Objective: Know the motives that hamper the problem-solving ability of ophthalmological care in secondary healthcare from the user's perspective and to identify suggestions to improve it. Methods: A qualitative-quantitative research was undertaken in a non-probabilistic sample of 208 patients, who were referred for ophthalmological care at a secondary health service in a city in the interior of São Paulo, Brazil. The interviews were recorded with the participants' consent, transcribed, and analyzed, using the methodological strategy of the Collective Subject Discourse. Results: Countless motives delay the problem-solving ability of care, which are linked to bureaucracy, lack of human and material resources and the non-existence of referral and counter-referral in the organization of the healthcare network. Conclusion: The difficulties the users feel reflect this service's lack of organization, which not only does not grant priority to care for the diabetic patients but does not commit either to proper forwarding or monitoring.

Efeito do Suporte Social e Personalidade no Bem-Estar Psicológico em Adolescentes de Diferentes Contextos Relacionais / Effect of Social Support and Personality on Psychological Well-Being in Adolescents from Different Relational Contexts

RESUMO O suporte social e as características da personalidade são evidenciados na literatura como fatores relevantes na promoção do bem-estar psicológico de jovens. Pretendeu-se analisar o efeito preditor do suporte social e da personalidade no bem-estar psicológico, testando ainda o efeito moderador dos contextos relacionais na associação anterior. Tratou-se de um estudo transversal de cariz exploratório. A amostra foi constituída por 350 jovens adolescentes portugueses de ambos os sexos, com idades entre 13 e 18 anos, provenientes de famílias tradicionais (seio familiar apenas com pais e filhos) e em acolhimento residencial. Os resultados sugeriram uma predição do bem-estar psicológico através das dimensões do suporte social e da personalidade. Verificou-se o papel moderador do contexto relacional e foi discutido o papel das ligações afetivas desenvolvidas enquanto fator promotor de bem-estar nos jovens.

ABSTRACT Social support and personality characteristics are highlighted in the literature as relevant factors promoting young psychological well-being. This research aims to analyze the effect of social support and personality on psychological well-being, also testing the moderating effect of relational context on the previous association. It was conducted a cross-sectional and exploratory study. The sample was composed of 350 young Portuguese adolescents of both sexes, aged between 13 and 18 years, from traditional families (family only with parents and child) and residential care. The results suggested there was a prediction of psychological well-being through the dimensions of social support and personality. There was a moderating role of relational context. The results were discussed, highlighting the role of affective bonds developed as well-being promoting factors in young people.

Effect of first aid training on teams from special education schools / Efecto de la capacitación sobre primeros auxilios en accidentes para los equipos de escuelas de enseñanza especializada / Efeito de capacitação sobre primeiros socorros em acidentes para equipes de escolas de ensino especializado

ABSTRACT Objectives: Analyze the effect of first aid training on the knowledge of multidisciplinary teams from special education schools, in school accidents. Methods: A quasi-experimental, before-and-after study with a single comparison group. Descriptive statistics and McNemar's test were used to evaluate the effect of the intervention. Results: This study had the participation of 162 higher education professionals, predominantly teachers (82.1%), female (97.5%), aged over 40 (69.2%). An increase in correct answers was observed, with statistical significance (≤0.05), especially in proper handling in case of fall with traumatic brain injury, electric shock, and burn due to hot liquid (98.1%, 98.1% and 96.9% of proper response, respectively). Conclusions: First aid training for child accidents, through content exhibition, in a dialogical and practical way, proved to be efficient for multidisciplinary teams from special education schools for people with disabilities.

RESUMEN Objetivos: Evaluar el efecto de la capacitación sobre los primeros auxilios ante accidentes escolares en el conocimiento del equipo multidisciplinario de escuelas de enseñanza especializada. Métodos: Estudio cuasiexperimental con análisis antes y después de un único grupo de comparación. Se realizaron la estadística descriptiva y la prueba de McNemar para evaluar el efecto de la intervención. Resultados: Participaron 162 profesionales de nivel superior, principalmente profesores (82,1%). El sexo y el grupo de edad predominantes fueron el femenino (97,5%) y la edad superior a 40 años (69,2%). Se observó un incremento de aciertos con significancia estadística en todas las cuestiones abordadas (≤ 0,05). Se destacan el manejo correcto ante la caída con traumatismo craneal encefálico, el choque eléctrico y la quemadura por líquido caliente (con un 98,1%, un 98,1% y un 96,9% de aciertos, respectivamente). Conclusiones: La capacitación sobre primeros auxilios ante accidentes, por medio de exposición de contenido de forma dialogada y práctica, fue eficaz para el equipo multidisciplinario de escuelas de enseñanza especializada para personas con discapacidad.

RESUMO Objetivos: Analisar o efeito de uma capacitação no conhecimento da equipe multidisciplinar de escolas de ensino especializado sobre primeiros socorros diante de acidentes escolares. Métodos: Estudo quase experimental do tipo antes e depois com grupo único de comparação. Realizou-se estatística descritiva e teste de McNemar para avaliar o efeito da intervenção. Resultados: Participaram 162 profissionais de nível superior, predominantemente professores (82,1%). Sexo e faixa etária preponderante foram, respectivamente, feminino (97,5%) e idade acima de 40 anos (69,2%). Houve aumento de acerto em todas as questões abordadas com significância estatística (≤ 0,05). Destacam-se o correto manejo diante de queda com traumatismo craniano encefálico, choque elétrico e queimadura por líquido quente (respectivamente: 98,1%, 98,1% e 96,9% de acertos). Conclusões: A capacitação sobre primeiros socorros diante de acidentes, por meio de exposição de conteúdo de forma dialogada e prática, se mostrou eficiente para a equipe multidisciplinar de escolas de ensino especializado para pessoas com deficiência.

Effect of first aid training on teams from special education schools / Efecto de la capacitación sobre primeros auxilios en accidentes para los equipos de escuelas de enseñanza especializada / Efeito de capacitação sobre primeiros socorros em acidentes para equipes de escolas de ensino especializado

ABSTRACT Objectives: Analyze the effect of first aid training on the knowledge of multidisciplinary teams from special education schools, in school accidents. Methods: A quasi-experimental, before-and-after study with a single comparison group. Descriptive statistics and McNemar's test were used to evaluate the effect of the intervention. Results: This study had the participation of 162 higher education professionals, predominantly teachers (82.1%), female (97.5%), aged over 40 (69.2%). An increase in correct answers was observed, with statistical significance (≤0.05), especially in proper handling in case of fall with traumatic brain injury, electric shock, and burn due to hot liquid (98.1%, 98.1% and 96.9% of proper response, respectively). Conclusions: First aid training for child accidents, through content exhibition, in a dialogical and practical way, proved to be efficient for multidisciplinary teams from special education schools for people with disabilities.

RESUMEN Objetivos: Evaluar el efecto de la capacitación sobre los primeros auxilios ante accidentes escolares en el conocimiento del equipo multidisciplinario de escuelas de enseñanza especializada. Métodos: Estudio cuasiexperimental con análisis antes y después de un único grupo de comparación. Se realizaron la estadística descriptiva y la prueba de McNemar para evaluar el efecto de la intervención. Resultados: Participaron 162 profesionales de nivel superior, principalmente profesores (82,1%). El sexo y el grupo de edad predominantes fueron el femenino (97,5%) y la edad superior a 40 años (69,2%). Se observó un incremento de aciertos con significancia estadística en todas las cuestiones abordadas (≤ 0,05). Se destacan el manejo correcto ante la caída con traumatismo craneal encefálico, el choque eléctrico y la quemadura por líquido caliente (con un 98,1%, un 98,1% y un 96,9% de aciertos, respectivamente). Conclusiones: La capacitación sobre primeros auxilios ante accidentes, por medio de exposición de contenido de forma dialogada y práctica, fue eficaz para el equipo multidisciplinario de escuelas de enseñanza especializada para personas con discapacidad.

RESUMO Objetivos: Analisar o efeito de uma capacitação no conhecimento da equipe multidisciplinar de escolas de ensino especializado sobre primeiros socorros diante de acidentes escolares. Métodos: Estudo quase experimental do tipo antes e depois com grupo único de comparação. Realizou-se estatística descritiva e teste de McNemar para avaliar o efeito da intervenção. Resultados: Participaram 162 profissionais de nível superior, predominantemente professores (82,1%). Sexo e faixa etária preponderante foram, respectivamente, feminino (97,5%) e idade acima de 40 anos (69,2%). Houve aumento de acerto em todas as questões abordadas com significância estatística (≤ 0,05). Destacam-se o correto manejo diante de queda com traumatismo craniano encefálico, choque elétrico e queimadura por líquido quente (respectivamente: 98,1%, 98,1% e 96,9% de acertos). Conclusões: A capacitação sobre primeiros socorros diante de acidentes, por meio de exposição de conteúdo de forma dialogada e prática, se mostrou eficiente para a equipe multidisciplinar de escolas de ensino especializado para pessoas com deficiência.

Correlação estatística entre parâmetros microscópicos e microbiológicos em pimenta-do-reino moída (Piper nigrum L) comercializada em Minas Gerais / Statistical correlation between microscopic and microbiological parameters in ground black pepper ( Pipper nigrum L) sold in Minas Gerais

A ausência de Boas Práticas de Fabricação durante a colheita, processamento e manuseio da pimenta-do-reino pode acarretar a contaminação do produto com sujidades microscópicas e microrganismos. Foram analisadas 227 amostras de pimenta-do-reino, comercializadas em Minas Gerais, coletadas entre 2008 e 2018, quanto à presença de fragmentos de pelo de roedor e de insetos, coliformes a 45°C ou Escherichia coli e Salmonella spp. Para verificar se havia correlação entre os contaminantes, foi empregado método estatístico de regressão linear múltipla. As análises microscópicas evidenciaram presença de fragmentos de pelo de roedor e de insetos em 26,0% e 30,5% das amostras, respectivamente, em valores superiores ao limite tolerado pela RDC 14/2014. Quanto às análises microbiológicas, 10% das amostras apresentaram coliformes a 45°C ou E. coli acima dos limites tolerados pela RDC 12/2001 e em 8,8% das amostras foi detectada presença de Salmonella spp. A avaliação estatística mostrou que houve correlação entre presença de fragmentos de insetos e de pelos de roedor e a contaminação por Salmonella spp. em pimenta-do-reino. Os resultados demonstraram a importância das análises microscópica e microbiológica simultaneamente para detecção dos contaminantes presentes bem como das possíveis relações existentes entre eles e a melhor compreensão dos fatores que favorecem as contaminações. (AU)

The absence of Good Manufacturing Practices during harvesting, processing and handling of black pepper can lead to contamination of the product with microscopic dirt and microrganisms. Two hundred and twenty seven black pepper samples, commercialized in Minas Gerais, collected between 2008 and 2018, were analyzed for the presence of rodent and insect fragments, coliforms at 45°C or Escherichia coli and Salmonella spp. To verify whether there was a correlation between the contaminants, a statistical method of multiple linear regression was used. Microscopic analysis showed the presence of rodent and insect fragments in 26.0% and 30.5% of the samples, respectively, in values above the limit tolerated by RDC14/2014. As for the microbiological analysis, 10% of the samples presented coliforms at 45°C or E.coli above the limits tolerated by the RDC 12/2001 and in 8.8% of the samples Salmonella spp. were detected. The statistical evaluation showed that there was a relationship between the presence of insect fragments and rodent hair and contamination by Salmonella spp. in black pepper. The results demonstrated the importance of simultaneous microscopic and microbiological analysis to detect the contaminants present, as well as the possible relationships between them and better understanding of the factors that favor contamination. (AU)

Correlação estatística entre parâmetros microscópicos e microbiológicos em pimenta-do-reino moída (Piper nigrum L) comercializada em Minas Gerais / Statistical correlation between microscopic and microbiological parameters in ground black pepper (Pipper nigrum L) sold in Minas Gerais

A ausência de Boas Práticas de Fabricação durante a colheita, processamento e manuseio da pimenta-do-reino pode acarretar a contaminação do produto com sujidades microscópicas e microrganismos. Foram analisadas 227 amostras de pimenta-do-reino, comercializadas em Minas Gerais, coletadas entre 2008 e 2018, quanto à presença de fragmentos de pelo de roedor e de insetos, coliformes a 45°C ou Escherichia coli e Salmonella spp. Para verificar se havia correlação entre os contaminantes, foi empregado método estatístico de regressão linear múltipla. As análises microscópicas evidenciaram presença de fragmentos de pelo de roedor e de insetos em 26,0% e 30,5% das amostras, respectivamente, em valores superiores ao limite tolerado pela RDC 14/2014. Quanto às análises microbiológicas, 10% das amostras apresentaram coliformes a 45°C ou E. coli acima dos limites tolerados pela RDC 12/2001 e em 8,8% das amostras foi detectada presença de Salmonella spp. A avaliação estatística mostrou que houve correlação entre presença de fragmentos de insetos e de pelos de roedor e a contaminação por Salmonella spp. em pimenta-do-reino. Os resultados demonstraram a importância das análises microscópica e microbiológica simultaneamente para detecção dos contaminantes presentes bem como das possíveis relações existentes entre eles e a melhor compreensão dos fatores que favorecem as contaminações.

The absence of Good Manufacturing Practices during harvesting, processing and handling of black pepper can lead to contamination of the product with microscopic dirt and microrganisms. Two hundred and twenty seven black pepper samples, commercialized in Minas Gerais, collected between 2008 and 2018, were analyzed for the presence of rodent and insect fragments, coliforms at 45°C or Escherichia coli and Salmonella spp. To verify whether there was a correlation between the contaminants, a statistical method of multiple linear regression was used. Microscopic analysis showed the presence of rodent and insect fragments in 26.0% and 30.5% of the samples, respectively, in values above the limit tolerated by RDC14/2014. As for the microbiological analysis, 10% of the samples presented coliforms at 45°C or E.coli above the limits tolerated by the RDC 12/2001 and in 8.8% of the samples Salmonella spp. were detected. The statistical evaluation showed that there was a relationship between the presence of insect fragments and rodent hair and contamination by Salmonella spp. in black pepper. The results demonstrated the importance of simultaneous microscopic and microbiological analysis to detect the contaminants present, as well as the possible relationships between them and better understanding of the factors that favor contamination.

Resolubility of eye care in a secondary care center: a quantitative approach / Resolubilidade do cuidado oftalmológico em um centro de atendimento secundário: abordagem quantitativa

ABSTRACT Objective To evaluate the resolubility of ophthalmologic care in an integrated health center. Methods This was a cross-sectional study including 816 patients who were attended from November 2013 to November of 2015. Data were collected from a medical consultation database and patients' medical records. Results The majority of participants were women, non-diabetic, and had high school education. The main cause of referral for ophthalmologic evaluation was the consultation with a specialist, the waiting time for consultation was shorter for non-diabetic patients. Conclusion This Integrated health center presented, partial resolubility conditions to meet the ophthalmologic needs of users of the Brazilian Unified Health System. Eye care needs to be reorganized particularly by consider the priority cases of those at ophthalmological risk, and referrals should be done to the adequate care level and on time to guarantee resolubility.

RESUMO Objetivo Avaliar a resolubilidade do cuidado oftalmológico em um centro integrado de saúde. Métodos Trata-se de estudo transversal realizado com 816 pacientes atendidos no período de novembro de 2013 a novembro de 2015. Os dados foram coletados consultando-se o banco de dados institucional e os prontuários. Resultados A maioria dos participantes era não diabética, do sexo feminino, e com Nível Médio de ensino. A principal causa de solicitação de avaliação oftalmológica foi a consulta com o especialista, cujo tempo de espera foi menor para os não diabéticos. Conclusão Este centro integrado de saúde apresentou, em parte, condições de resolubilidade para atender as necessidades oftalmológicas dos usuários do Sistema Único de Saúde, mas notou-se necessidade de reorganização deste cuidado, considerando prioridades baseadas em critérios de risco oftalmológico, conferindo que o encaminhamento ao nível de atenção deve ser capaz de propiciar, em tempo, a resolubilidade.