A Descriptive Study of Corneal Graft Failure in Retransplant Patients.

OBJECTIVE: To identify the main predictors for corneal graft failure in patients who underwent retransplantation. METHOD: This is a cross-sectional research with a quantitative and analytical approach, conducted based on data from secondary sources of a Human Eye Tissue Bank (HETB) in Northeast Brazil. Data were collected from the medical charts of all patients transplanted between January 2010 and December 2014. Descriptive statistics were used for the univariate analysis by means of absolute and relative frequencies and means. For the inferential analysis, the chi-square (X²) and the Fisher's Exact tests were used. RESULTS: A total of 241 records were reviewed, representing 258 keratoplasties, of which 27 (10.46%) were retransplantations due to corneal graft failure. Of the total, 55.56% of the individuals were female, with a mean age of 58.56 years, 55.56% of the population was brown, and the highest relative frequency of housing found was in the Central Mesoregion. Of the corneal graft failure cases, 88.89% were due to late failure, 30.77% of cases were classified as pseudophakic and 11.57% as aphakic. Through inferential analysis, a statistical association was obtained among the variable "corneal graft failure" and mesoregion of the state, presence of glaucoma, vascularization, and classification of the eye. CONCLUSION: The prognosis of keratoplasty is of multifactorial nature. Factors such as mesoregion of the State (place of residence), glaucoma, corneal vascularization, and aphakic eyes represent predictors for graft failure in the analyzed sample.

Non-Donors of Organs and Tissues Due to Medical Refusal in a Transplant Referral Service.

BACKGROUND: Obtaining organs for transplants through a deceased donor occurs exclusively through donation. However, some open protocols with potential donors do not become effective donors due to medical refusal. Our aim was to identify the profile of non-donors of organs and tissues due to medical refusal in a state reference service for transplants. METHODS: This is a cross-sectional study with retrospective data collection from medical records of patients who died and had a protocol opened to evaluate brain death and procurement of organs and tissues in 2019. RESULTS: The sample consisted of 27 patients, the majority of whom were female, aged over 71 years, had primary education, and were married. The main causes of medical refusal were age above the recommended age and septicemia. Brain death was mostly confirmed within 12 hours, and the main cause of hospitalization was a vascular event. CONCLUSIONS: Identifying the profile of non-donors due to medical refusal is necessary for services to identify possible misattributed medical contraindications and thus contribute to reducing the disproportion between supply and demand for organs and tissues for transplants.

Technologies used in ruminant grazing management: an integrative review.

The objective of this study was to identify the main technologies used in the management of ruminant grazing. We developed a review protocol in which the search terms were previously tested and based on the PVO strategy to determine the guiding question (population [P]: domestic ruminants; variables [V] of interest: grazing management technologies; and outcomes [O]: intake, performance, and productivity of animals raised exclusively on pasture). The guiding question was the following: What technologies are used in the grazing management of domestic ruminants on pasture? The databases used were SCOPUS (Elsevier), SciELO Citation Index, Science Direct, and Wiley Online Library, and the search was carried out until October 15, 2021. The search identified 2683 research articles; however, only 43 were considered eligible and included due to their methodological robustness for data extraction. The most commonly used species were Lolium multiflorum and Lolium perenne (20%), Panicum maximum (18%), and Brachiaria brizantha (14%). The most widely used grazing methods were continuous grazing (53.4%) and intermittent grazing (39.5%). Among the technologies, the most widely adopted were pasture height (55.8%) and herbage allowance (11.6%). The most frequent sampling methods were the use of a ruler (37.2%) and measuring stick (13.9%) to measure the height, and clipping with a frame (18.6%) to measure herbage allowance. The animals used in the included studies were cattle (n = 1335), sheep (n = 839), and goats (n = 41). Pasture height and herbage allowance were the most widely used grazing management technologies, with the data concentrated mainly in Brazil, in studies with continuous grazing by cattle.

Donation Process and Evaluation of Corneal Tissue in a Slit Lamp.

BACKGROUND: The process of capturing and classifying the viability of corneal tissue for corneal transplantation is complex. The biomicroscopic examination is one of the techniques used to evaluate the quality of corneal tissues. The aim of this study was to analyze the relationship between the evaluation criteria used in biomicroscopic examination using a slit lamp and the classification of the quality of corneal tissue. METHODS: This is a longitudinal, retrospective cohort study, performed at the Human Ocular Tissue Bank in the state of Rio Grande do Norte, Brazil. The sample consisted of 419 corneas donated between 2005 to 2016. RESULTS: After the evaluation, the 419 corneas were classified as excellent (8 -1.91%), good (217 - 51.79%), regular (85 - 20.29%), and bad (109 - 26.01%). The classification of corneal quality attributed by ophthalmologists considered 13 criteria: senile arch, scars, epithelial defect, epithelial exposure, stromal infiltrate, subepithelial opacity, pterygium, Descemet's folds, stromal edema, stromal streak, cornea guttata, specular reflex, and cell loss endothelial. The quality of the cornea classified as excellent and good showed a statistically significant association (P value < .05) with senile arch, scar, epithelial defect, epithelial exposure, Descemet's folds, stromal edema, stromal streak, cornea guttata, specular reflex, and losses of endothelial cells; they had evaluated criteria that were absent or slightly present. CONCLUSIONS: The evaluation of the corneal quality for corneal transplantation should involve the implementation of reliable techniques and trained, qualified professionals. There is a need to create evaluation instruments that consider the criteria according to their degree of interference in the quality of corneal tissue.

Evaluation procedures in health: Perspective of nursing care in patient safety.

OBJECTIVE: The objective research is analyzing the nursing care in intensive care units from the perspective of patient safety based on health evaluation. METHODS: This is an evaluation research, for the purpose of issuance of judgment or judgment on a given system, carried out in six intensive care units. Data collection occurred from April to July 2014, in locu, with a validated instrument containing 97 questions related to patient safety. These, 73 items targeted to analyze the element "process" in safety patient nursing care. The 73 items were grouped into three elements meaning of the patient safety: "Communication and Identification", "Health and Comfort" and "Drug and Nutritional Therapy". Data analyses were used from Kappa measurement, observations conducted by the evaluators and literature on the theme. RESULTS: The result of three elements significant showed the following: 23 items (31.5%) were considered adequate and 50 (68.4%), non-compliant with the required standards for reliable care. Of these, 29 (39.7%) were classified as partially adequate and 21 (28.7%) as inadequate, setting a worrying care in regards care of security with large probability precipitation of undesirable events. CONCLUSION: It is emphasized that the classification unsuitability of items prevailed. Patient safety is impaired due to unsafe actions in nursing care processes. Unsafe actions in care processes increase the risk to patient safety, as precipitation falls, errors in medication administration, communication difficulties and continuity of care. Thus, immediate interventions are imperative to implement a safety culture and to avoid negligence in relation to care.

Evidence of interventions for the risk of dry eye in critically ill patients: An integrative review.

AIMS: Identify the best scientific evidence available to eye care in order to prevent dry eye. METHOD: Review study conducted according to the three steps of the evidence-based practice, guided by the following question, grounded in the Patient, Intervention, Comparison, and Outcome strategy: "What is the best scientific evidence available to eye care related to preventing dry eye?" Two databases were used, the web portal Medical Literature Analysis and Retrieval System Online and two digital libraries. Data were organized by using three structured forms. RESULTS: Ten studies made up the final sample, in English, with evidence levels between I and III. The results pointed out differences regarding the best or most appropriate occlusion and ocular lubrication methods to prevent dry eye. CONCLUSION: Several care methods showed strong scientific evidence to prevent dry eye, related to occlusion and ocular lubrication. There is a need for further studies to determine the strength of this evidence.