Effects of calcium supplementation on changes in the IL2, IL4, IL6, IL10 axes and oxidative stress in pregnant women at risk for pre-eclampsia.

BACKGROUND: Pregnant women with hypertensive disorders are at increased risk for inflammatory diseases and oxidative stress. The dilemma raised by the best dosage of calcium supplementation on these factors is evident. The aim of the current study was to examine the effects of calcium on biomarkers of the purinergic system, inflammation and oxidative stress, which are factors contributing to vascular damage in pregnant women at high risk of pre-eclampsia. METHODS: A prospective, double-blind and placebo-controlled study conducted with 101 women at risk of pre-eclampsia were randomized to take 500 mg calcium/day or 1,500 mg calcium/day or placebo for 6 weeks from the 20th gestational week until delivery. Fasting blood samples were collected at the beginning of the study and 6 weeks after the intervention. RESULTS: Taking calcium supplements (500 mg calcium/day) led to a significant increase in ATP hydrolysis (p < 0.05), NTPDase activity with increased hydrolysis of ADP and AMP nucleotides in platelets and lymphocytes. In the intragroup analysis IL-2, IL-6, IL-4 and interferon-É£ presented lower values in the calcium 1,500 mg/day group (p < 0.005). Oxidative stress was assessed by TBARS pro-oxidant marker, with an increase for the calcium groups when compared to the placebo group. The Vitamin C antioxidant marker presented a significant increase (p < 0.005) for the group that received high calcium doses. CONCLUSIONS: Calcium administration for 6 weeks had antioxidant action and positively modulated the purinergic system and inflammatory markers in pregnant women at risk of pre-eclampsia.

Avaliação da cultura de segurança do paciente em um hospital do sul do brasil

RESUMO Objetivo: Avaliar o nível de cultura de segurança do paciente, na perspectiva dos profissionais de saúde, em um hospital do sul do Brasil. Material e Método: Estudo quantitativo aplicado pelo instrumento Hospital Survey on Patient Safety Culture (HOSPSC), de maio a junho de 2018; a amostra de 291 participantes foi obtida por conveniência, os dados foram organizados no programa Microsoft Excel®. Para a análise e interpretação das dimensões da cultura de segurança, foi aplicada a metodologia proposta pela Agency Healthcare Research and Quality (AHRQ). Resultados: O percentual geral de respostas positivas foi de 46%, a dimensão com maior percentual de respostas positivas foi "aprendizagem organizacional e melhoria contínua"; nenhuma dimensão atingiu um valor superior a 75%; a dimensão que apresentou maior fragilidade foi "resposta não punitiva ao erro", com menor percentual de respostas positivas (16%); a maioria dos profissionais (56%) não fez nenhuma notificação no período de 12 meses; em relação à percepção dos participantes sobre a segurança do paciente em sua unidade de trabalho, foi observada quantidade semelhante entre aqueles que têm percepção positiva (muito boa e excelente) e negativa (regular, ruim e péssima). Conclusões: Há fragilidades na cultura de segurança do paciente, evidenciando a necessidade de se discutir o tema em todas as áreas de atenção da instituição.

ABSTRACT Objective: To assess the level of patient safety culture, from the perspective of health professionals, in a hospital in southern Brazil. Material and Method: Quantitative study carried out using the Hospital Survey on Patient Safety Culture instrument, from May to June 2018. The sample was drawn using convenience sampling and consisted of 291 participants; data were organized in Microsoft Excel®. For the analysis and interpretation of safety culture dimensions, the methodology proposed by the Agency Healthcare Research and Quality (AHRQ) was applied. Results: The overall percentage of positive responses was 46%, the dimension that showed a higher percentage of positive responses was "organizational learning and continuous improvement", however no dimension reached a value above 75%. The dimension that showed the greatest fragility was a "non-punitive response to error" with the lowest percentage of positive responses (16%). Most professionals (56%) did not make any notification in the 12-month period. Regarding the participants' perception of patient safety in their work unit, a similar amount was observed among those who have a positive (very good and excellent) and negative (regular, bad and very bad) perception. Conclusions: The study reveals weaknesses in patient safety culture, highlighting the need to discuss the subject in all healthcare areas within the institution.

RESUMEN Objetivo: Evaluar el nivel de cultura de seguridad del paciente, desde la perspectiva de los profesionales de la salud, en un hospital del sur de Brasil. Material y Método: Estudio cuantitativo que aplicó el instrumento Hospital Survey on Patient Safety Culture (HOSPSC), de mayo a junio de 2018; la muestra de 291 participantes se obtuvo por conveniencia, los datos se organizaron en Microsoft Excel®. Para el análisis e interpretación de las dimensiones de la cultura de seguridad, se aplicó la metodología propuesta por la Agency Healthcare Research and Quality (AHRQ). Resultados: El porcentaje general de respuestas positivas fue del 46%, la dimensión con mayor porcentaje de respuestas positivas fue "aprendizaje organizacional y la mejora continua"; ninguna dimensión alcanzó un valor superior al 75%; la dimensión que mostró mayor fragilidad fue "respuesta no punitiva al error", con el porcentaje más bajo de respuestas positivas (16%); la mayoría de los profesionales (56%) no hicieron ninguna notificación en el período de 12 meses; con respecto a la percepción de los participantes sobre la seguridad del paciente en su unidad de trabajo, se observó una cantidad similar entre aquellos que tienen una percepción positiva (muy buena y excelente) y negativa (regular, mala y muy mala). Conclusiones: Existen debilidades en la cultura de seguridad del paciente, destacando la necesidad de discutir el tema en todos los ámbitos de atención de la institución.