Nursing recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes / Recomendaciones para abordar la propagación de COVID-19 en Hogares para Ancianos / Recomendações para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos

ABSTRACT Objective: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. Method: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem) Results: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. Final considerations: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.

RESUMEN Objetivo: desarrollar un protocolo de recomendaciones para abordar la propagación de COVID-19 en hogares para ancianos. Método: estudio de recomendaciones de expertos utilizando una forma estructurada aplicada utilizando la técnica Delphi, obteniendo un 100% de acuerdo entre profesionales después de cuatro rondas de análisis. La población estaba compuesta por seis enfermeras que son miembros del departamento científico de enfermería gerontológica de la Asociación Brasileña de Enfermería (Associação Brasileira de Enfermagem). Resultados: el protocolo se estructuró en un núcleo de intervenciones de enfermería para enfrentar la difusión de COVID-19 en Hogares para Ancianos y consta de 8 acciones. Consideraciones finales: el protocolo puede ayudar a los gerentes de enfermería a organizar la asistencia para enfrentar la pandemia, que puede adaptarse a cada realidad, facilitando la capacitación de los equipos de enfermería y salud.

RESUMO Objetivo: elaborar um protocolo de recomendações para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos. Método: estudo de recomendações de especialistas utilizando-se um formulário estruturado aplicado por meio da Técnica Delphi, obtendo-se 100% de concordância entre os profissionais após quatro rodadas de análise. A população foi constituída por seis enfermeiros membros do Departamento Científico de Enfermagem Gerontológica da Associação Brasileira de Enfermagem. Resultados: o protocolo foi estruturado em um núcleo de intervenções de enfermagem para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos, consistindo em 8 ações. Considerações finais: o protocolo poderá auxiliar os enfermeiros gestores a organizar a assistência para enfrentar a pandemia, que pode ser adaptável a cada realidade, facilitando o treinamento das equipes de enfermagem e saúde.

Deaths within 12 months after (125)I implantation for brachytherapy of prostate cancer: an investigation of radiation safety issues in Japan (2003-2010).

PURPOSE: The International Commission on Radiological Protection recommends removing the prostate before cremation if death occurs within 12 months after (125)I brachytherapy. However, the incidence of death within this time frame has not been robustly investigated in any country. The purpose this study was to investigate the incidence and cause of death and actions taken when death has occurred within 12 months after (125)I brachytherapy for prostate cancer in Japan. METHODS AND MATERIALS: Data were extracted from the Japan Radioisotope Association database to investigate the total number of implantation cases, number of early deaths after implantation, cause of death, and postmortem actions between September 2003 and the end of June 2010 in Japan. Early death was defined as occurring within 12 months after (125)I brachytherapy for prostate cancer. RESULTS: During the study period, 15,427 patients underwent (125)I brachytherapy and 43 (0.28%) died within 12 months after implantation. For 37 of the 43 patients (86%), the brachytherapy source was retrieved together with the prostate gland at autopsy; however, autopsy could not be performed in six (14%) of the deceased patients. The largest proportion of early deaths was because of cerebrovascular or cardiovascular disease (17/43, 40%), followed by malignant tumor (15/43, 35%), and respiratory disease or infection (7/43, 16%). CONCLUSIONS: The incidence of early deaths within 12 months after (125)I brachytherapy in Japan was 0.28%. In almost all cases, the brachytherapy sources were removed in the intact prostate before the body was cremated and stored appropriately.

Post-mortem considerations of Yttrium-90 90Y microsphere therapy procedures.

Yttrium-90 (Y) microspheres, either in the form of resin beads or glass, are currently used to treat unresectable hepatocellular cancer. It has been discovered that long-lived contaminants, principally Eu and Eu, can be found in the waste generated by this procedure. Recently, at our medical facility, an elevated count rate was discovered on a deceased patient scheduled to have an autopsy and who had undergone Y microsphere therapy nearly 5 months previously. Regulatory issues arose when the family of the patient requested that the body of the deceased be cremated. In this particular instance the exposure rate from the body was below regulatory concern; however, the potential contamination and exposure from these long-lived contaminants cannot be ignored for individuals working in the autopsy room, funeral home embalming area, and crematorium. Information provided to potential patients in pamphlet form from the manufacturer failed to identify the existence of long-lived contaminants and possible difficulties associated with cremation. To ensure potential Y microsphere patients and family members are aware of the possible existence of long-lived contaminants, a patient consent and notification form has been developed. The proper disposal of residual material associated with these procedures, i.e., long-lived radioactive contaminants in explanted organs, pose additional difficulties. Further education of medical staff and funeral home directors with crematoriums is necessary. Close cooperation with the regulatory authority was instrumental in resolving this situation.

Mummies.

Mummies are human remains with preservation of nonbony tissue. Mummification by natural influences results in so-called natural mummies, whereas mummification induced by active (human) intervention results in so-called artificial mummies, although many cultures practiced burial rites, which to some degree involved both natural and artificial mummification. Since they are so uniquely well-preserved, mummies may give many insights into mortuary practices and burial rites. Specifically, the presence of soft tissues may expand the scope of paleopathological studies. Many recent mummy studies focus on the development and application of nondestructive methods for examining mummies, including radiography, CT-scanning with advanced three-dimensional visualizations, and endoscopic techniques, as well as minimally-destructive chemical, physical, and biological methods for, e.g., stable isotopes, trace metals, and DNA. This article discusses mummification and gives a presentation of various key mummy finds and a brief history of mummy studies. A description of the extant key technologies of natural and medical science that are applied in mummy studies is given; along with a discussion of some of the major results in terms of paleopathology. It is also shown how mummy studies have contributed much to the knowledge of the cultural habits and everyday life of past populations. Finally the impact of mummy studies on analyses of mortuary practices and cultural history is discussed.