Eventos adversos em uma unidade de internação cirúrgica: estudo descritivo / Adverse events in a hospital surgical unit: a descriptive study / Eventos adversos en una unidad de internación quirúrgica: estudio descriptivo

Objetivo: Verificar a ocorrência de infecção do sítio cirúrgico, perda ou infecção do acesso venoso e quedas em pacientes internados em Unidade de Internação Cirúrgica de um Hospital de Ensino. Método: Estudo descritivo de abordagem quantitativa. O período de coleta de dados foi entre 23 de março e 14 de abril de 2015, em dias alternados, totalizando 94 pacientes. Resultado: A média do tempo de internação foi de 8,46 dias, com desvio padrão de 11,294. Observou-se um total de 20 (7,9%) eventos adversos. Houve nove (3,6%) notificações de perda do acesso venoso, sete notificações de infecção do sítio cirúrgico (2,8%) e quatro (1,6%) notificações de infecção do acesso venoso. Conclusão: Observou­se que o índice de ocorrência dos eventos adversos foi superior a um estudo semelhante, evidenciando a necessidade de ações que estimulem a notificação de eventos adversos e a promoção da segurança do paciente.

Objective: Verify the occurrence of infection at surgical sites, loss, or infection of venous access and falls in patients hospitalized in the Surgical Inpatient Unit of a Teaching Hospital. Method: Descriptive study with a quantitative approach. The period of data collection was between March 23 and April 14, 2015 on alternating days, totaling 94 patients. Results: The average hospitalization time was 8.46 days, with a standard deviation of 11.294. A total of 20 (7.9%) adverse events were observed. There were nine (3.6%) records of venous access loss, seven records of surgical site infections (2.8%), and four (1.6%) records of venous access infection. Conclusion: It was observed that the occurrence index of the adverse events was greater than in a similar study, showing the need for actions that stimulate the recording of adverse events and the promotion of patient's safety.

Objetivo: Verificar la ocurrencia de infección del sitio quirúrgico, pérdida o infección del acceso venoso y caídas de pacientes internados en Unidad de Internación Quirúrgica de un Hospital Escuela. Método: Estudio descriptivo de abordaje cuantitativo. El período de colecta de datos fue entre el 23 de marzo y el 14 de abril de 2015, en días alternados, totalizando 94 pacientes. Resultado: El promedio del tiempo de internación fue de 8,46 días, con desvío estándar de 11,294. Se observó un total de 20 (7,9%) eventos adversos. Hubo nueve (3,6%) notificaciones de pérdida del acceso venoso, siete notificaciones de infección del sitio quirúrgico (2,8%) y cuatro (1,6%) notificaciones de infección del acceso venoso. Conclusión: Se observó que el índice de ocurrencia de los eventos adversos fue superior a un estudio semejante, evidenciando la necesidad de acciones que estimulen la notificación de eventos adversos y la promoción de la seguridad del paciente.

Assessment of impact of late postoperative physical functional disabilities on quality of life in breast cancer survivors.

AIMS AND BACKGROUND: Breast cancer is the second most common malignancy among women. Surgical and supplemental (or adjuvant) therapies to combat the disease may implicate physical functional consequences for the ipsilateral upper extremity. These dysfunctions may persist for many years and have repercussions on the performance of daily living activities. The aim of this study was to assess the impact of physical functional disabilities on quality of life in women after breast cancer surgery. METHODS AND STUDY DESIGN: Eighty-two women in the postoperative period of conservative surgery for breast cancer participated in the study. Axillary lymph node dissection was performed in all patients and mean time since surgery was 5.78 (± 4.60) years. The women responded to a questionnaire to assess quality of life (FACT-B) and to another to assess functional capacity (QuickDASH). They were then referred to physical therapy examination to measure shoulder range of motion (flexion, abduction and external rotation) and arm volume. RESULTS: Range of motion in the ipsilateral shoulder was limited: shoulder flexion range of motion reached a mean value of 155.44º (± 28.31), mean abduction was 149.05º (± 29.51), and mean external shoulder rotation was 58.44º (± 29.17). These limitations had a negative impact on functional capacity and global quality of life. Lymphedema was present in 28.04% of women assessed and did not impair quality of life or functional capacity. CONCLUSION: Physical functional disabilities were present in the late postoperative period of breast cancer survivors and limited shoulder range of motion negatively influenced their functional capacity and quality of life. The presence of lymphedema did not impair functional capacity or quality of life in the postoperative period.

Drosophila wing-spot test for genotoxic assessment of pollutants in water samples from urban and industrial origin.

The Caí River (Rio Grande do Sul, Brazil) is an important watercourse that receives large amounts of industrial and untreated municipal discharges in its lower course. We employed the SMART in Drosophila melanogaster to evaluate the genotoxicity of surface waters collected from Caí sites receiving direct sewage discharge: from Montenegro (Km 52) and from São Sebastião do Caí (Km 78 and 80), and from two sites under the industrial influence (Km 13.6 and 18.6). The genotoxic analysis included three collections: March, June and September 1999, which were tested at crude sample and at 50 and 25% concentrations. Considering the industrial samples from Km 18.6 and 13.6, collected in March, June and September 1999, they were characterized as not having genetic toxicity. The urban samples collected in March--Km 52, 78 and 80--showed a significant increment in the frequencies of total spots. In Km 52 and 78 the genotoxic effect was associated to both mutational and recombinational events, although for Km 80 the increases observed were mainly related to the occurrence of homologous recombination. Moreover, the Km 80 crude sample from June and all the concentrations analyzed for Km 52 in September were also able to induce mitotic recombination. These effects were only observed in the ST cross, demonstrating the genotoxins present in the urban discharges act by direct interaction with the DNA of the somatic cells. The SMART in D. melanogaster was shown to be highly sensitive to detect genotoxic agents present in the aquatic environment, and must be better exploited for monitoring areas under anthropogenic discharges.