Patient safety culture in a COVID-19 ICU compared to a clinical-surgical ICU in the Brazilian Eastern Amazon: A cross-sectional study.

BACKGROUND: The COVID-19 pandemic highlighted the need for a new dynamic in the organization and practices of health services, as it required rapid restructuring to promote safe and harm-free assistance. OBJECTIVE: To assess the dimensions of the patient safety culture (PSC) from the perspective of the health team professionals in clinical-surgical ICU (G1) compared to a COVID-19 ICU (G2). METHODS: Cross-sectional, analytical, descriptive and inferential study, using the "Hospital Survey on Patient Safety Culture" questionnaire. RESULTS: The domain "Supervisor/Manager Expectations and Actions Promoting Patient Safety (PS)" was a potential weakness for G1 (p = 0.003). G2 was most positive on improving PS, being informed about errors, considering PS as a top priority to management, and that the units work together to provide the best care (p > 0.05). G1 was most negative about the work culture with staff from other units, exchange of information across units, and shift changes (p > 0.05). The highest PS grade was related to greater communication, and a smaller frequency of events was reported only for G2 (p > 0.05). CONCLUSION: There must be a balance in terms of attention focused on PS between different ICUs in times of crisis, especially regarding the supervisors/managers actions.

Effects of dance therapy in women with breast cancer: A systematic review protocol.

BACKGROUND: Cancer is an important public health problem with an increasing global incidence in the recent decades. Breast cancer has become the leading cause of death in women worldwide. Women suffering from breast cancer, as well as survivors, may experience some adverse effects of treatment-including cancer-related fatigue, sleep disorders, and pain-which may manifest alone or in combination with other symptoms. Non-pharmacological interventions, such as physical activity, have been associated with improvements in these adverse effects. This study aims to evaluate the effects of dance therapy in women with breast cancer. METHODS: We will perform a systematic review according to the Cochrane methodology. An overall search strategy will be developed and adapted for PubMed, Virtual Health Library, PEDro, SciELO, SciVerse Scopus, Cochrane Library, and Web of Science using the descriptors "Dance therapy" or "Dancing" and "Breast neoplasms" or "Breast cancer." The size of the intervention effect (Z) will be calculated for each outcome included in this review. Outcomes will be pain, cancer-related fatigue, sleep disturbance, body image and depression in women with breast cancer. Quality assessment will be performed using the Cochrane instrument. Metanalysis, if plausible, will be performed using Review Manager 5.3. DISCUSSION: Studies have reported positive results of dance therapy as a non-pharmacological intervention in women with breast cancer. Thus, it is expected that robust and conclusive evidence of the effects of dance therapy during or after treatment (radiotherapy, chemotherapy, hormone therapy, and/or surgery) can be obtained. TRIAL REGISTRATION: Systematic review registration: CRD42020152876. (S1 File).

Molecular epidemiology of methicillin-resistant Staphylococcus aureus in the Brazilian primary health care system.

OBJECTIVE: To evaluate the molecular epidemiology and to georeference Staphylococcus aureus isolated from wounds and nares of patients seen at Basic Health Units (BHUs) of a Brazilian city. METHODS: Observational, cross-sectional study conducted from 2010 to 2013. A total of 119 S. aureus strains isolated from the wounds and nares of 88 patients were studied. The isolates were characterised by identifying virulence genes encoding enterotoxins A-E, haemolysins α, ß and δ, exfoliatins A, B and D, biofilm production, Panton-Valentine Leukocidin and toxic shock syndrome toxin 1, and by pulsed-field gel electrophoresis (PFGE), multilocus sequence and spa typing. RESULTS: Eighteen methicillin-resistant Staphylococcus aureus (MRSA) (6 SCCmec type II and 12 SCCmec type IV) and 101 (85%) MSSA were identified. PFGE typing resulted in the formation of eight clusters, with STs 1, 5, 8, 30, 188, 1176 and 1635 and spa type t002 being the predominant types among MSSA. The 18 MRSA belonged to STs 5, 8 and 1176 and spa types t002 and t062. CONCLUSION: The results demonstrate widespread dissemination of MSSA and MRSA clones carrying haemolysin, biofilm and toxin genes. Kernel density estimation revealed the highest density of S. aureus in the 4, 5 and 8 BHUs.

OBJECTIF: Evaluer l'épidémiologie moléculaire et géoréférencer le Staphylococcus aureus isolé de plaies et de narines de patients vus dans les unités sanitaires de base (BHU) d'une ville brésilienne. MÉTHODES: Etude observationnelle transversale réalisée de 2010 à 2013. Au total, 119 souches de S. aureus isolées de plaies et de narines de 88 patients ont été étudiées. Les isolats ont été caractérisés par l'identification de gènes de virulence codant pour les entérotoxines AE, les hémolysines α, ß et δ, les exfoliatines A, B et D, la production de biofilm, la leucocidine de Panton-Valentine et la toxine 1 du syndrome de choc toxique, et par typage par électrophorèse sur gel en champ pulsé (PFGE), séquence multilocus et spa. RÉSULTATS: Dix-huit SARM (6 de type II SCCmec et 12 de type IV SCCmec) et 101 (85%) SASM ont été identifiés. Le typage PFGE a résulté à l'obtention de huit grappes, dont STs 1, 5, 8, 30, 188, 1176 et 1635 et le type spa t002 étant les types prédominants parmi les SASM. Les 18 SARM appartenaient aux STs 5, 8 et 1176 et aux types de spa t002 et t062. CONCLUSION: Les résultats démontrent une dissémination étendue des clones de SASM et de SARM portant les gènes de l'hémolysine, de biofilm et de toxine. L'estimation de la densité par noyau a révélé la densité la plus élevée de S. aureus dans les 4, 5 et 8 BHU.

Echinococcus granulosus: Evidence of a heterodimeric glutathione transferase built up by phylogenetically distant subunits.

In the cestode parasite Echinococcus granulosus, three phylogenetically distant cytosolic glutathione transferases (GSTs) (EgGST1, 2 and 3) were identified. Interestingly, the C-terminal domains of EgGST3 and EgGST2 but not EgGST1, exhibit all amino acids involved in Sigma-class GST dimerization. Here, we provide evidence indicating that EgGST2 and EgGST3 naturally form a heterodimeric structure (EgGST2-3), and also we report the enzymatic activity of the recombinant heterodimer. EgGST2-3 might display novel properties able to influence the infection establishment. This is the first report of a stable heterodimeric GST built up by phylogenetically distant subunits.

Autophagy proteins are modulated in the liver and hypothalamus of the offspring of mice with diet-induced obesity.

Nutritional excess during pregnancy and lactation has a negative impact on offspring phenotype. In adulthood, obesity and lipid overload represent factors that compromise autophagy, a process of lysosomal degradation. Despite knowledge of the impact of obesity on autophagy, changes in offspring of obese dams have yet to be investigated. In this study, we tested the hypothesis that maternal obesity induced by a high fat diet (HFD) modulates autophagy proteins in the hypothalamus and liver of the offspring of mice. At birth (d0), offspring of obese dams (HFD-O) showed an increase in p62 protein and a decrease in LC3-II, but only in the liver. After weaning (d18), the offspring of HFD-O animals showed impairment of autophagy markers in both tissues compared to control offspring (SC-O). Between day 18 and day 42, both groups received a control diet and we observed that the protein content of p62 remained increased in the livers of the HFD-O offspring. However, after 82days, we did not find any modulation in offspring autophagy proteins. On the other hand, when the offspring of obese dams that received an HFD from day 42 until day 82 (OH-H) were compared with the offspring from the controls that only received an HFD in adulthood (OC-H), we saw impairment in autophagy proteins in both tissues. In conclusion, this study describes that HFD-O offspring showed early impairment of autophagy proteins. Although the molecular mechanisms have not been explored, it is possible that changes in autophagy markers could be associated with metabolic disturbances of offspring.

Disordered eating among adolescent female swimmers: dietary, biochemical, and body composition factors.

OBJECTIVE: To verify associations among body composition, biochemical parameters, and food intake in adolescent female swimmers with and without disordered eating (DE). METHODS: Seventy-seven athletes 11 to 19 y old from clubs in Rio de Janeiro, Brazil were studied. DE was assessed through three questionnaires (Eating Attitudes Test-26; Bulimic Investigatory Test, Edinburgh; and Body Shape Questionnaire), body composition by dual-energy x-ray absorptiometry, and food intake by a 3-d diet record. Biochemical parameters related to iron, folic acid, and vitamin B12 were analyzed. The Fisher exact test, Mann-Whitney test, and the Spearman coefficient were calculated. RESULTS: DE was found in 44.2% of the sample. DE-positive compared with DE-negative athletes presented greater body fat percentage (11-14 y: 27.5% versus 23.4%, P = 0.023; 15-19 y: 30.2% versus 24.1%, P = 0.006) and fat mass (11-14 y: 13.8 versus 10.3 kg, P = 0.010; 15-19 y: 17.0 versus 13.2 kg, P = 0.027). In relation to food intake, DE-positive athletes presented lower protein consumption in the 11- to 14-y-old group and lower calcium intake adequacy in the 15- to 19-y-old group. Most other dietary parameters showed a low adequacy of consumption, with no difference between athletes with and without DE. Four DE-positive athletes presented anemia or iron deficiency. CONCLUSION: DE-positive compared with DE-negative athletes presented a higher percentage of body fat and fat mass, lower protein consumption in the 11- to 14-y-old group, and lower calcium intake adequacy in the 15- to 19-y-old group. Greater attention should be given to the nutritional state of these athletes, considering the number of adolescents with anemia and an inadequate dietary intake.