Iron(III) cross-linked hydrogels based on Alteromonas macleodii Mo 169 exopolysaccharide.

Recently, polysaccharide-based hydrogels crosslinked with the trivalent iron cation have attracted interest due to their remarkable properties that include high mechanical stability, stimuli-responsiveness, and enhanced absorptivity. In this study, a Fe3+ crosslinked hydrogel was prepared using the biocompatible extracellular polysaccharide (EPS) secreted by the marine bacterium Alteromonas macleodii Mo169. Hydrogels with mechanical strengths (G') ranging from 0.3 kPa to 44.5 kPa were obtained as a result of the combination of different Fe3+ (0.05-9.95 g L-1) and EPS (0.3-1.7 %) concentrations. All the hydrogels had a water content above 98 %. Three different hydrogels, named HA, HB, and HC, were chosen for further characterization. With strength values (G') of 3.2, 28.9, and 44.5 kPa, respectively, these hydrogels might meet the strength requirements for several specific applications. Their mechanical resistance increased as higher Fe3+ and polymer concentrations were used in their preparation (the compressive hardness increased from 8.7 to 192.1 kPa for hydrogel HA and HC, respectively). In addition, a tighter mesh was noticed for HC, which was correlated to its lower swelling ratio value compared to HA and HB. Overall, this preliminary study highlighted the potential of these hydrogels for tissue engineering, drug delivery, or wound healing applications.

Cutaneous hypersensitivity reaction to low molecular weight heparins in pregnancy, cross reactivity and prednisolone treatment: A case report.

In pregnant women, low molecular weight heparin is recommended as the preferred agent for venous thromboembolism prophylaxis and treatment. Despite their widespread application, heparin-induced skin lesions are probably under-reported and under-estimated. We present a case report of a primigravida treated with low molecular weight heparin for deep vein thrombosis, who developed a delayed-type hypersensitivity reaction to enoxaparin, tinzaparin and dalteparin. As the patient was pregnant, treatment options were restricted. Tolerance was achieved with dalteparin with adjuvant administration of prednisolone. An attempt to decrease prednisolone dose triggered delayed-type hypersensitivity reaction recurrence that was solved by keeping the initial prednisolone prescription. To the best of our knowledge, there are no described cases using this approach. In cases of delayed-type hypersensitivity reaction to low molecular weight heparin during pregnancy our case suggests that switching low molecular weight heparin and adjuvant administration of prednisolone can be an option.

Exploring the Drug-Loading and Release Ability of FucoPol Hydrogel Membranes.

The polysaccharide FucoPol has recently been shown to yield hydrogel membranes (HMs) characterized by good mechanical properties, biocompatibility, and anti-inflammatory activity that render them promising biomaterials for use in the biomedical field. Subsequently to such findings, envisaging their development into novel delivery systems for topical applications, in this study, FucoPol HMs prepared by crosslinking the biopolymer with iron cations were loaded with caffeine or diclofenac sodium as model drugs. Two loading methods, namely diffusion and mixing, were applied to evaluate the FucoPol's HM drug-loading capacity and entrapment efficiency. The diffusion method led to a higher caffeine loading (101.9 ± 19.1 mg/g) in the HM1_DCAF membranes, while the mixing method resulted in a higher diclofenac sodium loading (82.3 ± 5.1 mg/g) in the HM1_DDS membranes. The HM1_DCAF membranes were characterized by increased mechanical and rheological parameters, such as their hardness (130.0 ± 5.3 kPa) and storage modulus (1014.9 ± 109.7 Pa), compared to the HM1_DDS membranes that exhibited lower values (7.3 ± 1.2 kPa and 19.8 ± 3.8 Pa, respectively), probably due to leaching occurring during the drug-loading process. The release profiles revealed a fast release of both APIs from the membranes loaded by diffusion, while a prolonged and sustained release was obtained from the membranes loaded by mixing. Moreover, for all API-loaded membranes, the release mechanism followed Fickian diffusion, with the release rate being essentially governed by the diffusion process. These findings, together with their previously shown biological properties, support the suitability of the developed FucoPol HMs to be used as platforms for the topical delivery of drugs.

Novel Hydrogel Membranes Based on the Bacterial Polysaccharide FucoPol: Design, Characterization and Biological Properties.

FucoPol, a fucose-rich polyanionic polysaccharide, was used for the first time for the preparation of hydrogel membranes (HMs) using Fe3+ as a crosslinking agent. This study evaluated the impact of Fe3+ and FucoPol concentrations on the HMs' strength. The results show that, above 1.5 g/L, Fe3+ concentration had a limited influence on the HMs' strength, and varying the FucoPol concentration had a more significant effect. Three different FucoPol concentrations (1.0, 1.75 and 2.5 wt.%) were combined with Fe3+ (1.5 g/L), resulting in HMs with a water content above 97 wt.% and an Fe3+ content up to 0.16 wt.%. HMs with lower FucoPol content exhibited a denser porous microstructure as the polymer concentration increased. Moreover, the low polymer content HM presented the highest swelling ratio (22.3 ± 1.8 g/g) and a lower hardness value (32.4 ± 5.8 kPa). However, improved mechanical properties (221.9 ± 10.2 kPa) along with a decrease in the swelling ratio (11.9 ± 1.6 g/g) were obtained for HMs with a higher polymer content. Furthermore, all HMs were non-cytotoxic and revealed anti-inflammatory activity. The incorporation of FucoPol as a structuring agent and bioactive ingredient in the development of HMs opens up new possibilities for its use in tissue engineering, drug delivery and wound care management.

Cu(II) and Zn(II) Complexes of New 8-Hydroxyquinoline Schiff Bases: Investigating Their Structure, Solution Speciation, and Anticancer Potential.

We report the synthesis and characterization of three novel Schiff bases (L1-L3) derived from the condensation of 2-carbaldehyde-8-hydroxyquinoline with amines containing morpholine or piperidine moieties. These were reacted with CuCl2 and ZnCl2 yielding six new coordination compounds, with the general formula ML2, where M = Cu(II) or Zn(II) and L = L1-L3, which were all characterized by analytical, spectroscopic (Fourier transform infrared (FTIR), UV-visible absorption, nuclear magnetic resonance (NMR), or electron paramagnetic resonance (EPR)), and mass spectrometric techniques, as well as by single-crystal X-ray diffraction. In the solid state, two Cu(II) complexes, with L1 and L2, are obtained as dinuclear compounds, with relatively short Cu-Cu distances (3.146 and 3.171 Å for Cu2(L1)4 and Cu2(L2)4, respectively). The free ligands show moderate lipophilicity, while their complexes are more lipophilic. The pKa values of L1-L3 and formation constants of the complex (for ML and ML2) species were determined by spectrophotometric titrations, with the Cu(II) complexes showing higher stability than the Zn(II) complexes. EPR indicated the presence of several species in solution as pH varied and binding modes were proposed. The binding of the complexes to bovine serum albumin (BSA) was evaluated by fluorescence and circular dichroism (CD) spectroscopies. All complexes bind BSA, and as demonstrated by CD, the process takes several hours to reach equilibrium. The antiproliferative activity was evaluated in malignant melanoma cells (A375) and in noncancerous keratinocytes (HaCaT). All complexes display significant cytotoxicity (IC50 < 10 µM) but modest selectivity. The complexes show higher activity than the free ligands, the Cu(II) complexes being more active than the Zn(II) complexes, and approximately twice more cytotoxic than cisplatin. A Guava ViaCount assay corroborated the antiproliferative activity.

Intermittent versus Continuous Catheterization and Differences in the Evolution of Labor: Systematic Review and Meta-analysis.

OBJECTIVE: To evaluate the differences between bladder emptying options (permanent catheterization and intermittent bladder emptying/spontaneous urination) regarding the effects on labor length, need of operative vaginal deliveries, and cesarean section rate. DATA SOURCES: The search was conducted in MEDLINE, Scopus, Web of Science, and The Cochrane Central Register of Controlled Trials databases. SELECTION OF STUDIES: The survey returned 964 studies. A total of 719 studies were evaluated by title and abstract, of which 4 were selected for inclusion. DATA COLLECTION: All references were inserted in the Rayyan QCRI tool (Rayyan Systems Inc., Cambridge, MA, USA). The full text of the selected articles was obtained so we could later decide whether or not to include them in this systematic review. DATA SYNTHESIS: No differences were found in the number of instrumented deliveries or in cesarean section rate between groups. CONCLUSIONS: After evaluating the studies performed on the topic, we concluded that there is no clear advantage to either method, although continuous catheterization was associated with a greater occurrence of eutocic births. In the remaining outcomes, there were no differences between catheterization types.

OBJETIVO: Avaliar as diferenças entre as opções de esvaziamento vesical (cateterismo permanente e esvaziamento vesical intermitente/micção espontânea) em relação aos efeitos na duração do trabalho de parto, necessidade de partos vaginais operatórios e taxa de cesárea. FONTES DE DADOS: A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, Web of Science, e The Cochrane Central Register of Controlled Trials. SELEçãO DE ESTUDOS: A pesquisa retornou 964 estudos. Um total de 719 estudos foram avaliados por título e resumo, dos quais 4 foram selecionados para inclusão. COLETA DE DADOS: Todas as referências foram inseridas na ferramenta Rayyan QCRI (Rayyan Systems Inc., Cambridge, MA, EUA). O texto completo dos artigos selecionados foi obtido para posterior decisão de incluí-los nesta revisão sistemática. SíNTESE DOS DADOS: Não foram encontradas diferenças no número de partos instrumentados ou na taxa de cesariana entre os grupos. CONCLUSõES: Após avaliação dos estudos realizados sobre o tema, concluímos que não há vantagem clara de qualquer um dos métodos, embora o cateterismo contínuo tenha sido associado à maior ocorrência de partos eutócicos. Nos demais desfechos, não houve diferenças entre os tipos de cateterismo.

Ovarian vein thrombosis: a rare but not to be forgotten cause of abdominal pain.

A healthy 38-year-old woman, with no significant medical or surgical history, was referred to the gynaecology emergency department with acute low quadrant abdominal pain and nausea. On examination, painful palpation of right iliac fossa, abdominal guarding and positive Blumberg's sign were noted. An abdominal-pelvic CT scan showed a hypodense tubular structure with peripheral enhancement to the right of the inferior vena cava, suggestive of thrombosis of the right ovarian vein. The only risk factor identified was the use of the combined contraceptive pill.

Intermittent versus Continuous Catheterization and Differences in the Evolution of Labor: Systematic Review and Meta-analysis / Cateterismo intermitente versus contínuo e diferenças na evolução do trabalho de parto: Revisão sistemática e meta-análise

Abstract Objective To evaluate the differences between bladder emptying options (permanent catheterization and intermittent bladder emptying/spontaneous urination) regarding the effects on labor length, need of operative vaginal deliveries, and cesarean section rate. Data Sources The search was conducted in MEDLINE, Scopus, Web of Science, and The Cochrane Central Register of Controlled Trials databases. Selection of Studies The survey returned 964 studies. A total of 719 studies were evaluated by title and abstract, of which 4 were selected for inclusion. Data Collection All references were inserted in the Rayyan QCRI tool (Rayyan Systems Inc., Cambridge, MA, USA). The full text of the selected articles was obtained so we could later decide whether or not to include them in this systematic review. Data Synthesis No differences were found in the number of instrumented deliveries or in cesarean section rate between groups. Conclusions After evaluating the studies performed on the topic, we concluded that there is no clear advantage to either method, although continuous catheterization was associated with a greater occurrence of eutocic births. In the remaining outcomes, there were no differences between catheterization types.

Resumo Objetivo Avaliar as diferenças entre as opções de esvaziamento vesical (cateterismo permanente e esvaziamento vesical intermitente/micção espontânea) em relação aos efeitos na duração do trabalho de parto, necessidade de partos vaginais operatórios e taxa de cesárea. Fontes de Dados A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, Web of Science, e The Cochrane Central Register of Controlled Trials. Seleção de Estudos A pesquisa retornou 964 estudos. Um total de 719 estudos foram avaliados por título e resumo, dos quais 4 foram selecionados para inclusão. Coleta de Dados Todas as referências foram inseridas na ferramenta Rayyan QCRI (Rayyan Systems Inc., Cambridge, MA, EUA). O texto completo dos artigos selecionados foi obtido para posterior decisão de incluí-los nesta revisão sistemática. Síntese dos Dados Não foram encontradas diferenças no número de partos instrumentados ou na taxa de cesariana entre os grupos. Conclusões Após avaliação dos estudos realizados sobre o tema, concluímos que não hávantagem clara de qualquer um dos métodos, embora o cateterismo contínuo tenha sido associado à maior ocorrência de partos eutócicos. Nos demais desfechos, não houve diferenças entre os tipos de cateterismo.

Vulvar herpes zoster infection: a rare and challenging diagnosis.

A 26-year-old woman under immunosuppression with infliximab due to Crohn's disease was referred to the gynaecology emergency room with dispersed and coalescing vesicular lesions on the vulvar region extending to the right lower limb involving S2-S3 dermatome, associated with severe pain. Clinical history, physical examination and serological testing was consistent with herpes zoster infection. The patient was treated with valaciclovir for 14 days and cefradine for 7 days (due to the possibility of secondary bacterial infection). Significant symptomatic improvement was noted after 1 week. The 1-year follow-up was unremarkable. According to our knowledge and review of the literature, this is one of the few cases reported of vulvar herpes zoster, especially related to infliximab.

Nursing workload assessment in an intensive care unit: A 5-year retrospective analysis.

AIMS: To study the correlation between the workload of intensive care nursing teams and the sociodemographic, anthropometric and clinical characteristics of patients in critical condition in a Portuguese Intensive Care Unit (ICU) during a 5-year period. BACKGROUND: Currently, indices of nursing workload quantification are one of the resources used for planning and evaluating ICUs. Evidence shows that there are several factors related to critical patients and their hospitalisation which potentially influence the nursing workload. DESIGN: Retrospective cohort analysis of a health record database from adult patients admitted to a Portuguese ICU between 1 January 2015-31 December 2019. METHODS: Simplified Therapeutic Intervention Scoring System (TISS-28) scores of 730 adult patients. Three TISS-28 assessments were considered: first assessment, last assessment and average. The STROBE guidelines were used in reporting this study. RESULTS: The TISS-28 has an average of 34.2 ± 6.9 points at admission, which is considered a high nursing workload. A somewhat lower result was found for the discharge and average assessments. It shows that basic activities accounted for the highest percentage of time spent (38.0%), followed by the cardiovascular support category (26.5%). The TISS-28 shows consistent results throughout the study period, despite a small trend reduction in the last 2 years. CONCLUSIONS: Lower workloads were found for age ≤44 years and with a shorter length of stay. Higher workload was more probable in patients classified in Cullen Class IV (OR = 2.5) and with a normal to higher weight percentile (OR = 1.9 and 1.5, respectively). RELEVANCE TO CLINICAL PRACTICE: Knowledge of the factors influencing the nursing workload facilitates the implementation of rules to improve performance in nursing interventions, based on the redefinition of care priorities, increased productivity, human resources management and reduction of additional costs to the organisation, related to possible adverse events, among others.

Accidents at work and its impact on a hospital in Northern Portugal.

In order to describe accidents at work at a hospital in Northern Portugal and analyze their main impact in the period from 2008 to 2010, we conducted a retrospective cross-sectional study. The information was obtained from the notification records of accidents at work for 387 workers. The highest prevalence levels of accidents referred to superior health technician (56.1%), female workers (81.9%), in the age group 30-39 years (37.2%), with a secondary education degree (55.8%), working in shifts (72.4%) and in-patient services (35.9%). Needle pricks were the main cause (45.7%) and hands were the main injury location (37.5%). Wounds (32.6%) were the most frequent type of injury, followed by sprains and strains (23%). In total, 27.4% resulted in absence from work, with sprains and strains as the main reason. Preventive strategies should be adopted, aiming to promote these workers' health.

Accidents at work and its impact on a hospital in Northern Portugal / Acidentes de trabalho e suas repercussões num hospital ao Norte de Portugal / Accidentes de trabajo y su impacto en un hospital en el norte de Portugal

In order to describe accidents at work at a hospital in Northern Portugal and analyze their main impact in the period from 2008 to 2010, we conducted a retrospective cross-sectional study. The information was obtained from the notification records of accidents at work for 387 workers. The highest prevalence levels of accidents referred to superior health technician (56.1%), female workers (81.9%), in the age group 30-39 years (37.2%), with a secondary education degree (55.8%), working in shifts (72.4%) and in-patient services (35.9%). Needle pricks were the main cause (45.7%) and hands were the main injury location (37.5%). Wounds (32.6%) were the most frequent type of injury, followed by sprains and strains (23%). In total, 27.4% resulted in absence from work, with sprains and strains as the main reason. Preventive strategies should be adopted, aiming to promote these workers' health.

Com o objetivo de descrever os acidentes de trabalho num hospital ao Norte de Portugal e analisar as suas principais repercussões, no período de 2008 a 2010, realizou-se este estudo transversal retrospectivo. A informação foi obtida recorrendo-se ao registro de notificação dos acidentes de trabalho, referentes a 387 trabalhadores. A maior prevalência de acidentes recaiu nos técnicos superiores de saúde (56,1%), em trabalhadores do gênero feminino (81,9%), no grupo etário entre 30 e 39 anos (37,2%), com escolaridade superior ao 12º ano (55,8%), trabalhando por turnos (72,4%) e nos serviços de internamento (35,9%). A principal causa de acidentes foi a picada de agulha (45,7%) e a lesão mais prevalente verificou-se nos membros superiores (43,2%). As feridas representaram o tipo de lesão mais frequente (32,6%), resultando em ausência ao trabalho (27,4%), sendo as entorses/distensões o principal motivo. Estratégias preventivas devem ser adotadas objetivando a promoção da saúde desses profissionais.

Para describir los accidentes de trabajo en un hospital del norte de Portugal y analizar su impacto principal en período 2008 a 2010, se realizó un estudio retrospectivo de corte transversal. La información se obtuvo mediante la notificación de registro de accidentes de trabajo de 387 trabajadores. La mayor prevalencia de accidentes cayó en los técnicos superiores de salud (56,1%), en el sexo femenino (81,9%), con edad 30-39 años (37,2%), con la educación superior a los 12 años (55,8%), trabajando en turnos (72,4%) y servicios de hospitalización (35,9%). La causa principal fue el pinchazo de aguja (45,7%) y la lesión se produjo principalmente en las manos (37,5%). Las heridas (32,6%) fueran el tipo más frecuente de lesión. Dieron lugar a la ausencia del trabajo 27,4%, con esguinces y distensiones la principal razón. Las estrategias preventivas deben ser adoptadas con miras a la promoción de la salud de los profesionales.