Fatores que contribuem para reinternação de pacientes submetidos a cirurgia cardíaca / Factors contributing to reinternation of patients subject to heart surgery

Objetivo: Descrever os fatores que contribuem para reinternação de pacientes submetidos a cirurgia cardíaca. Métodos: Trata-se de uma pesquisa exploratória e descritiva realizada de março a julho de 2019 no Hospital do Coração com 22 pacientes admitidos com reinternação após cirurgia cardíaca. Pesquisa aprovada pelo CEP com parecer Nº 3.147.170. Resultados: Os pacientes eram do sexo masculino 81,82% (18), na faixa etária de 70 a 95 anos de idade 40,91% (09). A maioria apresentava Hipertensão Arterial Sistêmica 90,90% (20), eram tabagistas 72,73% (16), etilistas 63,64% (14) e dislipidêmicos 72,73% (16). Com base na história clínica dos pacientes evidenciou-se em sua maioria a cirurgia de Revascularização do Miocárdio 81,82% (18). Conclusão: Dentre os fatores que contribuíram para reinternação de pacientes submetidos a cirurgia cardíaca foram: idade avançada, HAS, DM, tabagismo, etilismo e dislipidemia, teve associação com nova hospitalização após a cirurgia e à existência de algum adoecimento no pós-operatório. (AU)

Objective: To describe the factors that contribute to the readmission of patients undergoing cardiac surgery. Methods: This is an exploratory and descriptive research conducted from March to July 2019 at the Heart Hospital with 22 patients admitted with readmission after cardiac surgery. Research approved by CEP with opinion No. 3.147.170. Results: The patients were male 81.82% (18), aged 70 to 95 years old 40.91% (09). Most had systemic arterial hypertension 90.90% (20), were smokers 72.73% (16), alcoholics 63.64% (14) and dyslipidemic 72.73% (16). Based on the clinical history of the patients, most of them showed myocardial revascularization surgery 81.82% (18). Conclusion: Among the factors that contributed to the readmission of patients undergoing cardiac surgery were: advanced age, hypertension, diabetes mellitus, smoking, alcoholism and dyslipidemia, was associated with new hospitalization after surgery and the existence of postoperative illness. (AU)

Objetivo: Describir los factores que contribuyen a la readmisión de pacientes sometidos a cirugía cardíaca. Métodos: Esta es una investigación exploratoria y descriptiva realizada entre marzo y julio de 2019 en el Heart Hospital con 22 pacientes ingresados con reingreso después de una cirugía cardíaca. Investigación aprobada por el CEP con opinión No. 3.147.170. Resultados: los pacientes eran varones 81.82% (18), de 70 a 95 años de edad 40.91% (09). La mayoría tenía hipertensión arterial sistémica 90.90% (20), eran fumadores 72.73% (16), alcohólicos 63.64% (14) y dislipidémicos 72.73% (16). Con base en la historia clínica de los pacientes, la mayoría de ellos mostró cirugía de revascularización miocárdica 81.82% (18). Conclusión: Entre los factores que contribuyeron al reingreso de pacientes sometidos a cirugía cardíaca se encuentran: edad avanzada, hipertensión, diabetes mellitus, tabaquismo, alcoholismo y dislipidemia, se asoció con una nueva hospitalización después de la cirugía y la existencia de enfermedad postoperatoria. (AU)

Safety alert for hospital environments and health professional: chlorhexidine is ineffective for coronavirus.

An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.

Safety alert for hospital environments and health professional: chlorhexidine is ineffective for coronavirus

SUMMARY An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.

RESUMO Um dado alarmante revelado por publicações a respeito dos agentes desinfetantes: o digluconato de clorexidina é ineficaz para desinfecção de superfícies contaminadas por coronavírus. Trata-se de uma constatação que reclama imediata divulgação, uma vez que essa substância é amplamente usada para degermação de mãos e antebraços dos cirurgiões e auxiliares e na antissepsia dos pacientes, em procedimentos minimamente invasivos, comumente em ambientes hospitalares. O objetivo deste trabalho foi comparar os diferentes desinfetantes usados para desinfecção em diversas superfícies em revisão de trabalhos mundiais. Foram pesquisados trabalhos científicos na BVS (Biblioteca Virtual de Saúde), PubMed, Medline e Anvisa (Agência Nacional de Vigilância Sanitária). Foram estudados os seguintes agentes: álcool 62-71%, peróxido de hidrogênio 0,5%, hipoclorito de sódio 0,1%, cloreto de benzancônio 0,05-0,2%, iodo povidina 10% e digluconato de clorexidina 0,02%, em superfícies de metal, alumínio, madeira, papel, vidro, plástico, PVC, silicone, látex (luvas), avental descartável, cerâmica e teflon. Os estudos demonstraram que o digluconato de clorexidina é ineficaz para a inativação de alguns subtipos de coronavírus, sugerindo que também seja ineficaz contra o novo coronavírus.

Angiogenic and antiangiogenic factors in preeclampsia.

BACKGROUND: Pre-eclampsia is a multifactorial hypertensive disorder that is triggered by placental insufficiency and that accounts for up to 15% of maternal deaths. In normal pregnancies, this process depends on the balance between the expression of angiogenic factors and antiangiogenic factors, which are responsible for remodeling the spiral arteries, as well as for neoangiogenesis and fetal development. PURPOSE: The aim of this review is to discuss the main scientific findings regarding the role of angiogenic and antiangiogenic factors in the etiopathogenesis of preeclampsia. METHODS: An extensive research was conducted in the Pubmed database in search of scientific manuscripts discussing potential associations between angiogenic and antiangiogenic factors and preeclampsia. Ninety-one papers were included in this review. RESULTS: There is an increased expression of soluble fms-like tyrosine kinase receptor and soluble endoglin in pre-eclampsia, as well as reduced placental expression of vascular endothelial growth factor and placental growth factor. Systemic hypertension, proteinuria and kidney injury - such as enlargement and glomerular fibrin deposit, capillary occlusion due to edema, and hypertrophy of endocapillary cells - are some of these changes. The complex etiopathogenesis of preeclampsia instigates research of different biomarkers that allow for the early diagnosis of this entity, such as vascular endothelial growth factor, placental growth factor, soluble fms-like tyrosine kinase receptor, soluble endoglin, placental glycoprotein pregnancy-associated plasma protein-A and protein 13. CONCLUSION: Even though it is possible to establish an efficient and effective diagnostic tool, three key principles must be observed in the management of preeclampsia: prevention, early screening and treatment.

Monocyte-derived dendritic cells from patients with cervical intraepithelial lesions.

Immunotherapy with dendritic cells (DCs) is a great promise for the treatment of neoplasms. However, the obtainment and protocol of differentiation of these cells may depend on extrinsic factors such as the tumor itself. The aim of the present study was to verify the influence of cervical neoplasia on different protocols of differentiation of monocyte-derived DCs resulting in an increased maturation phenotype. A total of 83 women were included in the study. The patients were grouped in low-grade squamous intraepithelial lesion (LSIL) (n=30), high-grade squamous intraepithelial lesion (HSIL) (n=22), cervical cancer (n=10) and healthy patients (n=21) groups. The mononuclear cells of patients were subjected to three differentiation protocols. In protocol I (pI), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-4 and tumor necrosis factor (TNF)-α were used for the differentiation of mature DCs (pIDCs). In protocol II (pII), monocytes were stimulated with GM-CSF, IL-4, TNF-α and activated lymphocytes in the absence of non-adherent cells (pIIDCs). In protocol III (pIII), monocytes were stimulated with GM-CSF, IL-4, TNF-α and activated lymphocytes in the presence of non-adherent cells (pIIIDCs). These cells were evaluated by flow cytometry for the expression of maturation markers such as cluster of differentiation (CD)11c, CD86 and human leukocyte antigen-antigen D related (HLA-DR). The main cytokines secreted (IL-4, IL-12 and transforming growth factor-ß) were measured by ELISA. Our results indicate a significantly lower mature profile of pIIDCs and a significant increase in CD11c+ pIIIDCs able to produce IL-12 (P=0.0007). Furthermore, a significant reduction in cervical cancer HLA-DR+ pIDCs (P=0.0113) was also observed. HSIL patients exhibited a higher percentage of HLA-DR+ pIIDCs (P=0.0113), while LSIL patients had a lower percentage of CD11c+ pIIIDCs (P=0.0411). These findings suggest that the extent of cervical lesions affects the process of differentiation of DCs. Furthermore, activated lymphocytes may induce a better maturation of monocyte-derived DCs, and the presence of mononuclear cells appears to contribute to the DC differentiation process.