Quality indicators for the processing of health products: A mixed-methods study.

OBJECTIVE: to analyze the use of quality assessment indicators and their implementation to improve quality in the processing of health products. METHOD: a mixed-methods study with a multiple case approach using Structure, Process and Results indicators and elaboration of a plan using Appreciative Inquiry, carried out in four central sterile supply departments from hospital units. RESULTS: the indicators for the Cleaning stage presented 47.8% compliance for Structure and 59.0% for Process: in addition 71.8% of the products were clean. In the Preparation operational stage, 50.0% of the Results indicators were in compliance for Structure and 66.7% for Process. In the Sterilization, Storage and Distribution stage, 43.5% compliance was obtained for Structure, 55.7% for Process and 78.6% for Packaging conservation. Appreciative planning proposed improvements to the physical structure, review of processes and protocols, promotion and appreciation of the work done and strengthening of teaching about processing and service management, highlighting the protagonism of the group and of the leaders. CONCLUSION: using indicators was positive in materializing reality; however, it was verified that the improvements proposed are related to people. The affirmative and constructive view of Appreciative Inquiry presented itself as a path to changes and quality improvements.

Enhancing Antibody-Specific Productivity: Unraveling the Impact of XBP1s Overexpression and Glutamine Availability in SP2/0 Cells.

Augmentation of glycoprotein synthesis requirements induces endoplasmic reticulum (ER) stress, activating the unfolded protein response (UPR) and triggering unconventional XBP1 splicing. As a result, XBP1s orchestrates the expression of essential genes to reduce stress and restore homeostasis. When this mechanism fails, chronic stress may lead to apoptosis, which is thought to be associated with exceeding a threshold in XBP1s levels. Glycoprotein assembly is also affected by glutamine (Gln) availability, limiting nucleotide sugars (NS), and preventing compliance with the increased demands. In contrast, increased Gln intake synthesizes ammonia as a by-product, potentially reaching toxic levels. IgA2m(1)-producer mouse myeloma cells (SP2/0) were used as the cellular mammalian model. We explored how IgA2m(1)-specific productivity (qIgA2m(1)) is affected by (i) overexpression of human XBP1s (h-XBP1s) levels and (ii) Gln availability, evaluating the kinetic behavior in batch cultures. The study revealed a two and a five-fold increase in qIgA2m(1) when lower and higher levels of XBP1s were expressed, respectively. High h-XBP1s overexpression mitigated not only ammonia but also lactate accumulation. Moreover, XBP1s overexpressor showed resilience to hydrodynamic stress in serum-free environments. These findings suggest a potential application of h-XBP1s overexpression as a feasible and cost-effective strategy for bioprocess scalability.

Characterization of ovine gammaherpesvirus 2 in a goat by nanoplate digital PCR and other diagnostic methods.

The Macavirus, ovine gammaherpesvirus 2 (OvGHV2), is the cause of sheep-associated malignant catarrhal fever (SA-MCF). Although SA-MCF occurs in a wide range of mammalian hosts, there are few descriptions of this disease and/or infection in goats. This report describes the findings observed in a goat that was infected by OvGHV2 and adds to the rare description of this infection in this animal species. A 6.5-year-old, female, Anglo Nubian goat, with a neurological syndrome, that was euthanized after severe esophageal obstruction was investigated to determine the cause of the brain disease. Histopathology revealed cerebral cortical edema, hemorrhagic rhombencephalitis, severe hepatic necrosis, and atrophic enteritis. An immunohistochemical (IHC) assay identified intracytoplasmic antigens of a malignant catarrhal fever virus (MCFV) within epithelial cells of the intestine, liver, lungs, and kidneys. A semi-nested PCR assay amplified the partial fragment of the OvGHV2 tegument protein gene from the intestine, confirming that the MCFV identified by IHC was OvGHV2. A qPCR assay that targeted the OvGHV2 polymerase gene revealed an elevated quantification cycle (Cq), while nanoplate-based digital PCR (dPCR) detected low viral copy load within the OvGHV2 DNA. Furthermore, the nucleic acids of several disease pathogens associated with diseases in ruminants were not amplified. However, the exact cause of the neurological syndrome remained obscure since nucleic acids of neurological disease pathogens such as bovine viral diarrhea virus, bovine alphaherpesvirus 1 and 5, Histophilus somni, and OvGHV2 were not detected from the brain. Collectively, the results of the Cq and dPCR confirmed that this goat was infected with a low viral load of OvGHV2, which probably was insufficient to induce the typical histopathological alterations and subsequent clinical manifestations associated with SA-MCF and/or infections by OvGHV2. Therefore, elevated viral loads of OvGHV2 would have been required for the development of histological lesions and/or clinical manifestations of SA-MCF in this goat. Furthermore, the dPCR methodology can be used for the efficient detection and quantification of OvGHV2 DNA in animals with or without clinical and/or histopathological evidence of SA-MCF. Additionally, since previous cases of OvGHV2 infections in goats did not have the typical clinical manifestations of SA-MCF, one wonders if this Macavirus can induce SA-MCF in goats.

Effects of two oral electrolyte solutions in healthy newborn lambs.

This study aimed to evaluate the effects of two oral electrolyte solutions (OES), commercialized for the hydration of calves, on the water, electrolyte, and acid-base balance of newborn lambs. Twenty healthy crossbred Santa Inês lambs, 10 days old, 4-5 kg of body weight (BW), and fed on mother's milk, were included. The OES tested were slightly hyposmolar (OES 1: 279 mOsm/L; and OES 2: 283 mOsm/L) and had an alkalizing potential with an effective strong ion difference (SID3) of 76 mmol/L (OES 1) and 58 mmol/L (OES 2). In a crossover design, all lambs received the two OES, one at a time, with an interval of 7 days. On the day of treatment, the lambs received a volume corresponding to 5% of BW administered by esophageal tube at 0 and 6 h. Physical examinations were performed and venous blood samples were taken at 0, 6, 12, 24, and 48 h. Packed cell volume, total plasma protein, pH, partial pressure of carbon dioxide, bicarbonate ion, base excess, sodium (Na+), potassium, chloride (Cl-), SID3, L-lactate, glucose, anion gap, total concentration of non-volatile weak acids, and percentage change in plasma volume were measured. Data were analyzed by two-way repeated measures ANOVA. OES caused iatrogenic imbalances characterized by expansion of plasma volume, change in the Na+ and Cl- ratio with increase in plasma SID3, and strong ion metabolic alkalosis. These imbalances were mostly reversed 24 h after the start of treatment and did not differ (P > 0.05) between the two tested OES. The absence of side effects indicates that the tested commercial OES are safe for use in newborn lambs. Further studies are needed to prove the therapeutic efficacy of these OES in dehydrated sick lambs with metabolic acidosis.

Fatores de risco para infecções relacionadas à assistência à saúde em unidades de terapia intensiva / Risk factors for healthcare-associated infections in intensive care units

Objetivo: Investigar os fatores de risco para infecções relacionadas à assistência entre pacientes internados em uma Unidade de Terapia Intensiva de uma capital do Norte do Brasil. Métodos: Estudo de coorte prospectiva, com 267 pacientes internados no período de 01 de outubro de 2017 a 30 de janeiro 2019. As informações foram coletadas de prontuário eletrônico, físico e padrão de acompanhamento dos pacientes. Investigaram-se informações demográficas sobre a internação e tratamento. Realizada regressão de Poisson para avaliação das variáveis com o desfecho. Resultados: A incidência de infecções foi de 10,49 casos por 100 pacientes, com a maior frequência para infecção de sítio cirúrgico. Na análise ajustada, internação por mais de cinco dias (RR: 6,98; IC95%: 1,42; 34,15), parada cardiorrespiratória (RR: 2,89; IC95%:1,05;7,96), ter ostomia (RR: 9,22; IC95%:1,47; 57,65) ou traqueostomia (RR: 10,23; IC95%: 1,56;67,22) foram associados às infecções relacionadas à assistência. Conclusão: A incidência de infecções encontrada foi superior às outras regiões brasileiras. Recomenda-se vigilância ativa, principalmente em pacientes com internação prolongada e ostomias, avaliação criteriosa da necessidade de dispositivos e uso de protocolos para adoção de boas práticas. Descritores: Infecção Hospitalar; Unidades de Terapia Intensiva; Segurança do Paciente.

Objective: To investigate the risk factors for infections related to care among patients hospitalized in an Intensive Care Unit in a capital in northern Brazil. Methods: A prospective cohort study, with 267 patients hospitalized from October 1, 2017 to January 30, 2019. Information was collected from electronic and physical medical records and patients' follow-up pattern. Information was collected from electronic and physical medical records and patients' follow-up pattern. Demographic information about hospitalization and treatment was investigated. Poisson regression was performed to assess the variables with the outcome. Results: Infection incidence was 10.49 cases per 100 patients, with the highest frequency for surgical site infection. In the adjusted analysis, hospitalization for more than five days (RR: 6.98; 95%CI: 1.42; 34.15), cardiopulmonary arrest (RR: 2.89; 95%CI:1.05;7.96), having an ostomy (RR: 9.22; 95%CI:1.47; 57.65) or tracheostomy (RR: 10.23; 95%CI: 1.56;67.22) were associated with healthcare-associated infections. Conclusion: The incidence of infections found was higher than in other Brazilian regions. Active surveillance is recommended, especially in patients with prolonged hospitalization and ostomy, careful assessment of the need for devices and use of protocols for the adoption of good practices. Descriptors: Cross Infection; Intensive Care Units; Patient Safety.

Adenosine triphosphate (ATP) sampling algorithm for monitoring the cleanliness of surgical instruments.

BACKGROUND: Timely detection of cleaning failure is critical for quality assurance within Sterilising Service Units (SSUs). Rapid Adenosine Triphosphate (ATP) testing provides a real time and quantitative indication of cellular contaminants, when used to measure surface or device cleanliness. The aim of this study was to investigate the use of an ATP algorithm and to whether it could be used as a routine quality assurance step, to monitor surgical instruments cleanliness in SSUs prior to sterilisation. METHODS: Cleanliness monitoring using rapid ATP testing was undertaken in the SSUs of four hospitals located in the western (Amazonia) region of Brazil. ATP testing was conducted (Clean Trace, 3M) on 163 surgical instruments, following manual cleaning. A sampling algorithm using a duplicate swab approach was applied to indicate surgical instruments as (i) very clean, (ii) clean, (iii) equivocal or (iv) fail, based around a 'clean' cut-off of 250 Relative Light Units (RLU) and a 'very clean' <100 RLU. RESULTS: The four cleanliness categories were significantly differentiated (P≤0.001). The worst performing locations (hospitals A & C) had failure rates of 39.2% and 32.4%, respectively, and were distinctly different from hospitals B & D (P≤0.001). The best performing hospitals (B & D) had failure rates of 7.7% and 2.8%, respectively. CONCLUSION: The ATP testing algorithm provides a simple to use method within SSUs. The measurements are in real time, quantitative and useful for risk-based quality assurance monitoring, and the tool can be used for staff training. The four-tiered approach to the grading of surgical instrument cleanliness provides a nuanced approach for continuous quality improvement within SSU than does a simple pass/fail methodology.

Autoavaliação dos Núcleos de Segurança do Paciente em um estado do norte do Brasil / Self-assessment of Patient Safety Centers in a state in Northern Brazil

Avaliar a estrutura organizacional dos Núcleos de Segurança do Paciente dos hospitais de Rondônia. Estudo transversal, realizado entre novembro e dezembro de 2020, com 25 dos 40 núcleos de segurança do paciente cadastrados na Agência Nacional de Vigilância Sanitária. Os dados foram coletados mediante instrumento com indicadores de estrutura, processo e resultados.Houve maior adesão aos indicadores de estrutura e quase todas as instituições possuíam núcleo de segurança totalmente implantado. Contudo, evidencia-se fragilidade na execução de algumas ações, principalmente no gerenciamento de riscos. Apenas seis organizações realizaram notificações de eventos adversos, demonstrando relação direta com a alta adesão às boas práticas de segurança (p = 0,04) juntamente com o tipo de instituição (p = 0,02).Embora os núcleos estejam totalmente implantados, os indicadores de processo e resultados indicam a necessidade de qualificação de seus membros e um acompanhamento mais próximo pela coordenação estadual de segurança do paciente.

To evaluate the organizational structure of Patient Safety Centers in hospitals in the state of Rondônia. Cross-sectional study, carried out between November and December 2020. The study population consisted of 25 out of the 40 patient safety centers registered with the National Health Surveillance Agency. Data were collected using an instrument with structure, process, and outcome indicators. There was greater adherence to structure indicators and almost all institutions had a fully implemented Safety Center, however, there was evidence of weakness in the execution of some actions, mainly in risk management. Only six institutions reported adverse events, which showed a direct relationship with high adherence to good safety practices (p=0.04) along with the type of institution (p=0.02).Although the centers are fully implemented, the process and outcome indicators indicate the need for the qualification of their members and closer monitoring by the state coordination of patient safety.

Enteral hydration in cows: Comparison between continuous flow and bolus administration.

BACKGROUND: Enteral hydration in cattle is most commonly performed as a bolus (B) via the ororuminal route, although continuous flow (CF) administration via the nasoesophageal route represents a viable alternative. Currently, no study has compared the effectiveness of these two methods. This study aimed to compare the efficiency of enteral hydration using CF and B to correct water, electrolyte and acid-base imbalances in cows. METHODS: Protocols for the induction of dehydration were applied twice to eight healthy cows, with an interval of 1 week. In a crossover design, two types of enteral hydration were performed using the same electrolyte solution and volume equal to 12% of bodyweight (BW): CF (10 mL/kg/h, between 0 and 12 hours) and B (6% BW, twice, at 0 and 6 hours). Clinical and blood variables were determined at -24, 0, 6, 12 and 24 hours and compared using repeated-measures ANOVA. RESULTS: Induced moderate dehydration and hypochloremic metabolic alkalosis were corrected after 12 hours using the two hydration methods, with no differences observed between the methods. LIMITATIONS: The study was conducted with induced rather than natural imbalances, so the findings should be interpreted cautiously. CONCLUSION: Enteral CF hydration is as effective as B hydration in reversing dehydration and correcting electrolyte and acid-base imbalances.

Hospitalizations for ambulatory care-sensitive conditions in children, Rondônia, Brazil, 2008-2019. / Internações por condições sensíveis à atenção primária em crianças, Rondônia, Brasil, 2008-2019.

This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Internações por condições sensíveis à atenção primária em crianças, Rondônia, Brasil, 2008-2019 / Hospitalizations for ambulatory care-sensitive conditions in children, Rondônia, Brazil, 2008-2019

Resumo Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Abstract This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Knowledge, attitudes and practices of undergraduate students and dentists about dental prenatal care.

INTRODUCTION: Prenatal care is a fundamental moment for health promotion to be carried out, since at that moment women are more receptive to new knowledge, with the aim of providing better healthcare for the baby. This study aimed to evaluate the knowledge, attitudes and practices of undergraduate students and professionals, both from the public and from private sectors in Brazil, regarding dental prenatal care. MATERIALS AND METHODS: This study corresponded to an online questionnaire survey, via Google Forms, consisting of 17 general questions for undergraduates (n = 103) and 16 for professionals (n = 227) for demographic and school mapping, and 18 specific questions about the importance and protocol of dental prenatal care. T-test, Mann-Whitney U-test and multiple linear regression were adopted (p < .05). RESULTS: The average total score of the questionnaire for students and professionals was 12.40 and 15.65, respectively (p < .0001), indicating moderate knowledge. Professionals showed a higher prevalence of moderate (77%) and high (2%) knowledge of the subject when compared to undergraduate students (51% and 0% respectively). The graduation period in which the students were enrolled was a predictor of the total score of the questionnaire [F (1, 101) = 21.21; p < .0001; R2  = .165]. The female gender and the lower weekly workload were the main predictors of the total score of the questionnaire for professionals [F (3, 223) = 6.74; p < .0001; R2  = .083]. CONCLUSIONS: Although professionals have greater knowledge about dental prenatal care than students, there are still deficiencies in the knowledge and practices of them in respect of dental management during pregnancy. Higher education institutions need to change the teaching-learning plan regarding the holistic dental approach for women during pregnancy.

Conhecimento dos profissionais da atenção primária à saude sobre segurança do paciente em Rondônia / Knowledge of primary health care professionals about patient safety in Rondônia / Conocimiento de los profesionales de atención primaria de salud sobre la seguridad del paciente en Rondônia

INTRODUÇÃO: O programa de Segurança do Paciente tem como principal objetivo a redução a um nível mínimo aceitável do risco de danos evitáveis associados à assistência em saúde. Visando qualificar esse cuidado na Atenção Primária à Saúde (APS), o Conselho Nacional de Secretários de Saúde tem desenvolvido a Planificação da Atenção à Saúde (PAS) com apoio de instituições de excelência e secretarias de saúde. OBJETIVO: Identificar o conhecimento dos profissionais da Atenção Primária à Saúde envolvidos na planificação acerca da segurança do paciente em Rondônia. MÉTODO: Estudo transversal conduzido no estado de Rondônia com profissionais e estudantes envolvidos na PAS que estiveram em um evento estadual nos dias 24 a 26 de agosto de 2022. A coleta de dados foi realizada por meio de formulário eletrônico em link e os dados foram analisados por meio do pacote estatístico Stata versão16. Este estudo faz parte do projeto matriz intitulado: Boas Práticas na Assistência ao Paciente, no Controle da Infecção e no Processamento de Produtos para a Saúde no Estado de Rondônia autorizado através do parecer número 3.771.377. RESULTADOS E DISCUSSÃO: Do total de 160 participantes do evento, 90 indivíduos aceitaram participar deste estudo. Entre os achados, constatou-se 80,7% de conhecimento geral sobre o tema, sendo que mais de 75% dos participantes apresentaram conhecimento sobre os conceitos de segurança do paciente e quase 68% avaliaram corretamente as situações de segurança do paciente na APS. O menor nível de conhecimento foi referente às situações específicas. CONCLUSÃO: Esse estudo contribui para um diagnóstico situacional do conhecimento dos trabalhadores da APS que participam do projeto de PAS no estado de Rondônia, podendo ser utilizado para o planejamento de outras ações educativas com a temática de segurança do paciente neste estado e em outros com o mesmo perfil dos trabalhadores e organização dos serviços de saúde.

INTRODUCTION: The main objective of the Patient Safety program is to reduce the risk of avoidable harm associated with health care to an acceptable minimum level. Aiming to qualify this care in Primary Health Care (PHC), the National Council of Health Secretaries has developed the Health Care Plan (PAS) with the support of institutions of excellence and health secretariats. OBJECTIVE: To identify the knowledge of Primary Health Care professionals involved in planning about patient safety in Rondônia. METHOD: Cross-sectional study conducted in the state of Rondônia with professionals and students involved in the PAS who attended a state event from August 24 to 26, 2022. Data collection was performed using an electronic form in the link and the data were analyzed using the statistical package Stata version16. This study is part of the matrix project entitled: Good Practices in Patient Care, Infection Control and Processing of Health Products in the State of Rondônia authorized through opinion number 3,771,377. RESULTS AND DISCUSSION: Of the total of 160 participants in the event, 90 individuals agreed to participate in this study. Among the findings, there was 80.7% of general knowledge on the subject, with more than 75% of the participants having knowledge about patient safety concepts and almost 68% correctly assessing patient safety situations in PHC. The lowest level of knowledge was related to specific situations. CONCLUSION: This study contributes to a situational diagnosis of the knowledge of PHC workers who participate in the PAS project in the state of Rondônia, and can be used for the planning of other educational activities with the subject of patient safety in this state and in others with the aim of same profile of workers and organization of health services.

INTRODUCCIÓN: El objetivo principal del programa de Seguridad del Paciente es reducir el riesgo de daño evitable asociado con la atención médica a un nivel mínimo aceptable. Con el objetivo de calificar este cuidado en la Atención Primaria de Salud (APS), el Consejo Nacional de Secretarías de Salud ha desarrollado el Plan de Atención a la Salud (PAS) con el apoyo de instituciones de excelencia y secretarías de salud. OBJETIVO: Identificar el conocimiento de los profesionales de la Atención Primaria de Salud involucrados en la planificación sobre la seguridad del paciente en Rondônia. MÉTODO: Estudio transversal realizado en el estado de Rondônia con profesionales y estudiantes involucrados en el PAS que asistieron a un evento estatal del 24 al 26 de agosto de 2022. La recolección de datos se realizó mediante un formulario electrónico en el enlace y los datos fueron analizados. utilizando el paquete estadístico Stata versión16. Este estudio forma parte del proyecto matriz titulado: Buenas Prácticas en Atención al Paciente, Control de Infecciones y Procesamiento de Productos de Salud en el Estado de Rondônia autorizado por dictamen número 3.771.377. RESULTADOS Y DISCUSIÓN: Del total de 160 participantes en el evento, 90 personas aceptaron participar en este estudio. Entre los hallazgos, se encontró un 80,7% de conocimientos generales sobre el tema, siendo más del 75% de los participantes con conocimientos sobre conceptos de seguridad del paciente y casi el 68% valorando correctamente situaciones de seguridad del paciente en la APS. El nivel más bajo de conocimiento estaba relacionado con situaciones específicas. CONCLUSIÓN: Este estudio contribuye para un diagnóstico situacional del conocimiento de los trabajadores de la APS que participan del proyecto PAS en el estado de Rondônia, y puede ser utilizado para la planificación de otras actividades educativas con el tema de seguridad del paciente en este estado y en otros con el objetivo de igualar el perfil de los trabajadores y la organización de los servicios de salud.

Use of Information and Communication Technologies among Adults in Weight Control: Systematic Review and Meta-Analysis.

Information and communication technologies are part of our day-to-day life in the execution of all activities, including health care. However, it is not known how much the use of technologies can contribute to the adoption of healthy lifestyle habits. Thus, the objective of this study was to analyze whether the use of information and communication technologies contributes to weight control among adults when compared to the traditional approach method. The search was performed in November 2021 in eight electronic databases in addition to gray literature bases. The quality of the studies was assessed using the Cochrane risk of bias tool. The standardized mean difference was used for the meta-analytic measurement using the random effects model using the Dersimonian-Laid method in the Stata statistical package version 17. The body mass index of the intervention group decreased by an average of 0.56 (95% CI: -0.83; -0.30) when compared to the control group. When comparing the before and after groups, the intervention group also had a greater reduction in BMI (summarized mean: -0.83; 95% CI: -1.40; -0.26). Information and communication technologies contribute to the reduction of the body mass index in the adult population when compared to the traditional model of monitoring. Prospero registration: number 42020186340.

Factors Associated with Cocaine Consumption among Suicide Victim.

Cocaine use is an increasingly frequent event, especially in young people, and can cause irreversible consequences, such as suicide. To evaluate the factors associated with cocaine use in the moments preceding to suicide. This is a population-based, cross-sectional, and analytical study conducted in the Brazilian Federal District by researchers from the Department of Health and the Civil Police Institute of Criminalistics. All people who died due to suicide in 2018 were included in the survey. Cocaine use was considered the dependent variable, and robust Poisson regression was performed to estimate the crude and adjusted prevalence ratios and their respective population confidence intervals. In 2018, 12,157 deaths were recorded, of which suicide accounted for 1.56% of all deaths. It was observed that being between 25 and 44 years old, male, and under the influence of alcohol or cannabis, had a strong positive association with cocaine consumption among suicide victims. Males, people with black skin, with lower level of education, with employment, and who were under the effect of the use of cannabis and/or alcohol in the previous hours of death had a higher propensity to consume cocaine immediately before suicide, with a moderate to strong magnitude of prevalence ratio. The findings of this research indicated the need for monitoring, by health services, of people most vulnerable to suicide through the consumption of psychoactive substances.

Reinternações não planejadas após cirurgias em um hospital do norte do Brasil: coorte prospectiva / Reingresos no planificados después de la cirugía en un hospital del norte de Brasil: cohorte prospectiva / Unplanned readmissions after surgery in a hospital in northern Brazil: prospective cohort

Objetivo:analisar as reinternaçõesnão planejadas após procedimentos cirúrgicos e seus fatores de risco em um hospital de grande porte no Norte do Brasil. Método:coorte prospectiva, com dados coletados de prontuários e à cabeceira do leito. Foram realizadas análises descritivas, análise bivariada e múltipla por meio da regressão de Poisson no Stata® v.16.0. Resultados:do total de 486 pacientes, 1,47% reinternaram. A incidência de reinternação foi 68 a cada 1.000 procedimentos (IC95%: 47,10; 93,85). Na análise ajustada apresentaram-se comofatores de risco não ser branco (RR: 2,06; IC95% 1,13; 3,75), usar implante na cirurgia (RR: 2,00; IC95%: 1,05; 3,81) e procedimentos das especialidades urologia/renal (RR: 3,17; IC95%:1,59-6,31) e ginecologia (RR: 2,18; IC95%:1,06-4,49). Conclusão:a incidência de reinternação nesta região é maior do que outras regiões. Características demográficas e tipo de procedimento cirúrgico foram fatores de risco para o desfecho

Objective:to analyze unplanned readmissions after surgical procedures and their risk factors in a large hospital in Northern Brazil. Method:prospective cohort, with data collected from medical records and at the bedside. Descriptive, bivariate and multiple analysis were performed using Poisson regression in Stata® v.16.0. Results: of the total of 486 patients, 1.47% were readmitted. The incidence of readmissions was 68 per 1,000 procedures (95%CI: 47.10; 93.85). In the adjusted analysis, the risk factors were not being white (RR: 2.06; 95%CI 1.13; 3.75), using implants in surgery (RR: 2.00; 95%CI: 1.05; 3.81) and procedures of the urology/renal specialties (RR: 3.17; 95%CI: 1.59-6.31) and gynecology (RR: 2.18; 95%CI: 1.06-4.49). Conclusion:the incidence of readmissions in this region is higher than in other regions. Demographic characteristics and type of surgical procedure were risk factors for the outcome

Objetivo:analizar los reingresos no planificados después de procedimientos quirúrgicos y sus factores de riesgo en un gran hospital del norte de Brasil. Método:cohorte prospectiva, con datos recolectados de historias clínicas y al lado de la cama. Se realizaron análisis descriptivos, bivariados y múltiples mediante regresión de Poisson en Stata® v.16.0. Resultados:del total de 486 pacientes, el 1,47% reingresó. La incidencia de reingresos fue de 68 por 1.000 procedimientos (IC del 95%: 47,10; 93,85). En el análisis ajustado, los factores de riesgo fueron no ser blanco (RR: 2,06; IC 95% 1,13; 3,75), uso de implantes en cirugía (RR: 2,00; IC 95%: 1,05; 3,81) y procedimientos de la urología/especialidades renales (RR: 3,17; IC 95%: 1,59-6,31) y ginecología (RR: 2,18; IC 95%: 1,06-4,49). Conclusión: la incidencia de reingresos en esta región es mayor que en otras regiones. Las características demográficas y el tipo de procedimiento quirúrgico fueron factores de riesgo para el resultado

Processamento de produtos odontológicos em unidades básicas de saúde na cidade de Porto Velho, Rondônia / Processing of dental products in basic health units of Porto Velho, Rondônia

Avaliar o processamento de produtos odontológicos em unidades básicas de saúde na cidade de Porto Velho, capital de Rondônia. Estudo transversal conduzido em 13 unidades com coleta em três etapas: preenchimento de questionário, observação não participante e leitura de registros. A conformidade no processamento dos produtos foi avaliada de acordo com as recomendações e normativas vigentes no Brasil. Pouco mais da metade das unidades apresenta sala de expurgo exclusiva (53,8%) e havia inconformidades relacionadas à iluminação (69,3%), água potável (100,0%) e falta de escovas adequadas (46,2%). Todas as unidades ofereciam equipamento de proteção individual. Apenas 18,6% utilizavam detergentes adequados ou sabão desincrustante e 100,0% dos produtos eram lavados manualmente. As principais inconformidades foram o uso de material abrasivo (46,2%), não utilização de óculos ou máscaras (100,0%), inspeção incorreta após a lavagem (100,0%), preparo inadequado de soluções de desinfecção química (77,0%) e 84,6% não realizavam o enxágue adequado. O processamento de produtos odontológicos na atenção básica de saúde na cidade de Porto Velho apresenta fragilidades que podem levar a infecções relacionadas à assistência à saúde.

To evaluate the processing of dental products in basic health units in the capital of Rondônia. Cross-sectional study conducted in 13 units with collection in three stages: filling out a questionnaire, non-participant observation and reading of records. Compliance in the processing of products was evaluated in accordance with the recommendations and regulations in force in Brazil. Just over half of the units have an exclusive purge room (53.8%) and there were nonconformities related to lighting (69.3%), potable water (100%) and lack of adequate brushes (46.2%). All units offered personal protective equipment. Only 18.6% used adequate detergents or descaling soap and 100.0% of the products were washed manually. The main nonconformities were the use of abrasive material (46.2%), non-use of glasses or masks (100.0%), non-correct inspection after washing (100.0%), inadequate preparation of chemical disinfection solutions (77.0%) and 84.6% did not rinse with abundant water. The processing of dental products in in primary care in Porto Velho has weaknesses that can lead to infections related to health care.

Early Cretaceous Ostracoda (Crustacea) from south-central Araripe Basin, Brazil, with descriptions of seven new species.

A systematic study is made of Early Cretaceous (late Aptian/earlyAlbian) ostracod assemblages from the Santo Antnio section. This section is characterized by sediment belonging to the post-rift sedimentary sequence of the Romualdo Formation in the southern-central region of the Araripe Basin, Brazil and represents on of the first marine ingression in the interior of the continent, during the beginning of the formation of the Atlantic Ocean. The Santo Antonio section presents ostracods in greater diversity than previously known. Nineteen samples were analyzed, yielding a total of 8,370 specimens. Fifteen taxa were identified, including six brackish ostracods: Pattersoncypris salitrensis, Pattersoncypris angulata, Pattersoncypris micropapillosa, Damonella grandiensis, Alicenula cf. leguminella and Theriosynoecum cf. quadrinodosum; and nine typically brackish-marine species, including seven new ones: Dicrorygma cf. minuta, Dicrorygma (Orthorygma?) dimorpha, Mongolianella aptianensis sp. nov., Mantelliana speculum sp. nov., Paracypris undulareventralis sp. nov., Microceratina retangularis sp. nov., Perissocytheridea oculusutilis sp. nov., Perissocytheridea poruslinearis sp. nov. and Perissocytheridea florisdorsalis sp. nov. Therefore, the detailed taxonomic study brings a new understanding of marine ostracods around the upper Aptian/lower Albian boundary of the Araripe Basin.

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil / Risk factors in neurosurgery: a cohort study in northern Brazil

Introdução: Pacientes neurocirúrgicos apresentam elevado risco de complicações locais e sistêmicas que podem aumentar o tempo de internação e o risco de morte. Este estudo tem como objetivo avaliar a incidência de infecções relacionadas à assistência à saúde e os fatores de risco associados em pacientes submetidos às neurocirurgias. Materiais e métodos: Estudo de coorte prospectiva, realizado em um Hospital de grande porte do estado de Rondônia, no período de 2018 a 2019, incluindo 36 pacientes. Resultados: A incidência de infecções relacionada à assistência à saúde foi 19,4 a cada 100 pacientes (IC95%: 8,19 ­ 36,02). Ter utilizado sonda nasoenteral aumentou em 6,5 vezes o risco de IRAS (IC 95%: 1,26 ­ 33,5), a ventilação mecânica aumentou 5,52 vezes o risco (IC95%: 1,23 ­ 24,6), a presença de traqueostomia aumentou seis vezes (IC95%: 1,34 ­ 26,8) e realização de exame invasivo aumentou o risco em 6,79 para ter infecção (IC95%: 1,31 ­ 35,05). Na análise ajustada as variáveis não apresentaram significância estatística. Discussão: A incidência de infecções foi maior do que em regiões com melhores condições socioeconômicas o que pode estar relacionado à menor adesão de boas práticas na assistência. Conclusão: Nas neurocirurgias além das infecções de sítio cirúrgico outras topografias também devem ser consideradas para investigação de infecção. O uso de dispositivos invasivos foi associado à ocorrência de infecções relacionadas à assistência à saúde, portanto as boas práticas no seu uso são essenciais no momento da indicação e uso destes dispositivos.

Introduction: Neurosurgical patients are at high risk of local and systemic complications that can increase the length of hospital stay and the risk of death. This study aims to assess the incidence of healthcare-associated infections and associated risk factors in patients undergoing neurosurgery. y. Materials and Methods:: Prospective cohort study, carried out in a large hospital in the state of Rondônia, from 2018 to 2019, including 36 patients. Results:The incidence of healthcare-associated infections was 19.4 per 100 patients (95%CI: 8.19 ­ 36.02). Having used a nasoenteral tube increased the risk of HAI by 6.5 times (95% CI: 1.26 ­ 33.5), mechanical ventilation increased the risk by 5.52 times (95% CI: 1.23 ­ 24.6) , the presence of tracheostomy increased six-fold (95%CI: 1.34 ­ 26.8) and performing an invasive examination increased the risk of infection by 6.79 (95%CI: 1.31 ­ 35.05). In the adjusted analysis, the variables did not show statistical significance. Discussion:The incidence of infections was higher than in regions with better socioeconomic conditions, which may be related to lower adherence to good care practices. Conclusions: : In neurosurgery, in addition to surgical site infections, other topographies should also be considered for the investigation of infection. The use of invasive devices was associated with the occurrence of infections related to health care, so good practices in their use are essential when indicating and using these devices.

Introducción:Los pacientes neuroquirúrgicos tienen un alto riesgo de complicaciones locales y sistémicas que pueden aumentar la estancia hospitalaria y el riesgo de muerte. Este estudio tiene como objetivo evaluar la incidencia de infecciones asociadas a la atención médica y los factores de riesgo asociados en pacientes sometidos a neurocirugía. Materiales y métodos: : Estudio de cohorte prospectivo, realizado en un gran hospital del estado de Rondônia, de 2018 a 2019, con 36 pacientes. Resultados: La incidencia de infecciones asociadas a la asistencia sanitaria fue de 19,4 por 100 pacientes (IC95%: 8,19 ­ 36,02). Haber utilizado una sonda nasoenteral aumentó el riesgo de IRAS en 6,5 veces (IC 95%: 1,26 ­ 33,5), la ventilación mecánica aumentó el riesgo en 5,52 veces (IC 95%: 1,23 ­ 24,6), la presencia de traqueotomía aumentó seis veces (IC95%: 1,34 ­ 26,8) y realizar un examen invasivo aumentó el riesgo de infección en 6,79 (IC95%: 1,31 ­ 35,05). En el análisis ajustado, las variables no presentaron significación estadística. Discusión: La incidencia de infecciones fue mayor que en las regiones con mejores condiciones socioeconómicas, lo que puede estar relacionado con una menor adherencia a las buenas prácticas de cuidado. Conclusión: En neurocirugía, además de las infecciones del sitio quirúrgico, también se deben considerar otras topografías para la investigación de la infección. El uso de dispositivos invasivos se asoció con la ocurrencia de infecciones relacionadas con el cuidado de la salud, por lo que las buenas prácticas en su uso son fundamentales a la hora de indicar y utilizar estos dispositivos

Is overweight associated with periodontitis in pregnant women? Systematic review and meta-analysis.

This systematic review and meta-analysis aimed to generate pooled evidence for the association between excessive weight and pregnancy induced periodontitis. EMBASE, SCOPUS, PubMed/MEDLINE, Web of Science, BVS/LILACS, Cochrane Library and SCIELO databases were accessed. Eligibility criteria were: human clinical studies published between year 2000 and 2021. Newcastle-Ottawa scale was used to evaluate risk of bias of the studies. Meta-analysis was performed using MedCalc® Statistical Software. Eleven studies were included, evaluating 2152 pregnant women (743 with overweight/obesity and 1409 with normal body mass index - BMI), with a mean age of 29.62 years. Most studies had low risk of bias. A positive association between overweight/obesity and periodontitis was found, with an average of 61.04% of women with overweight/obesity and periodontitis, showing the overall random-effects relative risk and 95% CI of 2.21 (1.53-3.17) (p < 0.001). Arterial hypertension, gestational diabetes mellitus and excessive gestational weight gain were the most common adverse effects of maternal obesity that may have been linked to periodontitis induced pro-inflammatory state. In conclusion, a positive association was found between overweight/obesity and periodontitis during pregnancy. However, the high heterogeneity between the studies related to sample size, periodontal classification and the cutoff-points for BMI are the main limitation.

Cultura de segurança do paciente em maternidade da Amazônia Ocidental / Culture of patient safety in maternity in the western amazon / Cultura de seguridad del paciente en maternidad en la amazonia occidental

Objetivo: analisar a cultura de segurança do paciente entre os profissionais de saúde de maternidade pública da Região Norte do Brasil. Método: estudo transversal, realizado em 2019, com 70 profissionais atuantes na gestão ou assistência à saúde. Analisaram-se 12 dimensões da cultura de segurança do paciente, por meio do questionário Hospital Survey on Patient Safety Culture. Procedeu-se à análise descritiva e aplicou-se o teste Qui-quadrado de Pearson para verificar associação estatística entre as variáveis do estudo. Resultados: a maioria dos participantes era do sexo feminino, média de idade 39 anos e com cursos de pós-graduação. Na avaliação das 12 dimensões da cultura de segurança do paciente, verificou-se uma área de fortaleza com mais de 75% de respostas positivas ­ "Expectativas e ações do supervisor/chefe para a promoção da segurança do paciente". Houve diferença estatisticamente significativa entre o tempo de trabalho na instituição e o modo com que o participante qualificou a segurança do paciente. Conclusão: substituir a cultura punitiva pelo aprendizado com os erros e estimular a comunicação interprofissional são ações que podem ser trabalhadas pelo serviço na busca de uma cultura positiva. Descritores: Estudos transversais; Segurança do Paciente; Cultura organizacional; Saúde materno-infantil; Maternidades; Profissionais de saúde.(AU)

Objective: to analyze the patient safety culture among health professionals in a public maternity hospital in the North region of Brazil. Method: cross-sectional study, conducted in 2019 with 70 professionals working in management or health care. The 12 dimensions of patient safety culture were analyzed using the Hospital Survey on Patient Safety Culture questionnaire. Descriptive analysis and Pearson's chi-square test were performed to verify statistical association among the study variables. Results: most participants were female, mean age of 39 years and had postgraduate degrees. In the evaluation of the 12 dimensions of Patient Safety Culture there was only one area of strength with more than 75% of positive answers - "Expectations and actions of the supervisor/chief for the promotion of patient safety". There was a statistically significant difference between the length of time working at the institution and the way this participant rated patient safety. Conclusion: replacing the punitive culture by learning from mistakes and stimulating interprofessional communication are actions that can be worked on by the service in the search for a positive culture.(AU)

Objetivo: analizar la cultura de seguridad del paciente entre los profesionales de la salud en una maternidad pública de la región Norte de Brasil. Método: estudio transversal realizado en 2019 con 70 profesionales que trabajan en la gestión de la salud o en la atención sanitaria. Las 12 dimensiones de la cultura de seguridad del paciente se analizaron mediante el cuestionario Hospital Survey on Patient Safety Culture. Se realizó un análisis descriptivo y la prueba de Chi-cuadrado de Pearson para verificar la asociación estadística entre las variables del estudio. Resultados: la mayoría de los participantes eran mujeres, tenían una edad media de 39 años y contaban con títulos de postgrado. En la evaluación de las 12 dimensiones de la Cultura de Seguridad del Paciente se verificó sólo un área de fortaleza con más del 75% de respuestas positivas - "Expectativas y acciones del supervisor/jefe para la promoción de la seguridad del paciente". Hubo una diferencia estadísticamente significativa entre el tiempo de trabajo en la institución y la forma en que este participante calificó la seguridad del paciente. Conclusión: reemplazar la cultura punitiva por el aprendizaje de los errores y estimular la comunicación interprofesional son acciones que pueden ser trabajadas por el servicio en la búsqueda de una cultura positiva.(AU)