Proton Therapy, Magnetic Nanoparticles and Hyperthermia as Combined Treatment for Pancreatic BxPC3 Tumor Cells.

We present an investigation of the effects on BxPC3 pancreatic cancer cells of proton therapy combined with hyperthermia, assisted by magnetic fluid hyperthermia performed with the use of magnetic nanoparticles. The cells' response to the combined treatment has been evaluated by means of the clonogenic survival assay and the estimation of DNA Double Strand Breaks (DSBs). The Reactive Oxygen Species (ROS) production, the tumor cell invasion and the cell cycle variations have also been studied. The experimental results have shown that the combination of proton therapy, MNPs administration and hyperthermia gives a clonogenic survival that is much smaller than the single irradiation treatment at all doses, thus suggesting a new effective combined therapy for the pancreatic tumor. Importantly, the effect of the therapies used here is synergistic. Moreover, after proton irradiation, the hyperthermia treatment was able to increase the number of DSBs, even though just at 6 h after the treatment. Noticeably, the magnetic nanoparticles' presence induces radiosensitization effects, and hyperthermia increases the production of ROS, which contributes to cytotoxic cellular effects and to a wide variety of lesions including DNA damage. The present study indicates a new way for clinical translation of combined therapies, also in the vision of an increasing number of hospitals that will use the proton therapy technique in the near future for different kinds of radio-resistant cancers.

Fast and non-destructive neutron activation analysis for simultaneous determination of TiO2 and SiO2 in sunscreens with attention to regulatory and research issues.

A new instrumental neutron activation analysis (INAA) for the simultaneous determination of titanium (TiO2) and silica (SiO2) dioxide as UV-filters in sunscreens is described. Samples are encapsulated, neutron irradiated (30 s) and after a suitable decay (3 min), the induced 51Ti (T1/2 = 5.76 min) and 29Al (T1/2 = 6.56 min) radionuclides are measured for the emitted γ-ray fingerprint. Three applications were carried out: (i) screening study (analysis of commercial sunscreens in combination with single particle inductively coupled plasma mass spectrometry (sp-ICP-MS); (ii) research study (development of innovative UV-filters such as titanium dioxide or bismuth titanate loaded inorganic mesoporous silica nanoparticles, MSN); (iii) validation study (intercalibration of a spectrochemical method - inductively coupled plasma optical emission spectrometry, ICP-OES). Collectively, the nuclear method appears a powerful tool adequate for quantifying TiO2 and SiO2 in the above studies. The limited accessibility at the nuclear reactor for neutron activation is probably one of the reasons why the excellent characteristics of the nuclear technique are not always fully known and exploited in the industrial and research chemical world.

Decommissioning procedure and induced activation levels, calculations and measurements in an 18 MeV medical cyclotron.

The present article describes the decommissioning of a self-shielded 18 MeV medical cyclotron IBA Cyclone 18/9 after 14 years of operation. A Monte Carlo simulation of the possible nuclear reactions was performed in order to plan the decommissioning activities. During the cyclotron dismantling, the activities of the cyclotron components, concrete wall and floor samples were measured. Residual activities were analysed by means of an HPGe detector and liquid scintillation counting, and compared with simulation data. Dosimetry of the staff involved in the decommissioning procedure was monitored by individual TL dosimeters and/or digital dosimeter. The cyclotron component analysis confirmed the presence of gamma and pure beta emitters,22Na,54Mn,60Co,65Zn,207Bi,55Fe,63Ni at different values of specific activity, depending on the positioning of the sample point and on the alloy of the sampled part. In these components the presence of gamma and pure beta emitters was measured 5 years after the shutdown at levels far above clearance limits as defined by the 'Recommended radiological protection criteria for the recycling of metals from the dismantling of nuclear installations' (RP89) guidelines. The simulation, carried out by FLUKA Code (version 2020.0.5) on the cyclotron components, provided good agreement with measurements, with a maximum discrepancy of the same order as the uncertainties. Four engineers of the cyclotron maintenance staff were involved in the dismounting of the hottest components and rigging of the cyclotron in the deposit 6 months after shutdown and two engineers were involved during the drilling phase 3.5 years after shutdown. The measured dose from external exposure of the involved staff was lower than 100µSv person-1during the first phase and lower than 20µSv person-1during the final drilling phase. Measured doses from intake were negligible. In conclusion, the decommissioning of the 18 MeV cyclotron does not represent a risk for the involved staff, but, due to the presence of long-lived radioisotopes, the cyclotron components are to be treated as low level radioactive waste, and stored in an authorised storage area for at least 25 years after shutdown.

Metallobiochemistry of ultratrace levels of bismuth in the rat II. Interaction of 205+206Bi3+ with tissue, intracellular and molecular components.

BACKGROUND: Knowledge on Bi metabolism in laboratory animals refers to studies at "extreme" exposures, i.e. pharmacologically relevant high-doses (mg kg-1 b.w.) in relation to its medical use, or infinitesimal doses (pg kg-1b.w.) concerning radiobiology protection and radiotherapeutic purposes. There are no specific studies on metabolic patterns of environmental exposure doses (ultratrace level, µg kg-1 b.w.), becoming in this context Bi a "heavy metal fallen into oblivion". We previously reported the results of the metabolic fate of ultratrace levels of Bi in the blood of rats [1]. In reference to the same study here we report the results of the retention and tissue binding of Bi with intracellular and molecular components. METHODS: Animals were intraperitoneally injected with 0.8 µg Bi kg-1 b.w. as 205+206Bi(NO)3, alone or in combination with 59Fe for the radiolabeling of iron proteins. The use of 205+206Bi radiotracer allowed the determination of Bi down to pg fg-1 in biological fluids, tissues, subcellular fractions, and biochemical components isolated by differential centrifugation, size exclusion chromatography, solvent extraction, precipitation, immunoprecipitation and dialysis. MAIN FINDINGS: At 24 h post injection the kidney contained by far the highest Bi concentration (10 ng g-1 wt.w.) followed by the thymus, spleen, liver, thyroid, trachea, femur, lung, adrenal gland, stomach, duodenum and pancreas (0.1 to 1.3 ng g-1 wt.w.). Brain and testis showed smaller but consistently significant concentrations of the element (0.03 ng g-1 wt.w). Urine was the predominant route of excretion. Intracellularly, liver, kidney, spleen, testis, and brain cytosols displayed the highest percentages (35%-58%) of Bi of homogenates. Liver and testis nuclei were the organelles with the highest Bi content (24 % and 27 %). However, when the recovered Bi of the liver was recorded as percent of total recovered Bi divided by percent of total recovered protein the lysosomes showed the highest relative specific activity than in other fractions. In the brain subcellular fractions Bi was incorporated by neuro-structures with the protein and not lipidic fraction of the myelin retaining 18 % of Bi of the total homogenate. After the liver intra-subcellular fractionation: (i) 65 % of the nuclear Bi was associated with the protein fraction of the nuclear membranes and 35 % with the bulk chromatin bound to non-histone and DNA fractions; (ii) about 50 % of the mitochondrial Bi was associated with inner and outer membranes being the other half recovered in the intramitochondrial matrix; (iii) in microsomes Bi showed a high affinity (close to 90 %) for the membranous components (rough and smooth membranes); (iv) In the liver cytosol three pools of Bi-binding proteins (molecular size > 300 kDa, 70 kDa and 10 kDa) were observed with ferritin and metallothionein-like protein identified as Bi-binding biomolecules. Three similar protein pools were also observed in the kidney cytosol. However, the amount of Bi, calculated in percent of the total cytosolic Bi, were significantly different compared to the corresponding pools of the liver cytosol. CONCLUSIONS: At the best of our knowledge the present paper represents the first in vivo study, on the basis of an environmental toxicology approach, aiming at describing retention and binding of Bi in the rat at tissue, intracellular and molecular levels.

Metallobiochemistry of ultratrace levels of bismuth in the rat I. Metabolic patterns of 205+206Bi3+ in the blood.

BACKGROUND: The number of the applications of bismuth (Bi) is rapidly and remarkably increasing, enhancing the chance to increase the levels to which humans are normally daily exposed. The interest to Bi comes also from the potential of Bi-based nanoparticles (BiNPs) for industrial and biomedical purposes. Like other metal-based NPs used in nanomedicine, BiNPs may release ultratrace amounts of Bi ions when injected. The metabolic fate and toxicity of these ions still needs to be evaluated. At present, knowledge of Bi metabolism in laboratory animals refers almost solely to studies under unnatural "extreme" exposures, i.e. pharmacologically relevant high-doses (up to thousand mg kg-1) in relation to its medical use, or infinitesimal-doses (pg kg-1 as non-carrier-added Bi radioisotopes) for radiobiology protection, diagnostic and radiotherapeutic purposes. No specific study exists on the "metabolic patterns" in animal models exposed to levels of Bi, i.e. at "environmental dose exposure" that reflect the human daily exposure (µg kg-1). METHODOLOGY: Rats were intraperitoneally injected with 0.8 µg Bi kg-1 bw as 205+206Bi(NO)3 alone or in combination with 59Fe for radiolabelling of iron proteins. The use of 205+206Bi radiotracers allowed the detection and measurement down to pg fg-1 of the element in the blood biochemical compartments and protein fractions as isolated by differential centrifugation, size exclusion- and ion exchange chromatography, electrophoresis, solvent extraction, precipitation and dialysis. RESULTS: 24 h after the administration, the blood concentration of Bi was 0.18 ng mL-1, with a repartition plasma/red blod cells (RBC) in a ratio of 2:1. Elution profiles of plasma from gel filtration on Sephadex G-150 showed four pools of Bi-binder proteins with different molecular sizes (> 300 kDa, 160 kDa, 70 kDa and < 6.5 kDa). In the 70 kDa fraction transferrin and albumin were identified as biomolecule carriers for Bi. In red blood cells, Bi was distributed between cytosol and membranes (ghosts) in a ratio of about 5:1. In the cytosol, low molecular components (LMWC) and the hemoglobin associated the Bi in a ratio of about 1.8:1. In the hemoglobin molecule, Bi was bound to the beta polypeptide chain of the globin. In the ghosts, Bi was detected at more than one site of the protein fraction, with no binding with lipids. Dialysis experiments and the consistently high recovery (80-90 %) of 206Bi from chromatography of 206Bi-containing biocomponents suggest that Bi was firmly complexed at physiological pH with a low degree of breaking during the applications of experimental protocols for the isolation of the 206Bi-biocomplexes. These latter were sensitive to acid buffer pH 5, and to the presence of complexing agents in the dialysis fluid. CONCLUSIONS: On the basis of an environmental biochemical toxicology approach, we have undertaken a study on the metabolic patterns of Bi3+ ions in rats at tissue, subcellular and molecular level with the identification of cellular Bi-binding components. As a first part of the study the present work reports the results concerned with the metabolic fate of ultratrace levels of 205+206Bi(NO)3 in the blood.

Genotoxicity and Immunotoxicity of Titanium Dioxide-Embedded Mesoporous Silica Nanoparticles (TiO2@MSN) in Primary Peripheral Human Blood Mononuclear Cells (PBMC).

Background: TiO2 nanoparticles (TiO2 NPs) are the nanomaterial most produced as an ultraviolet (UV) filter. However, TiO2 is a semiconductor and, in nanoparticle size, is a strong photocatalyst, raising concerns about photomutagenesis. Mesoporous silica nanoparticles (MSN) were synthetized incorporating TiO2 NPs (TiO2@MSN) to develop a cosmetic UV filter. The aim of this study was to assess the toxicity of TiO2@MSN, compared with bare MSN and commercial TiO2 NPs, based on several biomarkers. Materials and Methods: Human peripheral blood mononuclear cells (PBMC) were exposed to TiO2@MSN, bare MSN (network) or commercial TiO2 NPs for comparison. Exposed PBMC were characterized for cell viability/apoptosis, reactive oxygen species (ROS), nuclear morphology, and cytokines secretion. Results: All the nanoparticles induced apoptosis, but only TiO2 NPs (alone or assembled into MSN) led to ROS and micronuclei. However, TiO2@MSN showed lower ROS and cytotoxicity with respect to the P25. Exposure to TiO2@MSN induced Th2-skewed and pro-fibrotic responses. Conclusions: Geno-cytotoxicity data indicate that TiO2@MSN are safer than P25 and MSN. Cytokine responses induced by TiO2@MSN are imputable to both the TiO2 NPs and MSN, and, therefore, considered of low immunotoxicological relevance. This analytical assessment might provide hints for NPs modification and deep purification to reduce the risk of health effects in the settings of their large-scale manufacturing and everyday usage by consumers.

Hadron Therapy, Magnetic Nanoparticles and Hyperthermia: A Promising Combined Tool for Pancreatic Cancer Treatment.

A combination of carbon ions/photons irradiation and hyperthermia as a novel therapeutic approach for the in-vitro treatment of pancreatic cancer BxPC3 cells is presented. The radiation doses used are 0-2 Gy for carbon ions and 0-7 Gy for 6 MV photons. Hyperthermia is realized via a standard heating bath, assisted by magnetic fluid hyperthermia (MFH) that utilizes magnetic nanoparticles (MNPs) exposed to an alternating magnetic field of amplitude 19.5 mTesla and frequency 109.8 kHz. Starting from 37 °C, the temperature is gradually increased and the sample is kept at 42 °C for 30 min. For MFH, MNPs with a mean diameter of 19 nm and specific absorption rate of 110 ± 30 W/gFe3o4 coated with a biocompatible ligand to ensure stability in physiological media are used. Irradiation diminishes the clonogenic survival at an extent that depends on the radiation type, and its decrease is amplified both by the MNPs cellular uptake and the hyperthermia protocol. Significant increases in DNA double-strand breaks at 6 h are observed in samples exposed to MNP uptake, treated with 0.75 Gy carbon-ion irradiation and hyperthermia. The proposed experimental protocol, based on the combination of hadron irradiation and hyperthermia, represents a first step towards an innovative clinical option for pancreatic cancer.

On the production of 52gMn by deuteron irradiation on natural chromium and its radionuclidic purity.

The positron emitter 52gMn is used for the Positron Emission Tomography - PET imaging.In this work we investigate the nuclear reactions for production of 52gMn and 54Mn induced by deuteron beams on natural chromium targets at energies up to Ed = 28 MeV using the stacked-foils activation technique. We calculate the thick target yields for 52gMn and for the radionuclidic impurity 54Mn, and we compare the radionuclidic purity of 52gMn with that achievable in proton activation of Cr. The cross-sections of the reactions natCr(d,pxn)51Cr and natCr(d,x)48V are also presented.

Excitation function and yield for the 103Rh(d,2n)103Pd nuclear reaction: Optimization of the production of palladium-103.

Deuteron-induced nuclear reactions for the generation of 103Pd were investigated using the stacked-foil activation technique on rhodium targets at deuteron energies up to Ed=33MeV. The excitation functions of the reactions 103Rh(d,xn)101,103Pd, 103Rh(d,x)100g,cum,101m,g,102m,gRh and 103Rh(d,2p)103Ru have been measured, and the Thick-Target Yield for 103Pd has been calculated.

Uptake from water, internal distribution and bioaccumulation of selenium in Scenedesmus obliquus, Unio mancus and Rattus norvegicus: part B.

(75)Se-selenite transfer was investigated in a phytoplankton-mussel-rat food chain model consisting of Scenedesmus obliquus (Turpin) Kützing, Unio mancus Lamark and Rattus norvegicus Berkenhout. (75)Se-metabolized forms were investigated in order to identify potential critical steps in the food chain, as well as its relative bioavailability looking also at intracellular, cellular and organ partitioning. Tissue and intracellular distribution of (75)Se in mussels fed with (75)Se-S. obliquus was different compared to those exposed only to inorganic (75)Se-selenite. The intracellular distribution of (75)Se in the hepatopancreas and mantle of mussels fed (75)Se-microalgae was similar to hepatic and renal distributions in rats, suggesting that their stomach dissociated larger (75)Se-containing molecules. The (75)Se partitioned from water (culture medium) to microalgae showing a bioconcentration factor of 435. The bottleneck in the trophic transfer of (75)Se occurred between S. obliquus-U. mancus. From microalgae to mussels and subsequently to rats no bioaccumulation was verified.

Uptake from water, internal distribution and bioaccumulation of selenium in Scenedesmus obliquus, Unio mancus and Rattus norvegicus: part A.

The (75)Se internal bioavailability was investigated in microalgae, mussels and rats as biological experimental models. The (75)Se accumulation from freshwater to microalgae [Scenedesmus obliquus (Turpin) Kützing], from freshwater to mussels (Unio mancus Lamark) and, finally, per os to rats (Rattus norvegicus Berkenhout) was followed using (75)Se-labelled selenite looking at (75)Se uptake, retention, intracellular distribution and binding with cellular biocomplexes. After exposure to 10, 50 and 500 µg Se L(-1), the microalgae showed an inhibitory effect on population growth only at the highest concentration. Mussels exposed to 105 µg Se L(-1) showed an accumulation of the element with time in all tissues. Intracellularly, Se was present in all subcellular fractions, especially in the cytosol. Rats were treated via oral administration with 5 µg Se rat(-1). After 24 h, liver and kidney showed the highest Se concentration.

The excitation functions of (100)Mo(p,x)(99)Mo and (100)Mo(p,2n)(99m)Tc.

Proton-induced nuclear reactions for generation of (99)Mo and (99m)Tc radionuclides were investigated using the stacked-foil activation technique on 99.05% enriched (100)Mo targets at energies up to Ep=21MeV. Excitation functions of the reactions (100)Mo(p,x)(99)Mo and (100)Mo(p,2n)(99m)Tc have been measured.

Physical optimization of production by deuteron irradiation of high specific activity (177g)Lu suitable for radioimmunotherapy.

Deuteron-induced nuclear reactions for generation of no-carrier-added (NCA) Lu isotopes were investigated using the stacked-foil activation technique on natural Yb targets at energies up to Ed=18.18MeV. The decay curve of ¹77Yb, the growth curve of the cumulative (direct and indirect) and the direct production of (177g)Lu were determined. The analysis of these curves conducts to the evidence that the predominant route for the production of (177g)Lu is the indirect reaction ¹76Yb(d,p)¹77Yb, which decays to (177g)Lu. In the spectra acquired one year from the EOB the γ lines of (177m)Lu are not evident. A comparison between the calculated activity of (177g)Lu produced with a cyclotron and with a nuclear reactor is given.

[The construction process of managerial profile competencies for nurse coordinators in the hospital field]. / O processo de construção do perfil de competências gerenciais para enfermeiros coordenadores de área hospitalar.

The objective of this study was to construct a profile of managerial competencies, based on the consensus of nurse coordinators in the field. This study was developed in a philanthropic hospital in São Paulo, following the research-action model, and included 13 nurse coordinators as participants. The data collection was performed using the focal group technique. Data analysis was performed using the theoretical frameworks related to the working process and managerial competencies. The results identified the greater emphasis assigned to the competencies related to the mentor, coordinator and director roles. It was, therefore, possible to construct a professional development plan that is based on competencies in the technical, ethical-political, and communicative domains, as well as the development of citizenship. The analysis of the managerial working process and the study of the competencies within the managerial environment were shown to be important, because they highlighted the professionals' need to improve, thus fulfilling personal, professional, and organizational demands.

O processo de construção do perfil de competências gerenciais para enfermeiros coordenadores de área hospitalar / The construction process of managerial profile competencies for nurse coordinators in the hospital field / Proceso de construcción del perfil de competencias gerenciales para enfermeros coordinadores de área hospitalaria

Este estudo objetivou construir o perfil de competências gerenciais, consensuado por enfermeiros coordenadores de área. Desenvolvido em um hospital filantrópico de São Paulo, na modalidade de pesquisa-ação, participaram da pesquisa 13 enfermeiros coordenadores de área. A coleta de dados ocorreu por meio da técnica de grupo focal. Para a análise dos dados utilizaram-se os referenciais teóricos relacionados a processo de trabalho e competências gerenciais. Os resultados identificaram maior ênfase atribuída às competências relacionadas aos papéis de mentor, coordenador e diretor. Foi possível, então, construir um plano de desenvolvimento profissional, pautado em competências que atendam as dimensões técnica, ético-política, comunicativa e de desenvolvimento da cidadania. A análise do processo de trabalho gerencial e o estudo das competências no âmbito gerencial mostraram-se importantes, pois problematizaram necessidades de aprimoramento desses profissionais, assim, respondendo às demandas pessoais, profissionais e organizacionais.

The objective of this study was to construct a profile of managerial competencies, based on the consensus of nurse coordinators in the field. This study was developed in a philanthropic hospital in São Paulo, following the research-action model, and included 13 nurse coordinators as participants. The data collection was performed using the focal group technique. Data analysis was performed using the theoretical frameworks related to the working process and managerial competencies. The results identified the greater emphasis assigned to the competencies related to the mentor, coordinator and director roles. It was, therefore, possible to construct a professional development plan that is based on competencies in the technical, ethical-political, and communicative domains, as well as the development of citizenship. The analysis of the managerial working process and the study of the competencies within the managerial environment were shown to be important, because they highlighted the professionals' need to improve, thus fulfilling personal, professional, and organizational demands.

Estudio que objetivó construir el perfil de competencias gerenciales, consensuado por enfermeros coordinadores de área. Desarrollado en hospital filantrópico de São Paulo. Fue realizado en modalidad investigación-acción. Participaron de la investigación 13 enfermeros coordinadores de área. La recolección de datos se efectuó mediante técnica de grupo focal. Para análisis de datos se utilizaron los referenciales teóricos relacionados al proceso de trabajo y competencias gerenciales. Los resultados mostraron mayor énfasis atribuido a las competencias relacionadas al papel de mentor, coordinador y director. Se pudo efectuar un planeamiento de desarrollo profesional, pautado en competencias que atiendan las dimensiones técnica, ético-política, comunicacional y de desarrollo de la población. El análisis del proceso de trabajo gerencial y el estudio de competencias en el ámbito gerencial mostraron su importancia, pues problematizaron necesidades de mejoramiento de tales profesionales, atendiendo a las demandas personales, profesionales y organizacionales.

Fukushima fallout at Milano, Italy.

The radionuclides (131)I, (137)Cs and (134)Cs were observed in the Milano region (45°) of Italy early after the nuclear accident in Fukushima, Japan. Increased atmospheric radioactivity was observed on an air filter taken on 30 March 2011, while the maximum activity of 467 µBq m(-3) for (131)I was recorded at April 3-4, 2011. The first evidence of Fukushima fallout was confirmed with (131)I and (137)Cs measured in precipitation at two sampling sites at Milano on 28 March, 2011, with the concentrations of (131)I and (137)Cs in the rainwater equal to 0.89 Bq L(-1) and 0.12 Bq L(-1), respectively. A sample of dry deposition that was collected 9 days after the first rainfall event of 27-28 March, 2011 showed that the dry deposition was more effective in the case of (137)Cs than it was for (131)I, probably because iodine was mainly in gaseous form whereas caesium was rapidly bound to aerosols and thus highly subject to dry deposition. The relatively high observed values of (137)Cs in grass, soil and fresh goat and cow milk samples were probably from Chernobyl fallout and global fallout from past nuclear tests rather than from the Fukushima accident. Finally, a dose assessment for the region of investigation showed clearly that the detected activities in all environmental samples were very far below levels of concern.

Excitation function for deuteron induced nuclear reactions on natural ytterbium for production of high specific activity 177g Lu in no-carrier-added form for metabolic radiotherapy.

Deuteron-induced nuclear reactions for generation of no-carrier-added Lu radionuclides were investigated using the stacked-foil activation technique on natural Yb targets at energies up to E(d)=18.18 MeV. Excitation functions of the reactions (nat)Yb(d,xn)(169,170,171,172,173,174g,174m,176m,177g)Lu and (nat)Yb(d,pxn)(169,175,177)Yb have been measured, among them three ((169)Lu, (174m)Lu and (176m)Lu) are reported for the first time. The upper limit of the contamination from the long-lived metastable level (177m)Lu was evaluated too. Thick-target yields for all investigated radionuclides are calculated.

O processo de construção do perfil de competências gerenciais para enfermeiros coordenadores de área hospitalar / The construction process of the coordinating nurses' managerial competences profile of hospitable area

As mudanças no perfil do profissional enfermeiro se configuram historicamente em função da dinâmica que ocorre no mercado de trabalho em saúde, que por sua vez, sofre influências do contexto econômico, social e cultural. A crescente competitividade das organizações de saúde demanda a busca por profissionais cada vez mais qualificados e capacitados. A necessidade de incremento de competências assistenciais, gerenciais, de pesquisa e ensino objetivando o exercício da profissão, incorpora-se progressivamente ao perfil do profissional. O presente estudo teve como objetivos: construir o perfil de competências gerenciais, consensuado por enfermeiros coordenadores de área, para subsidiar um plano de desenvolvimento gerencial dos mesmos; identificar como os enfermeiros coordenadores de área percebem o processo de trabalho gerencial que desenvolvem na instituição hospitalar; analisar a percepção dos enfermeiros coordenadores quanto às competências necessárias para atuar no processo de trabalho gerencial e identificar as convergências e divergências entre o perfil de competências traçado pelos enfermeiros coordenadores e o perfil de competências definido pela Gerência de Enfermagem e Serviço de Educação Continuada. Caracterizado como um estudo qualitativo optou-se pela modalidade da pesquisa-ação. Esse método pressupõe a pesquisa voltada para a descrição de situações concretas e para a intervenção orientada em função da resolução de problemas efetivamentedetectados na prática. O cenário da pesquisa foi um hospital filantrópico do município de São Paulo. Participaram da mesma, 13 enfermeiros coordenadores de área. A coleta de dados ocorreu por meio da técnica de grupo focal, com a realização de 04 encontros. A análise dos dados foi realizada com base nos referenciais teóricos relacionados a processo de trabalho e competências gerenciais. Os resultados permitiram construir um ) plano de desenvolvimento profissional para os enfermeiros coordenadores de área, pautado em competências que atendam as dimensões técnica, ético-política, comunicativa e de desenvolvimento da cidadania. Entre as competências essenciais, atribui-se maior ênfase às relacionadas aos papéis de mentor, coordenador e diretor. A análise do processo de trabalho gerencial dos enfermeiros coordenadores de área e o estudo das competências necessárias para um melhor desempenho no âmbito gerencial mostraram-se importantes, pois possibilitam problematizar as necessidades de aprimoramento e desenvolvimento desses profissionais de modo articulado, atendendo as demandas pessoais, profissionais e organizacionais.

The changes in the professional nurse\'s profile set up historically in function of the dynamics occur in the health labor market, which then, suffer influences of the economics, social and cultural context. The increasing competitiveness of the health organizations demands the search of professional nurses more and more qualified and enabled. The necessity of development of the assistance competences, managerial, of research and teaching objectifying the exercise of the profession, it incorporates progressively to the professional\'s profile. The present study had as objectives: build the profile of managerial competences, according to coordinating nurses of area, to subsidize a plan of managerial development of the same; identify how the coordinating nurses of area realize the process of managerial working that develop in the hospitable institution; analyze the perception of the coordinating nurses regarding the necessary competences to act in the process of managerial working and identify the convergences and divergences among competences profile traced by the coordinating nurses and the competences profile defined by the Nursing and Service Management of Continued Education. Characterized as a qualitative study, was opted by the modality of the research-action. That method presupposes the research geared to the description of concrete situations and for the intervention guided regarding the problem solving indeed detected in the practice. The scenery of theresearch was a philanthropically hospital, in São Paulo, Municipal district. They took part in, thirteen coordinating nurses of area. The data collection occurred by means of the technique of focal group, it was made four encounters. The analysis of the data was accomplished based on theoretical references related to the working process and managerial competences. The results allowed to build a plan of professional development for the coordinating nurses of area, ruled in competences that answer the technical dimensions, ethic-politics, talkative and of development of the citizenship. Among essential competences, it assigns larger emphasis to the related to mentor, coordinator and director\'s roles. The analysis of the process of managerial working of the coordinating nurses of area and study of the necessary competences for a better performance in the managerial scope, they showed important, because they enable to create a problematic the needs to refinement and development of these coordinating nurses in an articulated manner, answering the personal, professional institutional demands.

Ocorrências adversas com medicaçäo em unidade de terapia intensiva: análise da administraçäo de soluçöes hidroeletrolíticas e antibióticos / Adverse occurences with drugs in intensive care unit: analysis of the adminitration of electrolyte solutions and antibiotics

O presente estudo teve por objetivos: 1) verificar a incidência de ocorrências adversas (OAs) com medicaçäo relacionadas ao tempo de infusäo das soluçöes hidroeletrolíticas e ao número de doses de antibióticos prescritos e administrados aos pacientes; 2) caracterizar a natureza dessas ocorrências. A investigaçäo foi realizada em duas UTIs de um hospital geral do Município de Säo Paulo...