Avaliação dos perfis minerais séricos, urinários e sedimentares de ovinos recebendo dieta calculogênica / Evaluation of mineral profile in serum, urine and sediment of sheep receiving calculogenic diet

A urolitíase obstrutiva em pequenos ruminantes é uma doença metabólica de etiologia multifatorial com distribuição mundial. A elevação da concentração urinária de solutos, minerais ionizados (cristaloides) que formam cristais insolúveis é citada por alguns autores como o fator mais importante. Assim, o conhecimento do perfil mineral dos animais submetidos a dietas calculogênicas e a composição química dos urólitos tornam-se ferramentas eficazes na prevenção da doença. Neste estudo, foram utilizados 14 ovinos hígidos, machos (não castrados), da raça Santa Inês, com idade aproximada de 90 dias, distribuídos em dois grupos (G1 - sem vitamina C e G2 - com vitamina C) e alimentados com dieta calculogênica. A análise dos perfis minerais, séricos e urinários revelou completo desbalanceamento na relação entre concentrações de cálcio, fósforo e magnésio, havendo elevação expressiva do fósforo e do magnésio e diminuição substancial do cálcio. Com isso, a análise bioquímica dos urólitos demonstrou que o cálcio esteve presente em 50% das amostras analisadas.(AU)

Urolithiasis in small ruminants is a metabolic disease of multifactorial etiology with worldwide distribution. Increased urinary concentration of solutes, ionized minerals (crystalloid) that form insoluble crystals is cited by some authors as the most important factor. Thus, knowledge of mineral profile of the animals fed calculogenic diets and chemical composition of uroliths becomes an effective tool in preventing the disease. In this study, we used 14 healthy, male, non-neutered sheep, of the Santa Ines breed, aged approximately 90 days, divided into two groups (G1-without vitamin C and G2-with vitamin C) fed calculogenic diet. Analysis of mineral profiles in serum and urine revealed complete imbalance in the relationship between concentrations of calcium, phosphorus and magnesium, with significant increase of phosphorus and magnesium and substantial reduction of calcium. Thus, biochemical analysis of uroliths showed that calcium was present in 50% of samples.(AU)

SubMICs of penicillin and erythromycin enhance biofilm formation and hydrophobicity of Corynebacterium diphtheriae strains.

Subinhibitory concentrations (subMICs) of antibiotics may alter bacterial surface properties and change microbial physiology. This study aimed to investigate the effect of a subMIC (⅛ MIC) of penicillin (PEN) and erythromycin (ERY) on bacterial morphology, haemagglutinating activity, cell-surface hydrophobicity (CSH) and biofilm formation on glass and polystyrene surfaces, as well as the distribution of cell-surface acidic anionic residues of Corynebacterium diphtheriae strains (HC01 tox(-) strain; CDC-E8392 and 241 tox(+) strains). All micro-organisms tested were susceptible to PEN and ERY. Growth in the presence of PEN induced bacterial filamentation, whereas subMIC of ERY caused cell-size reduction of strains 241 and CDC-E8392. Adherence to human erythrocytes was reduced after growth in the presence of ERY, while CSH was increased by a subMIC of both antibiotics in bacterial adherence to n-hexadecane assays. Conversely, antibiotic inhibition of biofilm formation was not observed. All strains enhanced biofilm formation on glass after treatment with ERY, while only strain 241 increased glass adherence after cultivation in the presence of PEN. Biofilm production on polystyrene surfaces was improved by ⅛ MIC of ERY. After growth in the presence of both antimicrobial agents, strains 241 and CDC-E8392 exhibited anionic surface charges with focal distribution. In conclusion, subMICs of PEN and ERY modified bacterial surface properties and enhanced not only biofilm formation but also cell-surface hydrophobicity. Antibiotic-induced biofilm formation may contribute to the inconsistent success of antimicrobial therapy for C. diphtheriae infections.

Concurrent diphtheria and infectious mononucleosis: difficulties for management, investigation and control of diphtheria in developing countries.

We report a case of concurrent diphtheria and infectious mononucleosis in an 11-year-old Brazilian child. Two days after specific treatment for diphtheria was started the patient was discharged following clinical recovery. This case highlights the difficulties in the clinical diagnosis of diphtheria in partially immunized individuals, and for the management and control of diphtheria in developing countries.

Potential pathogenic role of aggregative-adhering Corynebacterium diphtheriae of different clonal groups in endocarditis.

Invasive diseases caused by Corynebacterium diphtheriae have been described increasingly. Several reports indicate the destructive feature of endocarditis attributable to nontoxigenic strains. However, few reports have dealt with the pathogenicity of invasive strains. The present investigation demonstrates a phenotypic trait that may be used to identify potentially invasive strains. The study also draws attention to clinical and microbiological aspects observed in 5 cases of endocarditis due to C. diphtheriae that occurred outside Europe. Four cases occurred in female school-age children (7-14 years) treated at different hospitals in Rio de Janeiro, Brazil. All patients developed other complications including septicemia, renal failure and/or arthritis. Surgical treatment was performed on 2 patients for valve replacement. Lethality was observed in 40% of the cases. Microorganisms isolated from 5 blood samples and identified as C. diphtheriae subsp mitis (N = 4) and C. diphtheriae subsp gravis (N = 1) displayed an aggregative adherence pattern to HEp-2 cells and identical one-dimensional SDS-PAGE protein profiles. Aggregative-adhering invasive strains of C. diphtheriae showed 5 distinct RAPD profiles. Despite the clonal diversity, all 5 C. diphtheriae invasive isolates seemed to display special bacterial adhesive properties that may favor blood-barrier disruption and systemic dissemination of bacteria. In conclusion, blood isolates from patients with endocarditis exhibited a unique adhering pattern, suggesting a pathogenic role of aggregative-adhering C. diphtheriae of different clones in endocarditis. Accordingly, the aggregative-adherence pattern may be used as an indication of some invasive potential of C. diphtheriae strains.

Potential pathogenic role of aggregative-adhering Corynebacterium diphtheriae of different clonal groups in endocarditis

Invasive diseases caused by Corynebacterium diphtheriae have been described increasingly. Several reports indicate the destructive feature of endocarditis attributable to nontoxigenic strains. However, few reports have dealt with the pathogenicity of invasive strains. The present investigation demonstrates a phenotypic trait that may be used to identify potentially invasive strains. The study also draws attention to clinical and microbiological aspects observed in 5 cases of endocarditis due to C. diphtheriae that occurred outside Europe. Four cases occurred in female school-age children (7-14 years) treated at different hospitals in Rio de Janeiro, Brazil. All patients developed other complications including septicemia, renal failure and/or arthritis. Surgical treatment was performed on 2 patients for valve replacement. Lethality was observed in 40 percent of the cases. Microorganisms isolated from 5 blood samples and identified as C. diphtheriae subsp mitis (N = 4) and C. diphtheriae subsp gravis (N = 1) displayed an aggregative adherence pattern to HEp-2 cells and identical one-dimensional SDS-PAGE protein profiles. Aggregative-adhering invasive strains of C. diphtheriae showed 5 distinct RAPD profiles. Despite the clonal diversity, all 5 C. diphtheriae invasive isolates seemed to display special bacterial adhesive properties that may favor blood-barrier disruption and systemic dissemination of bacteria. In conclusion, blood isolates from patients with endocarditis exhibited a unique adhering pattern, suggesting a pathogenic role of aggregative-adhering C. diphtheriae of different clones in endocarditis. Accordingly, the aggregative-adherence pattern may be used as an indication of some invasive potential of C. diphtheriae strains.

[Permanence of nurses in their profession]. / Estudo da permanência dos enfermeiros no trabalho.

The main cause for nursing shortage in the world is that nurses are withdrawing the profession. However few research has been carried out to prove this. This study investigates nurses' permanence in job and their motives for withdrawing it. Researchers tried to contact 1112 nurses who enrolled the profession after finishing the undergraduate nursing course at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil, in the period from 1957 to 1990. They were not able to contact 95 nurses (8.54%) from the total. Therefore, 1017 (91.46%) were contacted by mail, telephone or interview to answer a questionnaire, 808 (72.66%) answered, 194 (17.45%) did not reply, 4 (0.36%) refused to answer and 11 (0.99%) died, generating the following data: 19 (2.35%) never worked, 661 (81.81%) are working in the profession, 102 (12.62%) worked and withdrew nursing, 26 (3.22%) retired. Considering this group, the analysis showed that the percentage who left the profession is small, nevertheless other studies are suggested in order to enable the comparison of these results. The motives for their permanence are their attachment to the profession, even though they say that their work is not recognized and they are badly paid. The reasons for withdrawing the profession are family and personal problems as well as constant changes in the schedule and general frustration. In sum, nurses love their profession and would like to continue working. Some of them are returning and asking for better conditions.

[Average working life of nurses graduating form the University of Sao Paulo at Ribeirao Preto, USP - Brazil]. / Vida média de labor dos enfermeiros egressos da Escola de Enfermagem de Ribeirão Preto, USP-Brasil.

This study aimed at measuring the average working time in health care of nurses graduating from the University of São Paulo at Ribeirão Preto College of Nursing, Brazil. This research includes 1,112 nurses who graduated from 1957 to 1990. It is a descriptive cross-sectional study. Data were obtained from March, 1992 to February, 1993. Statistical methods for survival data analysis were used. The average time was 18.12 years.

Post-discharge surveillance and infection rates in obstetric patients.

OBJECTIVE: To study the impact of post-discharge surveillance on the detection of nosocomial surgical site infection (SSI) after cesarean section and vaginal delivery. METHODS: During a 21-month period, all patients attending the obstetrics service in labor were recruited for a observational study on the incidence of SSI. Examinations to detect SSI were performed daily during the hospitalization period and up to 30 days after hospital discharge in an outpatient clinic supervised by the Infection Control Committee. The stratification of risk-factors and the criteria for the diagnosis of SSI were done in accordance with the methods described by the Centers for Disease Control and Prevention. The rates of surgical site infection detected during the hospitalization period were compared with those reported by the Centers for Disease Control and Prevention's National (United States) Nosocomial Infection Surveillance System (CDCNNIS) 'benchmarks'. The incidence of SSI detected by post-discharge outpatient surveillance was compared with that from in-hospital surveillance, for both cesarean section and vaginal delivery. RESULTS: A total of 4463 deliveries were performed during the study period, 2431 (54.5%) by the vaginal route and 2032 (45.5%) by cesarean section. In-hospital surveillance was done on all patients. Post-discharge examinations were done on 951 (46.8%) of the 2032 cesarean section patients. The incidence of SSI in cesarean section detected by in-hospital surveillance was 1.6% (32 cases) and lower than the 3.6% mean rate reported by the CDCNNIS. When SSIs detected by post-discharge surveillance were included, the total number of SSI was 196 cases (9.6%), a value much higher than that for the SSI detected by in-hospital surveillance alone. Only 5 cases (0.21%) of SSI were detected among the 2431 vaginal deliveries. CONCLUSIONS: The results of our study demonstrate that most of SSI following cesarean section were detected only after patient's discharge from the hospital and seems to indicate that failing to do follow-up evaluation of these patients could result in a substantial mis-calculation of the authentic SSIs rates. Therefore data on post-discharge surveillance should be included to realistically estimate the true rates of SSI in obstetric patients and to allow the implementation of measures to reduce post-partum infection.

[Analysis of the education of nurses for home care]. / Análise da formação do enfermeiro para a assistência de enfermagem no domicílio.

The authors observed that there is a tendency towards looking after the sick at home. Therefore they have carried-out this analisys of how nurses are prepared for home care. There are four historical periods with important bearings that have directly or indirectly influenced Brazilian nursing profession and education since 1923, the authors searched within the basic curriculum. To find references about home care in the courses oriented to public health. The analisys confirms a tendency in this area, both in public and private health services. However Nursing Schools are not considering yet these area, that will be really important in the near future.

Otimizaçäo das operaçöes sobre o pé e tornozelo / Optimization of surgical treatment of foot pathology

Os autores propoem um programa de atendimento aos pacientes portadores de patologias do pé, com indicaçao de tratamento cirúrgico, que visa diminuir custos e limitar ao mínimo o tempo de permanência hospitalar. Para isso há necessidade da interaçao das diversas equipes profissionais, tais como assistente social, enfermagem, médicos e familiares. A participaçao médica neste protocolo inclui o emprego do bloqueio anestésico regional e utilizaçao de técnica cirúrgica apropriada. Baseado em 23 casos, a eficácia do programa é analisada e o método, recomendado.

[Comparative study of the names of subjects in the official curriculum with those used by nursing schools in the southeast of Brazil]. / Estudo comparativo da nomenclatura das matérias e disciplinas do currículo mínimo com a utilizada pelas escolas de enfermagem da região Sudeste-Brasil.

The authors compared the names of the subjects that form the official curriculum to those offered by the schools of nursing in the South East of Brazil. Forty eight schools replied to the questionnaire, a variance in the names and numbers of the subjects offered was found, indicating a difference in the way each school performs the curriculum.

[Investigation of the school life of students entering an undergraduate nursing course at a Brazilian school from 1984-1988]. / Acompanhamento da vida escolar dos alunos ingressantes no curso de graduação em enfermagem numa escola Brasileira-Período 1984 a 1988.

An investigation of professional nursing training was carried out by examining the time spent in nursing school of the 336 students registered at the Nursing College of Ribeirão Preto at University of São Paulo from 1984 to 1988. The data showed that during this time 197 (58.6%) students graduated, two students were still enrolled, 26 (7.7%) transferred to other schools, 15 (4.4%) officially interrupted their course of study, and 96 (28.5%) abandoned the school.

Continuing education in Brazil.

In the present study, we discuss some specific aspects of the National Health System of Brazil in terms of nursing practice, education, and investigation, which require further professional training through continuing education. With this objective, we shall report a historic view of how this process occurred and is being transformed in this country in an attempt to meet the social realities of our time.

[Epidemiology for nurses]. / A epidemiologia para o enfermeiro.

The subject of this paper emphasizes the uses of Epidemiology to nurses like an essential tool to afford health service assistance and his application in practice. Equally it evidences that the epidemiology offers important support to the planning, administration, execution and evaluation of the health service and in addition an extremely useful and essential investigation instrument to his professional formation.

[Identification of the public health nurse within the public health work force in the Regional Health Department-6 of Ribeirão Preto, SP, (Brazil)]. / Identificação do enfermeiro de saúde pública na força de trabalho de enfermagem de saúde pública no Departamento Regional de Saúde-6 de Ribeirão Preto, SP, Brasil.

The general purpose of this study was the identification of the nurse within the public health work force in the Regional Health Department of Ribeirão Preto of the State Health Secretariat of S. Paulo. A questionnaire the options of which included: identification, level of training, progress in career, function, future professional expectations and membership of professional associations, was the chief data source. Of the group studies 35 were female, 40% of whom were between 20 and 39 years old, 51.5% were married and 77.2% had been in service for from zero to fifteen years. Regarding the other categories, distribution was as follows: 1 nurse per 13.5 assistants; 1 nurse per 9.1 doctors. Concerning professional training, 71.5% were qualified in Public Health Nursing and 8.6% specialized in Public Health. No career opportunities were available in the nursing profession and their salaries ranged from two to seven minimum salaries, only one receiving ten. All condemned the system of performance assessment. All nurses performed largely administrative services and the inspectors did so for some 65% of their time. Among nursing assistants this percentage rose to 73.3% for those in charge. The nurses were prepared to participate in primary care programmes and 84.3% intended to continue working until retirement.

Introducao a analise das transformacoes na pratica de enfermagem no Brasil, no periodo 1920-1978. / Analysis of changes in nursing practice in Brazil - 1920-1978

Este trabalho corresponde a uma investigacao em andamento, financiada pela Organizacao Panamericana da Saude (OPAS), cujo objetivo e a analise das transformacoes ocorridas na pratica da enfermagem na sociedade brasileira, da decada de 1920 ate o final da decada de 1970