Impact of In-Hospital infection with SARS-CoV-2 among Inpatients at a university hospital.

OBJECTIVE: The objective of this study was to evaluate the incidence of nosocomial infection and the impact of cross-transmission of SARS-CoV-2 among inpatients at a tertiary care teaching hospital. METHODS: This was a retrospective cohort study involving inpatients admitted to a tertiary university hospital in the city of São Paulo, Brazil, between March 2020 and February 2021. Cases were identified on the basis of a positive reverse-transcription polymerase chain reaction result for SARS-CoV-2 and the review of electronic medical records. Nosocomial transmission was defined by applying the criteria established by the Brazilian National Health Regulatory Agency. RESULTS: We identified 2146 cases of SARS-CoV-2 infection, 185 (8.6%) of which were considered cases of nosocomial transmission. The mean age was 58.3 years. The incidence density was 1.78 cases per 1,000 patient-days on the general wards, being highest on the cardiac surgery ward, and only 0.16 per 1,000 patient-days on the COVID-19 wards. Of the 185 patients evaluated, 115 (62.2%) were men, 150 (81.1%) cases had at least one comorbidity, and 104 (56.2%) evolved to death. CONCLUSIONS: Despite the preventive measures taken, nosocomial transmission of SARS-CoV-2 occurred throughout our hospital. Such measures should be intensified when the incidence of community transmission peaks.

A preceptoria e o ensino do autocuidado do diabético: das dificuldades aos caminhos possíveis / Preceptorship and the teaching of diabetic selfcare: from difficulties to possible paths

Objetivo: discutir as dificuldades e os caminhos possíveis para o ensino do autocuidado do diabético aos alunos em formação na Atenção Básica, evidenciados junto aos profissionais de saúde que atuam como preceptores nos serviços de saúde. Métodos: a pesquisa, tipo estudo de caso com abordagem qualitativa, utilizou como referencial teórico metodológico a análise institucional, em sua abordagem socioclínica institucional. Para a produção de dados foram realizados cinco encontros com trabalhadores da saúde em uma unidade do Programa Médico de Família. Resultados: os resultados revelaram que o sofrimento permeia o contexto do autocuidado, sentido, de um lado, pelos diabéticos, e de outro, pelos profissionais de saúde/preceptores no desempenho do seu duplo papel: educativo e assistencial. Como possíveis caminhos, a pesquisa possibilitou aos profissionais de saúde/preceptores repensarem suas práticas, sugerindo mudanças no processo de trabalho relativo ao ensino do autocuidado ao diabético. Conclusões: destaca-se a necessidade de ampliar as reflexões sobre o papel assistencial e educativo dos profissionais de saúde/preceptores nos serviços do Sistema Único de Saúde.

Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women.

Urinary tract infection (UTI) is a common condition in women. There is an increased concern on reduction of bacterial susceptibility resulting from wrongly prescribing antimicrobials. This paper summarizes the recommendations of four Brazilian medical societies (SBI - Brazilian Society of Infectious Diseases, FEBRASGO - Brazilian Federation of Gynecology and Obstetrics Associations, SBU - Brazilian Society of Urology, and SBPC/ML - Brazilian Society of Clinical Pathology/Laboratory Medicine) on the management of urinary tract infection in women. Asymptomatic bacteriuria should be screened at least twice during pregnancy (early and in the 3rd trimester). All cases of significant bacteriuria (≥105CFU/mL in middle stream sample) should be treated with antimicrobials considering safety and susceptibility profile. In women with typical symptoms of cystitis, dipsticks are not necessary for diagnosis. Urine cultures should be collected in pregnant women, recurrent UTI, atypical cases, and if there is suspicion of pyelonephritis. First line antimicrobials for cystitis are fosfomycin trometamol in a single dose and nitrofurantoin, 100mg every 6hours for five days. Second line drugs are cefuroxime or amoxicillin-clavulanate for seven days. During pregnancy, amoxicillin and other cephalosporins may be used, but with a higher chance of therapeutic failure. In recurrent UTI, all episodes should be confirmed by urine culture. Treatment should be initiated only after urine sampling and with the same regimens indicated for isolated episodes. Prophylaxis options of recurrent UTI are behavioral measures, non-antimicrobial and antimicrobial prophylaxis. Vaginal estrogens may be recommended for postmenopausal women. Other non-antimicrobial prophylaxis, including cranberry and immunoprophylaxis, have weak evidence supporting their use. Antimicrobial prophylaxis may be offered as a continuous or postcoital scheme. In pregnant women, options are cephalexin, 250-500mg and nitrofurantoin, 100mg (contraindicated after 37 weeks of pregnancy). Nonpregnant women may use fosfomycin trometamol, 3g every 10 days, or nitrofurantoin, 100mg (continuous or postcoital).

Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women

Urinary tract infection (UTI) is a common condition in women. There is an increased concern on reduction of bacterial susceptibility resulting from wrongly prescribing antimicrobials. This paper summarizes the recommendations of four Brazilian medical societies (SBI ­ Brazilian Society of Infectious Diseases, FEBRASGO ­ Brazilian Federation of Gynecology and Obstetrics Associations, SBU ­ Brazilian Society of Urology, and SBPC/ML ­ Brazilian Society of Clinical Pathology/Laboratory Medicine) on the management of urinary tract infection in women. Asymptomatic bacteriuria should be screened at least twice during pregnancy (early and in the 3rd trimester). All cases of significant bacteriuria (≥105 CFU/mL in middle stream sample) should be treated with antimicrobials considering safety and susceptibility profile. In women with typical symptoms of cystitis, dipsticks are not necessary for diagnosis. Urine cultures should be collected in pregnant women, recurrent UTI, atypical cases, and if there is suspicion of pyelonephritis. First line antimicrobials for cystitis are fosfomycin trometamol in a single dose and nitrofurantoin, 100 mg every 6 hours for five days. Second line drugs are cefuroxime or amoxicillin-clavulanate for seven days. During pregnancy, amoxicillin and other cephalosporins may be used, but with a higher chance of therapeutic failure. In recurrent UTI, all episodes should be confirmed by urine culture. Treatment should be initiated only after urine sampling and with the same regimens indicated for isolated episodes. Prophylaxis options of recurrent UTI are behavioral measures, nonantimicrobial and antimicrobial prophylaxis. Vaginal estrogens may be recommended for postmenopausal women. Other non-antimicrobial prophylaxis, including cranberry and immunoprophylaxis, have weak evidence supporting their use. Antimicrobial prophylaxis may be offered as a continuous or postcoital scheme. In pregnant women, options are cephalexin, 250­500 mg and nitrofurantoin, 100 mg (contraindicated after 37 weeks of pregnancy). Nonpregnant women may use fosfomycin trometamol, 3 g every 10 days, or nitrofurantoin, 100 mg (continuous or postcoital)

Pseudomonas aeruginosa in the ICU: prevalence, resistance profile, and antimicrobial consumption

Abstract INTRODUCTION: Pseudomonas aeruginosa is one of the main pathogens causing infection in intensive care units (ICUs) and usually presents antimicrobial resistance. METHODS: Data were obtained from ICUs between 2010 and 2013. RESULTS: P. aeruginosa had a prevalence of 14.5% of which 48.7% were multidrug resistant. We observed increasing resistance to carbapenems and polymyxin B and growing consumption of aminoglycosides, meropenem, ceftazidime, and polymyxin B. The regression impact between resistance and consumption was significant with respect to amikacin, imipenem, meropenem, and polymyxin B. CONCLUSIONS: Monitoring antimicrobial consumption and resistant microorganisms should be reinforced to combat antimicrobial- and multi-drug resistance.

Pseudomonas aeruginosa in the ICU: prevalence, resistance profile, and antimicrobial consumption.

INTRODUCTION: Pseudomonas aeruginosa is one of the main pathogens causing infection in intensive care units (ICUs) and usually presents antimicrobial resistance. METHODS: Data were obtained from ICUs between 2010 and 2013. RESULTS: P. aeruginosa had a prevalence of 14.5% of which 48.7% were multidrug resistant. We observed increasing resistance to carbapenems and polymyxin B and growing consumption of aminoglycosides, meropenem, ceftazidime, and polymyxin B. The regression impact between resistance and consumption was significant with respect to amikacin, imipenem, meropenem, and polymyxin B. CONCLUSIONS: Monitoring antimicrobial consumption and resistant microorganisms should be reinforced to combat antimicrobial- and multi-drug resistance.

Referencial teórico-metodológico de Paulo Freire: contribuições no campo da enfermagem / Paulo Freire's theoretical and methodological framework: contributions in the field of nursing / Referencial teórico-metodológico de Paulo Freire: contribuciones en el campo de la enfermería

Objetivo: rever estudos que abordam o referencial teórico-metodológico de Paulo Freire e suas contribuições para a enfermagem. Método: revisão integrativa da produção científica nacional, realizada de abril a junho de 2016, em bases de dados on line publicadas de 2011 a 2015. Resultados: foram identificados 19 artigos, evidenciando-se duas categorias analíticas: Aplicabilidade da Teoria Freireana na assistência de enfermagem; Teoria Freireana e a formação do profissional de enfermagem. Conclusão: o referencial teórico-metodológico de Freire é importante no campo da enfermagem, porquanto compreende o diálogo como o momento em que as pessoas se encontram para refletir sobre sua realidade tal como a fazem e refazem. Trata-se, portanto, de uma postura político-filosófica necessária diante do mundo e da existência, na medida em que os seres humanos se transformam a partir da reflexão crítica de sua realidade.

Objective: to review studies that address Paulo Freire's theoretical and methodological framework and his contributions to nursing. Method: from April to June 2016, an integrative review of Brazilian scientific production published from 2011 to 2015 was conducted in online databases. Results: 19 articles were identified, revealing two analytical categories: Applicability of Freire's Theory to nursing care; Freire's Theory and training for nursing professionals. Conclusion: Freire's theoretical and methodological framework is important in the field of nursing, in that it regards dialogue as the moment when people meet to reflect on their reality as they make and remake it. It is, therefore, a necessary political and philosophical attitude to the world and to existence, in that human beings change on the basis of their critical thinking about their reality.

Objetivo: revisar estudios que abordan el referencial teórico-metodológico de Paulo Freire y sus contribuciones a la enfermería. Método: revisión integrativa de la producción científica nacional, realizada de abril a junio de 2016, en bases de datos on-line publicadas de 2011 a 2015. Resultados: se identificaron 19 artículos, evidenciando dos categorías analíticas: Aplicabilidad de la Teoría Freireana en la asistencia de enfermería; Teoría Freireana y la formación del profesional de enfermería. Conclusión: el referencial teórico-metodológico de Freire es importante en el campo de la enfermería ya que comprende el diálogo como el momento en que las personas se encuentran para reflexionar sobre su realidad tal como la hacen y rehacen. Se trata, pues, de una postura político-filosófica necesaria ante el mundo y de la existencia, en la medida en que los seres humanos se transforman desde la reflexión crítica de su realidad.

Clinical Applications of Point-of-Care Testing in Different Conditions.

BACKGROUND: The use of point-of-care testing (POCT) in different clinical applications is justified by the fact that the time to release the result is shortened, allowing the physician to define the diagnosis and most appropriate therapy in a shorter time. However, the negative aspects must also be highlighted and studied so that we can move forward with the use of these devices. These negative aspects include greater analytical imprecision compared to laboratory automation, the variability between different equipment from different manufacturers, the risk of inappropriate use, a low level of global regulation, higher costs compared with laboratory testing and cost ineffectiveness in terms of health care. Methods and. RESULTS: This review presents some clinical applications of POCT in different scenarios, such as for diabetes mellitus, infectious diseases, pediatrics, and chronic kidney disease, among others. CONCLUSIONS: We hope to see a global consensus on an acceptable quality standard for performing POCT that is adaptable, practical, and cost effective in primary care settings, ensuring patient safety, and minimizing the risk of harm.

Point-of-Care Testing: General Aspects.

Point-of-Care Testing (POCT) has been highlighted in the health care sector in recent decades. On the other hand, due to its low demand, POCT is at a disadvantage compared to conventional equipment, since its cost is inversely proportional to the volume of use. In addition, for the implementation of POCT to succeed, it is essential to rely on the work of a multidisciplinary team. The awareness of health professionals of the importance of each step is perhaps the critical success factor. The trend towards the continuous advancement of the use of POCT and the great potential of its contributions reinforce the need to implement quality management tools, including performance indicators, to ensure their results. This review presents some advantages and disadvantages concerning POCT and the real need to use it. A worldwide call for the availability of easy-to-use health technologies that are increasingly closer to the final user is one of the main reasons for this focus.

Identification of the Infection Source of an Outbreak of Mycobacterium Chelonae Keratitis After Laser in Situ Keratomileusis.

PURPOSE: Nontuberculous mycobacteria keratitis is a rare but challenging complication of laser in situ keratomileusis (LASIK). This study was conducted to determine the source(s) of infection in a cluster of cases of keratitis after LASIK and to describe this outbreak and patients' outcomes. METHODS: In this retrospective, case series, single-center study, 86 patients were included who underwent LASIK or photorefractive keratectomy between December 2011 and February 2012. Corneal scrapes from the affected eyes, samples of tap and distilled water, water from the reservoir of the distilling equipment, steamer, and autoclave cassette; antiseptic and anesthetic solutions and surgical instrument imprints were cultivated in liquid and on solid media. Gram-negative bacteria and yeasts were identified using automated systems and mycobacteria by polymerase chain reaction-restriction enzyme analysis of the hsp65 gene (PRA-hsp65) and DNA sequencing. Mycobacterial isolates were typed by pulsed-field gel electrophoresis. The cases and outcomes are described. The main outcome measure was identification of the source(s) of the mycobacterial infections. RESULTS: Eight (15 eyes) of 86 patients (172 eyes) who underwent LASIK developed infections postoperatively; no patients who underwent photorefractive keratectomy developed infections. Mycobacterium chelonae was isolated from 4 eyes. The distilled water collected in the surgical facility contained the same M. chelonae strain isolated from the patients' eyes. Different gram-negative bacteria and yeasts were isolated from samples collected at the clinic but not from the patients' eyes. CONCLUSIONS: Tap water distilled locally in surgical facilities may be a source of infection after ocular surgery and its use should be avoided.

A cross-sectional study assessing the pharyngeal carriage of Neisseria meningitidis in subjects aged 1-24 years in the city of Embu das Artes, São Paulo, Brazil

ABSTRACT Meningococcal carriage is a prerequisite for invasive infection. This cross-sectional study assessed the pharyngeal carriage prevalence in healthy subjects aged 1-24 years in Embu das Artes city, São Paulo, Brazil. Pharyngeal swabs were examined for the presence of Neisseria meningitidis. The isolates were tested for different serogroups using agglutination and polymerase chain reaction. A logistic regression model assessed any independent association between Neisseria meningitidis carriage and various risk factors. A total of 87/967 subjects (9%, 95% Confidence Interval (CI): 7.3-11.0) tested positive for N. meningitidis: 6.2% (95% CI: 3.8-9.4) in 1-4 years, 8.5% (95% CI: 5.1-13.0) in 5-9 years, 12.5% (95% CI: 7.8-18.6) in 10-14 years, 12.6% (95% CI: 7.4-19.7) in 15-19 years and 9% (95% CI: 4.9-14.9) in 20-24 years age groups. Highest carriage prevalence was observed in adolescents 10-19 years old. Serogroup C was predominant (18.4%) followed by serogroup B (12.6%). The 15-19 years age group showed a significant association between number of household members and carriers of N. meningitidis. This cross-sectional study is the first in Brazil to evaluate meningococcal carriage prevalence and associated factors in a wide age range.

Evaluation of a rapid immunochromatographic test for detection of distinct variants of Klebsiella pneumoniae carbapenemase (KPC) in Enterobacteriaceae.

The rapid detection of KPC-producing Enterobacteriaceae by microbiology laboratories has been required for infectious control programs. Herein we evaluated the performance of a novel immunochromatographic test for detecting KPC-2-, KPC-3-, KPC-4-, KPC-6-, KPC-7-, KPC-8-, and KPC-11-producing isolates and the influence of different growth media on the test performance.

A cross-sectional study assessing the pharyngeal carriage of Neisseria meningitidis in subjects aged 1-24 years in the city of Embu das Artes, São Paulo, Brazil.

Meningococcal carriage is a prerequisite for invasive infection. This cross-sectional study assessed the pharyngeal carriage prevalence in healthy subjects aged 1-24 years in Embu das Artes city, São Paulo, Brazil. Pharyngeal swabs were examined for the presence of Neisseria meningitidis. The isolates were tested for different serogroups using agglutination and polymerase chain reaction. A logistic regression model assessed any independent association between Neisseria meningitidis carriage and various risk factors. A total of 87/967 subjects (9%, 95% Confidence Interval (CI): 7.3-11.0) tested positive for N. meningitidis: 6.2% (95% CI: 3.8-9.4) in 1-4 years, 8.5% (95% CI: 5.1-13.0) in 5-9 years, 12.5% (95% CI: 7.8-18.6) in 10-14 years, 12.6% (95% CI: 7.4-19.7) in 15-19 years and 9% (95% CI: 4.9-14.9) in 20-24 years age groups. Highest carriage prevalence was observed in adolescents 10-19 years old. Serogroup C was predominant (18.4%) followed by serogroup B (12.6%). The 15-19 years age group showed a significant association between number of household members and carriers of N. meningitidis. This cross-sectional study is the first in Brazil to evaluate meningococcal carriage prevalence and associated factors in a wide age range.

Comparison of DNA Extraction Protocols and Molecular Targets to Diagnose Tuberculous Meningitis.

Tuberculous meningitis (TBM) is a severe form of extrapulmonary tuberculosis. The aims of this study were to evaluate in-house molecular diagnostic protocols of DNA extraction directly from CSF samples and the targets amplified by qPCR as an accurate and fast diagnosis of TBM. One hundred CSF samples from 68 patients suspected of TBM were studied. Four DNA extraction techniques (phenol-chloroform-thiocyanate guanidine, silica thiocyanate guanidine, resin, and resin with ethanol) were compared and CSF samples were used to determine the best target (IS6110, MPB64, and hsp65 KDa) by qPCR. The extraction protocol using the phenol-chloroform-thiocyanate guanidine showed the best results in terms of quantification and sensitivity of PCR amplification, presenting up to 10 times more DNA than the second best protocol, the silica guanidine thiocyanate. The target that showed the best result for TBM diagnosis was the IS6110. This target showed 91% sensitivity and 97% specificity when we analyzed the results by sample and showed 100% sensitivity and 98% specificity when we analyzed the results by patient. The DNA extraction with phenol-chloroform-thiocyanate guanidine followed by IS6110 target amplification has been shown to be suitable for diagnosis of TBM in our clinical setting.

Sexualidade na Adolescência: Desafios para a Enfermagem na busca da construção de saberes junto aos familiares dos adolescentes / Sexuality in adolescence: challenges for nursing in the construction of knowledge with adolescents's family members

A sexualidade é um fenômeno presente na vida do ser humano desde o seu nascimento, mas é na adolescência que ela se evidencia a partir das mudanças que ocorrem no indivíduo e que envolvem aspectos bio-psico-sociais. Essas mudanças geram muitas vezes insegurança e modificações no contexto familiar, principalmente quando envolve o manejo das questões da sexualidade. Objeto de Estudo: A sexualidade na adolescência no contexto da família. Os objetivos foram: Compreender os modos de construção dos saberes dos familiares dos adolescentes sobre a temática sobre a sexualidade; Desvelar os sentidos que os familiares têm sobre a temática da sexualidade e como esta é abordada por eles junto aos adolescentes; Analisar, a partir dos discursos dos familiares os modos de reprodução deste tema na orientação sexual dos seus filhos adolescentes. Metodologia: Estudo de abordagem qualitativa, desenvolvido através do grupo focal, com 13 familiares/cuidadores dos adolescentes atendidos em uma Unidade Pré-Hospitalar, localizada na cidade de Duque de Caxias. O estudo foi realizado no período de julho de 2015 a maio de 2016. Os dados foram analisados a partir da análise de discurso e interpretados à luz do pensamento de Foucault. Resultados: A prática discursiva dos familiares/cuidadores revelou que a formação dos saberes sobre a sexualidade ocorreu basicamente a partir da adolescência. Entretanto, a falta de informação no interior da família, fez com que as participantes aprendessem sobre essas questões com as experiências de vida; a partir de conversas com pessoas mais velhas, profissionais de saúde e professores. Isto foi um fator determinante na decisão das mães participantes desse estudo em abordar essas questões com seus filhos nesse momento de sua adolescência. Evitando que os mesmos vivenciem a falta de esclarecimento sobre esse assunto, como aconteceu com elas no passado. Entretanto, o processo de transferência desses saberes se dá de forma restritiva, prescritiva e controladora. Dentre os temas mais abordados pelas familiares/cuidadoras junto aos seus filhos estão: as mudanças fisiológicas ocorridas na puberdade, as DSTs, os métodos contraceptivos, a gravidez e o ato sexual. Nesse sentido, a abordagem se dá no campo dos aspectos reprodutivos ou patológicos, em detrimento dos aspectos psíquicos, emocionais e sociais que envolvem essa temática. Conclui-se que os familiares/cuidadores precisam oportunizar espaços de diálogos junto a seus adolescentes, tornando as discussões sobre a temática da sexualidade como parte natural de uma conversa, numa relação dialógica, de reflexão-ação sobre essas questões. Implicações para a enfermagem: salienta-se a importância do enfermeiro em abordar essas questões junto aos familiares de adolescentes de modo a suprir as dificuldades encontradas por eles para abordar essa temática no interior de sua família.

Sexuality is a phenomenon present in human life since birth, but it is in adolescence that it is evidenced from the changes that occur in the individual and that involve bio-psycho- social aspects. These changes often generate insecurity and changes in the family context, especially when they involve the handling of sexuality issues. Object of study: The approach of sexuality by family members with adolescents. The objectives were: To understand the ways of building knowledge by the relatives of adolescents on the theme of sexuality; To unveil the senses that family members have about sexuality and how they approach them with the adolescents; and To analyze, from the discourses of the relatives about the theme of sexuality, the ways of reproducing the subject in the sexual orientation to their adolescent children. Methodology: A qualitative study, developed through focus group, with 13 adolescents's family members attending a Pre-Hospital Unit located in the city of Duque de Caxias/RJ. Data were collected from November 2015 to March 2016, analyzed through the discourse analysis and interpreted in the light of Foucault's thinking. Results: The discursive practice of family members revealed that the formation of knowledge about sexuality occurred basically from the time of adolescence. However, the lack of information within the family made the participants learn about these issues from life experiences; from conversations with older people; health professionals and teachers. This was a determining factor in the decision of the mothers participating in this study to address these issues with their children at this point in their adolescence, preventing them from experiencing the lack of clarification on this subject as they have in the past. However, the process of transferring this knowledge takes place in a restrictive, prescriptive and controlling way. Among the topics most approached by family members with their children are: the physiological changes occurring at puberty, sexually transmitted infections (STIs), contraceptive methods, pregnancy and sexual intercourse. In this sense, the approach is in the field of reproductive or pathological aspects, to the detriment of the psychic, emotional and social aspects that involve this theme. It is concluded that family members need to provide dialogue spaces with their adolescents, making the discussions on sexuality a natural part of a conversation, in a dialogical relationship of reflection-action on these issues. Implications for nursing: the importance of the nurse in addressing these issues with the relatives of adolescents is highlighted in order to overcome the difficulties they encounter in addressing this issue within their families.

Análise de discurso nas pesquisas de enfermagem na saúde da criança e do adolescente / Discourse analysis in nursing research on child and adolescent's health / Análisis de discurso en las investigaciones de enfermería en la salud del niño y del adolescente

Objetivo: identificar as características das publicações científicas da enfermagem na área da infância e da adolescência que utilizaram a análise de discurso como método de análise dos dados coletados. Método: investigação bibliográfica do tipo revisão integrativa realizada no período de maio a junho de 2016, em bases virtuais de dados, utilizando-se os descritores: análise de discurso, enfermagem, adolescente e criança. Foram selecionados 18 artigos e 10 teses/dissertações. Resultados: o maior número de publicações ocorreu no ano de 2013 e a maioria das produções (82,1%) abrange a população infantil. Os periódicos que mais publicaram foram a Revista Brasileira de Enfermagem e a Revista Enfermagem UERJ. Conclusão: a análise dos estudos mostrou como a análise de discurso pode promover a compreensão dos fenômenos e a reflexão sobre as condições de produção e apreensão dos textos produzidos junto a diferentes sujeitos, que constituem o foco de atuação dos profissionais da área infanto-juvenil.

Objective: to identify the characteristics of scientific publications on child and adolescent nursing that have used discourse analysis as their method of data analysis. Method: this integrative bibliographical review searched virtual databases, from May to June 2016, using the keywords: discourse analysis, nursing, adolescent and child. In all, 18 papers and 10 theses/dissertations were selected. Results: the year with most publications was 2013, and most publications (82.1%) addressed the child population. The periodicals which published most were: Revista Brasileira de Enfermagem and Revista de Enfermagem da UERJ. Conclusion: review of the studies showed how discourse analysis can foster understanding of the phenomena and thinking about the importance of discovering the meaning of the discourse of clients who constitute the focus of the work of child and adolescent nursing.

Objetivo: identificar las características de las publicaciones científicas de la enfermería en el área de la infancia y de la adolescencia que han utilizado el análisis de discurso como método de análisis de los datos recolectados. Método: investigación bibliográfica del tipo revisión integrativa realizada en el período de mayo a junio de 2016, en bases virtuales de datos, utilizando los descriptores: análisis de discurso, enfermería, adolescente y niño. 18 artículos y 10 tesis/disertaciones han sido seleccionados. Resultados: el mayor número de publicaciones ocurrió en 2013 y la mayoría de las producciones (82,1%) abarca la población infantil. Los periódicos que más han publicado fueron la Revista Brasileira de Enfermagem y la Revista Enfermeagem UERJ. Conclusión: el análisis de los estudios mostró cómo el Análisis de Discurso puede promover la comprensión de los fenómenos y la reflexión sobre las condiciones de producción y aprensión de los textos producidos junto a diferentes sujetos que constituyen el foco de actuación de los profesionales del área infanto-juvenil.

Influence of Culture Media on Detection of Carbapenem Hydrolysis by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

In this study, we evaluated the influence of distinct bacterial growth media on detection of carbapenemase hydrolysis by matrix-assisted laser desorption ionization-time of flight mass spectrometry. False-negative results were observed for OXA-25-, OXA-26-, and OXA-72-producing Acinetobacter baumannii isolates grown on MacConkey agar medium. The other culture media showed 100% sensitivity and 100% specificity for detecting carbapenemase.

Projeto Conscientização da Violência contra a Pessoa Idosa / Violence Awareness Project Against Elderly

O propósito principal deste trabalho foi de apresentar e analisar a frequência das diversas ações e manifestações de crimes contra o idoso, e pouco se tem feito para reduzir as violências domésticas, os acidentes de trânsito, suicídios, homicídios, agressões verbais e negligência em ambientes familiares, serviços públicos ou privados. A partir desta pesquisa pode-se perceber a importância de promover educação para a cidadania no âmbito do envelhecimento na sociedade em geral, mas, sobretudo, nos serviços de saúde, visando à valorização do idoso, o respeito a ele e a garantia de seus direitos (AU)

Detection of carbapenemase activity directly from blood culture vials using MALDI-TOF MS: a quick answer for the right decision.

OBJECTIVES: Recently, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) was successfully applied for the detection of carbapenemase activity directly from Gram-negative colonies. Based on this principle, we evaluated the performance of MALDI-TOF MS for rapid detection of carbapenemase activity directly from positive blood culture vials. METHODS: A total of 100 blood culture vials were randomly selected. MALDI-TOF MS carbapenemase assay results were confirmed by the detection of carbapenemase-encoding genes. RESULTS: A total of 110 bacterial isolates were recovered. The MALDI-TOF MS carbapenemase assay identified 21 of 29 (72.4%) of the carbapenemase-producing isolates directly from the blood culture vials, especially those encoding KPC-2 (100%) and SPM-1 (100%), after a 4 h incubation period. Although the majority of OXA-23-producing Acinetobacter baumannii isolates were not identified on day 1, all isolates were identified as carbapenemase producers directly from the colony on the next day. CONCLUSIONS: The MALDI-TOF MS carbapenemase assay is a feasible and rapid test to identify carbapenemase activity directly from blood culture vials. It may contribute to faster readjustment of empirical antimicrobial therapy and implementation of infection control measures.