Carbamoylase-based impedimetric electronic tongue for rapid detection of paralytic shellfish toxins.

Phytotoxins produced by marine microalgae, such as paralytic shellfish toxins (PSTs), can accumulate in bivalve molluscs, representing a human health concern due to the life-threatening symptoms they cause. To avoid the commercialization of contaminated bivalves, monitoring programs were established in the EU. The purpose of this work is the implementation of a PST transforming enzyme-carbamoylase-in an impedimetric test for rapid simultaneous detection of several carbamate and N-sulfocarbamoyl PSTs. Carbamoylase hydrolyses carbamate and sulfocarbamoyl toxins, which may account for up to 90% of bivalve toxicity related to PSTs. Conformational changes of carbamoylase accompanying enzymatic reactions were probed by Fourier transform mid-infrared spectroscopy (FT-MIR) and electrochemical impedance spectroscopy (EIS). Furthermore, a combination of EIS with a metal electrode and a carbamoylase-based assay was employed to harness changes in the enzyme conformation and adsorption on the electrode surface during the enzymatic reaction as an analytical signal. After optimization of the working conditions, the developed impedimetric e-tongue could quantify N-sulfocarbamoyl toxins with a detection limit of 0.1 µM. The developed e-tongue allows the detection of these toxins at concentration levels observed in bivalves with PST toxicity close to the regulatory limit. The quantification of a sum of N-sulfocarbamoyl PSTs in naturally contaminated mussel extracts using the developed impedimetric e-tongue has been demonstrated.

The role of GpsB in Staphylococcus aureus cell morphogenesis.

For decades, cells of the Gram-positive bacterial pathogen Staphylococcus aureus were thought to lack a dedicated elongation machinery. However, S. aureus cells were recently shown to elongate before division, in a process that requires a shape elongation division and sporulation (SEDS)/penicillin-binding protein (PBP) pair for peptidoglycan synthesis, consisting of the glycosyltransferase RodA and the transpeptidase PBP3. In ovococci and rod-shaped bacteria, the elongation machinery, or elongasome, is composed of various proteins besides a dedicated SEDS/PBP pair. To identify proteins required for S. aureus elongation, we screened the Nebraska Transposon Mutant Library, which contains transposon mutants in virtually all non-essential staphylococcal genes, for mutants with modified cell shape. We confirmed the roles of RodA/PBP3 in S. aureus elongation and identified GpsB, SsaA, and RodZ as additional proteins involved in this process. The gpsB mutant showed the strongest phenotype, mediated by the partial delocalization from the division septum of PBP2 and PBP4, two penicillin-binding proteins that synthesize and cross-link peptidoglycan. Increased levels of these PBPs at the cell periphery versus the septum result in higher levels of peptidoglycan insertion/crosslinking throughout the entire cell, possibly overriding the RodA/PBP3-mediated peptidoglycan synthesis at the outer edge of the septum and/or increasing stiffness of the peripheral wall, impairing elongation. Consequently, in the absence of GpsB, S. aureus cells become more spherical. We propose that GpsB has a role in the spatio-temporal regulation of PBP2 and PBP4 at the septum versus cell periphery, contributing to the maintenance of the correct cell morphology in S. aureus. IMPORTANCE: Staphylococcus aureus is a Gram-positive clinical pathogen, which is currently the second cause of death by antibiotic-resistant infections worldwide. For decades, S. aureus cells were thought to be spherical and lack the ability to undergo elongation. However, super-resolution microscopy techniques allowed us to observe the minor morphological changes that occur during the cell cycle of this pathogen, including cell elongation. S. aureus elongation is not required for normal growth in laboratory conditions. However, it seems to be essential in the context of some infections, such as osteomyelitis, during which S. aureus cells apparently elongate to invade small channels in the bones. In this work, we uncovered new determinants required for S. aureus cell elongation. In particular, we show that GpsB has an important role in the spatio-temporal regulation of PBP2 and PBP4, two proteins involved in peptidoglycan synthesis, contributing to the maintenance of the correct cell morphology in S. aureus.

Anatomo-functional basis of emotional and motor resonance elicited by facial expressions.

Simulation theories predict that the observation of other's expressions modulates neural activity in the same centers controlling their production. This hypothesis has been developed by two models, postulating that the visual input is directly projected either to the motor system for action recognition (motor resonance) or to emotional/interoceptive regions for emotional contagion and social synchronization (emotional resonance). Here we investigated the role of frontal/insular regions in the processing of observed emotional expressions by combining intracranial recording, electrical stimulation and effective connectivity. First, we intracranially recorded from prefrontal, premotor or anterior insular regions of 44 patients during the passive observation of emotional expressions, finding widespread modulations in prefrontal/insular regions (anterior cingulate cortex, anterior insula, orbitofrontal cortex and inferior frontal gyrus) and motor territories (rolandic operculum and inferior frontal junction). Subsequently, we electrically stimulated the activated sites, finding that (a) in the anterior cingulate cortex and anterior insula, the stimulation elicited emotional/interoceptive responses, as predicted by the 'emotional resonance model', (b) in the rolandic operculum it evoked face/mouth sensorimotor responses, in line with the 'motor resonance' model, and (c) all other regions were unresponsive or revealed functions unrelated to the processing of facial expressions. Finally, we traced the effective connectivity to sketch a network-level description of these regions, finding that the anterior cingulate cortex and the anterior insula are reciprocally interconnected while the rolandic operculum is part of the parieto-frontal circuits and poorly connected with the formers. These results support the hypothesis that the pathways hypothesized by the 'emotional resonance' and the 'motor resonance' models work in parallel, differing in terms of spatio-temporal fingerprints, reactivity to electrical stimulation and connectivity patterns.

Immuno-Transcriptomic Profiling of Blood and Tumor Tissue Identifies Gene Signatures Associated with Immunotherapy Response in Metastatic Bladder Cancer.

Blood-based biomarkers represent ideal candidates for the development of non-invasive immuno-oncology-based assays. However, to date, no blood biomarker has been validated to predict clinical responses to immunotherapy. In this study, we used next-generation sequencing (RNAseq) on bulk RNA extracted from whole blood and tumor samples in a pre-clinical MIBC mouse model. We aimed to identify biomarkers associated with immunotherapy response and assess the potential application of simple non-invasive blood biomarkers as a therapeutic decision-making assay compared to tissue-based biomarkers. We established that circulating immune cells and the tumor microenvironment (TME) display highly organ-specific transcriptional responses to ICIs. Interestingly, in both, a common lymphocytic activation signature can be identified associated with the efficient response to immunotherapy, including a blood-specific CD8+ T cell activation/proliferation signature which predicts the immunotherapy response.

Surface CD52, CD84, and PTGER2 mark mature PMN-MDSCs from cancer patients and G-CSF-treated donors.

Precise molecular characterization of circulating polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) is hampered by their mixed composition of mature and immature cells and lack of specific markers. Here, we focus on mature CD66b+CD10+CD16+CD11b+ PMN-MDSCs (mPMN-MDSCs) from either cancer patients or healthy donors receiving G-CSF for stem cell mobilization (GDs). By RNA sequencing (RNA-seq) experiments, we report the identification of a distinct gene signature shared by the different mPMN-MDSC populations under investigation, also validated in mPMN-MDSCs from GDs and tumor-associated neutrophils (TANs) by single-cell RNA-seq (scRNA-seq) experiments. Analysis of such a gene signature uncovers a specific transcriptional program associated with mPMN-MDSC differentiation and allows us to identify that, in patients with either solid or hematologic tumors and in GDs, CD52, CD84, and prostaglandin E receptor 2 (PTGER2) represent potential mPMN-MDSC-associated markers. Altogether, our findings indicate that mature PMN-MDSCs distinctively undergo specific reprogramming during differentiation and lay the groundwork for selective immunomonitoring, and eventually targeting, of mature PMN-MDSCs.

Plasmacytoid Dendritic Cell, Slan+-Monocyte and Natural Killer Cell Counts Function as Blood Cell-Based Biomarkers for Predicting Responses to Immune Checkpoint Inhibitor Monotherapy in Non-Small Cell Lung Cancer Patients.

The advent of immune checkpoint inhibitors (ICIs), for instance, programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) blockers, has greatly improved the outcome of patients affected by non-small cell lung cancer (NSCLC). However, most NSCLC patients either do not respond to ICI monotherapy or develop resistance to it after an initial response. Therefore, the identification of biomarkers for predicting the response of patients to ICI monotherapy represents an urgent issue. Great efforts are currently dedicated toward identifying blood-based biomarkers to predict responses to ICI monotherapy. In this study, more commonly utilized blood-based biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and the lung immune prognostic index (LIPI) score, as well as the frequency/number and activation status of various types of circulating innate immune cell populations, were evaluated in NSCLC patients at baseline before therapy initiation. The data indicated that, among all the parameters tested, low plasmacytoid dendritic cell (pDC), slan+-monocyte and natural killer cell counts, as well as a high LIPI score and elevated PD-L1 expression levels on type 1 conventional DCs (cDC1s), were independently correlated with a negative response to ICI therapy in NSCLC patients. The results from this study suggest that the evaluation of innate immune cell numbers and phenotypes may provide novel and promising predictive biomarkers for ICI monotherapy in NSCLC patients.

Secondary metabolites related to the resistance of Psidium spp. against the nematode Meloidogyneenterolobii.

The guava tree (Psidium guajava) is a tropical species native to South America and is recognized as the 11th most economically important fruit tree in Brazil. However, the presence of the nematode Meloidogyne enterolobii and the fungus Fusarium solani in the roots of guava plants leads to the development of root galls, causing significant damage. In contrast, the species P. guineense and P. cattleianum have been identified as resistant and immune to the nematode, respectively. In this study, the researchers aimed to compare the metabolomic profiles of infected and uninfected roots of P. guajava, P. cattleianum, and P. guineense using mass spectrometry coupled with liquid chromatography (LC-MS). The goal was to identify secondary metabolites that could potentially be utilized as biochemical resources for nematode control. The findings of the study demonstrated that the plant metabolism of all three species undergoes alterations in response to the phytopathogen inoculation. By employing molecular networks, the researchers identified that the secondary metabolites affected by the infection, whether produced or suppressed, are primarily of a polar chemical nature. Further analysis of the database confirmed the polar nature of the regulated substances after infection, specifically hydrolysable tannins and lignans in P. guineense and P. cattleianum. Interestingly, a group of non-polar substances belonging to the terpene class was also identified in the resistant and immune species. This suggests that these terpenes may act as inhibitors of M. enterolobii, working as repellents or as molecules that can reduce oxidative stress during the infection process, thus enhancing the guava resistance to the nematode. Overall, this study provides valuable insights into the metabolic alterations occurring in different Psidium spp. in response to M. enterolobii infection. The identification of specific secondary metabolites, particularly terpenes, opens up new possibilities for developing effective strategies to control the nematode and enhance guava resistance.

Conformational changes in the essential E. coli septal cell wall synthesis complex suggest an activation mechanism.

The bacterial divisome is a macromolecular machine composed of more than 30 proteins that controls cell wall constriction during division. Here, we present a model of the structure and dynamics of the core complex of the E. coli divisome, supported by a combination of structure prediction, molecular dynamics simulation, single-molecule imaging, and mutagenesis. We focus on the septal cell wall synthase complex formed by FtsW and FtsI, and its regulators FtsQ, FtsL, FtsB, and FtsN. The results indicate extensive interactions in four regions in the periplasmic domains of the complex. FtsQ, FtsL, and FtsB support FtsI in an extended conformation, with the FtsI transpeptidase domain lifted away from the membrane through interactions among the C-terminal domains. FtsN binds between FtsI and FtsL in a region rich in residues with superfission (activating) and dominant negative (inhibitory) mutations. Mutagenesis experiments and simulations suggest that the essential domain of FtsN links FtsI and FtsL together, potentially modulating interactions between the anchor-loop of FtsI and the putative catalytic cavity of FtsW, thus suggesting a mechanism of how FtsN activates the cell wall synthesis activities of FtsW and FtsI.

Minimally Invasive Concomitant Aortic And Mitral Valve Surgery - Initial Experience Of A Single Centre.

INTRODUCTION: Valve surgery through a median sternotomy has been the standard approach, but in the past decade various minimally invasive procedures have gained increasing traction among physicians and patients. MATERIALS AND METHODS: We present a series of three patients submitted to minimally invasive combined aortic and mitral valve surgery, performed through right lateral thoracotomy. RESULTS: We report no postoperative complication or mortality. Mean length of stay was 5 days, with a self-reported pain score 2/5 (mild/annoying pain). CONCLUSIONS: We report our initial experience, describing surgical technique and postoperative results, showing this technique to be safe, reproductible and comparable to conventional surgery.

Perspectiva legal del manejo de embriones supernumerarios en Italia. Soluciones prácticas de Derecho comparado / [Legal perspective of the management of supernumerary embryos in Italy. Practical Comparative Law Solutions]

Los avances en el ámbito de la medicina reproductiva han situado en un lugar destacado una nueva entidad: el embrión humano. La reconstrucción de su identidad jurídica reviste una importancia primordial en aras de encontrar soluciones a una de las cuestiones más sensibles que actualmente impulsan el debate en el contexto italiano, a saber, el destino de los embriones supernumerarios. La presente contribución realiza una sucinta revisión de las aportaciones efectuadas por la doctrina y la jurisprudencia tanto a nivel nacional como europeo en relación con este asunto, para posteriormente ahondar en algunas propuestas de carácter práctico, analizando sus potencialidades y aspectos críticos. (AU)

The advances in the field of reproductive medicine have placed a new entity at the forefront: the human embryo. The reconstruction of its legal identity assumes paramount importance in the pursuit of finding solutions to one of the most sensitive issues currently driving the debate in the Italian context, namely, the fate of supernumerary embryos. This contribution provides a concise review of the contributions made by doctrine and jurisprudence, both at the national and European levels, concerning this matter. Subsequently, it delves into some practical proposals, analyzing their potentialities and critical aspects. (AU)

Longitudinal effects of early psychosocial deprivation on macaque executive function: Evidence from computational modelling.

Executive function (EF) describes a group of cognitive processes underlying the organization and control of goal-directed behaviour. Environmental experience appears to play a crucial role in EF development, with early psychosocial deprivation often linked to EF impairment. However, many questions remain concerning the developmental trajectories of EF after exposure to deprivation, especially concerning specific mechanisms. Accordingly, using an 'A-not-B' paradigm and a macaque model of early psychosocial deprivation, we investigated how early deprivation influences EF development longitudinally from adolescence into early adulthood. The contribution of working memory and inhibitory control mechanisms were examined specifically via the fitting of a computational model of decision making to the choice behaviour of each individual. As predicted, peer-reared animals (i.e. those exposed to early psychosocial deprivation) performed worse than mother-reared animals across time, with the fitted model parameters yielding novel insights into the functional decomposition of group-level EF differences underlying task performance. Results indicated differential trajectories of inhibitory control and working memory development in the two groups. Such findings not only extend our knowledge of how early deprivation influences EF longitudinally, but also provide support for the utility of computational modelling to elucidate specific mechanisms linking early psychosocial deprivation to long-term poor outcomes.

Skin and soft tissue complications of bone-anchored hearing aids: Introducing a new classification system.

OBJECTIVES: There have been significant surgical and technological advances in bone-anchored hearing aid (BAHA) design, function, and implantation technique, but peri-implant skin complications remain the most frequent complication. The most important aspect in dealing with cutaneous complications is to identify the type of cutaneous lesion. Although Holger's Classification has been an extremely useful clinical tool, this grading system has been shown to be unsuitable for some cases. We therefore propose a new consistent and easy assessment classification of cutaneous complications associated with BAHA. METHODS: A retrospective clinical study was carried out at a tertiary centre, between January 2008 and December 2014. All patients under 18 years old with a unilateral BAHA were included in the study. RESULTS: A total of 53 children, with a BAHA, were included in the study. Post-operative skin complications were observed in 49.1% of the patients. Of the children, 28.3% presented with soft tissue hypertrophy, the most frequently reported skin complication, and grading according to the Holger's classification was not considered feasible. To overcome the difficulties we face in clinical practice, a new classification was developed and presented. CONCLUSION: The new proposed classification - Coutinho Classification - aims to fill the gaps in the one used currently by introducing new clinical features, most importantly the presence/absence of tissue overgrowth, and by providing a better description of what each category encompasses. This is an inclusive and objective new classification system, maintaining applicability, and useful in guiding the treatment.

Skin and soft tissue complications of bone-anchored hearing aids: Introducing a new classification system / Complicaciones de la piel y los tejidos blandos de los audífonos osteointegrados: introducción de un nuevo sistema de clasificación

Objectives: There have been significant surgical and technological advances in bone-anchored hearing aid (BAHA) design, function, and implantation technique, but peri-implant skin complications remain the most frequent complication. The most important aspect in dealing with cutaneous complications is to identify the type of cutaneous lesion.Although Holger's Classification has been an extremely useful clinical tool, this grading system has been shown to be unsuitable for some cases. We therefore propose a new consistent and easy assessment classification of cutaneous complications associated with BAHA.MethodsA retrospective clinical study was carried out at a tertiary centre, between January 2008 and December 2014. All patients under 18 years old with a unilateral BAHA were included in the study.ResultsA total of 53 children, with a BAHA, were included in the study. Post-operative skin complications were observed in 49.1% of the patients. Of the children, 28.3% presented with soft tissue hypertrophy, the most frequently reported skin complication, and grading according to the Holger's classification was not considered feasible.To overcome the difficulties we face in clinical practice, a new classification was developed and presented.ConclusionThe new proposed classification – Coutinho Classification – aims to fill the gaps in the one used currently by introducing new clinical features, most importantly the presence/absence of tissue overgrowth, and by providing a better description of what each category encompasses. This is an inclusive and objective new classification system, maintaining applicability, and useful in guiding the treatment. (AU)

Objetivos: La técnica de implantación de los audífonos osteointegrados (bone-anchored hearing aid [BAHA]) ha experimentado avances tecnológicos y quirúrgicos significativos en el diseño y en la función, aunque las complicaciones cutáneas periimplantarias son frecuentes. El aspecto más importante del tratamiento de las complicaciones cutáneas es identificar el tipo de lesión cutánea.Aunque la clasificación de Holger ha sido una instrumento clínico extremadamente útil, este sistema de clasificación ha demostrado ser inadecuado en algunos casos. Por lo tanto, proponemos una nueva clasificación, consistente y fácil, de las complicaciones cutáneas asociadas con BAHA.MétodosSe realizó un estudio clínico retrospectivo en un centro de tercer nivel, entre enero de 2008 y diciembre de 2014. Se incluyeron en el estudio todos los pacientes menores de 18 años a los que se colocó BAHA unilateral.ResultadosUn total de 53 niños a los que se colocaron BAHA fueron incluidos en el estudio. Se observaron complicaciones cutáneas postoperatorias en el 49,1% de los pacientes. El 28,3% de los niños presentaron hipertrofia de tejidos blandos, la complicación cutánea más frecuentemente reportada, y la clasificación de Holger no se consideró adecuada.Para superar las dificultades con que nos enfrentamos en la práctica clínica, se desarrolló y se presentó una nueva clasificación. (AU)

Evaluation of SARS-CoV-2 ORF7a Deletions from COVID-19-Positive Individuals and Its Impact on Virus Spread in Cell Culture.

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the COVID-19 outbreak, posed a primary concern of public health worldwide. The most common changes in SARS-CoV-2 are single nucleotide substitutions, also reported insertions and deletions. This work investigates the presence of SARS-CoV-2 ORF7a deletions identified in COVID-19-positive individuals. Sequencing of SARS-CoV-2 complete genomes showed three different ORF7a size deletions (190-nt, 339-nt and 365-nt). Deletions were confirmed through Sanger sequencing. The ORF7a∆190 was detected in a group of five relatives with mild symptoms of COVID-19, and the ORF7a∆339 and ORF7a∆365 in a couple of co-workers. These deletions did not affect subgenomic RNAs (sgRNA) production downstream of ORF7a. Still, fragments associated with sgRNA of genes upstream of ORF7a showed a decrease in size when corresponding to samples with deletions. In silico analysis suggests that the deletions impair protein proper function; however, isolated viruses with partial deletion of ORF7a can replicate in culture cells similarly to wild-type viruses at 24 hpi, but with less infectious particles after 48 hpi. These findings on deleted ORF7a accessory protein gene, contribute to understanding SARS-CoV-2 phenotypes such as replication, immune evasion and evolutionary fitness as well insights into the role of SARS-CoV-2_ORF7a in the mechanism of virus-host interactions.

Intrinsic Defects and Their Role in the Phase Transition of Na-Ion Anode Na2Ti3O7.

The development of high-power anode materials for Na-ion batteries is one of the primary obstacles due to the growing demands for their use in the smart grid. Despite the appealingly low cost and non-toxicity, Na2Ti3O7 suffers from low electrical conductivity and poor structural stability, which restricts its use in high-power applications. Viable approaches for overcoming these drawbacks reported to date are aliovalent doping and hydrogenation/hydrothermal treatments, both of which are closely intertwined with native defects. There is still a lack of knowledge, however, of the intrinsic defect chemistry of Na2Ti3O7, which impairs the rational design of high-power titanate anodes. Here, we report hybrid density functional theory calculations of the native defect chemistry of Na2Ti3O7. The defect calculations show that the insulating properties of Na2Ti3O7 arise from the Na and O Schottky disorder that act as major charge compensators. Under high-temperature hydrogenation treatment, these Schottky pairs of Na and O vacancies become dominant defects in Na2Ti3O7, triggering the spontaneous partial phase transition to Na2Ti6O13 and improving the electrical conductivity of the composite anode. Our findings provide an explanation on the interplay between intrinsic defects, structural phase transitions, and electrical conductivity, which can aid understanding of the properties of composite materials obtained from phase transitions.

Systematic Review of the Clinical and Experimental Research Assessing the Effects of Craniosynostosis on the Brain.

Although neurocognitive impairment has been considered as the main argument for the surgical treatment of craniosynostosis (CS), recent studies reported subtle deficits in neurological function even in operated patients. However, the cause of these deficits remains poorly understood. This systematic review sought to examine the impact of CS on the brain microstructure, mainly on functional connectivity, and comprehensively summarize the clinical and experimental research available on this topic. A systematic review was performed considering the publications of the last 20 years in PubMed and Web of Science, including relevant human and animal studies of the types of brain-microstructure disturbances in CS. Among the 560 papers identified, 11 were selected for analysis. Seven of those were conducted in humans and 4 in animal models. Resting-state functional magnetic resonance imaging, task-based magnetic resonance imaging, and diffusion tensor imaging were the main instruments used to investigate brain connectivity in humans. The main findings were increased connectivity of the posterior segment of cingulum gyri, reduced interconnectivity of the frontal lobes, and reduced diffusivity on diffusion tensor imaging, which were associated with hyperactivity behaviors and poorer performance on neurocognitive tests. Conversely, despite the lack of evidence of brain dysfunction in animal studies, they reported a tendency toward the development of hyperactive behaviors and impairment of neurocognitive function. Skull restriction caused by CS apparently chronically increases the intracranial pressure and produces white matter injuries. The current evidence supports the contention that an early surgical approach could minimize brain-connectivity impairment in this context.

Role of mastoid pneumatization in predicting tympanoplasty results: Will it have the same importance in different age groups?

INTRODUCTION: There are several factors that seem to affect the surgical success rate of tympanoplasty, one of them being the pneumatization of the contralateral mastoid. In the current literature, several studies have been published with classification proposals for temporal bone pneumatization pattern. This study aims to evaluate the role of mastoid air cell extension in relation to the sigmoid sinus in predicting the surgical success of tympanoplasty. MATERIAL AND METHODS: This case-control study was performed on patients diagnosed with chronic otitis media (COM) who underwent type I tympanoplasty. The study group did not close the tympanic membrane, or there was a retraction or lateralization of the graft. The control group consisted of patients with surgical success. RESULTS: No statistically significant difference was found between groups regrading age, gender, perforation side/type, previous nasal surgery, and the presence of chronic otitis media in contralateral ear. A statistically significant difference was found when groups were compared in relation to the degree of pneumatization of the contralateral ear (p = 0.046), and this relationship does not seem to be influenced by age. CONCLUSION: To predict surgical success in terms of tympanic membrane closure in tympanoplasty, classification of contralateral ear pneumatization degree using the sigmoid sinus as a reference seems to be a valid and easy to apply method, and makes it possible to restrict the evaluation of pneumatization to the mastoid, a cell complex that does not seem to change with age.

Aplicação da ferramenta de gestão na padronização e processamento de material ventilatório no Centro de Material e Esterilização / Implementation of a management tool to standardize and process ventilation devices in the Sterile Processing Department

Objetivo: Relatar a experiência da aplicação da ferramenta de gestão 5W2H para a padronização e processamento de material ventilatório no Centro de Material e Esterilização (CME) de um hospital de referência. Método: Trata-se de um relato de experiência com uma equipe de enfermagem atuante no CME em um hospital referência em cirurgia de alta complexidade e aplicação da ferramenta de gestão 5W2H para a padronização e processa-mento de material ventilatório. Resultados: Foram aplicadas quatro etapas: implementação da ferramenta de gestão e do quiz, capacitação da equipe de enfermagem, realização da padronização do material ventilatório e formulação do catálogo do material ventilatório. A ferramenta 5W2H favoreceu o pla-nejamento do processo de trabalho desenvolvido no CME e a identificação das fragilidades da equipe de enfermagem durante o processamento dos itens do material ventilatório. Conclusão: O uso da ferramenta de gestão para o detalhamento do problema associado à capacitação da equipe de enfermagem e à padronização do material ventilatório possibilitou reduzir os problemas relacionados à montagem incorreta e ao extravio dos materiais ventilatórios

Objective: To report the experience of implementing the 5W2H management tool to standardize and process ventilation devices in the Sterile Processing Department (SPD) of a referral hospital. Method: This is an experience report of a nursing team working in the SPD of a referral hospital for high-complexity surgery on the implementation of the 5W2H management tool to standardize and process ventilation devices. Results: The pro-cess consisted of four steps: implementing the management tool and administering the questionnaire, training the nursing team, standardizing the ven-tilation devices, and producing a catalog for the ventilation devices. The 5W2H tool helped plan the work process developed in the SPD and identify the nursing team's weaknesses during the processing of items from the ventilation devices. Conclusion: Using the management tool to detail problems associated with the nursing team training and with the standardization of ventilation devices allowed reducing issues related to incorrect assembly and loss of ventilation devices

Objetivo: Relatar la experiencia de la aplicación de la herramienta de gestión 5W2H para la estandarización y procesamiento de material ven-tilatorio en el Centro de Material y Esterilización (CME) de un hospital de referencia. Método: Se trata de un relato de experiencia con un equipo de enfermería actuante en el CME en un hospital referencia en cirugía de alta complejidad y aplicación de la herramienta de gestión 5W2H para la estanda-rización y procesamiento de material ventilatorio. Resultados: Fueron aplicadas cuatro etapas: implementación de la herramienta de Gestión y del quiz, capacitación del equipo de enfermería, realización de la estandarización del material ventilatorio y formulación del catálogo del material ventilatorio. La herramienta 5W2H favoreció la planificación del proceso de trabajo desarrollado en el CME y la identificación de las fragilidades del equipo de enfer-mería durante el procesamiento de los ítems del material ventilatorio. Conclusión: El uso de la herramienta de gestión para el detalle del problema aso-ciado a la capacitación del equipo de enfermería y a la estandarización del material ventilatorio posibilitó reducir los problemas relacionados al montaje incorrecto y al extravío de los materiales ventilatorios

Biomarcadores laboratoriais na covid-19 como norteadores para plano de cuidados de enfermagem: estudo de revisão / Biomarcadores de laboratorio en covid-19 como pautas para elaborar un plan de atención de enfermería: estudio de revisión / Laboratory biomarkers in covid-19 as guidelines for a nursing care plan: a review study

Objetivos: pesquisar, na literatura, o perfil laboratorial dos pacientes acometidos gravemente pela COVID-19, bem como organizar um plano de cuidados de enfermagem de acordo com as alterações de biomarcadores elencados nessa revisão. Método: revisão integrativa realizada nas bases de dados MEDLINE e PubMed. Incluíram-se artigos envolvendo pacientes adultos e hospitalizados. Excluíram-se aqueles que não responderam à questão norteadora, estudos genéticos ou imunológicos, estudos repetidos e artigos de opinião. Posteriormente, foram elencados diagnósticos e intervenções de enfermagem para alterações laboratoriais encontradas. Resultados: revisados 25 artigos, que mostraram alterações laboratoriais em biomarcadores inflamatórios, de coagulação, bioquímicos e hematológicos capazes de interferir na funcionalidade do organismo, podendo acarretar complicações clínicas, como sangramentos, edemas e tromboembolismos, tornando fundamental a elaboração de plano de cuidados pelo Enfermeiro. Considerações finais: biomarcadores laboratoriais são importantes para identificação de pacientes com risco de gravidade e mortalidade, contribuindo para definição de diagnósticos e condutas de enfermagem em terapia intensiva.

Objetivos: recurrir a la literatura para investigar el perfil de laboratorio de pacientes afectados gravemente por COVID-19, al igual que organizar un plan de atención de Enfermería de acuerdo con las alteraciones de biomarcadores indicadas en esta revisión. Método: revisión integradora realizada en las bases de datos MEDLINE y PubMed. Se incluyeron artículos cuyos participantes fueron pacientes adultos y hospitalizados. Se excluyeron aquellos materiales que no respondiesen a la pregunta guía, al igual que estudios genéticos o inmunológicos, estudios repetidos y artículos de opinión. Posteriormente, se generó una lista de diagnósticos e intervenciones de Enfermería para las alteraciones de los parámetros de laboratorios encontradas. Resultados: se revisó un total de 25 artículos que evidenciaron alteraciones en valores de laboratorio en términos de biomarcadores inflamatorios, de coagulación, bioquímicos y hematológicos capaces de interferir en la funcionalidad del organismo, con la posibilidad de derivar en complicaciones clínicas, como ser hemorragias, edemas y tromboembolias, volviendo así fundamental la elaboración de un plan de atención de Enfermería. Consideraciones finales: los biomarcadores de laboratorio son importantes para identificar pacientes con riesgo de cuadros de enfermedad graves u mortalidad, contribuyendo de esta manera a definir diagnósticos y acciones de Enfermería en cuidados intensivos.

Objective: to research, in the literature, the laboratory profile of patients severely affected by COVID-19, as well as to organize a Nursing care plan according to the changes in biomarkers listed in this review. Method: an integrative review carried out in the MEDLINE and PubMed databases. Articles involving adult and hospitalized patients were included. Those that did not answer the guiding question were excluded, as well as genetic or immunological studies, repeated studies and opinion articles. Subsequently, Nursing diagnoses and interventions were listed for the laboratory alterations found. Results: a total of 25 articles were reviewed, which showed laboratory changes in inflammatory, coagulation, biochemical and hematological biomarkers capable of interfering with functionality of the body and which may lead to clinical complications such as bleeding, edema and thromboembolism, making it essential for Nurses to prepare a care plan. Final considerations: laboratory biomarkers are important for identifying patients at risk of severity and mortality, contributing to defining Nursing diagnoses and course of action in intensive care.