Patient perspectives on topical minoxidil for hair loss: a survey-based study from the University of Michigan Alopecia Clinic.

Topical minoxidil is a widely used therapy for alopecia. Its availability over the counter in the United States makes it easily accessible. Various factors impact whether an individual decides to pursue treatment and/or continue long-term use. Our study aimed to investigate patient awareness, opinions, and hesitations regarding topical minoxidil use for hair loss treatment. The study also aimed to identify information sources influencing these viewpoints. A survey was administered to new patients seeking evaluation for alopecia aged 18 and above at the University of Michigan Alopecia Clinic. Data collection occurred between August 2022 and August 2023. Demographics, patient-reported hair loss diagnosis, history of minoxidil use, opinions on minoxidil, influential information sources, and concerns about minoxidil were collected. A total of 47 surveys were completed, primarily by females (78.7%) ages 18-40 years (44.7%). Respondents were aware of minoxidil (97.9%), with 63.8% reporting they had heard of minoxidil, but had not used it. Medical professionals were the most influential information source (34%), followed by close contacts (17%), internet searches (10.6%), and television (10.6%). Overall, positive opinions on minoxidil were expressed by 51.1%, negative opinions by 31.9%, and neutral opinions by 17%. Most common concerns included the need for continuous use (46.8%), required regular application (31.9%), skepticism about hair regrowth (29.8%), and expense (25.5%). Addressing personalized concerns and tailoring communication based on hair loss type and information sources may lead to more informed decisions and improved adherence. Gauging the opinions of this population provides valuable insights, aiding dermatologists in patient education and counseling strategies.

Dose-dependent pleiotropic role of neutrophils during acetaminophen-induced liver injury in male and female mice.

Acetaminophen (APAP) overdose is the leading cause of acute liver failure in western countries. APAP can cause extensive hepatocellular necrosis, which triggers an inflammatory response involving neutrophil and monocyte recruitment. Particularly the role of neutrophils in the injury mechanism of APAP hepatotoxicity has been highly controversial. Thus, the objective of the current study was to assess whether a potential contribution of neutrophils was dependent on the APAP dose and the sex of the animals. Male and female C57BL/6 J mice were treated with 300 or 600 mg/kg APAP and the injury and inflammatory cell recruitment was evaluated between 6 and 48 h. In both male and female mice, ALT plasma levels and the areas of necrosis peaked at 12-24 h after both doses with more severe injury at the higher dose. In addition, Ly6g-positive neutrophils started to accumulate in the liver at 6 h and peaked at 6-12 h after 300 mg/kg and 12-24 h after 600 mg/kg for both sexes; however, the absolute numbers of hepatic neutrophils in the liver were significantly higher after the 600 mg/kg dose. Neutrophil infiltration correlated with mRNA levels of the neutrophil chemoattractant Cxcl2 in the liver. Treating mice with an anti-Cxcl2 antibody at 2 h after APAP significantly reduced neutrophil accumulation at 24 h after both doses and in both sexes. However, the injury was significantly reduced only after the high overdose. Thus, neutrophils, recruited through Cxcl2, have no effect on APAP-induced liver injury after 300 mg/kg but aggravate the injury only after severe overdoses.

Perforating Calcinosis Cutis as a Complication of Intraosseous Fluid Infusion in the Setting of a Near-Drowning Event.

Iatrogenic calcinosis cutis represents a subset of calcinosis cutis resulting secondary to treatments or procedures. We present the first report of calcinosis cutis resulting from the intraosseous infusion and one of a few cases with associated transepidermal elimination. A previously healthy 2-year-old female presented with a new-onset unilateral shin rash 1 week following hospitalization for a near-drowning event. A dermatologic exam revealed multiple small, tender, firm, chalky-white papules with surrounding erythema, in addition to two erythematous macules superior and medial to the papular lesions, corresponding to prior intraosseous access sites. The rash persisted despite trials of topical mupirocin and acyclovir cream, prompting a referral to a dermatologist. An excisional biopsy was performed, revealing circumscribed dermal deposits of acellular basophilic material connected to the overlying epidermis through an invaginated keratin plug. A von Kossa silver stain highlighted the deposits, confirming the diagnosis of perforating calcinosis cutis. The lesions did not recur following the excisional biopsy. Iatrogenic calcinosis cutis may be seen as a complication of the infusion of calcium-containing fluids via intraosseous access, in addition to the more commonly observed peripheral intravenous access. Awareness of this disorder is important in order to distinguish it from an infectious mimic and guide the selection of therapy.

A non-human primate model of acute liver failure suitable for testing liver support systems.

Acute hepatic failure is associated with high morbidity and mortality for which the only definitive therapy is liver transplantation. Some fraction of those who undergo emergency transplantation have been shown to recover native liver function when transplanted with an auxiliary hepatic graft that leaves part of the native liver intact. Thus, transplantation could have been averted with the development and use of some form of hepatic support. The costs of developing and testing liver support systems could be dramatically reduced by the availability of a reliable large animal model of hepatic failure with a large therapeutic window that allows the assessment of efficacy and timing of intervention. Non-lethal forms of hepatic injury were examined in combination with liver-directed radiation in non-human primates (NHPs) to develop a model of acute hepatic failure that mimics the human condition. Porcine hepatocyte transplantation was then tested as a potential therapy for acute hepatic failure. After liver-directed radiation therapy, delivery of a non-lethal hepatic ischemia-reperfusion injury reliably and rapidly generated liver failure providing conditions that can enable pre-clinical testing of liver support or replacement therapies. Unfortunately, in preliminary studies, low hepatocyte engraftment and over-immune suppression interfered with the ability to assess the efficacy of transplanted porcine hepatocytes in the model. A model of acute liver failure in NHPs was created that recapitulates the pathophysiology and pathology of the clinical condition, does so with reasonably predictable kinetics, and results in 100% mortality. The model allowed preliminary testing of xenogeneic hepatocyte transplantation as a potential therapy.

Recovered Hepatocytes Promote Macrophage Apoptosis Through CXCR4 After Acetaminophen-Induced Liver Injury in Mice.

Acetaminophen (APAP) overdose is the main cause of acute liver failure in Western countries. The mechanism of APAP hepatotoxicity is associated with centrilobular necrosis which initiates infiltration of neutrophils, monocytes, and other leukocytes to the area of necrosis. Although it has been recognized that this infiltration of immune cells plays a critical role in promoting liver repair, mechanism of immune cell clearance that is important for resolution of inflammation and the return to normal homeostasis are not well characterized. CXCR4 is a chemokine receptor expressed on hepatocytes as well as neutrophils, monocytes, and hematopoietic stem cells. CXCR4 function is dependent on its selective expression on different cell types and thus can vary depending on the pathophysiology. This study aimed to investigate the crosstalk between hepatocytes and macrophages through CXCR4 to promote macrophage apoptosis after APAP overdose. C57BL/6J mice were subjected to APAP overdose (300 mg/kg). Flow cytometry and immunohistochemistry were used to determine the mode of cell death of macrophages and expression pattern of CXCR4 during the resolution phase of APAP hepatotoxicity. The impact of CXCR4 in regulation of macrophage apoptosis and liver recovery was assessed after administration of a monoclonal antibody against CXCR4. RNA sequencing analysis was performed on flow cytometry sorted CXCR4+ macrophages at 72 h to confirm the apoptotic cell death of macrophages. Our data indicate that the inflammatory response is resolved by recovering hepatocytes through induction of CXCR4 on macrophages, which triggers their cell death by apoptosis at the end of the recovery phase.

Activation of the adenosine A2B receptor even beyond the therapeutic window of N-acetylcysteine accelerates liver recovery after an acetaminophen overdose.

Acetaminophen (APAP) overdose is the most common cause of acute liver failure in the USA. The short therapeutic window of the current antidote, N-acetylcysteine (NAC) highlights the need for novel late acting therapeutics. The neuronal guidance cue netrin-1 provides delayed protection against APAP hepatotoxicity through the adenosine A2B receptor (A2BAR). The clinical relevance of this mechanism was investigated here by administration of the A2BAR agonist BAY 60-6583, after an APAP overdose (300 or 600 mg/kg) in fasted male and female C57BL/6J mice with assessment of liver injury 6 or 24 h after APAP in comparison to NAC. BAY 60-6583 treatment 1.5 h after APAP overdose (600 mg/kg) protected against liver injury at 6 h by preserving mitochondrial function despite JNK activation and its mitochondrial translocation. Gender independent protection was sustained when BAY 60-6583 was given 6 h after APAP overdose (300 mg/kg), when NAC administration did not show benefit. This protection was accompanied by enhanced infiltration of macrophages with the reparative anti-inflammatory phenotype by 24 h, accompanied by a decrease in neutrophil infiltration. Thus, our data emphasize the remarkable therapeutic utility of using an A2BAR agonist, which provides delayed protection long after the standard of care NAC ceased to be effective.

Kupffer cells regulate liver recovery through induction of chemokine receptor CXCR2 on hepatocytes after acetaminophen overdose in mice.

Acetaminophen (APAP) is a widely used analgesic, but also a main cause of acute liver injury in the United States and many western countries. APAP hepatotoxicity is associated with a sterile inflammatory response as shown by the infiltration of neutrophils and monocytes. While the contribution of the immune cells to promote liver repair have been demonstrated, the direct interactions between macrophages or neutrophils with hepatocytes to help facilitate hepatocyte proliferation and tissue repair remain unclear. The purpose of this study was to investigate the relationship between resident macrophages (Kupffer cells) and hepatocytes with a focus on the chemokine receptor CXCR2. C57BL/6J mice were subjected to an APAP overdose (300 mg/kg) and the role of CXCR2 on hepatocytes was investigated using a selective antagonist, SB225002. In addition, clodronate liposomes were used to deplete Kupffer cells to assess changes in CXCR2 expression. Our data showed that CXCR2 was mainly expressed on hepatocytes and it was induced specifically in hepatocytes around the necrotic area 24 h after APAP treatment. Targeting this receptor using an inhibitor caused a delayed liver recovery. Depletion of Kupffer cells significantly prevented CXCR2 induction on hepatocytes. In vitro and in vivo experiments also demonstrated that Kupffer cells regulate CXCR2 expression and pro-regenerative gene expression in surviving hepatocytes through production of IL-10. Thus, Kupffer cells support the transition of hepatocytes around the area of necrosis to a proliferative state through CXCR2 expression.

In Vivo Antitumor Effect against Murine Cells of CT26 Colon Cancer and EL4 Lymphoma by Autologous Whole Tumor Dead Cells.

Active immunotherapy against cancer is based on immune system stimulation, triggering efficient and long-lasting antigen-specific immune responses. Immunization strategies using whole dead cells from tumor tissue, containing specific antigens inside, have become a promising approach, providing efficient lymphocyte activation through dendritic cells (DCs). In this work, we generate whole dead tumor cells from CT26, E.G7, and EL4 live tumor cells as antigen sources, which termed immunogenic cell bodies (ICBs), generated by a simple and cost-efficient starvation-protocol, in order to determine whether are capable of inducing a transversal anticancer response regardless of the tumor type, in a similar way to what we describe previously with B16 melanoma. We evaluated the anticancer effects of immunization with doses of ICBs in syngeneic murine tumor models. Our results showed that mice's immunization with ICBs-E.G7 and ICBs-CT26 generate 18% and 25% of tumor-free animals, respectively. On the other hand, all carrying tumor-animals and immunized with ICBs, including ICBs-EL4, showed a significant delay in their growth compared to not immunized animals. These effects relate to DCs maturation, cytokine production, increase in CD4+T-bet+ and CD4+ROR-γt+ population, and decrease of T regulatory lymphocytes in the spleen. Altogether, our data suggest that whole dead tumor cell-based cancer immunotherapy generated by a simple starvation protocol is a promising way to develop complementary, innovative, and affordable antitumor therapies in a broad spectrum of tumors.

Recommendations for the use of the acetaminophen hepatotoxicity model for mechanistic studies and how to avoid common pitfalls.

Acetaminophen (APAP) is a widely used analgesic and antipyretic drug, which is safe at therapeutic doses but can cause severe liver injury and even liver failure after overdoses. The mouse model of APAP hepatotoxicity recapitulates closely the human pathophysiology. As a result, this clinically relevant model is frequently used to study mechanisms of drug-induced liver injury and even more so to test potential therapeutic interventions. However, the complexity of the model requires a thorough understanding of the pathophysiology to obtain valid results and mechanistic information that is translatable to the clinic. However, many studies using this model are flawed, which jeopardizes the scientific and clinical relevance. The purpose of this review is to provide a framework of the model where mechanistically sound and clinically relevant data can be obtained. The discussion provides insight into the injury mechanisms and how to study it including the critical roles of drug metabolism, mitochondrial dysfunction, necrotic cell death, autophagy and the sterile inflammatory response. In addition, the most frequently made mistakes when using this model are discussed. Thus, considering these recommendations when studying APAP hepatotoxicity will facilitate the discovery of more clinically relevant interventions.

Bridging bronchus (pseudocarina) and left pulmonary artery sling: A case report and literature review.

Congenital airway malformations can present with respiratory distress, cyanosis, and difficulty feeding in the neonate or infant. Clinical presentation may vary from asymptomatic to fatal airway obstruction. They may exist in isolation or in association with vascular rings and slings, bronchopulmonary malformations, and/or syndromes. We present an unusual case of bridging bronchus, complete bronchial rings, and left pulmonary artery sling presenting with recurrent croup, highlighting the importance of bronchoscopy and CT imaging to achieve an accurate diagnosis in patients with recurrent croup and/or respiratory failure not responding to usual treatment measures and a multidisciplinary treatment approach.

Chitosan-Based Nanoparticles for Intracellular Delivery of ISAV Fusion Protein cDNA into Melanoma Cells: A Path to Develop Oncolytic Anticancer Therapies.

Oncolytic virus therapy has been tested against cancer in preclinical models and clinical assays. Current evidence shows that viruses induce cytopathic effects associated with fusogenic protein-mediated syncytium formation and immunogenic cell death of eukaryotic cells. We have previously demonstrated that tumor cell bodies generated from cells expressing the fusogenic protein of the infectious salmon anemia virus (ISAV-F) enhance crosspriming and display prophylactic antitumor activity against melanoma tumors. In this work, we evaluated the effects of the expression of ISAV-F on the B16 melanoma model, both in vitro and in vivo, using chitosan nanoparticles as transfection vehicle. We confirmed that the transfection of B16 tumor cells with chitosan nanoparticles (NP-ISAV) allows the expression of a fusogenically active ISAV-F protein and decreases cell viability because of syncytium formation in vitro. However, the in vivo transfection induces a delay in tumor growth, without inducing changes on the lymphoid populations in the tumor and the spleen. Altogether, our observations show that expression of ISAV fusion protein using chitosan nanoparticles induces cell fusion in melanoma cells and slight antitumor response.

Lithraea caustic (Litre) Extract Promotes an Antitumor Response Against B16 Melanoma.

Melanoma immunotherapy, specifically the autotransplant of dendritic cells charged with tumors antigens, has shown promising results in clinical trials. The positive clinical effects of this therapy have been associated to increased Th17 response and delayed-type hypersensitivity (DTH) against to tumor antigens. Some synthetic compounds, such as diphenylcyclopropenone (DPCP), are capable of triggering a DTH response in cutaneous malignancies and also to induce clinically relevant effects against melanoma. In this work, we evaluated Litre extract (LExT), a standardized extract of a Chilean stinging plant, Lithraea caustic (Litre). As Litre plant is known to induce DTH, we used a murine B16 melanoma model to compare the topical and intratumor efficacy of LExT with synthetic DTH inducers (DPCP and 2,4-dinitrochlorobenzene [DNCB]). LExt contained mainly long chain catechols and sesquiterpenes. The intratumor injection of LExT induced a significant delay in tumor growth, similarly topical treatment of an established tumor with 0.1% LExT ointment induced a growth delay and even tumor regression in 15% of treated animals. No significant changes were observed on the T-cell populations associated to LExT treatment, and neither DNCB nor DPCP were capable to induce none of the LExT-induced antitumoral effects. Interestingly, our results indicate that LExT induces an antitumor response against melanoma in a mouse model and could bring a new -and affordable- treatment for melanoma in humans.

Auranofin Protects Intestine against Radiation Injury by Modulating p53/p21 Pathway and Radiosensitizes Human Colon Tumor.

PURPOSE: The radiosensitivity of the normal intestinal epithelium is the major limiting factor for definitive radiotherapy against abdominal malignancies. Radiosensitizers, which can be used without augmenting radiation toxicity to normal tissue, are still an unmet need. Inhibition of proteosomal degradation is being developed as a major therapeutic strategy for anticancer therapy as cancer cells are more susceptible to proteasomal inhibition-induced cytotoxicity compared with normal cells. Auranofin, a gold-containing antirheumatoid drug, blocks proteosomal degradation by inhibiting deubiquitinase inhibitors. In this study, we have examined whether auranofin selectively radiosensitizes colon tumors without promoting radiation toxicity in normal intestine. EXPERIMENTAL DESIGN: The effect of auranofin (10 mg/kg i.p.) on the radiation response of subcutaneous CT26 colon tumors and the normal gastrointestinal epithelium was determined using a mouse model of abdominal radiation. The effect of auranofin was also examined in a paired human colonic organoid system using malignant and nonmalignant tissues from the same patient. RESULTS: Both in the mouse model of intestinal injury and in the human nonmalignant colon organoid culture, auranofin pretreatment prevented radiation toxicity and improved survival with the activation of p53/p21-mediated reversible cell-cycle arrest. However, in a mouse model of abdominal tumor and in human malignant colonic organoids, auranofin inhibited malignant tissue growth with inhibition of proteosomal degradation, induction of endoplasmic reticulum stress/unfolded protein response, and apoptosis. CONCLUSIONS: Our data suggest that auranofin is a potential candidate to be considered as a combination therapy with radiation to improve therapeutic efficacy against abdominal malignancies.

Depression, fatigue, and health-related quality of life in head and neck cancer patients: a prospective pilot study.

PURPOSE: To assess the prevalence of depression and fatigue symptoms in head and neck cancer patients during radiotherapy treatment and relate them symptoms with these patients' quality of life. METHOD: This is a prospective study. The Beck Depression Inventory (BDI), Piper Fatigue Scale-revised and Functional Assessment Cancer Therapy Head and Neck (FACT-H&N) were applied to 41 head and neck cancer patients at three times: at the start of treatment (T1), approximately 15 days after the start of treatment (T2) and at the end of treatment (T3), approximately 30 days after the start of the radiotherapy. RESULTS: The mean BDI and PIPER increased during the radiotherapy treatment. BDI scores did not demonstrate the presence of depression, although the number of symptoms increased, and the presence of fatigue rose as treatment advanced. The mean FACT H&N decreased in the middle and at the end of treatment, indicating worsening in these patients' Quality of Life. CONCLUSIONS: Depression and fatigue symptoms increased during radiotherapy treatment, while QoL levels decreased. This demonstrates that these symptoms are strongly correlated and that their presence negatively influenced QoL. At the start of treatment, nurses need to advise patients and plan care, offering interventions to decrease these symptoms and improve QoL.

[Relationship between spirituality and cancer: patient's perspective]. / Relação entre espiritualidade e câncer: perspectiva do paciente.

OBJECTIVE: to understand the relationship between spirituality and cancer under cancer patients' perspective. METHOD: qualitative study, with the participating of fourteen cancer patients under chemotherapy treatment and analyzed according to inductive thematic content analysis. RESULTS: reports were organized into three categories: cancer diagnosis, faith for coping to the cancer, the search for cancer cure. It was understood that cancer patients search spirituality as a way to cope with the disease, aiming to minimize their suffering or obtaining a higher hope of cure with treatment. FINAL CONSIDERATION: the central theme "cancer frightens and spirituality renews" shows the importance of recognizing spirituality as a coping strategy in planning care to cancer patients.

Relação entre espiritualidade e câncer: perspectiva do paciente / Relationship between spirituality and cancer: patient's perspective / Relación entre espiritualidad y cáncer: perspetiva del paciente

OBJETIVO: compreender a relação entre espiritualidade e o câncer na perspectiva de pacientes oncológicos. MÉTODO: estudo qualitativo com participação de quatorze pacientes com câncer em tratamento quimioterápico e analisado segundo a análise de conteúdo temática indutiva. RESULTADOS: os relatos foram organizados em três categorias: a descoberta do câncer, a fé como enfrentamento ao câncer, a busca pela cura do câncer. Compreendeu-se que o paciente oncológico busca a espiritualidade como forma de enfrentamento da doença, com a finalidade de minimizar o sofrimento ou obter maior esperança de cura com o tratamento. CONSIDERAÇÃO FINAL: o tema central "o câncer amedronta e a espiritualidade renova" demonstra a importância do reconhecimento da espiritualidade como estratégia de enfrentamento no planejamento da assistência ao paciente oncológico.

OBJECTIVE: to understand the relationship between spirituality and cancer under cancer patients' perspective. METHOD: qualitative study, with the participating of fourteen cancer patients under chemotherapy treatment and analyzed according to inductive thematic content analysis. RESULTS: reports were organized into three categories: cancer diagnosis, faith for coping to the cancer, the search for cancer cure. It was understood that cancer patients search spirituality as a way to cope with the disease, aiming to minimize their suffering or obtaining a higher hope of cure with treatment. FINAL CONSIDERATION: the central theme "cancer frightens and spirituality renews" shows the importance of recognizing spirituality as a coping strategy in planning care to cancer patients.

OBJETIVO: comprender la relación entre espiritualidad y cáncer en la perspectiva de pacientes oncológicos. MÉTODO: estudio cualitativo realizado con catorce pacientes con cáncer en quimioterapia y analizado según el análisis de contenido temático inductivo. RESULTADOS: los relatos fueron organizados en tres categorías: el descubrimiento del cáncer, la fe como enfrentamiento del cáncer, la búsqueda por la cura del cáncer. Se comprendió que el paciente oncológico busca la espiritualidad como forma de enfrentar la enfermedad, para minimizar el sufrimiento u obtener mayor esperanza de cura con el tratamiento. CONSIDERACIÓN FINAL: el tema central "el cáncer amedrenta y la espiritualidad renueva" demuestra la importancia de reconocer la espiritualidad como estrategia de enfrentamiento en la planificación de la atención al paciente oncológico.

Standard operating procedure: use in nursing care in hospital services / Procedimiento operacional estándar: utilización en la asistencia de enfermería en servicios hospitalarios / Procedimento operacional padrão: utilização na assistência de enfermagem em serviços hospitalares

This is a descriptive and quantitative study, carried out in three hospitals in the Northwest of São Paulo, Brazil. It aimed to verify the existence and use of Standard Operating Procedures (SOP) by nursing teams. SOPs describe each critical and sequential step of a task to ensure its expected result. A total of 261 nursing professionals participated in the study, randomly selected from different units and shifts between August and September 2006. Results indicate that 56.7 percent use SOPs only when they have doubts; 54.02 percent of the nursing technicians and auxiliaries and 62.86 percent of nurses do not believe the procedures are being complied with. These findings indicate the need for continuing training on SOP use and compliance by all professionals, with a view to improving nursing care.

Se trata de un estudio descriptivo con abordaje cuantitativa, realizado en 3 instituciones hospitalarias en el noroeste del estado de San Pablo, con los objetivos principales de verificar la existencia y la utilización, por el equipo de enfermería, de los Procedimientos Operacionales Estándar (POEs), desarrollados a fin de describir cada paso crítico y secuencial para garantizar el resultado esperado de una tarea. Participaron, de forma aleatoria, 261 profesionales de enfermería de diversas unidades de internación en los distintos turnos, entre los meses de agosto y septiembre de 2006. Se verificó que 56,7 por ciento acceden a los POE solamente cuando tienen dudas; 54,02 por ciento de los técnicos y auxiliares y 62,86 por ciento de los enfermeros no creen en el seguimiento de los POE. Esos valores llevan a reflexionar sobre la necesidad de ofrecer entrenamientos continuos en relación a la utilización y seguimiento de los POE por todos los profesionales, a fin de mejorar la asistencia de enfermería.

Trata-se de estudo descritivo com abordagem quantitativa, realizado em 3 instituições hospitalares do noroeste paulista, com os objetivos principais de verificar a existência e a utilização pela equipe de enfermagem dos Procedimentos Operacionais Padrão (POPs), desenvolvido a fim de descrever cada passo crítico e seqüencial para garantir o resultado esperado de uma tarefa. Participaram, aleatoriamente, 261 profissionais de enfermagem em diversas unidades de internação nos distintos turnos, entre os meses agosto e setembro de 2006. Verificou-se que 56,7 por cento acessam o POP somente quando têm dúvidas; 54,02 por cento dos técnicos e auxiliares e 62,86 por cento dos enfermeiros não acreditam no seguimento do POP. Esses valores levam à reflexão sobre a necessidade de treinamentos contínuos em relação à utilização e seguimento do POP por todos os profissionais, a fim de melhorar a assistência de enfermagem.

Standard Operating Procedure: use in nursing care in hospital services.

This is a descriptive and quantitative study, carried out in three hospitals in the Northwest of São Paulo, Brazil. It aimed to verify the existence and use of Standard Operating Procedures (SOP) by nursing teams. SOPs describe each critical and sequential step of a task to ensure its expected result. A total of 261 nursing professionals participated in the study, randomly selected from different units and shifts between August and September 2006. Results indicate that 56.7% use SOPs only when they have doubts; 54.02% of the nursing technicians and auxiliaries and 62.86% of nurses do not believe the procedures are being complied with. These findings indicate the need for continuing training on SOP use and compliance by all professionals, with a view to improving nursing care.

Elementos básicos de salud infantil en mujeres cuidadoras de niños / Basic elements of child health in women taking care of children

Se realizó estudio descriptivo prospectivo en mujeres cuidadoras de niños en el área de salud de Cabezas, provincia Matanzas, en el período octubre 2002 - marzo 2003, con el objetivo de valorar aspectos vinculados a la cultura sanitaria en relación con la salud infantil. Se aplicó una encuesta para evaluar el cuidado de la enfermedad diarreica aguda, la enfermedad respiratoria aguda, la conducta ante cuadros febriles, uso de antibióticos y otros temas. Se apreció que sólo el 30,86 por ciento de las cuidadoras obtuvo una valoración adecuada respecto al tratamiento de estas afecciones y problemas. En la atención a la enfermedad diarreica aguda y la enfermedad respiratoria aguda se encontró un mayor nivel de conocimientos con respecto a los otros temas. La identificación de síntomas y signos de alarma ante la fiebre, la aplicación de medidas higiénicas para la prevención de la sepsis urinaria en las hembras, la ingestión de agua hervida y la atención adecuada de la fiebre, fueron las temáticas con menor dominio