Knowledge of and adherence to standard precautions in a hemodialysis unit: a cross-sectional study.

BACKGROUND: Standard precautions (SPs) are recommended safety measures for healthcare professionals to follow, with a view to preventing healthcare-related infections (HCRIs) and for their own protection. Inadequate adherence to these measures can lead to occurrences of occupational accidents and HCRIs. OBJECTIVES: To ascertain the knowledge of and adherence to SP measures among the nursing staff of a hemodialysis service and the relationship of these variables to occurrences of work accidents with biological material. DESIGN AND SETTING: Descriptive cross-sectional and correlational study with a quantitative approach developed in a hemodialysis clinic in Minas Gerais. METHODS: Data were collected through sociodemographic questionnaires and questionnaires on knowledge of and adherence to SPs. RESULTS: 29 professionals participated in the study. It is noteworthy that all of them had already participated in training related to SPs. However, no relationship was identified between knowledge of (15.17 points) and adherence to (71.86 points) SPs. In addition, inferential analysis showed that there was a relationship between suffering a work accident with biological material and the sociodemographic data and knowledge of and adherence to standard precautions. CONCLUSION: Knowledge of the SPs that had been established did not mean mastery of the subject. Despite positive results regarding adherence, factors requiring improvement were observed. It was possible to infer the characteristics that gave rise to greater risk of occurrences of accidents at work. Thus, this study showed the importance of assessing knowledge of and adherence to SP, in order to optimize and direct continuing education towards resolving occupational exposure.

Knowledge of and adherence to standard precautions in a hemodialysis unit: a cross-sectional study

Abstract BACKGROUND: Standard precautions (SPs) are recommended safety measures for healthcare professionals to follow, with a view to preventing healthcare-related infections (HCRIs) and for their own protection. Inadequate adherence to these measures can lead to occurrences of occupational accidents and HCRIs. OBJECTIVES: To ascertain the knowledge of and adherence to SP measures among the nursing staff of a hemodialysis service and the relationship of these variables to occurrences of work accidents with biological material. DESIGN AND SETTING: Descriptive cross-sectional and correlational study with a quantitative approach developed in a hemodialysis clinic in Minas Gerais. METHODS: Data were collected through sociodemographic questionnaires and questionnaires on knowledge of and adherence to SPs. RESULTS: 29 professionals participated in the study. It is noteworthy that all of them had already participated in training related to SPs. However, no relationship was identified between knowledge of (15.17 points) and adherence to (71.86 points) SPs. In addition, inferential analysis showed that there was a relationship between suffering a work accident with biological material and the sociodemographic data and knowledge of and adherence to standard precautions. CONCLUSION: Knowledge of the SPs that had been established did not mean mastery of the subject. Despite positive results regarding adherence, factors requiring improvement were observed. It was possible to infer the characteristics that gave rise to greater risk of occurrences of accidents at work. Thus, this study showed the importance of assessing knowledge of and adherence to SP, in order to optimize and direct continuing education towards resolving occupational exposure.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis.

Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis

Abstract Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Testosterone and Mast Cell Interactions in the Development of Kidney Fibrosis after Unilateral Ureteral Obstruction in Rats.

Mast cell and testosterone interactions involved in renal fibrosis in rats subjected to unilateral ureteral obstruction (UUO) were investigated. Orchiectomized (ORX) and nonorchiectomized Wistar rats were subjected to UUO, and a nonorchiectomized group was sham-operated (control: SO). Animals from the UUO group were treated with saline or sodium cromoglycate (CG). Some ORX rats from the saline or CG groups also received testosterone propionate replacement (TR). Kidneys and blood were collected 14 d after UUO or SO. Kidney sections were stained with toluidine blue to quantify mast cells, and picrosirius red was used for collagen analysis. Immunohistochemistry for α-smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) expression was also performed. Plasma testosterone levels (PTLs) were measured. ORX decreased and TR normalized PTLs. UUO increased mast cell density in the kidney pelvis, but not in the kidney parenchyma. UUO increased mast cell degranulation, and CG or ORX inhibited this effect. TR partially reversed the effect of ORX on mast cell degranulation, and CG partially inhibited that effect of TR. UUO increased the collagen areas of the renal parenchyma, whereas CG or ORX abolished that alteration; TR reversed the effects of ORX, and CG partially inhibited that effect of TR. UUO increased tubulointerstitial α-SMA expression and PCNA-positive cells, and these changes were sensitive to ORX or CG to the same degree, while TR again reversed the effect of ORX. Renal fibrosis after UUO appears to be determined by interactions between testosterone and mast cells.

Influence of hyperbaric oxygen on biomechanics and structural bone matrix in type 1 diabetes mellitus rats.

BACKGROUND: The aim of this study was to evaluate the biomechanics and structural bone matrix in diabetic rats subjected to hyperbaric oxygen therapy (HBO). METHODS: Twenty-four male rats were divided into the following groups: Control; Control + HBO; Diabetic, and Diabetic + HBO. Diabetes was induced with streptozotocin (STZ) in the diabetic Groups. After 30 days, HBO was performed every 48h in HBO groups and all animals were euthanized 60 days after diabetic induction. The femur was submitted to a biomechanical (maximum strength, energy-to-failure and stiffness) and Attenuated Total Reflectance Fourier transform infrared (ATR-FTIR) analyses (crosslink ratio, crystallinity index, matrix-to-mineral ratio: Amide I + II/Hydroxyapatite (M:MI) and Amide III + Collagen/HA (M:MIII)). RESULTS: In biomechanical analysis, diabetic animals showed lower values of maximum strength, energy and stiffness than non-diabetic animals. However, structural strength and stiffness were increased in groups with HBO compared with non-HBO. ATR-FTIR analysis showed decreased collagen maturity in the ratio of crosslink peaks in diabetic compared with the other groups. The bone from the diabetic groups showed decreased crystallinity compared with non-diabetic groups. M:MI showed no statistical difference between groups. However, M:MIII showed an increased matrix mineral ratio in diabetic+HBO and control+HBO compared with control and diabetic groups. Correlations between mechanical and ATR-FTIR analyses showed significant positive correlation between collagen maturity and stiffness. CONCLUSIONS: Diabetes decreased collagen maturation and the mineral deposition process, thus reducing biomechanical properties. Moreover, the study showed that HBO improved crosslink maturation and increased maximum strength and stiffness in the femur of T1DM animals.

Hyperbaric Oxygen therapy effects on bone regeneration in Type 1 diabetes mellitus in rats.

PURPOSE: The aim of this study was evaluate the effect of HBO on diabetic rats. MATERIALS AND METHODS: Twenty rats were distributed into four groups (n = 5): Control (C); Control + HBO (CH); Diabetes (D) and Diabetes + HBO (DH). Diabetes was induced by streptozotocin, and bone defects were created in both femurs in all animals. HBO therapy began immediately after surgery and was performed daily in the CH and DH groups. After 7 days, the animals were euthanized. The femurs were removed, demineralized, embedded in paraffin, and histologic images were analyzed. RESULTS: Qualitative histologic analyses showed more advanced stage bone regeneration in control groups (C and CH) compared with diabetic groups (D and DH). Histomorphometric analysis showed significantly increased bone neoformation in CH compared with the other groups (p < 0.001). Diabetic Group (D) showed decreased bone neoformation compared with non-diabetic groups (C and CH) (p < 0.001); however DH did not differ from C Group (p > 0.05). The mast cell population increased in CH compared with the other groups (C, D, and DH) (p < 0.05). The mast cell population did not differ between D and DH Groups. CONCLUSIONS: This study showed that HBO therapy improved early bone regeneration in diabetic rats and increased the mast cell population only in non-diabetic animals. HBO was shown to be important treatment for minimizing deleterious effects of diabetes on bone regeneration.

Polyploidy Analysis and Attenuation of Oxidative Stress in Hepatic Tissue of STZ-Induced Diabetic Rats Treated with an Aqueous Extract of Vochysia rufa.

Diabetes mellitus (DM) is characterized by hyperglycemia and alterations in the metabolism of lipids, carbohydrates, and proteins. Due to its hypoglycemic effect Vochysia rufa is frequently used in Uberlandia, Brazil, to treat DM. Despite its popularity, there is little information about its effect on hepatic tissue. Therefore, we evaluated the histoarchitecture, oxidative stress parameters, and polyploidy of liver tissue from streptozotocin- (STZ-) induced diabetic rats treated with aqueous extract of Vochysia rufa (AEV). Histology was determined by fixing the livers, processing, and staining with HE. Oxidative stress was determined by evaluating CAT, GPx, and SOD activity in liver homogenates and hepatic mitochondria fraction and by measuring GST, GSH levels and lipid peroxidation (MDA). Polyploidy was determined by subjecting isolated hepatocyte nuclei to flow cytometry. In the diabetic group, GST activity and GSH rates decreased whereas liver homogenate analysis showed that GPx, SOD activity and MDA increased. AEV treatment restored all parameters to normal levels. The oxidative stress analysis of hepatic mitochondria fraction showed similar results. Lower polyploid cell populations were found in the diabetic rat livers, even after glibenclamide treatment. Thus, AEV treatment efficiently reduced hepatic oxidative stress caused by STZ-induced diabetes and produced no morphological changes in the histological analysis.

The gastroprotective effects of Eugenia dysenterica (Myrtaceae) leaf extract: the possible role of condensed tannins.

We applied a taxonomic approach to select the Eugenia dysenterica (Myrtaceae) leaf extract, known in Brazil as "cagaita," and evaluated its gastroprotective effect. The ability of the extract or carbenoxolone to protect the gastric mucosa from ethanol/HCl-induced lesions was evaluated in mice. The contributions of nitric oxide (NO), endogenous sulfhydryl (SH) groups and alterations in HCl production to the extract's gastroprotective effect were investigated. We also determined the antioxidant activity of the extract and the possible contribution of tannins to the cytoprotective effect. The extract and carbenoxolone protected the gastric mucosa from ethanol/HCl-induced ulcers, and the former also decreased HCl production. The blockage of SH groups but not the inhibition of NO synthesis abolished the gastroprotective action of the extract. Tannins are present in the extract, which was analyzed by matrix assisted laser desorption/ionization (MALDI); the tannins identified by fragmentation pattern (MS/MS) were condensed type-B, coupled up to eleven flavan-3-ol units and were predominantly procyanidin and prodelphinidin units. Partial removal of tannins from the extract abolished the cytoprotective actions of the extract. The extract exhibits free-radical-scavenging activity in vitro, and the extract/FeCl3 sequence stained gastric surface epithelial cells dark-gray. Therefore, E. dysenterica leaf extract has gastroprotective effects that appear to be linked to the inhibition of HCl production, the antioxidant activity and the endogenous SH-containing compounds. These pleiotropic actions appear to be dependent on the condensed tannins contained in the extract, which bind to mucins in the gastric mucosa forming a protective coating against damaging agents. Our study highlights the biopharmaceutical potential of E. dysenterica.

Osteomas cutâneos miliares múltiplos da face - relato de caso / Multiple cutaneous miliary osteomas of the face: a case report

Introdução: Osteoma cutâneo miliar múltiplo é doença rara, caracterizada por tecido ósseo ectópico na derme e/ou hipoderme. Usualmente ocorre na face, em pessoas entre 17 e 79 anos. A etiologia é ainda desconhecida. Relata-se caso de paciente do sexo feminino, apresentando placa papulosa de coloração castanho-escura, endurecida, acometendo regiões malares e mentoniana, mal delimitada, com superfície irregular, formada por lesões papulonodulares, hipercrômicas, algumas branco-amareladas, há dois anos, referindo acne, desde os 16 anos de idade, não tratada, tendo o diagnóstico sido confirmado histopatologicamente e apresentado resultado terapêutico satisfatório com uso de tretinoína creme 0,1%.

Summary: Multiple cutaneous miliary osteoma is a rare condition characterized by ectopic bone tissue in the dermis and/or hypodermis. It usually occurs on the face, in individuals of 17 to 79 years old. Its etiology is still unknown. The present article reports the case of a female patient affected by a hardened, poorly delimited, papular plaque of dark brown hue and irregular surface, affecting the malar and mentonian regions. The patient sought medical care two years before the publication of this study, describing untreated acne since the age of 16. The papular plaque was composed of hyperchromic papular nodular lesions ­ some with white-yellowish hue. The diagnosis was confirmed histopathologically. Satisfactory therapeutic results were achieved with the use of 0.1% tretinoin cream.

Chondrosarcoma of the mandible: case report and literature review.

Chondrosarcoma is a malignant cartilaginous tumor that rarely occurs in the maxillofacial bones. A 44-year-old woman complained about swelling and mild pain during mastication in the right parasymphysis region. Clinical and radiographic examinations revealed characteristics of osteosarcoma. A microscopic examination revealed an abundant proliferation of malignant neoplastic cartilage cells of varying sizes arranged as immature tissue and the absence of an osteoid matrix. This article presents a case of chondrosarcoma of the jaw and discusses the differences between osteosarcoma and chondrosarcoma.

Estudo da expressão imunoistoquímica das proteínas não-colágenas da matriz extracelular óssea e dos fatores de transcrição CBFA1 e sox9 em osteossarcomas condrossarcomas de maxila e mandíbula / Study of the immunohistochemical expression of bone extracelular matriz non-colagen proteins and transcription factores Cbfa1 and Sox9 in jawbones osteosarcoma and chondrosarcomas

Osteossarcoma e condrossarcoma de maxila e mandíbula podem apresentar aspecto histopatológico semelhaente o que dificulta o diagnóstico diferencial. O objetivo deste trabalho foi estudar a expressão imunoistoquímica das principais proteínas não-colágenas da matriz extracelular óssea, a saber osteonectina (ONC), osteopontina (OPN), sialoproteina óssea (BSP) e osteocalcina (OCC), e dos fatores de transcrição Cbfa1 e Sox9 em 42 casos de osteossarcoma e 6 de condrossarcoma...