Ethanol Lock Therapy for the Prevention of Nontunneled Catheter-Related Bloodstream Infection in Pediatric Patients.

BACKGROUND: Ethanol lock therapy (ELT) has been reported as being effective in preventing central line-associated bloodstream infection (CLABSI) in tunneled (or long-term) central venous catheters (CVCs). To the best of our knowledge, no studies have evaluated this therapy in relation to nontunneled (or short-term) CVCs. OBJECTIVE: To evaluate the effectiveness of ELT in preventing CLABSI in nontunneled CVC in pediatric patients. METHODS: This randomized clinical trial was conducted with children aged 0-5 years and >2 kg in weight, in whom a double-lumen polyurethane nontunneled CVC had been inserted. Patients with catheters inserted in an emergency situation, critically ill patients, and/or those with a history of hypersensitivity or allergic reactions to ethanol were excluded from the study. The variables evaluated were CLABSI, etiological agents, adverse events, and the mechanical effects of ethanol on the catheter (breakage and obstruction). RESULTS: The CLABSI rate was lower in the ELT group compared with the control group (P = 0.0177). However, when the occurrence of CLABSI was evaluated per 1000 catheter-days, no significant difference was found between the groups (P = 0.077). The frequency of side effects and catheter breakage was greater in the ELT group (P = 0.0001 and P = 0.0005, respectively). CONCLUSIONS: The CLABSI rate was statistically significantly reduced in the ELT group compared with the controls, but the analysis of frequency per catheter-day showed no significant difference between the groups. Thus, we should not recommend ELT for CLABSI prophylaxis in nontunneled polyurethane CVC, which requires further clinical trials.

Hanseníase em menores de 15 anos na cidade de Juazeiro-BA / Leprosy in children under 15 years in the city of Juazeiro – BA

A hanseníase é uma doença que requer atenção dos órgãos e profissionais de saúde. A alta endemicidade da doença em um local pode ser detectada através do coeficiente de detecção em menores de 15 anos, quando maior de 10 por 100.000 habitantes indica alta taxa de transmissibilidade da doença no meio. Em 2010 em Juazeiro, esse coeficiente foi de 41,89 por 100.000 habitantes. O presente estudo trata-se de um projeto vinculado ao Programa de Educação para o Trabalho em Saúde (PET-Vigilância em Saúde) e à Universidade Federal do Vale do São Francisco (UNIVASF), o qual visa identificar e analisar de acordo com dados do Sistema de Informação de Agravos e Notificações (SINAN) e o Sistema de Informação da Atenção Básica (SIAB) os casos de Hanseníase notificados em menores de 15 anos,no ano de 2010. Dentre os dados analisados, destaca-seque dos 183 casos de hanseníase notificados em 2010,10% (18 casos) ocorreram em menores de 15 anos, com ocorrência predominante em bairros periféricos, nas faixas etárias de 6 a 11 anos e de 12 a 14 anos, sendo prevalente o sexo feminino, a classificação operacional predominante foi paucibacilar. A implantação e a efetividade de novas ações vinculadas ao PET caracterizam-se como de extrema importância para município, dado a sua hiper endemicidade para hanseníase. Educação em saúde, treinamentos, incentivo a notificação correta dos casos e acompanhamento dos doentes e seus contatos são ações que podem melhorar os índices encontrados e qualidade de vida da população.

Leprosy is a disease that requires attention of agencies and health professionals. The high endemicity of the disease in one location can be detected through the detection rate in children under 15 years, when greater than 10 per 100,000 population indicates a high rate of transmissibility of the disease in the middle. Juazeiro in 2010, this rate was 41.89 per 100,000 inhabitants. The present study deals with a project linked to the Education Program for Health Work (PET-Health Surveillance)and the Federal University of São Francisco Valley(UNIVASF), which aims to identify and analyze the data according to Information System Diseases and Notifications (SINAN) and Information System of Primary Care(ISPC) reported cases of leprosy in children under 15 in2010. Among the data analyzed, it is emphasized that the 183 leprosy cases reported in 2010, 10% (18 cases)occurred in children younger than 15 years, occurring predominantly in the suburbs, in the age groups 6-11 years and 12 to 14 years, is prevalent among females, the predominant operational classification was paucibacillary. The implementation and effectiveness of new shares linked to PET are characterized as extremely important for the city, given its hyperendemicity for leprosy. Health education, training, encouraging proper notification of cases and monitoring of patients and their contacts are actions that can improve the indexes found and quality of life of the population.