Applicability of 'Toolkit for Safety Assessment' tool to interventional radiology using probabilistic risk assessment techniques.

Interventional radiology brings extensive benefits to patients. Nevertheless, certain procedures may result in high doses of radiation, leading to health risks to occupationally exposed individuals (OEIs). Therefore, a more comprehensive risk analysis is essential to ensuring safety and minimising radiation exposures for all OEIs. The Toolkit for Safety Assessment (TOKSA) tool performs risk assessments based on the concepts described in 'General Safety Requirements' Part 3 (Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards) and Part 4 (Safety Assessment for Facilities and Activities). This tool was developed based on the 'Ibero-American Forum of Radiological and Nuclear Regulatory Agencies' risk models and can promote the use of the risk assessment processes by OEIs. The aim of this study was to experimentally analyse the applicability of the TOKSA tool in interventional radiology with the use/support of probabilistic risk assessment techniques. The results were used to reduce the risks associated with a hemodynamics room in a hospital in Belo Horizonte, Brazil.

Cancer risk in healthy patients who underwent chest tomography comparing three different technologies.

This research aimed to estimate the risk of cancer associated with patients without previous disease undergoing chest tomography. Siemens CT scanners have 6, 64, and 128 detectors. The Biologic Effects of Ionizing Radiation Reports - BEIR VII methodology was used. The study presented a sample of 64 patients aged between 18 and 80 years, in the city of Belo Horizonte, Minas Gerais - Brazil. The IMPACT CT software and CalDose X CT Online were used to calculate the absorbed and equivalent dose from the Volumetric Computed Tomography Dose Index - CTDIvol (mGy) and Dose Length Product - DLP values provided by the equipment. CT-Expo Software was also used to estimate Specific Dose Estimates (SSDEs) values. The CTDvol results for the MG1, MG,2 and MG3 Diagnostic Centers in mGy were respectively 4.369 ± 1.352, 6.99 4 ± 1.53,3 and 9.984 ± 2.282 and the SSDE values were 3.800, 6.40,0 and 9,.500. The values for the equivalent dose, at the MG2 Diagnostic Center, by IMPACT CT, in (mSv) for the breasts, esophagus, heart, thyroid, lung and thymus were respectively 3.9, 5.7, 4.7, 1.0, 4.8 and 5.7. The CalDose Software, for the same equipment and the same organs, in mSv, estimated the values 7.4, 9.4, 11.1, 5.3, 10.8 and 11.3 for women and 7.1, 9.3, 11.0, 5.3, 10.2 and 10.9 for men. The estimated risk of cancer decreased according to the patient's age, but with a higher incidence for females. The use of each software must be carefully analyzed to avoid undue values due to the particularities of each one. The results also showed that the risk of developing cancer due to radiation decreases with patient age and is higher in females.

DIAGNOSTIC REFERENCE LEVELS BASED ON PATIENT BODY MASS INDEX FOR SELECT INTERVENTIONAL PROCEDURES IN MINAS GERAIS/BRAZIL.

This work establishes local diagnostic reference levels (DRLs) in interventional radiology based on adult patient body mass index (BMI). The monitoring was carried out from 23 institutions and patient data from 3015 procedures were collected, being 907 Catheterism (CAT), 921 Percutaneous transluminal coronary angioplasty (PTCA) and 1187 CAT/PTCA and 6 BMI ranges were taken, going from under 18 up to 40 kg·m-2. It is presented that 18 initial DRL values to be used in the county of Minas Gerais. The overall 75th kerma-area product (KAP), commonly considered DRL, in Gy·cm2, is 94.6(SD 119)-CAT, 88.6(SD 121)-PTCA and 33.0(SD 47.6)-CAT/PTCA. In considering KAP-BMI individual values, one obtain the min-max ranges, in Gy·cm2, 3.2-BMI A to 101-BMI B for CAT, 65-BMI A to 102-BMI F for PTCA and 10.4-BMI A to 59.2-BMI E for CAT/PTCA. The KAP-BMI approach has shown to be feasible as a DRL optimization process.

Vibration spectroscopy and body biofluids: Literature review for clinical applications.

Vibrational spectroscopy techniques such as Raman and IR (infrared) allow real-time, non-invasive and non-destructive analysis of organic compounds with a good limit-of-detection. This review aims to show the progress of clinical diagnosis and prognosis due to advances of vibrational spectroscopy techniques in biofluids through an extensive literature review. This review was performed by searching for studies using the keywords "biofluids or biological fluids" and "diagnostic techniques" in PubMed, Scopus and Google Scholar. We found 580 articles in the 1990s, 1171 articles in the 2000s and 1688 in the years from 2011. Also, a second search including "biofluids or biological fluids" and "vibrational spectroscopy" returned only one article in the 1990s, three papers in the 2000s and 18 in the years from 2011.This growth suggests a great potential of biofluid research using vibrational spectroscopy. Sample collection variations(quantity and contaminations due to contact with other body parts and their secretions) are important factors that influence sample composition. Once these factors are taken into account, spectroscopic analysis may provide the necessary information to identify a disease, lesion, tumor or infection. With the present review we aim to encourage the study of vibrational spectroscopy techniques for analysis of biofluids focusing in clinical applications. In the future, it will widely benefit clinicians, allowing new diagnostic approaches, and for patients to have early diagnosis for most every disease.

Radiation therapy facility risk analysis in Brazil with SEVRRA software.

Risk assessment deals with processes, accident-initiating events, barriers and risk ratings to unveil the fragility and weakness of some processes; within this study, specifically related to radiation therapy facilities. Barriers are technical or organizational safety measures put in place to avoid, prevent, detect, control, reduce or mitigate the consequences of an accident once an initiating event has occurred. In this work, radiological risk analysis was performed for a set of 20 Brazilian radiotherapy facilities making use of the freeware sevrra risk-management software. The objective of this study was to define parameters that could be useful in creating an overall risk profile. This profile would be helpful for establishing priorities for decision making and support a risk-informed regulatory process. The most relevant missing barriers in facilities were identified according to three parameters: the 'importance index', 'impacted facilities index' and the 'barrier-effectiveness index'. Barriers such as 'in vivo dosimetry in the first treatment session', 'weekly in vivo dosimetry to detect errors in the dose delivering process', 'annual external audit for the control of reference dose rate' and 'independent verification of calibration by various medical physicists with a different dosimetry equipment' were found to be the most effective in reducing the risk level of the facilities. The present investigation reinforces the need to strengthen the mechanisms that guarantee the effectiveness of such barriers in radiation therapy procedures.

Effect of long-term ingestion of weakly oxidised flaxseed oil on biomarkers of oxidative stress in LDL-receptor knockout mice.

The effect of oxidised fatty acids on atherosclerosis progression is controversial. Thus, our objective was to evaluate the effect of long-term consumption of weakly oxidised PUFA from flaxseed oil on oxidative stress biomarkers of LDL-receptor(-/-) mice. To test our hypothesis, mice were separated into three groups. The first group received a high-fat diet containing fresh flaxseed oil (CONT-), the second was fed the same diet prepared using heated flaxseed oil (OXID), and the third group received the same diet containing fresh flaxseed oil and had diabetes induced by streptozotocin (CONT+). Oxidative stress, aortic parameters and non-alcoholic fatty liver disease were assessed. After 3 months, plasma lipid profile, glucose levels, body weight, energy intake and dietary intake did not differ among groups. Likewise, oxidative stress, plasma malondialdehyde (MDA), hepatic MDA expressed as nmol/mg portion (ptn) and antioxidant enzymes did not differ among the groups. Hepatic linoleic acid, α-linolenic acid, arachidonic acid and EPA acid declined in the OXID and CONT+ groups. Aortic wall thickness, lumen and diameter increased only in the OXID group. OXID and CONT+ groups exhibited higher concentrations of MDA, expressed as µmol/mg ptn per %PUFA, when compared with the CONT- group. Our results suggest that ingestion of oxidised flaxseed oil increases hepatic MDA concentration and is potentially pro-atherogenic. In addition, the mean MDA value observed in all groups was similar to those reported in other studies that used xenobiotics as oxidative stress inducers. Thus, the diet applied in this study represents an interesting model for further research involving antioxidants.

Healthcare context and nursing workforce in a main city of Angola.

BACKGROUND: Angola is one of the largest African countries with continuing levels of insecurity, considerable weakness in terms of respect for human rights, destroyed infrastructure and low transparency and social accountability levels. The health system displays gaps and nursing represents the main contingent among human resources in health. AIM: This research aims to understand the healthcare context in Angola from the perspective of Brazilian nurses who were involved in helping their Angolan colleagues. This general view of health services is followed by a description of nursing workforce particularities at a tertiary health service in the province of Luanda. METHODS: Data were extracted from the database of the Global Network of World Health Organization Collaborating Centres for Nursing and Midwifery Development, constructed based on technical visits to Angola in 2009. Information related to health service characteristics was used, focusing on nursing human resource activities at two tertiary, one secondary and one primary health institutions located in the province of Luanda. The study data were analysed through descriptive statistics. FINDINGS: Among the problems the nursing workforce faces, the lack of human, material and financial resources stands out, as well as insufficient professional qualification, excessive work journeys, low remunerations, non-valuation of professionals, leading to unsatisfactory work environments and discouraged human resources. CONCLUSIONS: Nursing in Angola is conquering its professional space. Therefore, regulatory policies are fundamental, defining the rights and obligations of all categories involved, with a view to determining nurses' function in the health team, including respect for and acknowledgement of their role in the community.

Potencial antioxidante e antimicrobiano de espécies da família Asteraceae / Antioxidant and antimicrobial potential of Asteraceae species

Espécies da família Asteraceae são amplamente utilizadas na medicina popular para diversos fins terapêuticos. Neste contexto, este estudo teve por objetivo averiguar a atividade antimicrobiana e antioxidante in vitro de extratos metanólicos de plantas pertencentes a Asteraceae, a maioria comumente utilizada na medicina tradicional. A prospecção química dos extratos também foi realizada. A atividade antimicrobiana foi avaliada pelo método de susceptibilidade em microdiluição em caldo e a atividade antioxidante determinada pelo ensaio com o radical DPPH. O extrato da folha de Baccharis dracunculifolia apresentou significativa atividade antimicrobiana para Pseudomonas aeruginosa,Bacillus cereus e Cryptococcus neoformans (CIM = 0,005; 0,005 e 0,039 mg mL-1, respectivamente). Os extratos das folhas de Bidens segetum e Matricaria chamomilla foram seletivos para Shigella sonnei e P. aeruginosa (CIM = 0,005 e 0,078 mg mL-1, respectivamente). Já as folhas de Acanthospermun australe e Baccharis trimera apresentaram atividade significativa apenas para Candida albicans (CIM = 0,039 mg mL-1) enquanto as folhas de Taraxacum officinale foram ativos contra ambas leveduras com CIM 0,039 mg mL-1. Em relação à atividade antioxidante, os extratos das folhas de B. dracunculifolia, T. officinale e das inflorescências de B. segetum apresentaram significativa atividade com CI50 de 5, 5 e 4 µg mL-1, respectivamente. A prospecção química dos extratos identificou presença de compostos como flavonoides, terpenos e outros que podem ser responsáveis pelas atividades observadas.

Asteraceae species have been largely used in folk medicine for several therapeutic purposes. Thus, the aim of this work was to investigate the in vitro antimicrobial and antioxidant activities of methanol extracts from plants belonging to the Asteraceae family, most of which are commonly used in traditional medicine. Chemical prospecting of extracts was also performed. The antimicrobial activity was evaluated through the broth microdilution susceptibility method and the antioxidant activity was determined through DPPH assay. Leaf extract of Baccharis dracunculifolia presented a significant antimicrobial activity against Pseudomonas aeruginosa,Bacillus cereus and Cryptococcus neoformans (0.005, 0.005 and 0.039 mg mL-1 MIC, respectively). Leaf extracts of Bidens segetum and Matricaria chamomilla were selective for Shigella sonnei and P. aeruginosa (0.005 and 0.078 mg mL-1 MIC, respectively). On the other hand, Acanthospermun australe and Baccharis trimera leaves only showed significant activity against Candida albicans (0.039 mg mL-1 MIC), while Taraxacum officinale leaves were active against both yeasts, with 0.039 mg mL-1 MIC. As regards antioxidant activity, extracts of B. dracunculifolia and T. officinale leaves and B. segetum inflorescences presented significant activity, with 5, 5 and 4 µg mL-1 IC50, respectively. The chemical prospecting identified the presence of flavonoids, terpenes and other compounds which may be responsible for the observed activities.

Mitracarpus frigidus aerial parts exhibited potent antimicrobial, antileishmanial, and antioxidant effects.

The crude extract and the hexane, CH(2)Cl(2), EtOAc, n-BuOH, and hydromethanolic fractions of the aerial parts of Mitracarpus frigidus were evaluated against promastigote forms of two species of Leishmania (L. chagasi and L. amazonensis), 11 strains of bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella enterica sorovar Tythimurium, Shigella sonnei, Klebsiella pneumoniae, Escherichia coli, Micrococcus luteus, Enterococcus faecalis, Enterobacter cloacae, Streptococcus pyogenes and Bacillus cereus) and two yeasts (Candida albicans and Cryptococcus neoformans). The antioxidant activity (DPPH radical scavenging activity and reducing power), cytotoxicity against mammalian cells, and the contents of phenolics and flavonoids were determined. Phytochemical analysis of the major groups of phytoconstituents is also reported. All samples showed antioxidant activity which was positively correlated to the content of phenolic compounds. S. sonnei, B. cereus and C. neoformans were susceptible to all extracts tested, except for the n-BuOH and hydromethanolic fractions, which demonstrated no antimicrobial activity. The lowest MIC was recorded for the CH(2)Cl(2) fraction against C. neoformans (MIC of 10 microg/ml), followed by B. cereus, S. sonnei, and E. cloacae (MIC of 20, 39 and 39 microg/ml, respectively). The CH(2)Cl(2) fraction was the most effective against L. chagasi (IC(50) of 6.7 microg/ml), and the hydromethanolic fraction exhibited the best activity against L. amazonensis (IC(50) of 9 microg/ml). A cytotoxic effect on mammalian cells was observed only for the crude extract and CH(2)Cl(2) fraction at the concentrations of 130 and 31 microg/ml, respectively. These results suggest that M. frigidus has interesting antimicrobial, antileishmanial and antioxidant activities.

Thermoluminescence response of K2YF5:Tb3+ crystals to photon radiation fields.

This investigation has been performed to test the feasibility of using K2YF5:Tb3+ crystals as thermoluminescence dosemeters (TLD). K2YF5 single crystals doped with 0.2, 10.0 and 50.0 at.% of trivalent optically active Tb3+ ions as well as K2TbF5 and undoped K2YF5 crystals have been synthesized under hydrothermal conditions. Polished crystal platelets with thickness of about 1 mm have been irradiated with X and gamma rays in order to study thermoluminescent (TL) sensitivity as well as dose and energy response in terms of the Tb3+ concentration in K2YF5. Within this concentration series, K2YF5 crystals doped with 10.0 at.% Tb3+ have been found to have maximum TL response due to a broad asymmetric TL glow peak at 269 degrees C with good linearity of dose response and reproducibility of dose measurements. After deconvolution, the main dosimetric peak has been revealed to be composed of two individual peaks, both with linear TL response behaviour, centered at 210 and 269 degrees C. As it has been proved, the linear TL signal coefficient for K2Y0.9Tb0.1F5 is almost 10 times greater than that for commercial TLD-100 (LiF:Mg,Ti), irradiated with a 137Cs gamma radiation source at the same conditions. The reported results indicate that K2YF5 crystals doped with Tb3+ have potential as promising materials for radiation dosemeters.

(HP)Ge Measurement of spectra for diagnostic X-ray beams.

The X-ray spectra applied in diagnostic radiology to the energy range between 50 and 125 kVp, were experimentally determined using a high-purity germanium detector, (HP)Ge, coupled to a multichannel analyser. A simple stripping procedure was implemented, according to that described by Seelentag and Panzer, to correct the pulse height distribution and then to determine the photon spectra. The measurements were performed for those conditions where the X-ray beam is transmitted through Pb filters 0.2-0.7 mm thick. It was necessary to estimate the effective dose in the same way that it is done for radiology diagnosis room shielding projects. The spectra were also determined to the X-ray qualities recommended by the IEC for primary diagnostic X-ray and for X-ray beams attenuated by aluminium filters 2.5-42.5 mm thick. The spectra obtained were compared with data derived from the literature presenting good agreement.

[Communication with the patient. A question of quality]. / Comunicación con el paciente. Una cuestión de calidad.

Interpersonal communication as a means to promote health and well-being is presented as a strategical orientation in the nursing care process. Meanwhile, in our medium, we have observed the development of communication from a perspective much more related to complying with a service. This article has these objectives: a) to investigate this theme by highlighting analytical instruments of interaction found in bibliographical references, b) to disclose the results of research about nurse-patient communication indicators, in the context as a forum for reflection, bearing in mind the quality of treatment. The authors highlight the need to assume a responsibility shared by teaching nurses and assistants, with the goal to constantly seek to develop communicative competence and thus to contribute to a greater efficiency and an improvement in the quality of nursing care.

[Human sexuality in nursing education]. / Sexualidade humana na formação do enfermeiro.

A questionnaire was applied to undergraduate nursing students in order to verify the ideas on the sexuality theme they had absorbed from the notions they received in their nursing undergraduate program. Results showed that most of these students have slightly, limited and unbased notions concerning human sexuality. They also use the terms sex and sexuality as if they were synonyms. Therefore, authors concluded that these students need to acquire knowledge about sexuality and some professional situations experienced are also mentioned. They also discussed the type of knowledge received and which courses approach it during the program.

[Humanistic approach to nursing communication: the case of a hospitalized adolescent female]. / Enfoque humanístico à comunicação em enfermagem: o caso de uma adolescente hospitalizada.

Nursing is a profession committed to the promotion of human beings. It takes into consideration their freedom, uniqueness and dignity. Therefore, communication plays an important role within the nursing process and its results, and it is also a fundamental component of the treatment. However, in the context of Brazilian hospitals, communication between nurses and patients is limited to the performance of these professionals' technical role. The purpose of this study is to analyse the case of a hospitalized female adolescent, focusing on the communication that happens between her and the nursing professionals who provide her assistance. This analysis was based on Bales' categories. Through the technique of direct observation, the behavior resultant from the interaction between nurses and the adolescent was analysed on a total of 30 hours during five days. The observation showed 428 units of interaction which were classified, by qualified professionals, in positive, negative and neutral socio-emotional areas. Considering the high incidence of interactions in the neutral area (89.2%), authors recommend a humanistic correction in the communication during the nursing process. This change in communication can qualify patient's care as well as generate satisfaction at work through empathy and solidarity.

[Therapeutic use of nitric oxide: implications for nursing]. / Utilização do óxido nítrico como terapêutica: implicações para a enfermagem.

Nitric oxide (NO) is a gas that transmits signals in the organism. Such signal transmission takes place by means of the gas synthesis and release in different cell types. After it is released, the gas penetrates the membrane of a neighboring cell and regulates its function. Such mechanism represents an entirely new signaling principle in biological systems. The discoverers of NO as a signaling molecule were awarded the Nobel Prize in Medicine and Physiology in 1998. This discovery has revolutionized medicine and originated new treatments for old problems. In this study, we review the role of NO in some pathologies such as sepsis, arterial hypertension and pulmonary hypertension and Nitric Oxide is explained in terms of its current merit for treatment and its impact on nursing care.

Effects of a neuronal nitric oxide synthase inhibitor on lipopolysaccharide-induced fever.

It has been demonstrated that nitric oxide (NO) has a thermoregulatory action, but very little is known about the mechanisms involved. In the present study we determined the effect of neuronal nitric oxide synthase (nNOS) inhibition on thermoregulation. We used 7-nitroindazole (7-NI, 1, 10 and 30 mg/kg body weight), a selective nNOS inhibitor, injected intraperitoneally into normothermic Wistar rats (200-250 g) and rats with fever induced by lipopolysaccharide (LPS) (100 microg/kg body weight) administration. It has been demonstrated that the effects of 30 mg/kg of 7-NI given intraperitoneally may inhibit 60% of nNOS activity in rats. In all experiments the colonic temperature of awake unrestrained rats was measured over a period of 5 h at 15-min intervals after intraperitoneal injection of 7-NI. We observed that the injection of 30 mg/kg of 7-NI induced a 1.5 degrees C drop in body temperature, which was statistically significant 1 h after injection (P<0.02). The coinjection of LPS and 7-NI was followed by a significant (P<0.02) hypothermia about 0.5 degrees C below baseline. These findings show that an nNOS isoform is required for thermoregulation and participates in the production of fever in rats.

Effects of a neuronal nitric oxide synthase inhibitor on lipopolysaccharide-induced fever

It has been demonstrated that nitric oxide (NO) has a thermoregulatory action, but very little is known about the mechanisms involved. In the present study we determined the effect of neuronal nitric oxide synthase (nNOS) inhibition on thermoregulation. We used 7-nitroindazole (7-NI, 1, 10 and 30 mg/kg body weight), a selective nNOS inhibitor, injected intraperitoneally into normothermic Wistar rats (200-250 g) and rats with fever induced by lipopolysaccharide (LPS) (100 µg/kg body weight) administration. It has been demonstrated that the effects of 30 mg/kg of 7-NI given intraperitoneally may inhibit 60 per cent of nNOS activity in rats. In all experiments the colonic temperature of awake unrestrained rats was measured over a period of 5 h at 15-min intervals after intraperitoneal injection of 7-NI. We observed that the injection of 30 mg/kg of 7-NI induced a 1.5oC drop in body temperature, which was statistically significant 1 h after injection (P<0.02). The coinjection of LPS and 7-NI was followed by a significant (P<0.02) hypothermia about 0.5oC below baseline. These findings show that an nNOS isoform is required for thermoregulation and participates in the production of fever in rats.

Humanizing nurse-patient communication: a challenge and a commitment.

Nurse-patient communication has been a pre-established, unvarying, technical professional and impersonal form of manifestation, reflecting mainly the achievement of nurse's instrumental role. This situation is opposed to our nursing concept as well as to the professional values that we incorporated during our professional life, all of which emphasize the importance of the person and the patient and the meaning of the visualisation of care to a total human being. The present study aims at discussing this question, propitiating an opportunity of reflection about the necessity of humanizing this relationship in the Brazilian scenery. Thus, we focused on the importance of nurse-patient relationship not only as an essential component of nursing assistance but also as a treatment in itself. In addition, we stimulate nurses to examine the way they are taking care of human beings: as objects to be manipulated and treated or as persons that need care and comprehension. The article is concluded with the thesis that nursing is not a technical profession that manipulates knowledge and technologies but a work of valuing human beings, their freedom and dignity.

[Performance of nursing students in the intramuscular administration of drugs]. / Desempenho discente de enfermagem na administração de terapêutica via intramuscular.

The goal of the present study was to compare the performance of two groups of nursing undergraduate students, submitted to two different teaching methods, in their ability to perform the intramuscular injection on clients needing the procedure. Both, control (CG) and experimental group (EG) (n = 35 each) were submitted to traditional method and instructional method respectively, according to the methodological procedure described by Nogueira (1995). The performance of the students was evaluated by a nurse who had no knowledge of the group each student belong. The nurse used the "check-list" in order to evaluate the performance of student. The results indicate that the time spent by the students of each group was approximately the same i.e. 9.4 min for CG and 9.3 for EG. The students of the control group showed ordinary performance (42.9%), good performance (48.9%) and very good performance (8.5%) whereas those of the EG showed ordinary performance (5.7%), good performance (60%) and very good performance (34.3%). The present results shows that the students are responsible by their own learning, motivating us to use new teaching methods on nursing undergraduate course.

[Experiences of a group of retired elderly: action research]. / La vivencia de un grupo de jubilados-anciano: investigación--acción.

The present study aims at comprehending the retired people through a group experience as well as allowing them to reflect about their condition. The authors utilized the research-action methodology, with 25 retired subjects who worked in the University, aging from 51 to 79 years old. The narratives related to their experiences were obtained through verbal interaction, group discussions and interviews. From the analysis of the experiences emerged questions associated to the retired-elderly interests, their physical and mental health, relationship, learning process, social environment and leisure.