RESUMO
Fundamentos: El cuidado de personas dependientes se ha incrementado, por lo que las reformas del sistema sanitario están visibilizando a las personas cuidadoras. Se desarrolló un plan funcional para personas cuidadoras en hospitalización, y esta investigación pretende indagar cómo ha sido su implementación, identificando puntos fuertes y débiles que promuevan cambios entre el sistema formal e informal. Métodos Se diseñó un estudio cualitativo, considerando como sujetos de estudio a los profesionales de enfermería y personas cuidadoras identificadas en el Hospital. Se utilizó la técnica de grupo focal seleccionando 8 personas en cada segmento. Se elaboraron 2 guiones de preguntas con los criterios de evaluación recogidos en las líneas estratégicas del plan: identificación/captación, acogida, descanso, dieta, atención sanitaria, información/educación sanitaria, gestión e implementación y otras propuestas. Los datos se recogieron durante mayo de 2011.ResultadosSe encontraron dificultades en la identificación y captación de las personas cuidadoras, por no realizar su valoración inicial. En cuanto a la acogida, en algunos casos no se entregaba folleto informativo. El descanso no es posible por la renuncia a alejarse de su familiar. La dieta es la principal causa del conflicto y destaca la falta de educación sanitaria para continuar con los cuidados domiciliarios. Se valoran positivamente los circuitos de atención preferente en urgencias. Los profesionales de enfermería consideran que el desarrollo del plan supone una sobrecarga de trabajo. Conclusiones Los puntos fuertes y débiles identificados permitirán establecer mejoras en la implementación del plan para conseguir el cambio en aspectos específicos como la información/educación, atención, descanso y dieta de la persona cuidadora. Destacamos la necesidad de potenciar el cambio de modelo (AU)
BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011.RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change (AU)
Assuntos
Humanos , Determinação de Necessidades de Cuidados de Saúde , Cuidadores/organização & administração , Cuidados de Enfermagem/tendências , Grupos Focais , Serviços Hospitalares de Assistência Domiciliar/organização & administração , Assistência Domiciliar/organização & administração , Doença Crônica , Hospitalização/tendências , Pacientes DomiciliaresRESUMO
BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011. RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change.
Assuntos
Cuidadores/organização & administração , Hospitalização , Humanos , Inquéritos e QuestionáriosRESUMO
AntecedentesMalassezia pachydermatis es una levadura de gran interés tanto en medicina humana como en veterinaria.ObjetivosConocer si la adición de gentamicina a los medios micologicos más comunes era capaz de inhibir el crecimiento de M. pachydermatis.MétodosSe estudiaron 20 cepas de M. pachydermatis en medios micológicos con gentamicina a diferentes concentraciones.ResultadosTodos los aislamientos se inhibieron con altas concentraciones de gentamicina.ConclusionesEl uso de placas con altas concentraciones de gentamicina puede llevar a resultados falsamente negativos en cultivo y a una errónea clasificación de M. pachydermatis como especie lípido-dependiente. Estas observaciones podrían llegar a tener dos aplicaciones hipotéticas: i) en veterinaria, la gentamicina tópica podría ser eficaz en procesos como la dermatitis o la otitis externa, y ii) en humanos, podría ser una terapia (antibiotic-lock) para las infecciones por Malassezia relacionadas con el uso de catéteres(AU)
BackgroundMalassezia pachydermatis is a yeast of importance in both veterinary and human medicine.AimsTo know if M. pachydermatis grow on micological media with high concentrations of gentamycin.MethodsTwenty M. pachydermatis strains were streaked on Sabouraud Dextrose Agar plates with different concentrations of gentamycin.ResultsAll isolates were inhibited when high concentrations of gentamycin were added.ConclusionsThe use of plates with high concentrations of gentamycin can lead to some important misdiagnoses: firstly, false-negative cultures, and secondly, an erroneous classification of M. pachydermatis as a lipid-dependent species. Morever, all of this could be useful in two therapeutic fields: i) in animals, topical gentamycin could be an efficacious treatment for a disease such as external otitis in dogs; ii) in humans, we hypothesize that gentamycin could be regarded as a possible therapy (antibiotic-lock) for catheter-associated Malassezia spp. infections(AU)
Assuntos
Humanos , Animais , Malassezia , Gentamicinas/farmacocinética , Tinha Versicolor/tratamento farmacológico , Meios de CulturaRESUMO
Alterations in the erm(A) regulatory region of six clinical isolates of Staphylococcus epidermidis and one of Staphylococcus haemolyticus displaying a constitutive resistance phenotype were investigated. Anovel deletion of 10 bp with respect to the corresponding sequence of Tn554 was identified in the attenuator of a constitutively expressed erm(A) gene of one of the S. epidermidis isolates. Thus far, this is the smallest deletion conferring constitutive resistance in the translational attenuator of erm(A) in a naturally occurring S. epidermidis strain of human origin.
Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Macrolídeos/farmacologia , Metiltransferases/genética , Staphylococcus epidermidis/efeitos dos fármacos , Staphylococcus epidermidis/genética , Sequência de Bases , Farmacorresistência Bacteriana/genética , Regulação Bacteriana da Expressão Gênica , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Biossíntese de Proteínas/genética , Sequências Reguladoras de Ácido Nucleico/genética , Deleção de Sequência , Staphylococcus epidermidis/isolamento & purificaçãoRESUMO
Alterations in the erm(A) regulatory region of six clinical isolates of Staphylococcus epidermidis and one of Staphylococcus haemolyticus displaying a constitutive resistance phenotype were investigated. A novel deletion of 10 bp with respect to the corresponding sequence of Tn554 was identified in the attenuator of a constitutively expressed erm(A) gene of one of the S. epidermidis isolates. Thus far, this is the smallest deletion conferring constitutive resistance in the translational attenuator of erm(A) in a naturally occurring S. epidermidis strain of human origin (AU)
No disponible
Assuntos
Staphylococcus epidermidis/genética , Antibacterianos/farmacologia , Metiltransferases/genética , Macrolídeos/farmacologia , Proteínas de Bactérias/genética , Staphylococcus epidermidis/isolamento & purificação , Staphylococcus epidermidis/patogenicidade , Deleção Cromossômica , Elementos de DNA Transponíveis/genética , Sequência de BasesRESUMO
In vitro fungistatic and fungicidal activities of voriconazole were evaluated against 114 isolates of Candida spp. MICs were determined using the NCCLS M27-A2 broth microdilution method. Minimum fungicidal concentrations (MFCs) were defined as the lowest drug concentrations that yielded < or = 5 colonies (> or = 98% killing activity). The fungicidal activity could be only evaluated against 45.6% of the isolates (52 of 114 isolates) because trailing growth occurred, and 30 of these 52 isolates (57.69%) showed MFC values < or = 1 mg/l. There was little or no fungicidal activity against C. albicans and C. tropicalis. In contrast, all C. krusei were killed by 1-2 mg/l voriconazole. In conclusion, our data show that the fungicidal effect of voriconazole against Candida spp. is species dependent.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Pirimidinas/farmacologia , Triazóis/farmacologia , Candida albicans/efeitos dos fármacos , Candida tropicalis/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Espanha , VoriconazolRESUMO
This study investigated the species distribution and antimicrobial resistance among 99 enterococci isolated from hospitalized patients in 12 hospitals in Cuba from October 2000 to September 2001. Species identification was performed by WIDER Automatic System (Francisco Soria Melguizo, Madrid, Spain), and the susceptibility testing was performed by disk diffusion, agar dilution, and E-test methods. Enterococcus faecalis was the most prevalent (85%) species, followed by E. faecium (10%), E. gallinarum (2%), E. casseliflavus (2%), and E. durans-hirae (1%). A higher percentage of resistance to ampicillin (50%), fosfomycin (40%), ciprofloxacin (30%), norfloxacin (20%), and tetracycline (90%) was detected in E. faecium isolates, whereas E. faecalis strains showed higher rates of resistance to erythromycin (52.4%), chloramphenicol (34.5%), rifampicin (62.5%), moxifloxacin (3%), and nitrofurantoin (2.4%). Resistance to glycopeptide was detected in E. faecalis (1.2%) and E. faecium (10%). Thirty-one E. faecalis (37%) and 3 E. faecium (30%) showed a high-level resistance to gentamicin. The results of this work will be very helpful to guide empirical antimicrobial therapy and the implementation of infection control measures in Cuban hospitals.
Assuntos
Enterococcus/isolamento & purificação , Farmacorresistência Bacteriana , Enterococcus/efeitos dos fármacos , Humanos , Testes de Sensibilidade MicrobianaRESUMO
En 1995, en las unidades de hospitalización de agudos del Complejo Asistencial de Salud Mental Benito Menni se inició un proyecto de gestión de cuidados que tiene como principal objetivo pasar de un trabajo de enfermería por tareas a cuidar al paciente mediante planes de cuidados. Se realiza una exposición del tema. El cambio organizativo se ha sustentado en tres puntos: a) definición de un modelo conceptual; el modelo Roper-Logan-Tierney es la base conceptual sobre la que se desarrolla toda la actividad asistencial de enfermería; b) cambio en el sistema de asignación del personal a la actividad (GER). Un GER es un equipo compuesto por enfermeros y auxiliares de diferentes turnos que son referentes de un grupo de pacientes con patologías comunes y cuidados similares a los que elaboran el plan de cuidados, y c) creación del dosier de enfermería, que es un conjunto de registros que forman parte de la historia clínica y que son el reflejo de la actividad asistencial; consta de: hoja de valoración de enfermería en el momento del ingreso, plan de cuidados y hoja de continuidad de cuidados (AU)
Assuntos
Humanos , Planejamento de Assistência ao Paciente , Transtornos Mentais/enfermagem , Hospitalização , Assistentes de Enfermagem , Diagnóstico de Enfermagem , Transtornos Mentais/diagnóstico , Atividades CotidianasRESUMO
Fluconazole susceptibilities of 150 Candida isolates were determined by a 25- micro g fluconazole disk diffusion agar test and compared with the microdilution NCCLS M27-A method. The agar test used three different media and was read at 24 and 48 h. When only the susceptible and nonsusceptible categories were used, disk diffusion with Müeller-Hinton agar supplemented with 2% glucose and 0.5 micro g of methylene blue (MHGM) per ml had a 95.37% correlation with the MIC method at 24 h, followed by RPMI 1640-2% of glucose agar (correlation, 94%) and Shadomy medium (SHDM) (correlation, 92.6%). The growth of microcolonies inside the inhibition zones was common (>63%) in the RPMI and SHDM media and minimal with MHGM (8.7%). At 48 h, MHGM and SHDM still had a >91% correlation with the MIC, while RPMI results had dropped to 75%. The best overall agreement was obtained with C. dubliniensis (100%).
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/crescimento & desenvolvimento , Fluconazol/farmacologia , Ágar , Candida/classificação , Meios de Cultura , Humanos , Testes de Sensibilidade Microbiana/métodosRESUMO
An enzyme-linked immunoassay (ELISA) using purified 5/B Echinococcus enriched antigen was used to follow IgG, IgM, and IgA antibody levels pre- and posttreatment or surgical removal of hydatid cysts. The sensitivity was 97%, 37.5%, and 54.5%, respectively, and the specificity was 95.7%, 100%, and 98.9%, respectively. All isotypes could be detected 3 years after surgical removal of cysts in patients showing no remaining cyst evidence. This was especially true for IgG, which persisted in 85.2% of the patients. The data indicate that antigen purification improves specificity without affecting sensitivity, although this new antigen offers no advantages in the postsurgical monitoring of the patients.
Assuntos
Equinococose/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina A/análise , Imunoglobulina G/análise , Imunoglobulina M/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Especificidade de Anticorpos , Complexo Antígeno-Anticorpo , Antígenos de Helmintos/imunologia , Equinococose/sangue , Equinococose/cirurgia , Feminino , Humanos , Imunoglobulina A/imunologia , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Isoantígenos/metabolismo , Masculino , Pessoa de Meia-Idade , Período Pós-OperatórioRESUMO
No disponible
Assuntos
Humanos , Testes Sorológicos , Bacteriemia , Brucella melitensis , Osteomielite , Artrite Infecciosa , Anticorpos Antibacterianos , Brucelose , Imunoglobulina A , Reações Falso-Negativas , Testes de AglutinaçãoRESUMO
A total of 102 Hafnia alvei clinical strains isolated from different patients with diarrhea has been tested, using polymerase chain reaction and dot-blot hybridization, for the enteropathogenic Escherichia coli attaching and effacing A (eaeA) gene to establish their role as a causative agent of diarrhea in our environment. None of them was positive for the eaeA gene. We cannot consider the eaeA gene as the virulence-associated factor implicated in the H. alvei strains isolated from diarrheal feces in our region (AU)
No disponible
Assuntos
Humanos , Adesinas Bacterianas/genética , Hafnia alvei/isolamento & purificação , Proteínas de Transporte/genética , Diarreia/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Espanha/epidemiologia , Genes Bacterianos , Hibridização de Ácido NucleicoRESUMO
No disponible
Assuntos
Animais , Bovinos , Adulto , Masculino , Humanos , Parasitologia de Alimentos , Contaminação de Alimentos , Sarcocystis , Sarcocistose , Dor Abdominal , Diarreia , Culinária , Carne , Enteropatias Parasitárias , FezesRESUMO
No disponible
