Impact of the multiplex molecular FilmArray Respiratory Panel on antibiotic prescription and clinical management of immunocompromised adults with suspected acute respiratory tract infections: A retrospective before-after study / Impacto del panel respiratorio molecular multiplex FilmArray ¿ en la prescripción de antibióticos y el manejo clínico de pacientes adultos inmunocomprometidos con sospecha de infección respiratoria aguda: un estudio retrospectivo antes/después

Abstract This study aimed to assess the impact of the implementation of a rapid multiplex molecular FilmArray Respiratory Panel (FRP) on the medical management of immunocompromised patients from a community general hospital. We conducted a single-center, retrospective, and before-after study. Two periods were evaluated: before the implementation of the FRP (pre-FRP) from April 2017 to May 2018 and after the implementation of the FRP (post-FRP) from January to July 2019. The inclusion criteria were immunocompromised patients over 18 years of age with suspected acute respiratory illness tested by conventional diagnostic meth-ods (pre-FRP) or the FilmArray™ Respiratory Panel v1.7 (post-FRP). A total of 142 patients were included, 64 patients in the pre-FRP and 78 patients in the post-FRP. The positive detec-tion rate was significantly higher in the post-FRP (63% vs. 10%, p <0.01). There were more patients receiving antimicrobial treatment in the pre-FRP compared with the post-FRP period (94% vs. 68%, p <0.01). A decrease in beta-lactam (89% vs. 61%, p <0.01) and macrolide (44% vs. 13%, p < 0.01) prescriptions were observed in the post-FRP. No differences were observed in oseltamivir use (22% vs. 13%, p = 0.14), changes in antimicrobial treatment, hospital admission rate, days-reduction in droplet isolation precautions, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, treatment failure and 30-day mortality. The implementa-tion of the FRP impacted patient care by improving diagnostic yield and optimizing antimicrobial treatment in immunocompromised adult patients.

Resumen El objetivo de este estudio fue evaluar el impacto de la implementación del panel respiratorio FilmArray® (FRP), un sistema automatizado de PCR multiplex, en el estándar de cuidado de pacientes adultos inmunocomprometidos en un hospital general. Es un estudio retrospectivo de un único centro con diseno antes/después. Los periodos evaluados fueron abril 2017-mayo 2018, previo a la implementación del FRP (pre-FRP), y enero 2019-julio 2019, luego de la implementación (post-FRP). Los criterios de inclusión fueron pacientes mayores de 18 años inmunocomprometidos con sospecha de infección respiratoria aguda a los que se les realizó, en pre-FRP, diagnóstico por métodos convencionales, y en post-FRP, el panel respiratorio FRP versión 1.7. Se incluyeron un total de 142 pacientes, 64 en pre-FRP y 78 en post-FRP. La tasa de positividad fue significativamente mayor en post-FRP frente a pre-FRP (63 vs. 10%, p<0,01). Hubo más pacientes con tratamiento antimicrobiano en pre-FRP que en post-FRP (94 vs. 68%, p <0,01). En pre-FRP hubo más pacientes tratados con betalactámicos (89 vs. 61%, p <0,01) y macrólidos (44 vs. 13%, p < 0,01). No se observaron diferencias significativas en el uso de oseltamivir (22 vs. 13%, p = 0,14), cambios en los tratamientos, número de hospitalizaciones, uso de aislamientos, duración de la estadía hospitalaria, ingreso a la unidad de cuidados intensivos, estadía en dicha unidad, falla de tratamiento y mortalidad a 30 días. El uso de FRP contribuyó a la atención del paciente mejorando el rendimiento diagnóstico y optimizando la terapia antimicrobiana en pacientes adultos inmunocomprometidos.

Clinical and sociodemographic aspects of cases of severe acute respiratory syndrome in southern Brazil / Aspectos clínicos e sociodemográficos dos casos de Síndrome Respiratória Aguda Grave no sul do Brasil / Aspectos clínicos y sociodemográficos de casos de Síndrome Respiratorio Agudo Severo en el sur de Brasil

Background and objectives: to compare the clinical and sociodemographic aspects of individuals with SARS reported in the countryside of Rio Grande do Sul in 2020 and 2021. Methods: a cross-sectional study, from March 2020 to October 2021. Clinical and sociodemographic variables of individuals with SARS symptoms were analyzed, compared through descriptive, univariate analyses, according to the year of reporting. Results: a total of 4,710 cases of SARS were reported; 53.4% were SARS related to COVID-19 in 2020 and 87.5% in 2021 (p<0.001). Comparing 2020 and 2021, the sociodemographic profile changed in terms of age group, skin color and education (p<0.001). Regarding clinical aspects, there was a reduction in prevalence of pre-existing health conditions, except obesity, changes in reported signs and symptoms and reduction in hospital and Intensive Care Unit admissions. Conclusion: the changes in the profile may reflect the effect of the different variants and the start of immunization for SARS-CoV-2.(AU)

Justificativa e objetivos: comparar, entre os anos de 2020 e 2021, os aspectos clínicos e sociodemográficos dos indivíduos com Síndrome Respiratória Aguda Grave (SRAG) notificados em uma região de saúde do interior do Rio Grande do Sul. Métodos: estudo transversal descritivo, realizado de março de 2020 a outubro de 2021. Foram analisadas variáveis clínicas e sociodemográficas de indivíduos com sintomas de SRAG, comparadas através de análises descritivas, univariadas, conforme o ano de notificação. Resultados: foram notificados 4.710 casos com SRAG; 53,4% foram SRAG relacionados à COVID-19 em 2020 e, 87,5%, em 2021 (p<0,001). Comparando os anos 2020 e 2021, o perfil sociodemográfico modificou quanto faixa etária, cor da pele e escolaridade (p<0,001). Quanto aos aspectos clínicos, houve redução da prevalência de condições de saúde preexistente, exceto obesidade, alterações nos sinais e sintomas relatados e diminuição de internações hospitalares e na Unidade de Terapia Intensiva. Conclusão: as mudanças no perfil podem refletir o efeito das diferentes variantes e o início da imunização para SARS-CoV-2.(AU)

Justificación y objetivos: comparar los aspectos clínicos y sociodemográficos de individuos con SARS notificados en el interior de Rio Grande do Sul en los años 2020 y 2021. Métodos: estudio descriptivo transversal, realizado de marzo de 2020 a octubre de 2021. Se analizaron variables clínicas y sociodemográficas de individuos con síntomas de SARS, comparadas mediante análisis descriptivos univariados, según el año de notificación. Resultados: se notificaron 4.710 casos de SARS; el 53,4% fueron SARS relacionados con COVID-19 en 2020 y el 87,5% en 2021 (p<0,001). Comparando los años 2020 y 2021, el perfil sociodemográfico cambió en cuanto a grupo de edad, color de piel y escolaridad (p<0,001). En cuanto a los aspectos clínicos, hubo reducción en la prevalencia de condiciones de salud preexistentes, excepto obesidad, cambios en los signos y síntomas reportados y reducción en los ingresos hospitalarios y en la Unidad de Cuidados Intensivos. Conclusión: los cambios en el perfil pueden reflejar el efecto de las diferentes variantes y el inicio de la inmunización para el SARS-CoV-2.(AU)

MALDI-TOF MS-Based KPC Direct Detection from Patients' Positive Blood Culture Bottles, Short-Term Cultures, and Colonies at the Hospital.

Carbapenemase resistance in Enterobacterales is a global public health problem and rapid and effective methods for detecting these resistance mechanisms are needed urgently. Our aim was to evaluate the performance of a MALDI-TOF MS-based "Klebsiella pneumoniae carbapenemase" (KPC) detection protocol from patients' positive blood cultures, short-term cultures, and colonies in healthcare settings. Bacterial identification and KPC detection were achieved after protein extraction with organic solvents and target spot loading with suitable organic matrices. The confirmation of KPC production was performed using susceptibility tests and blaKPC amplification using PCR and sequencing. The KPC direct detection (KPC peak at approximately 28.681 Da) from patients' positive blood cultures, short-term cultures, and colonies, once bacterial identification was achieved, showed an overall sensibility and specificity of 100% (CI95: [95%, 100%] and CI95: [99%, 100%], respectively). The concordance between hospital routine bacterial identification protocol and identification using this new methodology from the same extract used for KPC detection was ≥92%. This study represents the pioneering effort to directly detect KPC using MALDI-TOF MS technology, conducted on patient-derived samples obtained from hospitals for validation purposes, in a multi-resistance global context that requires concrete actions to preserve the available therapeutic options and reduce the spread of antibiotic resistance markers.

Community-associated Clostridioides difficile infection in a general hospital from Argentina.

Toxin-producing Clostridioides difficile infection (CDI) is the leading cause of hospital-acquired diarrhea. However, it is now recognized as a cause of diarrhea in the community. This single-center study aimed to determine the epidemiological origin of CDI cases between January 2014 and December 2019 and to compare demographic characteristics, comorbidities, risk factors, severity, and mortality of community CDI with healthcare facility-associated CDI. There were 52 CDI cases from the community (34.4%). Community patients were significantly younger (53 yo vs. 65 yo), less comorbid (Charlson Index 1.65 vs. 3.98), and less severe (only one case). The main risk factor was the use of antibiotics in the previous 90 days (65%). However, we did not find any known risk factor in 7 patients.

Impact of the multiplex molecular FilmArray Respiratory Panel on antibiotic prescription and clinical management of immunocompromised adults with suspected acute respiratory tract infections: A retrospective before-after study.

This study aimed to assess the impact of the implementation of a rapid multiplex molecular FilmArray Respiratory Panel (FRP) on the medical management of immunocompromised patients from a community general hospital. We conducted a single-center, retrospective, and before-after study. Two periods were evaluated: before the implementation of the FRP (pre-FRP) from April 2017 to May 2018 and after the implementation of the FRP (post-FRP) from January to July 2019. The inclusion criteria were immunocompromised patients over 18 years of age with suspected acute respiratory illness tested by conventional diagnostic methods (pre-FRP) or the FilmArray™ Respiratory Panel v1.7 (post-FRP). A total of 142 patients were included, 64 patients in the pre-FRP and 78 patients in the post-FRP. The positive detection rate was significantly higher in the post-FRP (63% vs. 10%, p<0.01). There were more patients receiving antimicrobial treatment in the pre-FRP compared with the post-FRP period (94% vs. 68%, p<0.01). A decrease in beta-lactam (89% vs. 61%, p<0.01) and macrolide (44% vs. 13%, p<0.01) prescriptions were observed in the post-FRP. No differences were observed in oseltamivir use (22% vs. 13%, p=0.14), changes in antimicrobial treatment, hospital admission rate, days-reduction in droplet isolation precautions, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, treatment failure and 30-day mortality. The implementation of the FRP impacted patient care by improving diagnostic yield and optimizing antimicrobial treatment in immunocompromised adult patients.

[Social distancing as protection factor against COVID-19 in a non-metropolitan area in the State of Rio Grande do Sul, BrazilLas medidas de distanciamiento social como factor de protección contra la COVID-19 en el interior de Rio Grande do Sul, Brasil]. / Medidas de distanciamento social como fator de proteção contra a COVID-19 no interior do Rio Grande do Sul, Brasil.

OBJECTIVE: To estimate the SARS-CoV-2 seroprevalence in a non-metropolitan area (Vale do Rio Pardo) in the state of Rio Grande do Sul, Brazil, and determine the association between seroprevalence and adherence to social distancing measures. METHOD: For the present population-based, cross-sectional study, data were collected in four stages from August to October 2020. SARS-CoV-2 seroprevalence was assessed using an IgG/IgM rapid test. Demographic, socioeconomic, clinical, and behavioral data were also collected, with administration of a three-question survey to determine adherence to social distancing measures with a focus on the level of social distancing practiced by participants, their routine activities, and circulation of people in the home. The association between sociodemographic data and social distancing was assessed using the chi-square test for linear trends in proportions, and the association between social distancing and seroprevalence was assessed using Poisson regression (95% confidence interval [95%CI]; P< 0.05). RESULTS: Of 4 252 tested and interviewed participants, 11.8% (95%CI: 10.8; 12.8) did not adhere to social distancing measures. The prevalence of a positive rapid test was 4.7% in participants who did not practice social distancing and 1.9% in participants who adhered to social distancing measures (P< 0.05). The variables male sex, age 20 to 59 years, having completed high school, monthly family income ranging from R$ 3 136.00 to R$ 6 270.00, and living in rural areas were associated with non-adherence to social distancing (P< 0.05). Adherence to all social distancing measures provided protection against SARS-CoV-2 infection (prevalence ratio: 0.37; 95%CI: 0.19; 0.73). CONCLUSIONS: The results indicate a reduction in seroprevalence with the adherence to social distancing measures.

OBJETIVO: Investigar la seroprevalencia del SARS-CoV-2 en la zona del Vale do Rio Pardo (Rio Grande do Sul, Brasil), y analizar la relación entre la seroprevalencia y el cumplimiento de las medidas de distanciamiento social por parte de la población. MÉTODO: Este estudio transversal basado en la población comprendió cuatro etapas de recopilación domiciliaria de datos entre agosto y octubre del 2020. La seroprevalencia se evaluó con la prueba rápida de anticuerpos IgM e IgG. Además, se recopilaron datos demográficos, socioeconómicos, clínicos y comportamentales por medio de un cuestionario de tres preguntas sobre el cumplimiento de las medidas de distanciamiento social, centrado en el grado de distanciamiento social que la persona entrevistada lograba tener, la rutina de las actividades de la persona entrevistada y la circulación de personas en el hogar. La relación entre los datos sociodemográficos y la práctica de distanciamiento social se evaluó con la prueba del ji cuadrado para determinar la tendencia lineal y la heterogeneidad de las proporciones, y la relación entre el distanciamiento social y la seroprevalencia se evaluó con el modelo de regresión de Poisson (intervalo de confianza de 95% [IC95%]; P< 0,05). RESULTADOS: De las 4 252 personas que se entrevistaron y a las que se les realizó la prueba, 11,8% (IC95%: 10,8; 12,8) no cumplían el distanciamiento social. La prevalencia de la realización de la prueba rápida con reactivo fue de 4,7% entre quienes no cumplían el distanciamiento social y de 1,9% entre quienes cumplían con esa medida (P< 0,05). Las variables relacionadas con el sexo masculino, el grupo etario de 20 a 59 años, la escolaridad de nivel medio, los ingresos familiares mensuales de R$ 3 136,00 a R$ 6 270,00 y la residencia en zonas urbanas guardaron relación con el incumplimiento del distanciamiento social (P< 0,05). El cumplimiento con todas las medidas de distanciamiento social fue un factor de protección contra la infección por SARS-CoV-2 (razón de prevalencia: 0,37; IC95%: 0,19; 0,73). CONCLUSIONES: Los resultados indican una reducción de la seroprevalencia a causa de las medidas de distanciamiento social.

Medidas de distanciamento social como fator de proteção contra a COVID-19 no interior do Rio Grande do Sul, Brasil

[RESUMO]. Objetivo. Investigar a soroprevalência de SARS-CoV-2 na região do Vale do Rio Pardo, Rio Grande do Sul, Brasil, e analisar a associação entre soroprevalência e adesão por parte da população às medidas de distanciamento social. Método. Este estudo transversal de base populacional compreendeu quatro etapas de coleta domiciliar de dados entre agosto e outubro de 2020. A soroprevalência foi avaliada utilizando teste rápido de anticorpos IgM e IgG. Foram coletados, ainda, dados demográficos, socioeconômicos, clínicos e comportamentais, com aplicação de um questionário de três perguntas sobre adesão a medidas de distanciamento social, com foco no nível de distanciamento social que o entrevistado conseguia praticar, rotina de atividades do entrevistado e circulação de pessoas na casa. A associação entre os dados sociodemográficos e a prática de distanciamento social foi avaliada pelo teste do qui-quadrado para tendência linear e heterogeneidade de proporções, e a associação entre o distanciamento social e a soroprevalência foi avaliada pela regressão de Poisson (intervalo de confiança de 95% [IC95%]; P < 0,05). Resultados. Dos 4 252 indivíduos testados e entrevistados, 11,8% (IC95%: 10,8; 12,8) não aderiram ao distanciamento social. A prevalência de teste rápido reagente foi de 4,7% entre aqueles que não realizaram distanciamento social e de 1,9% entre aqueles que realizaram distanciamento social (P < 0,05). As variáveis sexo masculino, faixa etária de 20 a 59 anos, ensino médio, renda familiar mensal de R$ 3 136,00 a R$ 6 270,00 e morar na zona urbana apresentaram associação com a não adesão ao distanciamento social (P < 0,05). A adesão a todas as medidas de distanciamento social foi fator de proteção contra a infecção de SARS-CoV-2 (razão de prevalência: 0,37; IC95%: 0,19; 0,73). Conclusões. Os resultados indicam uma redução da soroprevalência pelas medidas de distanciamento social.

[ABSTRACT]. Objective. To estimate the SARS-CoV-2 seroprevalence in a non-metropolitan area (Vale do Rio Pardo) in the state of Rio Grande do Sul, Brazil, and determine the association between seroprevalence and adherence to social distancing measures. Method. For the present population-based, cross-sectional study, data were collected in four stages from August to October 2020. SARS-CoV-2 seroprevalence was assessed using an IgG/IgM rapid test. Demographic, socioeconomic, clinical, and behavioral data were also collected, with administration of a three-question survey to determine adherence to social distancing measures with a focus on the level of social distancing practiced by participants, their routine activities, and circulation of people in the home. The association between sociodemographic data and social distancing was assessed using the chi-square test for linear trends in proportions, and the association between social distancing and seroprevalence was assessed using Poisson regression (95% confidence interval [95%CI]; P < 0.05). Results. Of 4 252 tested and interviewed participants, 11.8% (95%CI: 10.8; 12.8) did not adhere to social distancing measures. The prevalence of a positive rapid test was 4.7% in participants who did not practice social distancing and 1.9% in participants who adhered to social distancing measures (P < 0.05). The variables male sex, age 20 to 59 years, having completed high school, monthly family income ranging from R$ 3 136.00 to R$ 6 270.00, and living in rural areas were associated with non-adherence to social distancing (P < 0.05). Adherence to all social distancing measures provided protection against SARS-CoV-2 infection (prevalence ratio: 0.37; 95%CI: 0.19; 0.73). Conclusions. The results indicate a reduction in seroprevalence with the adherence to social distancing measures.

[RESUMEN]. Objetivo. Investigar la seroprevalencia del SARS-CoV-2 en la zona del Vale do Rio Pardo (Rio Grande do Sul, Brasil), y analizar la relación entre la seroprevalencia y el cumplimiento de las medidas de distanciamiento social por parte de la población. Método. Este estudio transversal basado en la población comprendió cuatro etapas de recopilación domiciliaria de datos entre agosto y octubre del 2020. La seroprevalencia se evaluó con la prueba rápida de anticuerpos IgM e IgG. Además, se recopilaron datos demográficos, socioeconómicos, clínicos y comportamentales por medio de un cuestionario de tres preguntas sobre el cumplimiento de las medidas de distanciamiento social, centrado en el grado de distanciamiento social que la persona entrevistada lograba tener, la rutina de las actividades de la persona entrevistada y la circulación de personas en el hogar. La relación entre los datos sociodemográficos y la práctica de distanciamiento social se evaluó con la prueba del ji cuadrado para determinar la tendencia lineal y la heterogeneidad de las proporciones, y la relación entre el distanciamiento social y la seroprevalencia se evaluó con el modelo de regresión de Poisson (intervalo de confianza de 95% [IC95%]; P < 0,05). Resultados. De las 4 252 personas que se entrevistaron y a las que se les realizó la prueba, 11,8% (IC95%: 10,8; 12,8) no cumplían el distanciamiento social. La prevalencia de la realización de la prueba rápida con reactivo fue de 4,7% entre quienes no cumplían el distanciamiento social y de 1,9% entre quienes cumplían con esa medida (P < 0,05). Las variables relacionadas con el sexo masculino, el grupo etario de 20 a 59 años, la escolaridad de nivel medio, los ingresos familiares mensuales de R$ 3 136,00 a R$ 6 270,00 y la residencia en zonas urbanas guardaron relación con el incumplimiento del distanciamiento social (P < 0,05). El cumplimiento con todas las medidas de distanciamiento social fue un factor de protección contra la infección por SARS-CoV-2 (razón de prevalencia: 0,37; IC95%: 0,19; 0,73). Conclusiones. Los resultados indican una reducción de la seroprevalencia a causa de las medidas de distanciamiento social.

Effect of Melatonin on the Reduction of Hepatic Steatosis and Intestinal Leptin Expression in Zebrafish Exposed to Fructose.

Melatonin is a hormone related to circadian rhythms and has potential clinical applications. Our objectives were to verify the effect of melatonin on the liver of zebrafish exposed to fructose and evaluate the expression of appetite-related genes (leptin, ghrelin, and melanocortin receptor 4 [MC4R]). Animals were divided into three groups: control (CG, n = 25), fructose (FG, n = 25), and fructose+melatonin (FMG, n = 25). The study was carried out in 8 weeks. FG and FMG were exposed to 2% fructose and FMG treated with 1 µM of melatonin. Histological liver studies and gene expression analyses of Leptin, Ghrelin, and MC4R (liver and intestines) were performed. FG developed hepatic steatosis, which did not occur with CG and FMG. Genetic expression of hepatic leptin and MC4R did not show significant difference among the groups. Animals exposed to fructose (FG) presented an increased expression of intestinal leptin compared to those administered with melatonin. Animals exposed to fructose gained weight and developed an important hepatic steatosis, but melatonin reduced significantly the hepatic damage. Intestinal leptin showed increased expression in the group exposed to fructose.

Testing of In Vitro Susceptibility of Neisseria gonorrhoeae to Azithromycin: Comparison of Disk Diffusion and Reference Agar Dilution Methods.

Azithromycin in combination with ceftriaxone is recommended as the first-line treatment for uncomplicated gonorrhea in many countries. Therefore, monitoring of azithromycin susceptibility of Neisseria gonorrhoeae isolates is essential. In 2019, the Clinical and Laboratory Standards Institute (CLSI) listed the MIC breakpoint for a susceptible-only category to azithromycin, but breakpoints for disk diffusion are not yet available. In this study, we evaluated the usefulness of disk diffusion for testing the susceptibility of N. gonorrhoeae isolates to azithromycin. A total of 189 clinical isolates susceptible and nonsusceptible to azithromycin were used. Agar dilution MICs were correlated with inhibition zone diameters of azithromycin disks (15-µg) manufactured by BBL and Oxoid. In addition, an interlaboratory study involving two clinical microbiology laboratories was conducted. There was a strong correlation between disk diffusion and agar dilution for BBL disks (r = -0.74; P < 0.001) and Oxoid disks (r = -0.75; P < 0.001). Using a zone diameter breakpoint of ≥27 mm (susceptible) and ≤26 mm (nonsusceptible) yielded good separation between susceptible and nonsusceptible isolates and the least number of discrepancies. Compared to agar dilution, disk diffusion showed high agreement and kappa values of 95.2% and 0.899 (P < 0.001) for BBL disks and 96.8% and 0.933 (P < 0.001) for Oxoid disks, respectively. Major and very major discrepancies were observed in isolates with azithromycin MICs (1 and 2 µg/ml, respectively) near to the breakpoint. These data illustrate that disk diffusion could be a reliable method in clinical laboratories to test susceptibility to azithromycin in N. gonorrhoeae isolates.

Percepções e vivências da equipe de enfermagem frente ao paciente pediátrico em cuidados paliativos / Perceptions and experiences of the nursing team before the pediatric patient in palliative care

Introduction:the proposal of Palliative Care is implemented for patients in situations of vulnerability to a serious, limiting disease that can inevitably lead to terminality. Objective: to know the perceptions and experiences of nursing professionals regarding the care of children in palliative care in pediatric units.Methodology:exploratory descriptive qualitative study conducted in pediatric units of a large university hospital in southern Brazil. Data were obtained through semi-structured interviews with nine participants, nurses and nursing technicians. Thematic content analysis was performed. Results: from the thematic analysis, four themes emerged: Child in palliative care: nursing view; Family-centered care; Experiences, feelings and perceptions of the nursing team; and Nursing team coping: challenges for care. The establishment of the principles of pediatric palliative care is fundamental to support qualified care. Nursing professionals reveal the need to be included in multidisciplinary meetings held to decide on conduct towards the patient, and feel the need for psychological support. Final considerations: the understanding that the philosophy of Palliative Care needs to be extended to an integrated network of care and respect for end-of-life decisions was revealed.

Introdução: a proposta dos Cuidados Paliativos é implementada para pacientes em situações de vulnerabilidade ante uma doença grave, limitante e que pode, inevitavelmente, se encaminhar para a terminalidade. Objetivo: conhecer as percepções e vivências dos profissionais de enfermagem frente ao cuidado à criança em cuidados paliativos em unidades pediátricas. Metodologia: estudo qualitativo, exploratório e descritivo, realizado em unidades pediátricas de um hospital universitário de grande porte do Sul do Brasil. Os dados foram obtidos mediante entrevistas semiestruturadas com nove participantes, enfermeiros e técnicos de enfermagem, submetidas à análise de conteúdo temática. Resultados: a partir da análise temática emergiram quatro temas: Criança em cuidados paliativos: olhar da enfermagem; Cuidado centrado na família; Vivências, sentimentos e percepções da equipe de enfermagem; e Enfrentamento da equipe de enfermagem: desafios para o cuidado. O estabelecimento dos princípios de cuidados paliativos pediátricos é fundamental para subsidiar o cuidado qualificado. Os profissionais de enfermagem revelam a necessidade de serem incluídos nas reuniões multidisciplinares realizadas para decidir condutas em relação ao paciente e sentem necessidade de apoio psicológico. Considerações finais: desvela-se a compreensão de que a filosofia de Cuidados Paliativos precisa ser ampliada para uma rede integrada de atenção e respeito às decisões para o final da vida.

Percepções da integração ensino-serviço-comunidade: contribuições para a formação e o cuidado integral em saúde / Perceptions of teaching-service-community integration: contributions to health education and to comprehensive healthcare / Percepciones de la integración enseñanza-servicio-comunidad: contribuciones para la formación y el cuidado integral en salud

O presente estudo objetiva conhecer a percepção dos sujeitos no processo de ensino-aprendizagem-cuidado no Sistema Único de Saúde (SUS), com base no perfil profissional e nas competências e habilidades recomendadas nas Diretrizes Curriculares Nacionais (DCNs) dos cursos de graduação da saúde. Trata-se de pesquisa qualitativa realizada por meio de técnicas de entrevista não diretiva e grupos focais, envolvendo 42 participantes, sendo: professores, estudantes e gestores das instituições de ensino além de usuários, profissionais e gestores da Secretaria Municipal de Promoção de Saúde (SEMUS). A percepção dos diferentes sujeitos que produzem e vivenciam a integração ensino-serviço-comunidade (IESC) revela afinidade com o perfil profissional e com as competências e habilidades comuns recomendadas nas DCNs dos cursos de graduação da área da saúde. A IESC é compreendida como espaço necessário para a efetivação das DCNs e para se alcançar o perfil profissional proposto.(AU)

The study aims to investigate the perception of subjects in the teaching-learning-care process within the Brazilian National Health System (SUS), based on the professional profile and on the skills and competencies recommended by the National Curricular Guidelines (DCNs) for undergraduate programs in the area of health. It is a qualitative research carried out through non-directive interviews and focus groups, involving 42 participants: teachers, students and managers of education institutions, as well as users, professionals and managers of the Municipal Health Promotion Department (SEMUS). The perception of different subjects who produce and experience teaching-service-community integration (TSCI) reveals affinity with the professional profile and with the common skills and competencies recommended by the DCNs. TSCI is understood as a necessary space for the fulfilment of the DCNs and of the proposed professional profile.(AU)

El presente estudio tiene el objetivo de conocer la percepción de los sujetos en el proceso de enseñanza-aprendizaje-cuidado en el Sistema Brasileño de Salud (SUS), con base en el perfil profesional y en las competencias y habilidades recomendadas en las Directrices Curriculares Nacionales (DCNs) de los cursos de graduación de la salud. Se trata de una encuesta cualitativa por medio de técnicas de entrevista no-directiva y grupos focales, envolviendo a 42 participantes, siendo ellos: profesores, estudiantes y gestores de las instituciones de enseñanza, además de usuarios, profesionales y gestores de la Secretaría Municipal de Promoción de Salud (SEMUS). La percepción de los diferentes sujetos que producen y experimentan la integración enseñanza-servicio-comunidad (IESC) revela afinidad con el perfil profesional y con las competencias y habilidades comunes recomendadas en las Directrices Curriculares Nacionales (DCNs) de los cursos de graduación del área de la salud. La IESC se entiende como un espacio necesario para hacer efectivas las DCNs y para alcanzar el perfil profesional propuesto.(AU)

Percepções e vivências da equipe de enfermagem frente ao paciente pediátrico em cuidados paliativos / Percepciones y experiencias del equipo de enfermería hacia el paciente pediátrico en cuidados paliativos / Perceptions and experiences of the nursing team before the pediatric patient in palliative care

RESUMO Introdução: a proposta dos Cuidados Paliativos é implementada para pacientes em situações de vulnerabilidade ante uma doença grave, limitante e que pode, inevitavelmente, se encaminhar para a terminalidade. Objetivo: conhecer as percepções e vivências dos profissionais de enfermagem frente ao cuidado à criança em cuidados paliativos em unidades pediátricas. Metodologia: estudo qualitativo, exploratório e descritivo, realizado em unidades pediátricas de um hospital universitário de grande porte do Sul do Brasil. Os dados foram obtidos mediante entrevistas semiestruturadas com nove participantes, enfermeiros e técnicos de enfermagem, submetidas à análise de conteúdo temática. Resultados: a partir da análise temática emergiram quatro temas: Criança em cuidados paliativos: olhar da enfermagem; Cuidado centrado na família; Vivências, sentimentos e percepções da equipe de enfermagem; e Enfrentamento da equipe de enfermagem: desafios para o cuidado. O estabelecimento dos princípios de cuidados paliativos pediátricos é fundamental para subsidiar o cuidado qualificado. Os profissionais de enfermagem revelam a necessidade de serem incluídos nas reuniões multidisciplinares realizadas para decidir condutas em relação ao paciente e sentem necessidade de apoio psicológico. Considerações finais: desvela-se a compreensão de que a filosofia de Cuidados Paliativos precisa ser ampliada para uma rede integrada de atenção e respeito às decisões para o final da vida.

RESUMEN Introducción: la propuesta de los Cuidados Paliativos es implementada para pacientes en situaciones de vulnerabilidad ante una enfermedad grave, limitante y que puede, inevitablemente, encaminarse para el fallecimiento. Objetivo: conocer las percepciones y experiencias de los profesionales de enfermería ante al cuidado al niño en cuidados paliativos en unidades pediátricas. Metodología: estudio cualitativo, exploratorio y descriptivo, realizado en unidades pediátricas de un hospital universitario de gran tamaño del Sur de Brasil. Los datos fueron obtenidos mediante entrevistas semiestructuradas con nueve participantes, enfermeros y técnicos de enfermería, sometidas al análisis de contenido temático. Resultados: a partir del análisis temático surgieron cuatro temas: Niño en cuidados paliativos: percepción de la enfermería; Cuidado centrado en la familia; Experiencias, sentimientos y percepciones del equipo de enfermería; y Enfrentamiento del equipo de enfermería: desafíos para el cuidado. El establecimiento de los principios de cuidados paliativos pediátricos es fundamental para fomentar el cuidado calificado. Los profesionales de enfermería revelan la necesidad de ser incluidos en las reuniones multidisciplinares realizadas para decidir conductas en relación al paciente y sienten la necesidad de apoyo psicológico. Consideraciones finales: se demuestra que la filosofía de Cuidados Paliativos necesita ser ampliada para una red integradora de atención y respeto a las decisiones para el final de la vida.

ABSTRACT Introduction: the proposal of Palliative Care is implemented for patients in situations of vulnerability to a serious, limiting disease that can inevitably lead to terminality. Objective: to know the perceptions and experiences of nursing professionals regarding the care of children in palliative care in pediatric units. Methodology: exploratory descriptive qualitative study conducted in pediatric units of a large university hospital in southern Brazil. Data were obtained through semi-structured interviews with nine participants, nurses and nursing technicians. Thematic content analysis was performed. Results: from the thematic analysis, four themes emerged: Child in palliative care: nursing view; Family-centered care; Experiences, feelings and perceptions of the nursing team; and Nursing team coping: challenges for care. The establishment of the principles of pediatric palliative care is fundamental to support qualified care. Nursing professionals reveal the need to be included in multidisciplinary meetings held to decide on conduct towards the patient, and feel the need for psychological support. Final considerations: the understanding that the philosophy of Palliative Care needs to be extended to an integrated network of care and respect for end-of-life decisions was revealed.

Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies.

INTRODUCTION: Cardiovascular medications are effective in prevention of cardiovascular diseases (CVD); however, medication non-adherence contributes to morbidity and mortality. OBJECTIVE: This systematic review and meta-analysis aims to summarise the evidence regarding the relationship between characteristics of drug therapy (pharmacotherapy) and medication non-adherence in the CVD population. METHODS: Systematic searches in PubMed, LILACS, Academic Search and CINAHL databases for observational studies that enrolled adults with CVD were performed, from January 1960 to December 2015. The meta-analysis tested the association between characteristics of pharmacotherapy and self-reported medication non-adherence outcome, using a random effects model. To investigate heterogeneity, we performed subgroup analysis and sensitivity analysis. RESULTS: Twenty-four cross-sectional studies and 7 cohort studies were included in this review. Based on 31 studies including 27 441 participants, we performed meta-analyses for all the characteristics of drug therapy that at least 2 studies evaluated, with a total of fourteen meta-analyses. The pooled results showed that studies which evaluate whether participants have insurance or another program that assists with medication costs, but not full coverage (OR = 0.63; 95% CI: 0.53-0.74; P < .001; I2  = 0%, P = .938), and a dosing frequency of twice or more daily (OR = 1.38; 95% CI: 1.13-1.69; P < .001) were associated with non-adherence. CONCLUSIONS AND RELEVANCE: The results of this review suggest that access to insurance or another program that assists with medication costs was a protection factor for non-adherence. On the other hand, a high frequency of dosing was a risk factor for non-adherence. Therefore, these characteristics of pharmacotherapy must be considered to improve medication adherence among CVD patients.

Conflito ético como desencadeador de sofrimento moral: survey com enfermeiros brasileiros / Ethical conflict as a trigger for moral suffering: survey of Brazilian nurses / Conflicto ético como desencadenador de sufrimiento moral: encuesta con las enfermeras brasileñas

Objetivo: analisar o sofrimento moral de enfermeiros brasileiros, desencadeado pelas situações de conflitos vivenciados no cotidiano do trabalho. Método:survey com aplicação de questionário aberto com 1050 enfermeiros brasileiros, em outubro de 2013. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Rio Grande com o número 144/2013. O total de 2.304 situações apontadas pelos participantes foi submetido à análise temática, dando origem a nove categoria, das quais duas são tratadas neste artigo. Resultados: foram identificadas duas categorias iniciais: conflitos e relações profissionais ­ que agregadas levaram às subcategorias: conflito e relações profissionais com a equipe de saúde e com o usuário/família. Conclusão: o enfermeiro vivencia múltiplas situações em seu cotidiano de trabalho, que podem se constituir em motivo do processo de SM.

Objective: to examine moral suffering triggered by situations of conflicts experienced in the daily work of Brazilian nurses. Method: survey of 1050 Brazilian nurses by applying an open questionnaire in October 2013. The project was approved by the research ethics committee of the Rio Grande Federal University (No. 144/2013). The 2,304 situations pointed out by the participants were submitted to thematic analysis, giving rise to nine categories, two of which are addressed in this article. Results: two initial categories ­ conflicts and professional relationships ­ were identified and, when aggregated, produced the subcategories conflict and professional relations with the health team and with the user and family. Conclusion: nurses experience multiple situations in their daily work, which may constitute reasons for the process of moral suffering.

Objetivo: analizar el sufrimiento moral de enfermeros brasileños, desencadenado por las situaciones conflictivas vivenciadas en el cotidiano del trabajo. Método: encuesta con aplicación de cuestionario abierto junto a 1050 enfermeros brasileños en octubre de 2013. El proyecto fue aprobado por el Comité de Ética en Investigación de la Universidad Federal de Rio Grande con el número 144/2013. El total de 2.304 situaciones señaladas por los participantes fue sometido al análisis temático, dando origen a nueve categorías; dos de ellas son estudiadas en este artículo. Resultados: se identificaron dos categorías iniciales: conflictos y relaciones profesionales, que, agregadas, llevaron a las subcategorías: conflicto y relaciones profesionales con el equipo de salud y con el usuario/familia. Conclusión: El enfermero vive múltiples situaciones, en su cotidiano de trabajo, que pueden formar el motivo del proceso de sufrimiento moral.

Chronic exposure to ethanol causes steatosis and inflammation in zebrafish liver.

AIM: To evaluate the effects of chronic exposure to ethanol in the liver and the expression of inflammatory genes in zebrafish. METHODS: Zebrafish (n = 104), wild type, adult, male and female, were divided into two groups: Control and ethanol (0.05 v/v). The ethanol was directly added into water; tanks water were changed every two days and the ethanol replaced. The animals were fed twice a day with fish food until satiety. After two and four weeks of trial, livers were dissected, histological analysis (hematoxilin-eosin and Oil Red staining) and gene expression assessment of adiponectin, adiponectin receptor 2 (adipor2), sirtuin-1 (sirt-1), tumor necrosis factor-alpha (tnf-a), interleukin-1b (il-1b) and interleukin-10 (il-10) were performed. Ultrastructural evaluations were conducted at fourth week. RESULTS: Exposing zebrafish to 0.5% ethanol developed intense liver steatosis after four weeks, as demonstrated by oil red staining. In ethanol-treated animals, the main ultrastructural changes were related to cytoplasmic lipid particles and droplets, increased number of rough endoplasmic reticulum cisterns and glycogen particles. Between two and four weeks, hepatic mRNA expression of il-1b, sirt-1 and adipor2 were upregulated, indicating that ethanol triggered signaling molecules which are key elements in both hepatic inflammatory and protective responses. Adiponectin was not detected in the liver of animals exposed and not exposed to ethanol, and il-10 did not show significant difference. CONCLUSION: Data suggest that inflammatory signaling and ultrastructural alterations play a significant role during hepatic steatosis in zebrafish chronically exposed to ethanol.

Avaliação das interações medicamentosas potenciais em prescrições de pacientes em Unidade de Terapia Intensiva / Evaluation of potential drug interactions in prescriptions for patients in Intensive Care Cnits

A identificação e prevenção de interações entre medicamentos estão diretamente relacionadas com a segurança do paciente e são de grande importância no ambiente hospitalar. O objetivo deste trabalho foi identificar e avaliar a existência de interações medicamentosas potenciais na farmacoterapia prescrita. Trata-se de estudo observacional, com 308 prescrições de 195 pacientes internados na Unidade de Terapia Intensiva de um hospital de ensino, realizado de agosto a dezembro de 2015. Para identificação das interações utilizou-se a base de dados Micromedex®. Das 308 prescrições analisadas, 101 apresentaram pelo menos uma interação medicamentosa, totalizando 173 interações, referentes a 71 pacientes. Destes, 43 eram do sexo masculino, com idade média de 61,9 anos. A média de internação na unidade foi de 7 dias. Nas 101 prescrições que apresentaram interações medicamentosas, foi prescrito o total de 1.349 medicamentos com média de 13,3 medicamentos/paciente/dia. Identificar essas interações possibilita evitar situações de insucesso terapêutico e toxicidade medicamentosa.

The identification and the interaction of drugs are directly related to patient´s safety and are highly relevant within the hospital. Current analysis identifies and evaluates potential drugs interactions within prescribed pharmacotherapy. The study, undertaken between August and December 2015, comprises 308 prescriptions of 195 patients hospitalized in the UTI of a university hospital. Micromedex® database identified interactions. Further, 101 out of 308 prescriptions revealed at least one drug interaction, with a total of 173 interactions with 71 patients, of which 43 were males with an average age of 61,9 years. Mean hospitalization period in the ICUs was 7 days. The 101 prescriptions with drug interactions totaled 1,349 drugs, at an average of 13,3 drugs/patient/day. The identification of these interactions avoids therapeutic failure and toxicity.

Formas utilizadas para tentativa de suicídio e características sociodemográficas dos pacientes atendidos no serviço de emergência de um hospital de ensino / Methods used in suicide attempts and sociodemographic characteristics of patients treated at the emergency department of a teaching hospital

OBJETIVOS: Caracterizar as formas utilizadas para tentativa de suicídio e características sociodemográficas de pacientes atendidos no serviço de emergência de um hospital de ensino. MÉTODOS: Estudo transversal retrospectivo, com busca ativa em prontuários eletrônicos de pacientes atendidos entre janeiro e dezembro de 2015 no serviço de emergência de um hospital de ensino, que integra a rede pública de saúde do interior do estado do Rio Grande do Sul, Brasil. Foram incluídos todos os casos de tentativa de suicídio, independente de sua forma. Não foram investigados os casos que resultaram em óbito por suicídio. Foi utilizada estatística descritiva e foram avaliadas associações por análise univariada, sendo aplicado o teste do quiquadrado de Pearson. RESULTADOS: No período estudado foram encaminhados 233 pacientes atendidos na emergência para realização de avaliação psiquiátrica, sendo 122 casos caracterizados por tentativa de suicídio. Desses, a média de idade dos pacientes foi de 36,8±14,3 anos, com mínima de 14 e máxima de 88 anos e, 74 (60,6%) eram do sexo feminino. As formas mais utilizadas de tentativa de suicídio foram ingesta de medicamentos (72 casos, 59%) e ingesta de agrotóxicos (14 casos, 11,5%). Do total de pacientes, 119 (97,5%) residiam no município de Santa Cruz do Sul, com predominância nos moradores da zona urbana (103 pacientes, 84,4%). Dos 50 (41,0%) encaminhamentos, 32 (64,0%) foram para o Centro de Atendimento Psicossocial, 7 (14%) para Centro de Atendimento Psicossocial da Infância e Adolescência, 6 (12%) para internação em unidade de saúde mental e 5 (10%) para o Centro de Atendimento Psicossocial Álcool e Drogas. Em 66 (54,1%) pacientes não foi encontrado nenhum registro em prontuário eletrônico sobre o desfecho após a alta e 6 (4,9%) pacientes evadiram. CONCLUSÕES: A maioria dos pacientes atendidos por tentativa de suicídio foram adultos jovens do sexo feminino. Como principal forma utilizada para a tentativa de suicídio identificou-se a ingesta de medicamentos e em seguida a de agrotóxicos.

AIMS: To describe the methods used in suicide attempts and sociodemographic characteristics of suicidal patients treated at the emergency department of a teaching hospital. METHODS: Observational and descriptive study, with active search for electronic medical records of patients treated at the emergency department of a public teaching hospital in the countryside of Rio Grande do Sul, Brazil, from January to December 2015. All cases of suicide attempt were included, regardless of the suicide methods used. Successful suicide cases were not investigated. The statistical analyses included descriptive statistics, univariate analysis, and Pearson's chi-square test. RESULTS: A total of 233 patients treated at the emergency department were referred for psychiatric evaluation, and 122 of them had attempted suicide. The mean age of the suicidal patients was 36.8±14.3 years, (minimum of 14 years and maximum of 88 years) and 74 (60.6%) of them were female. The most common suicide attempt methods were ingestion of medications (72 cases, 59%) and of pesticide (14 cases, 11.5%). Of all patients, 119 (97.5%) lived in Santa Cruz do Sul, predominantly in the urban area (103 patients, 84.4%). Of the 50 (41.0%) referrals, 32 (64.0%) were sent to the Center for Psychosocial Care, 7 (14%) to the Center for Children's and Adolescents' Psychosocial Care, 6 (12%) were admitted to a mental health unit, and 5 (10%) were sent to Psychosocial Care Center for Alcohol and Drug Abuse. Sixty-six (54.1%) patients had no electronic medical records of their outcome after discharge and 6 (4.9%) were lost to follow-up. CONCLUSIONS: Most of the treated suicidal patients were young adult females. The most common method of suicide attempt was the ingestion of medications, followed by the ingestion of pesticides.

Deleterious effects of interruption followed by reintroduction of enzyme replacement therapy on a lysosomal storage disorder.

Temporary interruption of enzyme replacement therapy (ERT) in patients with different lysosomal storage disorders may happen for different reasons (adverse reactions, issues with reimbursement, logistic difficulties, and so forth), and the impact of the interruption is still uncertain. In the present work, we studied the effects of the interruption of intravenous ERT (Laronidase, Genzyme) followed by its reintroduction in mice with the prototypical lysosomal storage disorder mucopolysaccharidosis type I, comparing to mice receiving continuous treatment, untreated mucopolysaccharidosis type I mice, and normal mice. In the animals which treatment was temporarily interrupted, we observed clear benefits of treatment in several organs (liver, lung, heart, kidney, and testis) after reintroduction, but a worsening in the thickness of the aortic wall was detected. Furthermore, these mice had just partial improvements in behavioral tests, suggesting some deterioration in the brain function. Despite worsening is some disease aspects, urinary glycosaminoglycans levels did not increase during interruption, which indicates that this biomarker commonly used to monitor treatment in patients should not be used alone to assess treatment efficacy. The deterioration observed was not caused by the development of serum antienzyme antibodies. All together our results suggest that temporary ERT interruption leads to deterioration of function in some organs and should be avoided whenever possible.

Effects of moral distress on nurses: Integrative literature review / Consequências do sofrimento moral em enfermeiros: Revisão integrativa / Consecuencias del sufrimiento moral en enfermeros: Revisión integrativa

The present study aimed to identify the effects of moral distress on nurses. Integrative literature review with data collection from May to September 2013 and updated in July 2015 in database Biblioteca Virtual em Saúde, using the terms: Moral Distress, Moral Suffering, Nurse andNursing.The final sample was composed of eighty-five studies.The outcomes are presented in four categories. The first one (Feelings) includes dissatisfaction, frustration and anger; the second (Sickening) emerged from the experience of physical and emotional sickening; the third (Quality of care) concerns the actions that resulted in ineffective care and denial of patient advocacy; and the fourth (Coping Strategies)showed the types of coping such as:abandonment of the profession and denaturalization of the practices. The effects are present in the daily routine of the professionals, causing damage often irreversible and, abandonment of the employment (AU).

O objetivo foi identificar as consequências de sofrimento moral em enfermeiros. Trata-se de uma revisão integrativa, com coleta dos dados realizada de maio a setembro de 2013 e atualizada em julho de 2015 na Biblioteca Virtual em Saúde, com os termos: Moral Distress, Moral Suffering, Nurse e Nursing. Oitenta e cinco estudos compuseram a amostra final. Os resultados são apresentados em quatro categorias. A primeira: Sentimentos composta pela presença de sentimentos como insatisfação, frustração, raiva; a segunda: Adoecimento emergiu da vivência de adoecimento físico e emocional; a terceira Qualidade do cuidado pela presença de ações que levavam ao cuidado ineficaz e negação da advocacia do paciente; e a quarta: Estratégias de enfrentamento, demonstrou as formas de enfrentamento utilizadas, como: abandono da profissão e a desnaturalização das práticas. Evidencia-se que as consequências estão presentes no cotidiano dos profissionais, e causam danos muitas vezes irreversíveis, inclinando para o abandono da profissão (AU).

Estudio cuyo objetivo fue identificar las consecuencas de sufrimiento moral en enfermeros. En esa revisión integrativa, los datos fueron obtenidos de mayo a septiembre de 2013, siendo actualizada en julio de 2015 en la Biblioteca Virtual en Salud, por medio de los términos: Moral Distress, Moral Suffering, Nurse y Nursing. La muestra final fue compuesta de ochenta y cinco estudios. Los resultados son presentados en cuatro categorías. La primera: Sentimientos, compuesta por sentimientos como insatisfacción, frustración, ira; y la segunda, Proceso de enfermarse, de donde surgieron: vivencia de la enfermedad física y emocional; la tercera, Cualidad del cuidado, por la presencia de acciones que llevaban al cuidado ineficaz y negación de la agocacía del paciente; y la cuarta: Estrategias de enfrentamiento, que demostró las formas de enfrentamiento utilizadas, como: abandono de la profesión y la desnaturalización de las prácticas. Se evidencía que las consecuencas están presentes en el cotidiano de los profesionales, y causan daños muchas veces irreversibles, podendo llevar al abandono de la profesión (AU).

Lactobacillus rhamnosus GG Effect on Behavior of Zebrafish During Chronic Ethanol Exposure.

Ethanol is a widely consumed drug, which acts on the central nervous system to induce behavioral alterations ranging from disinhibition to sedation. Recent studies have produced accumulating evidence for the therapeutic role of probiotic bacteria in behavior. We aimed to investigate the effect of Lactobacillus rhamnosus GG (LGG) on the behavior of adult zebrafish chronically exposed to ethanol. Adult wild-type zebrafish were randomly divided into four groups, each containing 15 fish. The following groups were formed: Control (C), received unsupplemented feed during the trial period; Probiotic (P), fed with feed supplemented with LGG; Ethanol (E), received unsupplemented feed and 0.5% of ethanol directly added to the tank water; and Probiotic+Ethanol (P+E), group under ethanol exposure (0.5%) and fed with LGG supplemented feed. After 2 weeks of exposure, the novel tank test was used to evaluate fish behavior, which was analyzed using computer-aided video tracking. LGG alone did not alter swimming behavior of the fish. Ethanol exposure led to robust behavioral effects in the form of reduced anxiety levels, as indicated by increased vertical exploration and more time spent in the upper region of the novel tank. The group exposed to ethanol and treated with LGG behaved similarly to animals exposed to ethanol alone. Taken together, these results show that zebrafish behavior was not altered by LGG per se, as seen in murine models. This was the first study to investigate the effects of a probiotic diet on behavior after a chronic ethanol exposure.