Survey of infection in orthopedic postoperative and their causative agents: a prospective study.

OBJECTIVE: to evaluate the cases of wound infections in orthopedic postoperative period. METHODS: postoperative patients who developed infection during the period from November 2012 to November 2013 were studied. Secretions were collected during surgery using sterile swabs, and sent for microbiological analysis. RESULTS: during the period analyzed, 38 surgical procedures progressed to infection. The type of surgery presenting the largest number of infections was osteosynthesis, in 36 (94.7%) patients. Among the materials used, 18 (36%) surgeries that used external fixator were infected, and 17 (34%) using plate. The species of bacteria that caused the largest number of infections were Staphylococcus aureus, infecting 16 (43.9%) patients, followed by Acinetobacter baumannii, which infected four (10.5%) patients. Regarding the resistance profile of Gram-positive strains to antibiotics, 100% of Staphylococcus aureus strains were susceptible to vancomycin and 31.3%, to ceftriaxone. As for the Gram-negative bacteria, 100% of Acinetobacter baumannii strains were resistant to ceftriaxone, gentamicin and imipenem. CONCLUSION: infection control in the postoperative period is necessary, using antibiotics correctly and consciously, avoiding resistance of bacterial agents.

Survey of infection in orthopedic postoperative and their causative agents: a prospective study / Avaliação de infecção no pós-operatório ortopédico e seus agentes causadores: estudo prospectivo

SummaryObjective:to evaluate the cases of wound infections in orthopedic postoperative period.Methods:postoperative patients who developed infection during the period from November 2012 to November 2013 were studied. Secretions were collected during surgery using sterile swabs, and sent for microbiological analysis.Results:during the period analyzed, 38 surgical procedures progressed to infection. The type of surgery presenting the largest number of infections was osteosynthesis, in 36 (94.7%) patients. Among the materials used, 18 (36%) surgeries that used external fixator were infected, and 17 (34%) using plate. The species of bacteria that caused the largest number of infections were Staphylococcus aureus, infecting 16 (43.9%) patients, followed by Acinetobacter baumannii, which infected four (10.5%) patients. Regarding the resistance profile of Gram-positive strains to antibiotics, 100% of Staphylococcus aureus strains were susceptible to vancomycin and 31.3%, to ceftriaxone. As for the Gram-negative bacteria, 100% of Acinetobacter baumannii strains were resistant to ceftriaxone, gentamicin and imipenem.Conclusion:infection control in the postoperative period is necessary, using antibiotics correctly and consciously, avoiding resistance of bacterial agents.

ResumoObjetivo:avaliar os casos de feridas infectadas em pós- -operatório ortopédico.Métodos:foram estudados pacientes de pós-operatório que evoluíram com processo infeccioso, durante o período de novembro de 2012 a novembro de 2013. Foi realizada coleta intraoperatória de secreções com o auxílio de swabs estéreis, e o material foi encaminhado para análise microbiológica.Resultados:durante o período analisado, 38 procedimentos cirúrgicos evoluíram para processo infeccioso. O tipo de cirurgia que apresentou o maior número de infecções foi a osteossíntese, em 36 (94,7%) pacientes. Em relação ao material utilizado, 18 (36%) cirurgias que empregaram fixador externo e 17 (34 %) que fizeram uso de placa se infectaram. A bactéria que causou o maior número de infecções foi a Staphylococcus aureus, acometendo 16 (43,9%) pacientes, seguida pela Acinetobacter baumannii, que acometeu 4 (10,5%) pacientes. Em relação ao perfil de resistência das cepas Gram-positivas aos antibióticos, 100% das cepas de Staphylococcus aureus foram sensíveis à vancomicina, e 31,3%, à ceftriaxona. Quanto às bactérias Gram-negativas, 100% das cepas de Acinetobacter baumannii apresentaram resistência a ceftriaxona, gentamicina e imipenem.Conclusão:o controle de infecções em pós-operatório se faz necessário, utilizando antibióticos de forma correta e consciente, evitando a resistência aos agentes bacterianos.

Gamasoidosis illustrated--from the nest to dermoscopy.

Gamasoidosis (acariasis, avian-mite dermatitis or bird-mite dermatitis) is a challenging diagnosis that is becoming more common because of the frequent use of window air conditioners in tropical countries. These devices may serve as shelters for nests of urban birds such as pigeons. Dermatologists should become familiar with this infestation to establish the correct diagnosis and treatment.

Gamasoidosis illustrated: from the nest to dermoscopy / Gamasoidose ilustrada: do ninho à dermatoscopia

Gamasoidosis (acariasis, avian-mite dermatitis or bird-mite dermatitis) is a challenging diagnosis that is becoming more common because of the frequent use of window air conditioners in tropical countries. These devices may serve as shelters for nests of urban birds such as pigeons. Dermatologists should become familiar with this infestation to establish the correct diagnosis and treatment.

Gamasoidose (acaríase, infestação por "piolhinho-de-pombo" ou dermatite por ácaros aviários) é um diagnóstico desafiador que está se tornando mais comum devido ao uso frequente de aparelhos de ar-condicionado de janela em países tropicais, que servem de abrigo para ninhos de pássaros urbanos tais como pombos. Dermatologistas devem se familiarizar com esta infestação para fazerem diagnóstico e tratamento adequados.

Carbon monoxide toxicity with neurological and cardiac complications

A family suffered carbon monoxide toxicity, with cerebral and / or cardiac complications, while sleeping in the cabin on a recreational boat. This article describes a couple exposed to a malfunctioning air-conditioning system on the boat, which subsequently developed the unique combination of cerebral symptoms and a non Q/non-ST elevation myocardial infarction, with enzyme elevations and electrocardiographic abnormalities. This interesting complication of a myocardial infarction secondary to carbon monoxide toxicity, associated with neurological manifestations, is reviewed.

Association of air-conditioning with respiratory symptoms in office workers in tropical climate.

UNLABELLED: To evaluate the association of heating, ventilation and air-conditioning systems (HVAC) and respiratory symptoms in a tropical city, self-administered questionnaires were given to 2000 individuals working in air-conditioned office buildings and to 500 control workers in naturally ventilated buildings. Reported symptoms from the two populations were analyzed using chi-square tests, univariate and multiple logistic regressions models. Symptoms were the outcome variable and the odds ratios were adjusted by gender, age, accumulated work time, smoking habits and atopic background. There was a 79.8% response rate and there was a positive association of nasal symptoms (odds ratio, OR = 1.59, 95% confidence interval, CI = 1.11-2.28), naso-ocular symptoms (OR = 1.58, 95% CI = 1.05-2.38), persistent cough (OR = 3.04, 95% CI = 2.00-4.63) sinusitis symptoms (OR = 1.85, 95% CI = 1.27-2.71) and building-related worsening of the symptoms (OR = 4.92, 95% CI = 2.93-8.27) with working in air-conditioned buildings. In conclusion, our study suggests that artificial air-conditioning is a matter of concern for respiratory symptoms in cities with hot and humid climate. PRACTICAL IMPLICATIONS: This study suggests that indoor air-related respiratory symptoms are a matter of concern in places with hot and humid climate. The regression models were adjusted by confounders that could be used in further reanalysis of indoor air quality related symptoms and ventilation systems with expanded variety of climatic conditions.

Carbon monoxide toxicity with neurological and cardiac complications.

A family suffered carbon monoxide toxicity, with cerebral and / or cardiac complications, while sleeping in the cabin on a recreational boat. This article describes a couple exposed to a malfunctioning air-conditioning system on the boat, which subsequently developed the unique combination of cerebral symptoms and a non Q/non-ST elevation myocardial infarction, with enzyme elevations and electrocardiographic abnormalities. This interesting complication of a myocardial infarction secondary to carbon monoxide toxicity, associated with neurological manifestations, is reviewed.

A manutenção como forma de prevenção de doenças originárias em ambientes climatizados / The mainterrance as a way of preventiry diseases caused by acilimatized environments

Em virtude da evolução dos conceitos e dos problemas relacionados com os sistemas de ar condicionado, o presente trabalho apresenta um histórico sobre os usos de sistemas e os possíveis impactos ligados ao funcionamento e à operação deles com a saúde pública. São utilizados nos processos de manufatura que exigem umidade, temperatura e pureza do ar, na fabricação de produtos farmacêuticos e alimentícios, em ambientes de trabalho que requerem conforto, em locais onde se necessita de segurança na manipulação de produtos e na guarda de patrimônios culturais e históricos, entre outros. Os principais impactos estão relacionados com o desconforto térmico e o desequilíbrio ambiental, podendo provocar danos aos produtos, ao patrimônio e sintomatologias, tais como: dores de cabeça, irritação nos olhos, na garganta e no nariz. Este trabalho considera ainda a avaliação das legislações atuais que definem os critérios e requisitos para o controle e operação de sistemas de ar condicionado, como forma de prevenção de doenças. A avaliação das técnicas de manutenção comumente empregadas em equipamentos relacionados com ambientes climatizados e a apresentação dos efeitos mais comuns, provocados ao ambiente interior pela ineficiência daquelas, são os objetivos mais principais deste projeto. Além dos resultados encontrados na bibliografia, também foram apresentados valores recentes, fruto de uma campanha de monitoramento, realizada em uma empresa, com o intuito de avaliar a eficácia das ações de manutenção empregadas e os possíveis riscos existentes. Conclui-se, a partir da análise dos dados obtidos, que os processos de manutenção implementados de maneira adequada são os mais eficientes como forma de prevenção das doenças originárias em sistemas de ar condicionado.

Decreased respiratory symptoms after intervention in artificially ventilated offices in São Paulo, Brazil.

BACKGROUND: The increase in work-related respiratory complaints in artificially ventilated buildings have multiple causes, and intervention studies are a valuable approach to understanding possible mechanisms. STUDY OBJECTIVES: To analyze the effects of an intervention in a ventilation system with > 20 years of continuous use, and with a high rate of building-related respiratory complains. DESIGN: An epidemiologic study was done among individuals working in places with ventilation machinery and ducts with > 20 years of use, before and after intervention. Analysis of symptoms and logistic regression were performed to check the associations between air-conditioning intervention and reported symptoms. RESULTS: The air-conditioning intervention showed a protective effect on building-related worsening of respiratory symptoms (odds ratio, 0.132; 95% confidence interval, 0.030 to 0.575), naso-ocular symptoms (odds ratio, 0.231; 95% confidence interval, 0.058 to 0.915), and persistent cough (odds ratio, 0.071; 95% confidence interval, 0.014 to 0.356). CONCLUSION: Intervention in high-risk occupational locations can be effective in improving perceived indoor air quality.

[Comments on studies of industrial and non-industrial environments in Brazil: a comparative approach]. / Considerações sobre estudos de ambientes industriais e não industriais no Brasil: uma abordagem comparativa.

Air quality in industrial environments has been studied since the second half of the 20th century. Well-documented results show that exposure to chemical pollutants through their consumption, production, and storage can damage workers' health. New research focusing on non-industrial environments has shown unexpected correlations between air quality and health effects. Artificial ventilation systems have been related to health-related complaints and a high rate of absenteeism. Symptoms related to air quality in non-industrial environments are recognized by the World Health Organization and encompassed under the so-called sick building syndrome (SBS). In Brazil there are few studies comparing indoor air quality and health. The present study is intended to map the studies already conducted in Brazil in order to encourage further research in this area, due to its importance for public health.

Upper respiratory symptoms associated with aging of the ventilation system in artificially ventilated offices in São Paulo, Brazil.

BACKGROUND: The increase of work-related respiratory complaints in artificially ventilated buildings has multiple causes, and the role of allergen exposure and symptoms is still controversial. STUDY OBJECTIVES: To analyze the risk factors and the association of work-related symptoms with allergen exposure and different conditions of the same air conditioning system in São Paulo, Brazil. DESIGN: Workers were classified according to characteristics of the air conditioning system: the first group (group 1) with ventilation machinery and ducts with > 20 years of use, the second group (group 2) with ventilation machinery with > 20 years of use and ventilation ducts with < 2 years of use, and the third group (group 3) with ventilation machinery and ducts with < 2 years of use. Logistic regression was performed to check the associations between air conditioning groups, allergen exposure (fungi, mites, animal dander, and cockroach), and symptoms. RESULTS: There was a higher prevalence of building-related worsening of respiratory symptoms (p = 0.004; odds ratio [OR], 8.53) and symptoms of rhinoconjunctivitis (p = 0.01; OR, 8.49) in group 1. There was a lower relative humidity (p = 0.05) and nonsignificant lower temperature in group 1, when compared to the other groups. The viable mold spores totals were higher outdoors than in the indoor samples (n = 45, p = 0.017). There were higher levels of Der p 1 in group 2 (p = 0.032). All allergen levels were considered low. CONCLUSION: There was a strong association of building-related upper-airway symptoms with places having ventilation systems with > 20 years of use.

Effect of ventilation systems on prevalence of symptoms associated with "sick buildings" in Brazilian commercial establishments.

In this questionnaire study, the authors compared the prevalence of certain symptoms and signs associated with Sick Building Syndrome and perceptions relative to environmental discomfort of employees in a central-air-conditioned dropping center and in natural-ventilation commercial shops located on the streets of Niteroi, Rio de Janeiro, Brazil. There was a statistically significant higher prevalence of symptoms (e.g., water and itching of eyes, sore throat, nose irritation, difficulty breathing, skin irritation, sneezing) that were characteristic of Sick Building Syndrome in the air-conditioned building than in the naturally ventilated stores. The results indicated that there exists a continuing need for further research in Brazilian work environments.

Saúde da populaçäo: controle da infecçäo hospitalar, Prêmio Jovem Cientista e contaminaçäo pela água, Prêmio Jovem Cientista do Futuro / Population health: cross infection control: Premium Young Cientist and water pollution: Premium Young Cientist of Future

Apresenta seis resumos dos trabalhos vencedores do Prêmio Jovem Cientista, todos abordando o tema saúde da populaçäo e os três resumos vencedores do Prêmio Jovem Cientista do Futuro, que incentivam a importância da pesquisa científica junto aos alunos do segundo grau de todas as escolas brasileiras, com o tema principal sobre problemas originados na contaminaçäo pela água

Qualidade em ambientes com ar condicionado (I) / Quality ambient at air conditioned (I)

Este estudo visou a descriçäo, análise e avaliaçäo dos agravos à saúde em trabalhadores expostos sob condiçöes específicas por prolongado período à ambientes pelo sistema de Ar Condicionado. A identificaçäo desse agravos foi feita através de entrevista dirigida , realizada com 61 trabalhadores expostos por mais de 12 dias consecutivos, na Plataforma de Garoupa . Foi feito um estudo microbiológico ,levantamento dos agentes químicos e um monitoramento físico ambiental do campo de estudo . Constatamos uma significativa incidência de sintomas relacionados com o trato respirátorio e alteraçöes dermatológicas nos trabalhadores pesquisados. Os estudos microbiólogicos, e o monitoramento ambiental, associados à incidência de agravos à saúde dos trabalhadores estudados, revelam que a qualidade do ar ambiental apresentava-se comprometida pelos fatores de riscos detectados, com influência direta sobre o organismo dos trabalhadores expostos por longo tempo, tendo como consequência, o absenteísmo e a queda do rendimento laboral .Esse estudo foi motivado pelos levantamentos feitos no períodos de 01 de janeiro à 31 de de julho de 1992