Precauciones del aislamiento de los pacientes con enfermedades transmisibles en una institución de tercer nivel / Isolation precautions in patients with communicable diseases in a third-level institution

El concepto de aislamiento para personas con enfermedades transmisibles fue aplicado desde tiempos bíblicos, una muestra de ello son las colonias de leprosos.1 Durante la guerra de Crimea, Florence Nightingal concluyó en la necesidad de dividir las salas comunes en cubículos y enfatizó la importancia de la asepsia y del mantener los ambientes limpios, cambiando así el concepto de la transmisión de las infecciones.2 Con estos ejemplos, podemos ver a través de la historia como los conceptos y procedimientos se van mejorando y avanzando con el propósito de controlar las infecciones. En 1996, el Comité Asesor de Prácticas sobre el Control de Infecciones Hospitalarias (HICPAC) publicó la Guía para las Precauciones de Aislamiento en los Hospitales, definiendo con ello las precauciones estándar y las precauciones basadas en la transmisión.3 El objetivo de este trabajo fue hacer una revisión bibliográfica de los diferentes artículos científicos sobre las precauciones del manejo de pacientes con enfermedades transmisibles en una institución de tercer nivel para comprobar si existe o no una estandarización en las recomendaciones y en los procedimientos de enfermería en la práctica diaria. Se enfocó en las precauciones del aislamiento de los pacientes con enfermedades transmisibles mediante la revisión exhaustiva de diversas fuentes bibliográficas y mediante de fuentes electrónicas. Como resultado de dicha revisión comprobamos que sí existe una estandarización en las recomendaciones para el aislamiento del enfermo infeccioso, sin embargo, con la revisión de los manuales de diferentes instituciones observamos que hace falta ser más específico en los procedimientos, uso y manejo del material requerido para cumplir con las recomendaciones para el aislamiento, ya que un número importante de estos manuales no cuenta con estos datos, así como la disponibilidad y difusión de éstos

The concept of isolation for people with contagious diseases, was applied since biblical times, a sample are leper colonies, during the Crimean ar Florence Nightingale concludes the need to divide the communal rooms in cubicles and emphasizes the importance of asepsis and maintain clean environments, so changing the concept of the transmission of infections. With these examples we can see through the history as the concepts and procedures are getting better and advancing in order to control infections. In 1996, the Advisory Committee for Practice on Control of Hospital Infections (HICPAC) published the Guidelines for Isolation Precautions in Hospitals defining for it the standard precautions and precautions based on transmission. The objective of this study was to review the literature of different scientific articles about precautions for handling patients with contagious diseases in a third level institution, to verify whether or not standardization exists in the recommendations and procedures in nursing daily practice. It focused on isolation precautions for patients with contagious diseases through an exhaustive review of various literature sources through electronic sources. As a result of that review we check that there is standardization in the recommendations for isolation of infectious patient. However, with the revision of textbooks from different institutions, we see that need to be more specific in the procedures, use and handling of material required to comply with the recommendations for isolation because a significant number of these manuals do not have these data. Well as availability and dissemination of these

Obligations, precautions and pending issues in regulatory development for radiopharmaceuticals in Brazil

Radiopharmaceuticals are compounds that have a radionuclide and may be gamma-radiation emitter (γ) or positrons emitter (β+), linked to a molecule with specific diagnostic and therapeutic purposes. The progress in the use of radiopharmaceuticals has culminated to a sector in common with other types of drugs: regulation and surveillance. From 2006 on, production, marketing and use of these drugs were open to the Brazilian market granting much more freedom due to the Constitutional Amendment 49, resulting from the previous Constitutional Amendment 199/03 which removes the Union monopoly for this kind of manipulation and granted this production to other nuclear medicine. From this date on, the amount of this type of sold product have been greatly increased, and the nucleus of surveillance and regulation in Brazil have also advanced in the legislative processes, creating documents that are now more focused on radiopharmaceuticals in the national territory (Resolutions No. 63 and No. 64). In international overview, there is too much to be done in regulatory terms in Brazil, such as adding mainly issues of drugs surveillance to pharmacovigilance practice in radiopharmaceuticals drugs.

Radiofármacos são compostos que possuem um radionucleotídeo, podendo ser emissor de radiação gama (γ) ou emissor de pósitrons (β+), ligado a uma molécula específica com finalidade diagnóstica e terapêutica. O avanço no uso dos radiofármacos tem culminado a um setor em comum com outros tipos de medicamentos: a regulamentação e fiscalização. Após 2006, a produção, a comercialização e a utilização destes medicamentos foram abertas ao mercado interno brasileiro com maior liberdade, pois a Emenda Constitucional 49, vinda da Emenda Constitucional 199/03, que retira da União o monopólio deste tipo de manipulação, ofereceu a outros centros de medicina nuclear a oportunidade desta produção. A partir desta data, a quantidade comercializada deste tipo de medicamento aumentou absurdamente e os núcleos de vigilância e regulamentação do Brasil avançaram também nos processos legislativos, criando os documentos mais voltados a Radiofármacos existentes no território nacional, as Resoluções n° 63 e n° 64. Em visão internacional, há muito ainda a ser feito em termos regulatórios no Brasil somando principalmente os assuntos vigilantes dos medicamentos como a prática de Farmacovigilância em Radiofármacos.