Thymulin related peptide attenuates inflammation in the brain induced by intracerebroventricular endotoxin injection

Based on significant amount of evidence, it is now generally believed, that one underlying cause for neurodegenerative diseases, could be dysregulation in inflammatory processes. The actual mechanisms involved are not yet well understood. Several studies have demonstrated the potent analgesic and anti-inflammatory actions of thymulin related peptide (PAT), in different animal pain models. In this study, we investigated the efficacy of PAT in a recently developed model of neuroinflammation, in conscious rats, caused by intracerbroventricular (ICV) injection of endotoxin (ET). Our results indicate that ICV injection of PAT alone did not elicit significant alteration of nociceptive thresholds, while ET injections produced significant thermal hyperalgesia and cold allodynia. Pretreatment with PAT resulted in significant alleviation of ET-induced hyperalgesia and increased body temperature. In other sets of experiments, ICV injection of ET resulted in a significant elevation in the concentration of pro-inflammatory mediators measured in different areas of the brain; this elevation was significantly following pretreatment with PAT. Taken together these results provide evidence in support of our hypothesis that as a potent anti-inflammatory and analgesic peptide, PAT might have potential therapeutic use for the treatment of neurodegenerative conditions induced by silent or overt inflammation. © 2010 Elsevier Ltd. All rights reserved

Delayed Epithelial Ingrowth Caused by Viral Conjunctivitis after LASIK

To report a patient who presented with epithelial ingrowth caused by viral keratoconjunctivitis 3 months after LASIK surgery. A 41-year-old man presented with decreased visual acuity in the right eye, which had developed about 3 weeks before. He had undergone LASIK surgery 3 months prior without complications. Two months after the surgery, he was treated for viral conjunctivitis. During the treatment period, filamentary keratitis developed, and a therapeutic bandage contact lens was applied for 2 weeks. Upon presentation, examination revealed a corrected visual acuity of 20/100 and irregular epithelial sheets under the edematous flap. The flap was lifted, and the in-grown epithelium was removed. The flap was repositioned with double continuous 10 - 0 nylon sutures. Post-operatively, the patient developed a mild diffuse lamellar keratitis that resolved rapidly with topical corticosteroid treatment. At 2 months, the corrected visual acuity was 20/20 without interface opacities. As the patient showed no complications prior to viral conjunctivitis, we suspect that the viral infection caused edema of the corneal flap, which caused epithelial ingrowth under the flap. Patients who have viral conjunctivitis after LASIK surgery should be examined carefully and managed with consideration of flap complications

O processo de implantação do prontuário eletrônico do paciente em um hospital público de alta complexidade: relato de experiência / The process of implementation of the electronic patient record in a public hospital of high complexity: experience report

Introdução:O Prontuário Eletrônico do Paciente (PEP) é uma importante ferramenta de registro dos dados, associada à redução de erros e ao aumento da segurança dos processos assistenciais. No entanto, para que sua implantação tenha sucesso, é necessário que os usuários sejam envolvidos e participem ativamente do processo. Objetivos: Relatar a vivência da equipe de enfermagem durante o processo de implantação do PEP em um Serviço de Transplante de Células-Tronco Hematopoéticas (STMO). Metodologia: Relato de experiência da observação realizada no STMO de um hospital público de grande porte e alta complexidade. A equipe de enfermagem é composta por40enfermeiros, 6 técnicos de enfermagem e 4 auxiliares de enfermagem. Resultados:O STMO foi escolhido como unidade piloto para implantação do PEP. Não foi adotado assinatura eletrônica, sendo necessária a impressão dos registros, e não existe ainda integração com setorescomo Laboratório, Farmácia e Centro Cirúrgico. Em outubro de 2015 houve a primeira reunião com a equipe de enfermagem, seguida por treinamentoprático de toda a equipeno mesmo mês, com carga horária de 3 horas. Foram instalados 4 novos computadores, totalizando 7 equipamentos, para atendimento da nova demanda. O PEP foi implantado em novembro de 2015, quando os consultores do software estiveram presentes por duas semanas, em todos os turnos, a fim de esclarecer dúvidas e identificar pontos de melhoria. Foram realizadas adaptações em algumas funcionalidades para atendimento de necessidades do serviço, e periodicamente são realizadas reuniões para acompanhamento. Houve percepção de importantes melhorias, principalmente com relação à segurança do paciente, embora tenha sido apontada como ponto negativo a ausência de redução do consumo de papel. Conclusão: A adoção ao PEP foi bem recebida pela equipe de enfermagem e colaborou para a melhoria da qualidade da informação e segurança do paciente. No entanto, a privação da assinatura eletrônica é um ponto negativo expressivo, devendo ser considerada futuramente. 

Development of EKC after Eximer Laser Photorefractive Surgery and Subsequent Recurrence of EKC-like Keratitis

This research focuses on four cases of patients having undergone eximer laser photorefractive surgery who were diagnosed with adenoviral keratoconjunctivitis during the postoperative period and who later developed epidemic keratoconjunctivitis (EKC)-like keratitis. Two of the patients had undergone laser-assisted subepithelial keratectomy (LASEK), one had undergone laser in situ keratomileusis and one had photorefractive keratectomy. After the surgery adenoviral keratoconjunctivitis and recurrent late-developing EKC-like keratitis were observed in the patients. Recurrent late-developing EKC-like keratitis occurred in one of the patients, who had received LASEK as many as three times. The others had only one or two episodes.The corneal infiltrates of keratitis mainly occurred in the central cornea. Successful resolution of recurrent late-developing EKC-like keratitis was achieved through the use of topical steroids without sequelae and the final best-corrected visual acuity was as good as the base line. These keratitis infiltrates have been presumed to represent an immune response to the suspected adenoviral antigens deposited in corneal stroma during the primary adenoviral infection. Previous reports argued that patients with a history of adenoviral ketatoconjunctivitis were succeptible to adenoviral keratoconjunctivitis becoming reactivated; however, in our research, our patients had their first adenoviral infections after the eximer laser photorefractive surgery and reactivation was confirmed. We recommend that attention be paid to adenoviral infection after laser refractive operations, because these patients seem to have more frequent recurrences

Percepções de acadêmicos sobre a enfermagem: escolha, formação e competências da profissão

Este estudo teve como objetivo identificar e analisar as percepções de acadêmicos sobre a Enfermagem: escolha, formação e competências da profissão. Trata-se de uma pesquisa transversal e descritiva, com abordagem quantitativa e qualitativa, realizada com 70 acadêmicos do Curso de Graduação em Enfermagem da Universidade Estadual de Montes Claros (Unimontes). Para a coleta de dados, utilizou-se um questionário semiestruturado. Para os dados quantitativos, foi feita a análise estatística no SPSS, e, para os dados qualitativos, utilizou-se a análise de conteúdo. A maioria dos acadêmicos é do sexo feminino, com idade entre 17 e 23 anos. O motivo que mais influenciou na escolha do Curso foi este ser da área saúde. Apesar de 54,1% terem relatado que a Enfermagem não era o curso pretendido e, sim, a Medicina, a maioria tem a pretensão de concluir o curso e está satisfeita com ele. Na abordagem qualitativa sobre as atribuições de um enfermeiro, os concluintes apresentaram uma visão mais ampla e realista, construída ao longo do curso e dos estágios. Conclui-se que uma maior divulgação sobre a Enfermagem e a atuação do enfermeiro é de suma importância, garantindo a inserção do estudante no curso de Enfermagem com expectativas compatíveis com a realidade

Management of Anterior Stromal Necrosis After Polymethylmethacrylate ICRS: Explantation Versus Exchange With Corneal Allogenic Intrastromal Ring Segments

PURPOSE: To evaluate management of keratoconic eyes with anterior stromal necrosis overlying the intracorneal ring segment (ICRS), by either ICRS explantation alone or exchange with corneal allogenic intrastromal ring segments (CAIRS). METHODS: Among 643 Intacs SK (Additional Technology, Inc) inserted at one institutional center, 16 eyes (15 patients) with overlying spontaneous anterior stromal necrosis were identified. Data included size of stromal defect and refractive and topographical findings before ICRS insertion, before anterior stromal necrosis, and 6 months after intervention. RESULTS: The 10-year incidence of anterior stromal necrosis after femtosecond laser–assisted ICRS insertion was 5.5%. Eight eyes underwent ICRS removal only and 8 eyes had ICRS exchanged with CAIRS. In the first group, CDVA worsened from 0.14 before melt to 0.28 logMAR after removal (P = .10), simulated keratometry (SimK) and maximum axial keratometry (Kmax) increased from 44.73 to 46.34 diopters (D) (P = .14) and from 49.23 to 52.26 D (P = .14), respectively, and coma worsened from 0.87 to 1.52 D (P = .02). In the CAIRS group, CDVA of 0.16 before melt improved to 0.11 logMAR postoperatively (P > .99), and topographic indices stabilized with SimK, Kmax, and coma mildly altering from 45.31 to 45.44 D (P > .99), from 49.25 to 49.64 D (P > .99) and from 0.87 to 0.81 D (P > .99), respectively. Whether the ICRS were explanted or exchanged, the visual and topographic mean values were better than those reported before ICRS implantation, whereas higher order aberrations in eyes without CAIRS regressed to levels before ICRS insertion. At the site of melt, thinnest residual stromal thickness averaged 327 µm with ICRS removal and 490 µm with CAIRS. Eyes with larger melt areas resulted in less optimal results with CAIRS implantation. CONCLUSIONS: Early experience in the management of anterior stromal necrosis by exchange of polymethylmethacrylate ICRS with CAIRS seems to avoid stromal thinning and confer better visual and topographic results, which were more pronounced with thicker segments. The benefit of CAIRS in large stromal melts needs to be investigated. Copyright © SLACK Incorporated

Perfil epidemiológico e análise de Tendência de HIV/AIDS/ Epidemiological profile and trend analysis of HIV/AIDS/ Perfil epidemiológico y análisis de tendencia del HIV/SIDA

Objetivo: traçar perfil epidemiológico de HIV/AIDS em Montes Claros, Minas Gerais e analisar a linha de tendência de crescimento da doença. Método: trata-se de estudo epidemiológico, transversal, descritivo-analítico e com abordagem quantitativa. Os dados foram coletados através do DATASUS, no SINAN e SIM, referentes ao intervalo entre 1986 e 2016. A análise do modelo preditivo se deu por Regressão Linear Simples, cujos pressupostos de validação foram atendidos. Resultados: desde o primeiro diagnóstico notificado em 1986 ocorreu grande disseminação da doença, totalizando 523 casos confirmados. A distribuição foi de 59,8% (313) para homens; 31,9% (167) na faixa etária de 30-39 anos; 33,7% (176) na raça parda; e 48,4% (256) da exposição por contato sexual heterossexual. A mortalidade condiz com 71,9% (23) do sexo masculino; 43,8% (14) na faixa etária de 30-39 anos. A reta de tendência da epidemia denota aumento progressivo na incidência, segundo a função de -2227,779 + 1,122*(Ano). Conclusão: os dados avaliados permitem inferir que a epidemia de HIV/AIDS ainda se encontra em expansão. Não obstante, desde o surgimento, o perfil sociodemográfico da doença assume característica mutável, necessitando de vigilância constante para adequação de políticas de controle

Evaluation of pharmaceutical counseling after hospital discharge of post-surgery patients

The aim of this study was to evaluate pharmaceutical counseling following hospital discharge. All subjects received pharmacist counseling before discharge in a private hospital in Aracaju-SE, Brazil, from October 2007 to February 2008. Medication adherence was measured by Haynes-Sacket and Morisky-Green-Levine scales at the end of post-discharge treatment. Post-surgery patients (n = 243) received counseling on the day of hospital discharge, while adherence was observed in 186 (76.5 %) of these patients. During the four months, the increase in adherence was observed in those patients that received the counseling: 68.7 %, 73.6 %, 82.9 % and 85.7 %, respectively. The patients were distributed according to the variables of age, chronic illness, and duration of treatment did not significantly vary during the study. At the end of pharmaceutical counseling period, more than three fourths of post-surgery patients were considered adherent after hospital discharge. This result indicates a potential opportunity to implement this service in other wards.Colegio de Farmacéuticos de la Provincia de Buenos Aire