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Validação de protocolo para a assistência de enfermagem ao paciente no transoperatório de cirurgia cardiovascular com circulação extracorpórea
(Universidade Federal de São Carlos, 2019-01-18) Albuquerque, Carla Lorenna Ferreira de; Machado, Regimar Carla; https://lattes.cnpq.br/1310723429860987; https://lattes.cnpq.br/6642594665041444
Objective: to construct and validate a protocol for the nursing care of the patient in the transoperative period of cardiopulmonary bypass with cardiopulmonary bypass (CPB). Method: methodological, quantitative study, developed in two stages referring to the construction and validation of the content of the protocol. The validation was performed using the Delphi technique in two rounds, with the participation of 14 experts as evaluators of each variable proposed in the protocol. The selection of experts was by snowball sampling. The items included in the instrument were evaluated using the Likert scale, with categories in four levels of importance and the selection of a single response for each analyzed variable, and by the analysis of the content of the instrument with the universal agreement of the index of content validity ( UA-IVC) and the Content Validity Index (CVI). Results: items related to surgical and patient room preparation, intraoperative care and report (intraoperative information) for the ICU were validated. The items obtained a mean score of 90% and UA-IVC concordance of 89%, in which eight items reached the 100% IVC and one the 93% IVC item; however, one item did not reach the IVC ≥80% being recommended the merger together with another item. Conclusion: the results of this study reflect the importance of the nurse's role in the implementation of a protocol with the purpose of guiding safe surgery practices that promote patient safety and effective communication within the context of cardiovascular surgeries.
Sensores inerciais móveis no rastreio e predição de risco de quedas em idosos
(Universidade Federal de São Carlos, 2019-01-18) Bet, Patrícia; Ponti, Moacir Antonelli; https://lattes.cnpq.br/5041497500746910; https://lattes.cnpq.br/0256435348164751
Background: The investment in acceleration sensor-based equipment as a fall prevention strategy can represent a viable option for the monitoring of the fall risk. However, more studies are needed on the analysis of such data, in particular for the prediction of future falls to be adopted for health care and prevention. Thus, the objective of this study is to investigate patterns for fall risk screening in the elderly with no recent history of fall, through three types of Timed Up and Go (TUG) tests using a single acceleration sensor. Methods: A prospective study was conducted with 74 healthy elderly non-fallers using waist acceleration sensors while performing three variations of the TUG. After evaluation at baseline, the occurrence of falls (outcome) was monitored quarterly during one year. We investigate frequency features extracted from the accelerometry signal and their ability to predict falls. Mann-Whitney U test was used to compare the groups. Besides, analyze of accuracy, sensitivity and specificity were performed. Results and Discussion: The best individual feature result shows an accuracy of 0.75, sensitivity of 0.71 and specificity of 0.76. A fusion of the three best features increases the sensitivity to 0.86. Statistical difference was found in the whole accelerometry data, without any type of processing, for three, six, nine and twelve months of follow-up. The cut-off points of the TUG seconds did not demonstrate adequate sensitivity for community-dwelling elderly. Conclusions: The results confirms previous evidence that accelerometer features can better fall risk, and support potential applications that try to infer falls risk in less restricted scenarios, even in a sample stratified by age and gender composed of active community-dwelling elderly.
Revestimento cutâneo de Cianocrilato para pacientes submetidos à cirurgia cardiotorácica: revisão sistemática da literatura
(Universidade Federal de São Carlos, 2019-01-18) Von Jakitsch, Camila; Machado, Regimar Carla; https://lattes.cnpq.br/1310723429860987; https://lattes.cnpq.br/8228170271475309
Objective: To compare the effectiveness of conventional dressings and / or sutures with cyanoacrylate coatings for the reduction of mediastinitis rates in cardiothoracic surgeries. Methods: Systematic review of the literature conducted according to the recommendations of the Cochrane Handbook. The PRISMA protocol was used as a guide for the systematic review. We searched for randomized controlled trials with no limitations on language and year of publication in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), National Library of Medicine (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Virtual Health Library (VHL), Web of Science, Science Direct, Central Cochrane Library and Repository of Gray Literature using the controlled and uncontrolled descriptors. It was also searched in the gray literature, in ANAIS of Congresses, in specific bases on the studied subject and in the references of the references with the purpose of exhausting the literature. Prior to the data analysis, a bias risk control form was used. Results: Four studies (2092 participants) aged 45 to 81 years who used cyanoacrylate in sternotomies were included in order to reduce mediastinitis rates. The studies were consistent with the proposed outcomes and presented a low risk of bias in the areas of the Cochrane Collaboration bias risk table except in the areas of secrecy and masking, since the studies involved surgical procedures. The selected studies responded to the primary outcome of this study, namely reduction of mediastinitis index with the use of cyanoacrylate, but did not respond to proposed secondary outcomes that were reduced hospitalization time and reduced treatment costs. Conclusions: The use of cyanoacrylate based coatings is equivalent to traditional skin preparation in cardiac surgeries, as it does not significantly influence the incidence of Surgical Site Infection (ISC). However, the use of cyanoacrylate decreased the incidence of SSI in groups more prone to infection, namely: elderly patients with chronic diseases (systemic arterial hypertension, Diabetes Mellitus or vascular diseases) and obese patients.
Extração de quitosana a partir de resíduo de camarão e seu efeito sobre leveduras do bioetanol
(Universidade Federal de São Carlos, 2019-01-18) Tanganini, Isabella Carvalho; Shirahigue, Ligianne Din; https://lattes.cnpq.br/2928453072274366; Ceccato-Antonini, Sandra Regina; https://lattes.cnpq.br/7600793543184032; https://lattes.cnpq.br/3137033888108821
Chitosan is a biopolymer widely used in agriculture and in the food, medical and pharmaceutical industries. It is obtained by the deacetylation of chitin, extracted from the carapace of crustaceans or fungal mycelia. Despite its potential as an antimicrobial agent, chitosan is still not used in the bioethanol industry to control process contaminant yeasts. Dekkera bruxellensis is an opportunistic yeast of great interest to the wine industry and fermentation processes for ethanol production in Brazil, and its control becomes necessary. In this context, the objective of this work was to obtain chitosan from shrimp residues by bacterial fermentation and subsequent chemical deacetylation and to evaluate its inhibitory effect on yeasts from bioethanol production. The bacterial fermentation was carried out in optimized concentrations of residue, inoculum and glucose aiming at higher production of acids. The chitin deacetylation process to obtain chitosan was done by the autoclave method, at 121 oC and 1 atm, using 45% sodium hydroxide. Chitin and chitosan obtained were characterized by infrared spectroscopy (FTIR), X-ray diffraction (XRD), differential thermal analysis (TG-DTA) and differential scanning calorimetry (DSC). The effect of the obtained chitosan (natural) and a commercial chitosan on the growth of D. bruxellensis and an industrial strain of Saccharomyces cerevisiae (PE-2) was evaluated in sugar cane broth and YPD culture medium. The effect of adding 500 mg/L of natural chitosan to the fermentation in sugar cane broth in co-cultivation with D. bruxellensis was also evaluated. In the chitin extraction by lactic fermentation step, the conditions of higher acid production were 10% (v/v) inoculum of L. plantarum and 100 g / L of glucose. At the concentration of 5% (m/v) residue, the best results were obtained in the fermentation to obtain chitin, producing 23.09 g of lactic acid / 100 mL. The demineralization rate was 77% and deproteinization was 43%. Infrared spectra (FTIR) confirmed the presence of chitin and chitosan in the samples after fermentation and after deacetylation respectively, with 80% deacetylation degree. X-ray diffractograms showed the crystallinity profile of the samples, with chitin being more crystalline. Thermogravimetric analysis showed higher thermal stability of natural chitosan compared to commercial chitosan. Both commercial chitosan and natural chitosan reduced the maximum specific growth rate (μmax) of both yeasts and caused an increase in the lag phase of D. bruxellensis in 6 and 3.5 hours, respectively, at the concentration of 500 mg / L. The same was not observed in S. cerevisiae. This concentration of natural chitosan when added to the fermentation reduced the number of D. bruxellensis in approximately 1 log cycle after 12 hours, with minor effect in S. cerevisiae population. The fermentative efficiency was 22% higher when compared to the fermentation without chitosan. The natural chitosan obtained under the conditions of this work presents as potential antimicrobial to be used in the fermentation for the production of ethanol fuel to control the contaminating yeast D. bruxellensis, without interference in the process.