Thaysa Leite Tagliaferri

Could peak oxygen uptake be estimated from proposed equations based on the six-minute walk test in chronic heart failure subjects?

Highlights • Measured and estimated VO2peak in CHF patients showed a moderate association.• With the exception of equation 1, all equations underestimated VO2peak by up to 51%.• The agreement evaluated using Bland–Altman was not consistent.

A avaliação do desenvolvimento infantil: um desafio interdisciplinar

OBJECTIVE: The aim of this study was to evaluate early childhood development, from two months to two years of age, based on Integrated Management of Childhood Illness, IMCI (or AIDPI in Portuguese) in the context of the Educational Program for Health Work (PET-Saude). METHODS: A cross-sectional study was conducted with 122 children two months to two years of age from the coverage area of the Sao Bernardo Health Center in Belo Horizonte, Minas Gerais State, in 2009. Data on the children´s development were obtained using two questionnaires: IMCI and the Childrens Health Booklet (CSC in Portuguese). Early childhood development according to the IMCI classification was compared to the results with CSC. The authors also investigated potential associations between independent variables and developmental delay. RESULTS: The most frequent characteristics in the study population were low maternal schooling (62.1%), followed by relatives with mental disability (71.3%), and problems during the pregnancy (71.3%). Based on the IMCI classification, 61.5% of the study population was normal with some risk factor, 16.4% normal without any risk factor, 11.5% with possible delay, and 10.7% with probable childhood developmental delay. Agreement between the IMCI and CSC classifications was 0.34, kappa index - 0.12 (p = 0.98). There was no statistically significant association between the variables (daycare attendance; contact with emotional problems; maternal schooling; gestational age; and birth weight) and possible or probable early childhood developmental delay according to the IMCI classification. CONCLUSION: PET-Saude, as a proposal for integration between education and work, provided an opportunity for contact and exchange of experiences between students and health professionals from various fields, working in a common project.

Knowledge, behaviour and microbial load of workers handling dental solid waste in a public health service in Brazil

Healthcare wastes are those generated inside healthcare services, including dental clinics. Workers coming into close proximity to hazardous healthcare waste are potentially at risk. In an attempt to assess the knowledge and attitudes of workers dealing with infectious waste, a questionnaire was administered. The biological risk was investigated by evaluating the microbial load and screening some clinically relevant micro-organisms in the nasal mucosa, hands and coats of these workers. The results showed that 66.6% of the study population had incomplete primary education. Only two workers have had their blood tested to confirm anti-HBs levels. Microbial load evaluation on hand surfaces of morning workers showed statistically significant lower microbial loads after the workday when compared with the beginning of the work period. It is important to highlight that some clinically relevant bacteria, such as Pseudomonas aeruginosa and Klebsiella pneumoniae were isolated from worker’s hands. This study revealed the need for more training programmes regarding awareness of safe waste disposal protocols and also the necessity of discussing vaccination and its implications. Data regarding microbial loads of the worker’s hands, mostly at the beginning of the workday when handwashing is recommended worldwide, emphasise that hygiene measures should receive more attention during training exercises.

Phenotypic and genotypic characterization of clinically relevant bacteria isolated from dental waste and waste workers' hands, mucosas and coats.

Infectious wastes are potential sources of pathogenic micro‐organisms, which may represent a risk to the professionals who manage them. In this study, we aimed to characterize the infectious bacteria present in dental waste and waste workers. The dental waste produced over 24 h was collected and waste workers were sampled by swabbing. Isolate resistance profiles were characterized by Vitek® and PCR and biofilm formation by Congo Red agar, string test and microtitre assay. To assess similarity between the waste and the workers’ samples, a random amplified polymorphic DNA test was used. Twenty‐eight bacteria were identified as clinically relevant. The most frequent gene was blaTEM present in five Gram‐negative micro‐organisms, and one blaSHV in Klebsiella pneumoniae. All Pseudomonas aeruginosa were positive to extracellular polymeric substances formation, except one isolated from a worker. Klebsiella pneumoniae had negative results for the string test. Pseudomonas aeruginosa showed better adherence at 25°C after 48 h of incubation and K. pneumonia had the best biofilm formation at the same temperature, after 24 h. The similarity between P. aeruginosa recovered from dental waste and from workers was low, however, it is important to note that a pathogen was found on a workers hands and that improvements in biosafety are required.