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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Häufigkeit des postoperativen Makulaödems nach primärer rhegmatogener Ablatio retinae / Incidence and Risk Factors for Cystoid Macula Oedema after Primary Rhegmatogenous Retinal Detachment Surgery

Gebler, Marie 01 April 2020 (has links)
No description available.
22

Modelagem da carga de poluição difusa em escala de bacia com valores de concentração média por evento a partir de dados de uma rede de monitoramento local / Modeling the diffuse pollution load at basin scale with event mean concentration values based on data from a local monitoring network

Martins, Renata Genova 06 April 2017 (has links)
As águas superficiais vêm sofrendo impactos em diversas cidades e o escoamento superficial tem sido uma das causas primárias de degradação dos recursos hídricos devido à poluição difusa, além das fontes pontuais, como efluentes domésticos e industriais. A Concentração Média do Evento (CME) tem sido muito utilizada para caracterizar a poluição difusa gerada no escoamento superficial durante o evento de precipitação, além de ser empregada como parâmetro de entrada na estimativa de carga de origem difusa por meio de modelos hidrológicos. Este estudo se dedicou especialmente à avaliação de como a CME influencia a estimativa de cargas difusas quando parâmetro de entrada para modelos hidrológicos. Para isso, além de atividades de campo visando à confecção de modelos de previsão da CME com base em dados reais de uma bacia hidrográfica urbana (Mineirinho, São Carlos, SP) em resposta a eventos chuvosos, buscou-se ajustar, à realidade brasileira, um modelo consagrado para estimativa de cargas difusas e aplicado principalmente em países com clima temperado. Os resultados desta pesquisa mostraram que, em geral, os valores de CME observados são de 2 a 12 vezes maiores que os encontrados na literatura internacional. Em comparação com estudos nacionais, observou-se uma variação nos dados encontrados dependendo das características da bacia hidrográfica monitorada. Além disso, ao adequar o modelo hidrológico L-THIA às características locais, verificou-se um aumento na estimativa da carga de origem difusa quando se utilizavam dados locais. Por fim, com base nas análises realizadas neste estudo, foi possível verificar que os valores de CME que melhor representam as características da bacia hidrográfica do Mineirinho são: nitrogênio total Kjeldahl 6,19 mg.L-1, fósforo total 1,00 mg.L-1, sólidos suspensos totais 870 mg.L-1, chumbo 0,78 mg.L-1, cobre 0,09 mg.L-1 e zinco 0,34 mg.L-1. Reforça-se, portanto, a necessidade de estudos locais para análise da poluição difusa para o planejamento de ações de mitigação de poluição difusa no Brasil. / Surface water has been impacted in several cities and surface runoff has been one of the primary causes of degradation of this resource due to nonpoint source pollution besides the point sources, like domestic effluents and industries. The Event Mean Concentration (EMC) has been widely used to characterize the diffuse pollution generated in the surface runoff during the precipitation event, and it is still used as input parameter in hydrological models that seek to estimate diffuse load. This study focused particularly on the evaluation of how the EMC influences the estimation of diffuse loads as input parameter for hydrological models. To that end, in addition to field activities for the preparation of EMC forecast models based on real data from a river basin in response to rainy events, we attempted to adjust to the Brazilian reality a well-established model for estimating diffuse loads and mainly applied in countries with temperate climate. The results of this research showed that, overall, the EMC observed values are from 2 to 12 times higher than those found in the international literature. Compared with national studies, a variation was observed in the data found depending on the characteristics of the monitored watershed. In addition, when adapting the L-THIA hydrological model to local characteristics, there was an increase in the diffuse source load estimate when using local data. Finally, based on the analyzes carried out in this study, it was possible to verify that the EMC values which best represent the characteristics of the Mineirinho river basin are: Total Kjeldahl Nitrogen 6.19 mg.L-1, Total Phosphorous 1.00 mg.L-1, Total Suspended Solids 870 mg.L-1, Lead 0.78 mg.L-1, Copper 0.09 mg.L-1 and Zinc 0.34 mg.L-1. Therefore, it is necessary to carry out local studies to analyze diffuse pollution in order to create a more solid basis for the planning of mitigation actions to control diffuse pollution in Brazil.
23

Obchodování s kreditními deriváty na světových finančních trzích / Trading in credit derivatives on world financial markets

Šotlíková, Lucie January 2011 (has links)
The thesis is focused on the process of trading in credit derivatives on the global financial markets. The first part deals with the history and the development of credit derivatives from the very beginning to the present and all factors that influenced and affected them during that time. Various derivative instruments are explained, in terms of their purpose, suitability for use and the risks arising from them. Mainy focus of the thesis is put on the selected stock markets (CME Group Inc., Eurex AG, NYSE Liff Holdings LLC). This section begins with their history, then it describes their structure and purpose. It explains stock market membership conditions and settlement of exchange contracts principles. The final part clarifies the role of credit derivatives in the financial crisis and the reasons that led to it. In the final part of the thesis organizations that regulate credit derivatives are described, in addition to regulation methods and aids, specifically in terms of new regulatory measures under Basel III and the organization of ISDA, which are also included. At the very end the possibilities of securitization and credit risk diversification are explained as well as methods of credit instruments valuation, which are demonstrated on an example of Credit Default Swap.
24

Modeling the complex ejecta on 2017 September 6-9 with WSA-ENLIL+Cone and EUHFORIA

Werner, Anita Linnéa Elisabeth January 2018 (has links)
Three CMEs which erupted on 2017 Sep 4 and 6 underwent mutual interaction before reaching Earth on Sep 6-9, where it gave rise to a complex and unexpectedly geoeffective structure as detected by WIND at L1. The spacecraft first observed an interplanetary (IP) shock on Sep 6 followed by a turbulent sheath. The leg of the CME flux rope is detected on Sep 7, in which clear signatures of a shock-in-a-cloud can be distinguished, coming from the third CME which propagated into the preceding flux rope. We model the source of this complex ejecta with WSA-ENLIL+Cone and EUHFORIA to assess and compare the overall performance for interacting CMEs as opposed to single CME events. We find that following the conventional algorithm for determination of input parameters give large deviation in the event prediction at L1. The overestimated density of the IP shock 1 is due to the way of implementation of the magnetogram in WSA model. Excluding the slow CME from the input leads to even larger deviation. The prediction of IP shock 1 drastically improves by introducing of a customized density enhancement factor (dcld) based on coronagraph image observations. This novel approach, is simple and accessible, and could be applied to improve the forecast for fast, undisturbed CMEs. The deviation in the prediction of IP shock 2 comes from its interaction with the low proton temperature environment of the preceding magnetic cloud, giving rise to an expansion of the shock front. Additionally, the properties of the background solar wind plasma have been preconditioned by passage of the previous IP shock. This was confirmed from the kilometric type II radio burst emission following the eruption of the third CME. The propagation profile of this CME implies an almost non-existent deceleration in the interplanetary medium, in contrast to the expected CME deceleration due to interaction with the background plasma. In summary, this study presents clear indications that magnetic interaction must be taken into account to reliably forecast multiple CME events. Preconditioning of previous CMEs must also be considered in more depth, and ultimately requires a realistic, time-dependent model of the ambient solar wind which responds well to propagating shock waves. Models in space physics presents us with the perfect tools for understanding not only the physical processes that the simplified models can predict, but perhaps more importantly, help us begin to understand what the models fail to predict.
25

[en] REFERENCE MODEL PROPOSITION FOR CENTRAL STERILE SUPPLY DEPARTMENT (CSSD) PROJECT / [pt] PROPOSIÇÃO DE MODELO DE REFERÊNCIA PARA PROJETO DE CENTROS DE MATERIAL E ESTERILIZAÇÃO (CME)

SUZANA GONZAGA DA VEIGA 11 December 2017 (has links)
[pt] O reprocessamento de materiais médicos é um processo essencial para manter a funcionalidade do hospital. O Centro de Material e Esterilização (CME) é a unidade de apoio técnico hospitalar orientado por normas e regulações específicas destinada a reprocessar os materiais, tendo como principal objetivo a prevenção de infecções e entrega de artigos médicos seguros. Contudo, é uma área de pouca visibilidade e com altas variabilidades no processo de esterilização e não são contemplandos com um modelo de tomada de decisão que contemple tanto os requisitos dos modelos assistenciais estabelecidos pelas legislações quanto os aspectos de projeto da gestão e gerência das operações. Dessa forma, a presente pesquisa visa elaborar um modelo de referência construído a partir das categorias de projetos de operações a fim de auxiliar o gestor a projetar um CME. O objetivo da pesquisa é atingido através do cumprimento dos seguintes objetivos específicos: a) levantamento do referencial teórico; b) levantamento e identificação dos instrumentos normativos e regulatórios; c) condução de uma pesquisa de campo em um CME representativo dos níveis de complexidade; d) análise e síntese da lógica de funcionamento à luz das categorias de operações; e) definição da estrutura do modelo de referência; f) validação do modelo com especialistas; g) refinamento do modelo; e h) aplicação do modelo. A proposição do modelo de referência de requisitos, com base na legislação e aspectos gerenciais da produção, é a principal contribuição da pesquisa. / [en] Reprocessing of medical supplies is an essential process to maintain the hospital s functionality. The Central Sterile Supply Department (CSSD) is the hospital technical support unit oriented by specific norms and regulations aimed at reprocessing the materials, having as main objective the prevention of infections and delivery of safe medical articles. However, it is an area of low visibility and with high variability in the sterilization process and there is not a model of decision making that has both the requirements of the assistance models established by the legislations and the design aspects of the management and operations management. In this way, the present research aims to elaborate a reference model based on the project operation categories in order to help the manager to design a CSSD. The research objective is achieved through the following specific objectives: a) survey of the reference theory; b) survey and identification of regulatory instruments; c) field research in a complexity levels representative CSSD; d) analysis and synthesis of the operating logic in the light of the categories of operations; e) definition of the structure of the reference model; f) validation of the model with specialists; g) model refinement; and h) model application. The proposal of the reference model of requirements, based on legislation and production management, is the main contribution of the research.
26

Modelagem da carga de poluição difusa em escala de bacia com valores de concentração média por evento a partir de dados de uma rede de monitoramento local / Modeling the diffuse pollution load at basin scale with event mean concentration values based on data from a local monitoring network

Renata Genova Martins 06 April 2017 (has links)
As águas superficiais vêm sofrendo impactos em diversas cidades e o escoamento superficial tem sido uma das causas primárias de degradação dos recursos hídricos devido à poluição difusa, além das fontes pontuais, como efluentes domésticos e industriais. A Concentração Média do Evento (CME) tem sido muito utilizada para caracterizar a poluição difusa gerada no escoamento superficial durante o evento de precipitação, além de ser empregada como parâmetro de entrada na estimativa de carga de origem difusa por meio de modelos hidrológicos. Este estudo se dedicou especialmente à avaliação de como a CME influencia a estimativa de cargas difusas quando parâmetro de entrada para modelos hidrológicos. Para isso, além de atividades de campo visando à confecção de modelos de previsão da CME com base em dados reais de uma bacia hidrográfica urbana (Mineirinho, São Carlos, SP) em resposta a eventos chuvosos, buscou-se ajustar, à realidade brasileira, um modelo consagrado para estimativa de cargas difusas e aplicado principalmente em países com clima temperado. Os resultados desta pesquisa mostraram que, em geral, os valores de CME observados são de 2 a 12 vezes maiores que os encontrados na literatura internacional. Em comparação com estudos nacionais, observou-se uma variação nos dados encontrados dependendo das características da bacia hidrográfica monitorada. Além disso, ao adequar o modelo hidrológico L-THIA às características locais, verificou-se um aumento na estimativa da carga de origem difusa quando se utilizavam dados locais. Por fim, com base nas análises realizadas neste estudo, foi possível verificar que os valores de CME que melhor representam as características da bacia hidrográfica do Mineirinho são: nitrogênio total Kjeldahl 6,19 mg.L-1, fósforo total 1,00 mg.L-1, sólidos suspensos totais 870 mg.L-1, chumbo 0,78 mg.L-1, cobre 0,09 mg.L-1 e zinco 0,34 mg.L-1. Reforça-se, portanto, a necessidade de estudos locais para análise da poluição difusa para o planejamento de ações de mitigação de poluição difusa no Brasil. / Surface water has been impacted in several cities and surface runoff has been one of the primary causes of degradation of this resource due to nonpoint source pollution besides the point sources, like domestic effluents and industries. The Event Mean Concentration (EMC) has been widely used to characterize the diffuse pollution generated in the surface runoff during the precipitation event, and it is still used as input parameter in hydrological models that seek to estimate diffuse load. This study focused particularly on the evaluation of how the EMC influences the estimation of diffuse loads as input parameter for hydrological models. To that end, in addition to field activities for the preparation of EMC forecast models based on real data from a river basin in response to rainy events, we attempted to adjust to the Brazilian reality a well-established model for estimating diffuse loads and mainly applied in countries with temperate climate. The results of this research showed that, overall, the EMC observed values are from 2 to 12 times higher than those found in the international literature. Compared with national studies, a variation was observed in the data found depending on the characteristics of the monitored watershed. In addition, when adapting the L-THIA hydrological model to local characteristics, there was an increase in the diffuse source load estimate when using local data. Finally, based on the analyzes carried out in this study, it was possible to verify that the EMC values which best represent the characteristics of the Mineirinho river basin are: Total Kjeldahl Nitrogen 6.19 mg.L-1, Total Phosphorous 1.00 mg.L-1, Total Suspended Solids 870 mg.L-1, Lead 0.78 mg.L-1, Copper 0.09 mg.L-1 and Zinc 0.34 mg.L-1. Therefore, it is necessary to carry out local studies to analyze diffuse pollution in order to create a more solid basis for the planning of mitigation actions to control diffuse pollution in Brazil.
27

Drag based forecast for CME arrival

Jaklovsky, Simon January 2020 (has links)
Coronal Mass Ejections (CMEs) are considered to be one of the most energetic events in the heliosphere. Capable of inducing geomagnetic storms on Earth that can cause damage to electronics, a pillar which the modern society we live in leans heavily upon. Being able to accurately predict the arrival of CMEs would present us with the ability to issue timely warnings to authorities and commercial actors, allowing for protective measures to be put in place minimizing the damage. In this study the predicted arrival times and speeds from the Drag Based Model (DBM) and Drag Based Ensemble Model (DBEM) were compared to observational data from a set of 12 events containing fast, Earth-directed Halo CMEs and their corresponding shocks. Although DBM was developed to model CME propagation, varying some parameters allow it to be used for estimating shock/sheath arrival. The results presented in this study indicate that on average DBM performs best when the drag-parameter γ is in the range 0.2 ≤ γ ≤ 0.3. However the variability in the results show that determining a universal value of γ for fast CMEs does not increase the consistency in the model's performance. For completeness, further investigation is needed to account for not only halo CMEs. This will allow to test broader range of variation in the DBEM input parameters.
28

Prazo de validade de esterilização de materiais utilizados na assistência à saúde: um estudo experimental / Sterility validity period of health care materials: an experimental study

Moriya, Giovana Abrahão de Araujo 05 April 2012 (has links)
Diversos países vêm adotando diretrizes que relacionam prazo de validade de esterilidade de materiais críticos utilizados na assistência à saúde com a ocorrência de eventos relacionados. Pesquisas têm validado a manutenção da esterilidade do material durante o transporte e armazenamento por longos intervalos de tempo. O racional teórico já refutava o antigo paradigma de prazo de validade de esterilidade, baseado no tempo relógio/calendário justificado pela eficiência das embalagens com características de barreira microbiana, selagem hermética e a teoria da ausência de geração espontânea dos micro-organismos. No entanto, no Brasil, pode-se afirmar que os Centros de Material e Esterilização ainda praticam o controle de materiais esterilizados, baseado em data arbitrariamente atribuída, sendo esta prática incentivada por recomendações de documentos elaborados por órgãos oficiais normatizadores e fiscalizadores nacionais. Na crença de que realizar uma investigação experimental in vitro, produzindo evidências científicas robustas contribuiria no fortalecimento da quebra do antigo paradigma, propôs-se avaliar a manutenção da esterilidade de materiais armazenados por até 6 meses, após as embalagens diversas sofrerem contaminação intencional em suas superfícies externas. O experimento consistiu em embalar corpos de prova que simulassem instrumental cirúrgico (cilindros de porcelana) em quatro diferentes tipos de invólucros: algodão tecido, papel crepado, tecido nãotecido (SMS) e papel grau-cirúrgico. Todos os pacotes foram previamente autoclavados em um mesmo ciclo de esterilização. Posteriormente, as superfícies externas dos pacotes foram intencionalmente manipuladas com mãos contaminadas com Serratia marcescens (106 U.F.C./mL). Após intervalos predeterminados de armazenamento (0, 7, 14, 28, 90 e 180 dias), uma quantidade determinada de pacotes de cada tipo de embalagem foi aberta e os corpos de prova foram semeados diretamente em meio de cultura caseína-soja. Os pacotes com corpos de prova com tempo zero de armazenamento foram considerados como grupo controle negativo. Com a finalidade de garantir a viabilidade do micro-organismo-teste na superfície externa das embalagens foram realizados semanalmente, até 180 dias, cultivos das amostras de cada uma das embalagens contaminadas com o micro-organismo-teste, constituindo-se o grupo controle positivo. Para cada intervalo de tempo de armazenamento, foram analisados 600 corpos de prova (150 para cada tipo de embalagem). Considerando o intervalo de confiança exato para distribuição binomial, o tamanho de amostra calculado na pesquisa garantiu um intervalo de confiança de 95% com probabilidade de 0 a 0,006 de se encontrar uma amostra contaminada. Como resultado, não foram recuperados micro-organismos-teste Serratia marcescens em nenhum dos intervalos de tempo de armazenamento. Todos os testes realizados no grupo controle positivo apresentaram recuperação do micro-organismo-teste. Com base nos resultados deste estudo, observou-se que pacotes embalados em invólucros com propriedades de barreiras microbianas e selados hermeticamente são capazes de proteger Resumo Giovana Abrahão de Araújo Moriya o conteúdo esterilizado por até 6 meses. Este estudo contribui para a prática em Centros de Material e Esterilização, impedindo o reprocessamento desnecessário dos materiais, ao mesmo tempo, alerta para que os eventos relacionados sejam controlados e que cada material, antes da sua utilização, seja inspecionado quanto à integridade da embalagem e selagem. / Many countries have adopted guidelines that relate sterility validity period of health care critical materials with the occurrence of related events. Research has validated the maintenance of sterility of the material during transportation and storage for long periods of time. The theoretical rationale has already refuted the old paradigm of sterility validity period based on the time clock/calendar (time-related) due to the efficiency of packaging with microbial barrier characteristics, hermetic seal and the theory of absence of spontaneous generation of micro-organisms. However, in Brazil, it can be stated that the Central Supply and Sterilization Departments still practice the control of sterilized materials based on arbitrarily assigned deadlines, this practice is encouraged by recommendation documents drawn up by official national entities of standardizing and supervising. In the belief that performing an experimental investigation in vitro, producing robust scientific evidence, would help in strengthening the breaking of the old paradigm, we proposed to evaluate the maintenance of sterility of materials stored for up to 6 months after the packages suffer intentional contamination of their external surfaces. The experiment consisted of packing the specimens that simulate surgical instrument (porcelain cylinders) in four different types of wrappers: cotton, crepe paper, nonwoven fabric (SMS) and paper-plastic pouches. All packages have previously been autoclaved at the same sterilization cycle. Subsequently, the external surfaces of the packages were intentionally manipulated with hands contaminated with Serratia marcescens (106 C.F.U./mL). After storage at predetermined intervals (0, 7, 14, 28, 90 and 180 days), a specific quantity of packages of each type of packaging has been opened and the samples were seeded directly in soybean-casein culture medium. The packages with samples with zero time of storage were considered as negative controls. In order to ensure the viability of the test micro-organism on the outer surface of the packages, cultivation of samples of each package contaminated with the test microorganism were made weekly up to 180 days, constituting the positive control group. For each interval of time of storage, 600 samples were analyzed (150 for each type of package). Considering the confidence interval for the exact binomial distribution, the sample size calculated in the study ensured a confidence interval of 95% with 0 to 0.006 probability of finding a contaminated sample. As result, there were no recovered test micro-organism Serratia marcescens in any of the time intervals of storage. Based on the results of this study, it was observed that packages wrapped in wrappers with microbial barrier properties and hermetically sealed are capable of protecting the sterile contents up to 6 months. This study contributes to the clinical practice in Central Supply and Sterilization Department, preventing unnecessary reprocessing of the material, while warns that the related events should be monitored and each material, before use, must be inspected for its integrity of the packaging and sealing.
29

Use and Misuse of Cognitive Enhancers by Students at an Academic Health Science Center

Bossaer, John B., Gray, Jeffrey A., Miller, Stacy E., Enck, Gavin, Gaddipati, Vamsi C., Enck, Robert E. 01 January 2013 (has links)
Purpose: Prescription stimulant use as "cognitive enhancers" has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. Method: Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. Results: Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). Conclusions: Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., "cognitive enhancement"), educational quality, and patient safety or health care quality.
30

Prazo de validade de esterilização de materiais utilizados na assistência à saúde: um estudo experimental / Sterility validity period of health care materials: an experimental study

Giovana Abrahão de Araujo Moriya 05 April 2012 (has links)
Diversos países vêm adotando diretrizes que relacionam prazo de validade de esterilidade de materiais críticos utilizados na assistência à saúde com a ocorrência de eventos relacionados. Pesquisas têm validado a manutenção da esterilidade do material durante o transporte e armazenamento por longos intervalos de tempo. O racional teórico já refutava o antigo paradigma de prazo de validade de esterilidade, baseado no tempo relógio/calendário justificado pela eficiência das embalagens com características de barreira microbiana, selagem hermética e a teoria da ausência de geração espontânea dos micro-organismos. No entanto, no Brasil, pode-se afirmar que os Centros de Material e Esterilização ainda praticam o controle de materiais esterilizados, baseado em data arbitrariamente atribuída, sendo esta prática incentivada por recomendações de documentos elaborados por órgãos oficiais normatizadores e fiscalizadores nacionais. Na crença de que realizar uma investigação experimental in vitro, produzindo evidências científicas robustas contribuiria no fortalecimento da quebra do antigo paradigma, propôs-se avaliar a manutenção da esterilidade de materiais armazenados por até 6 meses, após as embalagens diversas sofrerem contaminação intencional em suas superfícies externas. O experimento consistiu em embalar corpos de prova que simulassem instrumental cirúrgico (cilindros de porcelana) em quatro diferentes tipos de invólucros: algodão tecido, papel crepado, tecido nãotecido (SMS) e papel grau-cirúrgico. Todos os pacotes foram previamente autoclavados em um mesmo ciclo de esterilização. Posteriormente, as superfícies externas dos pacotes foram intencionalmente manipuladas com mãos contaminadas com Serratia marcescens (106 U.F.C./mL). Após intervalos predeterminados de armazenamento (0, 7, 14, 28, 90 e 180 dias), uma quantidade determinada de pacotes de cada tipo de embalagem foi aberta e os corpos de prova foram semeados diretamente em meio de cultura caseína-soja. Os pacotes com corpos de prova com tempo zero de armazenamento foram considerados como grupo controle negativo. Com a finalidade de garantir a viabilidade do micro-organismo-teste na superfície externa das embalagens foram realizados semanalmente, até 180 dias, cultivos das amostras de cada uma das embalagens contaminadas com o micro-organismo-teste, constituindo-se o grupo controle positivo. Para cada intervalo de tempo de armazenamento, foram analisados 600 corpos de prova (150 para cada tipo de embalagem). Considerando o intervalo de confiança exato para distribuição binomial, o tamanho de amostra calculado na pesquisa garantiu um intervalo de confiança de 95% com probabilidade de 0 a 0,006 de se encontrar uma amostra contaminada. Como resultado, não foram recuperados micro-organismos-teste Serratia marcescens em nenhum dos intervalos de tempo de armazenamento. Todos os testes realizados no grupo controle positivo apresentaram recuperação do micro-organismo-teste. Com base nos resultados deste estudo, observou-se que pacotes embalados em invólucros com propriedades de barreiras microbianas e selados hermeticamente são capazes de proteger Resumo Giovana Abrahão de Araújo Moriya o conteúdo esterilizado por até 6 meses. Este estudo contribui para a prática em Centros de Material e Esterilização, impedindo o reprocessamento desnecessário dos materiais, ao mesmo tempo, alerta para que os eventos relacionados sejam controlados e que cada material, antes da sua utilização, seja inspecionado quanto à integridade da embalagem e selagem. / Many countries have adopted guidelines that relate sterility validity period of health care critical materials with the occurrence of related events. Research has validated the maintenance of sterility of the material during transportation and storage for long periods of time. The theoretical rationale has already refuted the old paradigm of sterility validity period based on the time clock/calendar (time-related) due to the efficiency of packaging with microbial barrier characteristics, hermetic seal and the theory of absence of spontaneous generation of micro-organisms. However, in Brazil, it can be stated that the Central Supply and Sterilization Departments still practice the control of sterilized materials based on arbitrarily assigned deadlines, this practice is encouraged by recommendation documents drawn up by official national entities of standardizing and supervising. In the belief that performing an experimental investigation in vitro, producing robust scientific evidence, would help in strengthening the breaking of the old paradigm, we proposed to evaluate the maintenance of sterility of materials stored for up to 6 months after the packages suffer intentional contamination of their external surfaces. The experiment consisted of packing the specimens that simulate surgical instrument (porcelain cylinders) in four different types of wrappers: cotton, crepe paper, nonwoven fabric (SMS) and paper-plastic pouches. All packages have previously been autoclaved at the same sterilization cycle. Subsequently, the external surfaces of the packages were intentionally manipulated with hands contaminated with Serratia marcescens (106 C.F.U./mL). After storage at predetermined intervals (0, 7, 14, 28, 90 and 180 days), a specific quantity of packages of each type of packaging has been opened and the samples were seeded directly in soybean-casein culture medium. The packages with samples with zero time of storage were considered as negative controls. In order to ensure the viability of the test micro-organism on the outer surface of the packages, cultivation of samples of each package contaminated with the test microorganism were made weekly up to 180 days, constituting the positive control group. For each interval of time of storage, 600 samples were analyzed (150 for each type of package). Considering the confidence interval for the exact binomial distribution, the sample size calculated in the study ensured a confidence interval of 95% with 0 to 0.006 probability of finding a contaminated sample. As result, there were no recovered test micro-organism Serratia marcescens in any of the time intervals of storage. Based on the results of this study, it was observed that packages wrapped in wrappers with microbial barrier properties and hermetically sealed are capable of protecting the sterile contents up to 6 months. This study contributes to the clinical practice in Central Supply and Sterilization Department, preventing unnecessary reprocessing of the material, while warns that the related events should be monitored and each material, before use, must be inspected for its integrity of the packaging and sealing.

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