Os chás destacam-se como a segunda bebida mais consumida no mundo. Além disso, seu consumo tem se modernizado, adequando-se aos anseios dos consumidores. São uma boa fonte de compostos com atividade antioxidante, os quais podem trazer benefícios à saúde humana pelo retardamento do processo de envelhecimento, assim como pela prevenção de doenças crônicas, tais como o câncer e doenças cardiovasculares. Infusões de ervas processadas e frescas foram estudadas quanto a teor de compostos fenólicos totais, perfil de flavonóides e atividade antioxidante. Os teores de compostos fenólicos totais, determinados pelo método de Folin–Ciocalteu, variaram de zero a 46,46 mg/g. Os flavonóides miricetina, quercetina e campferol foram identificados e quantificados por cromatografia líquida de alta eficiência (CLAE) nos chás preto, verde e de camomila. A atividade antioxidante foi avaliada pelo método do seqüestro do radical 2,2'-difenil-1-picrilhidrazil (DPPH) e pelo sistema modelo β-caroteno/ácido linoléico (BCAL), usando hidroxitolueno butilado (BHT) e α- tocoferol como padrões. As maiores atividades encontradas pelo sistema modelo BCAL foram para as infusões de chá preto, mate, capim-limão, camomila e funcho, enquanto as infusões de ervas frescas apresentaram as menores atividades. Entretanto, quando a atividade antioxidante foi avaliada pelo método do DPPH, as infusões de ervas frescas de menta e funcho foram as que apresentaram as maiores atividades. Os chás processados que apresentaram os menores valores de IC50 foram verde e preto (147,63 µg/mL e 288,60 µg/mL, respectivamente). Os resultados obtidos demonstraram que as infusões analisadas são boas fontes de compostos com atividade antioxidante. / Teas are the second most consumed beverage in the world. Besides this, their consumption has been modernized to suit the consumers? desires. They are a good source of compounds presenting antioxidant activity, which can bring benefits to human health by retarding the process of aging, as well as by preventing chronic diseases, such as cancer and cardiovascular diseases. Processed teas and herbal infusions were studied for their total polyphenol content, flavonoid profile, and antioxidant activity. Total phenolics, determined by Folin?Ciocalteu procedure, ranged from zero to 46.46 mg/g. Flavonoids myricetin, quercetin, and kaempferol were identified and quantified by High Efficiency Liquid Chromatography (HPLC) in black, green, and chamomile tea. Antioxidant activity was evaluated using 2,2 Diphenyl-1-picryl-hydrazyl method (DPPH) and β-carotene bleaching test (BCB), with butylated hydroxytoluene (BHT) and α-tocopherol as reference substances. The highest activities using BCB were found for infusions of black tea, maté, lemongrass, chamomile, and fennel, whereas fresh herbal infusions presented the lowest activities. However, when the antioxidant activity was evaluated by DPPH, fresh herbal infusions of mint and fennel presented the highest activities. Processed teas with the lowest IC50 values were green and black (147.63 µg/mL and 288.60g/mL and 288.60 µg/mL, respectively). The results obtained demonstrate that the infusions analyzed are good sources of compounds presenting antioxidant activity.

Submitted by Eunice Novais (enovais@uepg.br) on 2018-05-07T18:21:20Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Bruna de Fatima P Schmite.pdf: 1583341 bytes, checksum: 0cbad71cd214749ae6e87e91447ced22 (MD5) / Made available in DSpace on 2018-05-07T18:21:20Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Bruna de Fatima P Schmite.pdf: 1583341 bytes, checksum: 0cbad71cd214749ae6e87e91447ced22 (MD5) Previous issue date: 2018-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O chá-mate é uma bebida muito consumida nos estados do Sul do Brasil, não só devido ao seu sabor e aroma, mas também por suas propriedades terapêuticas. Tais propriedades estão associadas à presença de diversos constituintes químicos em sua composição, como polifenóis, flavonoides, vitaminas e minerais. Esses minerais podem ser essenciais ao organismo humano, ou altamente tóxicos, dependendo da forma e concentração. Nesse sentido, o presente trabalho teve como objetivos determinar as concentrações totais de Cd, Cu, Pb e Al em chá-mate comercial, bem como o conteúdo desses elementos em infusões preparadas à temperatura ambiente (frio) e a quente. As concentrações de fenólicos em infusões também foram determinadas utilizando o método Folin-Ciocalteu. Além disso, avaliar as frações bioacessíveis desses elementos e, ainda verificar se a adição de alguns ingredientes as infusões (canela, limão, mel e açúcar) pode influenciar na biodisponibilidade do alumínio. As quantificações foram realizadas por espectrometria de absorção atômica com atomização eletrotérmica em forno de grafite e em chama. Para os teores totais a abertura de amostra, por via úmida (otimizada por planejamento fatorial) apresentou os melhores resultados, em relação a via seca. As concentrações totais para as quatro marcas estudadas variaram: Cd (0,08 à 0,320 μg g-1); Pb (0,36 à 0,44 μg g-1); Cu (10,3 à 12 μg g-1) e Al (347 à 526 μg g-1). Para as infusões os teores superiores de Al e Cd foram encontrados nas infusões a quente, enquanto que para o Cu e o Pb os maiores teores foram nas infusões a frio. Com isso, a ordem de extração nas infusões tanto a quente quanto a frio foi Cd>Pb>Al>Cu. Com relação aos teores de fenólicos, as maiores concentrações foram obtidas nas infusões a quente variando de 13 a 17 mg g-1. Nos estudos de bioacessibilidade in vitro empregando o método de simulação gástrica (PBET) os elementos Cd e Cu foram os metais mais bioacessíveis, enquanto o Al foi encontrado em forma relativamente inerte (baixa bioacessibilidade). Verificou-se também que o consumo diário de 100 mL da bebida, por um adulto, não ultrapassa os limites de ingestão diária desses metais recomendável pela Organização Mundial da Saúde. Por fim, verificou-se que a adição de ingredientes às bebidas, como o açúcar e mel podem diminuir os teores biodisponíveis de Al. / Yerba mate tea is a widely consumed drink in the southern states of Brazil, not only because of its flavor and aroma, but also due to its therapeutic properties. Such properties are associated with the presence of several chemical constituents in its composition, such as polyphenols, flavonoids, vitamins and minerals. These minerals may be essential to the human body, or highly toxic, depending on their form and concentration. In this sense, this study aimed to determine the total concentrations of Cd, Cu, Pb and Al in commercial mate tea, as well as the content of these elements in infusions prepared at room temperature (cold) and hot; to determine phenolic concentrations in infusions using the Folin-Ciocalteu method; to evaluate the bioaccessible fractions of these elements and to verify whether the addition of some ingredients to the infusions (cinnamon, lemon, honey and sugar) may influence the bioavailability of aluminium. The quantifications were performed using atomic absorption spectrometry with electrothermal atomization in graphite and flame furnace. For total content analyses, the wet route (optimized by factorial planning) showed the best results when compared to the dry route. The total concentrations for the four brands studied varied: Cd (0.08 to 0.320 μg g-1); Pb (0.36 to 0.44 μg g -1); Cu (10.3 to 12 μg g -1) and Al (347 to 526 μg g -1). Regarding infusions, the highest contents of Al and Cd were found in the hot infusions, while cold infusion presented the highest levels of Cu and Pb. Thus, the order of extraction in hot and cold infusions was Cd> Pb> Al> Cu. With respect to the phenolic contents, the highest concentrations were obtained in the hot infusions ranging from 13 to 17 mg g-1. In the in vitro bioaccessibility studies using the gastric simulation method (PBET) the Cd and Cu elements were the most bioaccessible metals, while Al was found in relatively inert (low bioaccessibility) form. It was also found that the daily consumption of 100 ml of the drink by an adult does not exceed the limits of daily intake of these metals recommended by the World Health Organization. It was also verified that the addition of ingredients such as sugar and honey to these beverages may decrease the bioavailable levels of Al.

O uso de dispositivos para infusões intravasculares representa um desafio, principalmente, pela possibilidade da dispersão microbiana do local de inserção até a ponta do cateter. O procedimento de desinfecção poderá reduzir a colonização no sítio de inserção desses dispositivos, entretanto instiga uma série de questionamentos acerca da possibilidade de dispersão para o interior do lúmen, espectro de ação do antimicrobiano, e a técnica do procedimento de desinfecção. O objetivo deste estudo foi avaliar in vitro o procedimento de desinfecção das dânulas/torneiras de três vias contaminadas propositalmente com Staphylococcus aureus e Pseudomonas aeruginosa, bem como a dispersão de soluções para o interior dos lúmens. Trata-se de um experimento laboratorial in vitro, controlado e desenvolvido em duas etapas: avaliação da dispersão bacteriana por meio da contaminação intencional com cepas padrão: S. aureus (ATCC 25923) e P. aeruginosa (ATCC 27853), e a dispersão de líquidos para o interior do conector por meio do corante cristal violeta a 1%, após a fricção com solução fisiológica ou álcool etílico a 70%, visando simular o processo de desinfecção. Todos os experimentos foram realizados em triplicata por três pesquisadores distintos. A fricção dos conectores com solução fisiológica demonstrou crescimento bacteriano (P. aeruginosa e S. aureus) no interior de 41,7% dos lúmens, no entanto não houve crescimento bacteriano nas amostras após a desinfecção com solução alcoólica a 70% (p<0,001). Com relação aos percentuais das ausências de dispersão de soluções para o interior dos lúmens das dânulas, observou-se que a fricção com as soluções fisiológica e alcoólica foram de 81,5% e 66,7%, respectivamente (p=0,079). Assim, a ausência do crescimento bacteriano no lúmen das dânulas após a fricção com solução alcoólica a 70% está associada a uma série de variáveis controladas as quais remetem a preocupação, principalmente, na possibilidade de dispersão de soluções desinfetantes para o seu interior. Nesse sentido, infere-se sobre os riscos que ameaçam a segurança das pessoas submetidas a infusões intravenosas, especialmente, no que concerne a execução do procedimento de desinfecção das dânulas / The use of intravascular infusion devices presents a challenge, mainly, due to the possibility of microbial dispersion of insertion site up to catheter tip. Disinfection procedure can reduce colonization at insertion site of these devices, but it instigates a series of questions about the possibility of dispersion into the lumen, antimicrobial action spectrum, and the technique of the disinfection procedure. The objective of this study was to evaluate in vitro disinfection procedure of three-way taps purposely contaminated with Staphylococcus aureus and Pseudomonas aeruginosa as well as the dispersion of solutions into the lumens. This is an in vitro laboratory experiment, it was controlled and developed in two steps: evaluation of bacterial dispersion by intentional contamination with standard strains: S. aureus (ATCC 25923) and P. aeruginosa (ATCC 27853), and liquid dispersion into the connector through 1% violet crystal dye, after friction with physiological solution or 70% ethyl alcohol, in order to simulate disinfection process. All experiments were performed in triplicate by three distinct researchers. The friction of connectors with physiological solution showed bacterial growth (P. aeruginosa and S. aureus) within 41.7% of the lumens, but there was no bacterial growth in the samples after disinfection with 70% alcoholic solution (p<0.001). Regarding the absence of dispersion percentages of solutions into the lumens from three-way taps, it was observed that the friction with physiological and alcoholic solutions were 81.5% and 66.7%, respectively (p=0.079). Thus, the absence of bacterial growth in the lumen from three-way taps after the friction with 70% alcoholic solution is associated to a series of controlled variables which refer, mainly, to the possibility of dispersion of disinfectant solutions to its interior. In that sense, it is inferred about risks that threaten the safety of people undergoing intravenous infusion, especially, concerning the disinfecting procedure execution for three-way taps

The concentrations of some drug solutions are often expressed as ratios or percentages. This system simplified prescription and dispensing when Imperial measures such as grains and minims were used. Ampoules of powerful vasoactive drugs such as catecholamines and potentially toxic local anaesthetics are still labelled as ratios and percentages, seemingly through habit or tradition than for any useful clinical reason. This thesis argues that adherence to this outdated system is confusing, causes drug administration errors, and puts patients at risk. Internet-based questionnaires were used to quantify medical students’ and doctors’ understanding of ratios and percentages. A substantial minority of almost 3000 doctors could not convert between ratios, percentages and mass concentration correctly, made dosing errors of up to three orders of magnitude in written clinical scenarios, and struggled with conversions between metric units. These findings are strong arguments for expressing drug concentrations as mass concentration and providing better drug administration teaching. High fidelity patient simulation was used to examine the influence of clearer ampoule labelling and intensive drug administration teaching. This allowed critical incidents to be reproduced realistically, clinical performances to be assessed, and outcome measures to be accurately recorded. Randomised controlled trials were conducted that demonstrated positive influences of both interventions for doctors and students. The difficulties that nurses encounter when preparing infusions of these drugs on critical care units were also studied and are reported. The findings presented should be sufficient to persuade regulatory authorities to remove ratios and percentages from ampoule labels – a straightforward, cheap, commonsense intervention. The lack of effective clinical error reporting systems and the extreme practical difficulties of conducting clinical trials in this field mean that a firm link between this intervention and patient outcome is unlikely ever to be made, but this should not be an excuse for maintaining the status quo.

Thesis (doctoral)--Ludwig-Maximilians Universität zu München, 1994. / Includes bibliographical references.

Reliable access to the circulation is paramount in most medical and surgical emergencies. When venous access cannot be expediently established, intraosseous (IO) access is indicated. This method has a high success rate even in relatively inexperienced hands and there is considerable clinical experience of IO administration of drugs and fluids. There is however limited evidence on the use of IO samples for laboratory analysis. Also, uptake of drugs during shock has not been extensively studied. Further, there have been concerns that analysis of IO samples may damage laboratory equipment. We have studied, in a porcine model, the use of IO samples for point of care analysis of blood gases, acid base parameters and blood chemistries in stable circulation, in experimental septic shock, and in hypovolemia after major hemorrhage, comparing IO samples with arterial and venous samples, and comparing IO samples from different sites. We have also studied coagulation assays on IO samples in stable circulation and after major hemorrhage. Furthermore, we have compared IO and intravenous administration of antibiotics in experimental sepsis. Average differences between IO and arterial/venous samples varied between the studied analytes. During stable circulation, average IO levels of blood gases, acid-base parameters, hemoglobin/hematocrit and several blood chemistries approximated venous levels relatively well. Differences in acid-base and blood gas parameters, and lactate, were more pronounced in hypovolemia, as well as in sepsis. The dispersion of the differences was often relatively large, indicating limited precision. Average differences between two intraosseous sites were small. Intraosseous samples were clinically hypercoagulable with a strong tendency to clot in vitro, and thromboelastography demonstrated shortened reaction times compared with venous samples. Major bleeding and hemodilution moderately affected the studied coagulation parameters. In endotoxemic animals with circulatory instability, concentrations of cefotaxime and gentamicin in samples from the pulmonary artery were comparable at 5 minutes after intraosseous and intravenous administration, and during a 3 hour observation period. In summary, agreement between analytes in intraosseous and conventional blood samples was variable and often unpredictable, especially during circulatory compromise. Intraosseous samples clinically appeared hypercoagulable, and thromboelastography confirmed this. High and comparable concentrations of cefotaxime and gentamicin were found after intraosseous and intravenous administration of equivalent doses, suggesting that uptake is acceptable during septic instability.

Os chás destacam-se como a segunda bebida mais consumida no mundo. Além disso, seu consumo tem se modernizado, adequando-se aos anseios dos consumidores. São uma boa fonte de compostos com atividade antioxidante, os quais podem trazer benefícios à saúde humana pelo retardamento do processo de envelhecimento, assim como pela prevenção de doenças crônicas, tais como o câncer e doenças cardiovasculares. Infusões de ervas processadas e frescas foram estudadas quanto a teor de compostos fenólicos totais, perfil de flavonóides e atividade antioxidante. Os teores de compostos fenólicos totais, determinados pelo método de Folin&#150;Ciocalteu, variaram de zero a 46,46 mg/g. Os flavonóides miricetina, quercetina e campferol foram identificados e quantificados por cromatografia líquida de alta eficiência (CLAE) nos chás preto, verde e de camomila. A atividade antioxidante foi avaliada pelo método do seqüestro do radical 2,2&#39;-difenil-1-picrilhidrazil (DPPH) e pelo sistema modelo &#946;-caroteno/ácido linoléico (BCAL), usando hidroxitolueno butilado (BHT) e &#945;- tocoferol como padrões. As maiores atividades encontradas pelo sistema modelo BCAL foram para as infusões de chá preto, mate, capim-limão, camomila e funcho, enquanto as infusões de ervas frescas apresentaram as menores atividades. Entretanto, quando a atividade antioxidante foi avaliada pelo método do DPPH, as infusões de ervas frescas de menta e funcho foram as que apresentaram as maiores atividades. Os chás processados que apresentaram os menores valores de IC50 foram verde e preto (147,63 &#181;g/mL e 288,60 &#181;g/mL, respectivamente). Os resultados obtidos demonstraram que as infusões analisadas são boas fontes de compostos com atividade antioxidante. / Teas are the second most consumed beverage in the world. Besides this, their consumption has been modernized to suit the consumers? desires. They are a good source of compounds presenting antioxidant activity, which can bring benefits to human health by retarding the process of aging, as well as by preventing chronic diseases, such as cancer and cardiovascular diseases. Processed teas and herbal infusions were studied for their total polyphenol content, flavonoid profile, and antioxidant activity. Total phenolics, determined by Folin?Ciocalteu procedure, ranged from zero to 46.46 mg/g. Flavonoids myricetin, quercetin, and kaempferol were identified and quantified by High Efficiency Liquid Chromatography (HPLC) in black, green, and chamomile tea. Antioxidant activity was evaluated using 2,2 Diphenyl-1-picryl-hydrazyl method (DPPH) and &#946;-carotene bleaching test (BCB), with butylated hydroxytoluene (BHT) and &#945;-tocopherol as reference substances. The highest activities using BCB were found for infusions of black tea, maté, lemongrass, chamomile, and fennel, whereas fresh herbal infusions presented the lowest activities. However, when the antioxidant activity was evaluated by DPPH, fresh herbal infusions of mint and fennel presented the highest activities. Processed teas with the lowest IC50 values were green and black (147.63 &#181;g/mL and 288.60g/mL and 288.60 &#181;g/mL, respectively). The results obtained demonstrate that the infusions analyzed are good sources of compounds presenting antioxidant activity.

Background: Medication errors continue to be one of the most prevalent problems in healthcare related to patient safety, often resulting in injury or death, with higher incidences of error occurring with intravenous medications. The purpose of this study was to explore the use of deliberate practice (DP) with second-degree nursing students in developing and maintaining fundamental intravenous medication management practices required for safe practice. Method: This was a feasibility study using a two-arm, single-blind, randomized controlled trial design. Vygotsky’s Zone of Proximal Development model was used to explore the use of a DP teaching intervention to achieve competency in skills associated with safe IV medication management. A convenience sample of first-year, first-semester nursing students enrolled in an accelerated graduate program (N = 32) were invited to participate; 19 enrolled, and 12 completed the study. Students (n = 12) received three 30- minute one-on-one practice sessions at 2-week intervals with an expert nurse (the intervention group focused on IV skills and the control group on skills unrelated to IVs). Pre- and post-intervention instruments tested participants’ confidence with IV management and safety skills. The primary outcome was their ability to safely administer and monitor IV medications during a 20-minute videotaped medication administration scenario. Results: Low recruitment (19 of 32) and high attrition (37%) were observed. Participants completing the study (5 in the intervention group and 7 in the control group) reported that the time required to attend the sessions was not burdensome (91.7%); time allotted was adequate (100%); 100% reported positive experience; 91.7% found the DP sessions essential to learning. Change in confidence scores for IV skills were not significant (P = 0.210), but were higher in the intervention group (2.97–4.14 = 1.50 change) compared to the control group (2.71–3.77 = 1.04 change). Significant differences were found in overall medication administration skills between the control and intervention groups (t [-2.302], p = 0.044) in favor of the intervention group, particularly with medication preparation skills (p = 0.039). Overall raw scores were low in both groups; only 16–42 (26%–70%) of the total 60 steps required for safe practice were completed. Participants scored lowest in the evaluation phase, with all participants performing less than 50% of the 14 steps. Conclusion: Even though participant satisfaction was high, significant attrition occurred. Students reported the DP sessions to be beneficial and they felt more confident in performing skills, but three 30-minute sessions (90 minutes) were not adequate to develop, maintain, or refine all the IV-management skills associated with safe medication practices. Determining the length and duration of DP sessions as well as comparing the efficacy of DP sessions between individual and group sessions with varying doses and frequencies is needed to advance our understanding of using DP within nursing education.

A busca pelo entendimento da etiofisiopatogênese da esquizofrenia permanece desafiadora e tratamentos convencionais com medicações antipsicóticas que agem principalmente através da modulação da neurotransmissão dopaminérgica mostramse insuficientes, vistos os elevados índices de refratariedade e superrefratariedade nesta população. Estudos recentes apontam resultados promissores de moduladores do sistema glutamatérgico com ação em receptores NMDA, como o nitroprussiato de sódio (NPS), um doador de óxido nítrico, capaz de reduzir sintomas positivos, negativos e cognitivos do transtorno. O objetivo do presente estudo foi estudar os efeitos da administração repetida de NPS sobre a sintomatologia de pacientes com esquizofrenia. Recrutados 17 pacientes portadores de esquizofrenia acompanhados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP, em idade entre 18-45 anos, submetidos ao protocolo experimental com delineamento cruzado, duplo-cego, randomizado e controlado por placebo. Cada participante recebeu oito infusões intravenosas, sendo destas, quatro de NPS (0,5 ?g/kg/min por 4 horas/sessão) e quatro de placebo, em intervalo de 15 dias entre as sessões. A avaliação dos sintomas positivos, negativos e cognitivos foi feita através dos seguintes instrumentos: Escala de Avaliação das Síndromes Positiva e Negativa para Esquizofrenia (PANSS), Escala de Avaliação Psiquiátrica Breve (BPRS), Escala de Impressão Clínica Geral - Esquizofrenia (CGI-SCH), Stroop Color Word Test (SCWT), N-back, Teste de Fluência Verbal (FAS). Para avaliação de efeitos colaterais das medicações foi usada a Escala de Avaliação de Efeitos Colaterais (UKU). A análise dos dados demográficos e clínicos da amostra foi realizada através de estatística descritiva. As análises estatísticas foram feitas com o programa Statistical Package for the Social Sciences versão 17.0. Para avaliar o efeito do NPS nos escores BPRS, PANSS, SCWT, N-back e FAS, os dados foram submetidos a análise de variância de medidas repetidas para modelos de estudo crossover. Análises independentes para sessões de nitroprussiato de sódio e placebo foram realizadas quando houve significância estatística, seguidas de teste t de Student, que também foi empregado para avaliações pareadas entre dados do ínicio e final das sessões. Para análise da CGI-SCH, foi utilizado o teste de Friedman para medidas não-paramétricas. O nível de significância adotado foi de p<0,05. A população amostral que completou o estudo foi de 14 indivíduos portadores de esquizofrenia crônica, refratária ou superrefratária, com bom nível de escolaridade, idade média de 32,94 anos e quase na totalidade usuários de clozapina. Foram realizadas 121 infusões. Observou-se diminuição estatisticamente significativa nos escores iniciais da BPRS, PANSS positiva e negativa e CGI-SCH, com manutenção da redução dos escores nos dias 15, 30 e 60 após término das sessões experimentais. Nas avaliações cognitivas, houve diferença significativa entre as sessões nos escores da SCWT e não houve diferença na análise da FAS e da Nback. Os resultados confirmaram achados anteriores de que o NPS, doador de NO, pode proporcionar melhora clínica significativa nos sintomas positivos e negativos daesquizofrenia, além de melhora parcial nos sintomas cognitivos. Além disso, o ensaio com administração repetida sugere que a droga é segura, não apresenta efeitos colaterais significativos na maioria dos casos e leva a uma melhora sustentada por até 60 dias nos sintomas da esquizofrenia / The knowledge about etiology of schizophrenia remains challenging and conventional treatments with antipsychotic medications that act mainly through the modulation of dopaminergic neurotransmission have proven insufficient, considering the high rates of treatment resistance in this population. Recent studies point to promising results of modulators of the glutamatergic system with action on NMDA receptors such as sodium nitroprusside (SNP), a nitric oxide donor, capable of reducing the positive, negative and cognitive symptoms of the disorder. The aim of the present study was to study the effects of repeated NPS administration on the symptomatology of patients with schizophrenia. A total of 17 schizophrenia patients were enrolled at the Ribeirão Preto Medical School University Hospital, aged 18-45 years took part in a double-blind, randomized, placebo-controlled, double-blind, experimental design. Each participant received eight intravenous infusions, four of SNP (0.5 ?g/kg/min for 4 hours/session) and four of placebo, with a 15-day interval between sessions. The Positive and Negative Syndromes Scale for Schizophrenia (PANSS), BPRS (Brief Psychiatric Rating Scale), Clinical Global Impression scale - Schizophrenia (CGI-SCH), in addition to the Stroop Color Word Test (SCWT), Nback, and the Verbal Fluency Test (FAS). The Side Effects Assessment Scale (UKU) was used to evaluate side effects. The analysis of the demographic and clinical data of the sample was performed through descriptive statistics. Statistical analyses were performed with the Statistical Package for Social Sciences. To evaluate the effect of SNP on BPRS, PANSS, SCWT, N-back and FAS scores, the data were subjected to repeated measures analysis of variance for crossover studies. Independent analyses for SNP and placebo sessions were performed when there were statistically significant differences between the conditions, followed by Student\'s t-test, which was also used for paired evaluations between data from the beginning and end of the sessions. For the analysis of CGI-SCH data, the Friedman test was used. The level of significance was set at p <0.05. The sample that completed the study consisted of 14 individuals with chronic, refractory or superrefractory schizophrenia, with a good level of education and mean age of 32.94 years . Almost all patients were in treatment with clozapine. A total of 121 infusions were performed. A statistically significant decrease was observed in the initial BPRS, PANSS positive and negative subscales, and CGI-SCH scores, which persisted on days 15, 30 and 60 after the end of the experimental sessions. In the cognitive assessments, there was a significant difference between the sessions in SCWT scores and no difference in respect to the FAS and N-back. The results confirmed earlier findings that SNP, an NO donor, can provide significant clinical improvement in the positive and negative symptoms of schizophrenia, as well as partial improvement in cognitive symptoms. In addition, the repeated administration trial suggests that the drug is safe, has no significant side effects in most cases and leads to sustained improvement for up to 60 days in the symptoms of schizophrenia

The purpose of this research study was to improve the nursing care of intravenous catheters by providing evidence on the effects of prolonged duration of intravenous administration set use. Intravenous therapy is a vital part of modern health care. However, its invasive nature can result in infection, with high associated morbidity and mortality. The highest infection rates are displayed in intensive care patients with central venous catheters. The duration of intravenous administration set use may have an impact on infection rates,however the current practice usage and the optimum duration of use is unknown. Previous studies of central venous catheters have reported equal infection rates with 1 to 4 days of administration set use; however few patients have been evaluated with administration sets used beyond this time. Previous research has been limited by the inadequacy of available definitions for Catheter-Related Infection. A prospective, randomised, controlled clinical trial was performed to assess the infection risk of using administration sets for prolonged periods. In the developmental phase prior to the clinical trial; definitions of Catheter-Related Bloodstream Infection (CRBSI) were developed; a nursing practice survey was undertaken to establish the current duration of administration set use; and laboratory experiments were executed to assess the impact of prolonged use on administration set physical integrity and performance. Central venous catheters were randomised to have their administration sets used for 4 days (n = 203) or 7 days (n = 201). Percutaneous central venous catheters were enrolled into the study from two adult intensive care units at a metropolitan, tertiary-referral, teaching hospital. Catheters were multiple-lumen, chlorhexidine-gluconate and silver-sulphadiazine coated lines, both inserted and removed in the intensive care unit. Catheters were cultured for microbial colonisation on removal using the Maki roll-plate technique. Patients were assessed for CRBSI using the developed definitions consisting of categories: definite, probable (type I and II), possible and absent. Prior to the clinical trial, a practice survey questionnaire was administered, and laboratory experimentation was performed. Normality of distribution for continuous variables was assessed using the Kolmogorov- Smirnov statistic. The distribution between groups of variables considered risk factors for Catheter-Related Infection were tested to assess for bias using Chi-square and T-test. Logistic regression modelling was performed to analyse the influence of potentially confounding variables. The incidence of catheter colonisation and CRBSI was tested between groups using Kaplan-Meier survival curve with Log-rank test. Paired T-tests were performed to test for difference in programmed and delivered volumes of administration sets. A general linear model (ANOVA)± a Scheffe post hoc test to isolate difference was fitted to the standardised values of delivered volumes to determine the effects of day of measurement and volume delivery rate on the accuracy of volume delivery. There were 10 colonised tips in the intervention group and 19 in the control group. This difference was not statistically significant (Kaplan Meier survival analysis, Log Rank = 0.87, df = 1, p = 0.35). There were 3 cases of CRBSI per group and the difference in survival from CRBSI was not statistically significant (Kaplan Meier with Log Rank test, p = 0.86). The pre-clinical trial phases of the research programme established that current clinical practice was 3 to 7-day use of administration sets; that administration sets were physically intact and delivered clinically accurate volumes after 7 days of use; and developed useful definitions of CRBSI. Prolonged intravenous administration set use of 7 days was found to have no significant impact on patient infection indicators or physical performance of the sets. This finding is congruent with previous research and trends in current clinical practice. In conclusion, the research findings support the use of intravenous administration sets for 7 days.