Objective: To evaluate nurses' knowledge about the definitions of Sepsis-3 and updates to the Surviving Sepsis Campaign. Methods: This descriptive study was carried out from July to August 2018, with 30 nurses from four wards of a large university hospital. For data collection, we created, structured, and validated a questionnaire composed of socio-demographic/occupational data and knowledge test. Results: Only 16.6% of the professionals received in-service training on the subject. There was no implementation of sepsis protocols in the institution, although 96.6% of the participants considered their implementation necessary. Professionals aged ≥35 years old had a higher level of knowledge about the new definition of sepsis (p=0.042). The knowledge about volume resuscitation (p=0.001) and use of vasopressors (p=0.025) was greater in those with ≥10.5 years of experience in the profession. Nurses from the clinical units presented a higher level of knowledge about the organic dysfunctions caused by sepsis (p=0.025). Conclusion and implications for the practice: Nurses do not have satisfactory knowledge for the proper identification, treatment, and clinical management of sepsis. There is a need for greater professional, institutional, and political incentives to implement a permanent education and the sepsis protocol.

The association between paracoccidioidomycosis (PCM) and AIDS is relatively rare in contrast to the higher incidence of other systemic mycosis. The explanation may be that AIDS is still predominantly an urban disease, and the PCM is endemic in Latin American rural areas. The aim of this study was to detect the prevalence of Paracoccidioides brasiliensis infection in HIV-positive patients at an endemic area of paracoccidioidomycosis in Brazil. Skin test with purified 43 kD glycoprotein (gp43) was performed in 90 HIV/AIDS patients. The prevalence found was 12.2% and it may be even greater, considering that HIV/AIDS patients may not respond to the intradermal test, which depends on cellular immunity for its positivity.

Aim: To investigate the incidence and risk factors for medical adhesive-related skin injury (MARSI) in catheters of critically ill patients. Methods: A prospective cohort study was conducted in adult intensive care units of two Brazilian university hospitals. A total of 150 patients (439 catheters) were included. Skin exposed to the catheter fixation adhesives (central venous, nasogastric, nasoenteral and indwelling urinary) was examined daily by four trained researchers. The patients sociodemographic and clinical data were collected from their electronic medical records. The association between independent variables and MARSI was investigated by bivariate statistics, followed by multiple logistic regression. Results: The MARSI incidence was 42% (8.64 MARSIs per 100 patients/day). Advanced age, prolonged hospital stay, dry skin, repetitive adhesive removal, low Braden Scale score and hypoalbuminemia were associated with MARSI (p < .05). According to multivariate logistic regression, dry skin increased the chance of MARSI by 5.21 times (odds ratio [OR] 5.21; 95% confidence interval [95% CI] 2.43-11.11), while the Braden Scale score was a protective factor, showing 31% less chance of MARSI for each added score (OR 0.69; 95% CI 0.57-0.85). A higher incidence of MARSI was observed in nasoenteral catheters and in those fixed with adhesive using natural rubber. The MARSI types were predominantly mechanical (70.3%): skin stripping (41.3%), skin tear (26.1%) and tension injury or blister (2.9%). Conclusions: MARSI is a common event in adult intensive care units and most risk factors are modifiable. Preventive actions are potentially capable of reducing incidence, optimizing financial resources and improving clinical results.

The aim of the present study was to detect and identify Mycobaterium spp. in 50 samples of coalho cheese sold in the Northeast region of Brazil. Of the 50 analyzed samples, 35 were produced by the artisanal process, using raw milk, and 15 originated from industrialized establishments that pasteurize milk. Conventional and real-time nested PCR for the rv2807 gene of the M. tuberculosis complex was performed directly from the 50 analyzed samples. Samples of coalho cheese were grown simultaneously in Stonebrink medium, and conventional PCR was performed from the bacterial isolates with primers that flank differentiation region 4 (DR4), specific to M. bovis, mb400F. Bacterial isolates negative by PCR for RD4 were subjected to PCR for hsp65 of Mycobacterium spp., with subsequent DNA sequencing. The cultures were negative for the M. tuberculosis complex, but two samples (4%) from the artisanal process (with raw milk) exhibited identity with hsp65 of Mycobacterium lehmanii (Sequence ID: KY933786.1, identities: 312/363 [86%]); and Mycobacterium rutilum (sequence ID: LT629971.1, identities: 331/371 [89%]), showing to be indicative environmental contamination. Non-tuberculous mycobacteria are emergent and ubiquitous microorganisms; therefore, they deserve greater attention in the cheese production chain, both in terms of Good Agricultural Practices (GAP) and food Good Manufacturing Practices (GMP).

Thanks to the introduction of new chemotherapeutic agents, treatment of non-seminomatous germinal cell tumours (NSGCT) has dramatically improved during the last two decades. The association of chemotherapy and surgery has further increased the therapeutic success rate. The authors report their experience on this subject over the last ten years. Although the number of patients is relatively small and statistically insignificant, the results compare well with those of large centres dealing with this pathology.