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Fetal lung hypoplasia is a common finding in several fetal conditions such as congenital diaphragmatic hernia (CDH). Interestingly, previous studies have demonstrated that hypoplastic lungs have the ability to recover to normal size, when relieved from mechanical factors. However, the underlying mechanisms remain largely unknown. Recently, interleukin-6 (IL-6) has been involved in catch-up growth phenomenon in children. Thus, we hypothesized that IL-6 could mediate fetal growth recover from hypoplastic lungs. Control and nitrofen-induced hypoplastic lung explants were cultured either in normal conditions or with IL-6 neutralizing antibodies. The total number of peripheral airway buds, epithelial perimeter, and total explant area were analyzed and daily branching rates were calculated. Additionally, IL-6 mRNA and protein expression was assessed both in qualitative (by in situ hybridization and immunohistochemistry) and in quantitative (by real-time PCR and Western blot) approaches, in control and hypoplastic lungs (nitrofen and CDH groups). Nitrofen-induced hypoplastic lungs showed in vitro, out of systemic environment, the ability to recover from hypoplasia and presented daily branching rates significantly higher than controls. Blocking IL-6 activity significantly diminished the intrinsic capacity of hypoplastic fetal lungs to recover from hypoplasia and attenuated their daily branching rates. Although more exacerbated in CDH, both nitrofen-exposed lungs presented significant IL-6 mRNA and protein over-expression throughout all studied gestational ages. The present study suggests, for the first time, that fetal lung is able to recover from growth retardation through a way that resembles the catch-up growth phenomenon, and it seems to be, at least partially, orchestrated by intrinsic mechanisms implicating IL-6.

Objetivo: relatar a experiência na construção de um projeto de melhoria contínua da qualidade para a identificação inequívoca do paciente. Método: trata-se de um descritivo, tipo relato de experiência, que compartilha a construção de um projeto que tem como finalidade a identificação inequívoca do paciente, no contexto hospitalar, segundo o referencial da Ordem dos Enfermeiros de Portugal. Resultados: apresentaram-se em oito etapas: identificação e descrição do problema; percepção do problema e suas causas; formulação de objetivos; definição do público-alvo e critérios de inclusão/exclusão; planejamento e execução das atividades; verificação dos resultados; proposta de medidas corretivas; uniformização e capacitação da equipe e, finalmente, reconhecimento e compartilhamento do sucesso. Conclusão: conclui-se que a identificação inequívoca do paciente se torna fundamental para diminuir os incidentes no decorrer da prestação de cuidados. Sugere-se, assim, criar estratégias para sensibilizar os profissionais para a implementação do procedimento de modo a garantir a qualidade e segurança dos cuidados prestados. Descritores: Segurança; Paciente; Qualidade da Assistência à Saúde; Garantia da Qualidade dos Cuidados de Saúde; Enfermagem; Enfermeiras e Enfermeiros.AbstractObjective: to report the experience in the construction of a project of continuous quality improvement for the unequivocal identification of the patient. Method: it is a descriptive, type of experience report, which shares the construction of a project that aims to unequivocally identify the patient, in the hospital context, according to the framework of the Order of Nurses of Portugal. Results: presented in eight stages: identification and description of the problem; perception of the problem and its causes; formulation of objectives; definition of the target audience and inclusion / exclusion criteria; planning and execution of activities; verification of results; corrective measures proposal; uniformity and training of the team and, finally, recognition and sharing of success. Conclusion: it is concluded that the unequivocal identification of the patient becomes essential to reduce the incidents during the provision of care. It is suggested, therefore, to create strategies to sensitize professionals to the implementation of the procedure in order to guarantee the quality and safety of the care provided. Descriptors:  Safety; Patients; Quality of Health Care; Quality Assurance, Health Care; Nursing; Nurses.ResumenObjetivo: reportar la experiencia en la construcción de un proyecto de mejora continua de la calidad para la identificación inequívoca del paciente. Método: es un informe descriptivo, de tipo de experiencia, que comparte la construcción de un proyecto que tiene como objetivo identificar inequívocamente al paciente, en el contexto hospitalario, de acuerdo con el marco de la Orden de Enfermeros de Portugal. Resultados: presentados en ocho etapas: identificación y descripción del problema; percepción del problema y sus causas; formulación de objetivos; definición del público objetivo y criterios de inclusión / exclusión; planificación y ejecución de actividades; verificación de resultados; propuesta de medidas correctivas; uniformidad y formación del equipo y, finalmente, reconocimiento y reparto del éxito. Conclusión: se concluye que la identificación inequívoca del paciente se vuelve esencial para reducir los incidentes durante la prestación de la atención. Se sugiere, por lo tanto, crear estrategias para sensibilizar a los profesionales sobre la implementación del procedimiento a fin de garantizar la calidad y seguridad de la atención brindada. Descriptores:  Seguridad; Pacientes; Calidad de la Atención de Salud; Garantía de la Calidad de Atención de Salud; Enfermería; Enfermeras y Enfermeros.

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