Introduction: Monitoring water quality in mobile dialysis (MD) services, assessing critical points and characterizing the risks inherent in the process, is essential to avoid risks to the patient's health. This study evaluated the microbiological quality of water in the MD of 36 hospitals with intensive treatment in the city of Rio de Janeiro. Methods: 204 water samples were collected from the points of entry to the network (NET), post-osmosis (PO) and dialysis solution (DS). The samples were evaluated for heterotrophic bacteria count, pathogen search, presence of endotoxins and aluminum content. Results: Bacterial contamination at 3 collection points in 36 hospitals was 30% (32/108); 42% from DS, 31% from PO and 17% from NET, with the presence of Pseudomonas aeruginosa, Stenotrophomonas maltophilia , Burkholderia cepacia and Ralstonia pickettii in the 3 points. Endotoxin concentrations above 0.25 EU/mL occurred in 77% of the samples (17/22) analyzed in the PO. In the aluminum content, values above 0.01 mg/L were presented in 47% (7/15) of PO samples and 27% (4/15) of NET samples. There is no specific legislation for water used in the MD; therefore, the limits of the RDC of the National Health Surveillance Agency (Anvisa) 11/2014 were used; which regulates conventional hemodialysis services. Conclusion: The results highlight the importance of evaluating water quality in MD services to ensure patient safety and support the sanitary monitoring of this process as a healthcare promoter.
ABSTRACT. Hemodialysis water and dialysates are fundamental in the treatment of kidney disease. During just one hemodialysis session, 120 liters of dialysate are consumed. Thus, it is essential that the parameters of chemical and microbiological quality of the fluids used in dialysis systems are carefully observed. In this study, water samples were collected at 12 hospitals in the state of Rio de Janeiro. The samples were obtained at three points of fluid reservoirs: pre-, post-osmosis and dialysis solution. After collection, colony forming units (CFU), total coliforms and Escherichia coli 100 mL -1 were quantified. Later, isolated colonies and endotoxin content were identified by biochemical assays. Data about total aluminum levels per sample (mg L -1 ) were also obtained. Samples of all mobile dialysis services and points of collection were contaminated above the levels set out by national laws, in particular by Pseudomonas aeruginosa. Endotoxin levels were also above the recommended by current legislation (> 0.25 EU mL -1 ). Only three samples contained detectable levels of aluminum, which were found to be above the recommended values for the corresponding resolution (0.01 mg L -1 ). Finally, there were no observable amounts of total coliforms and E. coli 100 mL -1 sample. The data from this study are an important step forward in the standardization and control of chemical/microbiological quality of mobile dialysis services.Keywords: dialysis, hemodialysis units, dialysis solutions.Detecção de microrganismos, endotoxinas e alumínio em serviços de diálise móvel RESUMO. Águas de hemodiálise e dialisatos são peças fundamentais na terapêutica da doença renal. Durante apenas uma sessão de hemodiálise, são consumidos aproximadamente 120 litros de dialisato. Desta forma, é essencial que os parâmetros de qualidade microbiológica e química dos fluidos utilizados em sistemas de diálise sejam cuidadosamente observados. Neste trabalho, foram coletadas amostras de água em 12 hospitais do Estado do Rio de Janeiro. Amostras foram obtidas em pontos pré-osmose, pós-osmose e solução de diálise. Após coleção, quantificaram-se unidades formadoras de colônias (UFC), coliformes totais e Escherichia coli 100 mL ). Por fim, não foram encontradas quantidades observáveis de coliformes totais e E. coli 100 mL -1 de amostra. Dados de nosso estudo são importante avanço na padronização e controle de qualidade química/microbiológica em serviços de diálise móvel.Palavras-chave: diálise, unidades hospitalares de hemodiálise, soluções para diálise.
Resumo O Telessaúde-RJ mantém espaços específicos para cada profissão da área de saúde, tendo o projeto Telenutrição, como exemplo de um dos pioneiros desta iniciativa. Objetivos: Avaliar o desempenho do curso "Promoção da Alimentação Saudável no Ambiente Escolar". Metodologia: O levantamento de registros referente aos acessos dos usuários do Telenutrição no curso "Promoção da Alimentação Saudável no Ambiente Escolar" no período de 27 de Abril de 2012 a 4 de junho de 2012 foi obtido através dos dados gerados pelo programa Moodle. Os mesmos foram submetidos à análise estatística descritiva. Resultados: O curso obteve um total de 186 inscritos. Desses, 62,4 % foram provenientes de cidades do interior. De todos os participantes, 43% concluíram o curso, sendo 65% usuários do interior e 35% das capitais. Os itens mais visualizados foram: aula, com 70,5%, seguido por bibliografia, com 11,7%. A região que obteve maior percentual de concluintes foi o Sudeste, representando 67,5%. Conclusão: O curso cumpriu seu objetivo, diante da adesão e conclusão de usuários de todas as regiões do Brasil, principalmente dos municípios externos às capitais.
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