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Inadequate initial antibiotic treatment of ESBL urinary tract infections (UTI) can lead to increase in the number of antibiotics used, return visits, longer hospitalizations, increased morbidity and mortality and increased costs. Given the important health implications on patients, this study aimed to examine the prevalence and predictors of ESBL UTIs among Emergency Department (ED) patients of a tertiary care center in Beirut, Lebanon.Single-center retrospective observational study involving all adult UTI patients who presented to the ED of the American University of Beirut Medical Center, a tertiary care center between August 2019 and August 2020.Out of the 886 patients that were included, 24.9% had an ESBL organism identified by urine culture. They had higher bladder catheter use within the previous 90 days, antibiotic use within last 90 days, and were more likely to have a history of an ESBL producing isolate from any body site in the last year. Antibiotic use in the last 90 days and a history of ESBL producing isolate at any site in the previous year were significantly associated with developing an ESBL UTI (OR = 1.66, p = 0.001 and OR = 2.53, p0.001 respectively). Patients diagnosed with cystitis were less likely to have an ESBL organism (OR = 0.4 95%CI [0.20-0.81], p = 0.01) CONCLUSION: The prevalence of ESBL organisms was found to be 24.9% in urinary tract infections. The predictors of an ESBL UTI infection were antibiotic use in the last 90 days, a history of ESBL producing isolate at any site in the previous year. Based on the findings of our study, we can consider modifying initial empiric antibiotic treatment for patients presenting with a UTI with the above stated risk factors.

Introduction The treatment of intestinal perforation caused by the SBC enters the small intestine in elderly patients is a challenge for urologists. The report is to share our experience of conservative treatment after a 90-year-old male with the suprapubic bladder catheter enters the small intestine. Presentation of case Because of the device was obstructed, a 90-year-old male went to our hospital with his family and requested to replace the SBC. When the fistula tube was replaced, it entered the intestine through the intestinal injury site instead of entering the bladder. During the hospitalization, the patient was given supportive treatments and the SBC was dynamically monitored daily and it was intermittently withdrawn out during this period. After the drainage volume was less than 10 mL for three consecutive days and the intestinal fistula was healing gradually, the catheter was taken out. Discussion According to our experience, the common complications in the process include failure to pull out the SBC, abnormal position of the SBC, and poor drainage of the SBC. However, the drainage tube placing into the small intestine through the original hole of the suprapubic bladder fistula during the replacement process is quite rare. When elderly patients have traumatic small bowel perforation, the diagnosis and treatment of intestinal perforation in elderly patients was particularly important. Conclusion The conservative treatment of intestinal perforation is suitable for elderly patients who are unsuitable or unwilling to undergo a surgical operation. Of course, it should be in accordance with the patient's condition to make the right choice of treatment.

RESUMO OBJETIVO: Avaliar a situação nutricional aguda de um grupo de pacientes em uma UTI pediátrica através da medida do balanço nitrogenado e estudar o impacto de um maior aporte de dieta nesse balanço. MÉTODO: Estudo de coorte prospectivo realizado de março a junho de 2018, envolvendo crianças com idade entre 29 dias e 14 anos, com sonda vesical de demora pela necessidade do próprio tratamento. Realizada coleta da urina de 24 horas para o cálculo do balanço nitrogenado, que foi classificado como positivo (BN > 0) ou negativo (BN < 0) para as análises. RESULTADOS: Foram avaliados 40 pacientes, sendo possível a coleta de uma segunda amostra em 7 deles. Das 47 amostras, 25 (53%) apresentaram um balanço nitrogenado positivo. Das amostras com balanço nitrogenado positivo, a média de aporte proteico e calórico foi de 1,4 g/kg/dia e 61 Kcal/kg/dia, respectivamente. Dos pacientes que obtivemos uma segunda coleta da urina de 24 horas, realizada com um maior aporte nutricional, os balanços nitrogenados da segunda coleta foram estatisticamente maiores que os da primeira, com um valor p de 0,018. CONCLUSÃO: A melhora no aporte calórico e proteico do paciente crítico pediátrico se reflete em uma melhora do balanço nitrogenado. Os valores encontrados de aporte calórico e proteico para atingir um balanço nitrogenado positivo foram semelhantes aos da literatura. Palavras-chave: Balanço Nitrogenado, UTI Pediátrica

Youssef’s syndrome has been first described in 1957 as an atypical presentation of a vesicouterine fistula after lower segment Cesarean section. It is characterized by a triad of cyclic hematuria, amenorrhea, and absence of urinary incontinence, which is usually found in other forms of genitourinary fistulas. We describe a case report of a woman who developed a delayed Youssef’s syndrome 3 months after her third Cesarean section. She was initially post-operatively treated conservatively and successfully for a bladder leakage through the wound with a bladder catheter for 1 month, and 2 months later, she developed symptoms as described above. She was successfully treated with uterus-sparing surgical fistula repair. Youssef’s syndrome is a rare and atypical presentation. Physicians may easily be misled and diagnosis delayed. We describe the diagnostic approach and review the literature as to therapeutic approaches.

El síndrome de la bolsa de orina púrpura es una entidad poco frecuente, con una prevalencia hasta de un 8% en pacientes con catéteres permanentes crónicos por más de 2 años. Esta condición se presenta en portadores de sonda vesical, siendo su principal signo clínico la aparición de orina de color púrpura, debida a la producción de sulfatasas y fosfatasas por enterobacterias. Se presenta un caso de una mujer de 63 años con diagnóstico de vejiga neurogénica, antecedente de enfermedad cerebrovascular y secuelas motoras debidas a neoplasia cerebral, quien consultó por presentar el color característico, con síntomas de infección del tracto urinario inferior. Se trató con nitrofurantoína y tuvo normalización del color urinario al quinto día de tratamiento. El diagnóstico de este síndrome implica un reto para el médico, y deben detectarse los factores de riesgo para proveer un adecuado manejo antimicrobiano y evitar el uso de recursos diagnósticos innecesarios.

Objective To describe our long-term experience with patients with vesicoureteral reflux (VUR) who underwent conventional surgery without postoperative bladder drainage. Material and methods Retrospective review of 45 patients surgically treated by extravesical Lich–Gregoir's ureterovesical reimplantation without postoperative bladder drainage between 2010 and 2013. Results 37 women (82.2%) and 8 men (17.8%). 28 patients with unilateral reflux, and 17 patients with bilateral reflux with a total of 62 operated kidneys. The mean age at surgery was 6 years (2–11 years). The main cause of surgical indication was the persistence of reflux in patients older than 6 years (73.3%); with grade III VUR (75.6%) being the most frequent. The mean surgical time was 44 min (35–70) for unilateral reimplantation, and 70 min (53–98) for bilateral ones. All patients presented spontaneous urination in the immediate postoperative period, without pain, no hematuria, full incontinence, and without a bladder balloon. None required bladder catheter placement, and hospital discharge was indicated between 7 and 36 h postoperatively (mean 11 h). All continued with spontaneous micturitions, without postvoid residual or voiding dysfunction during the 5-year follow-up. Conclusion The thorough selection of the patients, the detailed surgical gestures, the bladder emptying without instrumentation of the urethra, together with a correct use of analgesics and early ambulation allowed excellent outcomes obtained in these patients managed with a short hospital stay and without bladder drainage, also demonstrating the safety of the procedure at 5 years of follow-up.

Objectives To compare results of prostate laser photovaporization (PVP) by age groups to evaluate morbidity and functional results. Then, to specifically analyze surgical data for patients with an indwelling bladder catheter. Design Monocentric retrospective study of a prospective maintained database of all laser PVPs performed at our university hospital between December 2012 and June 2017. Settings and participants A total of 305 patients (three groups: younger than 70, 70-80, and older than 80 years) were operated on in our hospital center for the treatment of urinary tract disorders related to benign prostatic hyperplasia. Results A difference was found between the three age groups, with a higher rate of complications for patients older than 80 years (45%) (P = .013). Rate of patients with postoperative bladder catheters at 1 year was higher for patients older than 80 years (15%) (P = .004). Postoperative quality-of-life (QoL) score was worse for patients older than 80 years (P = .04). For patients with an indwelling bladder catheter undergoing surgery, morbidity was greater in patients older than 80 years, but the difference was not significant. International Prostate Symptom Score and QoL score were not significantly different between the three groups. Rate of patients with a remaining bladder catheter at 1 year was higher for patients older than 80 years (17.1% vs 7.1% for patients between 70 and 80, and 4.8% for patients under 70.) but with no statistical difference. Conclusion PVP had a greater morbidity in octogenarians compared to younger subjects. Functional results were less satisfactory for patients older than 80 years compared to younger ones. For subjects operated on with an indwelling bladder catheter, no significant difference in outcome and morbidity was found between the three groups. J Am Geriatr Soc 67:1888-1894, 2019.

Introducción: El objetivo del presente estudio fue determinar la frecuencia de las infecciones del tracto urinario intrahospitalaria y su asociación con el uso de sonda vesical, diabetes y postración. Métodos: Se realizó un estudio de prevalencia tipo observacional, descriptivo, transversal, retrospectivo en pacientes diagnosticados de infección del tracto urinario durante su hospitalización en el Hospital II Essalud- Huánuco, durante los meses de enero del 2015 hasta octubre del 2016. El muestreo fue por conveniencia y se seleccionó a los pacientes que tuvieran durante su estancia hospitalaria examen de orina patológico y urocultivo más antibiograma. Resultados: La frecuencia de infección del tracto urinario intrahospitalaria fue de 110 casos. Edad promedio de 45 años con una desviación estándar de +/- 19,6 años. El sexo femenino fue el más afectado 66,4%. Se encontró significancia estadística en relación al uso de sonda vesical y diabetes, no así para la postración. Los gérmenes más frecuentes fueron la E.coli (42,7%), Klebsiella (17,3%) y Proteus (16,4%). Se encontró que E.coli fue resistente a Ceftriaxona y Ampicilina. Conclusiones: Existe asociación entre la infección del tracto urinario intrahospitalaria con el uso prolongado de sonda vesical y el diagnostico de Diabetes. Las bacterias más frecuentes aisladas fueron E.coli, Klebsiella y Proteus.

Objective To investigate the feasibility of urethral stump length and width measurements in recorded videos of robot assisted radical prostatectomy procedures using the Kinovea software and to assess if these measurements could be used as predictors of postoperative urinary continence.Methods Fifty-three patients were selected from an institutional database of 1400 cases and included in the study. All videos were analysed using the computer software 'Kinovea'. All measurements were performed using the inserted bladder catheter as a reference point.Results The reference point (bladder catheter) was available in 33 out of 53 patients. The median surgical urethral length (SUL) was significantly higher in the continent group (1050 vs. 1294 mm, p = 0.018). The urethral width measurements did not show a difference between the groups. In order to validate the Kinovea software as an accurate tool for the measurement of the urethral stump length and width results were correlated with the magnetic resonance imaging measurements of the urethra.Conclusions The results of this study showed a significantly longer median SUL incontinent patients.

Patients with neurogenic lower urinary tract dysfunction (NLUTD), specially with indwelling bladder catheter (iBC), have an increased risk of developing bladder stones, incomplete bladder emptying, recurrent urinary tract infections, sepsis, urethral trauma and bladder cancer. We present the case of a patient with a large bladder stone in iatrogenic NLUTD treated with iBC for about 30 years, who underwent a cystectomy followed by several life-threatening complications, like septic episodes and multiple surgeries. Our case outlines the importance of limiting the time of iBC in favor of CIC to avoid severe complications. Clinicians should instruct on the correct CIC technique and hygiene practices, and monitor patients with periodic abdominal US in order to diagnose and treat precociously any disease, like bladder stones.(www.actabiomedica.it)

To systematically review tools for the prevention of urinary tract injury in adult women undergoing minimally invasive gynecologic surgery.A medical librarian (M.P.H.) searched Ovid Medline 1946 to, Ovid Embase 1929 to, CINAHL 1965 to, Cochrane Library 1974 to, Web of Science 1926 to, and SCOPUS 1974 to present on April 2 and April 3, 2020.Articles evaluating strategies for the prevention of urinary tract injury at the time of minimally invasive gynecologic surgery were included. Articles that were nongynecologic, nonhuman, and nonadult were excluded. If a study did not describe the surgical approach or type of surgical procedures performed, it was excluded. If the study population was50% gynecologic or50% minimally invasive, it was excluded. Articles evaluating techniques for the diagnosis or management of injury, rather than prevention, were excluded.The search yielded 2344 citations; duplicates were removed, inclusion criteria were applied, and 9 studies remained for analysis. Three studies evaluated bladder catheters, and 6 evaluated ureteral catheters. In the 3 studies evaluating bladder catheters, there were no urinary tract injuries. Urinary tract infection was greater in women who received a bladder catheter. In the studies evaluating the use of ureteral catheters, we found inconsistent reporting and heterogeneity that precluded meta-analysis. The results of the available studies do not indicate that ureteral catheters decrease the risk of injury, and indicate that they increase morbidity.The evidence is insufficient to support the routine use of bladder catheters or ureteral catheters for the prevention of urinary tract injury at the time of minimally invasive gynecologic surgery.

Objective: To analyze, through literature, the main preventive measures recommended to reduce rates of bladder catheter-associated urinary tract infection. Method: It is an integrative literature review, which has as sample cohort, case-control and clinical trial studies, randomized or not, published in Portuguese, English or Spanish, in the period between 2009 and 2018. The collect and data analysis occurred in April and May 2019. Results: The publications emerged from studies performed in intensive and non-intensive care units, in different countries. Among the preventive measures, hand hygiene and shorter usage time of bladder catheter were highlighted. Conclusion: The present review allowed different national and international data to be analyzed, they corroborate preventive strategies adopted in the Brazilian context; however, the limitations of this study are in highlighting in literature only two preventive measures.

Aim: To explore interventions and strategies to prevent catheter-associated urinary tract infections in hospitalized patients with a short-term indwelling urinary catheter. Background: Interventions and strategies to prevent catheter-associated urinary tract infections are reported in the literature, but it is not clear which might be relevant when the indwelling urinary catheter is in place for a short period of time. Methods: An integrative review was performed. A search was undertaken in databases using the following search terms: “urinary catheter, bladder catheter OR urethral catheter*”and “bundl* OR care OR manag* OR intervent*.” Electronic databases were searched up until June 2019. Manual searching of reference lists of included studies was undertaken. Twelve studies reported in 15 articles were identified and analysed by two independent reviewers. Results: Multifaceted interventions were informed by evidence-based protocols or guidelines. Implementation strategies included local adaption of guidelines or protocols, use of an opinion leader, audit and feedback, multidisciplinary team involvement, reminders and stop orders, and education and training. Conclusion: Multifaceted, evidence-based interventions to prevent catheter-associated urinary tract infections are effective in preventing infections in patients with short-term urinary catheters. However, there is little evidence to inform which combined strategies are more likely to be effective.

Objectives: to identify and map the invasive procedures performed by nursing that can cause Healthcare-Associated Infections in patients in Intensive Care Units. Methods: this is a scoping review carried out in the first half of 2018, based on search for studies in national and international databases, in which 2,209 studies were found, of which 35 constituted the final sample. The data were analyzed and organized by simple descriptive statistics. Results: among the invasive procedures performed by nursing that provide Healthcare-Associated Infections, delayed bladder catheter was indicated in 34 (66.67%) studies, the nasogastric catheter in 10 (19.61%) and the nasoenteral catheter in two (03.92%). Conclusions: in the face of such problems, better nursing planning and guidance for care in these invasive techniques becomes relevant and thus minimizes the incidence of infections. RESUMEN Objetivo: identificar y mapear los procedimientos invasivos realizados por enfermería que pueden ocasionar Infecciones Relacionadas con la Salud en pacientes en la Unidad de Cuidados Intensivos. Métodos: se trata de una revisión de alcance, realizada en el primer semestre de 2018, con base en la búsqueda de estudios en bases de datos nacionales e internacionales, en la que se encontraron 2.209 estudios, de los cuales 35 constituyeron la muestra final. Los datos fueron analizados y organizados mediante estadística descriptiva simple. Resultados: entre los procedimientos invasivos realizados por enfermería que brindan Infecciones Relacionadas con la Atención de la Salud, se indicó el catéter vesical retardado en 34 (66,67%) estudios, el catéter nasogástrico en 10 (19,61%) y el catéter nasoenteral en dos (03,92%). Conclusiones: ante tales problemas cobra relevancia una mejor planificación y orientación de la enfermería para el cuidado en estas técnicas invasivas, minimizando así la incidencia de infecciones. RESUMO Objetivos: identificar e mapear os procedimentos invasivos executados pela enfermagem que podem ocasionar Infecções Relacionadas à Assistência em Saúde em pacientes na Unidade de Terapia Intensiva. Métodos: trata-se de uma scoping review, realizada no primeiro semestre de 2018, a partir da busca de estudos em bases de dados nacionais e internacionais, nas quais foram encontrados 2.209 estudos, dos quais 35 constituíram a amostra final. Os dados foram analisados e organizados por estatística descritiva simples. Resultados: dentre os procedimentos invasivos realizados pela enfermagem que propiciam Infecções Relacionadas à Assistência em Saúde, a sonda vesical de demora foi apontada em 34 (66,67%) estudos, a sonda nasogástrica em 10 (19,61%) e a sonda nasoenteral em dois (03,92%). Conclusões: diante de tal problemática, torna-se relevante um melhor planejamento e orientação da enfermagem para o cuidado nessas técnicas invasivas e, assim, minimizar a incidência de infecções.

This research was supported by funding from the Funda??o de Amparo ? Pesquisa do Par?/Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (FAPESPA/CAPES) [Cooperation grant N?017/2014], Programa Institucional de Bolsas de Inicia??o Cient?fica/Funda??o Amaz?nia Paraense de Amparo ? Pesquisa/Universidade do Estado do Par? (FAPESPA/UEPA) [Cooperation grant N?001/2017/PPGBPA], Funda??o de Amparo ? Pesquisa do Par?/Universidade do Estado do Par? (FAPESPA/UEPA) [Cooperation grant N?004/2019] and the Instituto Evandro Chagas/Minist?rio da Sa?de/Secretaria de Vigil?ncia em Sa?de (IEC/MS/SVS) State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Programa de P?s- Gradua??o em Epidemiologia e Vigil?ncia em Sa?de. Ananindeua, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. State University of Par?. Center of Biological and Health Sciences. Parasite Biology in the Amazon Region . Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Abstract: Klebsiella pneumoniae appears as one of the most prevalent pathogens among cancer patients. The present study investigates the clinical, epidemiological and microbiological aspects related to infections caused by K. pneumoniae in cancer patients treated at an oncology referral center in the state of Par?, Amazon region, Brazil. Between July 2017 to July 2019, an epidemiological, observational, cross-sectional study, with a descriptive and analytical approach was conducted, including patients with confirmed diagnosis of cancer who acquired infection by K. pneumoniae 72 h after hospital admission. K. pneumoniae isolates included in the study were obtained from different clinical materials (blood, urine, catheter tip and bladder catheter, orotracheal secretions, oncological and surgical wounds). Antimicrobial susceptibility testing and molecular detection of the carbapenemase-encoding genes were performed. A high prevalence of MDR K. pneumoniae isolates was observed, including two colistin-resistant isolates and seven isolates harboring blaKPC-1 gene. To conclude, our findings provide the firsts insights into the epidemiology and infection by K. pneumoniae in the state of Par?, Brazil, and may be useful on treatment guidance and establishment of strategies to control the spread of resistance strains of K. pneumoniae in the region.

BACKGROUND It is still unknown whether ERAS program is safe, feasible and effective in elderly patients undergoing laparoscopic colorectal surgery. In addition, the definition of the "old patient" in terms of age varies across the studies and different age cut-off, such as 65, 70, and 75 years have been used worldwide. METHODS All adult patients undergoing primary, elective colorectal laparoscopic surgery between January 2017 and December 2018 were considered eligible to follow the ERAS protocol according to the Enhanced Recovery After Surgery (ERAS) Society guidelines. Elderly were defined according three different cut-off values

RESUMEN Introducción: La hospitalización por enfermedad aguda en pacientes ancianos puede significar la aparición de deterioro funcional hospitalario (DFH). Por su elevada frecuencia y las graves consecuencias derivadas, analizamos el deterioro funcional en pacientes ingresados en una unidad de Hospitalización a Domicilio (HAD). Método: Estudio descriptivo retrospectivo de pacientes ≥ 80 años ingresados en HAD. Se obtuvieron variables demográficas y sociofamiliares, procedencia del ingreso, duración del ingreso previo e ingreso en HAD, variables clínicas y comorbilidad. Se recogió situación funcional basal, al ingreso, al alta y a los 3 meses según índice de Barthel (IB). Se excluyeron las estancias cortas, los paliativos, los fallecidos, aquellos con IB previo < 10 y los reingresos como motivo de alta. Resultados: Se incluyeron 168 pacientes ≥80 años, 52.4% hombres. El 71.4% procedentes de urgencias. Los pacientes institucionalizados presentaron peor resultado funcional. El 40,5% presentó pérdida funcional (PF) al ingreso. Al alta, mejoraron 1.2%, se mantuvieron el 59,3% y empeoraron el 39,4%. La PF al alta es menor si la estancia hospitalaria es ≤ 2 días y la estancia total

Resume La rehabilitation amelioree apres chirurgie est sans conteste une innovation incontournable dans le processus des patients chirurgicaux. Cette approche multimodale comporte des elements de soins medicaux et chirurgicaux. Le but de cette revue exhaustive de la litterature est d’analyser les aspects chirurgicaux de la rehabilitation amelioree en chirurgie digestive, en insistant sur le fondement scientifique de chaque element. Est analysee la place actuelle de la preparation mecanique du colon avant chirurgie colorectale, de la chirurgie digestive mini-invasive, de la sonde d’aspiration gastrique, du drainage abdominal, du drainage vesical postoperatoires et de l’alimentation precoce. Les donnees de la litterature permettent actuellement de lever beaucoup de dogmes.

From the first radical prostatectomy (RP), this kind of surgeries have always led to the need of a vesicourethral anastomosis (VUA). We present a case of a 65 year-old patient with diagnosis of prostate cancer and candidate for laparoscopic RP. The approach was a conventional extraperitoneal access with complete urethral sparing that avoids the need of VUA. Bladder catheter was removed on the third postoperative day observing immediate urinary continence. The anatomopathological analysis revealed a pT2 adenocarcinoma with negative margins. We report for the first time, a minimally invasive technique that avoids the need of VUA with favorable functional results.

PURPOSE: To evaluate if a Full Access Underbody (FAU) blanket used preoperatively and intraoperatively in patients undergoing major spinal surgery prevents hypothermia compared with current practice and to explore patients' experiences of comfort.DESIGN: A nonrandomized controlled trial.METHODS: Sixty patients were included, 30 in each group. Temperature was assessed on arrival, after connecting to the bladder catheter, and at the start and end of surgery. In the FAU group, comfort was evaluated at arrival and after 10 minutes of prewarming.FINDINGS: The incidence of hypothermia at the start of surgery was significantly lower (relative risk [95% confidence interval], 0.28 [0.13 to 0.59]). Before prewarming, 77% felt comfortable, 20% cold, and 3% hot. After prewarming 60% felt comfortable, 37% hot, and 3% very hot.CONCLUSIONS: Patients using the FAU blanket had a 72% lower incidence of hypothermia at the start of the operation. Attention to thermal comfort during surgery is important.

Justificativa e Objetivos:As infecções do trato urinário (ITU) relacionadas ao uso do cateter vesical de demora (CVD) (ITU-RC) apresentam alta prevalência em unidades de terapia intensiva (UTI). Desse modo, objetivou-se determinar a prevalência e fatores relacionados à ITU-RC na UTI. Métodos: Pesquisa documental e retrospectiva de abordagem quantitativa, realizada por meio da análise dos prontuários de todos os pacientes internados em uma UTI de um hospital universitário do norte de Minas Gerais no período de janeiro de 2013 a dezembro de 2014. A coleta e análise de dados foram baseados nos prontuários e fichas de notificação das infecções relacionadas à assistência à saúde (IRAS). Adotou-se regressão de Poisson com intervalo de confiança de 95%. Resultados:Dos 169 pacientes analisados, 145 (85,8%) foram submetidos a cateterizações vesicais. A prevalência de ITU-RC foi de 16,6%. Os fatores associados foram tempo de internação ≥15 dias (Razão de prevalência: 4,6) e uso do cateter vesical ≥10 dias (Razão de prevalência: 7,4). Conclusão:O tempo de inter-nação e permanência do CVD está diretamente relacionado à ocorrência de ITU-RC, direcionando para o compromisso dos profissionais da saúde no monitoramento da permanência, avaliação contínua e indicação estrita do uso do CVD. Descritores:Infecção Hospitalar. Infecções Relacionadas a Cateter. Unidade de Terapia Intensiva. Cateterismo Urinário. Papel do Profissional de Enfermagem.

Le sondage urinaire ou vesical est une technique utilisee depuis l’antiquite qui repose sur l’utilisation de dispositifs medicaux invasifs pour le patient. Cet acte de soin doit se faire de facon securisee et s’appuyer sur des referentiels. Les objectifs ont ete l’evaluation durespect des recommandations du protocole institutionnel sur la pose d’une sonde urinaire a demeure chez l'adulte, le respect de l’hygiene et de l’asepsie et l’evaluation des conduites a tenir lors d’une fuite urinaire sur sonde. Dans le cadre d’une demarche d’evaluation des pratiques professionnelles, une enquete prospective basee sur le concept des « vignettes cliniques » a ete menee, avec des mises en situations des soignants du CHU Charles Nicolle, Bois-Guillaume et Oissel en 2011. L’enquete revele un suivi des recommandations sur certains points comme le respect de l’asepsie et du systeme clos. Des divergences ont ete mises en evidence concernant notamment l’usage de la bandelette urinaire chez le patient sonde, le choix du type de sonde et les couples de produits a utiliser pour la detersion et l’antisepsie. Des axes d’ameliorations sont proposes comme la sensibilisation des equipes soignantes mais egalement medicales par le biais notammentd’une plaquette simple et illustree de support d’information sur les bonnes pratiques de sondage vesical a demeure chez l’adulte et des kits « prets a l’emploi » de produits pour la detersion et l’antisepsie. Since antiquity, the urinary or bladder catheter is a technique that relies on the use of invasive medical devices for the patient. This care act must be done in a secure manner and rely on standards. First, the evaluation of the respect of the recommendations of the institutional protocol on hanging an indwelling urinary catheter in adult, the respect of the hygiene and finally, the asepsis and the evaluation of the behaviors to be maintained during a urinary leak on probe were the objectives. As part of an evaluation of professional practices, a prospective survey based on the concept of "clinical vignettes" was conducted, with situations from nurses from CHU Charles Nicolle, BoisGuillaume and Oissel in 2011. The survey reveals a follow-up of the recommendations like the respect of the asepsis and the closed system. Discrepancies have been identified about the use of the urine strip in the patient being probed, the choice of the type of probe and the pairs of products to be used for the debridement and antisepsis. Different areas for improvement are proposed, first of all, raising the awareness of health care teams, but also medical ones, in particular through a simple plaque illustrated with information support on good practice of adult bladder catheterization and then use the packaging “ready to use” for debridement and antisepsis.

The treatment of vesicoureteric reflux (VUR) is not consensual. Laparoscopic ureterovesical reimplantation by the Lich-Gregoir technique is one of the different surgical options available. It can be performed for uni- or bilateral VUR. It is performed with a 5 mm telescope and two 3 mm instruments. The exposure of the posterior wall is helped by transparietal bladder suspension. A trench is created on the posterior bladder wall exposing the mucosa. The ureter is laid in the trench. The detrusor is then reapproximated over the ureter with four or five stitches. The postoperative period is comfortable without haematuria and bladder spasms. No bladder catheter is necessary as the risk of voiding difficulties is low with careful dissection. Unilateral reimplantation can be performed as day-case surgery, and the success rate is over 95%.

Made available in DSpace on 2020-12-12T00:56:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-10-01 Objectives To investigate effects of postural changes and bladder distention on intrabladder pressure whilst estimating intra-abdominal pressure in horses. Design Two-year cohort study. Patients admitted for elective surgical procedures unrelated to gastrointestinal or genitourinary tract. Setting School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil. Animals 20 adult horses, 11 males (stallions and geldings) and 9 females; between 3.5 and 12 years, weighing 350 to 500 kg. Interventions Intra-abdominal pressure was directly-recorded through abdominocentesis at the ventral midline with a fluid-filled system. Intrabladder pressure was obtained from a bladder catheter with the fluid-filled system zeroed at the level of the tuber ischia with patients in dorsal recumbency or pubic symphysis if in lateral recumbency. Measurements and main results Body position directly influenced intra-abdominal pressure. In dorsal recumbency, intraabdominal pressure differed (p < 0.05) from intrabladder pressure at end-inspiration and end-expiration regardless of whether the bladder was empty or distended. There was no correlation nor association between the two pressures in this body position. In lateral recumbency a difference (p