RESUMO Introdução: A assistência cirúrgica tem sido indispensável na atenção em saúde. Entretanto, as falhas nos procedimentos cirúrgicos podem causar danos irreversíveis aos pacientes. Os eventos de cirurgias em local/lado errado e paciente errado é uma das complicações mais frequentes e medidas preventivas podem evitá-los em sua totalidade. Objetivo: Identificar estratégias para prevenir a ocorrência de cirurgia no local/lado errado nos serviços de assistência cirúrgica. Métodos: Tratou-se de uma revisão integrativa da literatura junto às bases de dados Medline, Science Direct, Portal Capes, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Indice Bibliográfico Español de Ciencias de la Salud (IBECS) e Cochrane Library, entre 2003 a 2015. Foram incluídos 14 artigos que apontaram como principais medidas para prevenção de cirurgia no local errado: o uso de checklist, a aplicação do protocolo universal para segurança do paciente da Organização Mundial da Saúde, a marcação do sítio a ser operado, a comunicação eficiente da equipe cirúrgica multiprofissional, além da participação do paciente, educação e sensibilização da equipe. Conclusão: A cirurgia do lado errado é um dano que pode ser evitado. Nesse sentido, ações que envolvam a equipe multiprofissional e o próprio paciente devem ser propostas constituindo uma prioridade nos serviços de saúde, visando a melhoria da segurança do paciente cirúrgico.

ABSTRACT Introduction: Surgical assistance has been indispensable in health care. However, failures in surgical procedures can cause irreversible damage to patients. Surgeries on the wrong side, wrong place, or to the wrong patient are the most frequent complications, while preventive measures can prevent them from occurring entirely. Objective: To identify the strategies for preventing the occurrence of this type of error in the surgical assistance services. Methods: An integrative literature review was carried out in the databases Medline, Science Direct, Portal Capes, the Latin America and the Caribbean Health Sciences (LILACS), the Spanish Bibliographic Index of Health Sciences (IBECS), and the Cochrane Library, in the period from 2003 to 2015. We included 14 works that indicated as main measures: the use of a checklist, the application of a WHO universal protocol for patient safety, marking the site to be operated, efficient communication among the multi-professional surgical team, and also patient involvement, as well as professional education and sensitization. Conclusion: Surgery on the wrong side can be avoided. In this respect, proposing activities involving both the multidisciplinary team and the patient is a priority in healthcare services, which contributes with the improvement of the surgical patient safety.

RESUMEN Introducción: la asistencia quirúrgica ha sido indispensable en la atención sanitaria. Sin embargo, las fallas en los procedimientos quirúrgicos pueden causar daños irreversibles a los pacientes. Cirugías en el lado equivocado, lugar equivocado o paciente equivocado son de las complicaciones más frecuentes, y que las medidas preventivas pueden evitar que ocurran en su totalidad. Objetivo: identificar las estrategias para prevenir la aparición de este tipo de error en los servicios de asistencia quirúrgica. Métodos: se realizó una revisión integradora de la literatura en las bases de datos Medline, Science Direct, Portal Capes, América Latina y el Caribe Ciencias de la Salud (LILACS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS) y Cochrane Library, en el período del 2003 a 2015. Se incluyeron 14 trabajos que apuntaban como las medidas principales: el uso de una lista de verificación, la aplicación de un protocolo universal para la seguridad de la Organización Mundial de la Salud de los pacientes, el marcamiento del sitio para ser operado, la comunicación eficiente entre el equipo quirúrgico multiprofesional, además de la participación de los pacientes, la educación y la sensibilización de los profesionales. Conclusión: la cirugía en el lado equivocado puede ser evitada. En este sentido, se deben proponer actividades que suponen un equipo multidisciplinario y el paciente constituye una prioridad en los servicios de salud, destinadas a mejorar la seguridad del paciente quirúrgico.

Trehalose biosynthesis and its hydrolysis have been extensively studied in yeast, but few reports have addressed the catabolism of exogenously supplied trehalose. Here we report the catabolism of exogenous trehalose by Candida utilis. In contrast to the biphasic growth in glucose, the growth of C. utilis in a mineral medium with trehalose as the sole carbon and energy source is aerobic and exhibits the Kluyver effect. Trehalose is transported into the cell by an inducible trehalose transporter (K M of 8 mM and V MAX of 1.8 µmol trehalose min-1 mg cell (dry weight)-1. The activity of the trehalose transporter is high in cells growing in media containing trehalose or maltose and very low or absent during the growth in glucose or glycerol. Similarly, total trehalase activity was increased from about 1.0 mU/mg protein in cells growing in glucose to 39.0 and 56.2 mU/mg protein in cells growing in maltose and trehalose, respectively. Acidic and neutral trehalase activities increased during the growth in trehalose, with neutral trehalase contributing to about 70% of the total activity. In addition to the increased activities of the trehalose transporter and trehalases, growth in trehalose promoted the increase in the activity of alpha-glucosidase and the maltose transporter. These results clearly indicate that maltose and trehalose promote the increase of the enzymatic activities necessary to their catabolism but are also able to stimulate each other's catabolism, as reported to occur in Escherichia coli. We show here for the first time that trehalose induces the catabolism of maltose in yeast.

The recombinant heat shock protein (18 kDa-hsp) from Mycobacterium leprae was studied as a T-epitope model for vaccine development. We present a structural analysis of the stability of recombinant 18 kDa-hsp during different processing steps. Circular dichroism and ELISA were used to monitor protein structure after thermal stress, lyophilization and chemical modification. We observed that the 18 kDa-hsp is extremely resistant to a wide range of temperatures (60% of activity is retained at 80ºC for 20 min). N-Acylation increased its ordered structure by 4% and decreased its ß-T1 structure by 2%. ELISA demonstrated that the native conformation of the 18 kDa-hsp was preserved after hydrophobic modification by acylation. The recombinant 18 kDa-hsp resists to a wide range of temperatures and chemical modifications without loss of its main characteristic, which is to be a source of T epitopes. This resistance is probably directly related to its lack of organization at the level of tertiary and secondary structures.

Cell cultures of Mandevilla velutina have proved to be an interesting production system for biomass and secondary metabolites able to inhibit the hypotensive activity of bradykinin, a nonapeptide generated in plasma during tissue trauma. The crude ethyl acetate extract of cultured cells contains about 31- to 79-fold more potent anti-bradykinin compounds (e.g., velutinol A) than that obtained with equivalent extracts of tubers. Somaclonal variation may be an explanation for the wide range of inhibitor activity found in the cell cultures. The heterogeneity concerning morphology, differentiation, carbon dissimilation, and velutinol A production in M. velutina cell cultures is reported. Cell cultures showed an asynchronous growth and cells in distinct developmental stages. Meristematic cells were found as the major type, with several morphological variations. Cell aggregates consisting only of meristematic cells, differentiated cells containing specialized cell structures such as functional chloroplasts (cytodifferentiation) and cells with embryogenetic characteristics were observed. The time course for sucrose metabolism indicated cell populations with significant differences in growth and metabolic rates, with the highest biomass-producing cell line showing a cell cycle 60% shorter and a metabolic rate 33.6% higher than the control (F2 cell population). MALDI-TOF mass spectrometric analysis of velutinol A in selected cell lines demonstrated the existence of velutinol A producing and nonproducing somaclones. These results point to a high genetic heterogeneity in general and also in terms of secondary metabolite content.