Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review

Background: Sexualized drug use (SDU), also known as chemsex, refers to the use of psychoactive substances for sexual purposes among men who have sex with men (MSM), which has been associated with mental health symptoms. The objective of this review is to systematically review the available evidence on mental health outcomes in MSM who use sexualized drugs. Methods: To prepare this systematic review, search strategies were developed and applied to the Web of Science, Science Direct, PubMed, and Scopus databases. A total of 117 articles were found, of which 12 were selected for the final review. Results: Those MSM who practiced SDU were more likely to experience from depression, anxiety, or a substance dependence, although these results were not found in all the studies analyzed. Among those who practiced the administration of intravenous drugs (referred to as slamsex), the mental health symptoms were more severe. Conclusions: This systematic review contributes to a fuller understanding of the mental health symptoms present in MSM who consume drugs for sexual purposes. Greater uniformity in data collection instruments is required, as well as the need to conduct a more in-depth assessment of the psychosocial adjustment of people who practice chemsex.

Oral Versus Intravenous Chemotherapy in COVID-19 Epidemic

The novel coronavirus has a significant impact on the routine clinical practice for cancer patients in China since December 2019. During the epidemic in mainland China, especially Wuhan, the intravenous chemotherapies of cancer patients were considerably delayed. Up to now, cancer patients throughout the world directly encounter similar obstacles. For patients who have the right to choose chemotherapeutic regimens with different administration routes, oral drugs can be considered to be applied. In this mini-review, oral chemotherapeutic drugs were compared with intravenous drugs in seven types of tumors. Accordingly, we intended to provide useful suggestions for clinicians to balance the benefits and risks of oral against intravenous chemotherapies and to choose properly substituted oral chemotherapeutic regimens for cancer patients amid the coronavirus disease 2019 (COVID-19) pandemic.

Mycobacterium chelonae Endogenous Endophthalmitis in a Person Addicted to Intravenous Drugs Presenting as an Intraretinal Peripapillary Granuloma With Tractional Retinal Detachment

Purpose: To report a case of Mycobacterium chelonae endogenous endophthalmitis in a 28-year-old man with recent intravenous drug use that presented as an intraretinal peripapillary granuloma extending from the optic nerve head with an associated macular tractional retinal detachment. Methods: Case report. Results: Anterior chamber tap yielded aqueous cultures positive for M chelonae. A diagnostic and therapeutic vitrectomy was performed after inpatient hospitalization for 3 weeks to relieve a progressively worsening tractional retinal detachment. Conclusions: Atypical causes of endophthalmitis, including nontuberculous mycobacterium, in the population of individuals addicted to intravenous drugs may present with intraretinal peripapillary granuloma associated with a macular tractional retinal detachment. Surgical debulking to relieve anteroposterior traction is an effective treatment option to improve long-term visual outcomes.

Pandora’s box in the dental clinic

Background: In June 2018, the Ministry of Health received notification from 2 hospitals about 2 patients who presented with overwhelming Enterobacter kobei sepsis that developed within 24 hours after a dental procedure. We describe the investigation of this outbreak. Methods: The epidemiologic investigation included site visits in 2 dental clinics and interviews with all involved healthcare workers. Chart reviews were conducted for case and control subjects. Samples were taken from medications and antiseptics, environmental surfaces, dental water systems, and from the involved healthcare professionals. Isolate similarity was assessed using repetitive element sequence-based polymerase chain reaction (REP-PCR). Results: The 2 procedures were conducted in different dental clinics by different surgeons and dental technicians. A single anesthesiologist administered the systemic anesthetic in both cases. Cultures from medications, fluids and healthcare workers’ hands were negative, but E. kobei was detected from the anesthesiologist’s portable medication cart. The 2 human isolates and the environmental isolate shared the same REP-PCR fingerprinting profile. None of the 21 patients treated by the anesthesiologist in a general hospital during the same period, using the hospital’s medications, developed infection following surgery. Conclusions: An outbreak of post–dental-procedure sepsis was linked to a contaminated medication cart, emphasizing the importance of medication storage standards and strict aseptic technique when preparing intravenous drugs during anesthesia. Immediate reporting of sepsis following these outpatient procedures enabled early identification and termination of the outbreak.

STATE OF SYSTEMIC HEMODYNAMICS FOR CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY IN DIFFERENT COMBINED ANESTHESIA TYPES

General anesthesia for a surgical correction of congenital malformations in children is accompanied, in particular, by the disorders of systemic hemodynamics. In order to assess the impact of different types of combined anesthesia on the state of systemic hemodynamics in surgical correction of congenital malformations, a retrospective study of the treatment of 150 newborns and infants was conducted. These were children with various congenital malformations, but the most common were intestinal obstruction and abdominal tumors. Three groups of patients were formed depending on the type of combined anesthesia during surgical correction of abnormalities: I − inhalation (sevorane) + regional anesthesia; II − inhalation (sevorane) + intravenous anesthesia (fentanyl); III − total intravenous anesthesia with two drugs: analgesic (fentanyl) and drug sleep on the background of intravenous injection of hypnotics (20 % sodium oxybutyrate). There were preformed the surgeries: thoracic, urological, abdominal. The study was retrospectively evaluated in five stages. The analysis of systemic hemodynamics showed a tendency to reduce diastolic blood pressure in children treated with anesthesia with two intravenous drugs (hypnotic and fentanyl), during all observation stages and a significant decrease in this index at the most painful and traumatic period. At the time of induction of anesthesia in children there was a decrease in heart rate. According to the research results, it is concluded that when using the pre−hypnotics as part of combined anesthesia in children with congenital malformations during surgery there is a risk of complications from central hemodynamics in the form of vasodilation, which leads to a drop in blood pressure and increases compensatively the heart contractions. Key words: infants, congenital malformations, anesthesia, hemodynamics.

Segurança do paciente pediátrico no processo de administração de medicamento endovenoso

Objetivo: Avaliar o processo de preparo e administração de medicamentos endovenosos em um hospital pediátrico. Métodos: Estudo transversal de natureza quantitativa. Foram realizadas 135 observações do processo de preparo e administração de medicamentos por via endovenosa em crianças. Para a avaliação do desempenho dos profissionais na execução de cada ação do processo determinou-se o Índice de Positividade para Qualidade da Assistência. A análise foi através de estatística descritiva obedecendo aos preceitos éticos. Resultados: Na etapa de leitura de prescrição médica uma ação obteve desempenho satisfatório (igual ou maior que 70%). As ações de todas as 15 ações da etapa de organização do ambiente e seleção dos materiais nove foram satisfatórias (maior que 70%). Conclusão: Os achados referentes ao estudo nos permite evidenciar que existem falhas no processo de preparo e administração de medicamentos. É imprescindível a melhoria dos cuidados em saúde através de educação permanente.Descritores: Segurança do Paciente; Enfermagem Pediátrica; Pediatria. PEDIATRIC PATIENT SAFETY IN THE INTRAVENOUS DRUG ADMINISTRATION PROCESSObjective: To evaluate the process of preparation and administration of intravenous drugs in a pediatric hospital. Methods: Cross-sectional study of a quantitative nature. 135 observations were made of the process of preparation and administration of drugs intravenously in children. To assess the performance of professionals in the execution of each action in the process, the Positivity Index for Quality of Care was determined. The analysis was through descriptive statistics obeying the ethical precepts. Results: In the step prior to the preparation of the medications, all actions achieved satisfactory performance (≥70%). Of the fifteen actions for preparing medications, nine were satisfactory (≥70%). During and after the administration of six of the seven actions, they obtained satisfactory performance (≥70%). Conclusion: The findings regarding the study allow us to evidence that there are flaws in the process of preparing and administering medications.Descriptors: Patient Safety; Pediatric Nursing; Pediatrics. SEGURIDAD DEL PACIENTE PEDIÁTRICO EN EL PROCESO DE ADMINISTRACIÓN DE DROGAS INTRAVENOSASObjetivo: evaluar el proceso de preparación y administración de drogas intravenosas en un hospital pediátrico. Métodos: estudio transversal de naturaleza cuantitativa. Se hicieron 135 observaciones sobre el proceso de preparación y administración de drogas por vía intravenosa en niños. Para evaluar el desempeño de los profesionales en la ejecución de cada acción en el proceso, se determinó el Índice de Positividad para la Calidad de la Atención. El análisis fue a través de estadísticas descriptivas que obedecen los preceptos éticos. Resultados: En el paso previo a la preparación de los medicamentos, todas las acciones lograron un desempeño satisfactorio (≥70%). De las quince acciones para preparar medicamentos, nueve fueron satisfactorias (≥70%). Durante y después de la administración de seis de las siete acciones, obtuvieron un desempeño satisfactorio (≥70%). Conclusión: Los hallazgos con respecto al estudio nos permiten evidenciar que hay fallas en el proceso de preparación y administración de medicamentos.Descriptores: Seguridad del paciente; Enfermería Pediátrica; Pediatría.

In(compatibility) of intravenous drugs in critical units: adult cohort

ABSTRACT Objectives: To analyze potential (in)compatibilities of intravenous drugs based on the scheduling prepared by the nursing team. Methods: historic cohort (retrospective) with 110 adults in critical units. Intravenous medications were identified concomitantly, whose pairs were analyzed for (in) compatibility using the screening system Trissel’s™ 2 Compatibility IV-Micromedex 2.0. Parametric and non-parametric statistic were used according to the nature of the variable. Results: 565 pairs of drugs were identified. Of these, 44.9% were compatible; and 8.8%, potentially incompatible. Most potentially incompatible pairs involved substances with alkaline pH such as phenytoin (32%) and sodium bicarbonate (8%) and weak acids such as midazolam (12%) and dobutamine (6%), which could result in precipitate formation. Conclusions: almost half of the mixtures simultaneously administrated was compatible, which indirectly reflects in the organized work between the nursing team and the clinical pharmaceutic in the discussions and decisions related to time scheduling.

Nursing training on the administration of medication in pediatrics: an assessment of observed and self-reported behavior

ABSTRACT Objectives: to evaluate the effect of a training program on the administration of intravenous drugs in pediatric patients on the observed and self-reported behavior of the nursing team. Methods: evaluation study carried out with 38 professionals during three phases: Assessment of the behavior observed in the actions performed before training; Training implementation; and Assessment of observed and self-reported behaviors (immediately and six months after training). Results: in the observed behavior, there was an improvement in six (6/12) hand hygiene actions; five (5/14) pertaining to environment Organization, selection, and preparation of materials; and in seven (7/10) referring to the Orientation of the procedure, administration and monitoring of the patient’s reactions. In self-reported behavior, there was an improvement in two (2/8) actions. Conclusions: the training resulted in an improvement in the actions of nursing professionals related to the administration of intravenous medications, both in observed and in self-reported behavior.