The long-term outcome after acute kidney injury: a narrative review

This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients.

Métodos de alimentação alternativos para recém-nascidos prematuros

OBJETIVO: Apresentar revisão de literatura sobre o uso do copo/xícara como método alternativo de alimentação para recém-nascidos prematuros e verificar se há consenso sobre sua indicação para essa população. FONTES DE DADOS: Revisão de literatura narrativa, tendo sido selecionados artigos nas bases de dados Medline, Lilacs, SciELO e Cochrane, independentemente do ano, usando descritores específicos: alimentação artificial, recém-nascido prematuro, aleitamento materno, métodos de alimentação. SÍNTESE DOS DADOS: Apesar de alguns estudos afirmarem que o método do copo/xícara é eficaz e seguro para alimentar recém-nascidos pré-termo e a termo, tais estudos não avaliam de forma objetiva o efeito do método sobre a deglutição desses pacientes. CONCLUSÕES: Verificou-se não haver consenso na literatura quanto à complementação da alimentação de recém-nascidos prematuros por meio do copo/xícara. Estudos controlados devem ser realizados com a finalidade de rever riscos e benefícios do uso de métodos alternativos na alimentação do recém-nascido prematuro.

Care to mastectomy with axillary lymphadenectomy, lymphedema prevention: An integrative review

Objective: to examine the care provided to women affected by breast cancer and who has performed axillary lymphadenectomy. Method: integrative review conducted in the databases LILACS and PubMed between 2000 and 2012, leaving the question << What care is provided to prevent lymphedema in women who underwent lymphadenectomy? >> Resulting in 18 articles, analyzed under the following variables: author, title, methodology, year, journal, goal, prevention and control of lymphedema therapies and adherence to rehabilitation. Results: three categories are identified for rehabilitation of patient: prevention and control, therapies and adherence. Conclusion: preoperative is poorly addressed by; emphasizes the importance of home visits as part of rehabilitation, which is effective with the accession of the patient who needs information for its follow-up, no need for a guideline for this type treatment.

A critical review of analytical methods for determination of ertapenem sodium

Antimicrobials have unquestionable importance in the control of many diseases; however the constant concern with evolution of resistant microorganisms is increasing. The ertapenem sodium is a β-lactam antibiotic of the carbapenem class, which it has a broader activity spectrum than most other β-lactam antimicrobials, and is more resistant to the enzyme β-lactamase, which is the main mechanism of resistance of many bacteria. The progress of microbial resistance to existing antibiotics is alarming. Thus we need to preserve antimicrobials that still have activity against these pathogens. In this context, the quality control has a key role to ensure the correct dosage, by contributing preventively to minimize the development of resistant microorganisms. Study of the physicochemical characteristics of the drug and the quantification of the content of active substance are of fundamental importance for the pharmaceutical industry to ensure the quality of the product sold. This work presents a literature survey of existing methods for ertapenem sodium quantification which was performed. Ertapenem sodium can be analyzed by many types of assays; however the HPLC is the most used method. This review will examine the published analytical methods reported for determination of ertapenem sodium, in biological fluids and formulations.

Acquired immunodeficiency syndrome in Brazil

Aim. To describe the acquired immunodeficiency syndrome (AIDS) epidemic in Brazil and analyze the impact of federal government measures addressing the problem since its onset.Method. Retrospective review of AIDS epidemic data from its onset in 1980 up to the last published data in June 2001.Results. AIDS was first reported in Brazil in 1980. By 1988, all 27 Brazilian states had diagnosed cases, and until June 2000 more than half of Brazilian municipalities had recorded at least one case of the disease. The AIDS incidence reached its peak between 1996 and 1997 (14.7 per 100,000 population), and then declined between 1998 and 2000 to 9 per 100,000 population. In the last two decades, the proportion of deaths has been also significantly reduced. These were not random events, but reflected the efficiency of the program implemented by the Brazilian Health Ministry's Coordination on Sexually Transmitted Diseases and AIDS. The program includes an epidemiological surveillance modeling system, which records cases from several regular epidemiological bulletins; national network of diagnosis and monitoring of HIV-infected individuals (ill or not); highly active antiretroviral therapy available free to all patients; mother-infant protection program; educational programs on condom use; the introduction of the female condom; development of AIDS studies in different areas to provide practical solutions; constant preoccupation about drug costs accounting for the patent breaking; and national production of many drugs currently in use.Conclusion. Well-planned and implemented national program against AIDS can significantly reduce the burden of this disease to the population.

Treatment of pulmonary thromboembolism in patients with systemic blood pressure stability and right ventricular dysfunction

Pulmonary thromboembolism (PTE) ranges from incidental, clinically unimportant thromboembolism to massive embolism with sudden death. Its treatment is well established in two groups of patients: heparin for those with normal systemic blood pressure without right ventricular dysfunction (RVD) and thrombolysis for those with RVD and circulatory shock. In an intermediate group of patients with systemic blood pressure stability combined with RVD, which is usually associated with worse outcome, the treatment is controversial. There are authors who strongly suggest thrombolysis while others contraindicate this procedure and recommend anticoagulation with heparin. This is a narrative review that includes clinical trials comparing thrombolysis and heparin for the treatment of PTE patients with systemic blood pressure stability and RVD published since 1973. The results show that there are only four trials on this subject with less than 500 patients. Many PTE patients with systemic blood pressure stability and RVD might benefit from thrombolysis but, on the other hand, the risk for hemorrhagic events may be increased. Large randomized clinical trials are required to clarify this. © 2008 Bentham Science Publishers Ltd.

Caracterização da resposta hipotensora pós-exercício

Hypertension is a disease that affects a large part of the world population, in which the treatment consists in changing habits of life, which include diet, weight loss and smoking cessation, among others, attending the physical activity outstanding recommendations, supported by its positive effects on the maintenance of blood pressure levels within the limits of normality. Objective: To characterize the post-exercise hypotensive response on individuals with hypertension. Method: Literature review from 1990 to 2011, searching the electronic databases MEDLINE, ScIELO, Lilacs and Cochrane. Articles were selected using keywords hypertension, physical exercise and high blood pressure. Results: One session of physical activity promotes the reduction of arterial hypertension, which is called post-exercise hypotension. However, this phenomenon will depend on some related factors such as the type, intensity and duration of exercise. Conclusion: The performance of activity and/or physical exercise is important in non-pharmacological treatment for lowering blood pressure, but is not yet defined the best type of exercise.

The biopsychosocial processes in autism spectrum disorder

Background: Autism is a disorder characterized by pervasive social and communicative impairments, repetitive and stereotyped behaviors and restricted interests. Its causes and effects have been researched from various neurocognitive theoretical perspectives and with the aid of neuroimaging technology. We aimed to describe biopsychosocial processes characteristic of the Autism Spectrum Disorders. Method: Literature review using Medline and Scopus databases published between 2001 and 2011, with the keywords "autism", "theory of mind", "executive functions", "central coherence" and “fMRI”. Results: The studies found were plotted and organized into tables and an explanatory diagram of the main findings was produced. Conclusions: The most popular neurocognitive theories are still unable to fully explain the characteristics of the complications that autistic spectrum disorder causes to the quality of life of individuals living with autism. The association of clinical research and neuroimaging may contribute to a better understanding of the functioning of the brain affected by the disorder.

Revisão sobre fármacos quirais e a sua importância na medicina atual

Aspects are discussed on the chirality of drugs and their action in the human body, the benefits of using a drug in enantiomerically pure form and why, even today, despite the risks, many drugs are marketed as racemic mixture. Among the methods of separation there is the High Performance Liquid Chromatography (HPLC) which can be given in different ways using chiral additives in the mobile phase as in the system of ligand exchange in the ion pair system and the system of cavity or inclusion. Note also the wide variety of chiral stationary phases available in the market that allow high specificity using them according to the need and purpose of the method. The review of the topic is extremely important since it is a matter of public interest world that brings into play issues and financial policies

Enfermagem e o gerenciamento de custos: revisão sistemática nacional e internacional

Objectives: conduct a systematic review of national and international literature, to classify the types of production, comparing the two literatures and synthesize knowledge in the area. Method: Systematic Review of Literature, in the databases LILACS, CINAHL and MEDLINE for selection of articles in their entirety, the data extracted from the articles selected were: the study of bibliographic information (title, author, journal, place of study and year of publication), and general information (multidisciplinary production or specific area, language, type of study, type of population and contributions of the study). The categories established for classification of publications were: raising the cost of procedures/ interventions, economic evaluation of specific intervention, inclusion of nursing in the economic context, using cost as an important variable in the study. Results: The study included 39 publications, with 31% of national production and the remaining 69%, internationally. Most publications were classified according to category of economic evaluation of specific intervention, followed by the category of raising the cost of procedure / intervention, which fits the majority of national production. Human resources is shaped as an important variable for obtaining cost studies that proposed to make this calculation. Conclusion: The production of literature in nursing cost management is relevant in number of publications within the proposed period and is directed to different areas within this theme. There are significant differences in national and international literature: these last use more accurate methods, have more content theorized, use more the economic evaluation tools and related more costs with a amplified context. The production of such knowledge should continue as far as possible and putting that knowledge relating the current reality, in order to amplify the field of nursing and add value

Synthesis and optical property of MgMoO4 crystals

In this work, we report on the synthesis of MgMoO4 crystals by oxide mixed method. The powder was calcined at 1100 degrees C for 4h and analyzed by X-ray diffraction (XRD), Fourier transform infrared (FT-IR), Field emission gun scanning electron microscopy (FEG-SEM), Ultraviolet-visible (UV-vis) absorption spectroscopy and Photoluminescence (PL) measurement. XRD analyses revealed that the MgMoO4 powders crystallize in a monoclinic structure and are free secondary phases. UV-vis technique was employed to determine the optical band gap of this material. MgMoO4 crystals exhibit an intense PL emission at room temperature with maximum peak at 579 nm (yellow region) when excited by 350 nm wavelength at room temperature.

Evidence-based medicine: an update on treatments for peritoneal dialysis-related peritonitis

Peritonitis continues to be a major complication of peritoneal dialysis (PD), and adequate treatment is crucial for a favorable outcome. There is no consensus regarding the optimal therapeutic regimen, and few prospective controlled studies have been published. The objective of this manuscript is to review the results of PD peritonitis treatment reported in narrative reviews, systematic reviews, and proportional meta-analyses. Two narrative reviews, the only existing systematic review and its update published between 1991 and 2014 were included. In addition, we reported the results of a proportional meta-analysis published by our group. Results from systematic reviews of randomized control trials (RCT) and quasi-RCT were not able to identify any optimal antimicrobial treatment, but glycopeptide regimens were more likely to achieve a complete cure than a first generation cephalosporin. Compared to urokinase, simultaneous catheter removal and replacement resulted in better outcomes. Continuous and intermittent IP antibiotic use had similar outcomes. Intraperitoneal antibiotics were superior to intravenous antibiotics in reducing treatment failure. In the proportional meta-analysis of RCTs and the case series, the resolution rate (86%) of ceftazidime plus glycopeptide as initial treatment was significantly higher than first generation cephalosporin plus aminoglycosides (66%) and glycopeptides plus aminoglycosides (75%). Other comparisons of regimens used for either initial treatment or treatment of gram-positive rods or gram-negative rods did not show statistically significant differences. The superiority of a combination of a glycopeptide and a third generation cephalosporin was also reported by a narrative review study published in 1991, which reported an 88% resolution rate.

Evidências à intervenção de enfermagem controle de infecção da classificação das intervenções de enfermagem: orientação e ensino sobre a lavagem das mãos

Pós-graduação em Enfermagem - FMB

Trajetórias negligenciadas: processos de resiliência em adolescentes com histórico de envolvimneto no tráfico de drogas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tuberculose urogenital: um diagnóstico desafiador

Objective: Review of scientific literature on the history of tuberculosis (TB), the natural history of TB in humans, extrapulmonary TB in urogenital form, including epidemiology, diagnosis and treatment. Method: Literature review using PubMed databases, BIREME, SciELO, LILACS and Google Scholar, as well as books, manuals and official documents of Ministério da Saúde (MS) and World Health Organization (WHO). Results: Focused as discussion topics, history, diagnosis and treatment of urogenital tuberculosis and reflection on the diagnostic challenge to be faced by health professionals. Conclusion: The diagnosis of urogenital tuberculosis is difficult and often delayed and may lead to important consequences. Faced with a patient with chronic urinary symptoms or infertility tuberculosis should always be investigated.