Representación social del paciente que se beneficia de la interacción universidad pública y hospitales generales

Hospitals are very important for the health system. The objective of this quali-quantitative research was to visualize patients' social representation, which profited of the interaction between public universities and hospitals. 105 patients in the waiting rooms at the Integrated Clinic at FOA _ UNESP in the first semester 2005 answered to the question: How did you know about the service at FOA? - in opened interviews, recorded or written. A collective speech of the subject represented the field that allouds a society to speak as one. Twenty three of all patients have been sent to FOA by Health Assistance Centers in Araçatuba (7) and region (16) and twenty one patients assisted in Araçatuba by emergency. We can observe that the interaction between the public universities and general hospitals is a reality.

Anestesia para colecistectomía videolaparoscópica en paciente portador de enfermedad de Steinert. Relato de caso y revisiõn de la literatura

BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.

Experiência discente com o cuidado a paciente portador de Epidermodisplasia Verruciforme

Report of an experience of nursing students in providing care to a patient with epidermodysplasia verruciformis, during the internship in the discipline Nursing in Transmittable Diseases, at the dermatology ward of a teaching hospital, located in the state of São Paulo, Brazil, in 2009. This is a rare genodermatosis, susceptible to infection with different types of human papilloma viruses, that cause exacerbated physical changes that impact the psyche of the affected individual. Care delivery was based on the assistance complexity indicated by the application of the Patient Classification System proposed by Perroca. The experience allowed students to learn how to cope with a patient affected by a rare and complex disease, of difficult resolution, and to provide integral care to this individual, perceiving him beyond the lesions. One conclude that the experience has greatly contributed to the growth of the students as future professionals.

Enfermagem cuidando de paciente adulto e família no processo de morte em sala de emergência

The purpose of the study was to understand the experience of nursing professionals on the care provided to adult patients and relatives who experience the dying process in an emergency room. Statements of 12 nursing professionals, being 8 technicians and 4 registered nurses of the emergency room of a high-complexity university hospital were analyzed. Data was collected by means of semi-structured interviews and evaluated according to Bardin’s content analysis. As a result, the theme entitled the relative’s mourning process emerged with two categories: alterity as an opening and suffering as a limit. when subjectivity, which was revealed under the principle of alterity, permeated the subjects’ actions, the nursing practices were targeted at the patients and their relative’s needs, but suffering as a limit imposed distancing by the professionals during care provision, even when it was perceived as necessary.