Construção de um software para avaliação do risco de úlcera por pressão em Unidade Terapia Intensiva

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Morbidades e consumo de álcool em pacientes internados na Clínica Médica de um hospital universitário

Abusive consumption of alcohol leads to several negative consequences to health and quality of life, as it increases the frequency of diseases that cause death or functional disabilities. The rates of patients admitted to hospital due to physical problems stemming from alcohol abuse are high. This study aimed at identifying patients according to variables age, gender and education level as well as at evaluating the prevalence of CAGE-positive patients and morbidity due to CID-10 (International Classification of Diseases) by the World Health Organization. It is a cross-sectional, observational, exploratory, descriptive and quantitative study. It was conducted at the Botucatu School of Medicine University Hospital (HC) from July to September 2010, at the Internal Medicine ward. This ward aggregates 5 specialties, namely, Cardiology, Hematology, General Medicine, Nephrology and Gastroclinic. Presently, it has 36 beds, of which four are for Intensive Care Therapy (ICT). Three hundred and ten medical charts were analyzed for identification of morbidities and of variables age, gender and schooling. A closed semistructured questionnaire including, among other questions, the CAGE test was applied to each individual. The CAGE test is a questionnaire that comprises four questions and considers that one who answers two or more of such questions affirmatively is a suspected case of alcoholism. The total population studied included 310 patients. Indexes of 60% (186) male and of 40% (124) female patients were found. As regards age range, a population with a higher prevalence of individuals from 51 to 70 years old (41%) was observed. The main education indexes were: incomplete Elementary School: 23.22% (72), complete Elementary School: 21.61% (67), incomplete Secondary School: 18.40% (57) and Illiteracy: 17.74% (55). As regards diseases, a higher proportion was observed for: ...(Complete abstract click electronic access below)

Acupuntura veterinária em pequenos animais

Acupuncture is one of the oldest forms of treatment, which is based in the grounds of Traditional Chinese Medicine. Despite the ancient history, it’s not completely widespread in Brazil, neither so comprehensive in veterinary medicine as used in humans. The technique of inserting needles into acupuncture points, can also be stimulated by heat, electrical stimulation or implants of metal, is mainly focused on neuromuscular disorders in small animals. The difficulty of comprehension of language and the lack of cientific bases restricted the possible applications of acupuncture. This work will address some of the clinical situations this complementary treatment can act, such as neurological, cardiorespiratory, reproductive, gastrointestinal, immunological, and postoperative intensive care

Pressão arterial em cães: uma revisão

The evaluation of blood pressure is an essential tool for veterinarian clinical practice and for monitoring anesthetized patients or patients in intensive care, because of its usefulness in diagnostics, treatment and monitoring of several diseases. Apart from the pathological factor, the blood pressure also suffers the influence of different variables, such as age, breed, gender, temperament (anxiety and stress especially during the treatment, “white coat syndrome”), disease state, physical activity and, with lower intensity, animal’s diet. One of the main indications of the evaluation of blood pressure is the observation of clinical changes resulting from hypertension in animals, which one is characterized by lesions in the nervous and cardiovascular systems, kidneys and eyes. Not least important, the evaluation of blood pressure is also essential in hypotensive states, which represent an imminent risk of death. The techniques used in measuring blood pressure correspond to invasive forms (direct) or non invasive (indirect), whose correlation has been the subject of study and improvement within the small animal clinic. Thus, the purpose of this review is emphasize the importance of measuring blood pressure within the veterinary clinic routine, studying the influence of variables associated or not with elevated blood pressure, comparing the different methods used to obtain the blood pressure

Avaliação da viabilidade de cateter epidural totalmente implantado em equídeos

Pós-graduação em Cirurgia Veterinária - FCAV

Parâmetros clínicos e laboratoriais relacionados ao prognóstico em cães com gastroenterite hospitalizados

Pós-graduação em Cirurgia Veterinária - FCAV

Família Enterobacteriaceae, Acinetobacter baumannii e Pseudomonados na microbiota bucal de pacientes mantidos em unidades de terapia intensiva

Enteric organisms, pseudomonads and other opportunistic microorganisms in the oral microbiota have been linked to serious infections in patients hospitalized in intensive care units (ICU). The present study evaluated the presence of family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii in the mouth of patients in ICU, correlating it with oral and systemic conditions. Data on health, socioeconomic status, medication use, drug addiction, medical and family histories of patients held for more than 72 hours in the ICU with a diagnosis of severe infection or that developed this condition after entry in said unit were obtained. Fifty patients provided clinical samples of supragingival and subgingival biofilms, saliva and oral mucous membranes were collected, as well as respiratory secretions from patients with pneumonia, blood and urine for sepsis. The presence of target microorganisms was carried out by polymerase chain reaction (PCR) and by culture using selective media. The Chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients were poor. The family Enterobacteriaceae was the most prevalent, affecting 39.5% of the supragingival biofilm samples of patients attended in ICU and 18.6% of patients in the control group, besides the rods were the only group found in extraoral samples.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Tratamento cirúrgico da úlcera loxoscélica: solução prática para um problema de difícil resolução

Contexto: O manuscrito descreve a reparação cirúrgica de uma úlcera crônica resultante da picada de uma aranhamarrom, um problema de difícil resolução, o qual habitualmente demora meses até a cicatrização. Descrição do caso: A vítima foi picada na coxa direita e desenvolveu fases de envenenamento típicas da picada de Loxosceles, incluindo a placa mármore, a escara e a úlcera profunda e de bordos emoldurados, características do acidente. Devido ao processo cicatricial lento, cuidados intensivos com curativos, dificuldade na deambulação, além do fator estético, optou-se por cirurgia excisional da lesão e sutura direta das bordas. O tratamento cirúrgico proporcionou cicatrização total da lesão dentro de 15 dias. Conclusões: A úlcera loxoscélica apresenta difícil cicatrização, evoluindo para a cronicidade. A cirurgia com excisão completa e síntese primária constitui técnica adequada para a cura da doença.

O significado do processo de trabalho cuidar para o enfermeiro da UTI

The study has resulted from the desire to comprehend how intensive care unit (ICU) nurses understand the caregiving process. The ICU nurses must be able to promote effective changes in the care provided, to give attention to adversities and be able to act promptly to attend several demands. Aim: understanding the meaning to nurses of the caregiving process at the ICU. Methodology: it consists of a qualitative research with a phenomenological view that has three moments: description, reduction and comprehension. After approval by the Research Ethics Committee (211/08) in 02/06/2008, individual interviews were conducted by using the following guiding questions: What is the working process to ICU nurses? What is it to you, to be an ICU nurse? The study subjects were twelve nurses who worked at the ICUs. Results: the analysis showed the themes: nursing process, relationship with the ICU patient and family, and humanization. Conclusion: From the results it is concluded that nurses working in ICUs in the study report difficulties as well as satisfaction related to caregiving process, especially in the context of the anxieties of patients and families, revealing the difficulties in the processing of feelings. A nurse is recognized by the team as a leader agent and a multiplier of the caregiving actions.

Care to terminal patients. Perception of nurses from the intensive care unit of a hospital

Objective. To identify the perception of nurses with regard to the process of providing care to patients in the context of hospice care. Method. Qualitative study using the methodological framework Collective Subject Discourse. A total of 18 nursing professionals of the adult intensive care unit of a public hospital in São Paulo, Brazil were interviewed between June and August 2012. Results. The process of providing care to terminal patients is permeated by negative, conflictive and mixed feelings. As regards communication, while the participants acknowledge its importance as a therapeutic resource, they also admit a lack of professional qualification. Conclusion. The interviewees have difficulties to deal with care provided to terminal patients. The qualification of these professionals needs to be improved, starting in the undergraduate program.