Hospital de Caridade São Pedro de Alcântara: assistência e saúde em Goiás ao longo do século XIX

Este artigo apresenta aspectos da trajetória do Hospital de Caridade São Pedro de Alcântara, na cidade de Goiás, ao longo do século XIX. Instituição leiga fundada no ano de 1825, o hospital nasceu da iniciativa de um grupo local influente que reconheceu um mal social: a ausência de assistência aos destituídos e enfermos. No que se referia à assistência social, ele abarcava funções e princípios caritativos cristãos, assistindo alienados, internados em cárceres, doentes e necessitados em geral, e, com a inauguração do cemitério público, sepultava gratuitamente os indigentes.

O julgamento simulado do Conselho Regional de Medicina do Estado de São Paulo: processo de ensino da ética médica

O julgamento simulado reproduz a dinâmica de um julgamento em que os envolvidos são substituidos por representações da realidade, podendo tornar-se importante estratégia para o ensino da ética médica.

Ligas Acadêmicas e formação médica: contribuições e desafios

Nos últimos anos tem havido um considerável aumento do número de ligas acadêmicas atuantes nos cursos de graduação em medicina no Brasil. Esse fenômeno, no entanto, não vem sendo acompanhado de adequada reflexão sobre seus determinantes, o papel das ligas dentro das instituições, ou mesmo sua função pedagógica. A partir destas constatações, os autores analisam a precária literatura sobre o tema, descrevem a experiência das ligas acadêmicas da Faculdade de Medicina de Botucatu - Unesp e refletem a respeito do papel destas na formação médica, na tentativa de suprir um pouco dessa lacuna e contribuir para esta importante discussão.

Avaliação da prescrição médica em pediatria, baseada nos indicadores do uso de medicamentos selecionados pela oms em municipio do interior do estado de São Paulo

The World Health Organization (WHO) recommends that prescriptions of medicaments must be one parameter utilized to know how the medication is used by people. To do so, one specific methodology has been indicated, that is, the selected indicators of the use the medicaments. We applied this methodology with the aim of presenting a descriptive study of the physician prescription in Pediatric Clinic of the Health Basics Units. The results obtained are: the average number of medicaments prescribed with prescription was 2.6; the percentage of the medicaments prescribed with the generic name was 32%; the percentage of the prescriptions with antibiotics was 44.6%; the percentage of the prescriptions with injections was 10.4%; the percentage of the medicaments prescribed that are part of the municipal list was 22.8%, 27.5% for the program Dose Certs of the secretary of the State of São Paulo, and 50.4% by adding by adding the two lists. The essentiality of the medicaments prescribed may be considered very low, because only 32.6% appear in the RENAME. The percentage of the medicaments really dispensed was 39.9%. The medicaments more prescribed, according to the classification of the Anatomic-Therapeutic-Chemical (ATC), were the ones which acted in Respiratory System (26.8%), followed by anti-infectives for systemic use (16.4%) and by medicaments with acted in Alimentary tract and metabolism (15.8%). The conclusion is that the prescribers are moved by commercial influence of the drug makers, first because of the low prescription of medicaments by their generic name, second by the low number of medicaments effectively dispensed and then the low concordance between the ones prescribed and the ones included in the lists patterned by Tabatinga and by the State of São Paulo.

Animais aquáticos de importância médica no Brasil

The injuries caused by venomous and poisonous aquatic animals may provoke important morbidity in the victim. The cnidarians (jellyfishes, especially cubomedusas and Portuguese-Man-of-War) caused nearly 25% of 236 accidents by marine animals, while sea urchins were responsible for about 50% and catfish, stingrays and scorpionfish nearly 25%). In freshwater, stingrays and catfish cause injuries with a very similar mechanism to the poisoning and the effects of the toxins of marine species. In a series of about 200 injuries observed among freshwater fishermen, nearly 40% were caused by freshwater catfish, 5% freshwater stingrays and 55% by traumatogenic fish, such as piranhas and trairas. The author presents the aquatic animals that cause injuries to humans in Brazil, the clinical aspects of the envenoming and the first measures for the control of the severe pain observed mainly in the accidents caused by cnidarians and venomous fishes.

Consumo de medicamentos por idosos segundo prescrição médica em Jaú-SP

This study was carried out in order to identify the interactions that occur most often between prescribed drugs as they are taken by elderly patients attending municipal public health centers in the city of Jaú, São Paulo State, Brazil. It is known that older people frequently have to live with chronic health problems, which oblige them to use the health service a great deal and to consume large quantities of medicines. When concomitant diseases are present, and polytherapy is being applied, the likelihood of adverse reactions and interactions between drugs increases. The population under study consisted of 148 persons aged 65 or more who frequented the pharmacy at the Núcleo de Gestão Assistencial (Municipal Health Centre, NGA25) in Jaú, between August and December 2004. Data were collected from medical prescriptions, the independent variables being the age and sex of the patient. For each patient, the pharmacological classes of drugs taken and drug-drug interactions were recorded. It was found that the mean numbers of drugs consumed were 3.8 among women and 3.9 among men. In terms of age, the highest number of drugs (4.2) was used in the group aged 75 to 84 years. The most frequently prescribed classes, in decreasing order, were: antihypertensives, 25.0%, heart drugs, 15.5%, diuretics, and anti-diabetic drugs, 10.7%. It was concluded that the classes most involved in drug-drug interactions were heart drugs, diuretics and antihypertensives. The most problematic active constituents were digoxin, amiodarone, frusemide, captopril, propranolol and nifedipine.

Igreja católica, assistência social e caridade: Aproximações e divergências

This article is the result of a research study concluded in 2003, which aimed at investigating how the conception of Law is expressed in the actions of the so-called social pastoral commissions of the Catholic Church in Londrina, Brazil. By observing that the conception of charity and that of social rights walk side-bi-side within the Catholic Church, a question emerged: how is the conception of social right expressed in the actions of social pastoral commissions? Charity is preached as a Christian duty, as an action expressed in the experience of solidarity towards others who are in a situation that prevents them from having minimal living conditions. At least at discourse level, the actions developed are not limited to provide basic goods, clothes or medicine. We realized that those who act in social pastoral commissions, driven by values such as love to fellow human beings and solidarity, have not lost sight of the idea of social right - on the contrary, they have been reinforcing it. © 2006 Programa de Pós-Graduação em Sociologia - UFRGS.

Multiplicadores reflexivos: Uma experiância do Instituto Familiae junto ao Grupo de Assistância em Transtornos Alimentares (GRATA) do HC-FMRP-USP

This article describes the Reflecting Practitioners Program developed by Instituto Familiae at GRATA (Grupo de Assistência em Transtornos Alimentares) placed at the Clinical Hospital of the Faculty of Medicine of Ribeirão Preto - University of Sao Paulo (HC-FMRP-USP). The aim of this program was to take care of the caretakers - the GRATA interdisciplinary team - through the development of their reflecting ability, the appropriation of their own resources and the support on constructing alternative histories and on solving situations defined by them as problematic. Thirteen monthly meeting had been carried out among Familiae members and GRATA interdisciplinary team. The changes described by the participants had occurred through sessions developed with interdisciplinary pairs and through the development of their capacity to construct more comfortable positions - as members of the team and in the relationship among professional/client/ family. This triad became to be seen by the team through its resources and abilities, instead of its flaws and lacks. As a result, horizontal relationships could be privileged instead of hierarchical ones.

Importância de Yersinia enterocolitica em microbiologia médica

Y. enterocolitica is a human invasive enteropathogen which causes a number of intestinal and extraintestinal clinical symptoms of various degrees of severity, ranging from mild gastroenteritis to mesenteric lymphadenitis, which mimics appendicitis and in rare cases can evolve to septicemia. Infection by Y. enterocolitica can also lead to post-infection immunological sequelae including arthritis, erythema nodosum and glomerulonephritis. Pathogenic Y. enterocolitica strains have traditionally been linked to specific biotypes and serogroups and associated to a variety of phenotypic characteristics related to virulence. Molecular genetics studies have pointed to the importance of the pYV virulence plasmid, which encodes various virulence genes, as well that of specific chromosomal virulence genes, in determining the pathogenesis of this bacterium. Intestinal infections by Y. enterocolitica are mostly self-limiting and usually do not need an antibiotic treatment. The occurrence of this microorganism is not as frequently described in Brazil as it is in other countries, such as Japan, USA and many European countries. This review focuses on the general characteristics, pathogenesis, clinical symptoms, virulence characteristics, treatment and antibiotic susceptibility of Yersinia enterocolitica strains isolated in Brazil and around the world.

Avaliação da assistência pré-natal e puerperal desenvolvidas em região do interior do Estado de São Paulo em 2005

Objectives: to evaluate the structure and process of the prenatal and puerperal care given by Direção Regional de Saúde (DIR) XI, at the city of Botucatu, State of São Paulo, Brazil. Methods: an evaluation of resources and activities developed during prenatal and puerperal care in twenty municipalities comprising DIR XI which had adhered the Prenatal and Birth Humanization Program until 2003. Interviews with city managers and analysis of 385 sampled patient charts taking into account recommendations by the Health Department. Results: structure analysis showed that caregiving was centered on medical work; basic equipment and instruments were available; 85.2% of patients began prenatal care with up to 120 days of pregnancy, and 75.9% had at least six prenatal consultations. The active search for absentees and strategies for early prenatal care initiation were observed in 30% and 50% of the municipalities, respectively. Process indicators showed that 3.6% of women had six prenatal consultations, one puerperal consultation, all basic exams and tetanus immunization. Recording of gestational age, arterial blood pressure and weight was of approximately 90%; 58.7% of the women underwent childbirth review and 31.5% were vaccinated. Conclusions: the performance of the set of activities is a challenge to prenatal care at DIR XI.

Sistematização da Assistência de Enfermagem: acidente por Loxosceles gaucho.

Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of accident can be classified as mild, moderate and severe, depending on the period of time elapsed between the occurrence of the accident and the moment of care provision. We aimed at applying nursing care systematization in a comprehensive and humanized manner. The following nursing diagnoses were established: acute pain, damaged skin integrity, risks for infection, constipation and low self-esteem. The therapeutic relationship favored student/patient interactions and enabled the recognition of the needs that deserved nursing interventions. The nursing process was a valuable instrument and provided important elements for the patient's daily development and planning adjustment by prioritizing care quality.

Utilização do brinquedo terapêutico na assistência à criança hospitalizada

This is an exploratory and descriptive study that was jointly carried out by Nursing Care and Occupational Therapy as part of a Research Project that intended to prepare children for elective surgery at the University of São Paulo's Hospital de Reabilitação de Anomalias Craniofaciais. Objective: using toys as a therapeutic resource for relieving the child's real and unconscious tensions concerning hospitalization for surgical treatment at the HRAC - USP. Method: 44 children participated in the study. An observation form was used to collect data and it was applied at two separate times: the first time was the day before the surgery was to take place and the second on the day of the surgery just before the event. Twenty one variables were elaborated by the researchers to categorize behaviors regarding hospitalization. The resources used were: storytelling, dramatization and demonstration of nursing interventions with puppets dressed in surgical garb (gloves, surgical gown, mask and cap) with medical equipment commonly used in hospital. Results: of the 21 variables analyzed, 8 showed statistically significant differences on the McNemar Test (p<0.05). Conclusion: interactive play enables hospitalized children to interact in the hospital environment, so that they can express feelings and emotions and it contributes to humanized hospital assistance.