Concepção morfológica de fórceps, para intervenção no paciente em posição supina e o operador sentado

Ergonomics, the science of working rationalization, seeks the best relationship between man and his working tools. In Dentistry, ergonomics is present as for the professional working correctly seated, in functional comfort, intervening of supine position patient, by means of suitable equipment and instrument. Nowadays, dental equipment is justly rationalized; however, some instruments should take shape, in order to adapt those requirements. The hand tool design should permit a comfortable, non-slip and safe handling. Thus, anatomical details, the correct position of the operator for its use and specific characteristics of application should be taken into account. The instrument under analysis - forceps - was conceived according to these requirements along with a new alveolar tooth extraction technique, based on electromyographic and biomechanical studies. The morphology of the instrument, which makes possible a simple and natural kinetics of the operator, was obtained by changing the paradigm of the conventional cross-action instruments (whose grip is always on the arms of the tool), divesting the handle from the tool arm. This induced on anatomical conceiving of perpendicular handles to the extremity of the tool arm, resulting an efficient and effective instrument, according to indicated on its experimental phase

Paralisia periódica hipocalêmica tireotóxica em paciente de ascendência africana

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

Cuidado ao paciente idoso hospitalizado: implicações para a equipe de enfermagem

The Brazilian population is ageing rapidly, and chronic diseases have increased. Due to deficient health care services, the diagnosis and treatment of such diseases occur in the tertiary level, which increases costs and reduces the possibilities of early diagnoses. In view of the elderly population‟s increase and of the great demand at hospitalization units, it is important to learn about the difficulties and facilities faced by nursing teams when giving care to hospitalized individuals. In order to reach the objectives, a cross-sectional, prospective, descriptive, analytical and qualitative study was performed with basis on Bardin‟s Content Analysis. Among the difficulties were patients‟ limitations, dependence level, behaviors and habits, interference from companions, feeling of abandonment, perception of needs, dealing with suffering and lack of time for adequate care. As to facilities, acceptance of the disease, adherence to treatment, collaboration, trust in the team, and older patients‟ politeness were reported, which shows that passiveness is an important indicator in caring for the elderly. Older individuals suffer the outcomes of certain physical, psychological and mental deficits. When facing disease conditions, they require special care, including hospitalization and greater attention. The nursing team provides daily care and follows patients‟ development; however, its members are still not knowledgeable enough about the ageing process. This contributes to increase prejudice and erroneous stereotypes about older persons. Therefore, not understanding such process compromises the full care to be provided to older patients. This leads team members to accelerate the care provision process in order to meet the daily work demand, thus compromising older patients‟ autonomy and making them more dependent on the team, whereas the process should follow the opposite path

O câncer e as alterações no estado nutricional do paciente: importância da atenção farmacêutica

O Câncer é uma doença epidêmica e multifatorial. O uso combinado ou não de cirurgia, radioterapia e quimioterapia formam o alicerce sobre o qual se assentam a quase totalidade dos tratamentos contra os mais variados tipos de câncer. Essas terapêuticas quase sempre são agressivas, o que leva a uma ameaça séria à integridade física, sabidamente associada a problemas nutricionais. Pela legislação RDC nº220, publicada pela Agência Nacional de Vigilância Sanitária (ANVISA) em 21 de setembro de 2004, que regulamenta os estabelecimentos públicos e privados do país que realizam tratamento de quimioterapia antineoplásica, o farmacêutico deve fazer parte da equipe multiprofissional em terapia antineoplásica, como responsável pela manipulação de todos os antineoplásicos. Levando isso em consideração, o trabalho realiza uma descrição geral desde o desenvolvimento da doença, passando pelos principais agentes causadores e destaca a importância da terapia nutricional, principalmente no período pós-tratamento que influencia diretamente na morbi-mortalidade do câncer. Associando conhecimentos interdisciplinares entendemos que o farmacêutico possa exercer além da manipulação de drogas, a atenção farmacêutica contribuindo positivamente na equipe de saúde, visando uma maior adesão ao tratamento além do aumento da qualidade de vida do paciente oncológico. A partir do levantamento bibliográfico apresentado ampliamos a compreensão da complexidade dos mecanismos da doença, a importância da Terapia Nutricional e o Papel que o profissional farmacêutico pode desempenhar nesse campo

Conduta do paciente hipertenso frente ao tratamento clínico

The urbanization process established in Brazilian society since the middle of last century brought changes in the population habits and customs, which was responsible for the increased of chronic diseases incidence, such as arterial hypertension, for example. Although this is a common disease nowadays, it is still difficult to establish a significant control in subjects with this disease and its consequences. This is apparently due to lack of interest to the correct plan of care developed for the treatment of this disease. The nursing consultation identifies potential problematic situations and the patient needs, setting actions that are complementary to their benefit in order to promote health. The present work aims to observe how the nursing consultation is being used as strategy for patients with arterial hypertension, and to understand the difficulties faced during treatment of these patients. For this purpose, it was performed qualitative and quantitative studies with patients from Centro Saúde Escola (CSE), Unidade Auxiliar, Faculdade de Medicina de Botucatu, UNESP, located in Botucatu, employing as methodology the Discourse of the Collective Subject and descriptive statistical analysis of quantitative results. The vast majority of consultations were held by medical professionals and it was observed that the multidisciplinary work still needs to be recognized and valued by users. The lack of knowledge of some individuals in relation to the potential and importance of the nursing consultation occurs not only for the treatment of arterial hypertension, but for the treatment and monitoring of the individual as a whole. Therefore, it is still necessary to clarify the true essence and necessity of the nursing consultation, since so important tool should be used in its entirely. Moreover, the role of the multidisciplinary team should be more discussed

Comparação de dois métodos de profilaxia dental: avaliação da pressão arterial e do conforto do paciente. Ensaio clínico controlado e randomizado

GOALS: This research evaluated the change in arterial pressure before and after two procedures of dental prophylaxis: Jet system baking soda and conventional prophylaxis and patient's opinion regarding the comfort of each one. MATERIAL AND METHOD: Were selected 32 patients with age between 18 to 30 years old, who need prophylaxis to remove biofilm and were subjected to three different types of treatment: sodium bicarbonate jet (G1), prophylaxis conventional (G2) and placebo (G3) at intervals of one month between them. Patients were divided randomly. Arterial pressure was measured by wrist digital Omron HEM – 6111. The measurements were realized in four times: before the prophylaxis, immediately the end of procedure, 15 and 30 minutes after finished of treatment. Patient comfort was measured by a Visual Analog Scale (VAS) after the end of the treatment. The data were analyzed using the variance test. The results showed that there was statistically significant difference to the comfort of the procedures. RESULTS: There was a statistically significant difference to the comfort of the procedures, and G2 and G3 better than G1. Regarding the variation of arterial pressure there was no statistically significant difference between groups. CONCLUSIONS: The methods of prophylaxis no effect on arterial pressure, but conventional prophylaxis is more comfortable than others treatments

Estudo sobre a necessidade e preferência sobre orientações de enfermagem ao paciente oncológico adulto em quimioterapia

Most cancer types are treated by antineoplastic chemotherapy, which can be performed conjointly with other treatments, such as radiotherapy and surgery. Due to its action, chemotherapy provides the possibility of cure, but it also leads to a number of adverse effects, such as myelosuppression, cutaneous and gastrointestinal toxicity, etc. Patients undergoing chemotherapy must receive constant information concerning how to prevent or minimize these effects in order to achieve better quality of life and, consequently, a more successful treatment. Hence, this study aimed at investigating the need and preference for different forms of information by oncologic patients submitted to chemotherapy. It is a cross-sectional, descriptive and quantitative study conducted at the chemotherapy division of the Botucatu School of Medicine University Hospital/SP on a sample of 50 patients older than 18 years. After previous knowledge of the study and formalization of Free Consent, the individuals answered a questionnaire containing 12 questions related to the importance attributed to the information received, from which professional and when to receive it. Data were analyzed by Fisher’s exact test and showed that 62% of the patients were females, and the remaining 38% were males of whom 46% were older than 60 years, 26% were from 50 to 60 years old, 24% from 30 to 50, and only 4% were younger than 30 years old. The patients had lymphatic (23.4%) and solid (76.6%) tumors. All the respondents reported that receiving information about the disease and its treatment was extremely important. As regards information related to side effects, 98% of patients answered that receiving it was extremely important, and only 2% answered that it was little important. Correlations were made between age, gender, and tumor type with the answers obtained for the best moment, how and from whom to receive such informatio... (Complete abstract click electronic access below)

Agressividade: a origem dos conflitos? : compreendendo o comportamento agressivo

As explosões de violência que assolam a sociedade humana são noticiadas diariamente pela mídia, e vivenciadas pelos indivíduos. As queixas sobre a disseminação da violência estão espalhadas como areia pelo vento. As manifestações de agressão podem ocorrer por diversos motivos: disputas por território, fama, “status”, para impor dominação, agressividade como forma de alerta, para atingir um objetivo sexual, um instrumento para humilhar e coagir o outro, entre outros tantos e variados motivos. As ciências que se ocupam do estudo das relações humanas abordam o tema, mas devido à complexidade e abrangência de suas manifestações, existem muito mais lacunas do que respostas. A agressividade e violência não são exclusivas da sociedade humana, mas graças ao desenvolvimento técnico-científico, para a humanidade a associação entre estas tendências e a capacidade destrutiva do homem, geralmente, são catastróficas, ameaçando não apenas sua própria espécie, mas tudo ao seu redor. É impossível negar a ancestralidade comum entre o homem e os grandes primatas, chimpanzés, orangotangos, gorilas e bonobos. Intrigante é o fato de encontrar ocorrências de atos violentos semelhantes aos humanos entre eles. Por exemplo, orangotangos cometem estupros, chimpanzés além de surras, atacam de modo mortal indivíduos da mesma espécie, e entre gorilas o infanticídio é um ato banal. Apenas os bonobos fogem deste legado violento, apresentando-se como sociedade pacífica, liderada por fêmeas, onde conflitos são resolvidos pelo ato sexual. Os chimpanzés são extremamente próximos aos humanos, compartilhando mais de 95% da bagagem genética. A diferença entre os chimpanzés e humanos é menor do que a existente entre eles e os gorilas. A agressividade em ambos é algo que chama atenção para o possível legado genético, visto ser uma característica comportamental típica dos animais. No caso do ser humano, este tipo de...

Humanização da assistência ao paciente crítico: revisão integrativa da literatura

This study aimed at analyzing the scientific production on health care humanization in intensive-care and emergency units based on publications in national journals. Therefore, this is an integrative review of the national literature. The online database Literatura Latino-Americana do Caribe em Ciências da Saúde - Literature in the Health Sciences in Latin America and the Caribbean (LILACS) based on the Health Virtual Library (BVS) platform was used to select articles. The final sample in this review consisted of 21 articles. The presentation of results and data discussion was descriptively performed and divided into three themes: communication with relatives and the team, caregiver humanization and, finally, the difficulties faced to implement humanization. As regards communication, it is seen by the authors as a fundamental strategy to ensure quality in intensive care, and it is placed as a central axis in the humanization policy. Concerning caregiver humanization, the physical and mental overload resulting from the work process in these units are factors that interfere with personal relations between team members as well as with that between team members and patients. Among the difficulties faced for implementing humanized care for critical patients are the units’s physical and organizational structures, technology and health care professionals’ education, which is centered on the biomedical model. It was concluded that communication is considered to be fundamental for humanization of the care provided to critical patients, since it allows for the development of a network of meanings between patients, the team, families and the establishment. In order to implement care with humanized actions in urgency and emergency sectors, particularly in ICUs, it is necessary to change organizational culture and value health care professionals

Participação da família no tratamento de paciente em diálise peritoneal

Dramatic changes occur in the lives of patients on peritoneal dialysis and his family life, changing lifestyle, professional and social activities. Considering the important role of family in treatment, is crucial for nurses to know how these families perceive their role as caregivers and their difficulties and needs, in the process of peritoneal dialysis. The approach chosen for the study was the phenomenological method, based on Merleau-Ponty, who proposes to understand the human experience, from the description of those who lived it. The study findings show that in the beginning of treatment, family members, feel impacted with the disease severity and eager to become responsible for maintenance treatment, fearing not match the expectations.Guided by staff, appear confident in taking care and deal with the difficulties and complications of treatment, supported by professionals. However, resent the great changes in their social activities and work, his life turns out to be quite limited, due to the dedication to a sick family member. Many feel overwhelmed because they are not supported by other family members. Some envision a future outlook for renal transplant, others seem skeptical, given the long waiting list, especially when advanced age of the sick family member. These results suggest the need for individualized attention to family caregivers, and to encourage the family to organize itself and develop a joint work. In this sense, the design of health care, taking care with the focus of the family, it seems highly appropriate in preparing the plan of family orientation, this is defined as a dynamic unity, which, working in harmony, can contribute positively in the treatment of health a sick member

Lipidose hepática felina

Feline hepatic lipidosis or fatty liver disease is a cholestatic syndrome that affects domestic cats and is characterized by excess fat accumulation in the liver of cats. Symptoms commonly seen with this syndrome are anorexia, weight loss, lethargy, vomiting, jaundice, and occasionally behavioral or neurologic signs such as excessive drooling, blindness, coma, and seizures. The diagnosis is based on the patient history, clinical examination, complementary examination, and the definitive diagnosis is obtained by cytology and/or histopathology of hepatic tissue. In serum biochemistry, the main findings include increased serum alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate amino transferase (AST) and bilirubin. The gamma glutamyl transferase (GGT) is normal or slightly increased. The cornerstone of therapy is aggressive feeding to supply the cat full caloric requirements. Without aggressive nutritional support and intensive monitoring the fatty liver disease can be fatal

A influência do enriquecimento ambiental no comportamento agressivo da tilápia do Congo Tilapia rendalli

O enriquecimento ambiental tem sido proposto como uma prática para melhoria do bem-estar de animais de cativeiro ou de produções zootécnicas. No caso de animais territoriais e agressivos, ao se enriquecer o ambiente, aumenta-se a quantidade de recursos a se defender, bem como o valor do território em disputa, aumentando as interações agressivas. Esse aspecto foi mostrado recentemente para o peixe ciclídeo tilápia-do-Nilo (Oreochromis niloticus). Do ponto de vista comparativo, isso pode ser um fenômeno espécie-específico. Para avaliar isso devemos observar se em condições similares outro peixe ciclídeo sofre a mesma influência do enriquecimento do ambiente. Assim, seguindo a lógica do confronto obtido para tilápia-do-Nilo, aventamos a hipótese de que as atividades agressivas aumentam em função do enriquecimento. Este estudo avaliou essa hipótese para a tilápia do Congo Tilapia rendalli. Como principal resultado, observamos que a latência para iniciar a luta é menor no ambiente enriquecido, mas a frequência de ataques é maior no ambiente não enriquecido (controle). Além disso, observamos clara definição hierárquica por meio da sinalização de submissão (corpo com listras escuras) e dominância (corpo claro sem listras) na condição sem enriquecimento do ambiente. Concluímos que ao contrário da tilápia-do-Nilo, na tilápia do Congo o enriquecimento do ambiente leva a diminuição da agressividade sem clara definição da hierarquia de dominância

Efeito da suplementação dietética com triptofano no comportamento agressivo em juvenis de tilápia-do-Nilo

Níveis elevados de agressividade estão diretamente relacionados ao crescimento heterogêneo e ao canibalismo, podendo levar a perdas significativas na produção no setor da aquicultura. Uma alternativa para redução da agressividade poderia ser o aumento da produção de serotonina por meio da suplementação dietética com o aminoácido triptofano (TRP). A serotonina é um neurotransmissor que regula diversos processos comportamentais, dentre eles, a agressividade e o estresse. Assim, neste estudo avaliamos o efeito da suplementação dietética com triptofano TRP no comportamento agressivo em juvenis de tilápia-do-Nilo. Os peixes foram mantidos em aquários individuais durante sete dias e alimentados uma vez ao dia “ad libitum” com as dietas: T1(controle: 0,32% de TRP), T2 (1,28% de TRP) e T3 (2,56% de TRP). O índice de agressividade foi avaliado com base na resposta do peixe à sua imagem no espelho. Contabilizamos o número de ataques (mordidas) à imagem de um espelho posicionado em uma das laterais do aquário durante vinte minutos. Os peixes alimentados com T3 apresentaram menor frequência de mordidas (P = 0,010849) durante o período de observação, em comparação ao grupo controle. Concluímos que a dieta contendo 25,6mg/g TRP altera a agressividade em juvenis de tilápia-do-Nilo e que a rações suplementadas com TRP podem ser uma estratégia eficiente no manejo de pisciculturas. Também avaliamos os efeitos do TRP exógeno na ansiedade (teste do objeto novo) e estresse (teste do confinamento) em juvenis da tilápia-do-Nilo, porém não houve diferenças significativas entre os tratamentos

O efeito da musicoterapia na qualidade de vida e nos sintomas depressivos do paciente em hemodiálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desperdício de dieta enteral em UTI: análise de modo de falhas e efeitos de danos ao paciente grave

Pós-graduação em Enfermagem (mestrado profissional) - FMB