O debate bioético e jurídico sobre as diretivas antecipadas de vontade

Pós-graduação em Direito - FCHS

Os efeitos psicológicos da atividade física nos cuidados de dependentes químicos

O profissional de educação física nos dias atuais deve ter amplo conhecimento sobre diversos assuntos relacionados à prevenção e manutenção da saúde de modo que este poderá atuar diretamente na melhora e reeducação da qualidade de vida de diferentes estados físicos e emocionais das pessoas em que irá trabalhar. O consumo abusivo de drogas ilícitas no século XXI, trás consequências emocionais e físicas, as dependências econômicas e de saúde geradas pelo seu consumo e propaga-se que, quando não tratadas adequadamente podem gerar um ciclo caótico de complicações, vindo a estabelecer problema real para a saúde pública mundial. O presente trabalho tem por objetivo enfatizar por meio da revisão de literatura os efeitos benéficos, tanto psicológicos como fisiológicos, que os programas de atividade física regular exerce no processo de cuidado e/ou zelo do dependente químico em meio ao tratamento. Constatou-se que a atividade física nos cuidados e/ou zelo do dependente proporciona inúmeros benefícios à saúde, além de contribuição fisiológica como desintoxicação, diminuição da frequência cardíaca de repouso e pressão arterial, melhorar a vascularização, diminuir a fadiga central, liberação do hormônio do prazer (endorfina) e as capacidades funcionais musculoesqueléticas. O exercício também é de fundamental importância para resgatar aspectos psicológicos como controle da ansiedade, depressão, alivio do estresse, melhora da autoimagem, autoestima, confiança e disciplina para seguir o tratamento e futuramente sua vida, e por fim possibilitou, ainda, entender as relações entre as funções fisiológicas e psicológicas do homem, de modo a deixar explícito que ambas caminham juntas e uma equipe multidisciplinar contando com psicólogos, nutricionista e profissionais de educação física se faz necessário, visto que eles trabalham em equipe levando em consideração as especificidades de cada...

Estratégia saúde da família e adolescência: as necessidades de cuidados e recursos utilizados em saúde mental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Diagnóstico de situação das práticas de manejo sanitário em sistemas de produção de bovinos de corte

We interviewed 21 farmers in order to access which sanitary practices adopted in the production systems of beef cattle on farms located in São Paulo, Mato Grosso, Mato Grosso do Sul and Rondonia. The survey was conducted through a qualitative approach to the collection of data obtained through questionnaire and personal interview with the landowners. We questioned the attitudes and sanitation procedures in these current production systems such as veterinary assistance, preventive health practices and disease surveillance, knowledge of health hazards for the safe production of food, animal feed, vaccine and immunizations, registration system, measures with newborns, products used in the environment and animals, grace period, employee training, destination of the dead animals, among others. Along with the data found that only 30% of properties had veterinary care, 67% said they meet the expiration dates of the products, although it was not mentioned on the products if there were any. In only 48% of properties were veterinarians who prescribed drugs to animals. Only two of the owners confirmed buying and using expired products in animals and only 48% have received some training on the property. In this setting, it is evident that farmers should be better prepared for insertion of its products in a highly demanding and competitive market. In this context, add value to the product depends mainly on the condition of sanitation of the herds.

Detecção de microrganismos de infecções bucais: perspectivas e cuidados a serem seguidos

The diagnosis of head and neck infections constitutes relevant step in their treatment. However, in spite of the fact that most of diseases in head and neck region are infectious in nature, several reasons collaborated for dentists do not ask laboratory tests in order to help clinical diagnosis. By mean of this review literature, based on research articles about the newest and most reliable methods of diagnosis for clinical laboratories, the authors discuss the advantages and disadvantages of each selected method and the relevant aspects in transportation of the specimens to the laboratory. Saliva, biofilm, pus, and blood are the most frequent specimens for microbial diagnosis, being that the most used methods are culture and those based on detection of deoxyribonucleic acid by polymerase chain reaction method. Whereas, the culture depends on cellular viability, and has reduced sensitivity, as well as needs favorable conditions in the sample collection and transportation, PCR shows high sensitivity and specificity, but it does not allow the determination of antibiogram, what reduces its usefulness. In addition, few laboratories possess conditions to perform cultivation of obligate anaerobes or have experience in the molecular detection of these microorganisms.

Enterococcus spp. em espécimes clínicos de pacientes atendidos em unidades de terapia intensiva

The relationship between the occurrence of enterococci in the oral microbiota and serious infections in patients hospitalized in intensive care units (ICU) has been established. This study evaluated the presence of Enterococcus faecalis and other species of this genus in the mouths of patients on ICU, correlating it with oral and systemic conditions. Data on health and socioeconomic, medication use, medical and family history of patients maintained for 72 hours in the ICU, diagnosed with severe infection or who have developed this condition after the entry to the unit were obtained. Fifty patients provided intraoral and extraoral clinical samples for analysis (above and subgingival biofilm, saliva and buccal mucosa, followed by obtaining samples of respiratory secretions for patients with pneumonia, and blood and urine for sepsis). The presence of target microorganisms was performed by polymerase chain reaction (PCR) and 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 showed poor. E. faecalis was significantly more frequent microorganism, followed by E. faecium. The use of broadspectrum antimicrobial action was associated with the presence of these opportunistic microorganisms. These bacteria were more frequent in patients with periodontitis or gingivitis. The results showed that enterococci associated with serious infectious processes may originate from resident microbiota of patients and its prevalence is not elevated in healthy individuals.

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.

Opiniões e atitudes dos médicos frente às ações promocionais da indústria farmacêutica

The pharmaceutical industry invests heavily in promoting their products, and studies suggest that these actions influence doctor’s prescribing. Therefore, this study aimed to analyze the opinions and attitudes of doctors when facing promotional activities of the laboratories. To this end, questionnaires were sent to doctors in Araraquara (SP) containing statements on the subject. Data analysis included study of the association by the chi-square. The results indicated that physicians relate to the propagandists (98%) by considering them useful (55%), but not as a main source update (86%). For 62% of them their prescriptions are not influenced by such relationships, while 24% disagree that doctors in general are influenced as well as new graduates (37%). The majority also disagrees that are influenced by amenities (86%) or free samples (70%) but only 38% believe their colleagues are not influenced by the samples. As for the ethics of these receipts, 57% considered to be appropriate when benefit patients, but only 32% while for personal use. The results show that doctors are vulnerable to the influences of marketing. Therefore, mechanisms and interventions are needed for prescribing drugs solely by criteria of effectiveness, safety, convenience and accessibility to the patient.

Atenção farmacêutica em idosos com hipertensão participantes da estratégia saúde da família

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Recomendações para prevenção clínica: aspectos relevantes em idosos

The American Academy of Family Physicians (AAFP) released a summary of the “Recommendations for Clinical Preventive Services”. It is a publication based on “Recommendations for Clinical Preventive Services” published by the United States Preventive Services Task Force (USPSTF). These recommendations are provided only as an aid to physicians in making clinical decisions about the care of their patients. They reflect the clinic references existing at the time of publication. But its only should be used with the clear understanding that continued research may result in new knowledge and consequently there is a need for updates. Some recommendations of the USPSTF are important in clinical practice with the elderly.

Saúde Mental e Morte: subsídios para implantação dos Cuidados Paliativos na Atenção Básica

The objective of this work was, from a bibliographical survey, to discuss the relationship between the subjects “Mental Health” and “Death”, in order to analyze possible contributions of the Psychiatric Reformation tied with the sphere of Palliative Cares. The characterization of madness as a social problem is related to the development of the capitalist mode of production. Unable to fulfill the requirements imposed by capital, insane persons are excluded from society and locked in psychiatric hospitals in order to be treated. In the same way, death is incompatible with the capitalist principles of accumulation of goods. Dying people are then transferred to the hospital in order to hide their invalidity, non-production and felt inexistence of wealth. Some principles for care in mental health that could be shared in the palliative cares are: deinstitutionalization; organization of assistance in a network; psychosocial assistance; interdisciplinarity and construction of the autonomy of family members and users. In this sense, some challenges are distinguished, between them, professional training.

Intervenções para aumentar adesão às precauçôes padrão e/ou baseadas nas vias de transmissão de micro-organismos aos cuidados do paciente: revisão sistemática de ensaios clínicos randomizados e não randomizados, séries temporais e estudos controlados antes e depois

Pós-graduação em Enfermagem - FMB

Cuidados paliativos para pacientes em estado terminal em Unidades de Terapia Intensiva: revisão sistemática e metanálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Adaptação transcultural do formulário POLST: Physician Orders for Life-Sustaining Treatment

Pós-graduação em Saúde Coletiva - FMB