Medicamentos inadequados para idosos na estratégia da saúde da família

The ageing process can change the pharmacodynamics and pharmacokinetics parameters. Therefore, some medications are considered potentially inappropriate (PIM) for the elderly people, since they can increase the likelihood of occurrence of adverse drug events. The objectives are to estimate the frequency of use of PIM in the elderly people, with potentially hazardous drug interactions (PHDI) and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional study was performed in a Health Family Strategy (region of Araraquara, SP), between January and February/2012. The medical records of patients aged ≥60 years, that use at least one drug, were consulted for identification of PIM, according to the Beers criteria. The MPI identified were classified considering the Anatomical Therapeutic Chemical Classification System (ATC) and the essentiality of the drug (safety, effectiveness, quality and cost parameters) The inclusion criteria were met by 358 elderly, being that 93 of them (26%) had taken at least one PIM. Of the 114 different drugs prescribed for elderly, ten were classified as PIM, of which four of them act on the central nervous system, four on cardiovascular system and two on the digestive tract. Seven MPI are essential medicines, belonging to national list of essential drugs (RENAME-2010). Fourteen drug interactions were identified, of which two are PHDI (fluoxetine/amitriptyline and digoxin/hydrochlorothiazide).After the PI, there was no change in medical prescriptions of patients with PIM use or with DI. Medical prescriptions of elderly attended in the Health Family Strategy show pharmacotherapeutic safety problems, of which may be responsible for health hazardous for this age group. Although the intervention carried out by letter had been ineffective for the adherence of doctors in prescribing safe alternatives, wide dissemination of the lists that contain PIM and PHDI is need, as well as the inclusion of safer equivalents in RENAME, in order to contribute for rational use of drugs.

Medical conditions and body pain in patients presenting orofacial pain

OBJETIVO: Verificar a frequência de problemas médicos autorrelatados e a frequência de áreas de dor no corpo em pacientes com dor orofacial, comparando-os a pacientes submetidos a tratamento odontológico de rotina. MÉTODOS: Os dados foram coletados dos arquivos da Clínica de Dor Orofacial (Grupo A, n=319) e de clínicas de tratamento odontológico rotineiro (Grupo B, n=84) da Faculdade de Odontologia de Araraquara, São Paulo, Brasil. Os indivíduos responderam a questionários e preencheram um mapa corporal indicando os locais de dor. RESULTADOS: O teste de Mann-Whitney demonstrou que o Grupo A apresentou uma média de relatos de problemas médicos superior ao Grupo B (p=0,004). Para ambos os grupos, o teste de correlação de Pearson demonstrou correlação positiva entre os problemas médicos e a frequência de áreas dolorosas (respectivamente, 0,478, p=0,001 e 0,246, p=0,000). CONCLUSÕES: O Grupo A relatou maior número de problemas médicos e houve correlação positiva entre a frequência desses problemas e a de áreas de dor para ambos os grupos.

Proposta de um dispositivo para adaptação em uma cama hospitalar para ajuste de altura

In hospitals, health professionals may face different situations and problems. By following them, it is remarkable that one of the difficulties is related to the support provided by the facilities to carry out their work. This also affects the quality of treatment offered to patients. One of the points of improvement that could be studied is hospital beds. The Fawler's simplest hospital bed type, used in most Brazilian public hospitals, is designed with an ergonomic average height that offers a default position for analysis and treatment of patients. There is no possibility of adjusting the height of those beds, and hence there is a limitation in this regard since that height is fixed, but the physical structures of the workers and patients may vary widely and there may be a conflict when there are people too large or small involved in this process. Beyond that, studies by experts show that beds with height adjustment decreases the muscular effort and improve the movement quality of the spine of nursing staff, reducing the force on certain vertebrae and also the ergonomic risk. Of course, patient comfort is also affected accordingly. As the beds made with height adjustment are very expensive, this study aims to design a device to adapt the not adjustable beds. The project must be viable from an economic and mechanic standpoint, being able to adapt both old and new simplest Fawler hospital bed models, since their dimensions are similar. The final result shows that it is possible to adapt such beds using the designed concept at a viable cost. Furthermore, this concept could be applied in other bed types or objects that have hollow feet

A NR-32 para os profissionais da estratégia saúde da família

Pós-graduação em Saúde Coletiva - FMB

Avaliação da resistência adesiva de diferentes sistemas resinosos de colagem ortodôntica

Recent orthodontic bonding materials have aimed to reduce the working time of the clinician, by simplifying the acid etching procedure by applying self-etching primer adhesive systems. However, the adhesion quality of these materials still demands investigation. Thus, the present study aimed to evaluate the bond strengths of three different adhesive systems. A hundred and eighty bovine lower incisors were cut and embebbed in acrylic resin matrices, in which orthodontic brackets were bonded with Transbond XT (2n = 60), Transbond XT Self Etching Primer (2n = 60) e Tyrian (2n = 60). For each composite, bond strength tests were executed immediately (n = 30) and 24 hours (n = 30) after the bonding, in the assay machine Versat 2000 (Pantec), by applying 500 Kgf of load at 1mm/min of velocity. Transbond XT, Transbond XT Self Etching Primer and Tyrian presented, respectively, average values of bond strength of 7.43, 7.09 and 3.41 MPa at the time immediately, and 7.42, 8.81 and 5.35 MPa at 24 hours after the bonding, where differences were statistically significant at 5% between Tyrian and Transbond groups at both observation times. It was concluded that Tyrian was the material that presented significant lower bond strength with regard to Transbond groups that were similar.

Evasão no cursinho pré-vestibular da FCA/UNESP: a interpretação do aluno evadido

The popular cram schools are voluntary initiatives aimed at people who are not able to afford the cost of private cram schools. The FCA popular cram school integrates a large project from UNESP, which has 30 cram school distributed throughout Sao Paulo State and located in different University units. Among the problems found in popular cram schools, school evasion, characterized when the student quits the course and is very common in this context. Thus, the aim of this work was to identify the profile of the drop out student from the FCA cram school as well as to know the reasons that led them to leave. The survey was conducted in two phases: 1) students´ profile when entering the cram school, through a structured questionnaire, 2) semi-structured interviews by telephone with all the drop out students, trying to identify the reasons that led them to abandon the course. The statistical analysis used was descriptive. Among the reasons that led them to leave, it was found that 65% of the students attributed this attitude to external factors as opposed to 35% who put the internal factors as the decisive reason of their departure. Some of the factors that could be attest for the FCA cram school evasion are: primarily, the heterogeneity of students and their need to work in order to support themselves and their family; students lack of motivation about a long-term success; lack of family encouragement; the difficulty of the student to establish significant personal links with cram school staff and the fact that the professors are mostly undergraduate students from different courses in different areas, with little didactic-pedagogic preparation and inability to work with students' heterogeneity.

Informação e ação moral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O ensino de pediatria na atenção básica em saúde entre as fronteiras do modelo biomédico e a perspectiva da integralidade do cuidado: a visão dos médicos supervisores

Trata-se de estudo sobre educação médica, focalizado no ensino de pediatria na atenção básica, com o objetivo de analisar a contribuição da disciplina de Pediatria Social e Comunitária no 4º ano de graduação em medicina da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista.Utilizou-se metodologia qualitativa de pesquisa, tendo como estratégia o estudo de caso. A análise foi fundamentada na abordagem sócio-histórica, subsidiada pelos estudos de Vigotski. Identificou-se o que os supervisores consideraram como aprendizados relevantes a sua contribuição no processo de mediação para que os estudantes aprendam sobre o processo de trabalho na atenção básica, o que não poderiam alcançar sozinhos. As entrevistas transcritas revelaram núcleos de significação comuns: importância da diversificação de cenários de ensino, aprendizado dos principais problemas de saúde, integralidade no atendimento da criança, com ênfase no vínculo e oportunidade do estudante aprender sobre promoção da saúde.