Eventos adversos em terapia medicamentosa em Unidade de Terapia Intensiva - UTI

Due to the complexity and instability of clinical conditions of ICU patients, the drug therapy applied in this type of environment requires a combination of several prescribed drugs, which is a favorable condition for drug interaction, toxic synergism and possible iatrogenia. In the possible universe of ICU occurrences, this study aimed at identifying and evaluating the incidence of adverse events in drug therapy at the Intensive Care Therapy Service (SETI) in wards I and II. It is a cross-sectional, descriptive, prospective and quantitative study conducted from August to September, 2011 in the Intensive Care Service of the Botucatu School of Medicine University Hospital - UNESP. The population consisted of fifteen clinical nurses, including those in the Improvement and Volunteer Internship Programs, who contributed to the investigation after signing an informed consent form and according to approval by the Research Ethics Committee number 10711/CE - FMB. The data were entered on a form and analyzed. Results showed that, on average, 8.9% of events/day occurred, and the highest frequency was observed on August 04, 2011. 63% and 22% were respectively observed in the morning and afternoon shifts, and 15% in the night shift. 48% of these were due to administration time errors, followed by drug prescription and dispensation errors, with percentages of 22% and 18%, respectively. Antibiotics showed the highest frequency of adverse events - 18%, which was followed by 13% for anticoagulant, 11% for antiemetic and 10% for antiulcerative drugs. As regards the occurrence of adverse events related to hospitalization time, the highest frequency occurred in patients who were hospitalized for 10 days. Concerning the ratio between reported events and the number of items in the prescription, the highest frequency of events was related to prescriptions with 20 items... (Complete abstract click electronic access below)

Opinião de familiares sobre a internação de crianças em uma Unidade de Terapia Intensiva Pediátrica

A Pediatric Intensive care Unit (PICU) is an environment where care is provided to seriously ill children. Hospitalization is regarded as an unpleasant experience that requires adaptation and routine change. To assess the opinion of relatives of children hospitalized at a PICU concerning tie breakage and/or separation between children and their families. It is a descriptive, cross-sectional, quantitative study. A structured interview was conducted with the families of hospitalized children from July to September, 2010. The data were statistically analyzed. RESULTS: Twenty relatives were interviewed, 80% of whom believed that children’s behavior changes when they are present in the unit, and 85% considered the visitation time established to be sufficient. All the respondents reported to be satisfied about the care provided. The feelings prevailing in 50% of the relatives were fear and hope. Change in the family’s union after hospitalization occurred in 85% of the families. The most fearful aspect concerning the ICU is the equipment (25%), and the most worrisome, as regards personal life, is the separation from other children (65%). Health care professionals must pay more attention to relatives by including them in their health care plan so that the health care team and the family, who are essential in children’s recovery, can interact in a congenial fashion. It is also necessary to improve the knowledge related to that subject so that the health care team and families can work together towards children’s recovery

Foraminíferos em testemunho do manguezal do Canal de Bertioga (SP): padrões de estrutura de comunidades aplicáveis em reconstruções paleoambientais

Nowadays, there is a search for knowledgment that could be applied in the solution of the problems caused by petrolific activities involving the environment, like the biodiversity preservation and the ecosystems monitoring and management. Foraminifera (Protista) are used as an important tool to the environment characterizarion, because they answer quickly to the fisic-quimic variations and indicate local alterations. The goal of this job is to create models of foraminiferal communities composition through the screening of subsuperficial samples obtained from a core collect from Bertioga Channel, Baixada Santista (SP), trying to understand the influence of the environmental variations along the time upon the indicator species presence, as well as making paleoenvironmentals reconstructions of the area. A 80 cm-core was removed in the outer edge of marsh adjacent to Bertioga Channel, not far from the confluence with the Itapanhaú River. There are presented in abundance, equitability, diversity and species richness obtained in nine samples along the sediment. The lower part of the core is compound by calcareous species (rotalideos and miliolideos) with domain Ammonia (Biofacies 1) and the intermediate and upper parts contain mainly agglutinated species (Biofacies 2 and 3, which is dominated by species of Ammotium). The qualitative and quantitative study of the microfauna of foraminifera present in the core reveals that in recent decades the sampling area passed from a condition of infra-marginal strip under significant coastal marine influence for the condition of inter-coastal swamp covered with mangrove vegetation. This change indicates that the site has undergone a process of sediment progradation, a phenomenon that may have been timely, localized, or a reflection of a relative fall in sea level at the regional level

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)

Perfil epidemiológico de parturientes submetidas à cesariana na maternidade de um hospital escola de Botucatu-SP

During the pregnancy process, the maternal organism commonly undergoes changes. Such changes follow the normal course of pregnancy; however, some maternal or fetal factors can interfere with pregnancy and adversely affect its outcomes, thus triggering what is referred to as high-risk pregnancy, which is responsible for increasing maternal, fetal or newborns’ morbimortality rates1,2. One of the obstetric alternatives for a safe resolution of this pregnancy type is the caesarean section. Nevertheless, an expressive increase in the number of caesarean sections has been observed worldwide, and they are, many times, unnecessarily indicated8. The world Health Organization (WHO) recommends that the total number of caesarean sections in relation to the total number of deliveries performed at health service should be a maximum of 15% 11, a limit that is easily surpassed in various services. To outline the epidemiological profile of pregnant women submitted to caesarean sections at a reference health care service in the city of Botucatu-SP. This is a cross-sectional, retrospective, exploratory, descriptive, quantitative study. The target population consisted of one hundred pregnant women assisted in this institution, who had been submitted to caesarean sections in 2010 and were randomly selected to compose the sample. In the analyzed period, there were 1,189 deliveries, of which 601 (50.5%) were natural deliveries, 588 (49.4%) were caesarean sections. As regards maternal age, 76% were in the age range of 19 to 36 years. A high percentage of patients (27%) had not completed elementary education and did not have a paid job; 67% were homemakers. Most of the participants were married (56%); 34% of the women were primiparas, but 19% were in their fourth or more pregnancies. Concerning prenatal care, little was found, since many of them had consultations out of the institution which were not recorded... (Complete abstract click electronic access below)

Morte e morrer: opinião dos profissionais de saúde de uma unidade de terapia intensiva pediátrica

Presently, the dying process and death most often occur in hospitals and, particularly, in Intensive Care Units (ICU), where patients’ lives are prolonged thanks to advanced technological devices and highly efficient medicines. To learn about the opinion of health care professionals working at a Pediatric Intensive Care Unit in relation to the dying process and dying. This is a descriptive quantitative study. A questionnaire was applied to the unit’s staff members from June to August, 2011. Data were statistically analyzed. Twenty-five professionals answered the questionnaire, and 72% faced death as a natural life process. 60% felt compassion, but that feeling did not interfere with how they cared for patients. Concerning their professional training, 52% reported not to have received any concerning patients’ caregivers in the dying process or death; therefore, they experienced such situation when they were already working, and 76% reported to be interested in updating courses on that theme. Further discussion about this topic during academic education is necessary. It is also necessary to provide health care professionals with specialization courses, debates and experience exchange so that they can better understand and deal with their feelings and limitations in face of death and thus give better care to patients and relate to patients’ families during the dying process of a loved one

Informatização na educação em saúde: avaliação de site educacional

Health education presently experiences the incorporation of information technology, thus making access to information more practical and attainable. The initiatives to make health care scientific content available virtually have shown to be useful for teaching, health care professionals and the general population. A website, however, must be constantly managed. To promote the dissemination of the website at www.educacaoemsaude.fmb.unesp.br among faculty members and undergraduate nursing students and students at Escola Técnica de Enfermagem (Vocational Nursing School) - ETE, by evaluating, among them, its graphic and functional aspects and seeking suggestions for its improvement. This is a descriptive quantitative study for which the participants were asked to fill out an instrument designed for the study. The evaluation was performed among nursing faculty members and students at Univ Estadual Paulista Júlio Mesquita Filho – UNESP and students at Escola Técnica de Enfermagem (Vocational Nursing School) – ETEC in the city of Botucatu. The number of participants totaled 88 individuals, of whom 23 were undergraduate students, 62 were students at ETEC, and 3 were faculty members. Eighty-one were females, and 7 were males. The participants’ age ranged from 17 to 56 years. Among the items that evaluated the website, the answers prevailed from “very good” to “good”. When the participants were asked what they had thought about the website, the answers were mostly positive, and the most frequently description given was “interesting”. Among the facilities, the most frequently reported was “easily understood content”, and as regards difficulties, handling the website was the most often mentioned. One hundred percent of the answers considered the maintenance of the website to be important. Suggestions for its improvement were given, and the most frequent... (Complete abstract click electronic access below)

A simple and portable instrument for determination of captopril in pharmaceutical formulations

Objective: This article describes the application and the performance of a cheap, simple and portable device that can be used for colorimetric quantitative determination of captopril (CPT) in pharmaceutical preparations. Methods: The sensor is a light detector resistor (LDR) placed into a black PTFE cell and coupled to a low cost multimeter (Ohmmeter). The instrument has been tested and is easy and fast to use. The quantitative study is based mainly on reduction of ammonium molybdate by captopril, in the presence of sulphuric acid, producing a green-yellow compound (max 407 nm). The calibration curves were obtained by plotting the electric resistance of the LDR against the CPT concentration on the range of 4.60 x 10-4 to 1.84 x 10-3 mol l-1 with a good coefficient of determination (R2 = 0.9962). Results: Statistical analysis of the obtained results showed no significant difference between the proposed methodology and the official reported method as evident from the t-test and variance ratio at 95% confidence level. Conclusion: The results of this study demonstrate that the instrument can be used for simple, accurate, precise, fast, in situ and low-cost colorimetric analysis of captopril in pharmaceuticals products.

Comportamento do IDEB nos municípios paulistas da região de Barretos e região central: algumas discussões para responsabilização e comprometimento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Eventos adversos relacionados à gravidade e carga de trabalho de enfermagem em Unidade de Terapia Intensiva

Pós-graduação em Enfermagem - FMB

Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction

This is a qualitative-quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P < 0.0001) post-treatment, with improvement among 106 (88.33%) subjects. There was a statistically significant (P < 0.0001) increase in the level of DHEA, while the levels of both serum testosterone (P = 0.284) and free testosterone decreased (P < 0.0001). Most adverse events recorded were related to the gastrointestinal tract. Physical examination showed no significant changes post-treatment. Based on the results, it is concluded that the T. terrestris extract is safe and effective in the treatment of female sexual dysfunction.

Avaliação do significado social, econômico e cultural do tabagismo em mulheres profissionais do sexo

Pós-graduação em Enfermagem - FMB

Fatores associados a adesão ao curso de capacitação a distância para líderes, voluntários, profissionais e gestores de Comunidades Terapêuticas

Pós-graduação em Saúde Coletiva - FMB

Organização da demanda de um Centro de Especialidades Odontológicas

Introduction: Secondary care in oral health in Brazil is still a little researched topic. Objective: The aim of this study was to analyze the resolution of dental services in SUS based on the referral to secondary attention and backreferral to primary attention. Methodology: It’s a descriptive, quantitative study that used secondary data collected from dental records of patients seen at Centre of Dental Specialties (Ceo) in a city of São Paulo State. Result: It was analyzed 1030 dental records. Just 1236 proceedings received referral to Ceo and among then, 86.4% showed the first attendance on Basic Health Unity (UBS) through spontaneous demand and 50.4% (n=623) received referral to endodontic treatment. There was evasion of 2.27% of studied population (n=28) on the first specialized consultation. Among 1208 proceedings that started the treatment in Ceo, 62.6% (n=757) were finalized and received back-referral to primary attention, that finalized 61.1% (n=463) of proceedings. To conclude the treatment, considering the time spent in Ceo and primary attention, there was variation according to specialty: periodontics – 62 days (sd ±68) and endodontics – 71 days (sd ±51.8), requiring 3 consultations in average, regardless specialty. Conclusion: The Centre of Dental Specialties gave referral and attention to the majority of demand, regardless specialty. However, there are many cases of evasion during dental treatment, alerting managers to develop methods to entice these patients, reducing service expenses and raising solvability of dental procedures previously initiated.

Diagnósticos de enfermagem prevalentes em geriatria segundo o grau de dependência

This is a quantitative study conducted at the Outpatient Clinic of the Geriatrics and Gerontology Academic League of Botucatu School of Medicine. It aimed at learning about the profile of elderly patients and their level of disability in relation to basic activities of daily living. Based on this information, nursing diagnoses for the population under study were made, and the most frequent diagnosed were selected with the purpose of composing a stage of the instrument for nursing consultation in geriatric. It was found that the disabled elderly patients were predominantly females and widowed. They had a mean age of 81 years and had completed the first 4 grades of elementary school. Chronic pain related to physical disability and impaired ambulation related to the presence of osteoarticular diseases are examples of the most common diagnoses in the studied population. It is important that geriatric nurses implement Nursing Care Systematization based on the knowledge of the population to which they attend by considering the level of disability of elderly patients with respect to basic activities of daily living, so that full and individualized care can be provided and the patients’ remaining autonomy can be preserved.