No grupo de teatro terap��utico: hospital J��lio de Matos

Este trabalho escrito visa relatar a experi��ncia vivenciada com o Grupo de Teatro Terap��utico do J��lio de Matos do Centro Hospitalar Psiqui��trico de Lisboa na prepara����o de um espect��culo de teatro pelo grupo. Nele v��m-se descritas as actividades referentes ao levantamento do trabalho teatral com um grupo de pessoas com diagn��stico psiqui��trico e ligadas a uma institui����o hospitalar, e s��o referenciadas as pr��ticas e teorias terap��uticas que s��o associadas �� dinamiza����o do grupo. Terminando com a reflex��o sobre a componente terap��utica indissoci��vel �� natureza do processo art��stico.

Implementa����o de um departamento de cobran��as estudo de caso do Hospital Santa Maria do Porto

Trabalho de Projeto apresentado ao Instituto de Contabilidade e Administra����o do Porto para a obten����o do grau de Mestre em Auditoria, sob orienta����o de Doutora Alcina Dias

O Desterro - de convento seiscentista a hospital civil, quatro s��culos de hist��ria

Actas da Reuni��o Internacional de Hist��ria da Medicina; Lisboa - 2001

Legionnaires' disease in the renal transplant unit of "Hospital das Clinicas, FMUSP": during a five year period (1988-1993)

Several reports have related Legionella pneumophila with pneumonia in renal transplant patients, however this association has not been systematically documented in Brazil. Therefore this paper reports the incidence, by serologycal assays, of Legionella pneumophila serogroup 1 in these patients during a five year period. For this purpose sera from blood samples of 70 hospitalized patients with pneumonia from the Renal Transplant Unit of Hospital das Clinicas, FMUSP collected at the acute and convalescent phase of infection were submitted to indirect immunofluorescence assay (IFA) to demonstrate anti-Legionella pneumophila serogroup 1 antibodies. Of these 70 patients studied during the period of 1988 to 1993,18 (25.71 %) had significant rises in specific antibody titers for Legionella pneumophila serogroup 1. Incidence was interrupted following Hospital water decontamination procedures, with recurrence of infections after treatment interruption. In this study, the high susceptibility (25.71%) of immunodepressed renal transplant patients to Legionella pneumophila serogroup 1 nosocomial infections is documented. The importance of the implementation and maintenance of water decontamination measures for prophylaxis of the infection is also clearly evident.

Satisfa����o profissional e v��nculo laboral : prestadores de cuidados directos num hospital distrital

RESUMO - A flexibilidade dos contratos de trabalho �� cada vez mais uma realidade. Em 2009, cerca de 18% da popula����o activa em Portugal tinha um v��nculo inst��vel. Na institui����o onde se realizou o estudo, 38,8% dos profissionais de sa��de t��m este tipo de v��nculo. Este estudo foi realizado num hospital distrital com a participa����o de 103 prestadores de cuidados directos ��� assistentes operacionais, enfermeiros, m��dicos e t��cnicos de diagn��stico e terap��utica - aos quais foi dado um question��rio de auto-resposta. Atrav��s deste, fez-se a compara����o dos n��veis de satisfa����o dos profissionais com diferentes tipos de v��nculo. Concluiu-se que as dimens��es mais valorizadas s��o as relacionais e condi����es de trabalho e sa��de. A dimens��o da Seguran��a no Emprego surge no meio da tabela. Ao contr��rio do que dizem os estudos, a autonomia e poder foi das menos valorizadas. Os profissionais com v��nculo laboral inst��vel d��o maior import��ncia �� seguran��a. As dimens��es relacionais s��o as que apresentam maiores n��veis de satisfa����o. As que apresentam menores n��veis s��o a Remunera����o, Condi����es de Trabalho e Sa��de e Seguran��a no Emprego, sendo que nesta ultima se registam diferen��as significativas entre profissionais com diferentes tipos de v��nculo. Verifica-se com 95% de confian��a que existem diferen��as significativas na dimens��o da Seguran��a no Emprego, onde os profissionais com v��nculo inst��vel apresentam menores n��veis de satisfa����o. Os profissionais com v��nculo inst��vel demonstram que este facto lhes trouxe consequ��ncias negativas ao n��vel pessoal e social. N��o existe signific��ncia na diferen��a entre os n��veis da satisfa����o dos profissionais de sa��de com diferentes v��nculos. -----------------------------------ABSTRACT - Employment contract flexibility is becoming a reality with each passing day. In 2009, around 18% of the active population in Portugal had an unstable bond. In the institution where this study was conducted, 38.8% of the health professionals have this kind of arrangement. This study was conducted in a district hospital with the participation of 103 direct care providers - operating assistants, nurses, doctors and technical diagnostic and therapeutic - that were given a self-response questionnaire. Through this questionnaire, the levels of satisfaction of the professionals with different types of employment bond were compared. It was concluded that the most valued dimensions are relational and work and health conditions. Work security appears in the middle of the table. Contrary to what studies say, autonomy and power were less valued. Professionals with an unstable bond give greater importance to safety. The relational dimensions are those with higher levels of satisfaction. Those with lower levels are the wages, working conditions and health and safety in employment, where in health and safety in employment show significant differences between professionals with different types of employment bond. We can verify with a 95% confidence interval that there are significant differences in the work safety dimension, where professionals with unstable employment bonds present lower levels of satisfaction. Professionals with an unstable employment bond show that this fact brought them negative consequences at the personal and social level. There is no significant difference between the levels of satisfaction of health professionals with different types of employment bond.

Histoplasmosis in the Mu��iz Hospital of Buenos Aires

Some epidemiological and immunological characteristics and the methodology of diagnosis of 44 cases of histoplasmosis (HP); 36 (27 males and 9 women) associated with AIDS (HP+AIDS) and 8 (7 males and 1 female) with other predisposing factors (HP+non AIDS), diagnosed in the Mu��iz Hospital (MH) during 1994, were retrospectively studied. The median age (MA) of HP+AIDS patients was 28 years; 25.5 (22-40) in the women and 28.5 (20-42) in the men and 50 (22-58) years in the HP+non AIDS patients. The more frequent risk factors for HIV infection were intravenous drug addiction (55%) and homo/bisexuality (19%). The MA of these groups were 28 (20-39) and 41 (26-42) years, respectively. Tobaccoism was a predisposing factor in 83% of HP+non AIDS patients. The muco-cutaneous lesions scraping and blood-cultures established the initial diagnosis in 53% and 36% of HP+AIDS patients, respectively and the muco-cutaneous lesions biopsies in 75% of HP+non AIDS cases. At time of diagnosis, all HP+AIDS patients had <200 while HP+non AIDS patients had > 200 CD4 + lymphocytes/��l. Seventy two per cent of HP+AIDS patients were born in Buenos Aires (Bs As) city and 62% of HP+non AIDS patients were born in provinces of Argentina other than Bs As. At moment of diagnosis, 87.5% of HP+AIDS and 62.5% of HP+non AIDS patients lived in Bs As city and Bs As outskirts.

Localiza����o ��ptima do futuro Hospital de Sintra: aplica����o de modelos de location-allocation no planeamento de cuidados de sa��de.

Disserta����o apresentada como requisito parcial para obten����o do grau de Mestre em Ci��ncia e Sistemas de Informa����o Geogr��fica

Seropositivity for anti-Trypanosoma cruzi antibodies among blood donors of the "Hospital Universit��rio Regional do Norte do Paran��", Londrina, Brazil

The most frequent form of acquisition of Chagas' disease in endemic areas was the transmission through the feces of contaminated triatominae. However, special attention should be paid in urban areas to transmission by blood transfusion, justifying the compulsory screening of blood donors. Early investigations at blood banks in the town of Londrina, Brazil, demonstrated that the seroprevalence of anti-Trypanosoma cruzi antibodies among blood donors was approximately 7.0% in the fifties9,34. Further studies demonstrated pratically the same seroprevalence until the eighties4,32,41. In an attempt to obtain data about the real dimension of the seropositivity for anti-Trypasonoma cruzi antibodies in the region, the authors carried out a large-scale study on 45,774 serum samples from blood donors of the Hemocentro of Hospital Universit��rio Regional do Norte do Paran�� (HURNP), Universidade Estadual de Londrina. The immunological tests were done at the Division of Clinical Immunology of HURNP from May 1990 to December 1994. The serum samples were studied by the indirect hemagglutination assay (IHA, using kits commercially obtained from EBRAM) and by indirect immunofluorescence (IFI, using kits from LIO SERUM) with anti-human IgG conjugate (LABORCLIN). The results demonstrated that 643 serum samples were positive in both assay corresponding to a seroprevalence of 1.4%, i.e., a significant decrease in anti-Trypanosoma cruzi antibodies in the region in comparison with the previously mentioned rates. Data correlating sex and age of seropositive blood donors are presented, as well as the possible factors that may have contributed to the results observed.

PRESENCE OF ANTI-TOXOCARA ANTIBODIES IN CHILDREN SELECTED AT HOSPITAL UNIVERSIT��RIO, CAMPO GRANDE, MS, BRAZIL

Visceral Larva Migrans syndrome (VLM) results from the presence or migration of helminth larvae in humans, who nonetheless only play the role of paratenic hosts in the helminths' life cycle. In humans, VLM can be caused by larvae of various nematode species, chiefly those of the ascarid Toxocara canis, which can then be found at a variety of body sites, such as the liver, lungs, heart, and brain. Clinical and pathological manifestations depend primarily on larvae number and location, infection duration, reinfection occurrence, and host's immunological condition. Signs and symptoms may range from asymptomatic infection to severe disease. In humans, infection is acquired through ingestion of T. canis eggs present in soil, containing larvae in the infective stage7, 8, 9. Indeed, eggs of Toxocara sp. have been found in sandboxes in several public places in the city of Campo Grande, Mato Grosso do Sul state2. This study was carried out to detect the presence of anti-Toxocara antibodies in children attending the Pediatrics division of Hospital Universit��rio of Universidade Federal de Mato Grosso do Sul at Campo Grande, Brazil. Over the years 1992-94, 454 serum samples, obtained from children of 5.25 �� 3.28 years of mean age and selected at that hospital on the basis of eosinophil count greater than or equal to 1000/mm3 of blood, were tested for the presence of antibodies by means of the ELISA technique employing Toxocara canis larvae excretory-secretory antigens5. A high prevalence rate for toxocariasis (35.55%) was found, which was observed to be associated with eosinophil levels lower than those usually reported in literature. Furthermore, a higher frequency of positive serology among boys was also observed (13 cases in contrast to only 3 among girls), a result also reported by other authors

Talk on water ecological economics and participatory watershed governance

Disserta����o apresentada para obten����o do Grau de Doutor em Ambiente pela Universidade Nova de Lisboa, Faculdade de Ci��ncias e Tecnologia

O erro nos cuidados de enfermagem a indiv��duos internados numa unidade de cuidados intensivos - Estudo de caso sobre as representa����es dos actores de uma unidade p��s cir��rgica de um hospital portugu��s

Estima-se que em Portugal existam entre 1330 e 2900 mortes anuais devido a erros cometidos por equipas prestadoras de cuidados m��dicos, mais mortes do que por acidente de via����o, 1145 no ano 2006, ou devido ao v��rus da imunodefici��ncia humana (VIH), 873 no mesmo ano. V��rios autores afirmam que os enfermeiros s��o respons��veis por mais efeitos adversos evit��veis do que qualquer outro profissional de sa��de, por representarem uma percentagem significativa dos recursos humanos da sa��de e por passarem uma grande parte seu do tempo com os utentes. A complexidade das fun����es desempenhadas, o stress, a imprevisibilidade e a elevada tecnologia que caracterizam uma unidade de cuidados intensivos s��o reconhecidos como factores indutores de erros humanos e do sistema. Recorrendo a uma abordagem do tipo qualitativo, procurou-se compreender o erro em enfermagem numa Unidade de Cuidados Intensivos (UCI) dando voz aos actores directamente envolvidos. O m��todo seguido foi o estudo de caso, atrav��s do qual se pretendeu conhecer em profundidade o fen��meno em estudo, utilizando como t��cnica o grupo focal, procedendo-se �� posterior an��lise de conte��do das grava����es transcritas. Foi poss��vel constatar que os enfermeiros d��o principal relev��ncia aos erros de execu����o, comunica����o e viola����o de procedimentos, considerando na sua maioria que os erros de execu����o se devem geralmente a lapsos e falhas, enquanto os erros de planeamento e viola����o de procedimentos t��m origem essencialmente em falhas de informa����o e conhecimento. Embora pare��a existir uma vis��o sist��mica do erro, as consequ��ncias surgem frequentemente associadas ao profissional implicado.

Some aspects of dermatophytoses seen at University Hospital in Florian��polis, Santa Catarina, Brazil

Dermatophytoses comprise mycoses which are very frequently diagnosed in the routine of clinical laboratories of Florian��polis, like any other Brazilian cities. However, no clinical or epidemiological studies data have been published for that city so far. To partially clarify these questions, we carried out a study on this subject on patients who sought the mycology services of Hospital of Federal University of Santa Catarina, from January 1995 to November 1996. The most prevalent dermatophyte was Trichophyton rubrum (58.6%), followed by T. mentagrophytes (25.3%), Epidermophyton floccosum (7.2%), Microsporum canis (4.8%), T. tonsurans (1.6%) T. violaceum (1.6%) and M. gypseum (0.8%). The prevalence of T. mentagrophytes was significantly higher for females than for males, with a frequency of 37.3% and 16.0% respectively, which could be explained by higher infection of T. mentagrophytes in feet and nails, which were percentually more affected in females than in males. These results suggest that, in general, the clinical and epidemiological characteristics of dermatophytoses of our study have similar patterns of those occurring in other southern and southeastern Brazilian cities

Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition

Relative Frequency of Nosocomial Microorganisms at Unicamp University Hospital from 1987 to 1994

The frequency of microorganisms identified in nosocomial infections at Unicamp University Hospital from 1987 to 1994 was analysed. The most common microorganism was S. aureus (20.9%), which was found in surgical wound, bloodstream and arterial-venous infections. In urinary tract infections (UTI), gram-negative rods (56.5%) and yeasts (9%) predominated. A. baumannii isolates were observed to have increased in the last three years. There was a gradual increase in the frequency of coagulase-negative staphylococci and A. baumannii in bloodstream infections but there wasn��t any change in Candida sp

RubBer Contact Dermatitis in patients attended at Walter Cant��dio Hospital, Federal University of Cear��, Brasil

Nowadays 70% of the world's rubber supply is synthesized artificially. The process involved in its manufacture is vulcanization which requires many chemical substances for speeding the process, as antioxidants to prevent deterioration of rubber, or others. These substances may constitute important sensitizers and thus be responsible for dermatological diseases like contact dermatitis. The objective of this study is to search for the main sensitizers among these rubber chemicals in a population mostly composed by women of a tropical country and compare the results with the ones obtained from previous studies which tested populations mainly composed by men and on different climates.