Emergence agitation in pediatric anesthesia: current features

Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia.Summary of the findings: This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment.Conclusion: No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.

Turismo e pobreza: percepções dos guias de turismo, moradores e não moradores que trabalham na favela da Rocinha Rio de Janeiro

This project refers to a study somewhat controversial , as in focusing less recognized and valued hand, although the dynamics of tourism pass to take another view , you can not beforehand consider favorable or unfavorable . Analyzes the phenomenon related to conception or perception of poverty from tourism residents and non residents of the Favela of Rocinha in Rio de Janeiro tourist guides . It is a subject to an object of research somewhat controversial , but about which there is already an academic and scientific concern and deserves an investigator look. Fits as a qualitative study whose methodological procedure based on interviews and participant observation , and the geographic divisions chosen the Rocinha slum , for its expressiveness and for being a pioneer in this type of tourism , had to conducting fieldwork lasting six months, which was accompanied by at least four hours walking work of sixteen tour guides, eight residents and eight non- residents in the community, working for different travel agencies and tourism. End of each tour, all tour guides answered a semi-structured questionnaire, containing nineteen questions. Most respondents tour guides authorized record interview, which has made it possible to analyze the speech through spoken language. In tourism, foreign tourists are the main target, although rarely also count with the participation of domestic tourists. Notes that the relationship between poverty and slums, from the perceptions of tourist guides residents better reflects the reality of favela residents compared with non residents guides, since they fully know all the intricacies and better the difficulties they have endured and still go, when it comes to the issue of stigmatization respect, by which has suffered by Brazilian society, in relation to live in slums, and have your dwelling place as a tourist attraction. While presenting the social reality of Rocinha consistently during his work, the non residents guides worry about being as natural as possible with tourists as much as the locals show slum, in the same way they avoid authorize tourists to take compromising photos and that will expose the intimacy of community residents . Concludes that, while recognizing the importance of elevation to the rank of tourist attraction and its promising prospects, requires attention and priority, given the greater precariousness of the human condition in relation to the prime areas in which it operates tourism should be a vector of development, not a masking of reality

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.

Urgências em traumatismos dentários: classificação, características e procedimentos

OBJETIVO: Discutir os aspectos das urgências odontológicas relacionadas aos traumatismos dentários, disponibilizando mais informações para médicos pediatras ou plantonistas de serviços de atendimento de urgências e emergências. FONTES DE DADOS: O levantamento dos dados foi realizado na base de dados Pubmed e Bireme, selecionando os artigos dos últimos 13 anos. As palavras-chave utilizadas foram: traumatismo dentário, dente decíduo e dente permanente. Os critérios de inclusão utilizados foram: artigos em inglês e português sobre incidência, prevalência e etiologia, guias de procedimentos e casos clínicos apenas de traumatismo dentário, sendo excluídos artigos de clareamento de dentes traumatizados, traumas faciais ósseos e casos clínicos de acompanhamento reduzido. SÍNTESE DOS DADOS: Os dados foram descritos de forma concisa para se tornar um guia de fácil leitura e rápido acesso em relação à conduta, necessidade de atendimento imediato e correta escolha de soluções para armazenagem dos dentes e fragmentos. CONCLUSÕES: O conhecimento sobre o assunto, a agilidade no tratamento de urgência e o correto encaminhamento do paciente proporcionam melhor prognóstico.

Avaliação da prescrição médica em pediatria, baseada nos indicadores do uso de medicamentos selecionados pela oms em municipio do interior do estado de São Paulo

The World Health Organization (WHO) recommends that prescriptions of medicaments must be one parameter utilized to know how the medication is used by people. To do so, one specific methodology has been indicated, that is, the selected indicators of the use the medicaments. We applied this methodology with the aim of presenting a descriptive study of the physician prescription in Pediatric Clinic of the Health Basics Units. The results obtained are: the average number of medicaments prescribed with prescription was 2.6; the percentage of the medicaments prescribed with the generic name was 32%; the percentage of the prescriptions with antibiotics was 44.6%; the percentage of the prescriptions with injections was 10.4%; the percentage of the medicaments prescribed that are part of the municipal list was 22.8%, 27.5% for the program Dose Certs of the secretary of the State of São Paulo, and 50.4% by adding by adding the two lists. The essentiality of the medicaments prescribed may be considered very low, because only 32.6% appear in the RENAME. The percentage of the medicaments really dispensed was 39.9%. The medicaments more prescribed, according to the classification of the Anatomic-Therapeutic-Chemical (ATC), were the ones which acted in Respiratory System (26.8%), followed by anti-infectives for systemic use (16.4%) and by medicaments with acted in Alimentary tract and metabolism (15.8%). The conclusion is that the prescribers are moved by commercial influence of the drug makers, first because of the low prescription of medicaments by their generic name, second by the low number of medicaments effectively dispensed and then the low concordance between the ones prescribed and the ones included in the lists patterned by Tabatinga and by the State of São Paulo.

Uso do óxido nítrico em pediatria

Objective: To review the literature on inhaled nitric oxide and to describe its main clinical applications in pediatrics. Sources of data: A 10 year literature review with selection of the most important publications on inhaled nitric oxide, using the Medline and Cochrane Systematic Review databases. Summary of the findings: This review was organized as follows: introduction; metabolism and biological effects; clinical applications; dosage, gas administration and weaning; precautions and side-effects. Inhaled nitric oxide use was described in persistent pulmonary hypertension and hypoxia of the newborn, acute respiratory distress syndrome, primary pulmonary hypertension, heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease. Conclusions: Inhaled nitric oxide is a therapeutic approach with wide clinical applications in pediatrics. Its use is safe when administered in pediatric intensive care units under strict monitoring. As a pulmonary vasodilator, nitric oxide has beneficial effects on gas exchange and ventilation. Controlled trials, focusing on early gas administration should be performed under many clinical conditions, especially acute respiratory distress syndrome.

Pautas administrativas mínimas para unidades de información sobre población (servicios, recepción de material bibliográfico, etc.

Explica las tareas de tipo administrativo específicas de cada unidad: mantención de archivos manuales y computacionales; recepción de correspondencia, material bibliográfico, facturas; solicitud de entrega de documentos, de búsquedas por computador, etc. En anexos, incluye formularios y cartas tipo.

Estudo de caso dos manuais de instrução do pólo moveleiro de Arapongas/PR: uma contribuição do design informacional

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A influência do design na aplicação de forças manuais para abertura de embalagens plásticas de refrigerantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação de forças manuais em atividades simuladas com indivíduos adultos brasileiros de diferentes gêneros e faixas etárias: aspectos do design ergonômico. -

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)