Humanização na Atenção à Saúde do Idoso

O artigo discute as práticas de assistência, políticas, estratégias e ações governamentais formalizadas para a saúde do idoso, visto que, embora o tema humanização se faça presente em várias discussões e que, inclusive, tornou-se diretriz da tão aclamada Política Nacional de Humanização, esses pacientes enfrentam, ainda, vários obstáculos para assegurar alguma assistência à saúde. À desinformação e ao desrespeito aos cidadãos da terceira idade somam-se a precariedade de investimentos públicos para atendimento às necessidades específicas dessa população, a falta de instalações adequadas, a carência de programas específicos e de recursos humanos. Dessa forma, faremos uma reflexão sobre a humanização na assistência à saúde focada nessa população, primeiramente fazendo um resgate da humanização nos diversos cenários do setor saúde, considerando a valorização dos diferentes sujeitos implicados nesse processo, para que o cuidado dessa especial e crescente fatia da população seja realizado de forma humanizada, visto ser este um paciente especial que requer um atendimento diferenciado.

Accurate Approach in the Treatment of Oral Bisphosphonate-Related Jaw Osteonecrosis

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is not completely understood and difficult to treat. Even though the occurrence of BRONJ is mainly related to the therapy with intravenous bisphosphonates (BPs), this article reports a case of long-term oral BP use and BRONJ occurrence. In addition, a literature review provides some additional information about BPs, BRONJ, and also a guideline for the prevention and treatment of BRONJ stages. A 79-year-old patient presented intense and persistent pain, purulent secretion, and exposed bone at the right side of the lower jaw. Thus, she was submitted to anamnesis, radiologic and tomographic examinations, and bacterial culture and sensitivity tests. These procedures were followed by surgical debridement of the bone and surrounding tissues/cyst and antibiotic prescription and histopathologic analysis of the fragments. Together, the examinations performed showed the occurrence of stage 2 BRONJ. Moreover, the antibiotic prescription, discontinuation of oral BP, and surgical procedures ensure that the patient had no more symptoms. Therefore, considering the presented case, we believe that an accurate approach is promising to diagnose and treat stage 2 BRONJ and other associated pathologic findings.

O ruído da unidade de terapia intensiva neonatal após a implementação de programa educativo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tunnelling behaviour of the Asian subterranean termite in heterogeneous soils: presence of cues in the foraging area

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Wastes released by tanneries at Patrocinio Paulista, São Paulo State, Brazil

This investigation was carried out within the Parana sedimentary basin, Brazil, and involved the sampling of sludge and residuary waters that were collected from reservoirs/decantation ponds settled in two tanneries situated at Patrocinio Paulista, São Paulo State Two samples from each tannery were collected, stored in appropriate flasks and transported to the LABIDRO for chemical analysis The LABIDRO (Laboratory of Isotopes and Hydrochemistry) of the Petrology Department at the Geosciences and Exacts Sciences Institute of UNESP is situated in Rio Claro city, about 240 km distant from the investigated area The data for residuary waters were compared with guideline values established by two different legislations (a) Rule No 12486 (NTA60) established in 20(th) October 1978 by São Paulo State for defining the potable water standards and (b) Register 997 published on 31 May 1976 that defines the permissible concentration limits in effluents to be released to water bodies (coastal, fresh or ground water) in São Paulo State The results confirmed that leather production is an activity with high environmental impact, despite improvements that may be achieved by tanneries

Hydrochemical evaluation of different spring waters for bottling

This investigation was carried out within the Parana sedimentary basin in São Paulo and Mato Grosso do Sul States, Brazil, and involved the sampling of different spring water samples with the purpose of evaluating their quality for bottling Several methods were utilized for acquiring the hydrochemical data, such as methyl orange end-point titration, potentiometry, ion selective electrodes, spectrophotometry, atomic absorption spectrophotometry and inductively coupled plasma spectrometry The results obtained for the analyzed samples were compared with the guideline values established by the São Paulo State and Brazilian Health Ministry legislations for defining the potable water standards The Brazilian Code for Mineral Waters that was established by Register 7841 published on 8 August 1945 was also taken into account for verifying if the spring waters are mineralized The hydrochemical data allowed the identification of anthropogenic and geogenic inputs of some constituents in most of the samples, which affected the water quality and did not allow them to be utilized for commercial purposes (bottling) The waters of these springs can only become appropriate for human consumption after previous chemical treatment

Natural radionuclides in major aquifer systems of the Parana sedimentary basin, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hydrochemical evaluation of the quality of some Brazilian waters

This investigation was carried out within the Parane sedimentary basin and neighbourhood in Brazil and involved the sampling of different water types with the purpose of evaluating its quality. Several methods were utilized for acquiring the hydrochemical data and a novel technique has been developed for evaluating the gross alpha and beta radioactivities in water, through a combined gamma-alpha spectrometry technique. The results obtained for the analyzed samples were compared with the guideline values established by the São Paulo State and Brazilian Health Ministry legislations for defining potable water standards and for the prevention and control of pollution in the environment. The hydrochemical data allowed evaluation of diverse problems related to the interaction between society and the environment such as sugarcane production and the releases associated with gas stations suppliers. The geogenic input of sulfate in groundwater was also identified. The established radiometric technique was properly calibrated and successfully applied to the analysis of different water types utilized for human consumption.

Efeito da implementação de diretriz para profilaxia de tromboembolismo venoso em pacientes cirúrgicos

INTRODUÇÃO: Estratégias efetivas para profilaxia do tromboembolismo venoso (TEV) são amplamente disponíveis, mas são ainda subutilizadas, principalmente no nosso meio. OBJETIVO: Avaliar o efeito da implementação de diretriz para profilaxia do TEV, em pacientes cirúrgicos, sobre a conduta da equipe de saúde na prescrição dessa profilaxia. Método. Estudo retrospectivo pré-intervenção - pós-intervenção. Prontuários de 150 pacientes antes e 150 depois da implementação de uma diretriz para a profilaxia (AID e DID) foram sorteados dentre pacientes de mais de 40 anos internados para cirurgia maior abdominal ou ortopédica. Foram registrados dados demográficos, referência a risco de TEV no prontuário, prescrição de profilaxia para TEV e diagnóstico de TEV durante a internação. RESULTADOS: Não houve diferença entre os dois grupos, AID e DID, quanto aos dados demográficos e ao tempo de profilaxia (5,6 x 6,6 dias). A frequência de profilaxia AID x DID antes da cirurgia foi: profilaxia farmacológica (PF), 6% x 9%; meias de compressão graduada (MCG), 4% x 3%; compressão pneumática intermitente (CPI), 2% x 3%. Após cirurgia: PF 53% x 53%; MCG, 23% x 40% (P<0,05); CPI, 26% x 32% . No total, AP, foi prescrita profilaxia para 60,5% dos pacientes AID e para 66,5% DID, mas a profilaxia foi considerada adequada em 34% dos pacientes AID e em 32% DID. Conclusão. A adoção do protocolo, embora com maior a preocupação com a profilaxia, traduzida pelo aumento na prescrição de MCG, melhorou minimamente sua qualidade, indicando a necessidade de outras intervenções ativas e contínuas para aumentar a aderência ao mesmo.

Recommended Guidelines for Submission, Trimming, Margin Evaluation, and Reporting of Tumor Biopsy Specimens in Veterinary Surgical Pathology

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.

Refining the intestinal motility test in mice to reduce animal stress

A new protocol using 3-h fast animal for intestinal motility test was developed in our laboratory aiming the 3R's concept to reduce the stress of animals. Our results may aid in formulating recommendations that can be included in revised guidelines with regard to fasting time of mice.

Princípios éticos na experimentação animal

The treatment of animals used in research or in education tests requires proper care, scientific judgment and qualified professionals to understand the needs of the animals and the special requirements of the research, tests, and educational programs. The established guidelines aim the development of knowledge necessary for the improvement of health and wellbeing of humans as well as animals to get precise and accurate results. The techniques should not be performed with inappropriate procedures that cause pain or suffering. Some principles should be considered to have an appropriate animal care and treatment.

Reflexão sobre o ensino farmacêutico

This paper aims to discuss the directions of pharmaceutical education based on the new curriculum guidelines from MEC (Ministry of Education - Brazil). In the recent past, Brazilian pharmaceutical faculties prioritized the formation of professional resources in specific modalities in detriment of pharmacist's private field: the prescription filling and delivery at the drugstore. In order to avoid repeating the same mistake it is necessary to develop new competence, allowing the graduates to develop skills to connect the scientific and technological knowledge to Brazilian social context. The new curriculum guidelines are about to finish a time when the undergraduate studies seemed to split the pharmacist into two different professionals: one for the clinical analysis and other for the pharmaceutical industry. The previous educational model, which supposedly allows for pharmaceutical care without providing a broad integral knowledge of health sciences, cannot be repeated in the new curriculum. However, teaching subjects in a superficial and segmented manner, replete of predictable and repetitive technical practices and without a skilled teaching staff, will give no improvement in pharmacists education care. It is clear that the return of the formation of specific human resources in the field won't happen in short time.

Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. Purpose: To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. Data sources: A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Study selection: Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Data synthesis: Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients ≥40 years-old with decreased mobility, and ≥1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. Conclusions: A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients. © 2007 Rocha et al, publisher and licensee Dove Medical Press Ltd.