Tumescent local anesthesia with ropivacaine in different concentrations in bitches undergoing mastectomy: plasma concentration and post-operative analgesia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cuidados essenciais e muitas vezes negligenciados na hospitalização de pequenos animais: nutrição e analgesia

The benefits of proper nutrition and analgesia are closely linked when it comes to animals that are suffering from any illness and are hospitalized. In patients who are ill or under the stress of hospitalization, increase secretion of glucagon, catecholamines, cortisol and growth hormone antagonize the effects of insulin, leading to hyperglycemia and degradation of tissue proteins to provide substrate for gluconeogenesis. These changes result in loss of lean body mass, reflecting negatively on tissue repair processes, immune response and prognosis. Likewise, the pain induced by noxious stimulation can lead to protein catabolism, stress, immunosupression, delayed wound healing and acceleration of disease processes. This review confirms the nutrition and pain control importance in hospitalized patients, showing their physiological benefits and reduction in hospital stay when the clinician understands these benefits and the animals are treated with such care

Cuidado ao paciente idoso hospitalizado: implicações para a equipe de enfermagem

The Brazilian population is ageing rapidly, and chronic diseases have increased. Due to deficient health care services, the diagnosis and treatment of such diseases occur in the tertiary level, which increases costs and reduces the possibilities of early diagnoses. In view of the elderly population‟s increase and of the great demand at hospitalization units, it is important to learn about the difficulties and facilities faced by nursing teams when giving care to hospitalized individuals. In order to reach the objectives, a cross-sectional, prospective, descriptive, analytical and qualitative study was performed with basis on Bardin‟s Content Analysis. Among the difficulties were patients‟ limitations, dependence level, behaviors and habits, interference from companions, feeling of abandonment, perception of needs, dealing with suffering and lack of time for adequate care. As to facilities, acceptance of the disease, adherence to treatment, collaboration, trust in the team, and older patients‟ politeness were reported, which shows that passiveness is an important indicator in caring for the elderly. Older individuals suffer the outcomes of certain physical, psychological and mental deficits. When facing disease conditions, they require special care, including hospitalization and greater attention. The nursing team provides daily care and follows patients‟ development; however, its members are still not knowledgeable enough about the ageing process. This contributes to increase prejudice and erroneous stereotypes about older persons. Therefore, not understanding such process compromises the full care to be provided to older patients. This leads team members to accelerate the care provision process in order to meet the daily work demand, thus compromising older patients‟ autonomy and making them more dependent on the team, whereas the process should follow the opposite path

O câncer e as alterações no estado nutricional do paciente: importância da atenção farmacêutica

O Câncer é uma doença epidêmica e multifatorial. O uso combinado ou não de cirurgia, radioterapia e quimioterapia formam o alicerce sobre o qual se assentam a quase totalidade dos tratamentos contra os mais variados tipos de câncer. Essas terapêuticas quase sempre são agressivas, o que leva a uma ameaça séria à integridade física, sabidamente associada a problemas nutricionais. Pela legislação RDC nº220, publicada pela Agência Nacional de Vigilância Sanitária (ANVISA) em 21 de setembro de 2004, que regulamenta os estabelecimentos públicos e privados do país que realizam tratamento de quimioterapia antineoplásica, o farmacêutico deve fazer parte da equipe multiprofissional em terapia antineoplásica, como responsável pela manipulação de todos os antineoplásicos. Levando isso em consideração, o trabalho realiza uma descrição geral desde o desenvolvimento da doença, passando pelos principais agentes causadores e destaca a importância da terapia nutricional, principalmente no período pós-tratamento que influencia diretamente na morbi-mortalidade do câncer. Associando conhecimentos interdisciplinares entendemos que o farmacêutico possa exercer além da manipulação de drogas, a atenção farmacêutica contribuindo positivamente na equipe de saúde, visando uma maior adesão ao tratamento além do aumento da qualidade de vida do paciente oncológico. A partir do levantamento bibliográfico apresentado ampliamos a compreensão da complexidade dos mecanismos da doença, a importância da Terapia Nutricional e o Papel que o profissional farmacêutico pode desempenhar nesse campo

Conduta do paciente hipertenso frente ao tratamento clínico

The urbanization process established in Brazilian society since the middle of last century brought changes in the population habits and customs, which was responsible for the increased of chronic diseases incidence, such as arterial hypertension, for example. Although this is a common disease nowadays, it is still difficult to establish a significant control in subjects with this disease and its consequences. This is apparently due to lack of interest to the correct plan of care developed for the treatment of this disease. The nursing consultation identifies potential problematic situations and the patient needs, setting actions that are complementary to their benefit in order to promote health. The present work aims to observe how the nursing consultation is being used as strategy for patients with arterial hypertension, and to understand the difficulties faced during treatment of these patients. For this purpose, it was performed qualitative and quantitative studies with patients from Centro Saúde Escola (CSE), Unidade Auxiliar, Faculdade de Medicina de Botucatu, UNESP, located in Botucatu, employing as methodology the Discourse of the Collective Subject and descriptive statistical analysis of quantitative results. The vast majority of consultations were held by medical professionals and it was observed that the multidisciplinary work still needs to be recognized and valued by users. The lack of knowledge of some individuals in relation to the potential and importance of the nursing consultation occurs not only for the treatment of arterial hypertension, but for the treatment and monitoring of the individual as a whole. Therefore, it is still necessary to clarify the true essence and necessity of the nursing consultation, since so important tool should be used in its entirely. Moreover, the role of the multidisciplinary team should be more discussed

Uso da morfina na analgesia de equinos

Pain control is an important aspect of equine medicine. Musculoskeletal and gastrointestinal diseases are the most important clinical and surgical painful situations in this specie. In these cases, opioids have been used successfully for the treatment of pain, administered both local (intra-articular and epidural) and systemically. Otherwise, opioids, specially mu agonists like morphine, present important side effects in horses. Amongst these effects, CNS stimulation with increased motor activity and impairment of intestinal motility are observed in several cases. Therefore, adequate dosing of administration are essential for the safe use of opioids in horses

Bloqueios anestésicos perineurais da região distal do membro torácico do equino para diagnóstico em claudicações

This work demonstrates the technique of perineural anesthetic blocks made in the distal forelimb of the horse, and also covers aspects relating to the interpretation of the results obtained with the procedure. The limit of the subject the distal forelimb of horses is explained by the distribution of common lameness, being more frequent in this region. The procedure is intended to provide analgesia to a region of the limb, causing the animal to stop limping or decrease the intensity of claudication temporarily, since this region is responsible for the claudication, allowing thus, the likely location of the lesion, which may be investigated by other helper methods to confirm the diagnosis. Besides the description of the technique, were approached concerning aspects to the location of the anatomical structures involved, materials needed, cares with the animals, and possible complications from the procedure

Comparação de dois métodos de profilaxia dental: avaliação da pressão arterial e do conforto do paciente. Ensaio clínico controlado e randomizado

GOALS: This research evaluated the change in arterial pressure before and after two procedures of dental prophylaxis: Jet system baking soda and conventional prophylaxis and patient's opinion regarding the comfort of each one. MATERIAL AND METHOD: Were selected 32 patients with age between 18 to 30 years old, who need prophylaxis to remove biofilm and were subjected to three different types of treatment: sodium bicarbonate jet (G1), prophylaxis conventional (G2) and placebo (G3) at intervals of one month between them. Patients were divided randomly. Arterial pressure was measured by wrist digital Omron HEM – 6111. The measurements were realized in four times: before the prophylaxis, immediately the end of procedure, 15 and 30 minutes after finished of treatment. Patient comfort was measured by a Visual Analog Scale (VAS) after the end of the treatment. The data were analyzed using the variance test. The results showed that there was statistically significant difference to the comfort of the procedures. RESULTS: There was a statistically significant difference to the comfort of the procedures, and G2 and G3 better than G1. Regarding the variation of arterial pressure there was no statistically significant difference between groups. CONCLUSIONS: The methods of prophylaxis no effect on arterial pressure, but conventional prophylaxis is more comfortable than others treatments

Avaliação da eficácia da analgesia com acupuntura pela análise imuno-histoquimica da expressão de proteína C-Fos: estudo em modelo experimental de dor aguda em ratos

The behavior and experience of pain are characterized by alertness and anxiety, which disappear soon after the healing process begins. Based on this area, the present study aimed to quantify the expression of c-fos in segments of the brain of rats after surgical stimulation in one rear hind paw (analgesia), using anesthesia with sodium thiopental and practices of acupuncture pre and post operative. The animals were stimulated with intraperitoneal injections of solution (NaCl) 0.2% (2ml), and divided into three groups, control, preoperative and postoperative. Each treatment was divided in manual acupuncture (AM) and electroacupuncture (EA). The animals were randomly distributed in each group. The c-fos expression was quantitated using immunohistochemistry for all situations. The results showed a great efficiency of all treatment compared to the control group (p <0.001), thus reenforcing data in the literature on the potential of acupuncture analgesia. There were no statistical differences among the different treatments, although there was a trend of EA being more efficient than AM

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)

Síntese de microesferas de quitosana para aplicação em liberação controlada de drogas pelo método de atomização e coagulação

Chitosan is a natural biodegradable polymer with great potential for pharmaceutical applications due to its biocompatibility, high charge density , nontoxicity and mucoadhesion. Gel formation can be obtained by the interactions of chitosans with low molecular counterions such as polyphosphates, sulphates and crosslinking with glutaraldehyde. This gelling property of chitosan allows a wide range of applications such as coating of pharmaceuticals and food products, gel entrapment of biochemicals, whole cells, microorganisms and algae. One of its main applications is the synthesis of microspheres for coating of pharmaceuticals , magnetic particles an other substances. In such a way, we can build targeted drug delivery systems. In the present work, we applied the method of spraying and coagulation. The resulting microspheres, then, were characterized by optical microscopy

Humanização da assistência ao paciente crítico: revisão integrativa da literatura

This study aimed at analyzing the scientific production on health care humanization in intensive-care and emergency units based on publications in national journals. Therefore, this is an integrative review of the national literature. The online database Literatura Latino-Americana do Caribe em Ciências da Saúde - Literature in the Health Sciences in Latin America and the Caribbean (LILACS) based on the Health Virtual Library (BVS) platform was used to select articles. The final sample in this review consisted of 21 articles. The presentation of results and data discussion was descriptively performed and divided into three themes: communication with relatives and the team, caregiver humanization and, finally, the difficulties faced to implement humanization. As regards communication, it is seen by the authors as a fundamental strategy to ensure quality in intensive care, and it is placed as a central axis in the humanization policy. Concerning caregiver humanization, the physical and mental overload resulting from the work process in these units are factors that interfere with personal relations between team members as well as with that between team members and patients. Among the difficulties faced for implementing humanized care for critical patients are the units’s physical and organizational structures, technology and health care professionals’ education, which is centered on the biomedical model. It was concluded that communication is considered to be fundamental for humanization of the care provided to critical patients, since it allows for the development of a network of meanings between patients, the team, families and the establishment. In order to implement care with humanized actions in urgency and emergency sectors, particularly in ICUs, it is necessary to change organizational culture and value health care professionals

Híbridos contendo nanopartículas de ZnO dopadas com Co para potencial liberação controlada de fármaco anticancerígeno

O câncer é uma patologia crescente entre a população atual e segundo a Organização Mundial da Saúde (OMS) está entre as principais causa de morte mundialmente. A relevância do perfil epidemiológico dessa doença desperta interesse em desenvolver materiais que forneçam qualidade de diagnóstico e tratamento. Na busca pela qualidade da saúde, o desenvolvimento de materiais que possam liberar fármacos de forma controlada e em um sítio alvo, tem se tornado cada vez mais intensa, pois estes materiais podem diminuir os efeitos colaterais além de aumentar a porcentagem do medicamento em ação direta com o sítio alvo. Neste contexto, materiais poliméricos híbridos orgânico-inorgânicos do tipo ureasil-poliéter que são biocompatíveis, transparentes e flexíveis permitem a incorporação de uma série de compostos, dentre os quais, nanopartículas e fármacos. Com base nestes argumentos, neste trabalho foi desenvolvido dispositivo de liberação controlada de fármacos formado por materiais poliméricos ureasil-poliéter contendo nanopartículas de ZnO dopadas com cobalto. A conjugação destes diferentes materiais teve como objetivo conferir as propriedades individuais de cada componente no mesmo material: o cobalto devido as suas propriedades magnéticas pode guiar o dispositivo de liberação de fármaco até o órgão doente; o ZnO devido às propriedades luminescentes permite monitorar a posição do dispositivo dentro do corpo humano.

Síntese e aplicações de inibidores peptídicos de topoisomerases associados a sistemas de liberação controlada de fármacos

O uso de novas tecnologias para o desenvolvimento de medicamentos constitui uma estratégia promissora no campo da biotecnologia. Nesse sentido, peptídeos com efeito antimicrobiano, produzidos por plantas, animais e microrganismos estão sendo utilizados como modelos para o desenvolvimento de novos medicamentos com aplicações em saúde. Resultados promissores têm sido obtidos em relação à inibição da atividade das enzimas bacterianas DNA girase e topoisomerase IV por derivados peptídicos de toxinas bacterianas, comprovados em ensaios in vitro. Porém, ensaios in vivo não demonstraram reprodutibilidade, basicamente devido à baixa permeabilidade da célula bacteriana a estes compostos. Desta forma, o objetivo deste projeto consiste em aplicar sistemas eficientes para promover o acesso de moléculas peptídicas sintéticas derivadas de toxinas bacterianas, ao meio intracelular e, consequentemente, aos seus alvos intracelulares: as enzimas DNA girase e/ou topoisomerase IV. Com isso, pretendemos solucionar a barreira técnica em que se encontram as aplicações dessa classe de biomoléculas como precursores de novos agentes antibacterianos, o que certamente causaria um importante avanço nas pesquisas desenvolvidas pelo grupo

Análise de dez anos de utilização de serviços de saúde por uma coorte de pacientes diagnosticados com hipertensão arterial, no CSE - Botucatu, em 1995

The arterial hypertension is a chronic disease, which can be controlled by changing the way of life, as well as by drug treatment, which demand specific Health Care sequence. The lack of adherence to sequence/treatment is one of the main obstacles the disease control. Characterize and analyze the profile of Health Care usage by a 192 patient cohort diagnosed with arterial hypertension in 1995, between the period of 2001 – 2005 and 2006 – 2010. It is a longitudinal study, retrospective and descriptive developed on School Health Center(SHC) which belongs to School of Medicine Botucatu –UNESP, in continuity of the previous research which has analyzed the sequence of the referred sample between the period of 1995 – 1999. The database was obtained from the patients records by using structured adapted forms appointed in the previous study phase. In the case there were transfers to other Health Care facilities, the database was obtained by the records either, while the patients attended the CSE. The database was analyzed by means of descriptive statistics. Predominated the patients in the age from 50 – 69 (47,9%), whites (93,2%), female (56,7%) with low level of education (72,7%). In the period of 2001 - 2005, 76 (39,5%) of the patients remained under sequence, and that 44 (22,9%) belonged to adherence group (GAD), 17 belonged to abandonment/adherent group (GAB/GAD) and 15 to the abandonment group (GAB), groups which were already identified by the study which has analyzed the period of 1995 – 1999. At the end of the third period of the sample sequence (2006 – 2010), 60 (31,2%) of the patients kept under medical sequence. The cohort’s mortality rate in the period reached 15,1% and 21,9% were transferred to other Municipal Health Care facilities. We conclude that the Health Care service usage by the 192 sample’s integrants kept the same model already identified in the previous analysis... (Complete abstract click electronic access below)