Uso de rastreadores de eventos adversos a medicamentos para farmacovigilância no âmbito hospitalar

Eventos adversos a medicamentos (EAM) ainda são uma das principais limitações nos serviços de cuidados com a saúde, causando risco aos pacientes, além de grande impacto econômico. Assim, fazem-se necessários métodos de identificação de eventos adversos mais eficazes que a tradicional notificação espontânea, a qual revela apenas 5% do total de eventos. A utilização de critérios rastreadores (ou trigger tools), elaborados pelo Institute for Healthcare Improvement, tem se mostrado como a alternativa mais válida e eficiente para a triagem dos EAM. Com o objetivo principal de identificar os principais eventos adversos e medicamentos envolvidos, uma seleção de três critérios rastreadores foi utilizada, a saber: INR (razão normalizada internacional) > 6, WBC (contagem de leucócitos) < 3000/mm³ ou registros de episódios de sedação excessiva, letargia ou queda. Informações sobre os rastreadores foram coletadas e analisadas a partir dos prontuários de pacientes internados no Hospital Estadual Américo Brasiliense internados, de novembro de 2011 a janeiro de 2012 e maio a julho de 2012, a fim de se confirmar a ocorrência de evento adverso. Foram analisados prontuários referentes a 3318 hospitalizações, nas quais foram detectados 69 eventos adversos, 49 dos quais foram causados por apenas quatro das 12 classes de medicamentos envolvidos em algum EAM: anticoagulantes orais, relacionados ao rastreador INR>6 (eficácia = 0,75), sedativos e antipsicóticos, relacionados ao rastreador de sedação excessiva, letargia ou queda (eficácia = 0,52), e antivirais, relacionados ao rastreador WBC<3000 (eficácia = 0,48). Quando os rastreadores eram acionados e não estavam relacionados a EAM, os fatores de confusão mais recorrentes foram: torpor secundário ao quadro clínico, acidentes não relacionados ao medicamento e pacientes propositalmente em regime de sedação. Apesar de valores-limite menos radicais poderem aumentar a ...

O ensino profissional no Plano Nacional de Educação: as questões da oferta, do atendimento e da formação profissional

The aim of this paper is to discuss the issues of supply, service and training put in the brazilian National Education Plan (Law No. 10.172/2001), whose term expired in January 2011. Since a new project of the National Education Plan for the next decade, is currently under discussion in Congress, believe to be of paramount importance to examine which goals that have been achieved, which were partially achieved and what have not yet been achieved, always aiming to better development of professional education in Brazil, we consider mode of teaching still undervalued in the context of public education policies in Brazil.

Qualidade de vida e satisfação das gestantes portadoras de diabete em uso de insulina em hospital universitário do interior de São Paulo

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

A juventude fora da CASA: os jovens egressos do Centro de Atendimento Socioeducativo ao Adolescente - Fundação CASA

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

Extensão do modelo hipercubo para análise de sistemas de atendimento médico emergencial com prioridade na fila

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Formação de alunos universitários em políticas de atendimento a crianças e adolescentes

O Estatuto da Criança e do Adolescente (ECA) preconiza que crianças e adolescentes são sujeitos de direitos e que esses direitos precisam ser obrigatoriamente assegurados e efetivados. Para que o ECA seja efetivado, se faz necessário o conhecimento e compreensão sobre o que esse documento prevê. Assim, chama-se as instituições formadoras a assumirem seu o compromisso éticopolítico de formação da sociedade. Reflete-se, portanto, sobre a inquestionável necessidade da utilização de estudos e pesquisas dentro das Universidades para que se possa construir espaços de formação diferenciados. Neste contexto, a pesquisa desse Trabalho de Conclusão de Curso objetivou uma análise sobre a formação e influência na vida profissional e pessoal de alunos universitários que participaram de um curso de extensão denominado Formação de Agentes Sociais, Professores e alunos em Políticas de atendimento a Criança e ao Adolescente. Tratou-se de uma pesquisa qualitativa, com a utilização de três instrumentos de coleta de dados: um questionário inicial; observação e registro em Diário de Campo e entrevista individual semi-estruturada. Na análise dos dados, tem-se que a maioria dos sujeitos participantes da pesquisa afirmou que foram atendidas muitas de suas expectativas, que tiveram bom aproveitamento do curso, e que o mesmo trouxe grandes contribuições para seus processos de formação acadêmica, pessoal e profissional. Os resultados desse trabalho também indicaram a necessidade de que os conteúdos referentes ao ECA e a política de atendimento a criança e ao adolescente sejam incorporados aos cursos de formação básica profissional

Avaliação da eficácia do tratamento da cessação do tabagismo iniciado durante internação hospitalar em pacientes com doença cardiológica ou respiratória agudizada

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Procura espontânea de atendimento por idosos da Estratégia Saúde da Família: análise não linear do comportamento temporal das morbidades

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Parâmetros assistenciais em saúde bucal: comparação entre duas programações do atendimento clínico no serviço público

Objective: To compare two forms of scheduling clinical dental care for the oral health teams (OHT) included in the strategy of family health, regarding productive aspects of assistance. Methods: Two OHT worked concurrently, using two methods of clinical care: the parameter recommended by the Ministry of Health Ordinance No. 1101, 2002, which establishes 03 dental visits per hour (c/h) per team, and a Testing model, with 02 c/h, being each method applied for a period of 615 hours. The quantitative data was collected in OHTs’ daily production spreadsheets, covering the following items: the number of dental visits (initial, for maintenance and for emergency procedures), procedures performed, consumption of material and sterilization cycles. Data was compared and statistically analyzed through the BioStat 5.0 by applying the paired t-test (p <0.05). Results: Under the Ministerial method and the Testing model, were performed, respectively, 288 and 365 first dental visits, 921 and 686 return dental visits, 167 and 172 emergency dental attendances, with 469 and 110 fouls, 212 and 327 treatments were finished and 2501 and 3046 dental procedures were realized. Among eleven analyzed consumables, five were consumed in smaller quantities in the Testing model: gloves (9%), anesthesia (38%), anesthetic needle (34%), suture material (24%) and aspirators (11%), while the six remaining items presented similar consumption rates between the two models. Conclusions: The testing model revealed to be more productive and economical.

Aplicação de princípios de ergonomia no atendimento odontológico

The dentist has been suggested as a professional vulnerable to labor risks mainly related to working posture. This study examined the application of ergonomics principles during the dental attendances made by university student of the last period of the Araçatuba Dental University. Twenty-four attendants were photographed and the images were digitally analyzed for the verification of 10 requirements that determine a healthy labor posture, defined by the project ISO Standard / TC 106/SC 6 N 411. It was observed that 50% of items from the check list obtained higher percentages of negative replies. The students had greater difficulties as to the correct position of the angle between the upper and lower leg when sitting, the ideal adjustment of the light focus reflector in the field of work and the patient positioning. It was concluded that the dental attendances were held without compliance with the ergonomic requirements. The greatest difficulties regarding the work posture were the sitting posture, the light beam and the patient positioning. Students need better guidance about ergonomic principles and requirements, which should occur at any time of life, but earliest they are installed, greater the benefits, assimilation and incorporation of adequate working postures will be. We need a reform that addresses all sectors of the dental system, so that learning and application of ergonomics in dentistry become effective, efficient and effective.

Reflexões sobre a importância da assistência odontológica preventiva e do adequado treinamento dos Cirurgiões Dentistas para o atendimento de pessoas com deficiência

People with disabilities require special dental care according to the type of disability, degree of involvement of intellectual and motor complications, such individuals may have dental problems that require specific training of the dentist. The objective of this study was a literature review emphasizing the need for early and preventive dental treatment for people with disabilities and training and technical knowledge necessary for quality service performed by the dentist. The literature review was conducted primarily using articles published nationally, to establish the development of dentistry for special patients in Brazil, thus emphasizing some policies and measures adopted in certain areas of the country. It was concluded that preventive care is essential and that the projects of health promotion are important facilitators of social inclusion and provide increased success in dental care. Technical training of professionals is extremely important, therefore, be important to trace an appropriate treatment plan and establish communication with the multidisciplinary team involved in patient care.

Reflexões sobre o conceito de atendimento humanizado em Odontologia

Humanization at dental care is highly important due to uneven relation between scientific / technical advances in dentistry and thequality of human contact. The dental treatment goes beyond the field of scientific knowledge. Therefore, the dental treatment requiresbalance among technical skill, scientific training, and humanist vision of health promotion. Contemporarily, humanization is understoodas tripod based on user's rights, dental practice and organization of a humanized model. Curriculum integration of ethical, humanistic,scientific and technical contents is an important and current challenge on teaching / learning process for professionals at Dentistry. Thispaper aims to, guided by the literature review, to present some considerations on human care in dentistry, with emphasis on theimportance of professional /patient relationship for promoting oral health. It is suggested that dentists reflect on the urgent need ontheoretical basis of humanization and patient-professional relationship for health care.Descriptors: Humanization of Assistance; Dental Staff

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Práticas parentais e repertório infantil: caracterização da demanda por atendimento e predição de abandono

The objective of this paper is: (a) to characterize behaviors of the 47 primary caregivers and their children who sought for psychological services, (b) to compare groups: abandonment x participants; boy x girl. The participants answered the interview inventory (RE-HSE-P), inventory (IHS-Del Prette) and scales (Rathus Assertiveness Scale and CBCL). For the results, 60% of the children presented behavior problems at clinical level. There is correlation between negative parenting practices and behavior problems and social skills among caregivers (HSE-P) and children. People who drop out psychological services, present lower frequence and quality of HSE-P and more behavior problems. There are not differences in comparisons between boys and girls. The results highlight the importance of evaluating clinical context, the contingent behaviors of parents and children employing different instruments in order to describe the relationship between behavior problem and potentialities of both interlocutors socially interacting.