Eventos adversos em terapia medicamentosa em Unidade de Terapia Intensiva - UTI

Due to the complexity and instability of clinical conditions of ICU patients, the drug therapy applied in this type of environment requires a combination of several prescribed drugs, which is a favorable condition for drug interaction, toxic synergism and possible iatrogenia. In the possible universe of ICU occurrences, this study aimed at identifying and evaluating the incidence of adverse events in drug therapy at the Intensive Care Therapy Service (SETI) in wards I and II. It is a cross-sectional, descriptive, prospective and quantitative study conducted from August to September, 2011 in the Intensive Care Service of the Botucatu School of Medicine University Hospital - UNESP. The population consisted of fifteen clinical nurses, including those in the Improvement and Volunteer Internship Programs, who contributed to the investigation after signing an informed consent form and according to approval by the Research Ethics Committee number 10711/CE - FMB. The data were entered on a form and analyzed. Results showed that, on average, 8.9% of events/day occurred, and the highest frequency was observed on August 04, 2011. 63% and 22% were respectively observed in the morning and afternoon shifts, and 15% in the night shift. 48% of these were due to administration time errors, followed by drug prescription and dispensation errors, with percentages of 22% and 18%, respectively. Antibiotics showed the highest frequency of adverse events - 18%, which was followed by 13% for anticoagulant, 11% for antiemetic and 10% for antiulcerative drugs. As regards the occurrence of adverse events related to hospitalization time, the highest frequency occurred in patients who were hospitalized for 10 days. Concerning the ratio between reported events and the number of items in the prescription, the highest frequency of events was related to prescriptions with 20 items... (Complete abstract click electronic access below)

Opinião de familiares sobre a internação de crianças em uma Unidade de Terapia Intensiva Pediátrica

A Pediatric Intensive care Unit (PICU) is an environment where care is provided to seriously ill children. Hospitalization is regarded as an unpleasant experience that requires adaptation and routine change. To assess the opinion of relatives of children hospitalized at a PICU concerning tie breakage and/or separation between children and their families. It is a descriptive, cross-sectional, quantitative study. A structured interview was conducted with the families of hospitalized children from July to September, 2010. The data were statistically analyzed. RESULTS: Twenty relatives were interviewed, 80% of whom believed that children’s behavior changes when they are present in the unit, and 85% considered the visitation time established to be sufficient. All the respondents reported to be satisfied about the care provided. The feelings prevailing in 50% of the relatives were fear and hope. Change in the family’s union after hospitalization occurred in 85% of the families. The most fearful aspect concerning the ICU is the equipment (25%), and the most worrisome, as regards personal life, is the separation from other children (65%). Health care professionals must pay more attention to relatives by including them in their health care plan so that the health care team and the family, who are essential in children’s recovery, can interact in a congenial fashion. It is also necessary to improve the knowledge related to that subject so that the health care team and families can work together towards children’s recovery

Susceptibilidade do Staphylococcus aureus à terapia fotodinâmica (PDT)

A terapia fotodinâmica (PDT), de maneira simplificada pode ser aplicada utilizando um fotossensibilizador (FS) e uma fonte de luz com comprimento de onda específico, que combinados na presença do oxigênio produzem espécies citotóxicas que causam o dano celular. O objetivo deste estudo piloto foi verificar a susceptibilidade de Staphylococcus aureus (ATCC 25923) à PDT, empregando diferentes concentrações de azul de metileno. As amostras desta bactéria foram sensibilizadas com azul de metileno nas concentrações de 6,25 μg/mL; 12,5 μg/mL; 25,0 μg/mL; 50,0 μg/mL; 100,0 μg/mL e 200,0 μg/mL e expostas à luz LED vermelha (660nm) por 20 minutos. Após o tratamento de todos os grupos estudados a fração de sobrevivência foi calculada pela contagem das unidades formadoras de colônia (UFC). O resultado deste estudo mostrou que o fotossensibilizador no escuro foi tóxico (dark toxicity) nas concentrações de 100 e 200 μg/mL. Já no grupo onde utilizamos apenas a luz, não houve redução bacteriana significativa. Entretanto, o uso combinado do AM e da luz LED (Grupo PDT) mostrou que todas as concentrações testadas causaram uma redução significativa de S aureus. Desta forma concluímos que a terapia fotodinâmica antimicrobiana pode ser um tratamento alternativo para redução de Staphylococcus aureus.

Depressão e apoio social percebido por mães de crianças hospitalizadas

This study was performed as a requirement of the final course in Nursing. The study is cross-cutting, in order to identify associations between socioeconomic factors, education, child hospitalization in the ICU or not, degree of depression and level of social support (material, affective, emotional, informational and positive social interaction) and how to identify subgroups of mother - child vulnerable. Constitute themselves as subjects, mothers of children 0 to 17 years, 11 months and 29 days in hospital after the second day of hospitalization in the pediatric unit of a State Hospital Interior Paulista. Data collection was initiated after obtaining the assent of the Research Ethics Committee, as well as signing the consent form. We used the following instruments to collect data: the data form for socioeconomic and hospitalization; Beck Depression Inventory and Medical Outcomes Study (MOS). We obtained the result that there is a strong association between availability and social support and income per capita and the degree of depression, but did not find an association between time and hospital stay and whether the child was admitted to the ICU or not. We conclude that it is necessary to establish treatment services from the patient’s family, plus an appropriate social service support to meet this big demand for mothers who need support

Relação solo-paisagem em um transecto da depressão periférica e do planalto ocidental, região de Rio Claro (SP)

As unidades de paisagens naturais se diferenciam pelo relevo, clima, cobertura vegetal, solos ou até mesmo pelo arranjo estrutural e do tipo de litologia. A caracterização pedológica e o entendimento das relações entre pedologia, geologia e geomorfologia são importantes para a compreensão da distribuição dos solos numa paisagem. Considerando esta como sendo uma combinação dinâmica e instável de elementos físicos, biológicos e antrópicos, e estando em constante evolução, realizou-se o estudo das características químicas, físicas, mineralógicas e morfológicas das coberturas superficiais de uma mesma Unidade Fisiográfica na região do Planalto Ocidental e da Depressão Periférica Paulista nas proximidades de Rio Claro – SP, para a compreensão de suas relações genéticas e cronológicas na evolução das paisagens da área. Para isso foram comparados os solos de dois transectos dentro dos compartimentos, levantando e analisando as características citadas para que se possa obter informações que permitiram o diagnóstico da evolução da área, visando contribuir para o avanço das coberturas superficiais e sua relação com a evolução da paisagem. Foi possível compreender determinados processos e produtos que deram origem às coberturas superficiais e consequentemente a algumas paisagens representativas da Quadrícula de São Carlos a partir dos métodos empregados. O estudo das coberturas de alteração intempérica da região centro-oeste paulista, e seu reconhecimento, são fundamentais para o ordenamento territorial e seu planejamento regional

Desenvolvimento e estabilidade de formulações semi-solidas contendo extratos de soja (Glycine max (L) Merr.)

Alguns vegetais, como a soja (Glycine max L. Merr), despertam interesse, pois fornecem, entre outras substâncias, as isoflavonas, que apresentam importantes propriedades estrogênicas e, também, atuam como antioxidantes, antifúngicos e anticancerígenos. A menopausa, causada pela deficiência hormonal, é acompanhada de vários transtornos metabólicos, como perda de massa óssea, fenômenos vasomotores, dislipidemia, resistência insulínica, ganho de peso, depressão e aceleração do envelhecimento cutâneo. A terapia de reposição hormonal (TRH) é eficaz, embora possa causar efeitos secundários, como câncer de mama. Nestes casos, a fitoterapia com fitormônios por via cutânea é uma alternativa importante. Dentre as preparações de uso tópico, sistemas emulsionados e géis são muito utilizados, pois favorecem a solubilidade e a estabilidade de fármacos. Para avaliar a estabilidade das formulações, foram consideradas as características organolépticas (aspecto, cor, odor) e as características físico-químicas (valor de pH, viscosidade e densidade, etc.), separação de fases e/ou coalescência. Algumas formulações apresentam-se com características desejáveis e adequadas para a veiculação de isoflavonas presentes em extrato de soja, podendo-se sugeri-las como sistemas adequados e estáveis para sua veiculação pela via dérmica

Redução bacteriana via terapia fotodinâmica

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

Terapia transfusional em pequenos animais

Blood transfusion is a very important therapeutic and profilatic procedure. However, the most part of the transfusions in animals in Brazil are done with total blood. The transfusion therapy made in an appropriate way, with hemotherapic products, can save lives and warranties a better health to patients. In all transfusion procedures, the cross match test must be done because there are lots of different blood group types, based on erythrocytes antigen. A slow infusion rate and intensive patient monitoration help to prevent transfusion reactions, mainly hemolytic reactions

Terapia fotodinâmica e luz branca: aspectos analíticos e perspectivas da viabilidade do tratamento

Photodynamic Therapy (PDT) is a technique used to treat several types of lesions, such as cancer, microbial control, and esthetic dentistry cases. The performance of PDT involves the use of a photosensitizer (PS), which mainly will be located in cancer cells and is irradiated with visible light. This process, when it occurs in the presence of oxygen triggers the formation of reactive oxygen species that are cytotoxic to cells. These species cause cell death and subsequent tumor necrosis. The use of white light as a light source for multispectral Photodynamic Therapy and its consequences to the photodynamic effect is not yet completely established, and therefore there is interest in studying the parameters involved for analyzing the best conditions for applying treatment. The wavelength is crucial to improve the therapeutic effect, since both the optical properties of the biological tissue as the PS depend on these parameters. For FS studied in this work (Photogem®) are most often used wavelengths in the red region, due to their larger penetration depth in biological tissue. Thus, the light source becomes a fundamental aspect, their choice depends on the specific application and is based on the tumor location, light dose to be delivered and FS chosen. Despite all the advantages presented by lasers, the fact of having an emission spectrum essentially monochrome makes only one possible transition possible for the absorption of FS is used. Therefore, more extensive light sources such as light emitting diodes (LED), could be better used in some cases the laser, with the additional advantage of a reduced cost. Therefore, the choice of the white LED comes from an emission spectrum that still wider LED colors defined by allowing greater use of the several absorption bands and with varying depths of operation, according to the wavelength... (Complete abstract click electronic access below)

Confecção e caracterização de filmes finos de boro para a medida da taxa de reação 10B(N, a)7LI na terapia por captura de nêutrons pelo boro

The Boron Neutron Capture Therapy (BNCT), based on the 10B(n,α)7Li reaction, represents a promising modality for the treatment of cancers that are resistents to conventional treatments. So, it is necessary to find drugs (boron compounds) with high selectivity for each type of cancer, the neutrons source should be well characterized and the rate of 10B(n,α)7Li reaction should be measured with great accuracy as possible. This study aimed to develop a method for manufacturing thin films of boron, for measure the 10B(n,α)7Li reaction, and analyze the uniformity of the films. Five thin films of boron were manufactured with three different concentrations of boric acid, heated to transform the acid in boron, irradiated with thermic neutrons coupled to CR-39 detectors, in BNCT line at the reactor IEA-R1 IPEN/CNEN, São Paulo. After the irradiation, the detectors were chemically attacked with NaOH to reveal the tracks. The methodology presented is effective because it resulted in deposition of boron as thin film enabling the quantitative analysis of 10B(n,α)7Li reaction. The analysis of the uniformity of density of the induced tracks in CR-39 shows that, in most of the films, there is no uniformity in surface distribution of boron, but when the film is divided, we obtain some uniform sectors

Terapia do diabetes mellitus em cães

Diabetes Mellitus is caracterized by a disturbance on endocrine pâncreas with reduction in serum levels of insulin. The deficiency or absence of insulin promotes alterations in the metabolism of carbohydrates, lipidis and proteins. The most common clinical signs of disease are polyuria, polydipsia, polyphagia and loses of weight. The diagnosis is made based on clinical symptoms, with laboratory confirmation through persistent hyperglycemia on fasting and glycosuria. Treatment includes insulin therapy, diet, exercise and oral hypoglycemic agents in an attempt to reverse the catabolic effects associated with deficiency or antagonism of insulin and restore normal homeostasis of the metabolism of proteins, lipids and carbohydrates

Diagnósticos de Enfermagem Prevalentes de Pacientes em Pós-Operatório de Cirurgia Bariátrica em uma Unidade de Terapia Intensiva

The goal of this study is to characterize the clinical outline of patients in postoperative of bariatric surgery attended in an Intensive Care Unit and identify the nursing diagnosis presented by these patients in accordance to Taxonomy II of North American Nursing Diagnosis Association (NANDA). This is a transversal, descriptive and prospective study that was desenvolved at the Intensive Care Unit of the Clinical Hospital of Botucatu Medical School – UNESP. The population was composed by all the patients who were submitted to the bariatric surgery and were attended at the Intensive Care Unit in the period between June and August of 2010, totalizing 13 patients. The data were collected based on the Nursing History that is composed by the Anamnesis, Physical Examination and Complementary Exams. The results were worked out: a) among the 13 patients studied, 10 are women (76,9%) and 3 men (23,1%); the majority is between 30 and 40 years old; 11 people of 13 are morbid obese, which means that they have Body Mass Index higher than 40 kg/m2; b) It was identified 22 nursing diagnosis and 14 of these were found in 100% of the patients. They belong to the dominions of Activity/Rest, Comfort, Elimination and Changing, Security and Protection, Functions and Relationships. Therefore, in relation to the factors, it was conclude that nursing diagnosis help nurses to understand the unsettled human answers or the risks to disturbance in an individual way, which contributes to plan specific interventions to these patients. It was possible to verify that the stage of the nursing diagnosis that is part of the nursing process should be executed by the nurses systematically, because it has been realized by the nurses’ clinical idea, but not in a systematical way

Morte e morrer: opinião dos profissionais de saúde de uma unidade de terapia intensiva pediátrica

Presently, the dying process and death most often occur in hospitals and, particularly, in Intensive Care Units (ICU), where patients’ lives are prolonged thanks to advanced technological devices and highly efficient medicines. To learn about the opinion of health care professionals working at a Pediatric Intensive Care Unit in relation to the dying process and dying. This is a descriptive quantitative study. A questionnaire was applied to the unit’s staff members from June to August, 2011. Data were statistically analyzed. Twenty-five professionals answered the questionnaire, and 72% faced death as a natural life process. 60% felt compassion, but that feeling did not interfere with how they cared for patients. Concerning their professional training, 52% reported not to have received any concerning patients’ caregivers in the dying process or death; therefore, they experienced such situation when they were already working, and 76% reported to be interested in updating courses on that theme. Further discussion about this topic during academic education is necessary. It is also necessary to provide health care professionals with specialization courses, debates and experience exchange so that they can better understand and deal with their feelings and limitations in face of death and thus give better care to patients and relate to patients’ families during the dying process of a loved one

Intervenção Farmacêutica na Terapia Antirretroviral (TARV) em Pacientes Não cumpridores

No Brasil, 190.000 pacientes HIV+ utilizam a terapia antirretroviral. Embora a distribuição da medicação seja gratuita, o problema enfrentado é a não adesão do paciente à terapia, que deve ser igual ou superior a 95%. A não adesão causa o aumento da carga viral, queda dos linfócitos CD4+ e resistência viral à medicação. A complexidade da farmacoterapia, as reações adversas à medicação e a falta de conhecimento sobre HIV e os hábitos necessários para cumprir a terapia comprometem a adesão. Embora o acompanhamento farmacêutico seja eficaz na promoção do cumprimento da terapia, faltam estudos que avaliem esta influência na adesão a TARV. Propor um plano de Intervenções Farmacêuticas e Educativas para promover o cumprimento da TARV. Trata-se de um estudo prospectivo, qualitativo e semi-experimental, realizado com pacientes não cumpridores da terapia segundo o autorrelato. Foram realizados seis encontros, sendo o primeiro para anamnese, aplicação de questionários de avaliação da adesão e qualidade de vida e consulta a exames clínicos; os quatro seguintes para intervenções farmacêuticas e educativas, e o sexto para a avaliação dos mesmos critérios do primeiro encontro, e da satisfação quanto à intervenção. Os encontros contemplaram: intervenções educativas sobre a síndrome, a terapia e mudanças no estilo de vida, proposta de um instrumento para auxiliar na tomada da medicação e recomendação ao médico sobre a necessidade da avaliação laboratorial. Apenas dois pacientes participaram de todos os encontros. Estes pacientes apresentavam carga viral indetectável e contagem de linfócitos T CD4+ desejável, relataram não utilizar estratégias para lembrar-se de tomar a medicação e possuiam pouco conhecimento sobre a doença e a terapia. Durante os encontros, estabeleceram-se plano de metas individuais... (Resumo completo, clicar acesso eletrônico abaixo)

Biomateriais e terapia celular na reparação da cartilagem articular em equinos

Articular cartilage is the structure that coats the bone ends in regions where two bones are articulated, allowing movement. It has inefficient intrinsic and extrinsic mechanisms of repair, usually resulting in fibrocartilage formation after injury. Such repair have lower strength, stiffness and usability features when compared to hyaline cartilage. The mesenchymal stem cells have the potential to regenerate tissue without the production of scar, and because of this feature it is well studied. But to have its maximum chondrogenic potential, it is necessary to use scaffolds and growth factors. Biomaterials play the role of scaffold for the cells allowing them to become attached, grow and produce extracellular matrix, leading to formation of repair with hyaline cartilage. In this sense, the purpose of this study is to provide information on the various studies using cell therapy and / or biomaterials to produce hyaline cartilage