Condições bacteriológicas da superfície das poltronas hematológicas par hemodiálise

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Relação do índice bispetral e da taxa de supressão do traçado do eletroencefalograma com disfunção cognitiva pós-operatória em cirurgia de revascularização do miocárdio

Pós-graduação em Anestesiologia - FMB

Planejamento protético para pacientes adultos portadores de fissura labiopalatal congênita, que não obtiveram oportunidade de um tratamento reabilitador ideal: execução de casos clínicos para pacientes selecionados

Although one cannot prevent the birth of human beings with cleft palate lesions one can adopt attitudes and various procedures entirely viable to rehabilitate and recuperate these persons through a team work composed of the facilities of a hospital, physician, dentist, psychotherapist, epeech pathologist, pedagogue and a social worker. In order to reduce the suffering of these patients we took up this work to prove that even if not in an ideal manner nevertheleses in an acceptable one we can reintegrate these persons to their families, friends and social milieu, offering them more security in their social, psychic and human relationships. We have made a review of the literature during the last three decades where we found many possibilities of prosthetic recuperations which concerns esthetics, mastication and maxillomandibular relationships beyond allowing these pacients conditions to perform satisfactory the functions of deglution and speech. We have selected and executed 5 clinical cases out of 15 pacients formely choosen looking to different prosthetic plannings. We have also shown the major contribution that the osseous integrated implants can offer to the rehabilitation and recuperation of pacients whith congenitall labio palatal lesions. To simplify the understanding we tried to discuss the most varied types of prosthesis in well defined subjects having a separate approach for each of them and we still showed that the specificity of each case leads to a specific type of rehabilitation founded om esthetics, occlusion, osseous suport, edentulous space, and above all based in the common sense and Professional integrity

Estimating outcomes in newborn infants using fuzzy logic

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

Healthcare-associated infections: challenges to public health in Brazil

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

Politicas públicas em oncologia: refletindo sobre a atuação da Terapia Ocupacional

A Política Nacional de Atenção Oncológica almeja o acesso e atendimento integral além de uma maior efetividade e efi ciência no controle do câncer. Assim, diversas ações, serviços e profi ssionais são exigidos para dar a assistência necessária. A respeito da atuação da Terapia Ocupacional, nota-se que a profi ssão não é especifi cada, e não tem a atuação regulamentada. Sendo assim, o objetivo principal do presente estudo foi identifi car a inserção, atuação e ampliação do campo de trabalho da Terapia Ocupacional no Estado de São Paulo para a área oncológica em contexto hospitalar, tomando por base as Políticas Públicas de Atenção Oncológica. Visou também identifi car os Centros de Assistência de Alta Complexidade em Oncologia do Estado de São Paulo que possuem o terapeuta ocupacional como parte da equipe. Para tanto, foi realizada: identifi cação dos Centros de Alta Complexidade em Oncologia do Estado de São Paulo cadastrados no Cadastro Nacional de Estabelecimentos de Saúde, por meio de dados fornecidos pelo INCA e do site ofi cial do Ministério da Saúde; mapeamento da inserção do terapeuta ocupacional nesses locais e aplicação de questionário aos profi ssionais, para caracterizar os serviços e ações desenvolvidas pela Terapia Ocupacional em oncologia. O estudo do tipo qualitativo descritivo constatou a existência de diferentes possibilidades assistenciais em oncologia, tendo em vista as demandas e organização dos hospitais. Quanto à inserção e ampliação do campo de trabalho, verifi cou-se que nem todos os CACONs contam com os serviços e ações da Terapia Ocupacional, o que sugere que ainda não há efetivamente a incorporação desse profi ssional nas equipes multiprofi ssionais desses centros.

Avaliação dos custos da assistência de recém nascidos de mães diabéticas no Hospital das Clínicas -UNESP – Botucatu

The present work had as objective to calculate and to analyze the costs of the assistance of just born of diabetic mothers interned in the units of Joint Lodging of the Maternity and Nursery and UTI Neonatology of the HC - FMB - Unesp. This is a exploratory, descriptive study with quantitative analysis of the data, with just born of carrying mothers of gestational diabetes and of light hyperglycemia, that had carried through the prenatal assistance in the HC - FMB - Unesp, in the period of 1o of January the 31 of December of 2009. The analysis of the data disclosed that the costs indirect and of the assistance to the just born in joint lodging had been of: R$ 160,20 for the group of RN of mothers with light hyperglycemia, R$204,10 for the group with diabetes and R$100,57 for the control. The costs indirect and of the assistance to the just born in Nursery had been of: R$ 494,94 for the group of RN of mothers with light hyperglycemia, R$565,89 for the group with diabetes and R$262,98 for the control. The weighed average cost of the assistance to the just born in Joint Lodging, Nursery and UTI of Neonatology was of: R$ 191,33 for the group of RN of mothers with light hyperglycemia, R$458,58 for the group with diabetes and R$210,48 for the control. It can be concluded that the costs of just born of diabetic mothers and with light hyperglycemia were higher and had similar perinatal results to the one of the control group

Estratégias tecnológicas para aumento de solubilidade e diminuição de toxicidade do fármaco antifúngico anfotericina B

A Anfotericina B é o fármaco antifúngico referência desde a sua descoberta na década de 50 até os dias atuais para o tratamento de infecções fúngicas sistêmicas. O objetivo do trabalho é realizar uma revisão bibliográfica que forneça os sistemas de liberação comercializados e os que estão em estudo, focando estratégias tecnológicas que possam servir para resolver os problemas da baixa solubilidade em água e da alta nefrotoxicidade da Anfotericina B. A AmB é um fármaco que apresenta inexpressiva solubilidade em meio-aquoso, principalmente na região de pH dos fluídos biológicos (7,4–8,0), sendo administrado atualmente por via endovenosa. Justificando a importância desse estudo para a área farmacêutica, novos sistemas de liberação que usem a via oral, aumentarão a adesão por crianças e idosos, além de aumentar o arsenal terapêutico e diminuir os gastos com hospitalizações. Por ter a sua utilidade clínica limitada em razão de sua alta toxicidade, tem-se buscado direcionar a AmB especificamente para o fungo ou pelo menos para o local da infecção, mantendo-se longe o fármaco das células hospedeiras. Para isso, se busca diferentes veículos que não o desoxicolato (Fungizone). Por fim, as formulações lipídicas mostram-se com maior eficácia e com menor toxicidade comparadas a Anfotericina B-desoxicolato, mas não fazem parte da rotina hospitalar em razão do seu alto custo

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

Avaliação dos custos da assistência de recém-nascidos de mães hipertensas no Hospital das Clínicas - UNESP - Botucatu

The Hypertension Arterial Gestationis is a of largest complications to the pregnant women, a time that is associated with to high risk of morbimortalidade fetal and maternal ;the term If referred the levels pressure equal or above of 140mmhg to the pressure systolic and of 90mmhg to the pressure diastolic (1).Hypertension in pregnancy can be classified into gestational hypertension, chronic hypertension, preeclampsia and eclampsia(3). This study aimed to calculate and analyze the cost of care of newborns of hypertensive mothers hospitalized in rooming, nursery and the neonatal intensive care unit (Neonatal UTI). It’s a study of exploratory, descriptive and quantitative data analysis, in newborns of mothers with hypertension, who underwent prenatal care in HCFMB, from January 1 to 31 in December 2010. The data analysis showed that the cost of care for newborn in rooming was R$ 38.62 for the control group and groups of hypertensive mothers were R$ 19.93 to R$ 37.38. The costs of care to the newborn in the nursery were R$ 1,781.81 for the control group and groups of hypertensive mothers were R$ 680.03 to 7544.10. The costs for the newborn who Neonatal UTI were R$ 7,468.60 for the control group and groups of hypertensive mothers were R$ 5,228.02 to R $ 18,372.75. The total costs of care for newborn in rooming, nursery and Neonatal UTI were R$ 916.15 for the control group, R$ 1,385.98 for the HAC group, R$ 327.23 for the group HAS, R$ 3,896.57 for the group of preeclampsia and R$ 6,326.54 for the group of eclampsia. Considerations It can be concluded that the costs of mothers with preeclampsia and eclampsia were higher, being conditions with increased risk of maternal-fetal morbidity / mortality, requiring care in intensive care unit and longer stay in hospital

Inspeção de Precaução de Contato: relato de Experiência de uma Graduanda de Enfermagem Botucatu

Infections Related to Healthcare (IRAS) is a problem of worldwide concern, responsible for much morbidity and lethality. The incidence of IRAS associated with resistant microorganisms has increased worldwide. It is also known that the etiology of bacterial resistance is multifactorial, thus controlling the spread of resistant microorganisms requires the implementation of control measures that involve the performance of standard and contact precautions, plus the use of antimicrobials. To diagnose the problem as to the likely accession of the measures of infection control was prepared in a form to inspect the practices of the health staff acting with patients in contact precautions. The inspections had an educational and awareness, no punitive measures were taken to staff as warnings, suspensions or complains of a breach of ethics. If any irregularities were found, the professional standards of care countershaft contact and the nurse responsible for the head nurse or unit area were notified and counseled about the correct practice of isolation. While an undergraduate student initiated precautionary inspections of contact in order to verify the actual use of isolation measures, since the professionals were unaware of my active participation in the Committee on Infection Control. Facilities and difficulties were encountered in the process, and from the inspections was possible interventions to facilitate compliance with standards for isolation imposed by contact. Since the instrument has significantly improved adherence to contact isolation practices, the members of the Infection Control regulated inspections and intend to use it as a permanent method