Reduced bioavailability of oral amoxicillin tablets compared to suspensions in Roux-en-Y gastric bypass bariatric subjects.

AIMS: To evaluate the relative bioavailability of oral amoxicillin (AMX) tablets in comparison to AMX suspension in Roux-en-Y gastric bypass bariatric subjects. METHODS: A randomized, double-blind, cross-over study was performed on the bioavailability of oral AMX tablets and suspension in Roux-en-Y gastric bypass subjects operated at least 3 months previously . Doses of 875 mg of the AMX tablet or 800 mg of the AMX suspension were given to all the subjects, allowing a washout of 7 days between the periods. Blood samples were collected at 0, 0.25, 0.5, 1, 1.5, 2, 4, 6 and 8 hours after drug administration and the AMX levels were quantified by liquid chromatography coupled with triple quadrupole tandem mass spectrometry. The pharmacokinetic parameters were calculated by noncompartmental analysis, normalized to an 875 mg dose and the bioavailability of the AMX from the tablets was compared to that from the suspension formulation. RESULTS: Twenty subjects aged 42.65 ± 7.21 years and with a body mass index of 29.88 ± 4.36 kg/m2 were enrolled in the study. The maximum AMX plasma concentration of the tablets and the suspension (normalized to 875 mg) were 7.42 ± 2.99 mg/L and 8.73 ± 3.26 mg/L (90% confidence interval of 70.71-99.11), and the total area under the curve from time zero to infinity were 23.10 ± 7.41 mg.h/L and 27.59 ± 8.32 mg.h/L (90% confidence interval of 71.25-97.32), respectively. CONCLUSION: The tablets presented a lower bioavailability than the suspension formulation and the total absorbed amount of AMX in these subjects was lower in comparison to the standard AMX absorption rates in nonbariatric subjects, regardless of the formulation.

Nursing activities scores (nas): carga de trabalho deenfermagem em uti e fatores associados / Nursing activities scores (nas): nurse workload in icu and associated factors / Nursing activities scores (nas): carga de trabajo de enfermería en uciy factores asociados

O conhecimento da carga de trabalho da equipe de enfermagem em unidades de terapia intensiva (UTIs) e dosfatores associados é imprescindível à gestão efetiva dessa equipe. Este estudo teve como objetivo identificar acarga de trabalho da equipe de enfermagem de uma UTI-A e verificar quais são as variáveis demográficas eclínicas que a influenciam. Trata-se de uma investigação prospectiva, realizada entre novembro de 2007 e maiode 2008, com 100 pacientes. Os dados foram coletados mediante a observação dos pacientes, dos seusprontuários e de esclarecimentos fornecidos pela equipe. A carga de trabalho de enfermagem foi classificada emBaixa (£107%) e Alta (>107%), de acordo com a mediana do Nursing Activities Score (NAS). Para verificar aassociação com as variáveis, utilizou-se o teste Qui-quadrado. Constatou-se que a carga de trabalho daenfermagem da UTI para adultos foi de 104%, valor muito próximo da alta carga e que somente o tratamento cirúrgico influenciou diretamente essa variável. Conclui-se que no serviço investigado é preciso repensar adinâmica da admissão de pacientes cirúrgicos.

Acknowledging Nursing workload in an Intensive Care Unit (ICU) and associated factors is essential to effectivelymanage a Nursing staff. The objective of this study was to identify the workload of the Nursing staff in an adultICU (A-ICU) and determine which demographic and clinical variables influence this workload. It is a prospectiveinvestigation, carried out between November 2007 and May 2008, with 100 patients. Data were collected fromobserving the patients, their registers and from explanations by the staff. The Nursing workload was classified aseither Low (£107%) or High (>107%), according to the median of the Nursing Activities Score (NAS). In order todetermine association with the variables, the chi-square test was applied. It was observed that the Nursingworkload in the A-ICU was 104%, nearly a High Workload, and only surgical treatment directly influenced thisvariable. It is concluded that, for the service investigated, the dynamics of surgery patient admission must berethought.

El reconocimiento de la carga de trabajo del equipo de enfermería en unidades de cuidados intensivos (UCIs) yde los factores asociados es imprescindible a la gestión efectiva de ese equipo. Este estudio tuvo como objetivoidentificar la carga de trabajo del equipo de enfermería de una UCI-Adulto y comprobar cuáles son las variablesdemográficas y clínicas que lo influencian. Se trata de una investigación prospectiva, realizada entre noviembredel 2007 a mayo del 2008, con 100 pacientes. Los datos fueron recolectados por intermedio de la observación delos pacientes, de sus registros y de aclaraciones suministradas por el equipo. La carga de trabajo de enfermeríafue clasificada en Baja (£ el 107%) y Alta (> el 107%), de acuerdo con la mediana del Nursing Activities Score(NAS). Para verificar la asociación con las variables, se utilizó la prueba chi cuadrado. Se constató que la cargade trabajo de la enfermería de la UCI para adultos fue del 104%, valor muy próximo al de la alta carga y quesolamente el tratamiento quirúrgico influenció directamente esa variable. Se concluye que en el servicioinvestigado es necesario repensarse la dinámica de la admisión de pacientes quirúrgicos.