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1.
Healthcare (Basel) ; 12(14)2024 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-39057586

RESUMEN

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.

3.
Acta Paul. Enferm. (Online) ; 37: eAPE02622, 2024. tab
Artículo en Portugués | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1533318

RESUMEN

Resumo Objetivo Identificar a prevalência do uso de drogas lícitas e ilícitas por gestantes que realizavam pré-natal na Atenção Primária à Saúde e fatores associados ao seu uso. Métodos Estudo transversal realizado por meio de roteiro estruturado, composto de variáveis sociodemográficas gestacionais e uso de drogas pela gestante e seus familiares, aplicado a 270 mulheres em pré-natal de baixo risco de 15 Unidades Básicas de Saúde, de dois municípios de uma região metropolitana do Sul do Brasil, onde existem diferenças socioeconômicas e demográficas negativas em relação a cidade-polo. A coleta de dados ocorreu no período de dezembro de 2019 a fevereiro de 2020. Os dados foram analisados por meio do teste do qui-quadrado de Pearson, sendo consideradas significativas as associações com valor de p<0,05. Resultados Jovens de 25 a 35 anos corresponderam a 77% da amostra; pardas/negras foram 60,4%; multigestas somaram 41,8% (com mais de três filhos). Tinham parceiro conjugal fixo 86,6%. A prevalência de uso atual de drogas foi de 46,2%. Houve associação estatisticamente significativa entre consumo de álcool e ter tido intercorrências gestacionais (razão de chance de 2,5; intervalo de confiança de 1,17-5,22); entre o consumo de maconha e a idade de 15 a 19 anos (razão de chance de 2,7; intervalo de confiança de 1,01- 7,03); entre consumo de tabaco e uso de drogas pelo esposo (razão de chance de 4,1; intervalo de confiança de 1,75- 9,55) e entre uso de tabaco e classificação familiar do tipo monoparental (razão de chance de 6,6; intervalo de confiança de 1,55 - 28,43). Conclusão A prevalência entre uso atual e uso na vida foi elevada. As gestantes eram multigestas em pré-natal de baixo risco. O uso de drogas esteve associado a intercorrências gestacionais, idade, uso de drogas pelo esposo e a classificação familiar do tipo monoparental.


Resumen Objetivo Identificar la prevalencia del consumo de drogas lícitas e ilícitas por mujeres embarazadas que realizaban control prenatal en la Atención Primaria de Salud y factores asociados a su uso. Métodos Estudio transversal realizado por medio de guion estructurado, compuesto por variables sociodemográficas gestacionales y el uso de drogas por parte de la mujer embarazada y sus familiares, aplicado a 270 mujeres en control prenatal de bajo riesgo de 15 Unidades Básicas de Salud, de dos municipios de una región metropolitana del sur de Brasil, donde existen diferencias socioeconómicas y demográficas negativas con relación a la ciudad principal. La recopilación de datos se llevó a cabo en el período de diciembre de 2019 a febrero de 2020. Los datos se analizaron mediante la prueba χ2 de Pearson, donde se consideraron significativas las relaciones con valor de p<0,05. Resultados Jóvenes de 25 a 35 años compusieron el 77 % de la muestra. El 60,4 % era parda/negra. El 41,8 % era multigesta (con más de tres hijos). El 86,6 % tenían pareja conyugal. La prevalencia de consumo actual de drogas fue del 46,2 %. Hubo asociación estadísticamente significativa entre el consumo de alcohol y haber tenido complicaciones gestacionales (razón de momios de 2,5; intervalo de confianza de 1,17-5,22); entre el consumo de marihuana y la edad de 15 a 19 años (razón de momios de 2,7; intervalo de confianza de 1,01-7,03); entre el consumo de tabaco y el consumo de drogas por parte del esposo (razón de momios de 4,1; intervalo de confianza de 1,75-9,55) y entre el consumo de tabaco y la clasificación familiar monoparental (razón de momios de 6,6; intervalo de confianza de 1,55-28,43). Conclusión La prevalencia entre el consumo actual y el consumo en la vida fue elevada. Las mujeres embarazadas eran multigestas con control prenatal de bajo riesgo. El consumo de drogas estuvo asociado a complicaciones gestacionales, edad, consumo de drogas por parte del esposo y la clasificación familiar monoparental.


Abstract Objective To identify the prevalence of the use of legal and illicit drugs by pregnant women who received prenatal care in Primary Health Care and factors associated with their usage. Methods Cross-sectional study carried out using a structured script, composed of gestational sociodemographic variables and drug use by pregnant women and their families, applied to 270 women undergoing low-risk prenatal care at 15 Basic Health Units, in two municipalities in a metropolitan region of Southern Brazil, where there are negative socioeconomic and demographic differences in relation to the hub city. Data collection took place from December 2019 to February 2020. Data were analyzed using Pearson's chi-square test, with associations with a value of p<0.05 being considered significant. Results Young people aged 25 to 35 accounted for 77% of the sample; brown/black were 60.4%; multigravidae accounted for 41.8% (with more than three children). 86.6% had a steady marital partner. The prevalence of current drug use was 46.2%. There was a statistically significant association between alcohol consumption and having had pregnancy complications (odds ratio of 2.5; confidence interval of 1.17-5.22); between marijuana consumption and the age of 15 to 19 years (odds ratio of 2.7; confidence interval of 1.01-7.03); between tobacco consumption and drug use by the husband (odds ratio of 4.1; confidence interval of 1.75-9.55) and between tobacco use and single-parent family classification (odds ratio of 6.6 ; confidence interval 1.55 - 28.43). Conclusion The prevalence between current usage and lifetime use was high. The multipregnancies in women were undergoing low-risk prenatal care. Drug use, age, drug use by the husband and single-parent family classification were associated with gestational complications.

5.
Arch Virol ; 168(1): 19, 2023 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-36593369

RESUMEN

Cases of reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported worldwide. We investigated reinfection cases in a set of more than 30,000 samples, and the SARS-CoV-2 genomes from selected samples from four patients with at least two positive diagnoses with an interval ≥ 45 days between tests were sequenced and analyzed. Comparative genomic and phylogenetic analysis confirmed three reinfection cases and suggested that the fourth one was caused by a virus of the same lineage. Viral sequencing is crucial for understanding the natural course of reinfections and for planning public health strategies for management of COVID-19.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Reinfección , Brasil/epidemiología , Filogenia , Genómica
6.
Rev. eletrônica enferm ; 25: 70654, 2023.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1434179

RESUMEN

Introdução: compreender como profissionais da Estratégia Saúde da Família percebem a intoxicação infantil e as práticas de cuidado desenvolvidas em comunidade em situação de vulnerabilidade social. Métodos: pesquisa de abordagem qualitativa baseada no referencial dialógico de Paulo Freire. Foi desenvolvida por entrevistas face a face, com 15 profissionais integrantes de equipes da Estratégia Saúde da Família de um município do Noroeste do Paraná, Brasil. As entrevistas foram áudio gravadas, transcritas e submetidas à Análise de Conteúdo de Bardin. Resultados: as percepções foram articuladas em três categorias temáticas: Intoxicações infantis e o ambiente domiciliar: como os acidentes ocorrem; Prática profissional para atendimento, encaminhamento e prevenção das intoxicações infantis; e Limites para a prática de promoção e prevenção das intoxicações infantis no território. Conclusão: as percepções revelam os profissionais não considerarem a família inserida em um contexto sociocultural como centro da ação profissional, poucos referiam ao cuidado no contexto da promoção da saúde e prevenção.


Introduction: to understand how Family Health Strategy professionals perceive child poisoning and care practices in a socially vulnerable community. Methods: the research adopted a qualitative approach based on Paulo Freire's dialogic framework. This consisted of face-to-face interviews with 15 health workers from Family Health Strategy teams in a municipality in the Northwest of Paraná State, Brazil. Audio recordings of the interviews were transcribed and submitted to Bardin's Content Analysis. Results: perceptions were organized into three subject categories: child poisoning and the home environment: how accidents occur; professional practice for care, referral and prevention of child poisoning; and limiting factors for health promotion and child poisoning prevention practices in the area. Conclusion: the health workers' perceptions reveal that they do not consider the family, embedded within its sociocultural context, as the center of professional action, with few of them referring to care in the context of health promotion and illness prevention.


Introducción: conocer la percepción de los profesionales de la Estrategia de Salud de la Familia sobre la intoxicación infantil y las prácticas asistenciales desarrolladas en una comunidad en situación de vulnerabilidad social. Métodos: se trata de una investigación cualitativa basada en el marco dialógico de Paulo Freire. Fue desarrollada a través de entrevistas cara a cara con 15 profesionales de equipos de la Estrategia de Salud de la Familia de un municipio del Noroeste de Paraná, Brasil. Las entrevistas se grabaron en audio, se transcribieron y se sometieron al análisis de contenido de Bardin. Resultados: las percepciones se articularon en tres categorías temáticas: Intoxicaciones infantiles y entorno familiar: cómo se producen los accidentes; Práctica profesional para la atención, derivación y prevención de las intoxicaciones infantiles; y Límites a la práctica de la promoción y prevención de las intoxicaciones infantiles en el territorio. Conclusión: las percepciones revelan que los profesionales no consideran a la familia dentro de un contexto sociocultural como el centro de la acción profesional, pocos se refirieron a la atención en el contexto de la promoción y prevención de la salud.


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Salud Infantil , Vulnerabilidad Social , Atención Primaria de Salud , Estrategias de Salud Nacionales
7.
Arq. ciências saúde UNIPAR ; 27(8): 4307-4323, 2023.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1444273

RESUMEN

Objetivo: Analisar a influência do nível de alfabetismo dos pais e/ou responsáveis na saúde bucal de crianças e adolescentes atendidos na Clínica Escola de Odontologia do Centro Universitário Maurício de Nassau, em Recife. Métodos: Estudo de campo de desenvolvimento transversal e natureza observacional realizado na Clínica Escola de Odontologia do Centro Universitário Maurício de Nassau, no período de janeiro a abril de 2023. A amostra foi composta por 32 pais e/ou responsáveis. Os instrumentos de coleta utilizados foram: ficha específica, Índice de Placa Visível (IPV) modificado e Índice de dentes cariados, perdidos e obturados (CPO-D)/ Índice de dentes cariados, extraídos e obturados (ceo-d), Critério de Classificação Econômica (CCEB) e Rapid Estimate of Adult Literacy in Dentistry ­ Brazil (REALD-B). Resultados: Observou-se uma predominância do acompanhamento materno nas consultas odontológicas de suas crianças/adolescentes. Quanto a procura por atendimento odontológico para seus filhos, a maioria afirmou buscar em caso de prevenção, diferente do resultado para o atendimento próprio, que prevaleceu os casos de tratamento. Ademais, ao associar o resultado obtido pelo CCEB e teste REALD-B, obteve-se que dos 19 participantes classificados como "ruim", ao acertarem entre 0 a 18 palavras, 18 são da Classe "C-D,E", com nível econômico médio-baixo. A inspeção de saúde bucal das crianças/adolescentes foi considerada razoável, com a média de 2 a 3 dentes acometidos, no entanto a faixa etária predominante da amostra variou entre 3 e 10 anos, ratificando o ínicio precoce dos problemas de saúde bucal. Conclusão: Foi observado uma associação entre o nível de alfabetismo em saúde bucal dos pais e/ou responsáveis e as condições clínicas de saúde bucal de suas crianças/adolescentes.


Objective: To analyze the influence of the level of literacy of parents and/or guardians on the oral health of children and adolescents attended at the Clinical School of Dentistry of the Maurício de Nassau University Center, in Recife. Methods: Field study of cross-sectional development and observational nature conducted at the Clinical School of Dentistry of the University Center Maurício de Nassau, in the period from January to April 2023. The sample consisted of 32 parents and/or guardians. The collection instruments used were: specific token, Visible Plate Index (IPV) modified and Index of decayed, lost and filled teeth (CPO-D)/ Index of decayed, extracted and filled teeth (ceo-d), Economic Classification Criterion (CCEB) and Rapid Estimate of Adult Literacy in Dentistry - Brazil (REALD-B). Results: A predominance of maternal follow- up was observed in the dental consultations of their children/adolescents. As for the search for dental care for their children, most said to seek in case of prevention, different from the result for the own care, which prevailed the cases of treatment. Furthermore, by associating the result obtained by the CCEB and the REALD-B test, it was obtained that of the 19 participants classified as "bad", when they hit between 0 to 18 words, 18 are of the Class "C-D,E", with medium-low economic level. Oral health inspection of children/adolescents was considered reasonable, with the average of 2 to 3 affected teeth, however the predominant age range of the sample ranged between 3 and 10 years, ratifying the early onset of oral health problems. Conclusion: An association was observed between the level of oral health literacy of parents and/or guardians and the clinical conditions of oral health of their children/adolescents.


Propósito: analizar la influencia del nivel de alfabetización de padres y/o funcionarios en la salud oral de niños y adolescentes atendidos en la Clínica de Odontología del Centro Universitario Maurício de Nassau de Recife. Métodos: estudio de campo sobre el desarrollo transversal y el carácter observacional realizado en la Facultad de Odontología del Centro Universitario de Mauricio Nassau, en el período comprendido entre enero y abril de 2023. La muestra consistió en 32 padres y/o funcionarios. Los instrumentos de recolección utilizados fueron: token específico, Índice de Tarjeta Viewable Modificado (IAB) y Índice de Dientes Muertos, Perdidos y Obturados (CPO-D)/ Índice de Dientes Recubierto, Extraídos y Obtuados (CCEB), Criterio de Clasificación Económica (CCEB) y Rapid Estimate of Adult Literacy in Dentistry - Brazil (REALD-B). Resultados: Se observó un predominio del acompañamiento materno en las consultas dentales de sus niños/adolescentes. En cuanto a la búsqueda de atención dental para sus hijos, la mayoría declaró que lo buscarían en caso de prevención, diferente del resultado de su propia atención, que prevalecía en los casos de tratamiento. Además, al asociar el resultado obtenido por la CCEB y la prueba REALD-B, se encontró que de los 19 participantes clasificados como "malos", al alcanzar entre 0 y 18 palabras, 18 pertenecen a la clase "C-D,E", con un nivel económico medio- bajo. La inspección de salud oral de los niños/adolescentes se consideró razonable, con un promedio de 2 a 3 pacientes afectados, pero el grupo de edad predominante de la muestra varió de 3 a 10 años, ratificando el inicio temprano de los problemas de salud oral. Conclusión: Se observó una asociación entre el nivel literario en la salud oral de los padres y/o responsables y las condiciones clínicas de salud oral de sus hijos/adolescentes. PALABRAS CLAVE: Alfabetización en Salud; Salud Bucal; Educación en Salud.

8.
Semina cienc. biol. saude ; 43(1): 15-26, jan./jun. 2022. ilus
Artículo en Portugués | LILACS | ID: biblio-1354396

RESUMEN

Introdução: os Resíduos de Serviços de Saúde (RSS) têm sido uma fonte de preocupação para os gestores hospitalares, pois necessitam atender às exigências legais; nos últimos anos houve mudanças no Brasil com a publicação da atual Resolução de Diretoria Colegiada (RDC) 222/18, que normatiza o gerenciamento interno dos resíduos. Objetivo: comparar a RDC 306/04 com a RDC 222/18 quanto ao gerenciamento de Resíduos de Serviços de Saúde, bem como apresentar as implicações da legislação em vigência. Material e Método: trata-se de uma pesquisa exploratória e descritiva, de abordagem qualitativa do tipo documental; para tal, criou-se um roteiro de análises baseado nas etapas de gerenciamento dos RSS; os resultados foram apresentados em tabelas por grupos (A, B, C, D e E) que foram as categorias documentais para a comparação da legislação RDC 306/04 com a RDC 222/18. Resultados: observou-se importantes mudanças na lei atual, com impacto para os gestores e profissionais que atuam em hospitais, como o descarte de bolsas de sangue e peças anatômicas caracterizadas como A1, liberação de descarte de equipamentos de proteção individual (EPIs) como resíduos do Grupo D comum, seringas e agulhas podem ser desconectadas quando tiverem o dispositivo de segurança, novos critérios para descarte de oito grupos de medicamentos, entre outras. Discussão: as mudanças citadas necessitam ser incorporadas nos planos de gerenciamento, planejamento de novos fluxos de segregação de resíduos e aquisição de novos coletores que em médio prazo podem contribuir na redução de custo financeiro, e diminuição dos impactos ambientais desses resíduos quando descartados de forma segura. Conclusão: ao comparar as duas legislações, o presente estudo contribui para direcionar as adequações necessárias, a fim de atender a atual legislação, com informações diretas para orientar novos critérios de classificação, acondicionamento, tratamento e destinação final para o gerenciamento seguro dos resíduos nos serviços de saúde.


Introduction: Waste from Health Services (RSS) has been a source of concern for hospital managers, as they need to meet legal requirements; in recent years there have been changes in Brazil with the publication of the current Resolution of the Collegiate Board 222/18, which regulates the internal management of waste. Objective: to compare Resolution of the Collegiate Board 306/04 with Resolution of the Collegiate Board 222/18 regarding the management of RSS, as well as present the implications of the legislation in force. Material and Method: this is an exploratory and descriptive research, with a qualitative approach of the documentary type; for this, an analysis script was created based on the steps of managing the RSS; the results were presented in tables by groups (A, B, C, D and E) which were the document categories for the comparison of legislation Resolution of the Collegiate Board 306/04 with Resolution of the Collegiate Board 222/18. Results: important changes were observed in the current law, with an impact on managers and professionals working in hospitals, such as the disposal of blood bags and anatomical parts characterized as A1, release of disposal of Personal Protective Equipment as waste from Group D common, syringes and needles can be disconnected when they have the safety device, new criteria for disposing of eight groups of drugs, among others. Discussion: the aforementioned changes need to be incorporated into management plans, planning new waste segregation flows and acquisition of new collectors that in the medium term can contribute to reducing the financial cost, and reducing the environmental impacts of these wastes when disposed of safely. Conclusion: by comparing the two legislations, this study contributes to direct the necessary adjustments, in order to meet the current legislation, with direct information to guide new classification, packaging, treatment and final disposal criteria for the safe management of waste in the services of health.


Asunto(s)
Humanos , Salud , Administración de Residuos , Servicios de Salud , Residuos Sanitarios , Colectores , Costos y Análisis de Costo , Agujas
9.
Microsc Microanal ; 28(1): 210-217, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34784993

RESUMEN

The interaction between cancer cells and the surrounding microenvironment is determinant for metastasis success. In this study, the ultrastructural relevance of cells in the malignant pleural effusion (MPE) of women with breast cancer history was investigated. In MPE, it is possible to observe single cells and clusters. Women whose MPE presents carcinomas in aggregates have a better prognosis when compared to cases in which metastatic single cells are found. Samples were collected via fine-needle aspiration puncture (US-FNA). Subsequent to the material preparation and ultrathin cuts, they were observed using light and transmission electron microscopy (LM/TEM). LM and TEM images served as a basis for the creation of a digital sculpture using ZBrush® software. Clusters exhibited structural stability, en route vesicles allowing exocytosis of electron-dense fibrous elements, and cytoplasmic protrusions contributing to migratory and invasive skills. Single cells presented different necrotic phenotypes and many displayed leukocyte-like characteristics. Cluster cooperative relationships seem to be related to a long-term permanence in MPE. The absence of a collaborative network presumably triggers a more aggressive behavior of single cells. Its putative fusion with leukocytes can maximize the efficiency for transendothelial migration, increasing chances of metastatic success and, unfortunately, reducing survival of women with recidivism.


Asunto(s)
Neoplasias de la Mama , Neoplasias Pulmonares , Derrame Pleural Maligno , Línea Celular Tumoral , Femenino , Humanos , Neoplasias Pulmonares/patología , Derrame Pleural Maligno/patología , Microambiente Tumoral
10.
Sci Educ (Dordr) ; 31(4): 1075-1099, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34658532

RESUMEN

In this article, we analyze images from the book "Our Friend the Atom," written by the astrophysicist Heinz Haber in 1957 and developed in the Disney Science Department. In addition to analyzing the work, we investigate its relevance for science education. After the US attack on two Japanese cities with atomic bombs, there was a severance of opinions on nuclear technologies. On one side, it had an association with the destruction arising from the war. On the other, a narrative highlighted the advantages of using nuclear power for developments that would benefit humanity. Haber and Disney's book aim to explain how such power works and supports its use for the good, despite the danger of destruction. Our goal is to contextualize the book's content and its visual imagery and identify aspects to contribute to the science curriculum. We summarized the historical elements of the post-war period and Walt Disney's entertainment approach and political stance. We discuss how it made a dialogue between a scientific concept and the general public through the book. For the matter of this article, we chose to examine one of the figures in the book, which represents through an illustration how chain reactions work to generate atomic power. For such, we followed a four-step methodology proposed by Silva and Neves Em Aberto, 31(103). (2018) to achieve an imagery analysis, giving us an understanding of the visual language contained in the book. It considers its visual choices, as shapes and colors, content, relations that involve the image, and interpretation of the picture as a whole by the reader. We came to understand the book's importance as scientific literacy was achieved through its illustrations, text, and popularity.

11.
Rev Rene (Online) ; 23: e78693, 2022. tab, graf
Artículo en Portugués | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1406529

RESUMEN

RESUMO Objetivo analisar as reinternações e os óbitos de pacientes internados por efeitos do abuso de álcool. Métodos estudo documental, longitudinal e retrospectivo, por análise de prontuário hospitalares, realizado em hospital de ensino, por análise descritiva, associação univariada, com uso do teste do Qui-quadrado de Pearson. Resultados foram analisadas 399 reinternações de 278 pacientes. Predominaram duas internações (69,6%). A maioria era do gênero masculino (85,2%), e a média da idade foi de 47,15 anos (± ١٣,٩١); 91,2% foram reinternações decorrentes do uso de bebida alcoólica, com 45,3% de complicações associadas a lesões, envenenamentos e causas externas de morbimortalidade. Evoluíram a óbito 27 (9,7%) pacientes. As reinternações de aposentados/do lar apresentaram razão de chances de 3,0 de evoluírem ao óbito. Conclusão a análise apresentou reinternações e mortalidade prevalentes no gênero masculino, faixa etária produtiva, com associação significativa de risco em internados em terapia intensiva e causa de óbitos associada a complicações do uso crônico de bebida alcoólica. Contribuições para a prática: a identificação das causas de reinternações auxilia os profissionais de enfermagem no reconhecimento precoce dos sinais de gravidade e serve como subsídio para o desenvolvimento de estratégias de prevenção e ações de melhoria na rede assistencial.


ABSTRACT Objective to analyze readmissions and deaths of hospitalized patients due to the effects of alcohol abuse. Methods documentary, longitudinal and retrospective study, by analysis of hospital records, carried out in a teaching hospital, by descriptive analysis, univariate association, using Pearson's chi-square test. Results 399 readmissions of 278 patients were analyzed. Two hospitalizations predominated (69.6%). Most were male (85.2%), and the mean age was 47.15 years (± 13.91); 91.2% were readmissions due to the use of alcoholic beverages, with 45.3% of complications associated with injuries, poisoning and external causes of morbidity and mortality. Twenty-seven (9.7%) patients died. The readmissions of retirees/housewives had an odds ratio of 3.0 of progressing to death. Conclusion the analysis showed prevalent readmissions and mortality in males, productive age group, with a significant association of risk in intensive care patients and cause of death associated with complications of chronic alcohol use. Contributions to practice: the identification of the causes of readmissions helps nursing professionals in the early recognition of signs of severity and serves as a subsidy for the development of prevention strategies and actions to improve the care network.

12.
Rev. Bras. Cancerol. (Online) ; 68(3)Jul-Set. 2022.
Artículo en Portugués | LILACS, Coleciona SUS | ID: biblio-1411229

RESUMEN

Introdução: A doença de Hodgkin (DH) é uma patologia que se inicia nos linfonodos, desenvolve-se nos tecidos neoplásicos e manifesta- -se, majoritariamente, em jovens adultos. Objetivo: Correlacionar os resultados da terapêutica cirúrgica e do protocolo DH-II-90 em jovens adultos acometidos pela DH, e associá-los ao perfil epidemiológico, aos dados de mortalidade pela doença e à distribuição de recursos físicos no Brasil. Método: Estudo ecológico exploratório, com informações coletadas do Departamento de Informática do Sistema Único de Saúde (DATASUS), do Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA), do Cadastro Nacional de Estabelecimentos de Saúde (CNES) e do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), entre 2013 e 2021. O estudo, portanto, compara os resultados da terapêutica cirúrgica e do protocolo DH-II-90 associados a dados epidemiológicos, sendo o protocolo considerado o método mais eficiente, por apresentar melhores resultados quando comparado a métodos mais invasivos. Resultados: A Região Sudeste concentra maior número de leitos e procedimentos com números mais expressivos de pacientes diagnosticados de 0 a 29 anos. Em resumo, as taxas de mortalidade bruta por DH reduziram-se a partir de 1990, período no qual o protocolo DH-II-90 foi aplicado. Conclusão: O presente estudo fornece uma visão relevante sobre o perfil epidemiológico da DH e contribui para a comparação entre a terapêutica cirúrgica e o protocolo DH-II-90, sendo possível concluir que, após a aplicação do protocolo, houve redução da taxa de mortalidade por DH no Brasil e no mundo


Introduction: Hodgkin disease (HD) is a pathology that starts in the lymph nodes, develops in the neoplastic tissues and manifests, mainly, in young adults. Objective: To correlate the results of the surgical therapy and the DH- II-90 protocol in young adults affected by HD, and to associate them with the epidemiological profile, the mortality data by the disease and the distribution of physical resources in Brazil. Method: Exploratory ecological study with information collected from the Informatics Department of the National Health System (DATASUS), the National Cancer Institute José Alencar Gomes da Silva (INCA), the National Registry of Health Establishments (CNES) and the SUS Outpatient Information System (SIA/ SUS) between 2013 and 2021. The study, therefore, compares the results of surgical therapy and the DH-II-90 protocol associated with epidemiological data, and the protocol is considered the most efficient method, as it produces better results when compared to more invasive methods. Results: The Southeast Region concentrates high number of beds and procedures and stands out due to more expressive numbers of patients diagnosed from 0 to 29 years. In short, crude mortality rates per HD decreased from 1990, the period where the DH-II-90 protocol was applied. Conclusion: This study provides a relevant view on the epidemiological profile of HD and contributes for the comparison between surgical therapy and the DH-II-90 protocol, being possible to conclude that after the application of the protocol, there was a reduction of the mortality rate by HD in Brazil and worldwide


Introducción: El linfoma de Hodgkin (LH) es una patología que inicia en los ganglios linfáticos, se desarrolla en los tejidos neoplásicos y se manifiesta mayoritariamente en adultos jóvenes. Objetivo: Correlacionar los resultados de la terapéutica quirúrgica y del protocolo DH-II-90 en jóvenes adultos acometidos por el LH, y asociarlos al perfil epidemiológico, a los datos de mortalidad por la enfermedad y a la distribución de recursos físicos en Brasil. Método: Estudio ecológico exploratorio, con información recolectada del Departamento de Informática del Sistema Único de Salud (DATASUS), del Instituto Nacional de Cáncer José Alencar Gomes da Silva (INCA), del Registro Nacional de Establecimientos de Salud (CNES) y del Sistema de Informaciones Ambulatorias del SUS (SIA/SUS), entre 2013 y 2021. El estudio, por lo tanto, compara los resultados de la terapéutica quirúrgica y del protocolo DH-II-90, asociados a datos epidemiológicos, siendo el Protocolo considerado el método más eficiente, por presentar mejores resultados cuando comparado a métodos más invasivos. Resultados: La Región Sudeste tiene más camas y procedimientos y presenta mayores números de pacientes diagnosticados de 0 a 29 años. En resumen, las tasas de mortalidad bruta por LH disminuyeron a partir de 1990, período en el que se incorporó el protocolo DH-II-90. Conclusión: El presente estudio proporciona una visión relevante sobre el perfil epidemiológico del LH y contribuye a la comparación entre terapéutica quirúrgica y el protocolo DH-II-90, concluyendo que, tras la inserción del protocolo, hubo reducción de la tasa de mortalidad por LH en Brasil y en el mundo


Asunto(s)
Radioterapia , Enfermedad de Hodgkin/epidemiología , Mortalidad , Quimioterapia
13.
Rev. SOBECC (Online) ; 26(3): 138-146, 30-09-2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1342349

RESUMEN

Objetivo: Identificar o custo das adequações necessárias a um centro cirúrgico para que este atenda à legislação brasileira vigente, que dispõe sobre resíduos de serviços de saúde. Método: Pesquisa exploratória, descritiva, de abordagem quantitativa na modalidade de estudo de caso do centro cirúrgico de um hospital universitário público. No protocolo, foi aplicada uma pesquisa documental, por meio de um check-list comparando a legislação brasileira vigente com a realidade encontrada, mapeou-se o processo com a técnica do mapa-fluxograma. Utilizou-se como método de custeio o custo direto médio. Resultados: Verificou-se o custo direto médio de R$ 7.891,25 para o hospital atender integralmente à legislação brasileira de resíduos de serviços de saúde, com adequações de infraestrutura e aquisições de longa permanência e um adicional no custo mensal de R$ 542,38. Conclusão: Para todos os grupos de resíduos de serviços de saúde do centro cirúrgico em estudo, são necessárias adequações a fim de atender à legislação, bem como articulação dos diversos gestores envolvidos no manejo e na mensuração dos custos relacionados aos resíduos para otimização de resultados econômicos em saúde.


Objective: To identify the cost of the necessary adjustments to a surgical center so that it meets the current Brazilian legislation, which provides for medical waste. Method: Exploratory, descriptive research with a quantitative approach in the modality of case study of the surgical center of a public university hospital. In the protocol, a documental research was applied, through a check-list comparing the current Brazilian legislation with the reality found, mapping the process with the technique of the flowchart map. The average direct cost was used as a costing method. Results: There was an average direct cost of R$ 7,891.25 for the hospital to fully comply with the Brazilian legislation on healthcare waste, with infrastructure adjustments and long-term acquisitions and an additional monthly cost of R$ 542.38. Conclusion: For all groups of waste from health services in the surgical center under study, adjustments are needed in order to comply with the legislation, as well as the articulation of the various managers involved in the management and measurement of costs related to waste to optimize economic results in health.


Objetivo: Identificar el costo de los ajustes necesarios a un Centro Quirúrgico (CQ), para que cumpla con la legislación brasileña vigente que prevé Residuos de Servicios de Salud (RSS). Método: Investigación exploratoria descriptiva con abordaje cuantitativo en la modalidad de estudio de caso de un CQ en un Hospital Universitario Público. En el protocolo se aplicó investigación documental, a través de un checklist de la legislación brasileña vigente con la realidad encontrada, se mapeó el proceso mediante la técnica de diagrama de flujo-mapa. Se utilizó el costo directo promedio como método de cálculo de costos. Resultados: Hubo un costo directo promedio de R$ 7.891,25 para que el hospital cumpliera plenamente con la legislación brasileña sobre RSS, con ajustes de infraestructura y adquisiciones de largo plazo y un costo mensual adicional de R$ 542,38. Conclusión: Para todos los grupos RSS del CQ en estudio, se necesitan ajustes para cumplir con la legislación. Existe la necesidad de articulación entre los distintos gestores involucrados en la gestión, medición de costos relacionados con los residuos para optimizar los resultados económicos en salud.


Asunto(s)
Humanos , Centros Quirúrgicos , Costos y Análisis de Costo , Residuos Sanitarios , Legislación Hospitalaria
14.
Diagnostics (Basel) ; 11(8)2021 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-34441375

RESUMEN

Serological assays emerged as complementary tools to RT-PCR in the diagnosis of SARS-CoV-2 as well as being needed for epidemiological studies. This study aimed to assess the performance of a rapid test (RT) compared to that of serological tests using finger prick blood samples. A total of 183 samples were evaluated, 88 of which were collected from individuals with negative RT-PCR and 95 from positive RT-PCR individuals. The diagnostic performance of RT (WONDFO®) and LUMIT (PROMEGA®) were compared to that of ELISA (EUROIMMUN®) for detecting antibodies against SARS-CoV-2 according to time from symptoms onset. The IgG antibody tests were detected in 77.4% (LUMIT), 77.9% (RT), and 80.0% (ELISA) of individuals. The detection of antibodies against SARS-CoV-2 increases in accordance with increasing time from symptoms onset. Considering only time from symptoms onset >21 days, the positivity rate ranged from 81.8 to 97.0% between the three tests. The RT and LUMIT showed high agreement with ELISA (agreement = 91.5%, k = 0.83, and agreement = 96.3%, k = 0.9, respectively) in individuals who had symptoms 15 to 21 days before sample collection. Compared to that of the ELISA assay, our results show sensitivity ranged from 95% to 100% for IgG antibody detection in individuals with symptoms onset between 15 and 21 days before sample collection. The specificity was 100% in individuals with symptoms onset >15 days before serological tests. This study shows good performance and high level of agreement of three immunoassays for the detection of SARS-CoV-2 antibodies.

15.
An Pediatr (Engl Ed) ; 95(1): 40-47, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34225955

RESUMEN

INTRODUCTION: The aim of the study was to evaluate the diagnostic performance of the item concerning physical activity of the Global Initiative for Asthma (GINA) asthma control questionnaire for detection of exercise-induced bronchoconstriction (EIB) in children and adolescents. MATERIAL AND METHODS: We divided participants (aged 6-18 years) with a diagnosis of asthma into two groups according to the GINA severity classification: mild/moderate asthma (MMA) and severe therapy-resistant asthma (STRA). We collected anthropometric, clinical and functional data (spirometry) and performed an EIB test. We used item 4 of the GINA questionnaire regarding exercise-induced symptoms to assess the diagnostic power of this instrument. RESULTS: We included 40 patients (17 with MMA and 23 with STRA) with a mean age of 11.3 years and a mean FEV1z-score of -0.33, of who 13 (32.5%) were classified as having uncontrolled asthma. Of the patients with uncontrolled asthma, 7 (53.8%) exhibited a decrease in the FEV1 after the EIB test. We found a higher frequency of EIB in participants with FEV1 z-score values of less than -1.0 compared to those with a z-score of -1.0 or greater (P = .05). There were no significant differences in the frequency of EIB based on disease severity and control. We also found no association of item 4 (GINA) with EIB. The area under the ROC curve demonstrated that the discriminative power of the GINA questionnaire for the detection of EIB is inadequate (P = .41), with sensitivity of 42.1% and specificity of 57.1%. CONCLUSIONS: The item concerning physical activity in the GINA questionnaire has insufficient diagnostic power to detect EIB in children and adolescents with asthma.


Asunto(s)
Asma Inducida por Ejercicio , Asma , Adolescente , Asma/diagnóstico , Asma Inducida por Ejercicio/diagnóstico , Broncoconstricción , Niño , Ejercicio Físico , Humanos , Encuestas y Cuestionarios
16.
An. pediatr. (2003. Ed. impr.) ; 95(1): 40-47, jul. 2021. tab, graf
Artículo en Inglés, Español | IBECS | ID: ibc-207544

RESUMEN

Introducción: El objetivo del estudio fue evaluar el rendimiento diagnóstico de la pregunta relacionada con la actividad física del cuestionario de control del asma de la Global Initiative for Asthma (GINA) para la detección de la broncoconstricción inducida por el ejercicio (BIE) en niños y adolescentes.Materiales y métodos: Se dividió a pacientes (de seis a 18 años de edad) con diagnóstico de asma en dos grupos de acuerdo con la clasificación de gravedad según el cuestionario GINA: asma leve/moderada (ALM) y asma grave refractaria (AGR). Se recogieron datos antropométricos, clínicos y funcionales (espirometría) y se realizó prueba de broncoprovocación con esfuerzo. Se utilizó la cuarta pregunta del cuestionario GINA, concerniente a los síntomas asociados con el esfuerzo físico, para evaluar el rendimiento diagnóstico de este instrumento.Resultados: Se incluyeron a 40 pacientes (17 con ALM y 23 con AGR) con una edad media de 11,3 años y un z-score medio de FEV1 de -0,33, de los que 13 (32,5%) se clasificaron como casos de asma no controlada. De los pacientes con enfermedad no controlada, siete (53,8%) mostraron caídas en el FEV1 tras la prueba de esfuerzo. Se observó una mayor frecuencia de BIE en sujetos con z-score de FEV1 < -1,0 en comparación con aquellos con un z-score ≥ -1,0 (p = 0,05). No hubo diferencias significativas en la frecuencia de BIE con base en la gravedad o el control de la enfermedad. Tampoco se observó asociación entre la pregunta cuatro (GINA) y la BIE. El área bajo la curva de características operativas del receptor (receiver operating characteristic, ROC) evidenció que el poder discriminatorio del cuestionario GINA resulta insuficiente para detectar la BIE (p = 0,41), con una sensibilidad del 42,1% y una especificidad del 57,1%.Conclusiones: La pregunta concerniente al ejercicio físico en el cuestionario GINA carece del poder diagnóstico necesario para detectar la BIE en niños y adolescentes asmáticos. (AU)


Introduction: The aim of the study was to evaluate the diagnostic performance of the item concerning physical activity of the Global Initiative for Asthma (GINA) asthma control questionnaire for detection of exercise-induced bronchoconstriction (EIB) in children and adolescents.Material and methods: We divided participants (aged 6 to 18 years) with a diagnosis of asthma into two groups according to the GINA severity classification: mild/moderate asthma (MMA) and severe therapy-resistant asthma (STRA). We collected anthropometric, clinical and functional data (spirometry) and performed an EIB test. We used item 4 of the GINA questionnaire regarding exercise-induced symptoms to assess the diagnostic power of this instrument.Results: We included 40 patients (17 with MMA and 23 with STRA) with a mean age of 11.3 years and a mean FEV1z-score of -0.33, of who 13 (32.5%) were classified as having uncontrolled asthma. Of the patients with uncontrolled asthma, 7 (53.8%) exhibited a decrease in the FEV1 after the EIB test. We found a higher frequency of EIB in participants with FEV1 z-score values of less than -1.0 compared to those with a z-score of -1.0 or greater (p = 0.05). There were no significant differences in the frequency of EIB based on disease severity and control. We also found no association of item 4 (GINA) with EIB. The area under the ROC curve demonstrated that the discriminative power of the GINA questionnaire for the detection of EIB is inadequate (p = 0.41), with sensitivity of 42.1% and specificity of 57.1%.Conclusions: The physical activity related question of GINA has insufficient diagnostic power to detect EIB in children and adolescents with asthma. (AU)


Asunto(s)
Humanos , Niño , Adolescente , Actividad Motora , Broncoconstricción , Asma Inducida por Ejercicio/diagnóstico , Estudios Transversales , Encuestas y Cuestionarios
17.
Discov Oncol ; 12(1): 37, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-35201456

RESUMEN

Tamoxifen (TMX) is used as adjuvant therapy for estrogen receptor-positive (ER+) breast cancer cases due to its affinity and inhibitory effects. However, about 30% of cases show drug resistance, resulting in recurrence and metastasis, the leading causes of death. A literature review can help to elucidate the main cellular processes involved in TMX resistance. A scoping review was performed to find clinical studies investigating the association of expression of molecular markers profiles with long-term outcomes in ER+ patients treated with TMX. In silico analysis was performed to assess the interrelationship among the selected markers, evaluating the joint involvement with the biological processes. Forty-five studies were selected according to the inclusion and exclusion criteria. After clustering and gene ontology analysis, 23 molecular markers were significantly associated, forming three clusters of strong correlation with cell cycle regulation, signal transduction of proliferative stimuli, and hormone response involved in morphogenesis and differentiation of mammary gland. Also, it was found that overexpression of markers in selected clusters is a significant indicator of poor overall survival. The proposed review offered a better understanding of independent data from the literature, revealing an integrative network of markers involved in cellular processes that could modulate the response of TMX. Analysis of these mechanisms and their molecular components could improve the effectiveness of TMX.

18.
Artículo en Portugués | LILACS | ID: biblio-1349118

RESUMEN

Objetivos: avaliar a frequência de alterações espirométricas e pletismográficas em crianças e adolescentes com asma grave resistente à terapia (AGRT). Além disso, testaram-se possíveis associações entre esses desfechos. Métodos: trata-se de um estudo retrospectivo, no qual foram incluídas crianças e adolescentes (6-18 anos), com diagnóstico de AGRT, e que se encontravam em acompanhamento ambulatorial regular. Todos deveriam possuir informações antropométricas (peso, altura, índice de massa corporal), demográficas (idade, etnia e sexo), clínicas (teste cutâneo, teste de controle da asma, tabagismo familiar e medicações em uso) e de função pulmonar (espirometria e pletismografia corporal) registradas no banco de dados do serviço. Os testes de função pulmonar seguiram as recomendações das diretrizes nacionais e internacionais. Para fins estatísticos, utilizou-se análise descritiva e o teste de qui-quadrado de Pearson. Resultados: de um total de 15 pacientes com AGRT, 12 deles foram incluídos na amostra. A média de idade foi de 12,2 anos, com predomínio do sexo feminino (66,7%). Destes, 50,0% apresentaram a doença controlada, 83,3% foram considerados atópicos e 50,0% tinham histórico de tabagismo familiar. Em relação aos testes de função pulmonar (% do previsto), as médias dos parâmetros espirométricos e de plestismografia corporal encontraram-se dentro dos limites inferiores da normalidade. Apenas 16,7% da amostra apresentou espirometria alterada (130,0%) e 16,7% hiperinsuflação pulmonar (capacidade pulmonar total>120,0%). Houve frequência estatisticamente maior (p=0,045) de aprisionamento aéreo nos participantes com espirometria alterada, em comparação à espirometria normal. Contudo, não se observou diferença (p=0,341) em relação à hiperinsuflação pulmonar. Conclusões: os achados demonstraram pouco comprometimento espirométrico e dos volumes e das capacidades pulmonares em crianças e adolescentes com AGRT. Além disso, aqueles participantes com espirometria alterada obtiveram frequência maior de aprisionamento aéreo no exame de pletismografia corporal


Aims: to assess the frequency of spirometric and plethysmographic changes in children and adolescents with severe therapy-resistant asthma (SRTA). In addition, possible associations between these outcome were tested. Methods: this is a retrospective study. Children and adolescents (6-18 years old), diagnosed with SRTA and who were in regular outpatient follow-up were included. Everyone should have anthropometric (weight, height, body mass index), demographic (age, ethnicity and gender), clinical (skin test, asthma control test, family smoking and medications in use) and pulmonary function (spirometry and body plethysmography) recorded in the service's database. Pulmonary function tests followed the recommendations of national and international guidelines. For statistical purposes, descriptive analysis and Pearson's chi-square test were used. Results: from a total of 15 patients with SRTA, 12 of them were included in the sample. The average age was 12.2 years, with a predominance of females (66.7%). Of these, 50.0% had the disease under control, 83.3% were considered atopic, and 50.0% had a family history of smoking. Regarding the pulmonary function tests (% of predicted), the means of spirometric parameters and body plestismography were within the lower limits of normality. Only 16.7% of the sample had altered spirometry (<5th percentile), 25.0% air trapping (residual volume>130.0%) and 16.7% pulmonary hyperinflation (total lung capacity>120.0%). There was a statistically higher frequency (p=0.045) of air trapping in participants with altered spirometry, compared to normal spirometry. However, there was no difference (p=0.341) in relation to pulmonary hyperinflation. Conclusions: the findings demonstrated little impairment of spirometry and lung volumes and capacities in children and adolescents with AGRT. In addition, those participants with altered spirometry had a higher frequency of air trapping in the body plethysmography exam.


Asunto(s)
Humanos , Niño , Adolescente , Asma , Pletismografía , Pruebas de Función Respiratoria , Espirometría , Mediciones del Volumen Pulmonar
19.
Rev. SOBECC ; 25(3): 151-158, 30-09-2020.
Artículo en Portugués | LILACS | ID: biblio-1122702

RESUMEN

Objetivo: Determinar o perfil de geração e mensurar os custos dos materiais utilizados no gerenciamento de resíduos de serviços de saúde em um centro cirúrgico. Método: Trata-se de pesquisa exploratória, descritiva, com abordagem quantitativa, na modalidade estudo de caso. O local foi o Centro Cirúrgico do Hospital Universitário da Universidade de São Paulo. A amostra estratificada foi de 1.120 cirurgias, e os resíduos foram pesados por 82 dias. Resultados: Os resíduos do Centro Cirúrgico representaram 6,38% do total hospitalar. O grupo mais representativo foi A-infectantes (50,62%). A média de geração foi de 3,72 kg por cirurgia. A sala de operação foi o local que mais gerou resíduos (55,93%), e as cirurgias buco-maxilares as que mais geraram resíduos, em termos de massa. O custo de um quilo foi: Grupo A (R$ 1,10), Grupo B (R$ 5,70), Grupo D Reciclado (R$ 0,96), Grupo D Não Reciclado (R$ 1,01) e Grupo E (R$ 3,23). Conclusão: O custo total médio por cirurgia foi de R$ 8,641, e sua redução depende da negociação de compra dos itens de consumo que tiveram maior representatividade nos custos.


Objective: To determine the waste generation profile and measure the costs of materials used in medical waste management in a surgical site. Method: This is an exploratory-descriptive survey, with a quantitative approach, in the case study modality. The site was the surgical site of the University Hospital of Universidade de São Paulo. The stratified sample was of 1,120 surgeries, and the waste was weighed for 82 days. Results: The surgical site waste accounted for 6.38% of the total hospital waste. The most representative group was A-infectious (50.62%). The mean generation was 3.72 kg per surgery. Most of the waste was generated in the operating room (55.93%), and oral maxillary surgeries generated most of the waste in terms of mass. The cost per kilo was: Group A (R$ 1.10), Group B (R$ 5.70), Group D Recycled (R$ 0.96), Group D Nonrecycled (R$ 1.01) and Group E (R$ 3.23). Conclusion: The mean total cost per surgery was R$ 8.641, and its reduction depends on strategies of purchasing consumable supplies that had greater impact on costs.


Objetivo: Determinar el perfil de generación y medir los costos de los materiales utilizados en la gestión de los Residuos De Los Servicios De Salud en un Centro Quirúrgico. Método: Esta es una investigación exploratoria, descriptiva, con un enfoque cuantitativo, en la modalidad de estudio de caso. El sitio fue el Centro Quirúrgico del Hospital Universitario de la Universidad de São Paulo. La muestra estratificada fue de 1.120 cirugías y los residuos se pesaron durante 82 días. Resultados: Los residuos del Centro Quirúrgico representaron el 6,38% del total del hospital. El grupo más representativo fue A-infeccioso (50,62%). La generación promedio fue de 3,72 kg por cirugía. El quirófano fue el lugar que generó la mayor cantidad de residuos (55,93%) y las cirugías orales-maxilares las que generaron la mayor cantidad de residuos, en términos de masa. El costo de un kilo fue: Grupo A (R$ 1,10), Grupo B (R$ 5,70), Grupo D Reciclado (R$ 0,96), Grupo D No Reciclado (R$ 1,01) y Grupo E (R$ 3,23). Conclusión: El costo total promedio por cirugía fue de R$ 8,641 y su reducción depende de la negociación de compra de los artículos de consumo que tuvieron mayor representatividad en los costos.


Asunto(s)
Humanos , Cirugía General , Centros Quirúrgicos , Administración de Residuos , Residuos , Costos y Análisis de Costo , Hospitales , Residuos Sanitarios
20.
Inflammation ; 43(5): 1680-1691, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32424605

RESUMEN

Anethole (AN) is a natural compound that has attracted great scientific interest because of its numerous biological activities, including anti-inflammatory effects. However, these effects were obtained with high doses of AN, which may be one limitation of its therapeutic use. This study evaluated the effects of a low-dose AN and ibuprofen (IB) combination on inflammatory parameters in Freund's complete adjuvant-induced arthritis (AIA) and arthritis-induced hepatic metabolic changes. Holtzman rats were used and divided into groups: normal, AIA (control), arthritics treated with IB, arthritics treated with AN, and arthritics treated with AN + IB. The volume of the paws, the appearance of secondary lesions, and the number of synovial leukocytes were evaluated. Gluconeogenesis and ureagenesis from alanine were determined in the rat liver in isolated perfusion. The AN + IB (62.5 + 8.75 mg/kg) treatment exerted an inhibitory effect on inflammatory parameters and partially prevented hepatic metabolic changes that was similar to the effect of high-dose IB (35 mg/kg) and AN (250 mg/kg) treatment. This effect of the treatments on hepatic metabolism can be, partly at least, explained by the preservation of both the alanine aminotransferase (ALT) activity and the cytosolic NADH/NAD+ redox potential in the liver. Taken together, the data obtained provided evidence that the AN + IB combination at lower doses than AN and IB treatment alone had beneficial inhibitory potential for the treatment of AIA and attenuated metabolic changes in the liver. Graphical Abstract.


Asunto(s)
Derivados de Alilbenceno/administración & dosificación , Anisoles/administración & dosificación , Antiinflamatorios no Esteroideos/administración & dosificación , Artritis Experimental/tratamiento farmacológico , Artritis Experimental/metabolismo , Ibuprofeno/administración & dosificación , Hígado/metabolismo , Animales , Artritis Experimental/inducido químicamente , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Adyuvante de Freund/toxicidad , Hígado/efectos de los fármacos , Masculino , Ratas , Ratas Sprague-Dawley
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