Impact of Polypharmacy and Risk Factors for Exacerbation of Lower Urinary Tract Symptoms in Patients with Urological Conditions: A Retrospective Study in a Japanese Municipal Hospital.

Polypharmacy exacerbates lower urinary tract symptoms (LUTS). Japan exhibits a higher prevalence of concomitant medication use in drug therapy than other countries. Previous age- and sex-specific reports exist; however, none include patients of all ages. Therefore, this retrospective study determined the impact of polypharmacy and its associated risk factors on LUTS exacerbation in outpatients with urological conditions. We included patients receiving medication who visited the Department of Urology at the Gifu Municipal Hospital (Gifu, Japan) between January, 2018 and December, 2018. The association between LUTS and polypharmacy and the risk factors for LUTS exacerbation were investigated. Patients were categorized into two groups according to their polypharmacy status. We performed propensity score matching and compared the International Prostate Symptom Score (IPSS) between the groups using the unpaired t-test. Multiple logistic regression analysis was performed to examine the risk factors, including "polypharmacy" and "taking multiple anticholinergic medications" for LUTS exacerbation. When comparing the IPSS between the groups, the polypharmacy group was found to have significantly higher scores than the non-polypharmacy group in six items, including "total score" and "storage score." Multiple logistic regression analysis results showed high significance in three items, including "polypharmacy" (odds ratio (OR) = 1.67, 95% confidence interval (CI): 1.03-2.71) and "taking multiple anticholinergic medications" (OR = 8.68, 95% CI: 1.05-71.7). In conclusion, this study revealed that "polypharmacy" and "taking multiple anticholinergic medications" were risk factors for LUTS. Particularly, "polypharmacy" is associated with storage symptom exacerbation. Therefore, eliminating "polypharmacy" and "taking multiple anticholinergic medications" is expected to improve LUTS.

Consolidation of the Journal Investigación y Educación en Enfermería as a Publication with Impact on the Dissemination of Nursing Knowledge

Almost 14 years ago, Dean Beatriz Elena Ospina Rave entrusted me with the direction of the IEE Journal, given the leave of absence taken by the then director, María del Pilar Pastor, who had been named Secretary of Health of the Municipality of Medellín. Meeting this responsibility represented a great academic and professional challenge because it was a scientific publication of the highest quality in the area of Nursing, recognized in Colombia and Latin America. I received a journal with 26 years of uninterrupted edition and which already had three years in category A2 in the PUBLINDEX by COLCIENCIAS, hence, I had the commitment to lead the preparation of the publication to ascend to the long-awaited maximum A1 category, for which it was "only" necessary to meet the most complex criterion to obtain: achieve indexing in Medline, or in at Consolidation of the Journal Investigación y Educación en Enfermería as a Publication with Impact on the Dissemination of Nursing Knowledge*Invest Educ Enferm. 2023; 41(3): e01least one of the bibliographic citational bases, like Elsevier's Scopus or in the Web of Science, now Clarivate.

Hospital Municipal Infantil Menino Jesus

Hospital Municipal Infantil Menino Jesus é referência no atendimento a crianças e adolescentes (de 0 a 17 anos) no município de São Paulo. Sob gestão do Instituto de Responsabilidade Social Sírio-Libanês (IRSSL), a unidade tornou-se especializada no tratamento de malformações congênitas, tendo recebido em 2018 a Certificação Nível 1 da ONA (Organização Nacional de Acreditação). No mesmo ano, foi inaugurada a nova ala da Escola de Transplantes, fruto da parceria entre Hospital Sírio-Libanês e Ministério da Saúde, por meio do Proadi-SUS, ampliando o atendimento às crianças com Síndrome do Intestino Curto (SIC) e patologias graves do fígado. Em 2020, o hospital foi reavaliado e conquistou a certificação ONA Nível 2. Em 2022, alcançou o Nível 3, certificação máxima da ONA, que atesta a Excelência na Gestão.

Hospital Municipal Dr. Ignácio Proença de Gouvêa

Hospital Municipal Dr. Ignácio Proença de Gouvêa conta com serviços de Enfermagem Obstétrica, Ginecologia Obstétrica, Neonatal, entre outros. Site institucional do Hospital Municipal Dr. Ignácio Proença de Gouvêa com informações sobre história, contato e serviços de especialidades oferecidos.

Hospital Municipal Tide Setubal - São Miguel

Hospital Municipal Tide Setubal atende em média 15.000 pacientes por mês, e conta com 172 leitos, divididos em Unidade de Pronto Socorro Adulto e de Pediatria, e Unidades de Internação – clínicas Médica, Pediátrica, Ortopédicas, Cirúrgicas, Obstétricas, Berçário, UTI Neo, UTI Adulto e Psiquiatria. O nome do Hospital homenageia Matilde Azevedo Setúbal nascida em 1925, que era conhecida como dona Tide Setúbal, casada com Olavo Setúbal, que foi Prefeito da cidade de São Paulo no período de 1975 a 1979. Em 11 de Setembro de 1975, foi criado o Corpo Municipal de Voluntariado, CMV, pela Senhora Matilde Azevedo Setúbal, no intuito de Ajudar aos pacientes do então Hospital de São Miguel Paulista.

Hospital Municipal Dr. Benedicto Montenegro - Jardim Iva

Localizado na rua Antonio Lázaro, 226, o Hospital Municipal Dr. Benedicto Montenegro atende cerca de sete mil pacientes por mês - em uma região com aproximadamente 500 mil habitantes -, e é referência em urgência psiquiátrica. Oferece as especialidades de clínica, pediatria, cirurgia geral, ortopedia, ginecologia, psiquiatria e odontologia emergencial. Conta com 56 leitos, sendo 14 para observação e um leito de isolamento no pronto-socorro. Outro diferencial é o ambulatório, vinculado ao PS, para assistência ortopédica em casos de fratura.

Hospital Municipal Vereador José Storopolli

O Hospital Municipal Vereador José Storopolli foi inaugurado em dezembro de 1989, fruto da conquista dos líderes comunitários de Vila Maria e Vila Guilherme. Trata-se de hospital geral, de complexidade secundária, pertencente à Prefeitura Municipal de São Paulo, planejado para 220 leitos. Iniciou-se uma parceria sólida, em conformidade com os princípios norteadores do Sistema Único de Saúde, assegurando uma atenção hospitalar integral e de qualidade, conjunta à formação e aprimoramento de profissionais da Saúde por meio de elevado nível do ensino promovido pelo aprendizado prático e pesquisas clínicas, suportados pela estrita colaboração com os Departamentos Acadêmicos da Universidade. A partir de janeiro de 2010, a parceria passa a ser norteada pelo contrato de gestão entre a Prefeitura Municipal de São Paulo e a SPDM, incluindo o Hospital à rede de serviços de saúde da Microrregião Vila Maria/Vila Guilherme, referenciando-o como unidade hospitalar da região.

Hospital Municipal Dr. Alexandre Zaio

Site institucional do Hospital Municipal Dr. Alexandre Zaio com informações sobre história, contato e serviços de especialidades oferecidos.

Hospital do Servidor Público Municipal - HSPM

Hospital Do Servidor Público Municipal oferece benefícios com direito à assistência aos servidores públicos municipais ativos e inativos, respectivos dependentes e pensionistas, da Administração Direta, das Autarquias Municipais, da Câmara Municipal e do Tribunal de Contas do Munícipio, abrangidos pelo Regime Próprio de Previdência Social dos Servidores Público do Município de São Paulo (RPPS).

Nurses' Willingness and Demand for Internet+Home Care Services and the Associated Factors in Municipal Hospitals in China: Cross-Sectional Survey.

BACKGROUND: Developing Internet+home care (IHC) services is a promising way to address the problems related to population aging, which is an important global issue. However, IHC services are in their infancy in China. Limited studies have investigated the willingness and demand of nurses in municipal hospitals to provide IHC services. OBJECTIVE: This study aims to investigate the willingness and demand of nurses in municipal hospitals in China to provide IHC services and analyze the factors to promote IHC development in China. METHODS: This cross-sectional study used multistage sampling to recruit 9405 nurses from 10 hospitals in 5 regions of China. A self-designed questionnaire with good reliability and validity was used to measure nurses' willingness and demand for providing IHC services. Data analysis used the chi-square test, Welch t test, binary logistic regression analysis, and multiple linear regression analysis. RESULTS: Nurses were highly willing to provide IHC services and preferred service distances of <5 km and times from 8 AM to 6 PM. An individual share >60% was the expected service pay sharing. Job title, educational level, monthly income, and marital status were associated with nurses' willingness to provide IHC services in binary logistic regression analysis. Supervising nurses were 1.177 times more likely to express a willingness to provide IHC services than senior nurses. Nurses with a bachelor's degree had a 1.167 times higher likelihood of expressing willingness to provide IHC services than those with a junior college education or lower. Married nurses were 1.075 times more likely to express a willingness than unmarried nurses. A monthly income >¥10,000 increased the likelihood of nurses' willingness to provide IHC services, by 1.187 times, compared with an income <¥5000. Nurses' total mean demand score for IHC services was 17.38 (SD 3.67), with the highest demand being privacy protection. Multiple linear regression analysis showed that job title, monthly income, and educational level were associated with nurses' demand for IHC services. Supervising nurses (B=1.058, P<.001) and co-chief nurses or those with higher positions (B=2.574, P<.001) reported higher demand scores than senior nurses. Monthly incomes of ¥5000 to ¥10,000 (B=0.894, P<.001) and >¥10,000 (B=1.335, P<.001), as well as a bachelor's degree (B=0.484, P=.002) and at least a master's degree (B=1.224, P=.02), were associated with higher demand scores compared with a monthly income <¥5000 and junior college education or lower, respectively. CONCLUSIONS: Nurses in municipal hospitals showed a high willingness and demand to provide IHC services, with differences in willingness and demand by demographic characteristics. Accordingly, government and hospitals should regulate the service period, service distance, and other characteristics according to nurses' willingness and demand and establish relevant laws and regulations to ensure the steady and orderly development of IHC services.

Ten years' experience in prenatal diagnosis of α-thalassemia in a municipal hospital and retrospective analysis of ultrasonic abnormalities.

OBJECTIVE: This study reviewed and analyzed the prenatal diagnosis experience of thalassemia in our center over the past decade and the abnormal ultrasonic characteristics of fetuses with hemoglobin (Hb) Bart's hydrops fetalis. METHODS: Pregnant women and their partners who tested positive for α0-thalassemia or were diagnosed with thalassemia intermedia (HbH diseases) underwent genetic counseling, and a prenatal diagnostic procedure for α-thalassemia was recommended. Ultrasonography was performed before prenatal diagnosis. RESULTS: Invasive prenatal α-thalassemia diagnosis and ultrasonography were performed in 1049 patients at risk for Hb Bart's hydrops fetalis syndrome at our hospital from 2012 to 2021. Chorionic villus sampling (CVS) was performed in 58 cases (5.5%), amniocentesis in 902 cases (86%), and cordocentesis in 89 cases (8.5%). Hb Bart's hydrops fetalis syndrome was diagnosed in 280 fetuses. The most common body cavity effusion was pericardial effusion, ascites, and fetal systemic edema. CONCLUSIONS: The extensive experience at our center shows that carrier screening, molecular diagnostics, genetic counseling, and prenatal diagnosis are effective measures to prevent Hb Bart's hydrops fetalis syndrome. The ultrasonographic abnormalities in fetuses with Hb Bart's hydrops are mainly caused by an increase in cardiac output, which leads to the body cavity effusion from various organs.

Melphalan Febrile Neutropenia Risk Factors.

This study aimed to identify the risk factors of febrile neutropenia(FN)onset associated with melphalan(L-PAM)therapy. Thirty-nine patients(21 men, 18 women)were administered L-PAM intravenously for multiple myeloma(MM)from April 2011 to February 2022 at the Department of Hematology of Gifu Municipal Hospital. Patients were classified into those with and without FN(Grade 3 or higher), complete blood count and liver function tests were performed immediately before starting therapy. Univariate analysis with Fisher's exact probability test was performed. Factors with p<0.2 were considered as independent variables for multivariate analysis in the multiple logistic regression analysis. A multivariate analysis with 2 independent variables, lactate dehydrogenase(LD)level>222 U/L(upper limit of the facility reference value)and white <3.3×103/µL(lower limit of the facility reference value)from the univariate analysis, and FN onset(Grade 3 or higher)as the dependent variable showed that LD level>222 U/L(odds ratio: 6.33, 95% confidence interval: 1.12-35.8, p=0.037)was a significant factor. In conclusion, patients with LD levels >222 U/L immediately before starting therapy require adequate monitoring for FN onset following L-PAM administration.

Evaluation of Maternal Fetal Outcomes of Pregnant Women and Mothers with Suspected Infection by SARS-CoV-2 Treated at the Municipal Hospital of São Bernardo do Campo (HMU-SBC), Brazil.

OBJECTIVES: The impact of Covid-19 infection on pregnancy and perinatal outcomes is not fully known. To describe the risk factors and perinatal outcome of pregnant women with suspected COVID-19 infection. METHODS: We evaluated medical records of women with suspected or confirmed SARS-CoV-2 infection who received health care services at the University Hospital of São Bernardo do Campo from March 1 to July 31, 2020, and personal, clinical, and laboratory data of these women and their newborns. RESULTS: Of the 219 women identified, 29% were asymptomatic. Considering the total population, 26% and 17% had obesity and hypertensive syndrome, respectively. Fever measured in the emergency room was the main reason for hospitalization. The presence or not of flu-like symptoms did not impact on perinatal outcomes. Pregnant women requiring hospitalization had newborns with lower birth weight (p < 0.01), shorter length (p = 0.02), and smaller head circumference (p = 0.03), and, in these cases, a higher number of cesarean section deliveries was observed. CONCLUSION: COVID-19 infection did not affect the prognosis of pregnancy and newborns. However, the worst clinical outcome, requiring hospitalization, had an impact on the anthropometric measurements of newborns.

What is already known on this subject?The SARS-CoV-2 infection is not fully undestood, specially during pregnancy and puerperae. There are conflicted information about this in the literature so far. However, it is known that respiratory infections such as influenza and SARS can develop unfavorably in pregnant women, since pregnancy changes the women's physiological condition, including altered immunity to tolerate placenta and fetus proper development.What this study adds?COVID-19 did not affect the prognosis of pregnancy and newborns in this study, but, the worst clinical outcome (hospitalization), impacted the anthropometric measurements of newborns.

Boletim COVID-19 - 16/05/2023

Boletim semanal COVID-19 no município de São Paulo de 16 de maio de 2023

Hospital Municipal Dr. Arthur Ribeiro de Saboya

Site institucional do Hospital Municipal Dr. Arthur Ribeiro de Saboya com informações sobre história, contato e serviços de especialidades oferencidos

Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study.

BACKGROUND: The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks. METHODS: The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc. RESULTS: PPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2-5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50). CONCLUSION: Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women's mental and physical health in the early postpartum in China.

Seroprevalence, trends, and risk factors of hepatitis B and C among family replacement blood donors; a 7-year retrospective study at Sunyani Municipal Hospital, Ghana.

Hepatitis B and C cause chronic infections which develop into liver-related sequelae, like cirrhosis and liver carcinoma. This study determined the seroprevalence, trends, and risk factors of HBV and HCV among family replacement donors. A retrospective review of primary data on blood donors screened between January 2015 and December 2021 was conducted at Sunyani Municipal Hospital. The data were assessed for seroprevalence, trends, and odds ratios using SPSS. Of 6847 donors, the majority were males (88.1% [6033]), ≤24 years (27.4% [1874]), O blood type (69.8% [4776]), and Rh-positive (89.9% [6154]). The seroprevalences of HBV and HCV were 3.2% and 1.9%, respectively, with more males infected with HBV and HCV (3.4% vs 2.0%). Males were 2.842 times (p = .001) and 2.399 times (p = .025) more susceptible than females to HBV and HCV, respectively. In the rainy season, donors were 1.489 times (p = .041) more susceptible to HCV. HBV and HCV seroprevalence declined over the period (slope: -0.5464, p ≤ .001 vs slope: -0.6179, p ≤ .001). Male gender and rainy season were significant determinants of both infections. The seroprevalence of HBV was higher than HCV despite the significant decline in both infections. We, recommend health authorities intensify health education among males and during the rainy season.

Autopsy Case Report of Severe COVID-19 Pneumonia at a General Municipal Hospital.

We present the autopsy procedure and findings of severe coronavirus disease 2019 (COVID-19) pneumonia in an 85-year-old man. The patient required intubation immediately after admission for severe COVID-19 pneumonia. He had severe hypoxia that did not improve despite treatment with remdesivir, corticosteroids, and appropriate mechanical ventilation. On day 13, the patient developed sudden hypercapnia. His renal dysfunction subsequently worsened and became associated with hyperkalemia, and he passed away on day 15. An autopsy was performed to clarify the cause of the hypercapnic hypoxia. None of the medical personnel involved in the autopsy developed symptoms of COVID-19. Histologic examination showed various stages of diffuse alveolar damage throughout the lungs, with intra-alveolar hemorrhage in the upper zones. Microscopic examination of the kidneys revealed acute tubular necrosis. There was no significant systemic thrombosis. The autopsy findings were consistent with those typical of COVID-19.

Bacterial Colonization on Healthcare Workers' Mobile Phones and Hands in Municipal Hospitals of Chongqing, China: Cross-contamination and Associated Factors.

BACKGROUND: Mobile phones are widely used in clinical settings and could be colonized by potential pathogenic bacteria which may lead to hospital-acquired infections (HAIs) transmission. This study aimed to determine the prevalence of bacterial contamination of healthcare workers' (HCWs) mobile phones, identify bacterial isolates, and assess the factors associated with mobile phone contamination. METHODS: Self-administered questionnaire was used to collect the information on the demographic characteristics and the use of mobile phones. A total of 111 HCWs' hands and their mobile phones were swabbed, then bacterial culture, isolation, and identification were performed. Univariate and multivariable logistic regression were applied to identify factors associated with mobile phone bacterial contamination. RESULTS: Totally 106 (95.5%) of the 111 mobile phones investigated were contaminated with bacteria. Staphylococcus epidermidis (13/111), Acinetobacter baumannii (4/111) and Staphylococcus aureus (3/111) were the predominant bacterial isolates from HCWs' mobile phones. Univariate analyses showed that age, gender, profession and the frequency of mobile phone utilization were significantly associated with the number of bacterial colonization. Frequency of phone utilization (OR 8.366; 95% CI 1.496-46.797) was found to be the most significant factors associated with the qualified rate of mobile phones bacterial load. In addition, phone cover using was associated with the increased risk of mobile phone bacterial contamination. CONCLUSION: There was cross-contamination between hands and phones. It is necessary to develop guidelines for mobile phone cleaning. Special attention needs to be paid to the disinfection of mobile phone covers to reduce contamination and transmission of pathogens.