CUIDADOS PALIATIVOS: RELAÇÃO EFICAZ ENTRE EQUIPE DE ENFERMAGEM, PACIENTES ONCOLOGICOS E SEUS FAMILIARES / PALLIATIVE CARE: EFFECTIVE RELATIONSHIP BETWEEN NURSING TEAM, ONCOLOGICAL PATIENTS AND THEIR FAMILIES

A OMS, em 2002, traz uma redefinição no conceito de Cuidado paliativo, evidenciando nesse cuidado uma qualidade de vida ao paciente terminal, objetivando sua dor e sua melhora como fator primordial nesse cuidado direto. Trata-se de uma pesquisa qualitativa, descritiva de revisão bibliográfica, realizadas nas bases eletrônicas BVS (Biblioteca Virtual de Saúde). Tendo como objetivos: destacar a importância da comunicação na relação entre família equipe de enfermagem e pacientes em finitude; ressaltar a relevância dos familiares na habilidade e presteza da assistência estabelecida ao doente oncológico em cuidados paliativos. É imprescindível que a enfermagem estabeleça meios facilitadores na comunicação que se institui no processo de cuidar do paciente com câncer terminal, buscando para esse cuidado agregar os familiares presentes no processo de finitude do seu ente. Apesar do grande esforço que os enfermeiros realizam na assistência aos pacientes em cuidados paliativos mediante a rotina diária e complexa, denota-se que a própria dinâmica de atendimento não possibilita momentos de reflexão para que sua equipe se atente numa orientação melhorada e humanizada aos pacientes em finitude. É imprescindível que a enfermagem estabeleça meios facilitadores na comunicação que se institui no processo de cuidar do paciente com câncer terminal, buscando para esse cuidado agregar os familiares presentes no processo de finitude do seu ente.

The WHO in 2002 brings a redefinition in the concept of Palliative Care, evidencing in this care a quality of life to the terminally ill patient, objectifying their pain and their improvement as a prime factor in this direct care. This is a qualitative research, descriptive of bibliographic review, carried out in the electronic databases VHL (Virtual Health Library). Having as objectives: to highlight the importance of communication in the relationship between family nursing team and patients in finitude; emphasize the relevance of relatives in the ability and promptness of the care established to the cancer patient in palliative care. Despite the great effort that nurses make in assisting patients in palliative care through the daily and complex routine, it is pointed out that the dynamics of care does not allow moments of reflection so that their team is aware of an improved and humanized orientation for patients in finitude. It is imperative that nursing establish facilitating means in the communication that is established in the process of caring for the patient with terminal cancer, seeking for this care to add the relatives present in the process of finitude of their entity

Selfie Aging Index: An Index for the Self-assessment of Healthy and Active Aging.

INTRODUCTION: Governments across Europe want to promote healthy and active aging, as a matter of both public health and economic sustainability. Designing policies focused on the most vulnerable groups requires information at the individual level. However, a measure of healthy and active aging at the individual level does not yet exist. OBJECTIVES: This paper develops the Selfie Aging Index (SAI), an individual-level index of healthy and active aging. The SAI is developed thinking about a tool that would allow each person to take a selfie of her aging status. Therefore, it is based entirely on self-assessed indicators. This paper also illustrates how the SAI may look like in practice. METHODS: The SAI is based on the Biopsychosocial Assessment Model (MAB), a tool for the multidimensional assessment of older adults along three domains: biological, psychological, and social. Indicators are selected and their weights determined based on an ordered probit model that relates the MAB indicators to self-assessed health, which proxies healthy and active aging. The ordered probit model predicts the SAI based on the estimated parameters. Finally, predictions are rescaled to the 0-1 interval. Data for the SAI development come from the Study of the Aging Profiles of the Portuguese Population and the Survey of Health, Aging, and Retirement in Europe. RESULTS: The selected indicators are BMI, having difficulties moving around indoors and performing the activities of daily living, feeling depressed, feeling nervous, lacking energy, time awareness score, marital status, having someone to confide in, education, type of job, exercise, and smoking status. The model also determines their weights. CONCLUSION: Results shed light on various factors that contribute significantly to healthy and active aging. Two examples are mental health and exercise, which deserve more attention from individuals themselves, health-care professionals, and public health policy. The SAI has the potential to put the individual at the center of the healthy and active aging discussion, contribute to patient empowerment, and promote patient-centered care. It can become a useful instrument to monitor healthy and active aging for different actors, including individuals themselves, health-care professionals, and policy makers.

Planning waste cooking oil collection systems.

This research has been motivated by a real-life problem of a waste cooking oil collection system characterized by the existence of multiple depots with an outsourced vehicle fleet, where the collection routes have to be plan. The routing problem addressed allows open routes between depots, i.e., all routes start at one depot but can end at the same or at a different one, depending on what minimizes the objective function considered. Such problem is referred as a Multi-Depot Vehicle Routing Problem with Mixed Closed and Open Inter-Depot Routes and is, in this paper, modeled through a mixed integer linear programming (MILP) formulation where capacity and duration constraints are taken into account. The model developed is applied to the real case study providing, as final results, the vehicle routes planning where a decrease of 13% on mileage and 11% on fleet hiring cost are achieved, when comparing with the current company solution.

Modelling a recovery network for WEEE: a case study in Portugal.

The European Union directive for electric and electronic waste, published in 2003, enforced all European countries to meet some targets concerning the recycling and recovery of these products. This directive was transposed to the Portuguese legislation in 2004. Following this, a group of EEE producers set up an organization (Amb3e) whose mission was to design and manage a nationwide recovery network for WEEE, which will be the subject matter of this work. A generic MILP model is proposed to represent this network, which is applied to its design and planning, where the best locations for collection and sorting centres are chosen simultaneously with the definition of a tactical network planning. Several analyses are performed to provide further insights regarding the selection of these alternative locations. The results gave support to the company strategic expansion plans for a high number of centres to be opened and to their location near the major WEEE sources.

Effects of synbiotic-based Bifidobacterium animalis in female rats experimentally infected with Toxoplasma gondii.

The aim of this study was to assess the effects of a synbiotic composed of Bifidobacterium animalis and fructooligosaccharides on female rats infected with Toxoplasma gondii. Female Wistar rats, treated or not with dexamethasone, were daily supplemented with synbiotics for 21 days. After 15 days of supplementation, the rats were orally infected with 10(4)T. gondii bradyzoites. Blood samples were collected to measure the levels of IFN-γ, IL-10 and T. gondii antibodies. All synbiotic-supplemented rats survived until the end of the experiment; however, non-supplemented dexamethasone-treated rats died between the fifth and the eighth days after T. gondii infection. Dexamethasone-treated rats supplemented with synbiotics (P<0.05) were capable of synthesizing IFN-γ, and this immunological response was essential to ensure their survival. In addition, brain cysts were found in one rat not supplemented with synbiotics. Results suggest that the synbiotic composed of B. animalis and fructooligosaccharides may be beneficial to toxoplasmosis control.

Potencial bioterapêutico dos probióticos nas parasitoses intestinais: [revisão] / Probiotics as potential biotherapeutic agents targeting intestinal parasites

Probióticos são microrganismos vivos que, se administrados em quantidades adequadas, promovem benefícios à saúde do homem e dos animais. O crescente interesse nos probióticos fundamenta-se em estudos clínicos nos quais a administração desses organismos foi avaliada na prevenção e no tratamento de desordens intestinais e sistêmicas. Os potenciais mecanismos de ação desses microrganismos incluem a exclusão competitiva, a produção de metabólitos com atividade antimicrobiana e a modulação da resposta imune. Em algumas circunstâncias clínicas específicas, os benefícios produzidos por esses microrganismos foram amplamente documentados, enquanto que em outras os resultados são contraditórios. No presente artigo de revisão, os probióticos foram abordados considerando-se o potencial bioterapêutico desses microrganismos nas parasitoses intestinais.

Probiotics are live microorganisms which, when administered in adequate amounts, beneficially affect the general health status of man and animal. The great interest in probiotic microganisms is based on evidences from clinical studies indicating benefits in the prevention or treatment of a broad spectrum of gastrointestinal and systemic disorders. The potential mechanisms by which probiotics beneficially affect health include strengthening of the intestinal barrier, modulation of the immune response, and antagonism of pathogens either by the production of antimicrobial compounds or through competition for mucosal binding sites. In some specific clinical circumstances, there is clear evidence of benefit whereas in others, the results are dubious and important questions remaining unanswered. The aim of this review article is to focus probiotics on their potential as biotherapeutic agents against intestinal parasites.

Avaliaçäo do teor de lipídios em queijos Minas Frescal industrializados e artesanais e em ricotas comercializados na regiäo de Botucatu/SP / Lipid level evalution in industrialized and handmade Minas Frescal cheese and rocottas from the region of Botucatu/SP

Este trabalho teve por objetivo avaliar o teor de lipídios em 23 marcas de queijos Minas Frescal industrializados, 9 de queijos artesanais e 10 de ricotas comercializadas na regiäo de Botucatu/SP. Para avaliaçäo de lipídios foi utilizado o método de Gerber. As informaçöes contidas nas embalagens de cada produto foram comparadas com os resultados obtidos. Todas as marcas de queijo Minas Frescal apresentaram teor de lipídios acima do declarado nas embalagens (16-18 por cento). Entre os queijos artesanais, de um total de 9 marcas, 4 apresentavam uma média de teor de lipídios de 16 por cento, semelhantes ao indicado nas embalagens dos queijos Minas Frescal industrializados. Já as ricotas, todas as marcas analisadas apresentavam teor de lipídios (por cento) ora do padräo estabelecido. Frente aos resultados obtidos, torna-se necessário um maior controle sobre a produçäo industrial brasileira destes tipos de queijos. (AU)

This present work aims to evaluate the level of lipids out of the total of mass, within 12 different Minas Frescal industrialized brands and 10 varieties of Ricotta from the region of Botucatu/ SP. Information included on the packages of each product were compared with the results in order to know whether the consumer is being well informed or not. The Gerber method was used to evaluate the lipids. Results were submmited to statistical analysis using the "F Test of Variance Analysis" and Tukey test. Industrialized varieties of Minas Frescal cheese showed, in 7 out of the 12 brands, a lipid level (%) fitting the established average standard, however, none of them matched the information described in their respective packages (16%-18%). Among the handwork cheeses, 5 out of 9, matched the established standard for Minas Frescal cheeses. The ricottas, all the 10 brands analyzed here did not match the established average standard of lipids grade (%). Face to the obtained results, it's up to the population to demand a more effective control of the imdustrialized Brazilian production.(AU)

Retinoblastoma: incidência no IPB nos últimos 10 anos / Retinoblastoma: incidence in ten years in the IPB

Os autores revisam 56 casos de retinoblastoma atendidos no Instituto Penido Burnier no período de 1979-1991. Comparam dados atuais com levantamentos precedentes no próprio serviço e aqueles apresentados pela literatura

Analgesia pós-operatória em oftalmologia: bupivacaína subconjuntival / Analgesia postoperative in ophtalmology: subconjuntival bupivacaine

O alívio da dor pós-operatória é uma exigência cada vez mais frequente. As cirurgias oftálmicas que manipulam os músculos extra-oftálmicos que manipulam os músculos extra-oculares provocam intensa dor. Os resultados da irrigaçäo ou da injeçäo subconjuntival de bupivacaina. 0,75 por cento ao término de cirurgias de descolamento de retina, estrabismos e enucleaçäo de globo permitiram analgesias significativas em 102 pacientes

Pulsoterapia endovenosa com corticosteróides no tratamento da neurite óptica / Intravenous pulsetherapy with corticosteroids in treatment of optic neuritis

Foram estudados 6 casos de neurite óptica submetidos a pulsoterapia com corticosteróides. Os pacientes apresentavam, invariavelmente, como queixa principal, diminuiçäo da acuidade visual. Com o tratamento instituído observou-se rápida recuperaçäo da visäo e näo foram observados efeitos colaterais graves que exigissem terapêutica específica. Desta forma, vê-se a pulsoterapia endovenosa com corticosteróides como alternativa eficaz e benéfica no tratamento da neurite óptica

Padrao de prescricao em hospital-escola pediatrico de Porto Alegre / Prescription pattern in children's university hospital of Porto Alegre

A partir de trabalhos sobre prescricoes hospitalares para adultos, realizou-se uma analise dos medicamentos prescritos para pacientes pediatricos hospitalizados. Foram avaliadas as prescricoes em um hospital-escola, em tres dias diferentes, com intervalos de um mes, durante o ano de 1988. As criancas recebiam em media 4,5 prescricoes por dia. As drogas de acao no trato respiratorio e as de uso topico apareceram entre as mais prescritas para criancas, juntamente com os analgesicos-antipireticos-antiinflamatorios, os antiinfecciosos e as drogas de acao no trato gastrointestinal. Estes tres ultimos tiveram perfil semelhante ao dos adultos. O uso de aminoglicosideos apresentou-se sem acompanhamanto adequado da funcao renal, bem como o uso geral de antiinfecciosos foi precedido poucas vezes de antibiograma, Por outro lado, o perfil do uso de psicofarmacos foi significativamente diferente ao dos adultos