Nível de conhecimento dos profissionais da estratégia de Saúde da Família sobre a relação bidirecional doença periodonta-diabetes mellitus / Level of knowledge of family health strategy's professionals regarding the periodontal disease-diabetes mellitus bidirectional relationship

A relação entre as condições de saúde sistêmica e doença periodontal é bidirecional, na qual a manutenção de uma auxilia no controle da outra. O diabetes é uma dessas condições, que pode aumentar a gravidade e extensão da doença periodontal, e em contramão, a infecção periodontal pode agravar o controle glicêmico. Objetiva-se avaliar o nível de conhecimento dos profissionais atuantes na Equipe de Saúde da Família (ESF), em Arcoverde/PE, em relação à doença periodontal e o Diabetes Mellitus. O estudo é de caráter quantitativo, exploratório e transversal, no qual foi aplicado um questionário adaptado da literatura com 18 perguntas prevalentemente objetivas a 38 profissionais de saúde (médicos, enfermeiros e cirurgiões dentistas) atuantes em 13 Unidades Básicas de Saúde. Constatou-se que a maioria dos profissionais participantes apresentam bom nível de conhecimento acerca dos principais exames laboratoriais empregados para o diagnóstico do diabetes. Entretanto, no que se refere à influência que o tratamento periodontal básico oferece sobre o controle glicêmico dos pacientes diabéticos descompensados, 50% dos médicos, 62% dos enfermeiros e 31% dos dentistas não conheciam tal mecanismo. Pode-se afirmar que o conhecimento sobre a relação Diabetes mellitus e doença periodontal ainda é escasso entre expressiva parte dos profissionais... (AU)

The relationship between the conditions of systemic health and periodontal disease is two-way, in which the maintenance of one helps in the control of the other. Diabetes is one such condition, which can increase the severity and extension of periodontal disease, and on the other hand, periodontal infection may aggravate glycemic control. The aim is to evaluate the knowledge of the professionals working in the "Family Health Strategy's", in Arcoverde/PE, in relation to periodontal disease and Diabetes Mellitus. Quantitative, exploratory and cross-sectional study, in which a questionnaire adapted from the literature was applied with 18 predominantly objective questions to 38 health professionals (doctors, nurses and dentists) working in 13 Basic Health Units. it was verified that the majority of the participants present a good level of knowledge about the main laboratory tests used for the diagnosis of diabetes. However, regarding the influence that basic periodontal treatment has on glycemic control of patients decompensated diabetics, 50% of doctors, 62% of nurses and 31% of dentists did not know such mechanism. It can be affirmed that the knowledge about the relation diabetes and periodontal disease is still scarce among expressive part of the professional... (AU)

Implementation of a perioperative management protocol for patients undergoing orthopedic surgery.

OBJECTIVE: To evaluate the initial results after the implementation of perioperative protocol in patients over 60 years of age undergoing surgical treatment for femur fractures. METHODS: We conducted a prospective study of patients older than 60 years who were hospitalized with femur fracture. They were operated under spinal anesthesia and analgesia by lumbar plexus blockade. Data evaluation was performed before arrival in the operating room during surgery, in the post-anesthesia recovery room and in the ward the next morning of the operation. RESULTS: 105 patients underwent various types of surgical corrections of the femur. The hospital stay ranged from three to 86 days. Fasting ranged from 9h15min to 19h30mn. Hypotension occurred in 5.7%. The duration of motor blockade ranged from 1h45min to 5h30imn. Maltodextrin feeding ranged from 50min to 3h45min and the time spent in the post-anesthetic care unit ranged from 50 minutes to 4 hours. Onset of oral intake in the ward ranged from 4hto 8h15min. The duration of anesthesia ranged from 14 to 33 hours. No patient required a urinary catheter, nor was transferred to the ICU. All patients were able to be discharged on the first postoperative day. CONCLUSION: The use of a protocol to accelerate the postoperative period may reduce the fasting time, length of hospital stay and provide faster i discharge n elderly patients with femur fractures.

Implementation of a perioperative management protocol for patients undergoing orthopedic surgery / Avaliação dos resultados da implantação de um protocolo de cuidados perioperatórios em pacientes submetidos à cirurgia ortopédica

OBJECTIVE: To evaluate the initial results after the implementation of perioperative protocol in patients over 60 years of age undergoing surgical treatment for femur fractures. METHODS: We conducted a prospective study of patients older than 60 years who were hospitalized with femur fracture. They were operated under spinal anesthesia and analgesia by lumbar plexus blockade. Data evaluation was performed before arrival in the operating room during surgery, in the post-anesthesia recovery room and in the ward the next morning of the operation. RESULTS: 105 patients underwent various types of surgical corrections of the femur. The hospital stay ranged from three to 86 days. Fasting ranged from 9h15min to 19h30mn. Hypotension occurred in 5.7%. The duration of motor blockade ranged from 1h45min to 5h30imn. Maltodextrin feeding ranged from 50min to 3h45min and the time spent in the post-anesthetic care unit ranged from 50 minutes to 4 hours. Onset of oral intake in the ward ranged from 4hto 8h15min. The duration of anesthesia ranged from 14 to 33 hours. No patient required a urinary catheter, nor was transferred to the ICU. All patients were able to be discharged on the first postoperative day. CONCLUSION: The use of a protocol to accelerate the postoperative period may reduce the fasting time, length of hospital stay and provide faster i discharge n elderly patients with femur fractures. .

OBJETIVO: avaliar os resultados clínicos iniciais após a implantação de protocolo perioperatório em pacientes com mais de 60 anos de idade submetidos ao tratamento cirúrgico de fratura do fêmur. MÉTODOS: estudo prospectivo com pacientes com idade superior a 60 anos que foram internados com fratura de fêmur. Operados sob raquianestesia e analgesia através do bloqueio plexo lombar. A avaliação dos dados foi realizada antes da chegada ao centro cirúrgico, durante o procedimento cirúrgico, na sala de recuperação pós-anestésica e, na enfermaria, na manhã seguinte da operação. RESULTADOS: os 105 pacientes foram submetidos a diversos tipos de correção cirúrgica no fêmur. A internação variou de três a 86 dias. O jejum variou de 9h15min a 19h30min. Hipotensão arterial ocorreu em 5,7%. A duração do bloqueio motor variou de 1h45min a 5h30min, a alimentação com maltodextrina variou de 50min a 3h45min e o tempo de permanência na sala de recuperação pós-anestésica variou de 50min a 4 horas. A alimentação oral na enfermaria variou de 4h a 8h15min. A duração da analgesia variou de 14 a 33 horas. Nenhum paciente necessitou de sonda vesical de demora, nem foi encaminhado à UTI. Todos os pacientes tinham condições de alta hospitalar no primeiro dia de pós-operatório. . CONCLUSÃO: a utilização de um projeto de aceleração do pós-operatório pode diminuir o tempo de jejum, a duração da internação e proporcionar alta hospitalar mais rápida em pacientes idosos com fratura de fêmur. .

Clinical strategies to accelerate recovery after surgery orthopedic femur in elderly patients.

BACKGROUND: The prevalence of hip fracture is increasing with the continued aging of the population. The aim of this study was to compare the results after implementing the project accelerated post-operative recovery after surgery femur in patients aged over 60 years. METHODS: Patients were observed during two distinct periods: Before implantation and after the implementation of the project Acerto. Patients underwent spinal anesthesia with post-operative analgesia by lumbar plexus block. Data evaluation was carried out in four stages of the study in both groups: Before arrival to the operating room during surgery, post-anesthesia care unit and on the ward in the morning of day 1 post-operatively. RESULTS: The project implementation significantly reduces the length of stay, the number of suspension of surgery, duration of fasting, the incidence of hunger and thirst and the reintroduction of oral feeding. Oral feeding 2-4 h before surgery with dextrinomaltose not attended with nausea and vomiting. All patients were able to discharge on day 1 post-operatively. CONCLUSIONS: The use of clinical measures of accelerating patient recovery decreased length of stay, the number of suspensions of surgery, the time of fasting, the time of oral food reintroduction, high earlier and faster return to family life, working as humanization of treatment to the elderly.