[Construction and implementation of nursing actions in the gastroenterology outclinic]. / Construção e implementação de ações de enfermagem em ambulatório de gastroenterologia.

UNLABELLED: The reorganization of the Schistosomiasis Sector of Gastroenterology at UNIFESP started in 1998, when the Nursing Service was implanted. OBJECTIVE: to develop administrative nursing actions, systematization of care and orientation program for the schistosomic patient. METHOD: a descriptive study carried out at the Gastroenterology Outclinic, which attends schistosomic patients of different clinical types. RESULTS AND DISCUSSION: the reorganization of activities in this Sector resulted in the creation of an organizational structure and the implantation of the nursing visit; creation and distribution of explanatory leaflets and development of the Schistosomiasis Education Program; beginning of the database pilot project with all outpatients and an electronic register of the collection of biologic material. CONCLUSION: this initiative opens up a new opportunity for nursing actions and contributes to quality improvement in ambulatory care.

[Serum gamma-glutamyltransferase alteration in hepatic schistosomiasis doesn't correlate with parasitic load and precedes ultrasound alterations]. / Elevação da gamma-glutamiltransferase sérica na hepatopatia esquistossomótica não se correlaciona com a carga parasitária e precede alterações ultra-sonográficas.

BACKGROUND: Liver disorders are the major manifestations of schistosomiasis mansoni. Factors that account for increased concentrations of cholestasis-indicating enzymes in the hepatosplenic form of the disease are unknown. OBJECTIVE: To assess the correlation between increased gamma-glutamyltransferase serum levels and both the parasitic load and ultrasound alterations in patients with schistosomiasis. PATIENTS AND METHODS: Twenty-five patients with the chronic form of schistosomiasis were assessed for the presence or absence of increased enzymatic levels, for the parasitic load (low x medium/high) and for ultrasound parameters. Furthermore, analysis of prothrombin time and a platelet count were performed. RESULTS: Of the 25 patients, 13 showed increased gamma-glutamyltransferase plasma levels. No significant correlation was found between increased gamma-glutamyltransferase levels and the parasitic load, or between increased enzyme levels and ultrasound alterations. Nor did the prothrombin index or the platelet count differ between the two groups (normal gamma-glutamyltransferase levels and increased gamma-glutamyltransferase levels). CONCLUSION: The parasitic load explains no rise in gamma-glutamyltransferase plasma levels in patients with the chronic form of schistosomiasis, and conventional ultrasound is not a sensitive method to detect the alteration suggested by the increased enzyme level in those patients.